outbreak! (ebola, sars, coronavirus, etc)

The people who haven't got the vaccine will not get one now, pretty much. It's all about how our health and social care systems are able to cope with that.

Not sure about that, I know a couple of people who aren’t vaccinated and have had it bad, anyone bad enough to go into hospital and survive it is hopefully going to want to avoid that experience, you’d imagine. And even a mild unvaccinated size can be very unpleasant. There’s always going to be a hard core of people you can never reach but it’s about reaching those that are hesitant for various reasons and I think there will be a longer tail on vaccine take up.

if you're vaxxed, covid is not necessarily the end of the world, and that people like Wachter may be a little hyperbolic.

His thread is exactly about how it's not the end of the world and you don't need to beg borrow or steal monoclonal antibodies for a thirtysomething with a mild case, it will be fine! Like the entire thread is statistics about how unlikely death or even serious illness is for someone in his son's situation. Is he worried about Long Covid? "A little," he says, "the literature is a mess.. It seems like vax lowers the risk. So it’s a concern, but there’s not much we can do but wait & see." Does he think his son made a big mistake by going to the movies? He says no, it seemed like a "fairly safe encounter," and his advice in the face of the more contagious omicron is to hunker down "a bit." He calls it "an experience best avoided if you can."

And people are dragging him like he held a funeral for his son and think we need to lock down! When he is very clearly saying "Vaccines are great and reduce this to something you should worry about but not to excess, take reasonable short-term measures during the weeks of this surge but this is not the apocalypse."

He could have just said that instead of a 25 post draaaaaama.

I’ve seen governments and non-profits reporting success penetrating unvaxxed populations that aren’t white Christian Identarians. Those people are hopeless and never getting vaxxed but the Hispanic guy down the block will if someone he trusts talks to him directly about it.

See, this is the kind of hyperbolic stuff I was talking about:

https://apnews.com/article/coronavirus-pandemic-science-health-pandemics-rochelle-walensky-0f9d46ab55b0f2f6951ffddd6ca8a511

Headline: "Hospitalizations skyrocket in kids too young for COVID shots."

But then you read the article, and the stats as cited just do not bear out the headline. It's more like "covid cases rise in kids who are hospitalized," and even then the numbers are low and the certification criteria pretty generous. I mean, thank goodness, but headlines like this one are just not helpful.

To their credit NBC last night ran a story questioning exactly that.

Basically my spots I’m going to over the next theee weeks: physical therapy twice a week (and a visit to my orthopedist), laundry, shopping and takeout once a week, and the corner store as needed. Otherwise, hunker down time.

Great wisdom.

A lot of triple vaxxed people here got it mild. Covid will be like cold next year.

isn't this assuming that every new strain will be mild?

This strain has been more mild than Delta.

There is the theory that viruses by design *want* to be milder, because it's harder to spread when you seriously sicken or kill off your host. Which is why some were/are in a sense rooting for Omicron to stay dominant and prevent potentially stronger strains from gaining a hold.

This strain has been more mild than Delta.

I am aware yes, but not sure this guarantees every next one will progressively be milder than that. Hadn't heard of this theory, how much consensus is there around that?

There is the theory that viruses by design *want* to be milder, because it's harder to spread when you seriously sicken or kill off your host.

short incubation period and high transmissibility unfortunately means the virus has plenty of time to spread to a new host before you finally cark it.

For sure. Anyway, here's a couple of articles I saw that addresses this from a couple of perspectives:

https://news.northeastern.edu/2021/12/13/virus-evolution/

https://www.npr.org/2022/01/09/1071663583/viruses-evolve-and-weaken-over-time-what-does-that-mean-for-the-coronavirus

When syphilis emerged in Europe, it ran through its course in a year or two. Now it takes 20-30 years for the third stage to arrive.

On the other hand, those Europeans were really ruttin'.

LAVINE: Omicron is really way, way better at transmitting in this current human population than, for example, delta was in the population that it was transmitting in - not knocking delta here, but I'm just saying omicron is fantastic at transmitting in this population.

https://decider.com/wp-content/uploads/2019/05/alien-ash-robot.jpg?quality=90&strip=all&w=646&h=431&crop=1

A lot of triple vaxxed people here got it mild. Covid will be like cold next year.

This may be reassuring for the vaxxed, but it ignores the enormous unvaxxed population. A big surge in cases among them can overwhelm the health system to the breaking point. Colds do not threaten the health system with collapse.

it also ignores the fact that we seem to have gotten incredibly lucky with omicron, and there's no reason to think that will continue to be the case with future variants (and lots of reason to think it won't be, since it hasn't been true of most variants).

on the other hand, i think we may be reaching the point where the anti-vaxxers + the "vaccinated and done" (i.e. i got vaccinated, and i'll get boosted again if you tell me to, but i'm done with not going out) are well over 50% of the population in both the US and UK, so in that sense i do think the pandemic is "over" for a lot of people intellectually.

Well, yeah, for a lot of bosses the pandemic has been "over" for at least six months, if not a year, in some places.

there are different grades of 'over'. i'm still masking up in public confined spaces and sanitising my hands regularly, for example

you should wash your hands but that has nothing to do with covid (which is airborne).

but I'm sure we all fondly remember the "everyone stop touching your face!" era.

Yes, it was a relief to move past that once it was confirmed that hand-to-face transmission was wildly unlikely.

Seattle has mask and vax mandates to enter any business with seating, and mask dispensers by the door on trains, buses and trams. “I’m still masking in crowded spaces” reads as “my locality is treating it as over” imo

Yep, that’s certainly a fair read as far as my locale goes. I’m masking in public AND most of my community is acting like it’s over. Even though we literally just set a one-day case record and hospitalizations are going up. Oh and also our local health department decided that NOW is the time to switch from daily case reporting to weekly.

Is it possible omicron spreads via other methods than just aerosols?

lads we got there

A popular far-right and anti-vaccine leader has a new remedy for followers who fall sick with Covid-19: drink their own urine.https://t.co/v6PhSnScQs

— Zachary Petrizzo (@ZTPetrizzo) January 10, 2022

An addendum

My son's now 5d since symptoms. He's better (now mild sore throat, no fever). Binax is below. I study this for a living & am confused by CDC recs. Work (with mask) would've been OK if we didn't test, but since we did, he should stay home 5 more days? Huh? https://t.co/2SiMecGunt pic.twitter.com/ojtuhRZKCe

— Bob Wachter (@Bob_Wachter) January 10, 2022

xp https://www.youtube.com/watch?v=1tYvGfF1Gkg

I study this for a living & am confused by CDC recs.

Welcome to the resistance, Dr. Wachter.

xp Vaccine is stored in the balls

would love for one of the incentives to be nationalization

Private insurers will be required to cover up to 8 tests per person per month + admin is incentivizing insurers to work with pharmacies/retailers to eliminate upfront cost/avoid reimbursements https://t.co/ZsjW5edSzv

— Zeke Miller (@ZekeJMiller) January 10, 2022

An interesting chart for critical care cases in the UK in the past six months

The chart showing ICNARC's analysis of COVID admissions to ICU was quite popular, so here's a slightly clarified version (typo on the date corrected in the footnote & a reworded label for clarity).
Also, a few responses to questions that came up a lot.
(1/6) pic.twitter.com/UdITP9Or3I

— Paul Mainwood (@PaulMainwood) January 9, 2022

People wondered why the unvaccinated rates for 70+ were lower than for 60-69.
Amongst other reasons: there are medical criteria for admitting someone to ICU; a traumatic process of being sedated and intubated. Sadly, fewer patients tend to hit those criteria at 70+.
(4/6)

— Paul Mainwood (@PaulMainwood) January 9, 2022

Sorry, hit post bc this is evidence of vaccines working in plain numbers and I’m sick of people pretending we’re at square one again

vaccines work but 20% of people aren't vaccinated and omicron is ~5x more contagious so we kind of are (for now) tbh.

40% have had no vaccine. As of yesterday, half the vaccines administered daily are third doses.

A lot of triple vaxxed people here got it mild. Covid will be like cold next year.

This may be reassuring for the vaxxed, but it ignores the enormous unvaxxed population. A big surge in cases among them can overwhelm the health system to the breaking point. Colds do not threaten the health system with collapse.

― more difficult than I look (Aimless), Monday, 10 January 2022 bookmarkflaglink

Yes I have said this in other posts (though the unvaxxed population here is not enormous). The health service here needs to be invested in more, as does social care. That's the only reason there is pressure this year, nothing else.

I mean yes, we do have a long way to go and the unvaxxed population is way too high, but I think it does a disservice to say things like "back to square one", because it's simply not true. We do have vaccines to slow down the rate of hospitalizations, we have advances in treatment to hopefully reduce deaths, etc. Which isn't to bury my head in the sand and say it's over or anything, but I think it's important to have perspective on the key ways we very much aren't in a March 2020 position.

That urine therapy guy — we had a City Council candidate here last year who was a big anti-vaxxer and had posted some things about the benefits of urine therapy. It became a minor issue in the campaign — she was widely known as "the pee drinker" — but she was part of a Republican slate who all ran together and she did about as well as the rest of them. Which wasn't well — city elections are the only ones Democrats can win around here, and the Republicans all lost by 10-12 points. But the pee drinker was just as acceptable to local Republican voters as, like, a fairly well-known guy who owns a bunch of popular restaurants.

i think a big part of the disconnect on this thread is ultimately due to this:

With a variant that spreads so far and so fast, the Omicron wave more than any other will be exceptionally good at seeking out the last few unprotected people, so even a small difference in the immunonaive share of the population could make a big difference to ICU pressure pic.twitter.com/693OU68C96

— John Burn-Murdoch (@jburnmurdoch) January 4, 2022

slow down the rate of hospitalizations

rate of hospitalisation vs case numbers FITE

(xpost and also add yr own italics)

That’s how effective wearing a mask is https://t.co/2z9z6tj5oR

— Dondrè (@Boss_Emotions) January 9, 2022

lol

I know referencing Camus is very April 2020, but this feels familiar (to my surroundings at least):

"It was now that Rieux and his friends came to realize how exhausted they were. Indeed, the workers in the sanitary squads had given up trying to cope with their fatigue. Rieux noticed the change coming over his associates, and himself as well, and it took the form of a strange indifference to everything. Men, for instance, who hitherto had shown a keen interest in every scrap of news concerning the plague now displayed none at all.

Rambert, who had been temporarily put in charge of a quarantine station — his hotel had been taken over for this purpose — could state at any moment the exact number of persons under his observation, and every detail of the procedure he had laid down for the prompt evacuation of those who suddenly developed symptoms of the disease was firmly fixed in his mind. The same was true of the statistics of the effects of anti-plague inoculations on the persons in his quarantine station. Nevertheless, he could not have told you the week's total of plague deaths, and he could not even have said if the figure was rising or falling."

Private insurers will be required to cover the cost of up to eight at-home coronavirus rapid tests per person per month, the Biden administration said Monday, as the country continued to battle record levels of newly reported cases fueled by the omicron variant.

The plan, announced by the Department of Health and Human Services, will take effect Saturday and applies to all at-home tests approved by the Food and Drug Administration. Consumers may purchase the tests online or in person at a pharmacy or store, and the cost will be covered upfront or be eligible for reimbursement after the fact, HHS said in an announcement.

appreciated this thread, tho it made me sad

I keep getting asked if SARS-CoV-2 is endemic yet.

Record-busting case counts are not endemicity. https://t.co/bk1LUJICZ3

— Dr. Angela Rasmussen (@angie_rasmussen) January 11, 2022

Yeah, that's a good thread, but a sobering reminder that we may not have even reached the halfway point towards endemicity.

I had to argue a little about endemicity with our local health department last week, when I was challenging their decision to move to weekly data reporting in the midst of our current surge. One of the admins gave me the "Well, COVID's just going to be here from now on ..." line, and I practically yelled, "Yes, but not registering 1000 cases a day like it is right now!"

Massive amount of wishful thinking going on.