(2021-11-29) ZviM Omicron Variant Post-2

Zvi Mowshowitz: Omicron Variant Post #2. It’s now been three days since Post #1 ((2021-11-26) ZviM Omicron Variant Post 1 Were F-ed It's Never Over). The situation is evolving rapidly, so it’s time to check in.

What should we look for here and in the coming days?

No news is good news.

The pattern of where and how we find cases, and the details of those cases, will give us better insight

Information on how deadly Omicron is should update us quickly, and matters a ton for how to react, but beware of confounding factors

Noah Smith gives his overview of the situation here. It provides a lot of the same links, some good new links, a set of views broadly similar to mine, and is generally reasonable. I do disagree with the conclusion, in that I think on the margin the most valuable focus is now testing and treatment, with further vaccinations vital but not primary.

Immune Erosion and Transmissibility

Travel Restrictions

As I noted last time, travel restrictions have zero chance of stopping Omicron, but they will be effective at slowing down Omicron so long as there is a large asymmetry in Omicron’s presence in different areas. I do think the time will come relatively soon when the restrictions stop accomplishing anything, but that time is not today.

I am no travel expert but your backup plan right now should very much be ‘stay home for a while’ or at least something not international.

Vaccinations and Boosters

If you’re worried your booster shot is interfering with other people’s access to the vaccines, or with ‘vaccine equity,’ please stop. You’re not doing that, except to the extent you having less and someone else not getting more means more ‘equity.’ Link to article Alex links to. South Africa in particular has a surplus, the same as we do

Lockdowns

Americans need to be prepared to do “anything and everything” to fight the omicron Covid variant, U.S. infectious disease expert Dr. Anthony Fauci said Sunday.

Anything and everything is an appropriate response to an existential threat. I still have some probability mass in Omicron being deadlier than Delta, but almost none that it is sufficiently deadly that ‘anything and everything’ would make any sense. That kind of rhetoric is laying the foundation for very poor trade-offs

Similarly, notice rhetoric where lockdowns are punishments for non-compliant populations who have sinned against public health, rather than a tool to accomplish a goal.

The scariest signs are coming here in New York, where I am worried I am going to start missing Andrew Cuomo and I do not even slightly miss Andrew Cuomo.

Kathy Hochul has no idea how exponential growth works. Clearing hospital capacity now and stopping elective surgery now is exactly the opposite of any reasonable procedure

The Timeline

Other New Information

Current Model

Chance that Omicron has a 100% or bigger transmission advantage in practice versus Delta: 30% → 35%.

Chance that Omicron will displace Delta: 70% → 80%.

*Chance that Omicron is importantly more virulent than Delta: 25% → 10%.

Chance that Omicron is importantly less virulent than Delta: ?% → 40%*

Also Zeynep points out explicitly a point that’s easy to miss, which is that being immune erosive will lower average severity because breakthrough cases are less severe, so Omicron will probably look less virulent even if it isn’t

Chance that Omicron is importantly immune erosive, reducing effectiveness of vaccines and natural immunity: 50% → 80%.

Final Thoughts

More vaccinations and booster shots help, but I believe what matters most will be our ability to:
Manufacture as much Paxlovid as possible as quickly as possible.
Get testing that will allow those with symptoms to get tested and found reliably and quickly. We still haven’t fixed this. FIX IT!
Get a distribution system ready