This actually seems like strong evidence against your hypothesis - that we suddenly have strong evidence of quite a bit of Omicron all at once, and cities are locking down. If Omicron had already been running rampant for a while these actions don't make sense.
> We also know from Hong Kong what it could look like if a population that only had access to Sinovac and has had few previous infections has uncontrolled spread of Omicron. Things get very bad very quickly.
I meant this more in the sense that there would be huge numbers infected at once, rather than that the IFR wouldn't be reduced - it's still way more than their systems are capable of handling, I'd assume?
OK, let's do rule of thumb. 30% of elderly are vaccinated in HK, more of non-elderly. So if vaccine was completely ineffective we'd expect vaccinated to be slightly less than 30% of deaths. Instead they are 10% of deaths. So if we take at face value, Sinovac reduces death by 80% or so? That's good, but far less good than mRNA...
I dont understand why it would be a good idea for them to get mRNA vaccines because those vaccines proved weak against Omicron (and I imagine that additional mutations on BA 2.2 will not help).
Reasoning:
BA.2.2, a descendant of Omicron is already here and causing much damage in Asia. This one has about 20 mutations different from Omicron. This is how fast this virus is mutating and causing damages.
The mRNA vaccines as constructed against the Wuhan virus have been great at protecting people through the many waves of variants but, as Omicron shows, the virus is mutating away from them. This is likely because these vaccines mostly help the immune system learn about parts of the spike proteins that are often subjected to mutation, not the ones resistant to that.
Repeated boosting mRNA vaccines could help the immune system to learn better about epitopes on the spike protein that is resistant to mutation. But, that is a tremendous financial cost to society, not to mention health cost in terms of side effects. Lastly, changing vaccine formulation to target Omicron directly will not do much long term as long as the mechanism of action is the same. The virus will just mutate away from that formulation too.
They're still the best we have and definitely way better than Sinovac, especially against severe disease and death. I agree they're not the perfect weapon we wanted or thought we had, but we don't have another alternative.
From my understanding of the origins of Omicron its emergence was unrelated to the vaccine and it would have taken over even without it, the drift away from the vaccine was simply a side effect of changes that were optimal for other reasons as well (assuming it didn't come from a lab).
We (EU countries) already have an alternative = Novavax. Their results are robust in terms of Omicron response and they offer full protection for longer periods of time. Hopefully it will be available in US soon.
That depends on how vulnerable China turns out to be on various fronts and how effective their vaccine is vs. death under Omicron which is impossible to currently know, but probably China ends up similar to the world's overall rates by default. I'm trying not to focus on this, though.
Agreed it's what matters in the end (although disruptions too), but that's mostly about how many people get infected and whether proper care is available for them. So it again comes down to whether the whole country is going to get infected or not.
A 15% chance of keeping it under control sounds far too high at this stage. I'd sell to 3%.
Original-recipe covid could be eradicated through lockdown, Delta was borderline. I don't think it's possible with Omicron even with a "full" Chinese-style lockdown, and Shanghai is not under full lockdown.
I agree it intuitively sounds too high, but my intuition would have lost money repeatedly betting against China's COVID containment in the pandemic to-date.
I didn't think a priori that original COVID could be eradicated by lockdown. They had multiple cases in 6-7 population centers, and original COVID had a 5-7 day asymptomatic period. Contact tracing and eliminating the spread effectively in multiple cities seems very difficult, and you have to win in EVERY one to win. But they managed it.
Delta wasn't that much more contagious than original COVID, but maintaining will and vigilance to heavily manage all border crossings on a country as large as China seemed very difficult. Surely there was some non-negligible ongoing odds of a sizable COVID infection sneaking through and not getting contact-traced to death? And yet it never happened.
So while my intuition again says that containing Omicron is nearly impossible, I have to give them credit. They've already done the very improbable with COVID twice. Maybe it could happen again?
I'd probably sell to 10%, but given their track record I think 3% is way too low.
The comparatively milder infections with the Omicron variant and higher levels of population immunity have raised hopes for a weakening of the pandemic. We argue that the lower severity of Omicron is a coincidence and that ongoing rapid antigenic evolution is likely to produce new variants that may escape immunity and be more severe.
While this post is about China, cases in Europe are climbing again as well: http://kjplanet.com/coronavirus-data-explorer-europe-mar-16-2022.png. (Of course, we know cases aren't the best metric, but deaths lag. Hospital admissions are not always as well tracked, but also seem to be ticking up.)
I've heard speculation linking this to the BA.2 Omicron variant, but I'm struggling to understand why this would affect Europe and not other major nations (US, Canada, India, etc.). Any insight here?
Will discuss on Thursday. The presumption is that other areas are 'behind' Europe on this in some way, but still looking at it. I don't understand the rapidity of the rise because if BA.2 is that much more contagious this should have happened earlier.
This actually seems like strong evidence against your hypothesis - that we suddenly have strong evidence of quite a bit of Omicron all at once, and cities are locking down. If Omicron had already been running rampant for a while these actions don't make sense.
> We also know from Hong Kong what it could look like if a population that only had access to Sinovac and has had few previous infections has uncontrolled spread of Omicron. Things get very bad very quickly.
This isn’t a fair characterization. Sinovac has been surprisingly effective at preventing deaths. Hong Kong’s high death rate is almost entirely a result of Omicron spreading through elderly people (60+) who are completely unvaccinated. (See https://hongkongfp.com/2022/02/21/covid-19-almost-90-of-fifth-wave-deaths-analysed-by-hong-kong-govt-were-among-unvaccinated/, though it’s from early in the wave.)
I meant this more in the sense that there would be huge numbers infected at once, rather than that the IFR wouldn't be reduced - it's still way more than their systems are capable of handling, I'd assume?
OK, let's do rule of thumb. 30% of elderly are vaccinated in HK, more of non-elderly. So if vaccine was completely ineffective we'd expect vaccinated to be slightly less than 30% of deaths. Instead they are 10% of deaths. So if we take at face value, Sinovac reduces death by 80% or so? That's good, but far less good than mRNA...
Why was the vaccination rate among the elderly so low in Hong Kong? Is it similar in mainland China? (Are the numbers out of mainland China reliable?)
I dont understand why it would be a good idea for them to get mRNA vaccines because those vaccines proved weak against Omicron (and I imagine that additional mutations on BA 2.2 will not help).
Reasoning:
BA.2.2, a descendant of Omicron is already here and causing much damage in Asia. This one has about 20 mutations different from Omicron. This is how fast this virus is mutating and causing damages.
The mRNA vaccines as constructed against the Wuhan virus have been great at protecting people through the many waves of variants but, as Omicron shows, the virus is mutating away from them. This is likely because these vaccines mostly help the immune system learn about parts of the spike proteins that are often subjected to mutation, not the ones resistant to that.
Repeated boosting mRNA vaccines could help the immune system to learn better about epitopes on the spike protein that is resistant to mutation. But, that is a tremendous financial cost to society, not to mention health cost in terms of side effects. Lastly, changing vaccine formulation to target Omicron directly will not do much long term as long as the mechanism of action is the same. The virus will just mutate away from that formulation too.
They're still the best we have and definitely way better than Sinovac, especially against severe disease and death. I agree they're not the perfect weapon we wanted or thought we had, but we don't have another alternative.
From my understanding of the origins of Omicron its emergence was unrelated to the vaccine and it would have taken over even without it, the drift away from the vaccine was simply a side effect of changes that were optimal for other reasons as well (assuming it didn't come from a lab).
We (EU countries) already have an alternative = Novavax. Their results are robust in terms of Omicron response and they offer full protection for longer periods of time. Hopefully it will be available in US soon.
Link to extended protection info: https://ir.novavax.com/2022-02-28-Novavax-Announces-Extended-Durability-of-Protection-Against-Infection-and-Disease-in-United-Kingdom-COVID-19-Vaccine-Phase-3-Clinical-Trial
Btw Hong Kong had Corminatry and used it widely.
Link: https://www.covidvaccine.gov.hk/en/dashboard/
Obviously there is no way that China would ever use American vaccine anyway so it is just purely theoretical.
Any guesses on the death toll?
That depends on how vulnerable China turns out to be on various fronts and how effective their vaccine is vs. death under Omicron which is impossible to currently know, but probably China ends up similar to the world's overall rates by default. I'm trying not to focus on this, though.
Why not focus on mortality? My intuition would be that’s the metric that matters most.
It matters the most but the other metrics matter as well. For example infection rates are important because they can create massive disruptions.
Agreed it's what matters in the end (although disruptions too), but that's mostly about how many people get infected and whether proper care is available for them. So it again comes down to whether the whole country is going to get infected or not.
Is it not intellectually interesting to you? I’m trying to understand why this question is intentionally out of scope for you.
Dead bodies seem easier to measure and more impactful than fake-ish case data.
A 15% chance of keeping it under control sounds far too high at this stage. I'd sell to 3%.
Original-recipe covid could be eradicated through lockdown, Delta was borderline. I don't think it's possible with Omicron even with a "full" Chinese-style lockdown, and Shanghai is not under full lockdown.
I agree it intuitively sounds too high, but my intuition would have lost money repeatedly betting against China's COVID containment in the pandemic to-date.
I didn't think a priori that original COVID could be eradicated by lockdown. They had multiple cases in 6-7 population centers, and original COVID had a 5-7 day asymptomatic period. Contact tracing and eliminating the spread effectively in multiple cities seems very difficult, and you have to win in EVERY one to win. But they managed it.
Delta wasn't that much more contagious than original COVID, but maintaining will and vigilance to heavily manage all border crossings on a country as large as China seemed very difficult. Surely there was some non-negligible ongoing odds of a sizable COVID infection sneaking through and not getting contact-traced to death? And yet it never happened.
So while my intuition again says that containing Omicron is nearly impossible, I have to give them credit. They've already done the very improbable with COVID twice. Maybe it could happen again?
I'd probably sell to 10%, but given their track record I think 3% is way too low.
I'd like to point everyone to this comment published in Nature - https://www.nature.com/articles/s41579-022-00722-z
The comparatively milder infections with the Omicron variant and higher levels of population immunity have raised hopes for a weakening of the pandemic. We argue that the lower severity of Omicron is a coincidence and that ongoing rapid antigenic evolution is likely to produce new variants that may escape immunity and be more severe.
While this post is about China, cases in Europe are climbing again as well: http://kjplanet.com/coronavirus-data-explorer-europe-mar-16-2022.png. (Of course, we know cases aren't the best metric, but deaths lag. Hospital admissions are not always as well tracked, but also seem to be ticking up.)
I've heard speculation linking this to the BA.2 Omicron variant, but I'm struggling to understand why this would affect Europe and not other major nations (US, Canada, India, etc.). Any insight here?
Will discuss on Thursday. The presumption is that other areas are 'behind' Europe on this in some way, but still looking at it. I don't understand the rapidity of the rise because if BA.2 is that much more contagious this should have happened earlier.