For those people who say we need data and studies before we can say Omicron leads to less severe cases, we are starting to get some studies. In a study out of South Africa, released overnight, it found people infected with Omicron are 80% less likely to need hospitalization.

If this statistic holds, the Omicron variant could be the road to endemicity for Covid-19.

COVID update:
New study from South Africa says patients infected with the #omicron variant are 80 percent less likely to require hospitalization than those with other strains.https://t.co/7ZcDZc7UB0

— Jim Roberts (@nycjim) December 22, 2021

Apparently, the first death from Omicron in Texas was not a death from Omicron.

Public officials and media reported that a man in Texas became the first American to die from the Omicron variant. I checked with the Harris County Public Health Department. Turns out that's not true.

Here's audio of my phone call. pic.twitter.com/fIDZNPzYuj

— Dan Cohen (@dancohen3000) December 22, 2021

Unlike 2020, high cases do not translate into high hospitalizations. With the advent of vaccines and the new Omicron variant that data suggests is less severe than past variants, high case numbers (a favorite metric of the uninformed media) are not translating into higher than normal hospitalizations.

If I get some time tomorrow, I will provide some more information on NC and how cases and hospitalizations for this Winter wave are much lower than last year's Winter wave.

More evidence that NYC hospitals are not entering into a crisis state at this time due to high case numbers.

Additionally, “Currently, about 40% of patients who have been admitted to NYU Langone facilities who have COVID are “incidental.” https://t.co/fzZiB2IpK8

— Alicia Smith (@Alicia_Smith19) December 23, 2021

As I mentioned in my lengthy post yesterday, even though Omicron is able to evade the vaccine and previous infection induced antibodies much more easily than past variants, it is not evading the body's secondary defense of T and B-Cells.

Data from South Africa and Denmark. Omicron is 80% ⬇️ likely to cause hospitalization

"Breakthrough infections and reinfections from O were less severe and immune protection from T and B-cells mediated its progression to severe disease"@MonicaGandhi9 https://t.co/aZ3z1CPeEa

— Covid News (@covidgoodnews) December 22, 2021

TheStorm said:

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Daviewolf83 said:

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Unlike 2020, high cases do not translate into high hospitalizations. With the advent of vaccines and the new Omicron variant that data suggests is less severe than past variants, high case numbers (a favorite metric of the uninformed media) are not translating into higher than normal hospitalizations.

If I get some time tomorrow, I will provide some more information on NC and how cases and hospitalizations for this Winter wave are much lower than last year's Winter wave.

More evidence that NYC hospitals are not entering into a crisis state at this time due to high case numbers.

Additionally, “Currently, about 40% of patients who have been admitted to NYU Langone facilities who have COVID are “incidental.” https://t.co/fzZiB2IpK8

— Alicia Smith (@Alicia_Smith19) December 23, 2021

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Maybe, just maybe, health care staffing is a concern in New York City because of their stupidly, dumb, idiotic vaccine mandate for Health Care workers - and the fact that many of them have been let go already for refusing to comply? Just a thought.

Also read a report from yesterday that one NC Hospital system (UNC Pardee) in Hendersonville in Western North Carolina (of all places, and not Duke, not Chapel Hill, not Baptist, etc.) has somehow already determined that monoclonal antibody infusions are not effective in treating Omicron and have discontinued any use of them at their facilities. One hospital in Western NC with no guidance from anywhere else yet. Seems kind of like a strange and very quick decision on their part… Omicron's only been here just a few short weeks so far.

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There are a few issues with monoclonal antibodies at the moment that could be impacting hospitals and their decisions regarding their use:

1. Due to their high use and effectiveness against some of the variants, they are in extremely short supply. Hospitals are starting to ration them out to the most at-risk patients and some hospitals have run out of all supply of the antibodies.
2. Reports indicated that most of the monoclonal antibodies in use are not effective against the Omicron variant. As I mentioned in my lengthy post a couple of days ago, I mentioned that Omicron is able to more easily evade both the antibodies from natural infection and vaccines, in addition to many of the monoclonal antibodies doctors have at their disposal. Currently, there is ONE monoclonal antibody (sotrovimab) that appears to be effective against the Omicron variant and it is in very short supply, both in the US and in other countries. At this point, given the supply issues, I would only want sotrovimab to be used on patients with lab confirmed cases of the Omicron variant.

One of the failings of the Biden administration has been to not focus on the increased production of the monoclonal antibody supply. While they have emphasized vaccination, testing (recent change), and masks, they have neglected the treatment options and looking for ways to "crash" the timeline for treatment manufacturing. Just yesterday, they finally approved the new antiviral (paxlovid) for use in the US. Hopefully, it's effectiveness is as good as reported (89% effective in reducing the need to be hospitalized).

Quite frankly, the emphasis needs to be less on testing and more on the increased production of the antivirals and monoclonal antibody treatments. I am not trying to argue with you about this particular hospital, since I do not have all of the details, but I did want to point out that the monoclonal antibody treatments have some issues at the moment.

More news this morning on Omicron and lower levels of severity and hospitalization. I hope this good news continues as cases ramp in the US.

Very encouraging news out of Scotland. A study from the University of Edinburgh using early national data suggests that Omicron is associated with a two-thirds REDUCTION in the risk of COVID-19 hospitalization when compared to Delta.

Let’s talk about that and more! 🧵

— Chise 🧬🧫🦠💉 (@sailorrooscout) December 23, 2021

PackPA2015 said:

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I used to work for Pardee earlier in my career and rotated through there as a student, so I still get a few of their emails here and there.

Per their last email, they only have access to Casirivimab plus imdevimab (Regeneron) at the moment. Studies, so far, have not shown any benefit with Omicron. So, they decided to not use up something that is in short supply that likely will have no benefit for patients until better treatments are available. Is it too early to make that call? Still to be determined.

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Thanks for providing this additional insight. Their decision makes a lot of sense and is in keeping with what I would expect, given what I mentioned regarding Omicron and the monoclonal antibodies. Hopefully, they will be able to secure some supply of Sotrovimab soon, since it appears to be the only one that has any success against Omicron.

This morning, I decided to create a new metric to try and measure the impact of cases on hospitalizations. Using the daily cases reported (cases by specimen date) and the daily hospitalizations (hospital admissions by date), I created a Case Hospitalization Rate (CHR). This is similar to the better known CFRs and IFR's, used to measure the impact of cases and infections on fatality.

By charting the CHR, you can hopefully see the percentage of cases that lead to a daily hospital admission. It is an inexact measure, since some of the hospitalizations are not directly due to a Covid infection, but can be due to other reasons (elective surgeries or other diseases) where a patient also tests positive for Covid.

Interestingly and not totally unexpected, the period when Delta was really starting to spread had the highest CHR, since the data has been reported by NCDHHS. You also see an increase in October/early November. I am not totally sure what could have lead to this increase, but I suspect it may have been people who were admitted for other reasons (more elective surgeries perhaps?) that also tested positive for Covid.

More recently, you can observe that CHR's have been declining in November and early December and now appears to be flattening out slightly. As Omicron continues to spread and becomes most of the cases (it is the dominant one now), I would expect the CHR to fall even more in late December and early January. This assumes Omicron does indeed produce milder infection levels and fewer hospitalizations than past variants. I will likely not be able to update this information until the middle of next week, since NCDHHS will not be updating data over the Christmas holiday.

Wayland said:

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Still a lot of data needs to be reviewed out there.

This out of Denmark shows negative efficacy for Omicron after 3 months of original series. Only have data for less than 30 days post booster which gets you back to where you were 30 days post initial series.

But then are you back to square one (or -1) again after three months or with different variants? Again, still lots to study. Why we should be judicious about constant reboosting of a variant that is no longer circulating. Will this data hold? Who knows... but so much science just to do. And considering what we thought of these vaccines and their efficacy less than a year ago... we should consider nuance to our strategy other than "BOOOOST MOAR!!!!!!!!!!!!!!!!!"

I really do feel like no critical thought has gone into out plans. Just moving reacting and moving forward without updating priors... it is bizarre.

Again, who knows how this data holds under further review, but all these mandates and schools requiring boosters for a variant that doesn't even circulate any more is disturbing.



https://www.medrxiv.org/content/10.1101/2021.12.20.21267966v2.full.pdf

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We really need to get the Novavax vaccine approved. It has been approved by the EU and should be soon in the UK. Maybe for early 2022 for the US?

Vaccines based on the RNA for the spike protein will continue to be problematic, given how much the viruses seems to mutate and mutate in a way to reduce the effectiveness of the vaccines to limit transmission. Prior to Omicron, the vaccines were able to hold up against the mutations, including the Delta variant. Omicron comes along and says "hold my beer." The good news is the T and B-Cell effectiveness against all of the variants appears to be holding up.

caryking said:

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How would someone know what variant of COVID they have? Does the PCR test tell the strain?

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You are not likely to find out, but the lab can identify it when they run the PCR test on a sample. Here's some info from the web:

Quote:

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"Dr. Manoj Gandhi is the senior medical director at Thermo Fisher Scientific. He explains that the PCR tests widely used in the US (polymerase chain reaction tests that pick up the virus' genetic material) have three signals or genes to be detected a signal from two of the three genes means the sample is positive for COVID-19. While the delta variant causes all three gene signals to show up on a PCR test, the omicron variant causes one to drop off in what's also called an S gene target failure.

When scientists in South Africa noticed a change in the PCR test signals (which was also found in cases caused by the alpha variant), they alerted virologists and sent the newer samples in for additional tests, which revealed a new variant with many mutations omicron."

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Can you tell which Covid variant you have?