How severe are Omicron Infections?

https://www.nature.com/articles/d41586-021-03794-8

by News-Dog • 5 years ago

48 97 5 years ago

Hospital data from London:

https://coronavirus.data.gov.uk/details/healthcare?areaType=...

Admissions are rising markedly, compared to flat for the rest of the UK. Omicron is surging in London, again (as yet) flat elsewhere.

turnerc2• 5 years ago

Please note the data above includes people admitted with an incidental COVID infection and went to hospital for another reason.

NicoJuicy3• 5 years ago

This is not Omicron. As far as I'm aware, main infections in the UK are currently from Delta.

Edit: @downvoters. How do you know hospital cases are currently Omicron? As far as i know there is a delay between new cases and hospitalized cases of multiple days. And the difference isn't shown in the article.

A hospitalized case of delta is averaged at ~ 8,5 days of hospitalization. So we have to wait at least another week.

leoedin• 5 years ago

London is primarily Omicron at this point - it was 50% of infections 4 days ago and spreading much quicker.

metafunctor• 5 years ago

The latest data released on Friday by the U.K. Health Security Agency indicates that 54% of positive tests in England taken on Tuesday and Wednesday were of Omicron, and more than 80% of cases in London.

sterlind• 5 years ago

As of 12/17, Omicron seems to be around 50% of new cases in UK, measured by proxy with S-gene target failure:

https://assets.publishing.service.gov.uk/government/uploads/...

turnerc2• 5 years ago

Per [1] As of 18th December, a majority of cases testing with the SGTF (indicator for Omicron) reached over 50% on the 14th December. It's clearer to see in Figure 2.

[1] https://assets.publishing.service.gov.uk/government/uploads/...

drited2• 5 years ago

Things have changed fast. In London, 86.4% of COVID-19 cases with known S-gene status have s-gene target failure[1] which is a marker of Omicron (albeit with pending sequencing confirmation for certainty[2])

[1] https://assets.publishing.service.gov.uk/government/uploads/...

[2] https://www.who.int/news/item/26-11-2021-classification-of-o...

parkingrift4• 5 years ago

I find the data presentation on that site to be quite disappointing. The age brackets 0-5, 6-17, 65-84, 85+, …and 18-64.

contravariant• 5 years ago

For the relative admission rates that's not a problem, but for the absolute numbers... yeah a bar chart isn't a good choice there.

parkingrift4• 5 years ago

Seems the evidence bar for bad news is quite low, but the bar for good news is unbelievably high. Is there a good source for variant circulation? As a layperson how can I find what percentage of cases in a given area are from omicron vs delta?

tehjoker4• 5 years ago

If good news happens, you don't need to do anything. If bad things happen, you need to do something fast. I don't think this is unreasonable.

redisman2• 5 years ago

That’s what the news business would like you to think. How much action are you taking from the 100+ bad news stories bombarding you every day?

hanoz• 5 years ago

If good news happens, you don't need to do anything.

There's plenty you need to stop doing.

scns• 5 years ago

If you want to read good news, you proactively look for them eg here https://www.goodnewsnetwork.org/

JackFr• 5 years ago

If good news happens, you don't need to do anything. If bad things happen, you need to do something fast.

That is actually a terrible heuristic. The need to “do something fast” leads to tremendous amounts of wasted time and resources and often a codified public policy that is unproductive or counterproductive.

The bias to action over inaction exists, among other reasons, because it plays out conceit that we control our own fate.

adam_arthur7• 5 years ago

Fear and despair sells better.

But if Omicron happens to be benign enough, it almost acts as a natural vaccine. This would be a very positive development for covid, not negative.

For some reason the focus still seems to be largely on case counts instead of actual outcomes.

Economic impact of lockdowns was mitigated somewhat by mass money printing and fiscal spending. If we lockdown again, will be disastrous for global economy as most monetary and fiscal firepower has been exhausted. Very troubling to see nations moving towards this again

weaksauce3• 5 years ago

But if Omicron happens to be benign enough

Here's my speculation on the reason that the virus is seeming benignish so far... omicron requires fewer ACE2 receptors to bind to in order for it to infect a host(because of the incredible reproduction rate over delta once it takes hold). The younger are generally not taking as many precautions as the elderly did(elderly have more ACE2 receptors but have mostly been vaccinated or died already). so as the pool of eligible candidates for infection trend younger (fewer ACE2 required moves the bar of easy infection down younger) you have younger people generally having a better time with the infection because their immune system is slightly more robust. and that tracks with younger people (generally) during the delta wave and original variant; younger people tended to have fewer really bad outcomes.

matthewmacleod4• 5 years ago

For some reason the focus still seems to be largely on case counts instead of actual outcomes.

The reason seems obvious - it’s been only 25 days since the discovery of the first case. There haven’t been many outcomes yet to focus on - as far as I remember, the average time between symptom onset and hospitalisation is something like 10 days, depending on the age group.

epgui8• 5 years ago

This is an editorial in the world’s top scientific journal— they don’t need to “sell” anything, and they need neither clicks nor views.

lucas_membrane• 5 years ago

For some reason the focus still seems to be largely on case counts instead of actual outcomes.

For vaccines, the focus still seems to be largely the percentage of effectiveness, as if that effectiveness will be a reliable constant for each combination of particular vaccine, particular variant, and particular undesired outcome (case, symptomatic case, hospitalized case, oxygenized case, ventilated case, long covid, death, whatever). However, that effectiveness will almost certainly vary both with the attributes of the person (e.g. age, sex and `comorbidities`) exposed to the variant and with the environment, particularly the number of times the typical vaccinated person is exposed to the variant and how heavily exposed. For example, if we now observe, when omicron is starting to spread, that a vaccine shows 50% reduction in cases or hospitalizations or deaths, what will be the observed reduction when omicron is more prevalent, when it may be common for typical persons to be exposed multiple times per day for a few weeks? Could the 50% reduction still occur? Could the vaccine give a percentage of people super-immunity and the other people none at all? Otherwise, will the increased presence of omicron in the environment overwhelm the effects of the vaccine and drive that observed reduction from vaccination (or boosterization, or whatever) down significantly? What do the experts know from experience about this?

I wish Mr Biden nothing but success in his efforts to get us all doing the right thing, and I hope that his emphasis on vaccination now brings good results.

downWidOutaFite• 5 years ago

I don't think that's right, we all heard the tentative good news as soon as it was available. I think the bias is that there is a massive thirst for certainty and definitive conclusions for each new pandemic development, but science does not work that fast. There's also a bias towards wanting your political side to be proven correct, but the virus doesn't care and has proven all predictions and conclusions wrong at one point or another.

parkingrift4• 5 years ago

Perhaps so. I’m just on the lookout for good news, and it seems the good news is always wrapped up in caution tape. Maybe I’m just bitter.

sega_sai• 5 years ago

I disagree with your statement, but here are the results for the whole UK https://www.gov.uk/government/publications/covid-19-variants...

and here's the plot for London https://twitter.com/theosanderson/status/1471907339397738502

parkingrift4• 5 years ago

Interesting. Thanks for the link. Do you happen to know of equivalent data for NYC? I’m apparently not adept at finding this information.

the-dude• 5 years ago

Why is the delta graph blocky and the omicron one smooth?

throwhauser• 5 years ago

Seems the evidence bar for bad news is quite low, but the bar for good news is unbelievably high.

It seems safer to believe bad news, and remain wary, than to believe good news and drop your guard.

ineedasername6• 5 years ago

In this case, it's neither good nor bad news because there is insufficient data. Per the article:

So far, the data are scarce and incomplete

The rest of the article consists of anecdotes that could point in either direction. If you want good news, check out the piece from WaPo from a few days ago [0]

Just keep in mind the scarce and incomplete factor. Give it another 2-3 weeks and we'll know more. Meanwhile it's probably not a good time to stop whatever precautions you have already been taking.

[0] https://www.washingtonpost.com/world/2021/12/14/south-africa...

Retric4• 5 years ago

Many people take longer to die of COVID than has elapsed since the first Omicron variant was discovered. We simply don’t know at this point, and won’t for probably 2 months.

Extrapolating from hospitalization rates and limited sample sizes is mostly just guesswork. It’s probably not much worse, but beyond that is up in the air.

epgui8• 5 years ago

The rationale for the bar being at different heights is:

1) the “precautionary principle”

2) the consequence asymmetry: if we’re vigilant at a time when we could relax, the consequence is small, but if we relax when we should increase vigilance, the consequence is larger.

nradov2• 5 years ago

The precautionary principle is garbage. If our hominid ancestors had followed the precautionary principle they would have never come down out of the trees. Embrace risk and accept the consequences.

mint2• 5 years ago

This article summarized the studies and the results are mixed. Not really sure what good news there is yet, aside that it does not appear worse.

Unvaccinated who haven’t had the virus should be very worried due to the transmission. For people with some immunity, the jury is out but personally I am not looking forward to probable mild Covid, until recently I thought I had a good chance of simply not catching it due to being vaccinated. that seems to be no longer the case.

rsynnott• 5 years ago

There isn’t much good news, or at least not great news. It seems likely that it’s not _worse_ than delta, and there’s some early evidence that it might be slightly better (eg the 30% lower hospitalisation thing). And it seems like existing vaccines and prior infections are probably at least somewhat protective against severe disease. That’s all good in that it’s not as bad as it could have been; the very worst case scenarios seem to have been all but ruled out. But it’s certainly not good enough for anyone to be feeling particularly optimistic now.

DantesKite• 5 years ago

Someone made an interesting point that Omicron might become the most virulent disease ever.

So I like how the bar has shifted, because everybody is so fed up with the disruptions to their daily life. Understandably so. But most virulent disease every is still pretty bad. Just from a logistical standpoint.

For me, the real problem is what comes after Omicron.

HIV is a completely different disease with a different etiology but it never went away. Treatments just got better with time.

I suspect the pandemic will force a lot of adaptations and legislation. I’m most excited about rapid testing at home though. I feel like that’ll do a lot to stifle the pandemic.

adam_arthur7• 5 years ago

Ease of spread is only notable if it causes bad health outcomes. Policy should only be made in response to actual outcomes, not case counts or other inaccurate proxies.

Historians will look very poorly on the authoritarian type policies being implemented that are, in fact, ignoring the science (actual data, second order effects), not following it.

weaksauce3• 5 years ago

Policy should only be made in response to actual outcomes

the problem with that kind of lagging reaction to policy is that if you wait for the results of the variant you may have a situation where you are unable to contain or curtail the virus enough to not overwhelm the hospital systems. deaths and hospitalizations are a very lagging indicator of the effects

culi5• 5 years ago

health outcomes vary widely by location. South Africa seems to be particularly less severe than in other places (suggesting population and environmental factors may play a big role). The fact is that in other countries death rates are still rising so there's a lot of unknowns and the science says this could be really bad

ineedasername6• 5 years ago

It's probably better to ratchet up precautions slightly for the additional 2-3 weeks from now that it will take to get more data.

I don't think history will look poorly on a scenario of "A more infectious version of COVID emerged, so for the following 6-8 weeks we asked people to increase social distancing and mask wearing".

If the mandate was "Cancel Christmas and arrest people found at holiday parties" then yes, "authoritarian" history would look poorly on that. As it stands, I haven't seen any governments take drastic steps towards more lockdowns due to Omicron. It's all "urging more caution".

michaelbrave• 5 years ago

I'm not so sure, some countries that clamped down very hard("Authoritarian type policies") like Singapore, Korea or New Zealand have done quite well, while countries who did half measures ("USA, Italy") or very little ("Brazil") seem to be struggling.

yung_steezy• 5 years ago

The issue is transmissibility rather than severity. Say it was 50% less severe but 25% more infectious that would cause hospital infrastructure to fail because the absolute number of hospitalisations go up as more people are infected.

culi5• 5 years ago

Also the fact that the severity of omicron varies from country to country. In the US it is likely to be much more severe than in South Africa

https://www.npr.org/sections/goatsandsoda/2021/12/17/1065315...

proc0• 5 years ago

We solved a complex bio-engineering immunity problem in record time, but we cannot solve a simple logistic problem of whatever special treatment hospitals are doing.

tim3332• 5 years ago

Depends where the thing peaks. In SA cases seem to have peaked already with fairly modest hospitalisations.

Gatsky• 5 years ago

My take on this is that if you live in a country where there was widespread use of less effective vaccines, where resources are limited for booster doses, and there is very limited access to treatments which we now know reduce disease severity after infection (sotrovimab probably still works for Omicron infections and paxlovid almost certainly does), then Omicron is going to be bad.

Unfortunately a lot of the world which isn't Europe and North America seems to fit into this category.

culi5• 5 years ago

It's important to note the severity of omicron seems to vary a lot from country to country. Omicron in South Africa seems to be much less severe than in other countries.

Also if you do wanna take the hot take of omicron spreading and displacing other variants, then it's still very important to get the booster shot. The vaccine has a much bigger effect on those variants than on omicron. In Norway at a party of 120 fully vaccinated people, 80 of them got infected with omicron. So no matter what, it's still important to get your boosters!

chrismcb• 5 years ago

Why do you say it is still important to get your boosters?

monopoledance• 5 years ago

Trolling.

javagram• 5 years ago

https://news.yahoo.com/booster-shots-neutralize-omicron-isra...

Early lab tests suggest the antibodies generated by the immune system after the booster shot are able to target and eliminate Omicron particles. “ Those who did not receive the booster shots, had no neutralization ability against Omicron. Researchers said the booster increased this about a hundred fold.”

culi5• 5 years ago

Because it strongly limits the spread of other variants and only weakly limits the spread of omicron. Which means if you were cheering for omicron in the rat race, getting the booster would actually give it a competitive advantage

jgalt212• 5 years ago

Similarly, a 16 December report from Imperial College London found no evidence of diminished hospitalizations from Omicron infections compared with Delta in England, although this was again based on relatively few cases.

I trust almost nothing that comes out of Imperial College these days. The architect and the salesman of the first lockdown (to Boris and then Trump) clearly did not believe in them enough to apply them to himself.

https://en.wikipedia.org/wiki/Neil_Ferguson_(epidemiologist)...

tim3332• 5 years ago

Not very severe going by South African data. There's a thing here arguing the case fatality rate has been 19x lower than delta https://twitter.com/pieterstreicher/status/14726238790719365...

There's a graph here of cases vs deaths for the 4 waves in SA showing pretty much no sign of deaths shooting up in this one while they shot up in waves 1,2 and 3. For those saying - ah the South Africans were immune, why didn't that work in wave 3 but did in wave 4 if not for the virus being different? https://mobile.twitter.com/ScottGottliebMD/status/1472664060...

The "16 December report from Imperial College London found no evidence of diminished hospitalizations" thing is ridiculous if you look at the paper - they didn't find statistical significance in English data because there was hardly any at that point and didn't even bother looking at African data because why bother. Bit like me saying there is no evidence of Ebola being more dangerous than having a cup of tea because I've done a study in my kitchen and no one has died there.

How severe are Omicron Infections?

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