(2022-01-07) ZviM Omicron Post #13 Outlook

Zvi Mowshowitz Omicron variant Post #13: Outlook. In addition to some amount of the usual business, the focus of this post will be an explicit attempt to look at what’s likely to happen from here, and give my baseline scenario.

The world can be divided into five (highly unequally sized) parts, with increasing levels of uncertainty

South Africa and Other Already-Peaked Areas

Uncontrolled spread: Europe, North America, India, Israel, Australia and Argentina.

Infection rates increase exponentially until they hit a peak. In major cities, this plateau will usually be quite high, with more than 1% of people infected each day, and likely 10%+ of the population testing positive at any given time

Once you hit that peak, there will be a short period (a week or less probably in most cases) before the decline starts in earnest, then picks up speed.

There are substantial disruptions during the peak period, lasting roughly a month, but nothing as scary or severe as early 2020, and no breakdowns of civil order.

Without an Omicron wave, or without good data: Third world, Russia.

Previous containment: South Korea, Japan, Taiwan and New Zealand

China

China is the big question. They managed to maintain a zero Covid policy so far, so almost none of them have immunity that way. The Chinese vaccine was always less effective, and offers minimal protection against infection by Omicron

Meanwhile, they’re planning to host the Olympic Games, and, well, whoops?

I’ve underestimated China’s containment abilities throughout, and been repeatedly surprised. Once again, I’m skeptical they can pull this off, and once again it’s mostly a Boolean, either the strategy works or it doesn’t. But given their track record I can’t count them out of it, neither result would surprise me

Now a round up of the other Omicron News

Vaccine Effectiveness

accines in children are ludicrously effective in terms of reducing what risk is left, a 180x reduction, although they are also largely unnecessary in terms of the kids not having been at much risk in the first place

Testing

*Here’s some new results, which suggest that nasal swabs are slow to start turning positive, in the study median additional time required was 3 days after the PCRs were positive, which is in the range of not being all that useful if you need to confirm you’re not infectious. Suggestion is to use saliva for rapid tests to get that time back, but by the time we do that, I’m assuming the wave will already be over.

Combined with a lot of anecdotal reports I’ve seen, I’m moving towards assuming that while rapid tests are probabilistically very useful, transmission with Omicron is much faster and has outpaced the speed at which the tests turn positive, and this means that if you want to be confident rapid tests are not that useful on their own. And strongly agree with Mina that if you have symptoms, you have to act as if you’re positive unless you’re negative several days later*

Hospitals

Threads and Posts

Probability Updates

Median peak cases day for United States: ??? → January 19, 2022

China keeps daily cases under 50 per million through 2022: ?% → 40%.

Chance we are broadly looking at a future crisis situation with widely overwhelmed American hospitals, new large American lockdowns and things like that: 5% → 3%.