Some HAWT TAEKS on Omicron

With this as an overarching caveat:

Anyway, some HAWT TAEKS:

  1. The key thing is to Keep Calm and Carry On. Unless you’re laying odds in Vegas on an Omicron surge and you ‘need’ to know what will happen over the long term, over the short and medium terms, it’s the same policy as before: depending on the prevalence and vaccination uptake, indoor masking, testing, and vaccination (along with improvements in ventilation and cheap rapid testing–but you, as an individual, probably can’t do that much about those things).
  2. Will it be better at dodging the immune system, even in vaccinated people? Nobody knows that right now. It does have a lot of changes in the spike protein that suggest this, but it also has two changes that previously were thought to be disadvantageous for the virus. So we don’t know. Remember that there have been other variants that are harder for the immune system to grapple with that haven’t taken off globally. And southern Africa, the region, has some unique characteristics (we’ll get to that).
  3. Will it spread? Most variants have spread somewhat, but haven’t dominated globally, but I have no idea right now–there’s some dumb luck, in either direction, involved with all of this. Moving on to southern Africa, the region, and South Africa, the country…
  4. Should we blame South Africa (the country) or claim that it originated from there? No to both. We don’t know where it originated, but South Africa is the regional hub for surveillance, so if it originated in another country and spread to South Africa, it likely would be detected only when it hit South Africa. Besides, it’s not like the U.S. response to COVID has been… exemplary, so blaming other countries is more than a little hypocritical.
  5. This is a point only a few people in The Discourse™ have raised, but seems important: there is likely a significant role of immunocompromised people with long-term infections (many weeks or months) in the generation of novel variants. When these patients are sampled through time, the pace of evolution within a patient is much more rapid. This shouldn’t be surprising, but what it means is that we need to protect immunocompromised people to protect ourselves (though we should protect sick people for their own sake because who wants to suck as a human?).
  6. Returning to southern Africa, there is an incredibly high prevalence of HIV in southern Africa. In South Africa, 18.1% of people are HIV-positive (that’s not a typo, eighteen percent). Other southern African countries have a lower prevalence, but the surveillance in those countries isn’t as good either. That means a significant fraction of those who are supposed to be the healthiest (younger adults) are immunocompromised. It’s not clear that what happens (and will happen) in South Africa is a model for countries with much lower HIV prevalence (e.g., in the U.S., 0.35% of the population is HIV positive). In addition, some of South Africa’s political response (not the public health workers’ response) to HIV/AIDS would have made Trump sound sane, and Florida Governor and COVID Quisling Ron DeSantis cringe. Western pharmaceutical companies’ greed has compounded this. There is a ton of misinformation, disinformation, and distrust, which doesn’t help matters at all. Again, extrapolating from this particular circumstance might not shed as much light as we would like.
  7. To repeat, even if Omicron turns out to be a nothingburger, as long as we don’t protect the immunocompromised (and increase vaccination rates in general), we are creating conditions for more variants. To use a(n odious) phrase, we have to fight it over there, so we don’t fight it here.
  8. The one truly scary thing from South Africa, and may have nothing to do with Omicron at all, is the report over the weekend that 61 out of 624 passengers on a single plane from South Africa to the Netherlands tested positive for COVID. All passengers were supposed to have either a recent negative test or have been vaccinated. Hopefully, that’s an reporting error or an artifact of a very sensitive PCR test (i.e., they were ‘infected’, but at such low levels or long enough before that they are unable to transmit the virus, even though viral RNA could be detected). But at face value, that report and its implications for air travel, not TEH OMICRON, is what worries me right now.

Those are my provisional HAWT TAEKS.

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5 Responses to Some HAWT TAEKS on Omicron

  1. CB says:

    Thanks, this is very clarifying and helpful. Lots more to understand.

  2. David in Tokyo says:

    Ditto on the thanks bit, but…

    “But at face value, that report and its implications for air travel, not TEH OMICRON, is what worries me right now.”

    This whole thing is happening because too damn many people travel by air. Over 1.5 million people flew into (ditto for out of) Australia every f-ing month in 2019. That’s seriously insane. The only reason this was Covid and not Ebola is that no one visits rural Africa. If we don’t cut air travel back to close to 2020 levels permanently, we won’t have to wait for climate change to make the planet unlivable. Really. The next time could be much worse.

    Sorry for the rant, but someone needs to say it.

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