outbreak! (ebola, sars, coronavirus, etc)

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.

I'm starting to wonder if there isn't a decent chunk of the wishful thinking just being a part of coping strategies for otherwise well-intentioned folks at this point. I mean, practically every level of American government messaging at this point is, "shut up and get back to work", so I can see how people might want to just throw up their hands, realizing that no further form of government support is coming.

(Which isn't to say said people aren't still masking and isolating when necessary, or otherwise taking appropriate precautions, but when everything else is beyond their control and the government has absolutely fucked off without any further support, a certain element of "well, this is how things are now" kicks in.)

Not Panglossian, but:

New York’s Covid-19 infections may have reached a peak, about a month after the city’s first case of the omicron variant was identified.

The seven-day average of people visiting New York emergency departments with Covid-like illness has dipped significantly in all five boroughs since the end of December, according to data from the New York City Department of Health and Mental Hygiene. The Bronx saw the biggest drop, with the 7-day average retreating 35% in the week through Friday.

Citywide, the rate of positive tests also appears to be declining, with the 7-day average down to 31% on Thursday, from a peak of 34% on Jan. 2.

New York officials warned the recent data are subject to revisions and are affected to a degree by the holiday effect, which can artificially depress trend lines due to delays or underreporting. Gatherings during the New Year’s Eve holiday could also prolong the Covid spike.

https://www.bloomberg.com/news/articles/2022-01-10/new-york-sees-signs-of-omicron-peak-as-icus-remain-pressured

I will note it has once again become easy to schedule a rapid or PCR test in Miami. The lessening of travel has surely helped.

everyone i know in new york is basically waiting to hear that we've hit the spike and are starting to come down. If that shit doesn't happen by February, panic is gonna set in.

The friend who send this link said Bellevue was seeing a drop.

our daycare has 6 classes each with about 8 kids. they're making every kid take a PCR test today for the first time. any class with >0 positive results on monday will close next week. any class with a kid who has a sibling in a class with >0 positive results will also close.

over/under on how many classes there are next week? i'd be surprised if 3/6 are still open.

― 𝔠𝔞𝔢𝔨 (caek), Friday, January 7, 2022 3:31 PM (four days ago) bookmarkflaglink

6/6 are still open, but not because everyone tested negative but. it's because 40% tested negative and the other 60% are still waiting for test results 2-5 days after being tested.

So here's the word from my workplace re current patient counts with COVID:

Unvaccinated: 11
Primary vaccine series (2 doses): 23
Boosted: 4

Of these total, only 6 are ICU, thankfully. But it absolutely underscores that 1) you need the booster and 2) even that might not be enough. And again, this is not the city as a whole, just one spot. As I know no further details beyond this count, I wouldn't speculate further but again, I'm essentially hunkered down as noted beyond necessary trips, and shows/movies/etc are simply not happening for the moment for me, even if they are for others.

Youch, six in the ICU?

xpost Yeah, was gonna say, getting a PCR test here is relatively easy. Getting the results back, on the other hand ...

I got a PCR test at some shipping container pop-up last Tuesday and still don't have results, and if I ever finally got them what good are they now? Even less shady spots are taking several days.

I have Covid, tested positive on Friday from a home test. All mild symptoms, nothing to worry about. But having read about home tests not being reported and causing the overall figures not to be accurate etc, I dutifully left a message with my doctor's office saying I had it. But got nothing back at all from them to acknowledge it or ask how I was doing. Wish I hadn't bothered now.

Sucks they didn't call you back, but I'm guessing in most doctor's offices right now they're not expending a lot of energy on people who tell them they're doing OK. But I hope you keep doing OK!

Meanwhile, speaking of wishful — or just weird — thinking:

When you read Speed the Spread of Omicron, you know we've got a problem 🤯https://t.co/bWziC47qH5 pic.twitter.com/j8GYxoSwUn

— Eric Topol (@EricTopol) January 11, 2022

xpost - Worth a try I guess, at least you attempted to get counted. I wouldn't be surprised if we are closer to 2.5 to 3 million cases, just going by anecdotal stories of people with positive rapid tests or even people who are isolating and sure they have it but can't find rapid tests.

I'm not a virologist, but I don't think the logic of "oh just let everybody get it" holds up to any kind of scrutiny. First, when you say that you're acknowledging up front that a bunch of people will die as a result — mostly unvaccinated and/or with pre-existing conditions but still a lot of actual people who are alive now being dead soon. But also, we don't really know how long acquired immunity from infection lasts, Omicron has infected tons of previously infected people, so it's not like even a 100 percent Omicron-exposed population is going to stop circulating the virus, enabling new variants, etc. People act like "prior infection" is some kind of magic potion, but it isn't any more than the vaccines are. (OK, statistically, maybe somewhat more than the vaccines. But not a lot.)

I get the impulse to "get it over with," but I'm not sure how that is actually supposed to work.

I called our daughter's doctor just to let them know she tested positive and to update her files, and they actually called me back a few hours later just to check up, which surprised me.

Noticing something new the last couple of days in the way the Canadian news is reporting hospital admissions: those who were admitted for COVID, and those who were admitted for something else and tested positive. That was running about 55/45 in the direction of COVID today. Is this an important distinction?

It's a super important distinction and I wish that data were more readily available.

More from Bob W on SF numbers and elsewhere. Per final post, he’s sticking with awful January leading to better February, but it’s a really awful January.

Covid (@UCSF) Chronicles, Day 665
I haven’t done a SF update for a week – it’s a good time to catch up. Any impact of holiday gatherings should now be baked in, we all know scores of people with Covid, & hospitals are getting overwhelmed. So is SF’s high vax rate helping? (1/20)

— Bob Wachter (@Bob_Wachter) January 11, 2022

http://www.bccdc.ca/health-info/diseases-conditions/covid-19/prevention-risks/covid-19-and-sex

Use barriers, like walls (e.g., glory holes), that allow for sexual contact but prevent close face-to-face contact.

for/with is an important but extremely subtle distinction, and it's often used as FUD by people who suggest people admitted with covid are somehow not relevant to the pandemic.

people who are admitted to hospital (for anything) are more likely to have comorbidities that makes covid more dangerous, and getting covid doesn't improve the prognosis of anything else. so the implication that people admitted with covid are not in danger from covid doesn't stand up to scrutiny.