You must all be tired of this, but really:
There is still a lot of uncertainty about omicron’s characteristics, especially its severity.
Yes, there are more and more pieces of the puzzle, but they don’t fit together all that well and there are a LOT of questions and hypotheses.
You can look at the current data and come up with a lot of theories - and the less you know the easier it is for that theory to fit what you know.
But some of the smartest people I know have told me they are simply not sure what to think yet.
Just one example:
I talked to @trvrb briefly yesterday (for a story to come later) and asked about data from South Africa on severity vs. early reports in Europe. He said: “I don’t know how to square these two things and that is probably giving me the most pause at the moment.”
@trvrb Could #omicron have changed to infect upper airways more and cause milder disease? Yes
Could the generation time be shorter leading to explosive but shorter outbreak? Yes
Could immunity to Beta in South Africa play a role? Yes
And so on and so on...
@trvrb Point is: Scientists are doing the hard work of finding the right answers.

And we all have to do the (apparently similarly hard) work of not jumping to conclusions and living with the uncertainty for the moment.
(Politicians meanwhile have to make hard decisions NOW.)
@trvrb It may look smart in retrospect if you say it’s milder now.

But honestly: It’s not much better than betting on red in roulette. You have a decent chance of being right. But you’re just gambling -
and I don’t want the people making decisions to gamble, given what’s at stake.
@trvrb A few days ago @EvolveDotZoo told me he felt like "variant watching" had become a spectator sport.

I think there is truth in that. And I understand it. This virus keeps changing our lives.
Of course we all want to know more as soon as more is known.
@trvrb @EvolveDotZoo But as with any spectator sport it can be nerve-racking to watch without the power to change the outcome.

So if you are anxious already it might also be good to check twitter a little bit less often.
@trvrb @EvolveDotZoo A lot of people here are like the guy at the bar who knows EXACTLY how the game will go even though the second half hasn’t even started.
So remember, as a wise man once said: The game is 90 minutes and in the end the germs win. (kidding, they won’t. and apologies to @GaryLineker)
@trvrb @EvolveDotZoo @GaryLineker Given what we know so far, the consensus from scientists is clear that we have to assume #omicron can cause massive harm at a societal level.
And as many scientists have pointed out: We will see how #omicron behaves in the real world long before we understand exactly why.
@trvrb @EvolveDotZoo @GaryLineker That was my rant of the day.
I feel better already.

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More from @kakape

22 Dec
Interesting early data on #omicron severity in this preprint from SAfrica.

Main take-away for me still:
Population with high protection from severe disease but low protection from infection means more infections with mild symptoms.
Inherently milder? 🤷‍♂️

medrxiv.org/content/10.110…
The authors compared SGTF cases with non-SGTF cases during the same time period (1/10 - 30/11).

Remember: SGTF is S gene target failure, the signal in certain PCR tests that is currently used as an (imperfect) proxy for omicron infections.
The authors found that the risk of these likely #omicron cases to end up in hospital was only about one fifth the risk (10-30%) of cases without SGTF (likely not omicron)
But once patients were in hospital, their risk of severe disease was about the same.
Read 9 tweets
21 Dec
"We are clearly in a new and troubling phase of this pandemic. What we have seen so far is sobering but there is still much to learn about Omicron. We cannot afford to cross our fingers and hope this crisis blows over”, @JeremyFarrar writes in a statement just out.
@JeremyFarrar If transmission isn’t slowed, "we could see profound impacts on health systems but also across sectors such as education, hospitality, public transport, police and essential national infrastructure as infections prevent people from working.".
@JeremyFarrar It's "staggering and deeply frustrating that two years into this pandemic – when we have gathered so much evidence and made huge scientific progress – that governments are still not anticipating events and acting early or working together anywhere near the scale that is required"
Read 5 tweets
21 Dec
Gemany’s @rki_de (basically our CDC) just put outs its recommendations for measures to curb #omicron.

Background: Number of delta infections and hospitalisations are declining, but #omicron cases are currently doubling about every 3 days and ICUs still very full.
@rki_de They recommend immediately:
- continuous masking indoors (and outdoors if <1,5 m distance), incl. for vaccinated people and in schools
- closing all bars, clubs, restaurants (except for takeaway), indoor sports
- cancelling large events
@rki_de - 2G+ for cultural events etc (so vaccinated or recovered, and test needed)
- 2G in most shops (only vaccinated or recovered allowed)
- 3G in supermarkets etc (so test needed for those not vaccinated or recovered)
- no singing indoors (for instance in church)
Read 4 tweets
19 Dec
Germany’s new expert council weighs in on #omicron:

"Due to the simultaneous, extreme number of patients, a considerable overload of the hospitals is to be expected - even in the unlikely case of significantly weakened disease severity compared to the Delta variant"
They call for:
- further measures to reduce contacts
- enforcing current measures
- intensifying vaccination and booster campaigns
"all models show that booster vaccinations alone do not adequately contain the omicron wave, but that additional contact restrictions are necessary"
Beyond political decisions, "the population must be called upon to actively control infections. This includes avoiding larger gatherings, the consistent, preferred wearing of FFP2 masks, especially indoors, as well as the increased use of rapid tests at gatherings…"
Read 9 tweets
17 Dec
Going by what we know so far, places like Germany or the US are in for a world of trouble in the coming weeks.

So I want to make a few general points here once that go beyond the science (will do the rest later):
Firstly, why are we in trouble?
Forget everything else for a moment and just look at the growth rate of #omicron in places like Denmark and Norway. Look at London. This virus is moving fast. It spreads fast. And it will find those most vulnerable fast.
Unfortunately, places like Germany and the US still have a lot of vulnerable people who are unvaccinated.
This variant will find those people fast and if it is anything like previous variants it will make a significant portion of these people very, very sick.
Read 18 tweets
16 Dec
As promised, a brief thread on main points from the Denmark paper in @Eurosurveillanc looking at the first 785 cases of #omicron in the country.

Paper is here:
eurosurveillance.org/content/10.280…
@Eurosurveillanc First off: Things are moving incredibly fast with #omicron.
This timeline gives a good overview of how fast things happened in Denmark:
eurosurveillance.org/content/table/…
@Eurosurveillanc One key finding: More than one in five cases cannot be linked to previous cases.
"This indicates that within 1.5 weeks from identifying the first case of #Omicron, there is already widespread community transmission in Denmark, which challenges further epidemic control."
Read 9 tweets

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