How Bad Is Omicron?
nature.com
nature.com
We should all be hoping that severity takes a hit.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252012/
Fortunately we now have vaccines and other treatments which can significantly reduce the death toll.
If you have too severe of a virus, then all its hosts are killed and it can't live on. Too weak of a virus and the host's immune systems will kill it before it has a chance to transmit.
Increased viral load in the asymptomatic phase increased virality, but also increased deadliness once the symptoms started. At least that’s what I recall reading. Normally you’re correct, but it doesn’t necessarily need to be that way.
Hopefully we’re lucky and it’s both way more transmissible and way less deadly, but no one knows yet.
Ever played "Plague Inc" ?
Its a fascicle way to show how this model is unlikely to play itself out in todays hyper mobile population.
The real concern is if we're currently in the "still getting worse before it gets better" part of the timeline.
We're all waiting to see how many severe hospitalizations occur w/ a large enough population.
That's sort of a rule-of-thumb, not a fixed law. In the case of covid there's a relatively long period of time (up to several days) in which people can spread the virus without yet showing symptoms. As such there isn't a lot of evolutionary pressure for it to become less virulent.
But I wonder: isn't a random mutation unlikely to improve on any of its profiles (transmissibility or lethality)? If so a more transmissible virus is unlikely to also be more lethal.
What if (not sure) a random mutation actually tends to do slightly worse? Then more transmissible viruses tend to be less lethal over time.
Sure we still get more lethal mutations from time to time, but the more transmissible ones are the ones which win out.
indeed, but subsequent success or failure does. Mutation and selection. Mutation prepares the pool to sieve the successful ones.
Whether that outweighs the randomness you describe I don't know. Maybe nobody knows for this virus?
I also heard the opposite thesis btw, higher transimissibility might sacrifice something in terms of lethality. Like you can't really add much as I'm not an expert.
If the lethality of Covid were to drop to seasonal flu levels there wouldn’t be anywhere near the amount of research into medical interventions nor would we feasibly maintain our current levels of public health interventions.
> The people have dramatically altered their behavior on a global scale (on average anyways) because of COVID’s lethality. There is absolutely selective pressure in that dimension.
This reads to me: "Covid is certainly more lethal than the average flu, therefore is undoubtedly getting less lethal" (effect of selective pressure). It doesn't make much sense.
> there wouldn’t be anywhere near the amount of research into medical intervention
Right, how's that has to do with whether there's selective pressure or not?
It almost feels like you are attributing a different meaning to "selective pressure", but cannot understand which one.
Selective pressure is anything that disrupts replication. If people take measures to prevent spread of a disease that’s literally selective pressure. I don’t understand what is confusing about that concept.
> there's no selective pressure for it to become less lethal.
> If people take measures to prevent spread of a disease that’s literally selective pressure.
How trying to slow down its spread can "force" it to become less lethal?
The only possible answer is that lower lethality gives it more time to spread around right?
It turns out Covid has a long incubation period, in fact plenty to use the host to infect other people.
Tl;dr: Given the length of the incubation period a less lethal virus would not gain much in terms of its ability to spread. That's the thesis I'm hearing.
The virus behind Marek's disease in chickens hasn't gotten less severe over time, it's gotten much, much more severe, as an example. HIV does not seem to have gotten less severe, nor smallpox.
Here's some introductory material:
https://www.pbs.org/newshour/science/tthis-chicken-vaccine-makes-virus-dangerous
https://www.nationalgeographic.com/science/article/leaky-vaccines-enhance-spread-of-deadlier-chicken-viruses
https://www.youtube.com/watch?v=haRMKsI-jKY
https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1002198
https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1002236Edit: add masks
A virus doesn't want anything. It just exists and, if the environment is amenable, reproduces with mutations.
My comment is in response to a 100% scientifically false statement. It's like saying that heat flows from cold to hot. Saying that viruses "want" is as false as that, if not worse.
The correction I posted is 100% scientifically correct, does not personally attack anyone and isn't even pedantic. Are we in favor of misinformation now?
To be fair, articles like this one [0], don't help when they get loose with language and say things like "SARS-CoV-2 is one smart virus". Ironic, when the site's tagline includes the term "academic rigor".
At one point in the article they say:
"Of course, viruses and bacteria don’t have brains so they don’t “think,” per se. But like all life forms, these particular living creatures are trying to maximize their chances of reproducing and having their offspring survive and reproduce."
That starts out well. The first sentence is accurate. The second sentence is false as can be. A sad failure for a publication that claims to have "academic rigor".
Viruses don't "try" --which implies a directed objective, thought, intent, goals-- to do anything. Evolution is brutally simple and ridiculously stupid. It has no intent. It has no objectives. I doesn't say "let's make an eye" for a million years until done. It just happens. I know this is hard for some to understand, yet this is the truth.
I can understand how people who have not studied and understood the scientific theory of evolution by natural selection can develop false ideas about how it works, particularly when exposed to material, such as this article, that mix false statements with accurate information.
That second word, understood, is important. Every high school student learns about evolution. I don't think I can say most of them understand it.
SARS-CoV-2 is as smart as a key with 30,000 teeth. Evolution is a process with stochastic mutation that cuts the teeth in different configurations. If a given configuration happens to be effective at penetrating human defenses and do damage, it can be serious. Other configurations could penetrate and have little to mild effects (this, so far, appears to be the case with Omicron). And yet others could be completely ineffective. The mutation isn't directed, it's stochastic.
Above all, I think rigor is important because, without it, crazy ideas like "intelligent design" can find footholds that can be used or further distorted to support them.
[0] https://theconversation.com/think-like-a-virus-to-understand...
In spite of some propaganda trying to instil the epistemological blasphemy that called anecdotal phenomena irrelevant, "some of us know people directly" to have the notion that consequences should not be taken lightly. And this is valid for the bad-lottery tickets in both infection and vaccination. The risk averse have material for concern.
The idea of facing issues with exhaustion and worsened mental health for months on end sounds like a nightmare.
My wife got hit pretty hard (no hospital though). She would up with a cough too, but the worst part has been headaches. Worst headaches of her life for almost 3 weeks. Thankfully, they seem to be getting more intermittent and less intense.
I’m all for vaccines and safety measures, but feel really burnt out by the situation.
Get to >90% population immunity. For now, it seems that's around the level that hospitalizations and deaths are manageable.
Evolution does not have objectives like "let's make an eye" or "let's get worse". Organisms mutate and either thrive and reproduce (with mutations) or die off over time.
Because of this, I think the answer to your question is: There is no way to know.
There might be epidemiologists or researchers on HN who could offer a different perspective. I am sure there are other mechanisms at play. There's also understanding the statistical behavior of mass infections.
And press GO button on your life. Living in fear is so 2001.
So let's hope!
Even the present death rate for the untreated (at ~3%) would historically be quite weak for an epidemic. I'm not sure it would even make history books (as a "bad flu") pre-enlightenment.
The statement remains.
The statement used as deadly and indeed wasn't affected by it. Statement remains valid ;)
> Omicron can infect 3 to 6 times as many people as Delta, over the same time period
That's ominous if true
Definitely not a few.
We were on the downslide of the third big bump of COVID deaths per worldometers, but let's face it, there's going to be a big fourth even without Omicron from the infections from far less restrained Xmas/Thanksgiving get togethers.
I hope I'm wrong...
The US is one of the worst examples of COVID response, both during Trump's era and the post-Trump/QAnon/Fox/OAN/etc spread of bullshit propaganda.
It's not Xmas/Thanksgiving that's the issue, it's the lack of following logical safety and vaccination measures, somehow tied to "freedom" without considering the "general welfare".
The issue is this disease is killing younger people than those who typically die of the flu. There number of general hospitalizations is significantly higher, with more longer lasting after infection effects.
Nearly all my friends who have had Covid can't taste or smell. That alone should scare you. I have not had it, because I am vaccinated and wear a mask while I do my normal social activities here in South Africa.
The problem is that most of the things that governments around the world have been doing to try to combat corona are completely useless, and carry a huge cost for society. We're killing people with lockdowns and school closures and by limiting medical procedures. Suicides among children and teenagers are up. Deaths of despair are up. Cancer screenings are down. The future healthcare debt is just piling up. If our strategy is killing more people than we're saving, we should stop and re-think the strategy!
The hubris is enormous. Countries think they can eradicate sars-cov-2, and every single attempt has been an abysmal failure. Omicron has been detected in Australia. How? They have incredibly strict border controls, quarantine camps, vaccine requirements and testing requirements for travelers, and yet the virus slipped through.
OP isn't saying we should throw our hands in the air and just ignore the virus, but we also shouldn't double down on useless measures that do more harm than good, and we shouldn't succumb to wishful thinking that the virus can be magically erased if only everyone did X.
Those that arrive through other locations (eg Melbourne, Sydney) etc were quarantined through hotel quarantine, which had/has leaks.
Our infection rate from COVID is substantially lower than other countries of similar size and economy, our hospitalization and death rates are substantially lower as well.
We have achieved 80-90+% vaccination rates for the majority of the population (ie 12+) and have started rolling out the 3rd shot/booster as well as planning for vaccination of 5+ starting early next year, hopefully getting 5+ kids vaccinated early in the school term.
The people protesting and complaining are a very small but noisy minority, and their arguments are becoming less and less relevant. In the two largest states, Victoria and NSW, we are "living with" COVID, with minimal restrictions (masks in internal retail spaces, hospitals and other vulnerable population locations, requirement for double vaccination in most businesses etc).
We're not trying (anymore) to "eradicate" covid, we're adapting to it, but in a way that maximizes safety and minimizes risk.
Anecdotally, me and my family have not been sick with the cold or flu ounce since all the Covid measures started. Normally we all get sick with the cold or flu at least ounce a year if not more, but now for over 2 years not sick ounce.
So it does seem like the measures do work to contain the spread of airborne disease to some extent. Will it be enough to eradicate Covid, probably not, that I can concess.
Just get vaccinated, avoid crowded poorly ventilated places, stop trying to herd 7 billion cats, and move on with your life.
Honest question, how does this one go away on the timescale of a few years to a decade (or, worst case in what truly interests us, a generation)? Couldn't seem to find an answer on pubmed or scholar when I looked, I'm jabbed and have been mindful this whole time but my logic tells me that is not happening. We'd have to get it's R0 low enough that it disappears before mutating a variant that escapes immunity (if that is even necessary given the likelihood of impermanent immunity, at least partial). Is that possible barring a new type of vaccine that entirely prevents infection and reinfection for which we'd have to get full planetary coverage of in time?
There is no real risk that a new variant will completely evade immunity from previous infections. Nothing is 100%. Over the long run it will probably play out similar to the previous coronavirus pandemic. Fortunately this time we have vaccines and other treatments which can prevent most deaths.
A lot of them lasted for centuries. People would get it and play the lottery, maybe 3 in 10 would die, the rest develop immunity for example.
Most pandemics either end because too many people die, and you're only left with the immune survivors, like the plague. Or they end because of improvement to public health and sanitary practices. Vaccines ended smallpox, condoms and awareness reduced AIDS impact, better water sanitization ended cholera, even the plague ended with help by quarantine and lockdowns.
I'm not sure how this one will end, but they almost never "just end" magically. Either some level of herd immunity is achieved, for example by having everyone have it very quickly, and being left with only immune survivors, or the spread is contained through public measures, or immunity is achieved through vaccination, or a drug to cure it is found.
[0] https://www.nytimes.com/2021/12/02/world/africa/virus-omicro...
Similarly Omicron seems to have a higher breakthrough rate for vaccinated folks than the previous variants.
>Under a scenario of 90% population immunity against previous variants, we get the following picture where Omicron could lie anywhere along the dashed line ranging from an intrinsic R0 of 3 and 83% immune escape to an intrinsic R0 of 9 and 20% immune escape.
With covid we need to move beyond infection rates and just focus on deaths and really start getting ready for the long haul as its not going anywhere and we will never beat covid. Every year will see a new variant, as much the same as every flu virus before it.
And then you have long debilitating covid. If it's not gone - unlikely - then it's most likely worse.
Warning, I just follow some Twitter accounts. But some scientists who have a good track record with their comments on covid since it started are very much concerned.