A brief update on the status of Omicron. We are still in a fog of information. There is again a disturbing shortage of actual hard information, except for evidence that it spreads rapidly in certain areas, such as New York City, The 72-hour positive rate doubles.

As GM pointed out, the only good news is that Omicron cases are rising rapidly in New York and Florida, and we will soon have a better understanding of the severity of Omicron, rather than spreading.

Please forgive me for trying to find flaws in some optimistic views of emerging information. Although they may be correct to a large extent, the vast majority of people are inclined to positive explanations. However, at this stage, the precautionary principle strongly advocates seeking and preparing to go down, and only relax when there are reliable and favorable results.

One seemingly encouraging fact is that infection and hospitalization rates in South Africa are beginning to decline.¹ However, we don’t yet know whether this model will continue or whether it will be transformed into other countries.

Why is the SA mortality rate the same as 4-6 weeks ago? https://t.co/b0pyq2ybts pic.twitter.com/DFJHVdypIn

-Doug Henwood (@DougHenwood) December 17, 2021

Recall that when the United Kingdom held the Covid Restriction “Freedom Day” on July 19, many people, including you, did expect the obvious, and this situation would increase. Instead, they fell. Is it because of summer? Widespread criticism of Johnson’s actions has led some people to take subtle or overt protective measures, such as going to the store during off-hours, wearing more masks, or even being more vigilant not to approach others in public?

By early August, many American media said that the United Kingdom had proven that Delta Air Lines could be controlled. But then a new Delta wave started in October, Public health experts call for new restrictionsRecall that a study in the UK in August also found that Delta’s hospitalization risk is twice that of Alpha, Although due to rising vaccination rates, official statistics do not reflect this.

Some Twitterati also found good news in the review How did the participants of the Oslo Christmas party performRecall that despite being vaccinated, most people are still infected with Covid, and since some people have been confirmed to have Omicron, The authorities assume that most people doHowever, apart from the high attack rate (70%) and not that hot, it is difficult to draw conclusions, because 3/4 are still sick:

https://www.fhi.no/en/news/2021/preliminary-findings-from-outbreak-investigation-after-christmas-party-in-o/

Even if the list of symptoms does not look so bad, fatigue can hide many sins. Long-term Covid victims often report regular episodes of absolute weakness and single-grade fatigue.

The country with the best population coverage test is Denmark, where there is much less information. An expert looked back from his Omicron cases and Omicron hospitalized cases to estimate the severity, such as the proportion of cases that were eventually hospitalized.

I didn’t understand how this model works at first, but when the infection rate rises rapidly, from case to hospitalization, you can solve the final hospitalization by assuming the average number of days since the test was positive.

Below is An early version of this model with both Delta and Omicron drawn. Then there is an updated version with only new data from Omicron.

As GM explained:

They are taking cases and hospitalizations observed so far, then moving them by a given number of days and calculating the percentage of hospitalizations relative to the cases. They have no information about the actual time between a positive PCR test and hospitalization-the authorities have this information, but they did not publish such an analysis.

Because it broke out so quickly, most of the cases are in the last few days, and it actually takes time to deteriorate to the point where hospitalization is required, so it is difficult to judge the severity of Omicron.

This is a method of evaluating the parameter space.

According to this analysis, there are three possibilities

1. If the time between PCR testing and hospitalization is short-about 4 days-then Omicron will be as bad as Delta’s situation in Denmark, that is, 0.5% of cases are hospitalized. This is quite “mild” (there was a time when we did not conduct enough tests, and the fatality rate in many places was 10%), but it was the result of the vaccine reducing the serious consequences of Delta Air Lines. Therefore, this means that Omicron is inherently less toxic, because in this case we have more immune escapes.

2. If PCR detects that the interval of hospitalization is 8-9 days, then Omicron is 1.5-2 times worse than Delta, and 1% of cases will be hospitalized. Again, this is among the vaccinated people.This may be due to antigen drift and residual protection of the vaccine to a large extent

3. If the time is 11-12 days, then Omicron itself is more serious, and it damages the vaccine more than expected.

Even in the first case, we have a real problem because how fast it spreads, which means there are many patients in a short period of time.

But option #3 is a total disaster.

The usual hospital stay is 8 days, but that starts from the onset of symptoms.

To emphasize GM’s point of view, even in the most favorable “moderate” situation, the hospitalization rate is similar to Delta Air Lines. Considering its speed of transmission, this is a train wreck…unless the patient responds better to existing treatments (most importantly oxygen), so the average hospital stay is much shorter. Please keep in mind that we already have some bad news in terms of treatment. Omicron can indeed resist all monoclonal antibodies, but GlaxoSmithKline’s sotrovimab may be in short supply. Therefore, at the edge, some, perhaps many patients who could have been discharged from the hospital with monoclonal antibodies would not.

Update the model with more current information Pushing this line up, as far as I know, it means more serious. For example, in the first version, a 1% admission rate is equivalent to approximately 8.5 days. In the version below, it is now 6 days. Remember that 1% is about twice the Delta:

Now, as more information becomes available, this picture may improve. But it certainly doesn’t look so hot now.Oh remember Denmark’s vaccination rate exceeds 90%.

This last sad sighting showed that with the burning of Omicron, the United States was indeed playing with the guitar. I am not exaggerating. This is 40 seconds of a 3-minute news clip starting at 2:08.

If we have sheep to lead, we will do better. As far as I know, at least sheep will not run off the cliff together like lemmings.

____

¹ I have to use South African data to debunk a new tweet in advance: https://twitter.com/michaelzlin/status/1471749391585214465. This is another example of eager use of available data, as opposed to representative/conclusive data, causing experts and commentators to ignore obvious biases.

The latest data in this tweet is from November 7th to December 4th. For Omicron, this effectively represents approximately November 20 to December 4, or a maximum of 14 days, and the number of Omicron cases will account for a large proportion of the time after that. Recall that as of November 26, there were 77 confirmed Omicron cases. You can assume that it is actually 10 times as much as it was at the time, but there are also 3 days twice as long. Remember that the initial outbreak occurred on and near campus, so the first cases tend to be in their early 20s.

This is not enough to see death. I went through some research quickly. For example, a large-scale study of the less annoying wild type (v. Delta) in Belgium found that the median time between symptom onset and hospitalization was between 3 and 10.4 days, while the median hospitalization of recovered patients The time is between 5 days for young people to 15.7 years old.

Also consider the famous Oslo party we mentioned above. About 3/4 of the positive cases did not get sick. They still have symptoms. The party is November 26th.

The chart in the tweet seems to try to solve this problem by presenting “resulting cases.” But for patients without symptoms, you will not get results! For early Covid variants, this pattern is that some patients are less severely ill, usually for 5 to 7 days, and then get worse, requiring more aggressive treatment, such as monoclonal antibodies or hospitalization. Recall that the famous Boris Johnson continued to work and then had to go to the hospital.

Therefore, the chart appears to only include Omicron cases that recovered before December 4, which will effectively select less severe cases. Likewise, it is likely that more data will fit these happy findings, but we cannot draw conclusions from this too short window.