[conspire] Omicron, holiday gatherings, upcoming CABAL meeting

[Rick Moen]

Things known so far about the SARS-CoV-2 B.1.1.529 "Omicron" variant[1]:

1.  It almost certainly did _not_ originate in South Africa, despite 
what you might have heard.  It was first detected/isolated there because
that country (and adjoining Botswana) has advanced detection and
virus-sequencing facilities.  After that happened, additional cases in
other continents that were diagnosed _before_ the South Africa findings
were confirmed to be Omicron.

Predictably, the knee-jerk shutting down of international travel (USA,
Israel, Japan, others) was dumb and futile -- particularly in being
aimed at South Africa and nearby African countries.  It was dumb because
the variant was already pretty much everywhere before shutdown. 

By the way:  30 confirmed Omicron cases in the US so far, of which nine
are in California, including one in San Francisco and a cluster of five
in Alameda County
(https://www.kron4.com/health/coronavirus/5-cases-of-omicron-variant-reported-in-alameda-county/amp/).
California's COVID-19 caseload remains 99% Delta, at this writing, with
cases slightly upticking in what _may_ or may not be the beginning of a
winter surge.  The Bay Area, however, is still trending downwards.  Even
counties like Contra Costa that are seeing a slight uptick in total
COVID-19 infections are seeing an ongoing decline in hospitalisations.
https://www.sfchronicle.com/bayarea/article/Bay-Area-holds-breath-on-omicron-delta-variant-16680698.php

Why is the Bay Area doing better than most places?  Yep, vaccination
rate.

2.  Early data suggest it's more infectious than is Delta (and other
variants).  But that same data suggests it might cause less-severe 
disease -- notably among unvaccinated people who've taken a fearful
toll from Delta.  With Omicron infections, those South Africans
sometimes need admission to hospital, but don't have severe disease,
i.e., don't require supplemental oxygen, etc.

If these preliminary findings are confirmed, then on balance that's 
really good news, and takes COVID-19 well on its way to becoming just 
like a seasonal headcold.

In South Africa, Omicron has in the preliminary data been outcompeting
other variants.  (Again, if it's a mild infection, that's good news.)

Maybe about another two weeks' data are required for a clearer picture.
For one thing, severe Covid illness often takes a week or more to
develop, and the world has been aware of Omicron for less than two
weeks -- so the other shoe hasn't yet dropped.  Also, South Africa's
population skews young and in many cases had some existing level of
disease-conferred immunity, interfering with extrapolation of its
preliminary results to elsewhere ("confounding variables", as we stats
people say).

So, the key question of severity remains one of the biggest and most
important areas of uncertainty.


3.  The variant has 50 genetic mutations, 32 of which are on the 
vital "spike" protein that SARS-CoV-2 uses to infiltrate cells, and
these are speculated to be key to Omicron's greater transmissibillity.
Changes to the "spike" are of particular concern beause that's the
feature targeted by almost all of the world's COVID-19 vaccines.


4.  We don't yet know much about how those mutations may or may not
help Omicron evade vaccine-derived or infection-derived immune system
response.  However, again, preliminary data show that there is increased
likelihood of both vaccinated and non-vaccinated persons getting
infected or reinfected.  (Infected doesn't necessarily mean ill.)  E.g.,
at Scatec ASA renewable-energy company's recent (indoor, maskless)
Christmas party at Louise Restaurant & Bar in Oslo, Norway, where 120
vaccinated persons were present and exposed, around 70 attendees became
infected with Omicron, _but_ all of those persons show mild or no
symptoms of illness _so far_ (but see point #2).  "Mild" mean headache,
cough, sore throat, and flulike symptoms, and isolating at home.

Similar clusters then cropped up in Denmark at yet another 150-person
Christmas lunch ("julefrokost") party resulting in 50 cases, and at
another the UK, with many more to follow, I'm sure.
https://twitter.com/GANyborg/status/1466874636554100737
https://threadreaderapp.com/thread/1466874636554100737.html
https://www-dagbladet-no.translate.goog/nyheter/kan-ikke-stoppe-julebord-utbruddet/74825102?_x_tr_sl=auto&_x_tr_tl=en&_x_tr_hl=en-US
https://en.wikipedia.org/wiki/Scatec
https://www.wsj.com/articles/omicron-cases-at-norway-christmas-party-provide-clues-on-new-variants-spread-11638554033

And the pattern continues, e.g., in a cluster of 11 Omicron cases in
Israel, 6 infectees were triple-vaccinated (boostered) with Pfizer.
https://twitter.com/Meir_Rubin/status/1467532114421862402

Also, in Israel (reported Sunday morning):

  Of 14 'protected' people (boosted, vaxed or recovered in the last 6
  months) with confirmed or likely Omicron, only 3 are experiencing
  symptoms

  Of 19 'unprotected' people with confirmed or likely Omicron, 9 are
  experiencing symptoms.

https://twitter.com/ariehkovler/status/1467537991061188608

(The terms "vaccinated" and even "fully vaccinated" now must be considered
vague-ish, because of antibody decline over time, and Norway has not
deployed boosters -- except to some persons over age 65 and persons at
high risk -- but broader booster rollout is starting.  "Case" is also
vague. as this includes people with mild or no disease.  If looking at
metrics, hospitalisations are a more certain guide.)


But, remember, mild cases of a diseease can and do kill vulnerable 
people like the elderly and cancer patients, e.g., every year from the
flu.

What _is_ clear is that that immunity among the vaccinated and
previously infected does fade over time.  Get the damned booster.
https://www.theatlantic.com/science/archive/2021/12/covid-boosters-omicron-effective/620883/
(About 1,000 Americans per _day_ are still dying of COVID-19.  Being
topped up on antibodies is key to not being counted among them.)


5.  Vaccine hoarding by rich countries has a lot to answer for, as does
vaccine hesitancy (22% of Russians, 18% of Americans, 10% each of
Germans, Canadians, and French: see
https://www.theatlantic.com/politics/archive/2021/12/which-countries-have-most-anti-vaxxers/620901/
).  If the vaccine deployment had been global, there probably would not
be any post-Delta variants.  We are all suffering from the effects of 
failing to treat this as a humanity-wide problem.

New variants were always a given, as that's what coronaviruses do, but 
having huge pools of unvaccinated humans makes the problem worse and
last longer.  More spread means more opportunity to evolve and adapt.


6.  The existing vaccines _can_ be quickly tweaked to re-aim them more
specifically at Omicron.  A Moderna representative said something about
three month lead time.  I don't have details on that or the
pluses/minuses of making that a top priority, or how quickly public
rollout could occur on an emergency basis, etc.  In any event, as
mentioned, all of this is still really new.

There are also a couple of new,good antiviral pills, one from Merck
("molnupiravir", named after Mjölnir -- cute, guys:
https://www.theatlantic.com/health/archive/2021/10/mercks-experimental-covid-pill-cant-fix-everything/620320/ and I note $700 for a course of treatment) 
and the other Pfizer ("Paxlovid" -- $530 per course of treatment).


7.  Yes, existing PCR-RT and rapid screenings for COVID-19 _do_ detect
Omicron.



All of this is of keen interest to Chez Moen, as we consist of a pair of
boostered sexagenarians and a boostered octogenarian, who aspire to live
and do well, not to mention avoiding making others ills -- and because
Deirdre and I intend to go to District of Columbia next week for the
5-day, 2800-live-attendee Worldcon, DisCon III.   https://discon3.org/

Note:  DisCon III requires proof at admission of full vaccination, no
exceptions, and requires wearing a proper mask at all times except when
eating or drinking while seated in designated places only, no
exceptions.   https://discon3.org/covid-faq/

Risk assessment is now a way of life.



And that brings me to the long-burning-fuse item in the nightmare
closet:  the parlous state of our medical infrastructure.  The pandemic
has caused a _great_ deal of long-term damage to the ability of our
health-care system to deal with everything and anything, not just
COVID-19.

20% of health-care workers have now left the profession.  Gone.
Deirdre may follow up with short versions of one or two horror stories
that illustrate why.

It is reliably reported that hospitals are now dangerously low on basic,
ordinary supplies such as saline solution.

In consequence, even more than during the worst of the pandemic in 2020, 
y'all will want to do everything possible to _not need hospitals_ for
at least the next few months.  Seriously.  Remember those new stories
about the system being under strain and in danger of collapse?  Well, 
guess what:  It's not really better, and the (remaining) professionals 
are now bone-tired.

Season's Greetings.  Be well.


Announcement is forthcoming for this Saturday's CABAL.  It'll be
outdoors in the back patio, with a roaring fire, and I'l have made a
hearty stew along with fresh garlic bread.  Perhaps mulled apple cider,
as it's that kind of weather.




[1] https://www.nature.com/articles/d41586-021-03614-z
https://www.theatlantic.com/science/archive/2021/11/omicron-coronavirus-variant-what-we-know/620827/