Omicron news

[kabbes]

FFS! Is that really the best that can be predicted? The high figures are ten times that of the low. Ten times.

Deaths are a proportion of a proportion of a range of predictions. It doesn't take much variation in each element of that model to get to a 10x variation overall. 600-6,000 seems like a sensible range to me. I'm pretty sure it doesn't even represent a proper 95% confidence interval, or anything -- just a range of reasonable best estimates.

 

[8ball]

FFS! Is that really the best that can be predicted? The high figures are ten times that of the low. Ten times.

Sometimes that’s the nature of the models. Once you factor in variability in “lucky” (ie. unlucky) super-spreader events, then you can end up with very wide confidence intervals.

Not to mention the fact that the starting conditions are very uncertain, and we are guessing about at what point we are at in an exponential growth phase.

 

[elbows]

Note for example this bit from the SAGE minutes the Guardian mentioned earlier:

SAGE 99 minutes: Coronavirus (COVID-19) response, 16 December 2021

www.gov.uk

In England it is almost certain that there are now hundreds of thousands of new Omicron infections per day. Levels of Omicron infection are currently highest in London. Reported numbers of confirmed and suspected Omicron infections will only be a small proportion of the actual number. This is because there are lags between people becoming infected, being tested, and getting test results (data lags matter most when growth is very fast); not all tests allow the variant to be identified; and not everyone who is infected is tested.

 

[elbows]

Various modelling documents are also available int he December 16th section. I havent had time to read them just yet.

SAGE meetings, December 2021

Minutes and papers from the Scientific Advisory Group for Emergencies (SAGE) meetings held in December 2021.

www.gov.uk

 

[elbows]

From those minutes:

13. Behavioural factors are likely to significantly affect the timing and scale of the peak. Behaviour remains a source of major uncertainty in modelling. Some data indicate that people have been adopting safer behaviours in recent days including increased use of face coverings (up to around 95% self-reported usage) and reductions in contacts. These changes will take some time to lead to any slowing of growth in infections, and longer to affect hospitalisations, and so whilst potentially significant, are unlikely on their own be sufficient to avert the large wave of hospitalisations.

14. Enabling people to make safer behavioural choices will remain important, particularly over the festive period where they may feel obligations or pressures to participate in some higher-risk activities or events in addition to the ones they do want to prioritise.

 

[kabbes]

I produced a model once that suggested a number would probably be between 0 and 100 million with a median of about 500k. I couldn't be sure it wouldn't be more than 100 million, but at least I knew it wasn't possible to be less than 0.

 

[elbows]

Sometimes that’s the nature of the models. Once you factor in variability in “lucky” (ie. unlucky) super-spreader events, then you can end up with very wide confidence intervals.

Not to mention the fact that the starting conditions are very uncertain, and we are guessing about at what point we are at in an exponential growth phase.

Significant unknowns include peoples behaviour, severity of Omicron, and remaining protection against severe Omicron illness by vaccines.

 

[8ball]

Significant unknowns include peoples behaviour, severity of Omicron, and remaining protection against severe Omicron illness by vaccines.

Indeed. Just about all the input parameters are guesswork. One order of magnitude seems fairly tight tbf.

 

[elbows]

I produced a model once that suggested a number would probably be between 0 and 100 million with a median of about 500k. I couldn't be sure it wouldn't be more than 100 million, but at least I knew it wasn't possible to be less than 0.

Due to a lack of functioning time machines, imperfect modelling remains a critical tool for making policy decisions. Even a wide range is much better than leaving it to peoples imagination, especially when some of them seem to lack an imagination or have deluded quantities of optimism.

 

[Badgers]

Speaking to emergency services people over the last two days has been a bit of an eyeopener. Loads and loads actually positive and sick. I doubt 500 police will be on duty throughout tomorrow.

Those 500 will be busy

 

[Badgers]

 

[elbows]

Some of my comments about the impact of behaviour are reflected in SAGE modelling group documents from December 15th:

SPI-M-O: Consensus statement on COVID-19, 15 December 2021

www.gov.uk

16. Behaviour change (spontaneous, recommended or mandated) could significantly affect the peak of infections and hospitalisations. Current modelling assumes no change in behaviours beyond those previously seen upon imposition of equivalent measures in the past. Non-mandated behaviour change, however, has the potential to make a big difference in either direction. If cases increase to high levels very rapidly, there may be a spontaneous precautionary reduction in mixing patterns, thus slowing transmission. The festive period, however, may see changes in mixing between households and generations, joining up networks, that could lead to increased transmission.

17. Hospital admissions have been between 500 and 1,000 per day in England since mid-July 2021, likely due to spontaneous behaviour changes. It is possible that similar behavioural changes could result in a long, extended period of high hospitalisations, rather than a single sharp peak.

 

[Sasaferrato]

Sometimes that’s the nature of the models. Once you factor in variability in “lucky” (ie. unlucky) super-spreader events, then you can end up with very wide confidence intervals.

Not to mention the fact that the starting conditions are very uncertain, and we are guessing about at what point we are at in an exponential growth phase.

Och, I know. Ignore me, I'm fed up and crabbit tonight.

I've been (along with hordes of others) been pretty much isolating for nearly two years now. I just want it to stop.

 

[8ball]

Och, I know. Ignore me, I'm fed up and crabbit tonight.

I've been (along with hordes of others) been pretty much isolating for nearly two years now. I just want it to stop.

Yep. It feels like a decade.

 

[elbows]

Other stuff from that modelling document:

20. In June to July 2021, the ‘pingdemic’ and significant behaviour change coincided with (and may have caused) a sharp reversal of epidemic growth; at the time, the R value for England was slightly above 1 (approximately 1.2 to 1.4 over this period, with a growth rate of approximately +3% to +6% per day). It is unlikely that such an ‘intervention’ would have such a significant impact now due to the significant growth of Omicron (estimated percentage growth rate of around 50% per day [footnote 5] ). If, however, many people were isolating as a result of being a COVID-19 case or potential contact of one, then this reduction in network transmission would reduce Omicron cases.

22. Even a marked reduction in any aspect of severity is unlikely to offset the impact of a larger susceptible pool (a consequence of immune escape) or increased transmissibility without further measures, as is implied by Omicron’s evident growth advantage. The severity of a disease, however, is multi-layered and includes: whether people require hospital treatment if infected (infection hospitalisation risk (IHR)); how long they spend in hospital when they get there (length of stay); and whether they need to be transferred, for example, to intensive care. Omicron may appear to have lower severity as a result of protection due to prior infection or vaccination – this apparent decreased severity may not correspond to an intrinsically lower severity of this variant. This may also be affected by the demographics of individuals infected with Omicron and their immune status. Pressure on health and care settings, particularly hospital bed occupancy, will depend on all aspects of severity and how these interact. It may be that a changed average length of stay affects how hospitals are able to manage their admissions.

23. Previous epidemic waves have seen the hospital fatality risk increase, together with substantial changes in length of stay. The coming wave of admissions and increased pressure in hospitals is likely to see similar observations, although these will be modified by changes in treatment options and clinical requirements of patients.

24. There are early indications for shorter lengths of stay in South Africa, however, it is unknown whether such observations would be seen in the UK, given differences in population demographics, COVID-19 epidemic timing and variant composition to date, vaccination types and programmes, health care systems, and so on. It is too early to make an assessment of what the UK’s average length of stay would be for hospitalisations due to Omicron infection.

28. There remains considerable uncertainty whilst the full range of biological parameters of the Omicron variant remain poorly described. Information about Omicron’s transmissibility and immune escape compared to Delta will be significantly improved over the next 2 weeks, although disentangling the difference between these 2 may take longer.

29. Other uncertainties also remain, such as how Omicron infections will move through and affect different age groups, how differently Omicron may evade natural and vaccine-acquired immunity and how this may hold for booster vaccinations, and the relative scale of reduction in vaccine effectiveness between infection and severe disease. Current analyses assume Omicron has the same generation time as Delta, but this remains unknown.

 

[elbows]

I guess my point is that things are fucked up enough as it is. There is no need to create things unrealistically beyond fucked-up to talk about. If the paper talks about the rate reaching "2m daily infections" and then it actually "only" reaches 1m daily infections (and that for "only" five days, say), you give the establishment an out to say, "well, it wasn't as bad as they said it might get."

Pandemic shitheads will always find some dubious way to make their points, we've seen that plenty in the past. I do not believe in falsely sugarcoating worst case estimates in at attempt to pander to such bullshitters. They will just make shit up and return to make the same false claims again and again, no matter how deadly their errors of judgement were in the past. No matter how ridiculous their past utterances were before we were swamped by death in previous waves, plenty of them still have the nerve to repeat the exercise despite the evidence of how wrong they were. Brass necks and brass eyes.

I would have been useless in this pandemic if I were too afraid of leaving myself open to the accusation that I had cried wolf. Better to err on that side of things rather than reckless optimism and wishful thinking. Unknowns about Omicron and a messy picture of immunity make the crying wolf risk greater this time, but I still dont consider that a reason to change my approach this time.

 

[elbows]

Since I often moan about a lack of published covid wastewater analysis for England, I should point out that Omicron detection via those means is covered by pages 32-34 of the variant technical report of December 17th. However the info it provides is now rather out of data and uninteresting and irrelevant compared to other sources. They say that such data will be published monthly in experiemental form from 2022.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1042046/Technical_Briefing_32.pdf

 

[MrCurry]

Do we have any better info now on characteristic symptoms of omicron cases, or are they maybe as varied as delta and undifferentiated from other variants?

MiL has come down with vomiting overnight, following heartburn and painful tummy yesterday evening, and while it could be anything, I’m wondering if it maybe fits omicron? She hasn’t eaten anything different from others who are unaffected.

 

[platinumsage]

Do we have any better info now on characteristic symptoms of omicron cases, or are they maybe as varied as delta and undifferentiated from other variants?

MiL has come down with vomiting overnight, following heartburn and painful tummy yesterday evening, and while it could be anything, I’m wondering if it maybe fits omicron? She hasn’t eaten anything different from others who are unaffected.

Certainly not typical symptoms of omicron or any other variant. That doesn't mean it isn't, as some people experience unusual symptoms, but I'd be looking for other causes first.

 

[LDC]

Do we have any better info now on characteristic symptoms of omicron cases, or are they maybe as varied as delta and undifferentiated from other variants?

MiL has come down with vomiting overnight, following heartburn and painful tummy yesterday evening, and while it could be anything, I’m wondering if it maybe fits omicron? She hasn’t eaten anything different from others who are unaffected.

You're trying to make symptoms that clearly fit something else fit covid. I'd rule out the something else first.

 

[8ball]

But do a test anyway.

Just FYI - there has been a bit of norovirus about.

 

[nagapie]

Do we have any better info now on characteristic symptoms of omicron cases, or are they maybe as varied as delta and undifferentiated from other variants?

MiL has come down with vomiting overnight, following heartburn and painful tummy yesterday evening, and while it could be anything, I’m wondering if it maybe fits omicron? She hasn’t eaten anything different from others who are unaffected.

Lots of friends in London reporting tummy aches and vomiting actually. More among their positive children but not only.

 

[weltweit]

WHO urges cancelling some holiday events over Omicron fears

"An event cancelled is better than a life cancelled," warns the World Health Organization's head.

www.bbc.co.uk

The World Health Organization has urged people to cancel some of their holiday plans to protect public health, as the Omicron variant spreads globally.

 

[elbows]

4th dose for older and more vulnerable Israelis to fight the Omicron wave (because their previous vaccines were given longer ago):

Israeli PM announces fourth Covid jab for over-60s to tackle Omicron

Booster will also be available to medical teams and immunodeficient people four months after third dose

www.theguardian.com

 

[magneze]

Just saw that. Is this what we're onto next? Ffs

 

[8ball]

Just saw that. Is this what we're onto next? Ffs

Our next one is likely to be an Omicron-specific vaccine, and if we get lucky there might be a “universal Covid” vaccine not too far behind it.

 

[gentlegreen]

I've only ticked-off two of the four techs - I hope we at least get to try the protein one

 

[elbows]

I might be growing paranoid, living under this government for what seems like decades, but it seems possible that they'll change the rules on isolation, to make it significantly shorter, to address the staffing disaster that is happening. The numbers are incredible, not just the firefighters and hospital staff but everything else too the less visible stuff.
Already we don't have to isolate at all if we are a vaccinated confirmed contact of covid positive people which tbh makes no medical sense really at all does it.

It didnt take long to come true. I've nothing to add really since I already shared my thoughts when you brought the possibility up.

Covid: Self-isolation cut from 10 days to seven with negative tests

The new rules in England mean some people could end their self-isolation in time for Christmas.

www.bbc.co.uk

 

[elbows]

It doesnt sound like the awaited early analysis of Omicron severity and vaccine protection is going to add much to the picture beyond what we might already have expected:

London Playbook: SCOOP: Omicron milder in UK — New Year’s fireworks — Liz vs. No. 10

What's driving the day in Westminster. Politics and policymaking in the UK capital.

www.politico.eu

The best news in the early data is that Britons who fall sick with Omicron are less likely to become severely ill than those who caught Delta. More people are likely to have a mild illness with less serious symptoms — probably in part due to Britain’s large number of vaccinated and previously infected people, and possibly because Omicron may be intrinsically milder.

The less good news is that while Omicron seems milder overall, the UKHSA has found it is not necessarily mild enough to avoid large numbers of hospitalizations. The experts have found evidence that for those who do become severely ill, there is still a high chance of hospitalization and death. The UKHSA has also confirmed that transmissibility of Omicron is very high, meaning that even though it is milder, infections could rocket to the point large numbers still end up in hospital — essentially negating the reduction in severity.

Playbook is told the UKHSA is also expected to conclude that while two doses of a vaccine are not enough to offer strong protection, a booster dose does significantly reduce the chance of both symptomatic infection and ending up in hospital.

 

[littlebabyjesus]

Study published yesterday that appears to be being referenced in various places in the news at the moment.

Early assessment of the clinical severity of the SARS-CoV-2 Omicron variant in South Africa

Findings:

80% reduced risk of hospitalisation per infection with omicron compared to delta. (adjusted odds ratio (aOR) 0.2, 95% confidence interval (CI) 0.1-0.3)

Significantly reduced risk of severe disease compared to previous delta infections (aOR 0.3, 95% CI 0.2-0.6) but not compared to concurrent delta infections (aOR 0.7, 95% CI 0.3-1.4). They did find a possible small reduced risk (at 0.7), but don't consider it statistically secure due to wide confidence intervals, which seem to have been set at 'double' and 'half' the given figure, which is probably a bit of a guesstimate - the old problem 'what are the error bars on my error bars?'