U.S. Omicron Happy Talk v. Britain and Israel’s tough restrictions

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It is frustrating to see Omicron’s optimistic statement because its knowledge is far from sufficient to make a firm assessment, except for its delta-trouncing transmission rate.As we emphasized in the first article, when the variant has not yet been named (save as B.1.1.529), we warn The precautionary principle means that what appears to be an overreaction is the correct response.

On the contrary, U.S. officials and the media downplayed Omicron, which has had some success since a few days ago, and most people have not even heard of it:

In the past few days, two news have spread widely in the United States. One is that three doses of Pfizer vaccine will provide protection against Omicron, which is mild. We will process them in order. The first tidbit is from Pfizer and requires a handful of salt. The second is dangerously premature at best and is based on anecdotal reports of skewed samples.

General Motors made a useful contribution to Pfizer’s spin manufacturing yesterday morning:

Regarding “VAX VAX VAX”, Pfizer just held a press conference an hour ago and they announced loudly that three doses of wild-type vaccine can protect you from Omicron.

Although yesterday’s third preprint showed the opposite—most people who took three doses of Pfizer were below the detection limit within 3 months.

It seems that this incident was immediately photographed by the media, and it exploded from all directions…

Four different neutralization studies came out yesterday. We will only pay attention to and believe in the most optimistic ones, which happen to be the only ones with huge conflicts of interest?

Somehow, the media managed to erase the warning from the CEO of Moderna that he doesn’t think the current vaccine is very effective for Omicron. We point out that Moderna is the most honest report in the scientific community, not only among vaccine manufacturers but also among public health officials.

Although the plural form of anecdote is not data, remember that the first three cases in Israel were all on drug users. Remember that Israel is Pfizer’s single culture. The story of the first case in Israel shows that Pfizer’s three injections did not prevent infection or infection. Even so, the patient got moderate rather than mild cases. From the Jerusalem Post:

[Dr. Elad] Maor tested positive for COVID-19 on November 28 and was diagnosed with the mutation a few days later. He received three doses of Pfizer’s coronavirus vaccine.

The variant hit Maor more than he expected, causing 48 hours of fever and 72 hours of extreme fatigue. He said he also had muscle aches.Even now [ten days later], Maor said he did not change his mind.

The article reported that Maor spread Omicron to another person who was “completely stabbed”, which means three shots in the context.

Some early data from Denmark:

The fact that infection is directly proportional to the level of vaccination in the population means that, broadly speaking, existing vaccines cannot provide protection against Omicron infection.

GM provided some additional intelligence via several emails:

It is obvious from what happened in Gauteng-most hospitalizations were re-infections, but the first infection was never recorded.

In addition, they still have at least 20% of people vaccinated in the hospital, and most people vaccinated there are not only vaccinated, but also vaccinated on the basis of undocumented previous infections. So I don’t have too much hope for the ability of “mixed immunity” and 3 doses to prevent catastrophic situations-of course it won’t be as bad as in a completely naive population, but it will reduce some surprisingly large numbers for you. Another surprisingly large number…

After 25 weeks after the second vaccination, when the vaccine’s effectiveness against infection diminishes to zero:

https://www.medrxiv.org/content/10.1101/2021.08.25.21262584v1

The effectiveness of vaccines against serious diseases has dropped to 71%, but the interval is very large

So this is the absolute upper limit of Omicron.

But it may be worse, because one of the mechanisms behind the original vaccine 71% VE is to wake up memory B cells and prevent uncontrolled replication of the lower lung. But for Omicron, we don’t have those B cells, because Omicron’s spikes are very different, and we don’t have many memory B cells to fight it…

In any case, no one can give everyone three doses on time-even in highly drug users, this situation doubles every 3-4 days. There are already at least one million infected people in the world. At this rate, most people will be well-infected within the 100 days needed to obtain the Omicron vaccine (not to mention distribution), and given how to get the third dose of the vaccine, up to 10-15% of people will get any benefit The third dose is being injected quickly outside Israel and in some other places. So it was either locked or everyone caught it.

Now to the “Oh, but not bad” meme. First, it was spread without any evidence. A South African doctor was mistakenly described as “discovering” Omicron (no, that was Dr. Thomas Peacock from Imperial College London, who posted his findings on GitHub ) And selected reviews:

The doctors admitted that these comments were actually based on the clinical impressions made in the first two weeks of the patients admitted to the Tshwane district (n=166). They just guessed which is Delta or Omicron, because they couldn’t screen the S gene. However, the admission rate has shifted to young people (in the past 80% were over 50 years old, now 19% are 0-9 years old, and 28% are 30-39 years old), the rate of pneumonia has fallen, and the average length of hospital stay.

The author warns that this is only the first two weeks and the situation may change. They also pointed out that the province has a high RSA infection rate, with 57% of people over 50 and 34% of people aged 18-49, while the overall proportion of all RSA populations is 26%.

My concern is that no one has good enough data to draw correct inferences. The biggest question here is why there are so few elderly patients? Remember, the seroprevalence of RSA is about 70% to 80%, which means that most people have been infected with Covid. This means that most cases are asymptomatic. RSA has never seen a Covid hospitalization in people aged 0-9 years before.

Therefore, the analysis that can provide more insight is:

1. Age stratified hospitalization results. Young people are stronger. If you compare your current hospitalization results (days in hospital, percentage of supplemental oxygen required) and cases under Delta by age group, the results may not be much different.

2. The ratio of symptomatic and asymptomatic cases between Delta and Omicron. This is something we cannot obtain, but we need to understand what is happening. Compared to the symptomatic Delta cases, don’t those (the average level so far) look so bad? However, if the proportion of infected people who use Omicron is higher than those who use Delta, then “not bad” is illusory, because the proportion of illness is higher (eg “mild” symptoms are worse than “no symptoms” , And a large number of mild infections instead of previous absence of symptoms may mask the average increase in severity).

Deepti Gurdasani provided a cautious but appropriately focused response. I strongly recommend that you read the entire Twitter storm. Some key bits:

In the United Kingdom, Boris Johnson, contrary to the normal form of the Conservative Party, will implement new restrictions starting from next Monday, which has curbed Christmas and fourth-quarter profits. From the Financial Times:

Boris Johnson announced comprehensive coronavirus restrictions on Wednesday to combat the rapid spread of Omicron variants as he apologized “unreservedly” for a leaked video showing his assistant Joking about the Christmas party during the lockdown.

The new restrictions in England include guidance on working from home from Monday, and from Friday, all indoor places except bars and restaurants must wear masks.

Covid-19 passports will be introduced to large indoor and outdoor gatherings, and Johnson also proposed the idea of ??intensifying vaccination to avoid endless loop restrictions…

Johnson defended the new restrictions by saying that he described them as “appropriate and responsible.” He said: “We know that the ruthless logic of exponential growth can lead to a substantial increase in hospital admissions, so sadly the increase in deaths.”

Allowing people to stay open in bars and restaurants may seem foolish, but maybe other restrictions will reduce attendance. But to my surprise, the United Kingdom did not impose restrictions like the first wave of Michigan, requiring customers to wear masks before food and drinks arrive. This will shorten the infection time to a certain extent.

Israel took a less compelling move, Extend the quarantine period for Omicron cases from the first 10 days to 14 days.

As I have always said, it would be better if I was wrong, but now is not the time to give up caution. IM Doc reported that two patients in his hospital refused to determine whether they had Omicron, but they both accepted vaxxed and boosted, and were in good general health, were sick enough to warrant doing something, and both received zero benefit from Regeneron . Recall that it was predicted from the beginning that monoclonal antibodies would fail on Omicron. So far, the early observers have been proven correct.



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