(2021-12-16) ZviM Omicron Post #7

Zvi Mowshowitz: Omicron Variant Post #7. I am grateful to all my news sources and those who help gather the information together, and everyone working tirelessly in the lab, but the whole thing is still a slapstick hodgepodge, and we know so much less than we could know so much slower than we could know it.

There is some uncertainty about how far along things are. There is uncertainty regarding how much milder Omicron is than Delta

But the main uncertainty that I’m now wondering about, that feels central, is how we will react.

rediction markets believe and I even more strongly believe that Omicron will become the majority of cases by year’s end in the USA and most of Europe

What are we willing to do to try and not fail?

Meanwhile, there’s still the question of exactly where we are

United Kingdom

50% Omicron yesterday in London, 60% today

It also looks like London cases are spreading into older groups.

If you live in London, you have a choice to make right now that is similar to the one many others will likely have to make soon

If you go about your business as usual, you’re going to get infected. If you don’t want that to happen, extreme prevention measures need to happen now.

Denmark

Note that the UK data and Denmark’s data seem like they live in different universes, with very different relative R0s for Delta versus Omicron. It’s a mystery, and I don’t yet know how to reconcile them.

The bad news from Denmark is this report (in Danish) claiming that severity for Omicron is similar to Delta.

South Africa

The CDC has a nowcast, which is more like a thencast given it reflects a bunch of lag

They have Omicron at 2.9% of infections already last week, after being only 0.4% the previous week

Here’s the word from Ontario and all I can say here is holy f** this is bad, that’s R0 = 7.7 when Delta would be stable*

If these numbers are accurate, it’s game over, man, game over.

Even in the most optimistic scenarios we run out of tests, and have to adjust to things like positivity rate to estimate number of cases

Omicron is spreading in China. Given their vaccination situation and lack of prior infections this could get ugly quickly. The techniques they used before likely won’t work now, although we’ve been wrong about that before.

The Lab on Vaccines

The Lab on Spread

We’re starting to get more color on why Omicron is spreading so fast. It’s not purely that it has escape properties. A lot more is going on.

Severity

Andrew Lilley responds to arguments against his case that Omicron is indeed less severe even if you take into account all the other factors, in his analysis they can’t add up to enough and arguments otherwise are increasingly convoluted special pleading

Official Statements

*December 14 statements by Dr. Fauci on Omicron.

He nails the central question of virulence, for which we still lack clarity*

There’s still pure denial about the size of the wave that is going to hit soon

For some reason this kind of thing is happening a lot with Fauci in particular, where reporters change his words in ways that importantly distort their meanings

*I’ve been in a few conversations about how to get Omicron boosters working faster, perhaps fast enough to get to the vulnerable before the wave becomes a tsunami, and had debates over whether that was the right focus. Everyone I know who thinks about this considers starting the process as fast as possible both important and a no brainer. Instead, everyone with any power over the situation seems to have suddenly decided that there’s no point, so it isn’t going to happen until far too late, and our entire ability to update the vaccines for a variant was effectively fake. We can’t actually do this until after we know we needed to have already done it. That’s marginally better than nothing, but it’s a lot closer to nothing.

It seems like, when there’s a strain that spreads three times as fast as the original or more, a vaccine that works about half the time is considered good enough, and good enough to force people to take it. This isn’t people modeling and thinking about the physical world and plotting exponential growth curves. This is moralistic thinking, or worse.*

Once again, we have a generic call to, in Dido’s words, do the things we usually do. This is mostly the same measures they would have called for without Omicron. It contains nothing that has any hope of actually stopping Omicron.

*Kai notes in this thread that the UK seems to not be taking the WHO’s ‘vaccines and’ message to heart. I still don’t know what would be in the ‘and.’

Science article on what we know, seems reasonable but nothing new, once again downplaying the actually bad scenarios. Even when saying ‘I don’t think we got the message through’ I think ‘true, but I also think you didn’t get the message either.’*

The Lab Leak Hypothesis Part 2

if this comes from a mouse I do not believe in that level of coincidence.

Probability Updates

Chance that Omicron has a 100% or bigger transmission advantage in practice versus Delta: 85% → 90%.

Chance that Omicron is importantly more virulent than Delta: 3% → 3%.

Chance that Omicron is importantly less virulent than Delta: 60% → 60%.

Will the CDC label Omicron a variant of high consequence before 2022? 11% → 11%

I mean they should based on what I think it means, but whether or not they will doesn’t have much to do with that

Chance we will be getting boosters modified for Omicron within 6 months of our previous booster shot: 50% → 30%.

Chance we are broadly looking at a future crisis situation with widely overwhelmed American hospitals, new large American lockdowns and things like that: 25% → 35%.

There’s no sign of a robust policy response anywhere, so maybe we really will let it burn, but I have no idea how we actually do it.

I notice increasingly that I don’t have a good handle on how to think about the policy response that we’ll actually get because neither do any of the policymakers. I don’t think they’re thinking about it much at all.

Will Omicron be >1% of all cases by the end of the year? 97%+ → 99.9%+