Is Omicron a Milder? -Government executives

When Omicron appeared, scientists Had Three big questions.

First, is Omicron more contagious than previous variants? Judging from the nearly vertical charts of case growth in South Africa, Europe, New York City, and almost everywhere else where Omicron showed an unwelcome look, the answer is yes. This may be the most contagious coronavirus strain we have ever seen.

Second, will Omicron evade immune defenses from our vaccines and previous infections? The evidence here is also overwhelming: yes. The daily surge in most vaccinated areas is compelling enough. For a more obvious example, look at the hundreds of breakthroughs in the NFL, NHL, and NBA, which are leagues with vaccination rates above 90%.Despite mandating a vaccine, Cornell shut down Campus after nearly 1,000 students test positive.

Third, will Omicron cause more serious illnesses? This was the most difficult to answer due to the two components of simple and difficult questions.

[Ashish K. Jha: Don’t panic about Omicron. But don’t be indifferent, either.]

The simple question is whether a typical vaccinated (or recently infected) adult has the same face. Individual The risk of serious illness due to Omicron she faced from the original coronavirus in March 2020. The answer is almost certainly no. The United States has accumulated a lot of immunity through infection and vaccination, and Omicron variants do not appear to circumvent all of their accumulated protection.Last month we learned that Omicron Excellent for breaking through The first layer of immunity that is our neutralizing antibody.But our Next protective layer, our T cell response, Seems to hold up much better against variants. Thinking of the vaccine as a castle defense system, Omicron can expand the wall (that is, bypass neutralizing antibody protection), but cannot fight the knights in it (that is, overcome T cell protection). It’s like an invading army. Boosted Americans are particularly well equipped for the Omicron variant, as the third shot increases the number and quality of neutralizing antibodies and effectively builds the immune wall.

Now, the more difficult question. How serious are Omicron variants for non-immune people? Overall, evidence from countries and studies of Omicron outbreaks provide a tentative optimistic answer. But even optimistic answers to individuals can be bad news for the healthcare system.

Data by country

South Africa — Quite optimistic, but potentially misleading. National hospitalization rate It plummeted In this wave, and so far, the case seems to have already peaked.In the hospital, a doctor I am reporting Decreasing the proportion of people in need of oxygen supplementation. This predicts a reduction in overall mortality. South Africans of all ages are less likely to die of Omicron.Most cohorts Case fatality rate reduced by 50-70% By one analysis compared to previous coronavirus strains. And the wave of national warp speed may suggest the existence of many asymptomatic cases. Compared to the most pessimistic scenarios, this is all promising. But South Africa is a younger country than the United States and is widely exposed to the waves of previous illnesses, so you shouldn’t expect every country to have the exact same experience.

UK — Not optimistic, but very early. Hospitalization is increasing rapidly in London and elsewhere moderately All over England. However, researchers are still unable to determine how much the increase in hospitalization is the result of the resurrection of Delta and how much is due to the rise in Omicron. A Widely shared headlines from Financial TimesSummarizing a study from Imperial College London, claimed that there was “no evidence” that Omicron was less severe than Delta. However, the authors of this study are more careful than most journalists, and the findings are “Very limited“Hospitalization data. The United Kingdom is a better agent than South Africa for the Omicron experience that the United States expects, but for now it is a worse source of high-quality data. This is a wait-and-see case.

Denmark — Somewhat optimistic, but also very early on. The Omicron case graph is basically vertical in Denmark, but the national Omicron hospitalization rate is About 60% lower than Delta, According to some measures, the government reports: Less than 5 patients Omicron was diagnosed in the intensive care unit. The Average daily deaths In addition, it does not change. However, given the delay between increasing cases and death, even death or hospitalization may be premature to use as an indicator.

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South Africa — Lots of evidence of mild illness, but all need attention: A Real world analysis According to Discovery, South Africa’s largest health insurance company, adults infected with Omicron are estimated to be about 30% less likely to be hospitalized than adults infected with other waves. (On Thursday, an early assessment published prior to the peer review showed that patients with Omicron had Omicron infection compared to Delta infection. 70% less likely to develop severe illness.. Most of South Africa’s Omicron hospitalizations (including over 80% of ICU admissions) were unvaccinated. The Discovery newspaper also found that double doses of the Pfizer vaccine were only 30% effective in reducing infections, but were approximately 70% effective in reducing infections. hospitalization..

Hong Kong — Possible Mechanisms of Mild Illness: One analysis Twenty-four hours after infection, Omicron grows 70 times faster than the delta variant of the bronchi, the airway that connects the trachea to the lungs, and the original virus, according to Hong Kong researchers studying virus samples in dishes. I concluded that I did. However, the study also found that Omicron was significantly less effective than previous strains in growing in lower lung tissue. This may suggest a different disease profile for Omicron. Upper respiratory tract infections usually cause colds and sore throats, but lower respiratory tract infections are more likely to cause pneumonia. This finding may also suggest a larger infectious mechanism. Viral particles in the upper lungs are unlikely to cause serious illness, but are more likely to be excreted when people talk, sing, or breathe.

Cambridge — Another Possible Mechanism of Mild Illness: Ravi Gupta, a professor of clinical microbiology at the University of Cambridge, New report We have found that a variant of Omicron bypasses neutralizing antibodies, but has less replication in the lungs. It’s like an invading medieval army that specializes in scaling walls, but not fighting knights inside the walls. Similar to the Hong Kong study, Cambridge’s study of Omicron is consistent with viruses that are more contagious but less likely to cause severe respiratory illnesses such as pneumonia. (The study also concluded that a third dose of mRNA “saves” neutralizing antibody levels in the short term, reducing the likelihood of infection or serious illness.)

Before the evidence materialized, there was my assumption that Omicron would be about as strict as Delta.At this point, based on national data and lab research, my best rating is that a bit The severity is lower for healthy, unvaccinated adults who have not been pre-infected. Not so serious For individuals who are protecting T cells from previous infections or vaccinations.

[Read: We know enough about Omicron to know that we’re in trouble ]

Pandemic arithmetic is Individual experience. Viruses are a problem of proliferation. Overall, viruses that are 60% milder but 300% more infectious create more serious cases. The delta wave is already continuing in the United States, killing more than 10,000 people a week. Any Accidental variants, even much milder, can carry the risk of overloading the medical system. Already worn out..

What does this mean you?? The difficulty in answering this question is that you don’t know who you are, what your T cell protection is, or how you spend your vacation. The best way to think about the overall severity of the United States is to imagine four concentric circles. In this circle, the risk of illness increases as you fan out.

In centering, non-seniors are boosted. This group seems to be very safe from severe illness and well protected from infection. One ringout is a double-vaccinated American under the age of 65 with no immune system complications. This group is at high risk for breakthrough Omicron cases, expand Omicron cases for more vulnerable people — but T cell immunity seems to provide considerable protection from serious illness. (I don’t think there is any good information yet about the long COVID risk from these groups of Omicrons, but the previous strains. Associated With months of dyspnea and pulmonary dysfunction. )

In the third ring, there are people who have been vaccinated or boosted, but are still at risk. This group, including the elderly and individuals with weakened immunity, deserves special attention. People in the central circle need to be careful about the mix of households and the elderly. This is because, in the case of breakthroughs, there is no certainty that T cell protection in the elderly will protect them from severe illness. Keep in mind that age is still important among the boosted older people. According to the CDC, people over the age of 85 have an approximate risk of COVID death 5 times higher From a typical 65 years old.

Finally, the fourth circle represents a wider unvaccinated population, both in the United States and around the world. Omicron is so contagious that hospitalization for unvaccinated people is expected to surge, even if it is an overall mild illness.

Putting all the rings together, you can see why the severity issue is so difficult. Individuals in Rings 1 and 2 may not face much of the personal risk of severe infection with Omicron. However, if they are infectious when celebrating with people in Rings 3 and 4, they can spread the disease to a very vulnerable group that can really get sick.

Be careful when mixing households during this holiday season. Try to get a quick test to make sure you are not contagious when spending time with older relatives. Omicron may not be as serious as we were afraid of. But we can be optimistic and at the same time careful.

This article was originally published Atlantic. Their sign up Newsletter..