Continuation The One Covid-19 Science and Medicine Thread Part 4

[junkshop]

So I guess covid has been eradicated in the UK now.

I can only assume this is the case given that I had my iinitial vaccine (AZ) in May '21, a booster (MOD) in December '21, and have not been offered anything since.

Ain't that dandy?

[novaphile]

Originally Posted by junkshop

So I guess covid has been eradicated in the UK now.

I can only assume this is the case given that I had my iinitial vaccine (AZ) in May '21, a booster (MOD) in December '21, and have not been offered anything since.

Ain't that dandy?

I'm not sure about the "offered anything" part above.

I've just had my fifth vaccine, all Pfizer, the latest one being a bivalent vaccine that covers the original 2020 strain and the Omicron variant BA.1.

Note that no one 'offered' these vaccines to me, I had to seek them out, make appointments etc.

[junkshop]

Originally Posted by novaphile

I'm not sure about the "offered anything" part above.

I've just had my fifth vaccine, all Pfizer, the latest one being a bivalent vaccine that covers the original 2020 strain and the Omicron variant BA.1.

Note that no one 'offered' these vaccines to me, I had to seek them out, make appointments etc.

By 'offered' I meant 'made available in any way shape or form through the NHS (the only source of Covid vaccinations and boosters in the UK)'. This is the current availability.

I've not yet turned 50, and am therefore immune until I do, apparently.

[Sherkeu]

Originally Posted by junkshop

By 'offered' I meant 'made available in any way shape or form through the NHS (the only source of Covid vaccinations and boosters in the UK)'. This is the current availability.

I've not yet turned 50, and am therefore immune until I do, apparently.

From your link it says

"Coronavirus (COVID-19) vaccine booster doses are offered seasonally. The next COVID-19 booster doses will be available later in the year and if you are eligible the NHS will contact you when it’s your turn to be vaccinated."

So, in Autumn you can get one.

Seroprevalence in the U.K is over 96% (above 179ng/ml). Odds are you've got Omicron antibodies already. Maybe several variant exposures.

see u.k. data here:
https://www.ons.gov.uk/peoplepopulat...hts/antibodies

[zooterkin]

Originally Posted by Sherkeu

From your link it says

"Coronavirus (COVID-19) vaccine booster doses are offered seasonally. The next COVID-19 booster doses will be available later in the year and if you are eligible the NHS will contact you when it’s your turn to be vaccinated."

So, in Autumn you can get one.

Seroprevalence in the U.K is over 96% (above 179ng/ml). Odds are you've got Omicron antibodies already. Maybe several variant exposures.

see u.k. data here:
https://www.ons.gov.uk/peoplepopulat...hts/antibodies

I’ve highlighted the crucial word. As junkshop said, only over-50s, and some who are vulnerable, were eligible for the latest booster.

[Skeptic Ginger]

Originally Posted by Planigale

We are strongly discouraged from using broad spectrum antibiotics.

That's not the question I asked you.

Originally Posted by Planigale

An example; a high risk patient (mild immunosuppression and chronic lung disease) presents to ED with cough and increased breathlessness. They have a point of care test that is positive for Flu, negative for covid and RSV. They are sent home (reasonable) on an antibiotic (doxycycline) to cover for secondary bacterial infection (no evidence that they had one) but no antiviral for their primary viral infection. Despite the patient clearly meeting the national guideline criteria for treatment. Guideline in fact authorised empirical anti-flu treatment for a person with suspected influenza who was high risk. So even without a positive flu test the person would have met criteria.

That's not the standard of care here. They would be given an antiviral for influenza*. If the patient was sick enough to be seen, they probably should have the flu treated.

*If they'd had symptoms for say a week or so, then it might be too late to give a flu med.

I understand adding the antibiotic, but then why did you just say you are discouraged from using broad spectrum antibiotics? Doxy is moderate to broad spectrum.

[marting]

Eric Topol's has a new, excellent substack piece discussing the endemic phase we are now in He notes that no new variants have appeared showing the high relative advantage of earlier ones. Also discusses risks in the coming years.

https://erictopol.substack.com/p/a-b...a-breakthrough

Topol does a great job anotating the metformin trial I recently posted. Much more readable. He goes on to call it a "A Breakthrough for Prevention of Long Covid" He rarely uses "breakthrough."

He suggests a head to head RCT with Paxlovid:

Quote:

The only other drug to date with some promising data to prevent Long Covid is Paxlovid, but that is from a large observational database, not derived from a randomized trial. Ideally, a 2X 2 factorial design trial would be conducted to test metformin plus paxlovid, either drug alone, or placebo.

Don't expect pharma to spring for the study. Metaformin is dirt cheap.

And he notes nothing to date treats long covid and this is badly needed:

Quote:

And to emphasize, we still have no drug validated to treat Long Covid, only 1 that now appears likely to help prevent it.

[Sherkeu]

Originally Posted by zooterkin

I’ve highlighted the crucial word. As junkshop said, only over-50s, and some who are vulnerable, were eligible for the latest booster.

Seems Canada has similar guidelines published Mar 4:

Public health no longer advising boosters for most Canadian adults

Quote:

...The recommendation excluded Canadians under the age of 65 – so long as the person did not have complex medical needs or live in a long-term care home.

Public health recommends booster-shots exclusively to at-risk groups because Covid-19 has stabilized in Canada, Dr. Tam said. She wrote the general population has high levels of antibodies, resulting from vaccination and previous infections.

[Sherkeu]

Originally Posted by marting

Eric Topol's has a new, excellent substack piece discussing the endemic phase we are now in He notes that no new variants have appeared showing the high relative advantage of earlier ones. Also discusses risks in the coming years.

https://erictopol.substack.com/p/a-b...a-breakthrough

Topol does a great job anotating the metformin trial I recently posted. Much more readable. He goes on to call it a "A Breakthrough for Prevention of Long Covid" He rarely uses "breakthrough."

Will be interesting to see why it wasn't used outpatient before-

It seems that this study of older overweight/obese populations with Covid-19 would be prone to known covid glucose spikes, covid-onset diabetes, and steroidal additions to that -- even if participants have never been formally diagnosed with diabetes.

Metformin, as a diabetes drug to regulate glucose seems like a logical choice for outpatient care of these at-risk groups with a milder cases that dont require a hospital stay with insulin management. Not just for covid, but other illnesses/surgeries that can cause dangerous spikes. Hyperglycemia can do damage.

But having read the study, there were no tests or blood panels done. It doesnt even mention insulin in a study specific to overweight/obese persons getting a diabetic drug. Seems odd to me it is not addressed.

[marting]

Originally Posted by Sherkeu

Metformin, as a diabetes drug to regulate glucose seems like a logical choice for outpatient care of these at-risk groups with a milder cases that dont require a hospital stay with insulin management. Not just for covid, but other illnesses/surgeries that can cause dangerous spikes. Hyperglycemia can do damage.

But having read the study, there were no tests or blood panels done. It doesnt even mention insulin in a study specific to overweight/obese persons getting a diabetic drug. Seems odd to me it is not addressed.

Since they did exclude candidates that were already taking metaformin, the study population has underweighted diabetics. It appears their only interest was the interaction of mataformin with the general, long covid risk cohort. But had they included those taking metaformin, presumably for type 2, it would have required a larger N to get anything useful.

This does bring up the issue of how at risk diabetics on mataformin are relative to those that aren't or even the general population of similar age and BMI. Good areas for futher study. Especially since metaformin was only given for 2 weeks and started days after symptoms. Diabetics would have been on the drug before, at, and during, the time of infection.

There is a discussion of the relevant safety issues in non-diabetics.

[dann]

Originally Posted by marting

Eric Topol's has a new, excellent substack piece discussing the endemic phase we are now in He notes that no new variants have appeared showing the high relative advantage of earlier ones. Also discusses risks in the coming years.

https://erictopol.substack.com/p/a-b...a-breakthrough

Sounds good ... so far.

Quote:

Topol does a great job anotating the metformin trial I recently posted. Much more readable. He goes on to call it a "A Breakthrough for Prevention of Long Covid" He rarely uses "breakthrough."

He suggests a head to head RCT with Paxlovid:



Don't expect pharma to spring for the study. Metaformin is dirt cheap.

Since Paxlovid isn't cheap, shouldn't that make it easier to persuade public health care authorities to participate in a Metaformin test? I assume health insurance companies would also be interested in a cheaper alternative to Paxlovid.

Quote:

And he notes nothing to date treats long covid and this is badly needed:

I don't think long Covid should be considered as one disease with one treatment. That treatment is needed doesn't mean that treatment is possible. Blood clots. Liver, heart, kidney and/or lung damage. Brain fog. Autoimmune diseases. It's a long list. The treatment will have to depend on how the infection damaged the individual patients or groups of patients.

And in many cases, I don't think any treatment can be expected. It will be 'wait and hope that the body will be able to repair the damage to some extent once the infection is gone'. And maybe palliative care in the meantime.

As almost always, prevention is preferable to treatment.

[marting]

Originally Posted by dann

Sounds good ... so far.
I don't think long Covid should be considered as one disease with one treatment. That treatment is needed doesn't mean that treatment is possible. Blood clots. Liver, heart, kidney and/or lung damage. Brain fog. Autoimmune diseases. It's a long list. The treatment will have to depend on how the infection damaged the individual patients or groups of patients.

Indeed. The unknown is how much and kind of long covid is a result of the infection that is no longer there and how much is due to some, ongoing, chronic infection. There are studies that show covid-19 can be detected upwards of 6 months after initial infection in around 10% of cases.

But likely most long covid is the multi-organ damage from the initial infection. So one can just treat, not cure, the damage done if not done early.

So the best hope is early treatment in the first days of infection. And right now, the 2x2 study of Paxlovid and Metaformin that Topol suggests makes all kinds of sense.

[marting]

As a personal anecdote, my brother, just under 70 y/o, almost certainly got covid in late June 2021. A friend he had spent time with two days earlier tested positive the day after and my brother got sick as a dog for a week just 2 days after spending time with the friend. This was 3 months after he got the second Pfizer shot and at the start of the rise of Delta. Delta showed significant immune escape and the vaccine effectiveness starts to wane at 3 months. Probably lucky he got the shot even if he did get sick. BTW, he didn't have a bad reaction to the vaccine, just the usual arm soreness for a few days.

While he almost certainly got covid-19, he wasn't tested. He and his wife live nearly an hour away from the nearest town or testing place in the mountains of the mid-west. She got a mild case a few days after him lasting about 3 days. No indication of long covid in either.

[junkshop]

Originally Posted by Sherkeu

From your link it says

"Coronavirus (COVID-19) vaccine booster doses are offered seasonally. The next COVID-19 booster doses will be available later in the year and if you are eligible the NHS will contact you when it’s your turn to be vaccinated."

So, in Autumn you can get one.

Seroprevalence in the U.K is over 96% (above 179ng/ml). Odds are you've got Omicron antibodies already. Maybe several variant exposures.

see u.k. data here:
https://www.ons.gov.uk/peoplepopulat...hts/antibodies

Not this autumn.

Not until autumn 2025.

Four years after my last dose.

This is fine because clearly there is no more covid, and even if there is, there's no chance of new variants emerging when most of the population are essentially unvaccinated.

This is fine, because politics, over science.

This is fine.

Everything is fine.

[Sherkeu]

Originally Posted by junkshop

Not this autumn.

Not until autumn 2025.

Four years after my last dose.

This is fine because clearly there is no more covid, and even if there is, there's no chance of new variants emerging when most of the population are essentially unvaccinated.

This is fine, because politics, over science.

This is fine.

Everything is fine.

Most of the Earth's population now has antibodies for Omicron or it's substrains, the current viruses going around- without additional boosters. Vaccination is just one way. Given the x100 or x1000 transmission capability since the start of the pandemic, most people have natural immunity at this point- as the seroprevalence studies are showing.... and keep showing.

Protection wanes faster in older or immunocompromised persons.
If you are one of those persons at high risk, you have a case to get the additional booster, and it is recommended. If you have concern for your own health, I'm sure you have asked your doctor about this already. What did they say?

[dann]

You seem to forget or ignore that immunity, whether natural or vaccine-induced, isn't worth much with "new variants emerging" capable of evading the already acquired immunity.

And then there are problems like this one - even though you are not one of those persons at high (or any) risk of this particular ailment:
Prior COVID-19 infection associated with increased risk of newly diagnosed erectile dysfunction (Nature, Mar 15, 2023)
However, since the erectile dysfunction may be due to the microclots caused by Covid-19, it may give rise to many other ailments. Women are at risk of those microclots, too. The more infections, the higher the risk of sequelae.

[marting]

Prior SARS-CoV-2 infection enhances and reshapes spike protein–specific memory induced by vaccination

https://www.science.org/doi/10.1126/...nslmed.ade0550

From the abstract:

Quote:

Together, our data suggest that prior SARS-CoV-2 infection increases the titers of SARS-CoV-2 spike protein–specific antibody responses elicited by subsequent vaccination and induces modifications in the composition of the spike protein–specific memory B cell pool that are compatible with enhanced functional protection at mucosal sites.

[The Atheist]

Originally Posted by dann

You seem to forget or ignore that immunity, whether natural or vaccine-induced, isn't worth much with "new variants emerging" capable of evading the already acquired immunity.

Except, as marting has taken pains to point out, new variants outside the omicron line aren't emerging, or seem at all likely to.

In other covid news, even arch-protective South Korea is ditching mask mandates and has stopped pre-departure testing for Chinese travellers.

[Dr.Sid]

Japan ditched masks outside months ago. People still used them. This Monday they ditched masks inside. And as for what I can tell from webcams .. over 80% of people still are using them everywhere. But at least you can see a rebel here and there. And people in cars, traveling alone, with a mask ? Yep.
That might bite back, as recent spread of other viruses everywhere shows.
Of course I mainly want the habit to die down before my May trip. I learned to hate the masks last October, when I was there.

[angrysoba]

Originally Posted by Dr.Sid

Japan ditched masks outside months ago. People still used them. This Monday they ditched masks inside. And as for what I can tell from webcams .. over 80% of people still are using them everywhere. But at least you can see a rebel here and there. And people in cars, traveling alone, with a mask ? Yep.
That might bite back, as recent spread of other viruses everywhere shows.
Of course I mainly want the habit to die down before my May trip. I learned to hate the masks last October, when I was there.

I’m in the gym now here in Osaka. About 80% are masked. I am in the 20%.

The same is true is walking around and even more so on trains or in shops. The vast majority are still masked.

[Puppycow]

Originally Posted by Dr.Sid

Japan ditched masks outside months ago. People still used them. This Monday they ditched masks inside. And as for what I can tell from webcams .. over 80% of people still are using them everywhere. But at least you can see a rebel here and there. And people in cars, traveling alone, with a mask ? Yep.
That might bite back, as recent spread of other viruses everywhere shows.
Of course I mainly want the habit to die down before my May trip. I learned to hate the masks last October, when I was there.

Originally Posted by angrysoba

I’m in the gym now here in Osaka. About 80% are masked. I am in the 20%.

The same is true is walking around and even more so on trains or in shops. The vast majority are still masked.

Here in Tokyo and Yokohama it is more like 90%, although some people might be wearing them due to pollen allergies. Pollen season should be over by May.

My understanding is that you are still supposed to wear them in crowded commuter trains or hospitals, but not, for example, in a Shinkansen train, which are less crowded. Unless you want to, and some people will continue to wear them no matter what the government says.

[steenkh]

Originally Posted by Puppycow

Here in Tokyo and Yokohama it is more like 90%, although some people might be wearing them due to pollen allergies. Pollen season should be over by May.

My understanding is that you are still supposed to wear them in crowded commuter trains or hospitals, but not, for example, in a Shinkansen train, which are less crowded. Unless you want to, and some people will continue to wear them no matter what the government says.

When we were in Japan some years ago, long before Covid, lots of people wore masks, particularly women. The percentage of people wearing masks will probably not go below the level of before Covid.

[Dr.Sid]

Originally Posted by steenkh

When we were in Japan some years ago, long before Covid, lots of people wore masks, particularly women. The percentage of people wearing masks will probably not go below the level of before Covid.

Well, "lots" before Covid was like 1%. I've never seen more.

[dann]

Originally Posted by The Atheist

Except, as marting has taken pains to point out, new variants outside the omicron line aren't emerging, or seem at all likely to.

I guess The Atheist still believes that Omicron is the mild variant ... or something.

Quote:

Variants of Interest (VOI)
For these variants, evidence is available on genomic properties, epidemiological evidence or in-vitro evidence that could imply a significant impact on transmissibility, severity and/or immunity, realistically having an impact on the epidemiological situation in the EU/EEA. However, the evidence is still preliminary or is associated with major uncertainty. In addition, all the criteria for variants under monitoring outlined below apply.
(...)
Variants under monitoring
These additional variants of SARS-CoV-2 have been detected as signals through epidemic intelligence, rules-based genomic variant screening, or preliminary scientific evidence. There is some indication that they could have properties similar to those of a VOC, but the evidence is weak or has not yet been assessed by ECDC. Variants listed here must be present in at least one outbreak, detected in a community within the EU/EEA, or there must be evidence that there is community transmission of the variant elsewhere in the world.
SARS-CoV-2 variants of concern as of 9 March 2023 (European Centre for Disease Prevention and Control)

Originally Posted by The Atheist

ditching mask mandates and has stopped pre-departure testing for Chinese travellers.

That will certainly help crush the pandemic: Cumulative confirmed COVID-19 deaths per million people

[The Atheist]

Originally Posted by dann

I guess The Atheist still believes that Omicron is the mild variant ... or something.

It demonstrably is.

The South African doctors noted it when it arose, and it's held true.

Omicron is far milder than delta.

I realise a publication like British Medical Journal saying:

Quote:

The research confirms earlier studies from South Africa and South Korea, which suggested that infection with the omicron variant was notably less severe than with the previous dominant variants.

...means nothing to people wanting to still panic over the disease, but most people understand it, so it's cool.

Originally Posted by dann

Cumulative confirmed COVID-19 deaths per million people[/url]

Still working on complete misrepresentation of the facts, I see.

Cumulative totals are utterly irrelevant in 2023.

We're 2.5 months into the year and just over 100,000 people have died of covid in 2023.

In 2021, it was 900,000, and in 2022, 600,000 people died, in the exact same period.

Just for comparison, during the first 2.5 months this year, 'flu has killed 100k, HIV 350k and car crashes 280k.

[dann]

Originally Posted by The Atheist

It demonstrably is.

The South African doctors noted it when it arose, and it's held true.

Omicron is far milder than delta.

I realise a publication like British Medical Journal saying:

...means nothing to people wanting to still panic over the disease, but most people understand it, so it's cool.

Yeah, right! Far 'milder'! And making up for it in transmissibility:

Quote:

Vaccinated people infected with the omicron variant of SARS-CoV-2 had symptoms for 6.87 days on average, compared with 8.89 days with the delta variant, data from the ZOE app have shown.

So why don't we skip all other measures against the virus and learn to live with it, right?!
Wait, that is just what we did, only it didn't really turn out the way The Atheist predicted, did it?!

Some people don't understand that transmissibility may be more important (and kill more people) than virulence. Numbers from my own country: March 2020 to Nov 30, 2021: 2,883 Covid-19 deaths; Nov 30, 2021 to March 16, 2023: 5,433 Covid-19 deaths.

Originally Posted by The Atheist

Still working on complete misrepresentation of the facts, I see.

Cumulative totals are utterly irrelevant in 2023.

We're 2.5 months into the year and just over 100,000 people have died of covid in 2023.

In 2021, it was 900,000, and in 2022, 600,000 people died, in the exact same period.

Just for comparison, during the first 2.5 months this year, 'flu has killed 100k, HIV 350k and car crashes 280k.

Yes, The Atheist is still working on complete misrepresentation of the facts, which is probably the reason why he didn't want to copy my link (a tendency I have noticed before). But let us look at the same graph after the arrival of the mild variant instead: Cumulative confirmed COVID-19 deaths per million people

And he never gets tired of his comparison with car crashes, which is why I always confront him with the NZ numbers* whenever he does:

Originally Posted by dann

New Zealand road deaths in 2022: 373 - a little more than the average of recent years and yet no comparison to the SARS-CoV-2 death toll:
New Zealand Covid-19 deaths in 2022: 2,280

The Atheist is not ignorant of the difference between the actual number of Covid-19 deaths and the registered number of Covid-19 deaths. He just likes to pretend that the registered number is the actual number.
And even when we look at the registered number of Covid-19 deaths, this number is 172,000. Don't be surprised that The Atheist calls this "just over 100,000". That is what minimizing is all about.

* The numbers from any country with reliable statistics will do.

[Dr.Sid]

Actually no. New Zealand had the luxury of being an isolated island. They managed to keep delta (and older variants) out. In EU and US omicron has more cases than delta (showing poor delta induced immunity) but less deaths even considering higher case numbers.

https://ourworldindata.org/explorers...European+Union

Every country which had delta, saw omicron as a relief.

[marting]

Eric Topol updates variant watch:

All remains quiet on the new variant front
https://twitter.com/EricTopol/status...78952554590208

[The Atheist]

Originally Posted by marting

Eric Topol updates variant watch:

All remains quiet on the new variant front
https://twitter.com/EricTopol/status...78952554590208

Yes, very steady as she goes.

I think we can be pretty confident that we're not going to see a sudden shift to a more dangerous form now.

It's now 15 months since omicron struck, and it's notable how the waves have declined each time, while deaths keep trending ever-lower.

[dann]

Originally Posted by Dr.Sid

Actually no. New Zealand had the luxury of being an isolated island. They managed to keep delta (and older variants) out. In EU and US omicron has more cases than delta (showing poor delta induced immunity) but less deaths even considering higher case numbers.

https://ourworldindata.org/explorers...European+Union

Every country which had delta, saw omicron as a relief.

You leave out the effect of vaccinations in your calculations. Delta arrived more or less pre-vaxx (or only partly vaxxed).

In the Nordics, we didn't have fewer deaths. On the contrary, we saw a drastic rise in the death toll due to a rising number of infections.

The reason was, as I have mentioned already, that Omicron was more contagious - in spite of vaccinations and boosters:
Cumulative confirmed COVID-19 deaths per million people, Dec 2021 to Nov 2022.
In the first year after the arrival of Omicron, the death roll rose considerably in all countries. We an extreme increase in the number of deaths in:
Denmark: x 2,5 (495 --> 1,430)
Norway: almost x 4 (213 --> 824)
Finland: more than x 5 (270--> 1,430)
Iceland: x 6,5 (100 --> 640)

And this was in spite of the vast majority of adults being well-vaxxed (and then boosted in November and December), which we hadn't been in the (Delta) summer of 2021.
Does it look mild to you?! As I said, the transmissibility sometimes more than makes up for virulence, and in the winter of 2021-22, the Nordic countries went for the fabled hybrid immunity or 'super immunity': vaxx + infection. The latter, i.e. infection, was very easy to achieve since Omicron was as infectious as it was even after three jabs of Pfizer or Moderna.

There was no doubling, quadrupling or worse in Sweden, which had been hit much harder than the other Nordics in their attempt to achieve herd immunity by infection, but they still had a considerable increase in the number of deaths by Covid-19:
Sweden: 1,437 --> 2,008 - considering both vax + immunity acquired by earlier infection.


ETA: Cuba, of course, was almost unvaccinated when Delta arrived, but fared much better with Omicron. Not because it was mild, which it isn't, but because the whole population, including children, had then been vaccinated. Singapore had been vaccinated prior to Delta, and also vaccinated even very young children:
Cumulative confirmed COVID-19 deaths per million people: Nordics + Cuba + Singapore, Dec 2021 to Nov 2022.

[marting]

Originally Posted by dann

You leave out the effect of vaccinations in your calculations. Delta arrived more or less pre-vaxx (or only partly vaxxed).

No. In fact it was the Delta variant's emergence that triggered develoment and push for additional shots. Prior to Delta there had been a strong reduction in cases/hospitalizations/ and deaths by summer 2021 because the vaccines had been quite effective.

It was the summer crowds in Provincetown, MA. that changed things. P-town, as it is known, is a gay Mecca. And gays tended to get vaxxxed at higher rates with 80% being "fully vaxxed." Delta sprang up and large numbers of celebrants got Covid-19 vaxxed or not. 3/4 of the cases were "fully vaxxed."

This resulted from two factors. Vaccine protection against infection starts to wane after 4 months and Delta exhibited substantial immune escape.

And boosters were born.

https://www.kff.org/coronavirus-covi...g-lgbt-adults/
https://www.npr.org/sections/health-...-more-about-de

[The Atheist]

Originally Posted by dann

ETA: Cuba, of course, was almost unvaccinated when Delta arrived, but fared much better with Omicron. Not because it was mild, which it isn't...

The position so far:

One bloke on the internet screaming "omicron isn't milder!!11!!!"

BMJ - as above: omicron is milder.

USA's National Institute of Health (via Nature): [vaccinationm/received immunity...] Most likely both play a part in what is by now clear: Omicron leads to less severe disease at the population level.

Who will win?

[dann]

Originally Posted by marting

No. In fact it was the Delta variant's emergence that triggered develoment and push for additional shots. Prior to Delta there had been a strong reduction in cases/hospitalizations/ and deaths by summer 2021 because the vaccines had been quite effective.

It was the summer crowds in Provincetown, MA. that changed things. P-town, as it is known, is a gay Mecca. And gays tended to get vaxxxed at higher rates with 80% being "fully vaxxed." Delta sprang up and large numbers of celebrants got Covid-19 vaxxed or not. 3/4 of the cases were "fully vaxxed."

This resulted from two factors. Vaccine protection against infection starts to wane after 4 months and Delta exhibited substantial immune escape.

And boosters were born.

https://www.kff.org/coronavirus-covi...g-lgbt-adults/
https://www.npr.org/sections/health-...-more-about-de

Yes!
Dr. Sid and I are EU Europeans. Maybe you are unaware or maybe you just forgot, and it's very easy to forget because by the end of 2021 the EU (at least in Western Europe) had overtaken the USA, but the vaccine rollout in 2021 was very different in Europe from what it was in the USA. You object to what I wrote and support your claim by referring to an article about "the Provincetown, Mass., cluster that started around July Fourth weekend", and you mention that "vaccine protection against infection starts to wane after 4 months".

That may have been true in the USA, but it wasn't in Europe because the rollout was much slower. Denmark was one of the fastest countries in the EU at the time, but it only managed to get a majority of the population vaxxed by the end of the summer because it benefitted from the vaccine hesitancy in some countries in Eastern Europe:
Denmark buys 1.17 million doses of Pfizer-BioNTech COVID vaccines from Rumania (The Ministries of the Interior and of Health Care, June 29, 2021)
One million vaccines made a huge difference in a population of 5.86 million!

I.e. Denmark only had the problem of waning vaccines in the summer of 2021 in the very oldest and most frail parts of the population by the summer of 2021. In the age group corresponding to the one that appears to have been hit as one of the first in Provincetown, Mass. around July Fourth, vaccinations had probably hadn't even (or had only just) started in early July. What I wrote and you quoted was that "Delta arrived more or less pre-vaxx (or only partly vaxxed)." And my numbers referred to the Nordics (+ Cuban and Singapore).
I don't know about Singapore, but due to delay in the delivery of some of the ingredients of the vaccines (due to the U.S. blockade), the Cuban vaccination campaign didn't get up to full speed until the (Delta) summer of 2021. And it shows! Cumulative confirmed COVID-19 deaths in Cuba, June 1 to Nov 29, 2021.

I no longer remember any details about the vaccine rollout in the Czech Republic. Maybe Dr. Sid does. My guess is that it will have been a little faster than in Rumania, but considerably slower than in Denmark due to the extra doses Denmark was able to purchase at a critical moment.

[dann]

Originally Posted by The Atheist

The position so far:

One bloke on the internet screaming "omicron isn't milder!!11!!!"

BMJ - as above: omicron is milder.

USA's National Institute of Health (via Nature): [vaccinationm/received immunity...] Most likely both play a part in what is by now clear: Omicron leads to less severe disease at the population level.

Who will win?

I guess we all have to be grateful that The Atheist now seems to have understood that Omicron isn't mild, and that it isn't even "far milder" than Delta, which is what I pointed out, but The Atheist is always very selective when he quotes my posts!

Notice that The Atheist leaves out that the reason for describing Omicron as "milder" in the BMJ is the comparison with the extremely virulent Delta variant: Vaccinated people infected with the omicron variant of SARS-CoV-2 had symptoms for 6.87 days on average, compared with 8.89 days with the delta variant, data from the ZOE app have shown.

Omicron just isn't "far milder" than Delta. It is only slightly milder, and it more than makes up for it in transmissibility, which is how it managed to kill several more people in most Nordic countries than the other variants, including Delta, had managed to kill before the arrival of Omicron - and in a shorter time span. That The Atheist also doesn't want to quote this goes without saying. It's his strategy for winning his imaginary contest, "Who will win?", in spite of Omicron's death toll "at the population level," which he only pretends to be concerned about anyway.

Originally Posted by dann

The reason was, as I have mentioned already, that Omicron was more contagious - in spite of vaccinations and boosters:
Cumulative confirmed COVID-19 deaths per million people, Dec 2021 to Nov 2022.
In the first year after the arrival of Omicron, the death roll rose considerably in all countries. We an extreme increase in the number of deaths in:
Denmark: x 2,5 (495 --> 1,430)
Norway: almost x 4 (213 --> 824)
Finland: more than x 5 (270--> 1,430)
Iceland: x 6,5 (100 --> 640)

[Dr.Sid]

Cherry picking. Add EU and USA to that graph. And also, the whole world. Yes, Omicron was worse in some countries. But globally it was not.

[zooterkin]

UK cases on the way up again, according to Zoe and hospital admissions (up 12% in the last week). UK Government has decided to stop the ONS surveys, so we will not have reliable data any more. Also, funding for tests in hospital has changed, according to Chris Pagel, so again less reliable figures in future for patients being admitted. The bottom of each recent successive wave seems to be higher, even if the peaks are lower.

[zooterkin]

Originally Posted by Planigale

You are not alone. Come into hospital with a cough and fever and you will be given an antibiotic even in the absence of a proven bacterial infection. Come in with flu or covid proven on PCR and you may not be given antivirals. The is despite he fact most antivirals are safer than antibiotics and in general there is no greater evidence of efficacy. There seems to be a reluctance to give antivirals which doesn't apply to antibiotics.

Antivirals seem to be limited to those at high risk in the UK.

[The Atheist]

Originally Posted by zooterkin

UK cases on the way up again, according to Zoe and hospital admissions (up 12% in the last week).

Appears to be no differentiation between people admitted for covid and with covid, which is misleading at best.

The current numbers are a small fraction of what's happened in the past couple of years.

[zooterkin]

Originally Posted by The Atheist

Appears to be no differentiation between people admitted for covid and with covid, which is misleading at best.

The current numbers are a small fraction of what's happened in the past couple of years.

It's an indication that numbers of people infected with Covid is going up again. People will be off work, and some will get long Covid.

[Planigale]

Originally Posted by zooterkin

Antivirals seem to be limited to those at high risk in the UK.

Anyone admitted to hospital with flu meets criteria for anti-virals. For Covid-19 you would in general have to be symptomatic and 'vulnerable'.