1/ With the omicron wave putting untold pressure on staffing across a wide variety of industries, it is not inconceivable for these staffing shortages to become more “endemic” with behaviors that have likely changed forever. 🧵
2/ An estimated 5 million people are isolating at home due to omicron, which could “deal a significant hit to the economy over the next month or two.”
3/ In historical flu seasons, the current omicron-driven work absentee rate would be ~2x the average peak of workplace absence due to all illnesses in the US (largely flu).
4/ The @IHME_UW model predicts that we will see 140 M new infections this quarter in the US — almost half the country (!)
5/ Our tolerance for working while sick has clearly been suppressed due to the pandemic compared to this survey from 2018. I’ll bet the threshold for working while sick has come down significantly with COVID and that this will persist long beyond omicron.
6/ From a survey this fall: “65% of…workers who reported being sick in the last month said they went to work anyway. That’s lower than the 85% who showed up to work sick before the pandemic, but much higher than it should be"
9/ Our vaccines are great at preventing hospitalization and death but not sickness. The case rate for vaccinated people in SF is higher than it has ever been, even compared to unvaccinated people during delta. What will the sick leave rate look like during the next surge?
10/ With billions of people having become watchful of flu-like symptoms, it will be hard for many to ignore symptoms and “power through them” for a while. Will some of these new behaviors stick, similar to mask-wearing in Asia post-SARS?
11/ Interesting to see Gavin Newsom announce plans to supplement paid COVID-19 sick leave, which will protect frontline workers from having to make a choice between going to work sick or losing jobs but could exacerbate the labor shortage.
12/ Given the vaccine effectiveness of boosters versus symptomatic disease, I wonder if some employers will urge or require booster shots from an “enlightened self-interest” standpoint to prevent mass absences ahead of the next surge.
13/ Of course, the way to prevent mass sick-out events is to prevent wide-scale transmission through a broader set of mitigations, but that all goes out the window if we are going to continue to “let it rip” after omicron.
1/ One of the biggest policy failures over the last 2 years is the lack of COVID testing, particularly evident now with omicron — both the supply and the quality of what we have available at scale. Where is our Operation Warp Speed for diagnostics? 🧵
2/ Based on the sheer scale of testing volume, it’s clear many are concerned with exposure to omicron and are not yet “done with COVID”. Labs are reporting >1.5 million PCR tests per day right now. But this is a massive underestimate of the total volume w/antigen tests in the mix
3/ Based on recent disclosures, the leading antigen test kit mfg. production volumes right now are estimated to be ~120 M tests/month
1/ There are a lot of takes that this omicron wave will bring us closer to “normal” in 2022 when COVID will become endemic and be “just like the flu.” A comparison with historical flu seasons shows just how far away this really is and how much longer we may need to go. 🧵
2/ The key societal question is what level of mortality & morbidity do we accept from COVID in the long run. If influenza is the right analogue, then this chart shows that COVID has broken well beyond the baseline and “epidemic” threshold of mortality of prior flu seasons.
3/ “Just like the flu,” you say?
Let’s drill into some US data:
* 11,707 weekly PIC (pneumo, influenza, COVID) deaths since Labor Day
* At the peak of Delta, ~18,000 weekly PIC deaths
This is 3-5x our pre-COVID flu baseline (~3,500 weekly deaths).
1/ The great hope right now is that the orals from @pfizer and @Merck are the “silver bullet” that will bring an “end” to omicron and the pandemic. These are amazing new Rx’s, but deploying them properly will be way harder than people think. 🧵
2/ We now have another weapon in the toolkit with oral pills that do not have the same burdensome requirements of mAbs. ~90% risk reduction from Pfizer’s Paxlovid in high-risk patients is indeed excellent. pfizer.com/news/press-rel…
3/ The FDA EUA for Paxlovid specifies that the treatment must be administered within 5 days of symptoms. The name of the game here is speed: the longer the treatment start is from symptom onset, the less impact these orals will likely have.
1/ Lots of questions on why I think we could be in the early part of the COVID decade. Tons of focus right now on omicron, but not many talking about the long game. This isn’t a deterministic prediction but a scenario very few policymakers are willing to talk about openly. 🧵
2/ At almost every turn of this pandemic, numerous experts have declared that the end of the pandemic is near, if we can only hold on for a few weeks or months. This has raised a lot of false hope over the last couple years.
3/ With omicron, some experts are declaring that this last wave will spell the end of the pandemic in 2022.
1/ With the omicron surge, I have had more friends send me screenshots of exposure notifications (EN) in the last week than I have in the last year. Here are some reflections based on the work I led at @Apple working with @Google and some thoughts on the road ahead. 🧵
2/EN was one of the most exciting projects I have ever worked on with an unbelievable amount of technical talent at both companies deployed to deliver in a matter of months. (Recent gathering of a small subset of the crew below)
3/ As we worked on the effort, it became clear to me that public health agencies did not fully grasp the power of the technology as a way to massively augment more traditional NPIs.
2/ The struggle is real, but this is true for anyone trying to make a dent in healthcare, whether at a startup or a large tech company. So I agree with @chrissyfarr, the takeaway isn’t “Health care is hard.” Of course it’s hard.