Moderna is working on a vaccine targeting the Omicron variant for 2022.[1]
The mRNA vaccine technology is "agile". There's a workflow from sequencing a virus to generating a candidate vaccine. It only took two days to generate the original COVID-19 vaccine. It's the clinical testing in small, then large groups that's the time consuming part.
Also, the inhaled vaccines are entering clinical testing.[2] It's not like we're stuck with the original vaccines.
Yes and this means governments can quickly adapt to new variants by reformulating the vaccine, dumping old stock by "donating" it to developing nations, or dumping it, and buying new stock from big pharma.
Since developing nations will always have far lower vaccination rates than first world countries, the virus will continue to mutate and proliferate outside of America and Europe, ensuring new opportunities for revving the vaccine.
That's a sustainable business model for the first world.
Nothing you've said is incorrect. I have to wonder though if this dumping of old vaccines on people who wouldn't have gotten them in the first place might allow people to survive who might otherwise have not. Sure, the vaccines are not optimal, but they do reduce risk. And of course this situation isn't fair, but perhaps it's still better than the baseline conditions these folks would have had to live with.
Right, but the underlying tech was in development for a decade or more.
I can deploy an app to Azure, tell it to allocate a server farm, databases, Redis, queues, etc... in 5 minutes too. But that's only because someone took years to do all the necessary work.
Execs are paid mostly in stock, and it's a bad idea to leave all your money in one stock basket. Seeing how they are mostly round numbers on a regular schedule, it's probably a https://www.investopedia.com/terms/r/rule-10b5-1.asp sale on a schedule.
Here[0] is a better website to look at this data. He started selling in November 2019, before the pandemic, and has kept a steady-ish pace. If there is a pharma agenda here for endless boosters, why is he not accumulating/holding rather than off-loading his shares?
Meanwhile, the Biontech CEO thinks that a fourth booster may be needed. For all the agility of mRNA, the reality looks like we are indeed stuck with the original vaccines.
And I suspect that countries which want to implement mandatory vaccination like Austria and perhaps Germany will force people to get the now worthless first and nearly worthless second doses of the original vaccine, because anything else won't be available.
What level of testing would make these vaccines non experimental in your mind, and what other vaccine do you know that has had that level of rigour applied? I'm genuinely curious
First: "The study by Discovery Health, South Africa’s largest health insurer, of 211,000 positive coronavirus cases, of which 78,000 were attributed to omicron, showed that risk of hospital admissions among adults who contracted covid-19 was 29 percent lower than in the initial pandemic wave that emerged in March 2020."
and second: "At the same time, the vaccine may offer 70 percent protection against being hospitalized with omicron, the study found, describing that level of protection as “very good.”"
Yes the vaccine does improve outcomes BUT the hospitalization rate for unvaccinated people is still lower with Omicron than previous variants.
I don't understand this study. Why not compare the hospitalization/fatality rates between _current_ omicron/delta infections between similar cohorts?
Comparing to an earlier wave is hopelessly confounded on prior infections in the intervening time and similarly, on the most susceptible having already been killed off.
Maybe they did what I'm suggesting and its mostly just bad reporting?
edit from the summary :-/ :
Vaccine effectiveness:
The two-dose Pfizer-BioNTech vaccination provides 70% protection against severe complications of COVID-19 requiring hospitalisation, and 33% protection against COVID-19 infection, during the current Omicron wave.
Reinfection risk: For individuals who have had COVID-19 previously, the risk of reinfection with Omicron is significantly higher, relative to prior variants.
Severity: The risk of hospital admission among adults diagnosed with COVID-19 is 29% lower for the Omicron variant infection compared to infections involving the D614G mutation in South Africa’s first wave in mid-2020, after adjusting for vaccination status
Children: Despite very low absolute incidence, preliminary data suggests that children have a 20% higher risk of hospital admission in Omicron-led fourth wave in South Africa, relative to the D614G-led first wave.
Thank you for removing the uncertainty on that! Agreed regarding the unspecific reporting. Seemed to me to be one of those areas where the author assumed you'd assume... I dislike that as it introduces the possibility of misinterpretation.
Now the next question is what is the percentage reduction in deaths for Omicron vs prior variants. It seems like more than the 29 percent reduction in hospitalisation given the first death from Omicron was reported in Britain last week right?
Don't forget this part:
"South Africa has a quite high seroprevalence of prior infection, particularly after delta, and in some parts of South Africa up to 80 percent of people were exposed to previous infection"
So it could simply be that the mild cases were previously infected, what happens to an unvaccinated without prior infection is a different story.
Furthermore SA got hit quite badly by Beta. Beta and Omicron are closer than either to Delta, so there may be some immune protection from the prior Beta wave. Beta never got established in Europe/US.
Of all people, the YC News crowd really ought to understand that O(exp(n)) overwhelms O(1) literally exponentially. Not figuratively. Literally.
If a virus variant has a constant factor reduction in its side-effects, but a higher exponential factor in infectiousness, the latter will overwhelm the former in short order, and then continue to overwhelm it even more. Exponentially.
Let me do some simple maths assuming that it spreads "just" twice as quickly as Delta.[1] Lets assume that at some point, Omicron will be the primary strain, and there are 29% less patients in hospital because of it. Assume the doubling-time of Delta is 1 month. (It's better or worse than this depending on circumstances, but start here.) The doubling time of Omicron is then 2 weeks.
So with Delta you have: 1.0 == .71 * 2^(t/30d) which solves to about 15 days to get back to a full hospital.
With Omicron the equation is 1.0 == .71 * 2^(t/14d) which means it'll be back to a full hospital in just 7 days. Then the hospitals will be at 200% capacity in 21 days, 300% capacity at 29 days, and 1000% of capacity in just 53 days.
Of course, the full mathematical model is more complicated, typically something like SEIHRD, but the point is that a mere 29% reduction in mortality is next to nothing compared to an exponential increase in infectiousness. It would have to be more like 90% less dangerous for that to matter at all in the long run.
The human population is finite, and exponential growth hits its bounds pretty quickly. In the long run, if you assume that most non vaccinated and a large part of the vaccinated will eventually get COVID (probably the case), then the 29% reduction in mortality does, actually result in a 29% reduction in mortality, and the exact same number of people will have been infected either way.
The difference will be in timing; the people will have been infected more quickly, with the (severe) problems that entails.
Hi, I'll admit I didn't fully understand that, and your explanation helped. I'll also use this for when my friends and family miss the point too, thanks :)
I think we have to be very careful with data from around the world. There are a lot of co-factors. We already know that generally being immuno-compromised makes covid a much riskier proposition for those groups. In a recent deep dive into the Ivermectin studies done around the world, it was shown and proven that in Bangladesh that Ivermectin reduced covid mortality. However, when digging deeper, Bangladesh has a 80%+ infection rate of worms with most people having 7-23. So taking Ivermectin helped save patients from covid mortality but only in the sense that it made them less immuno-compromised. The US population (e.g.) doesn't have worm infections like that. Any data from a specific geographic area/country/race/etc. may only have validity within that same group.
The worm hypothesis is a hypothesis, and a good one. But it is a hypothesis. assuming good sounding hypotheses are true and running with it have been the root of a lot of problems in this pandemic.
it isn't apples to apples. Some studies show that SA has >70% seroprevalence [1], most of which from infection. If it holds that recovered immunity confers __better__ protection than naive vaccine immunity [2], then that 30% decrease might as well be from the protection conferred mostly by the former, and we have no idea how that would translate to vaccine naives, who are the majority in highly vaccinated developed countries.
> Yes the vaccine does improve outcomes BUT the hospitalization rate for unvaccinated people is still lower with Omicron than previous variants.
In this very specific demographic. Other countries will have different outcomes, as seen with the current state of the pandemic (looking at Europe, for example).
Did anyone notice the comparison of vaccine-based immunity to natural immunity in the findings within the source PR [0]? With a little work, you can compare them.
If we convert the measure used in finding 2 (relative risk of reinfection) to finding 1's (relative protection), then the study found that natural immunity from Delta variant gives 60% protection against Omicron; roughly double the vaccine's protection.
Unfortunately, no stat was given for natural immunity's protection against hospitalization.
From finding 1: individuals who received two doses of the Pfizer-BioNTech vaccine had 33% protection against infection, relative to the unvaccinated
From finding 2: People who were infected with COVID-19 in South Africa’s third (Delta) wave face a 40% relative risk of reinfection with Omicron
Am I reading this right? Wonder why they used different metrics?
Given the high percentage of the population in SA who has already had an infection, there's probably a significant chunk of people in finding 1 who also already had natural immunity. That's probably going to make it difficult to use these results to compare vaccine-based immunity to natural immunity, right?
I have a question for anyone who has a serious level of knowledge on virus evolution: As viruses evolve over time is there any correlation to severity - do they have trade offs as they evolve?
I am hoping that it would be some kind of trade off that the virus makes in that it can spread more easily but not be as severe (I understand that it is unlikely nature requires a trade-off). I ask as my concern is that while this variant might be much more effective at spreading and hopefully less severe in its disease - are we not just making a massive breeding ground for the variant after this one that could potentially be as quick spreading but with a greater severity of disease?
One thing that makes Covid-19 a bit different from other viruses that have trended towards milder infections is its long incubation time (while still being infectious). So it can already spread pretty easily even if it's killing those people, and thus there's not a lot of darwinian pressure to become milder.
It might still trend towards that over time, but it will probably be slower at it than other viruses, and thus the 'it gets milder over time' aphorism about viruses doesn't apply as strongly to Covid-19.
Another pressure is social response to infection: so far, the predominant response to a more-virulent or more-lethal strain has been lockdown and/or other behavioral change, see: delta in India. On the flip side, a variant that causes milder symptoms is less likely to cause the same social response, which allows the virus to spread more widely.
This may (may!) be what we’re observing with Omicron. In any case, we’ll know much more in a few weeks.
I think that the basic severity-lowering gradient still applies, but now it happens in two dimensions. Furthermore, it seems plausible that the sequence of variants "Original" -> Delta -> Omicron follows such a pattern.
First, evolutionary pressure will select for a lower dormancy period, i.e. a lower time to contagion. This is because a variant with a shorter dormancy will spread faster than one with a longer dormancy period if both are present in the same population. This is also exactly what happened with the Delta variant, which is asymptomatic generally for a shorter period[1] than the original variant, because it replicates faster.
Second, the usual process occurs for the usual reasons. This may be happening with Omicron.
Viruses evolve according to evolutionary pressures. I'm surprised we don't see Covid mutations that invalidate PCR tests - perhaps it's too soon, or even, who knows, maybe they are there and we don't know?
The common trope is that if the virus is too deadly, then it doesn't have a chance to find new hosts. This is kind-of what happened to "SARS-1" - it tended to kill its hosts before they could pass it on.
Unfortunately, this is only a weak effect in Covid. Most of the spread happens well before people are very ill; in terminal stages of severe Covid, many people in fact would test negative for virus presence. So there is little evolutionary pressure on the virus to be less deadly - by the time it kills people, we are spent vessels from its point of view.
I suppose a mutation that makes it completely benign would be beneficial, as current rules on self-isolation curb the spread of strains causing symptomatic disease.
There are pressures that make it more deadly: a mutation leading to higher viral load is both more deadly and more transmissible. So unless the transmissibility increases too much (and virus is way too deadly), we might even expect the virus to become more deadly. This hasn't happened yet, thankfully.
An example I used elsewhere was the introduction of Myxomatosis in Australia, to control the invasive rabbit population. Over time, the local strain evolved to be more deadly, but with a longer incubation periods. This way, bunnies had more time to pass the virus around, then once that job was done, the virus was happy to kill them off.
On the flipside (and very long timescales), since some people appear to be genetically more resistant to the virus, you can expect natural selection to do its job. But since overall death rate from Covid is low-ish (no more than 1%, you'd say, and skewed towards older, non-reproducing individuals) this would take a long time.
Another hope is that, if the disease is less serious in children, perhaps immunity it built up during the usual period of childhood infections. There is another coronavirus, which causes a mild cold in children, but can be very serious in adults (apologies, I can't remember what it's called). Thankfully, a single infection gives more-or-less complete lifetime protection - so most people have it as children and never worry about it again.
In either of these cases, we're talking about generational timescales.
The current PCR tests detect three different regions of RNA that are expected to be relatively well conserved, so there's no single mutation that can cause PCR tests to not detect them and we'll hopefully get a substantial early warning that allows the tests to be adapted if they ever head in that direction. One of the three markers detected by some of the PCR tests is actually invalidated by Omicron and some other variants but it's likely either bad luck or the result of some other benefit this mutation gives the virus. In order to get much benefit the virus would basically have to dodge all the things the PCR tests check for at once and that's hard to evolve.
> So there is little evolutionary pressure on the virus to be less deadly - by the time it kills people, we are spent vessels from its point of view.
A variant that infects more people from a single host (assuming everything else held constant) is a positive selective pressure. So increasing the contagious period is beneficial. But the length of the contagious period is inversely related to the timing and strength of the immune response. So we should expect the virus to become less deadly over time, assuming there's a hard limit to its ability to evade a typical immune system.
> I'm surprised we don't see Covid mutations that invalidate PCR tests
The people who design the tests know which parts of the sequence are more likely to mutate, so they pick the more conserved parts. Also, most PCR tests check for 3 different parts of the sequence. Which is why Omicron can still be detected even if there is a mutation in one part checked by the test, since the other 2 parts still match (the so called S-gene-dropout).
> An example I used elsewhere was the introduction of Myxomatosis in Australia, to control the invasive rabbit population. Over time, the local strain evolved to be more deadly, but with a longer incubation periods. This way, bunnies had more time to pass the virus around, then once that job was done, the virus was happy to kill them off.
> This is kind-of what happened to "SARS-1" - it tended to kill its hosts before they could pass it on.
Quick nit: while this is true, SARS-1 was also not particularly transmissible before symptoms appeared, in contrast to Covid, which made control much easier (in addition to the much higher fatality rate causing everyone to take it much more seriously).
> I'm surprised we don't see Covid mutations that invalidate PCR tests
PCR tests for RNA or DNA, that's not something a mutation can change. I don't know for Covid, but usually a PCR test targets something fundamental & stable. That might need to be updated with new variants.
Viruses that evade the PCR test for Covid would be a different species almost by definition, and with enough mutations that could happen. These tests don’t detect other common cold causing coronaviruses for example.
Imo part of the joy of hn is that this isn't actually true. Obviously not everyone knows what they are talking about, but some of the people who really do have serious knowledge on any given topic are on hn, and the average person here is at least slightly less likely to think they have knowledge when in fact they don't.
From what I know as not being a professional doctor, I would say that it appears to me that viruses get less dangerous over time, not more dangerous. This appears to be because viruses that are overly dangerous kill off their hosts too quickly, limiting their ability to spread, whereas the milder forms don't kill their hosts as easily and spread more broadly, building immunity against the stronger variants over time.
Edit: The result of this, if you look at previous diseases that have plagued humanity (see Black Death), is a high initial death count when the virus breaks out, but the death rate declines as the milder variants spread and people survive them, building immunity to stronger versions, until eventually the virus mostly disappears.
It's not something you can count on; smallpox remained highly lethal across thousands of years. There's probably also a bit of an element of natural selection against humans involved; the people who died early of the Black Death may have been genetically more susceptible to it.
In this article he clarified that generally viruses that spread more are less severe (as killing the host makes it tougher to spread). The asymptotic nature of Covid sort of broke this assumption because Covid can lie dormant in someone for a week before the person shows severe illness
>In this article he clarified that generally viruses that spread more are less severe (as killing the host makes it tougher to spread).
It takes far less than death to reduce spread. People who feel sick stay home from work (not guaranteed, but with enough frequency that it matters), don't go out to eat, don't wander around and go to parties, and so on. Any time they're sitting home, they've hurt the chances that their variant is the winning-est variant.
Again with the caveat about dormancy periods for Covid.
Asymptomatic spread is not nearly as prevalent as originally feared.
Also, those who do not get symptoms (that is, most who catch covid) do not spread the virus in general, which is why it's now called "presymptomatic" spread.
If severity means the host dies quickly rather than slowly, there's obviously selection pressure and that mutation will die off relatively quickly vs the rest, since it won't have as many chances to spread as the less severe strain. E.g. SARS/MERS.
If severity means the host dies more often, but it still takes a long time to die, the selection pressure is much lower, and it will roughly spread the same as the less severe strain, all other things being the same. E.g. Spanish Flu.
Viruses evolve to be more fit. Presumably, a mild version and more contagious version may even have evolved in one of the billions that were infected these years, but it didn't spread much because of self-isolation and restrictions. A variand that s more debilitating would be less likely to transmit.
"I am hoping that it would be some kind of trade off that the virus makes in that it can spread more easily but not be as severe..."
I've definitely seen outlets postulating that the endgame for COVID-19 would be it doing exactly this— becoming way more contagious but way less severe, basically a just a kind of cold. These "final" variants would quickly spread everywhere, choking off the supply of new hosts for the more deadly variants, effectively achieving herd immunity.
Any genetic mutation which causes premature death of the host, or fails to be communicative will generally die off. Any mutation which keeps the host alive (or at least longer), or makes it easier to transmit the virus to another host, will keep the virus around. This type of behavior can be muted if there is an animal host that acts as a reservoir.
> Any genetic mutation which causes premature death of the host, or fails to be communicative will generally die off. Any mutation which keeps the host alive (or at least longer), or makes it easier to transmit the virus to another host, will keep the virus around.
Not necessarily[1]:
> Some viruses provoke severe symptoms in their hosts that make it easier to transmit the virus to others. But those same symptoms can wind up killing the hosts.
> Adalja said one example is Ebola, a deadly virus that spreads through the blood and body fluids of infected people. Another example is norovirus, which causes diarrhea and vomiting, and leads to hundreds of deaths each year in the U.S.
> “The virus, speaking anthropomorphically, just wants to spread and have its genes replicated,” said Adalja. “If the best way for it is to spread by causing severe symptoms it will continue to do that.”
I can't find the excerpt, but I read "The Great Influenza: The Story of the Deadliest Pandemic in History" by John M. Barry during this pandemic. It was an okay read if you're looking for something to pass the time.
There was a passage that suggested that virus evolutions happens all the time which sometimes gives us a super severe strain. But usually these super sever strains don't evolve into even more severe strains - generally they evolve back towards the "baseline" severity and the severe strain burns itself out.
From that, I had hope that the Delta variant of COVID was one of these outlier super severe strains and that all subsequent evolutions would fall back but it's not looking like that is the case when omicron was found.
I’ve heard that it depends on the virus. Some become less severe as they become more contagious, but sometimes their severity stays the same.
Naively, you’d think selection pressure would decrease severity, because severity is not how viruses spread. However, if (some of) the same mechanisms that ar causing the virus to spread better are also responsible for (some of) its severity, then things may not really get better over time —unless our immune systems themselves adapt, but that generally requires a first infection…
You are right about the trade-off: A more infectious, less deadly virus is the natural evolutionary path for them.
But about the breeding ground, not really: If one day some super deadly variant evolves, it's not popping up in all of the infected hosts at the same time. It'd still need to infect everyone from scratch, and since we all have our guard up right now, it'd definitely have an incredibly hard time doing so.
gjsman addressed the issue of severity very well, so I'll just comment on tradeoffs.
The adaptations that affect severity and those that affect transmissibility generally seem to be different. These are two axes on which a new variant can very in either way. The most successful new variants will tend to be highly transmissible (for obvious reasons) but also tend to be lower severity for the reasons gjsman gave in a sibling comment.
That's only a tendency though, evolution will throw up variants on all sorts of different points on the transmissibility and severity scales and may the most successful virus win. Yes high severity variants will tend to kill off their victims sooner, but if also highly infectious that might overcome that effect. In any case killing off victims still leaves a trail of devastation. It can take a while for all of this to play out.
Every single press title the last two years can be related somehow to a single Game. New variants, new mutations, spreading faster vs killing more people, ... All these tradeoffs are quite well modeled.
Building a resistance to vaccines ("the cure") is also one areas where your virus can evolve, and -to be honnest- I prefer it to fight vaccines than to develop a "total organ failure" mutation.
It's a game, not a model. Real mutations aren't directed or instantly spread to all infected people like in the game. Iirc people also don't get better once infected.
I would imagine that a virus would eventually adapt/evolve to a point to where it co-exists harmoniously with the host organism. I've heard somewhere that herpes simplex virus used to have terrible symptoms, like genital blisters, but over the years the most common variant has no symptoms, and most people have no idea they have it.... and a huge proportion of human have it.
I would imagine all viral contagions would eventually go that route. Because a virus cannot propagate if the host organism goes extinct, or for whatever reason the host organism is itself not fit for survival, or diminished in any way.... anything that might impact virus propagation.
I've read some where the common cold was probably a pandemic virus originally, and it mutated to a common cold we have today, and we mutually evolved to deal with the common cold. Something like that...
> If the patient is contagious before developing symptoms, the virus can spread very effectively even if many patients die.
For better or worse all that means is that viruses may evolve to delay their symptoms rather than overall peak severity if that's possible. It means still just as delay but with a good enough delay to spread.
I don't really see the selective pressure however for this virus to become more benign. It seems to have enough people to infect without it given how contagious it is. It doesn't really have to become more benign to allow even more spread.
Arguably covid is already less deadly, the majority of deaths are concentrated in older populations. Generally the disease isn't as impactful to those under 50, meaning its not interfering with your ability to have children or raise children.
DNA integration won't happen with COVID though, it's not a retrovirus so it stays as RNA. I dunno what coexisting looks like for such viruses - maybe like the common cold.
> I've read some where the common cold was probably a pandemic virus originally, and it mutated to a common cold we have today, and we mutually evolved to deal with the common cold. Something like that...
A factor that comes into play is the following. Diseases tend to be less dangerous to children. When a new disease emerges, no-one has immunity to it, so there's plenty of adults who may get it more severely. But, after a certain point, the people being born are exposed to that disease when they are young, where it won't affect them as badly.
This can look like the disease getting milder, but it's just that after a while most people will experience it when young when they will get milder effects from it. And after that point they'll have some immunity for it.
Viral evolution can go down that path, provided there are selection pressures that select for weaker viruses. Viral evolution can also not follow that path at all. Evolution doesn't have a chosen path, and it doesn't have an end-goal. Evolution is the name that we give to the effect that chance has on genetics.
The selection pressure that can select for weaker viral variants is the rapid and widespread deaths of viral hosts. The stronger viral variants literally die off in the hosts they kill, and can't keep spreading, whereas the viral variants that didn't kill their hosts before spreading their genes can keep replicating.
The majority of people with COVID do not die before spreading it to other people. That selection pressure isn't there for COVID, therefore there is nothing really stopping it from mutating into stronger variants. If it starts killing people like Ebola does, then the selection pressure for weaker variants might exist because a lot of hosts will die. Even in that case, it isn't a given that a highly fatal virus would mutate to become weaker. It could very well wipe out entire species and die off itself like the majority of species in the history of the Earth, or it could become endemic in a different species afterwards and live on.
All of this selection happens over evolutionary timelines, which span over many human lifetimes. If the virus becomes weaker, it could take many human lifetimes to reach that point.
From the AP's "Viruses can evolve to be more deadly" article[1]:
> “Becoming more transmissible and less lethal are absolutely what’s best for the pathogen,” said Day. “But the problem is that it’s not always possible, and in many instances is never possible, to be more transmissible and also less lethal.”
> Day said there are documented cases of animal viruses that evolved over time to become more lethal, including myxoma virus in rabbits and Marek’s disease in chicken.
> Some viruses provoke severe symptoms in their hosts that make it easier to transmit the virus to others. But those same symptoms can wind up killing the hosts.
> Adalja said one example is Ebola, a deadly virus that spreads through the blood and body fluids of infected people. Another example is norovirus, which causes diarrhea and vomiting, and leads to hundreds of deaths each year in the U.S.
> “The virus, speaking anthropomorphically, just wants to spread and have its genes replicated,” said Adalja. “If the best way for it is to spread by causing severe symptoms it will continue to do that.”
Yes; and additionally, there's non-sterilizing vaccine immunity at play. If the vaccines are highly effective at keeping people alive, but less effective at teaching the immune system to sterilize it as quickly as possible, that removes some evolutionary pressure which would naturally kill off more lethal mutations. In other words, a more lethal "viral payload" mutation could have its lethality kept in check by vaccines which are good at targeting the spike protein, until a second mutation comes around on that spike protein which better escapes the vaccines; or, simply, until it transmits to a population that is undervaccinated or has waning natural or vaccinated immunity and isn't getting revaccinated.
Given all the other mammal reservoirs that Covid has found, we're just probably the most numerous one and it won't bat an eye (pun intended) if we die off.
“
The study by Discovery Health, South Africa’s largest health insurer, of 211,000 positive coronavirus cases, of which 78,000 were attributed to omicron, showed that risk of hospital admissions among adults who contracted covid-19 was 29 percent lower than in the initial pandemic wave that emerged in March 2020.”
29% LOWER THAN OG COVID
In other words, a bad cold or the flu. This is possibly our way out of this mess if it can become the dominant strain, why are we still peddling fear about omnicron instead of hope?
If Covid was only 40% worse than the flu and the cold, then this wouldn't have been a pandemic at all.
Also, one thing that possibly distorts this study is that a large amount of South Africans got only vaccinated in recent months. Given that the vaccine is most effective in the beginning, this might positively affect South Africans's resilience against Omicron and it's not clear yet (afaik) to what extent that skewed the stats.
Out of curiosity, do we really require these studies? Like it is good to have more and more sources, but wouldn't the expected outcome to be the following:
- vaccines that replicated the spike protein will be less effective since omicron has a modified spike protein, because the immune system only was trained to notice the spike protein and not the payload
- naturally induced immunity from prior exposure to Sars-Cov-2 will be more effective because the body made immunity to the payload alongside the total viral shape
Yes, we need to know how severe the illness from this variant is.
It was never a question of transmission. When we got news from Norway where 120 vaccinated negative tested people came into the restaurant for a couple of hours and at least 60 of them came out with positive omicron test - it became clear that we are fucked. Also, news from South Africa, where two people were quarantined in a hotel their rooms was across the corridor, and virus got from one to another, despite they never get out, just opened the door to take food and make tests.
So it looks like everybody will have this variant in the next year, except maybe people in distant places. The question was how many will get seriously sick and how many of them will die. Looks like numbers will be lower than expected.
The virus can only modify the spike protein so much before the spike protein won't work to infiltrate cells any longer and go extinct. It appears that the body is forgetting how to make antibodies rather quickly the vaccines are still pretty effective even against omicron if relatively recent or a booster has happened.
Need wasnt the word I was really thinking, more about having more people predict the expected outcome accurately
there is fundamental knowledge involved here that colleges teach, and its good to know what the expected outcome is and how the studies conform to that expected outcome
the studies are conforming to the expected outcome, which is good
Omicron doesn't change fundamentally where we were with Delta. Its infection enough that everyone will get it. Vaccines protect you (they are banned for kids under 5). Pfizer's treatment (Paxlovid) is a very effective cure (currently banned). The death rate for vaccinated individuals is extremely low, at its current rate its about 26 per 100,000. The flu killed 24 per 100,000 in california.
We are at the endgame. These are the last things left to "end the pandemic", and they are all policy decisions: (1) allow peditricians and parents to decide if they want to vaccinate their under 5 year olds. (2) Stop banning Paxlovid (3) Stop any mandates, there just isn't the numbers to justify them. (4) Ensure people have reasonable rights to keep wearing masks or something in public.
It’s not “banned” it’s just not approved yet. The US is making plans to buy tons of it in advance. Banned has a very specific connotation that is wildly out of place.
Doesn't “not approved yet” fall into the opposite trap since it has the connotation that it's somehow justified / natural?
I think that it subtly masks the responsibility of our bureaucratic system. It is literally killing people by preventing them from having access to a potentially effective treatment (that would be accessible if not for this legislation / bureaucratic burden).
Due to this I think that “banned for now” is more appropriate. It highlights the fact that our legislative framework bans medicine by default (it could allow them by default in another world, and then selectively ban medicines that prove dangerous / ineffective).
If we're only looking at deaths, only for vaccinated people - then yes.
If hospitals still get overwhelmed, that seems like an issue. Unless you say hospitals shouldn't treat unvaccinated people (doubt it) - unvaccinated people are going to be causing problems on the hospital system for a while still.
We could have saved so many more lives. I remember midway through the first year (pre-vaccine) people arguing against mandates and masks and lockdowns, while severely underestimating the damage. One exchange I had here was from a person allowing that maybe they'd reconsider if we ever reached US deaths at something like 350,000, as if that were an astronomical figure.
And the vaccines... one thing I haven't found yet is an article that tries to make a well-studied estimate of where we'd be right now if the vaccine hadn't come out, or had been just a year later, or had the kind of (lower) efficacy that people were initially trying to set expectations for. In contrast to that, the kind of numbers I believe we would have seen or experienced... makes all our fighting about masks and mandates and lockdowns seem pretty irrelevant. I doubt we can even fathom the difference.
> And the vaccines... one thing I haven't found yet is an article that tries to make a well-studied estimate of where we'd be right now if the vaccine hadn't come out, or had been just a year later, or had the kind of (lower) efficacy that people were initially trying to set expectations for.
At the beginning of the pandemic, I saw an estimate of projected deaths from COVID in a scenario where mitigations were taken and in another scenario where none were taken. It was the difference between projecting 300k to 600k dead in the US after more than a year, and 2 million to 6 million dead in the US.
Hospitalizations and deaths lag behind cases, mortality shoots up above some case load threshold (hence attempts to flatten the curve), etc. Feels like most people skipped their 2020 homework.
Aside from that, most countries are not even on pace to triple vax their population by end of winter, so letting it rip is a not an option. The countries currently led by populists will lock down just like the rest, only later and with more deaths.
Food for thought: Has China changed their pandemic strategy? Why not?
Can't speak for the US, but e.g. generally Norwegian teachers aren't allowed to wear masks at work. Unless things have happened behind the scenes that I'm not aware of, this is under threat of being fired, although I doubt anyone has actually been fired over it.
Surely there must be other professions with similar rules, or cultural quirks to the same effect.
Austria has made it illegal to hide your face in public. They did this to effectively stop women from wearing Burkas but because of equality principles they couldn't spell it out like that. Instead they added lots of exceptions (scarfs, carnival, sports, street artists, etc.) It's ridiculous.
we don't know yet that omicron won't help more than it hurts if catching it helps with future infections, say delta comes around to those who aren't yet vaccinated
Readit News
The mRNA vaccine technology is "agile". There's a workflow from sequencing a virus to generating a candidate vaccine. It only took two days to generate the original COVID-19 vaccine. It's the clinical testing in small, then large groups that's the time consuming part.
Also, the inhaled vaccines are entering clinical testing.[2] It's not like we're stuck with the original vaccines.
[1] https://www.cnbc.com/2021/11/28/moderna-says-an-omicron-vari...
[2] https://www.thetimes.co.uk/article/e1637976-5c3f-11ec-90d0-c...
Yes and this means governments can quickly adapt to new variants by reformulating the vaccine, dumping old stock by "donating" it to developing nations, or dumping it, and buying new stock from big pharma.
Since developing nations will always have far lower vaccination rates than first world countries, the virus will continue to mutate and proliferate outside of America and Europe, ensuring new opportunities for revving the vaccine.
That's a sustainable business model for the first world.
A primary complaint is that “rich nations” hoard vaccines. doesn’t this exacerbate this?
I can deploy an app to Azure, tell it to allocate a server farm, databases, Redis, queues, etc... in 5 minutes too. But that's only because someone took years to do all the necessary work.
https://finance.yahoo.com/screener/insider/BANCEL%20STEPHANE...
Too much profit? Sure. I don't think the boosters are going to be what solidifies that issue for corporations though..
Some timing issue with selling? I don't see it.
0: https://www.secform4.com/insider-trading/1443340.htm
Dead Comment
And I suspect that countries which want to implement mandatory vaccination like Austria and perhaps Germany will force people to get the now worthless first and nearly worthless second doses of the original vaccine, because anything else won't be available.
First: "The study by Discovery Health, South Africa’s largest health insurer, of 211,000 positive coronavirus cases, of which 78,000 were attributed to omicron, showed that risk of hospital admissions among adults who contracted covid-19 was 29 percent lower than in the initial pandemic wave that emerged in March 2020."
and second: "At the same time, the vaccine may offer 70 percent protection against being hospitalized with omicron, the study found, describing that level of protection as “very good.”"
Yes the vaccine does improve outcomes BUT the hospitalization rate for unvaccinated people is still lower with Omicron than previous variants.
Comparing to an earlier wave is hopelessly confounded on prior infections in the intervening time and similarly, on the most susceptible having already been killed off.
Maybe they did what I'm suggesting and its mostly just bad reporting?
edit from the summary :-/ :
Vaccine effectiveness:
Now the next question is what is the percentage reduction in deaths for Omicron vs prior variants. It seems like more than the 29 percent reduction in hospitalisation given the first death from Omicron was reported in Britain last week right?
So it could simply be that the mild cases were previously infected, what happens to an unvaccinated without prior infection is a different story.
I’m going to wait for severity data from where I live, because that’s what matters.
No it's not, the study specifically mentions "the relative reduction of risk conferred by prior proven COVID-19 infection"
https://www.discovery.co.za/corporate/news-room
There are these estimates that ~80% of SA had Covid.
If so - previous variants were 1/4th as severe - since 3/4ths of the cases went undetected... Right?
Of all people, the YC News crowd really ought to understand that O(exp(n)) overwhelms O(1) literally exponentially. Not figuratively. Literally.
If a virus variant has a constant factor reduction in its side-effects, but a higher exponential factor in infectiousness, the latter will overwhelm the former in short order, and then continue to overwhelm it even more. Exponentially.
Let me do some simple maths assuming that it spreads "just" twice as quickly as Delta.[1] Lets assume that at some point, Omicron will be the primary strain, and there are 29% less patients in hospital because of it. Assume the doubling-time of Delta is 1 month. (It's better or worse than this depending on circumstances, but start here.) The doubling time of Omicron is then 2 weeks.
So with Delta you have: 1.0 == .71 * 2^(t/30d) which solves to about 15 days to get back to a full hospital.
With Omicron the equation is 1.0 == .71 * 2^(t/14d) which means it'll be back to a full hospital in just 7 days. Then the hospitals will be at 200% capacity in 21 days, 300% capacity at 29 days, and 1000% of capacity in just 53 days.
Of course, the full mathematical model is more complicated, typically something like SEIHRD, but the point is that a mere 29% reduction in mortality is next to nothing compared to an exponential increase in infectiousness. It would have to be more like 90% less dangerous for that to matter at all in the long run.
[1] https://www.forbes.com/sites/masonbissada/2021/12/03/scienti...
The difference will be in timing; the people will have been infected more quickly, with the (severe) problems that entails.
Why "BUT"? Shouldn't the second part be, uh, a good thing?
[1]: https://www.medrxiv.org/content/10.1101/2021.11.18.21266496v... [2]: https://www.medrxiv.org/content/10.1101/2021.12.04.21267114v...
In this very specific demographic. Other countries will have different outcomes, as seen with the current state of the pandemic (looking at Europe, for example).
If we convert the measure used in finding 2 (relative risk of reinfection) to finding 1's (relative protection), then the study found that natural immunity from Delta variant gives 60% protection against Omicron; roughly double the vaccine's protection.
Unfortunately, no stat was given for natural immunity's protection against hospitalization.
From finding 1: individuals who received two doses of the Pfizer-BioNTech vaccine had 33% protection against infection, relative to the unvaccinated
From finding 2: People who were infected with COVID-19 in South Africa’s third (Delta) wave face a 40% relative risk of reinfection with Omicron
Am I reading this right? Wonder why they used different metrics?
0: https://www.discovery.co.za/corporate/news-room#/pressreleas...
Deleted Comment
I am hoping that it would be some kind of trade off that the virus makes in that it can spread more easily but not be as severe (I understand that it is unlikely nature requires a trade-off). I ask as my concern is that while this variant might be much more effective at spreading and hopefully less severe in its disease - are we not just making a massive breeding ground for the variant after this one that could potentially be as quick spreading but with a greater severity of disease?
It might still trend towards that over time, but it will probably be slower at it than other viruses, and thus the 'it gets milder over time' aphorism about viruses doesn't apply as strongly to Covid-19.
Another pressure is social response to infection: so far, the predominant response to a more-virulent or more-lethal strain has been lockdown and/or other behavioral change, see: delta in India. On the flip side, a variant that causes milder symptoms is less likely to cause the same social response, which allows the virus to spread more widely.
This may (may!) be what we’re observing with Omicron. In any case, we’ll know much more in a few weeks.
A new variant need only replicate slightly faster to dominate (eventually).
First, evolutionary pressure will select for a lower dormancy period, i.e. a lower time to contagion. This is because a variant with a shorter dormancy will spread faster than one with a longer dormancy period if both are present in the same population. This is also exactly what happened with the Delta variant, which is asymptomatic generally for a shorter period[1] than the original variant, because it replicates faster.
Second, the usual process occurs for the usual reasons. This may be happening with Omicron.
[1]: https://www.health.govt.nz/our-work/diseases-and-conditions/...
Deleted Comment
Viruses evolve according to evolutionary pressures. I'm surprised we don't see Covid mutations that invalidate PCR tests - perhaps it's too soon, or even, who knows, maybe they are there and we don't know?
The common trope is that if the virus is too deadly, then it doesn't have a chance to find new hosts. This is kind-of what happened to "SARS-1" - it tended to kill its hosts before they could pass it on.
Unfortunately, this is only a weak effect in Covid. Most of the spread happens well before people are very ill; in terminal stages of severe Covid, many people in fact would test negative for virus presence. So there is little evolutionary pressure on the virus to be less deadly - by the time it kills people, we are spent vessels from its point of view.
I suppose a mutation that makes it completely benign would be beneficial, as current rules on self-isolation curb the spread of strains causing symptomatic disease.
There are pressures that make it more deadly: a mutation leading to higher viral load is both more deadly and more transmissible. So unless the transmissibility increases too much (and virus is way too deadly), we might even expect the virus to become more deadly. This hasn't happened yet, thankfully.
An example I used elsewhere was the introduction of Myxomatosis in Australia, to control the invasive rabbit population. Over time, the local strain evolved to be more deadly, but with a longer incubation periods. This way, bunnies had more time to pass the virus around, then once that job was done, the virus was happy to kill them off.
On the flipside (and very long timescales), since some people appear to be genetically more resistant to the virus, you can expect natural selection to do its job. But since overall death rate from Covid is low-ish (no more than 1%, you'd say, and skewed towards older, non-reproducing individuals) this would take a long time.
Another hope is that, if the disease is less serious in children, perhaps immunity it built up during the usual period of childhood infections. There is another coronavirus, which causes a mild cold in children, but can be very serious in adults (apologies, I can't remember what it's called). Thankfully, a single infection gives more-or-less complete lifetime protection - so most people have it as children and never worry about it again.
In either of these cases, we're talking about generational timescales.
A variant that infects more people from a single host (assuming everything else held constant) is a positive selective pressure. So increasing the contagious period is beneficial. But the length of the contagious period is inversely related to the timing and strength of the immune response. So we should expect the virus to become less deadly over time, assuming there's a hard limit to its ability to evade a typical immune system.
The people who design the tests know which parts of the sequence are more likely to mutate, so they pick the more conserved parts. Also, most PCR tests check for 3 different parts of the sequence. Which is why Omicron can still be detected even if there is a mutation in one part checked by the test, since the other 2 parts still match (the so called S-gene-dropout).
https://www.theguardian.com/world/2021/dec/07/scientists-fin...
Do you have other examples besides Myxomatosis?
Quick nit: while this is true, SARS-1 was also not particularly transmissible before symptoms appeared, in contrast to Covid, which made control much easier (in addition to the much higher fatality rate causing everyone to take it much more seriously).
PCR tests for RNA or DNA, that's not something a mutation can change. I don't know for Covid, but usually a PCR test targets something fundamental & stable. That might need to be updated with new variants.
https://www.smithsonianmag.com/science-nature/how-viruses-ev...
https://pubmed.ncbi.nlm.nih.gov/30734920/ (really good one)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255208/
In short, we don't know and won't know until this is all "over" a few years in the future, at least.
Edit: The result of this, if you look at previous diseases that have plagued humanity (see Black Death), is a high initial death count when the virus breaks out, but the death rate declines as the milder variants spread and people survive them, building immunity to stronger versions, until eventually the virus mostly disappears.
I have been basing a lot of my virus information from Tomas Pueyo. Here is my source:
https://unchartedterritories.tomaspueyo.com/p/the-omicron-qu...
In this article he clarified that generally viruses that spread more are less severe (as killing the host makes it tougher to spread). The asymptotic nature of Covid sort of broke this assumption because Covid can lie dormant in someone for a week before the person shows severe illness
It takes far less than death to reduce spread. People who feel sick stay home from work (not guaranteed, but with enough frequency that it matters), don't go out to eat, don't wander around and go to parties, and so on. Any time they're sitting home, they've hurt the chances that their variant is the winning-est variant.
Again with the caveat about dormancy periods for Covid.
Also, those who do not get symptoms (that is, most who catch covid) do not spread the virus in general, which is why it's now called "presymptomatic" spread.
Didn't we learn anything from Plague Inc?
If severity means the host dies quickly rather than slowly, there's obviously selection pressure and that mutation will die off relatively quickly vs the rest, since it won't have as many chances to spread as the less severe strain. E.g. SARS/MERS.
If severity means the host dies more often, but it still takes a long time to die, the selection pressure is much lower, and it will roughly spread the same as the less severe strain, all other things being the same. E.g. Spanish Flu.
Deleted Comment
I've definitely seen outlets postulating that the endgame for COVID-19 would be it doing exactly this— becoming way more contagious but way less severe, basically a just a kind of cold. These "final" variants would quickly spread everywhere, choking off the supply of new hosts for the more deadly variants, effectively achieving herd immunity.
Not necessarily[1]:
> Some viruses provoke severe symptoms in their hosts that make it easier to transmit the virus to others. But those same symptoms can wind up killing the hosts.
> Adalja said one example is Ebola, a deadly virus that spreads through the blood and body fluids of infected people. Another example is norovirus, which causes diarrhea and vomiting, and leads to hundreds of deaths each year in the U.S.
> “The virus, speaking anthropomorphically, just wants to spread and have its genes replicated,” said Adalja. “If the best way for it is to spread by causing severe symptoms it will continue to do that.”
[1] https://apnews.com/article/fact-checking-011488089270
Deleted Comment
There was a passage that suggested that virus evolutions happens all the time which sometimes gives us a super severe strain. But usually these super sever strains don't evolve into even more severe strains - generally they evolve back towards the "baseline" severity and the severe strain burns itself out.
From that, I had hope that the Delta variant of COVID was one of these outlier super severe strains and that all subsequent evolutions would fall back but it's not looking like that is the case when omicron was found.
Naively, you’d think selection pressure would decrease severity, because severity is not how viruses spread. However, if (some of) the same mechanisms that ar causing the virus to spread better are also responsible for (some of) its severity, then things may not really get better over time —unless our immune systems themselves adapt, but that generally requires a first infection…
As viruses evolve they generally have 2 paths of evolution – they either become more deadly, or more contagious.
The ones that become more deadly will kill the host quicker, and so won't have enough time to spread to others.
The ones that become more contagious are by definition weaker, they will spread to more people, but the effects will be milder.
There are some theories to suggest that pandemics (like the Spanish flu) ended because the virus eventually mutated to a milder, more contagious form.
But about the breeding ground, not really: If one day some super deadly variant evolves, it's not popping up in all of the infected hosts at the same time. It'd still need to infect everyone from scratch, and since we all have our guard up right now, it'd definitely have an incredibly hard time doing so.
The adaptations that affect severity and those that affect transmissibility generally seem to be different. These are two axes on which a new variant can very in either way. The most successful new variants will tend to be highly transmissible (for obvious reasons) but also tend to be lower severity for the reasons gjsman gave in a sibling comment.
That's only a tendency though, evolution will throw up variants on all sorts of different points on the transmissibility and severity scales and may the most successful virus win. Yes high severity variants will tend to kill off their victims sooner, but if also highly infectious that might overcome that effect. In any case killing off victims still leaves a trail of devastation. It can take a while for all of this to play out.
Every single press title the last two years can be related somehow to a single Game. New variants, new mutations, spreading faster vs killing more people, ... All these tradeoffs are quite well modeled.
Building a resistance to vaccines ("the cure") is also one areas where your virus can evolve, and -to be honnest- I prefer it to fight vaccines than to develop a "total organ failure" mutation.
I would imagine all viral contagions would eventually go that route. Because a virus cannot propagate if the host organism goes extinct, or for whatever reason the host organism is itself not fit for survival, or diminished in any way.... anything that might impact virus propagation.
I've read some where the common cold was probably a pandemic virus originally, and it mutated to a common cold we have today, and we mutually evolved to deal with the common cold. Something like that...
If the patient is contagious before developing symptoms, the virus can spread very effectively even if many patients die.
For better or worse all that means is that viruses may evolve to delay their symptoms rather than overall peak severity if that's possible. It means still just as delay but with a good enough delay to spread.
I don't really see the selective pressure however for this virus to become more benign. It seems to have enough people to infect without it given how contagious it is. It doesn't really have to become more benign to allow even more spread.
Age and Date Data: [https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm#Se...]
Deleted Comment
Well, how much of our own actual DNA is nothing but virus DNA that got stuck in there for nigh eternity?
Answer: 8%.[0]
[0] https://www.cshl.edu/the-non-human-living-inside-of-you/
A factor that comes into play is the following. Diseases tend to be less dangerous to children. When a new disease emerges, no-one has immunity to it, so there's plenty of adults who may get it more severely. But, after a certain point, the people being born are exposed to that disease when they are young, where it won't affect them as badly.
This can look like the disease getting milder, but it's just that after a while most people will experience it when young when they will get milder effects from it. And after that point they'll have some immunity for it.
The selection pressure that can select for weaker viral variants is the rapid and widespread deaths of viral hosts. The stronger viral variants literally die off in the hosts they kill, and can't keep spreading, whereas the viral variants that didn't kill their hosts before spreading their genes can keep replicating.
The majority of people with COVID do not die before spreading it to other people. That selection pressure isn't there for COVID, therefore there is nothing really stopping it from mutating into stronger variants. If it starts killing people like Ebola does, then the selection pressure for weaker variants might exist because a lot of hosts will die. Even in that case, it isn't a given that a highly fatal virus would mutate to become weaker. It could very well wipe out entire species and die off itself like the majority of species in the history of the Earth, or it could become endemic in a different species afterwards and live on.
All of this selection happens over evolutionary timelines, which span over many human lifetimes. If the virus becomes weaker, it could take many human lifetimes to reach that point.
From the AP's "Viruses can evolve to be more deadly" article[1]:
> “Becoming more transmissible and less lethal are absolutely what’s best for the pathogen,” said Day. “But the problem is that it’s not always possible, and in many instances is never possible, to be more transmissible and also less lethal.”
> Day said there are documented cases of animal viruses that evolved over time to become more lethal, including myxoma virus in rabbits and Marek’s disease in chicken.
> Some viruses provoke severe symptoms in their hosts that make it easier to transmit the virus to others. But those same symptoms can wind up killing the hosts.
> Adalja said one example is Ebola, a deadly virus that spreads through the blood and body fluids of infected people. Another example is norovirus, which causes diarrhea and vomiting, and leads to hundreds of deaths each year in the U.S.
> “The virus, speaking anthropomorphically, just wants to spread and have its genes replicated,” said Adalja. “If the best way for it is to spread by causing severe symptoms it will continue to do that.”
[1] https://apnews.com/article/fact-checking-011488089270
There is no intelligence making this decisions, its just some random mutations, so we cannot predict what path the virus will take.
29% LOWER THAN OG COVID
In other words, a bad cold or the flu. This is possibly our way out of this mess if it can become the dominant strain, why are we still peddling fear about omnicron instead of hope?
If Covid was only 40% worse than the flu and the cold, then this wouldn't have been a pandemic at all.
Also, one thing that possibly distorts this study is that a large amount of South Africans got only vaccinated in recent months. Given that the vaccine is most effective in the beginning, this might positively affect South Africans's resilience against Omicron and it's not clear yet (afaik) to what extent that skewed the stats.
Edit: after looking at sources again I’m no longer quite as confident that flu is significantly worse, but covid is definitely not 10x worse for kids: https://data.cdc.gov/widgets/9bhg-hcku?mobile_redirect=true
- vaccines that replicated the spike protein will be less effective since omicron has a modified spike protein, because the immune system only was trained to notice the spike protein and not the payload
- naturally induced immunity from prior exposure to Sars-Cov-2 will be more effective because the body made immunity to the payload alongside the total viral shape
It was never a question of transmission. When we got news from Norway where 120 vaccinated negative tested people came into the restaurant for a couple of hours and at least 60 of them came out with positive omicron test - it became clear that we are fucked. Also, news from South Africa, where two people were quarantined in a hotel their rooms was across the corridor, and virus got from one to another, despite they never get out, just opened the door to take food and make tests.
So it looks like everybody will have this variant in the next year, except maybe people in distant places. The question was how many will get seriously sick and how many of them will die. Looks like numbers will be lower than expected.
Someone needs to check if masks and cloths over nose and face still have moderate effectiveness in densely populated areas.
This seems like a pretty big assumption TBH, and something that needs study. Is it better? How much? Why? How long does it last?
there is fundamental knowledge involved here that colleges teach, and its good to know what the expected outcome is and how the studies conform to that expected outcome
the studies are conforming to the expected outcome, which is good
We are at the endgame. These are the last things left to "end the pandemic", and they are all policy decisions: (1) allow peditricians and parents to decide if they want to vaccinate their under 5 year olds. (2) Stop banning Paxlovid (3) Stop any mandates, there just isn't the numbers to justify them. (4) Ensure people have reasonable rights to keep wearing masks or something in public.
I think that it subtly masks the responsibility of our bureaucratic system. It is literally killing people by preventing them from having access to a potentially effective treatment (that would be accessible if not for this legislation / bureaucratic burden).
Due to this I think that “banned for now” is more appropriate. It highlights the fact that our legislative framework bans medicine by default (it could allow them by default in another world, and then selectively ban medicines that prove dangerous / ineffective).
That’s likely what’s going on here.
If hospitals still get overwhelmed, that seems like an issue. Unless you say hospitals shouldn't treat unvaccinated people (doubt it) - unvaccinated people are going to be causing problems on the hospital system for a while still.
And the vaccines... one thing I haven't found yet is an article that tries to make a well-studied estimate of where we'd be right now if the vaccine hadn't come out, or had been just a year later, or had the kind of (lower) efficacy that people were initially trying to set expectations for. In contrast to that, the kind of numbers I believe we would have seen or experienced... makes all our fighting about masks and mandates and lockdowns seem pretty irrelevant. I doubt we can even fathom the difference.
At the beginning of the pandemic, I saw an estimate of projected deaths from COVID in a scenario where mitigations were taken and in another scenario where none were taken. It was the difference between projecting 300k to 600k dead in the US after more than a year, and 2 million to 6 million dead in the US.
Aside from that, most countries are not even on pace to triple vax their population by end of winter, so letting it rip is a not an option. The countries currently led by populists will lock down just like the rest, only later and with more deaths.
Food for thought: Has China changed their pandemic strategy? Why not?
When was that ever forbidden, except on demonstrations?
Surely there must be other professions with similar rules, or cultural quirks to the same effect.