Important Pandemic Reads, Omicron Edition

Ed Yong, possibly the best American reporter on the pandemic, at the Atlantic:

Omicron didn’t much shift the way I weighed my personal risk. Although the new variant can evade some of our immune defenses, early data suggest that boosted people are roughly as protected against Omicron infection as people with two vaccine doses are against Delta. That protection isn’t foolproof, but even if immune systems can’t block the virus from gaining an initial foothold, they should still be able to stop it from causing too much damage. If I got the virus on my birthday, I’d expect to be knocked down for a time but okay by Christmas—and I’d expect the same to be true for everyone who was meant to come…

My friends, of course, are adults who can make informed decisions about their own risks and their own loved ones’ risks. But the logic of personal responsibility goes only so far. Omicron is spreading so rapidly that if someone got infected at my party, my decision to host it could easily affect people who don’t know me, and who had no say in the risks that I unwittingly imposed upon them. Omicron is unlikely to land me in the hospital, but it could send my guests’ grandparents or parents to one…

I feel haunted by [health care workers’] words when I make decisions about the pandemic. When I stare out my window, the world looks normal, but I know through my reporting that it is not. This has already changed the way I behave, and not just to avoid getting COVID. I’ve been trying to drive more carefully, in the knowledge that if I got into an accident, I wouldn’t get the same care that I would have two years ago. I feel that the medical system in this country is at a tipping point—a fragile vase balanced so precariously on an edge that even a fly could knock it over. Omicron is a bullet. It’s one that we can each choose whether to fire…

It is easy to despair, but we cannot afford the luxury of nihilism. Grim though the stories I’ve written may be, I have tried to infuse every one with some hope—with the acknowledgment that a better future is at least possible, if not probable. And despite everything, I firmly believe that it is. Failed systems constrain us, but we still have agency, and our small choices matter immensely. The infectious nature of a virus means that a tiny bad decision can cause exponential harm, but also that a tiny wise decision can do exponential good

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Don’t Panic About Omicron. But Don’t Be Indifferent, Either:

Much remains unknown about the dynamics of Omicron, and new evidence is emerging as rapidly, it seems, as the variant is spreading. But we know enough to anticipate some key features, particularly the variant’s unprecedented transmissibility. We should now expect a very large wave of infections—one that is gathering steam already in New York City, and will spread quickly throughout the country. We will see cases rise rapidly in the next few weeks, likely peaking sometime in mid-January. With any luck, cases will then fall as quickly as they rose, getting to very low numbers by the end of February. All of this suggests that the work ahead is to manage the next six to eight weeks.

Given the transmissibility of this virus, nothing short of a hard lockdown will prevent a large spike in cases. That is the path the Netherlands has taken. But at this point in the pandemic, in our country, a lockdown would fail because too many Americans would refuse to comply. Thankfully, we can take a very different approach…

We have choices to make. During this Omicron wave, we can’t do everything we’d want to do if the pandemic were over. But we can do so much, and far more safely than at the beginning of the pandemic. Large indoor holiday parties with eating and drinking? As fun as they are, we should probably be canceling those. But seeing friends and family? That is essential, and we should feel comfortable celebrating with our nearest and dearest these holidays—as long as everyone eligible is vaccinated and boosted, and uses rapid testing as an additional layer of protection.

This isn’t the holiday season we had wished for, but it needn’t be anything like the fearful and isolated winter a year ago. Omicron’s spread makes a surge of infections inevitable, but the impact of those infections depends on the steps we take over the next few weeks. Boosted folks will largely do fine; partially vaccinated people will get infected at very high rates. Unvaccinated and high-risk folks with breakthroughs will be at risk for hospitalizations…

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The issue is how shots are recorded — no one disputes the number of shots administered. But they’re concentrated in fewer arms.

If you can’t link a shot to others (like my 2nd dose being linked to my 1st) it’s sort of a straggler and the fallback is calling it a first dose.

The U.S. health system is so fragmented that data are getting skewed. This was a problem before the summer but took off then and in the fall, as people sought booster shots before they were cleared.

For example, someone goes and gets a “first shot,” but really it’s a booster.

Or, someone might get a shot in one county and their second in another county, or another state. Some places have addressed that, but generally, there’s a risk that that person is double-counted as two half-vaccinated people, rather than one fully vaccinated one.

No politician is all that incentivized to bat an eye, because sorting this out will reduce their favorite metric — how many people have gotten “at least one shot.”

It allows them to tout widespread vaccine coverage. But it’s at least partially a mirage…

The CDC data lake is, to be very fair, in an unenviable position. They’re sucking in data from 50 states, from pharmacies and other providers, from other entities like cities, or federal agencies, etc. All count things a bit different or use different software. It’s messy.

So anyhow, now, the CDC data show that 37 million people in the U.S. allegedly never got their second dose, or 11 percent of the entire nation. That gap — 11 percentage points between “at least one dose” and fully vaccinated — far exceeds similar countries. It’s 2.6% in the EU.

So the question is: are Americans who get one shot uniquely likely to never get a 2nd? Or is there another factor at least partially at play?

States and other jurisdictions have started to dig into it. Some found this problem: their first dose count was too high.

Other states found no problems, and say their data has no material issues. (I asked all of them.) Others revised, but not for this issue. Others said the CDC process was too onerous for them to participate & revise. And others said they’re still planning to submit revisions…

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From a looong thread:

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