Isn’t it likely though, that future variants/strains will follow the Omicron BA5 path, and become less virulent? I mean, it would seem to me that a respiratory virus that neither kills the host nor makes them so sick they don’t go out would be selected for strongly vs. one that did either or both of those things.
Isn’t that also what likely happened with the other human coronaviruses?
… So far. /Homer
That’s not at all a given at this point. From what I’ve seen on earlier waves, they were initially thought to be less virulent, then later studies determined that there were just more impediments in certain situations (vaccination levels, recency of prior waves, mitigation measures, etc.). Like a forest fire spreading through the trees, areas that burned recently don’t burn again easily, but fire is just as dangerous.
That doesn’t square with my lived through experience with Omicron. How it manifested itself quite differently in infected peoples’ bodies, much less in the lungs and use of ventilators plummeted. Shorter hospitalizations as well. Omicron was and is milder. I understand some people are comforted by a belief that all varieties of Covid must be equally or more virulent. It’s not what I have seen based on hospital reports etc.
If I understand correctly, @duality72 is saying that you experienced Omicron as milder because of the effect of vaccinations (and perhaps other measures), not because Omicron itself produces milder symptoms all else being equal. (I myself have no idea whether this is, in fact, true.)
As @Thudlow_Boink states, much of the mildness of the Omicrons is due to prior immunity of the populace. People have been either vaccinated, infected or both. There was one study, in-vitro, that showed that BA.1 preferentially infected cells from the upper respiratory tract, but most the scientists comments I’ve read put greater stock in immunity.
Here’s how I see this playing out. People who are up-to-date on their vaccinations will occasionally get a mild infection. Those who aren’t will get sicker. Older unvaccinated people may accumulate comorbidities due to their covid infections and die sooner than expected, but they’ll never make the connection. Life expectancies may continue to fall but not as bad as 2020 and 2021.
What Jay-Z is saying is correct in the United States when viewed from a top-of-the-mountain perspective. Omicron BA.4/BA.5 did not have nearly the collective health effects that Omicron BA.1 did this past winter or that Delta did in summer/fall 2021.
We don’t have to guess about this or go by “feel” or anything like that – there is assembled data on this stuff. Open the Johns Hopkins Weekly Hospitalization Trends page below and toggle between COVID inpatients and COVID ICU admissions. The orange area (kind of reminds me of layers of sediment) serves as an approximation of the severity of COVID’s effects on the U.S. population. Where the orange ‘layer’ is thicker, COVID is laying us low. Where the layer is thinner, COVID is easing up.
Now then. There have been times when COVID’s collective effects were less than they are right now (e.g. spring/summer 2021, April-May 2022). But that doesn’t mean the U.S. population is not far, far better off right not against COVID than we were, say, throughout all of 2020.
COVID has been and is bad enough, but it is not going to be the Forever Pandemic. There will not be a consistent parade of worse and worse variants for all time to come. COVID may have essentially stabilized with BA.5 but if not, I’d wager it’s very close to doing so. Yes, it will still mutate and continue to throw off new (but generally dead-end) variants - but the odds of flopping 100 royal flushes in a row continue to be remote.
Exactly. From the article, hopefully not too much length taken, bolding mine:
One thing I looked at with Omicron other than anecdotal hospital reports is average age of someone dying from Covid.
With OG Covid it was fairly high, late 70s to early 80s. For most if not all of OG Covid there was no vaccination for anybody.
With Delta the average age of the deceased went down. At this point a good percentage of the populace and higher of the elderly is vaccinated. At this point vaccination was still providing good sterilizing immunity, doing a better job at preventing people from getting Covid at all. At this point we had the biggest difference between the vaccinated and unvaccinated. I’m willing to believe that Delta was actually more virulent than OG Covid and at that time, vaccinations may have been the complete difference maker.
I’m not willing to believe that with Omicron. When Omicron supplanted Delta, age of death IMMEDIATELY shot back up to what it had been with OG Covid, and it’s only risen since then. I think we all accept that Omicron is more infectious. I would accept that actual case counts at any particular time have been higher with Omicron than they were with the other Covid variants.
But there wasn’t some sea change in the state of vaccination between Delta and Omicron. Both attacked populations with about the same level of vaccination. I do not believe that Delta infections provided enough natural immunity to unvaccinated cohorts to be able to weather Omicron that easily.
Similar individuals can get different case outcomes from Covid due to viral load or whatever reason they do. We know that. Older people die more frequently from Covid because their systems are less robust, and it takes a less strong case for them to die. If you rate severity of particular cases of Covid on a scale from 1 to 100, maybe it takes a 99 or 100 to kill a 50 year old, whereas a 90 year old in frail health would die from a case in the 30s.
So if the disease becomes less virulent, the average age of death is going to go up. Because more of the younger populations survive, because they only died with the worst cases anyway, and those are gone. But the milder cases, still enough to kill the old and frail, are still around. So the average age of death goes up. There’s no other explanation for why age of death shot up immediately upon the introduction of Omicron.
On this front:
Racial disparities. Interestingly, age-adjusted racial disparities continue to attenuate. I would attribute this to two things: 1) massive community engagement on the ground to reduce disparities; and 2) Black and Hispanic adults were more likely to be in the “wait and see” category for vaccines compared to non-Hispanic Whites adults, who were more likely to be in the “never get vaccinated” group. The Kaiser Family Foundation continues to update their data on deaths over time, and this closing gap is apparent.
The items above from the 9/13/2022 edition of Your Local Epidemiologist:
Just to make clear – it doesn’t need to be a matter of belief. Delta replication speed is known conclusively to be much faster than the early strains:
https://www.cnn.com/2021/07/21/health/delta-variant-covid-19-explainer/index.html
I am not familiar with any claims that Delta was less virulent than OG Covid. Only with Omicron, which was widely claimed to be less virulent, have there been these counter claims that in fact it isn’t, that vaccines and other mitigations are doing 100% of the work. My argument is that the difference in the population between Delta and Omicron is insignificant, and that differences in the data are clearly visible that Delta and Omicron in fact do impact populations differently.
Antibodies from vaccines wane, especially by six months following vaccination. The older you are, the faster they diminish. During the Delta wave, many older people had been vaccinated within the previous six months. By December 2021, only about 20% of the population was boosted meaning that many older people had now lost quite a bit of their protection. Even now, only 40% of > 65 yr have gotten their second booster.
But that means that the mitigation for Omicron would have been poorer than for Delta, not better. And the argument is that Omicron really isn’t less virulent and that all statistics that show it to be so are due to mitigating efforts. Those efforts would have to be better with Omicron, not worse.
Delta is actually thought to be more virulent than OG covid.
I’m, personally, not claiming that immunization is doing all the work. I’m saying that scientists are saying that the omicron variants may not be that much less virulent than the OG strain. It’s just that the population has some level of immunity and that the older you are, the quicker your immunity wanes.
Again, there is evidence that BA.1 is milder in tissue culture and rodents. However, I remember studies out of the UK during BA.1 showed a much larger effect of prior immunity. In fact, you can look at the deaths in vaccinated, boosted, and unvaccinated. There’s a drastic difference in death rate for older people.
Yes. As you stated earlier, mitigation for Omicron in older people was poorer than for Delta. I’m saying that the reason is probably because their immunity waned and half of them (or less) had gotten their boosters.
In fact, I’ll go one step further. There are even suggestions that BA.5 has enhanced pathogenicity compared to BA.1. Yet, the US felt a relatively mild surge in hospitalizations and even milder death rate. Why? Because over 60% of the population had BA.1 and probably 10-20% more had BA.2. By the time BA.5 came around, nearly everyone was either boostered or had hybrid immunity (vaccine+infection or more than one prior infection).
This is getting into Occam’s Razor territory.
It is better for people, the country, the world for Covid to have gotten milder with Omicron. Rather than “we timed our immunity efforts just right.” Because I don’t think we are going to be able to do that if we even did it in this case.
Covid is currently the third leading cause of death in the US, killing about 400/day. Flu has never been that dangerous in my lifetime.
It did? What alternate reality do you live in where people like to hide in bunkers?
This. Masking works best outgoing, it works best to protect people from you. I hoped we might move towards a society where it was routine to wear a mask during flu season, and when covid is prevalent. (Which it unfortunately still is.)
I certainly don’t think everyone should be staying home, hiding in bunkers, avoiding human contact. That’s what we did in 2000, and it was horrible. But one thing we’ve learned from the pandemic is that masks work. Holy shit they work well.
We’ve also learned that long covid is common and nasty. And at least for me, it’s fairly concrete. One friend who is retiring early because she struggles to do her job due to brain fog. Another thinking he needs to retire due to waves of exhaustion. Another who had six months of assorted bacterial pneumonias after recovering from a mild case of covid. Another who just can’t shake this annoying cough.
And back then, i was literally hiding at home, shopping only once a month. Yes, i hope those days are gone for good.
I just want to point out that this is a bizarre and insulting comment. Who would be “comforted” by that? I was really excited by the rodent studies showing omicron was milder. And really disappointed by the follow-up studies of actual human outcomes showing that if you adjust for the effects of vaccination, it was slightly deadlier than original-strain covid. As to why it went back to mostly killing old people, that’s likely because old people were, at the time it hit, a lot further out from their most recent vaccination than younger people.
Anyway, I’m not looking for government mandates. I AM looking for fact-based guidance from the CDC encouraging the use of masks to protect others. I AM looking for improved building/occupancy codes calling for better ventilation. It could be implemented like the ADA, and only be triggered for new buildings and substantial renovations, so as not to be too onerous. But we ought to be explicitly moving towards better ventilation standards. We ought to be testing ventilation, so employees and prospective employees have some ideas what risk they are taking by accepting a job.
And I’m really frustrated by, “it’s all over, back to exactly what we did before”. Because it’s not all over.
All numbers have to be put into context. Throwing out the number 400 deaths per day is meaningless if it is simply applied to the general population.
Two factors are vitally important in interpreting that number: the percentage of deaths that come from unvaccinated people and the age of the people who died.
The death rate among vaccinated people is extremely low, even according to the page with the scare headline. A more recent chart from Washington state shows that below 65 deaths are too small to pull out and that 65+ death rates are 4.4 times as high in the unvaccinated population.
Vaccination greatly protects you. If everyone were to be properly vaxxed and boosted, then there would be no crisis. Since people blindly do not, COVID has not and probably will not go away.
In practical terms, this calls for staying away from or taking precautions if one will be in close contact with older people, especially if you know they are unvaccinated. If you are among the population at high risk for other reasons, you should also take precautions. If you are among the majority who are younger and vaxxed, then the severe protocols of 2020 would not seem to be warranted.
I do not know you, I do not know your situation, I do not know what your daily life is life, I do not know what special times you have. All I can say is that the numbers as currently given by the authorities indicate that 2022 is not 2020.
Right. It’s not 2020. It’s also not 2019. Can we acknowledge that there is a much higher risk of death or disability than there was before covid without saying it’s exactly like 2020, when NYC was literally stacking bodies in refrigerator trucks because they couldn’t process them fast enough?
(I mentioned in another thread that my mil, who died of a stroke in 2020, couldn’t be cremated for a few weeks after her death.)
And on a board that leans older, brushing away the risk as “mostly over 65” is somewhat thoughtless. And “currently the third leading cause of death” is kinda a big number, whoever it is.
But it’s not just death. Long covid is somewhat common in people over 35 who had a modest initial infection. Long covid is fuzzy, since it seems to be a lot of different outcomes (asomnia, chronic fatigue, brain fog, respiratory troubles, rapid onset diabetes, kidney, and liver disease, heart and blood vessel problems) but collectively, it’s a fair chunk of disability that is new to us.
And I’m not suggesting we lock down. That can’t be the best choice right now. It’s NOT 2020. But it would be nice if the CDC recognized that we still have this nasty disease going around, and that people can reduce its spread not just by getting vaccinated, but also by wearing masks to protect others, and by improving ventilation.
Preach it, sister.
It’s insensitive and thoughtless wherever that is said or implied. I’m heartily sick of strangers volunteering me to die.