Context is missing and the information provided in this tweet is misleading: It takes time for people to progress to severe disease. Omicron cases in this study have an average observation period only of 5.5 days, compared to 15.8 days for Delta. 1/
The study quoted treats this using a dynamic statistical (Cox) model but this doesn’t fix the limited data availability, whose analysis is limited to 14 days after infection. 2/
Essentially all Omicron hospitalizations start less than 14 days before study ends, limiting observation of severe cases & mortality, which generally take longer—less than 1 in 10 expected Delta deaths occur during these 14 days (14 day mortality ~0.07%, Nov US mortality .85%) 3/
This means uncertainty (error bars) for ICU & mortality are quite large—described in the study but not in the tweet—and the only statistical claim made by the study about mechanical ventilation is that it is less likely for Omicron than Delta 4/
(i.e. the study acknowledges a lack of sufficient data to claim how much less likely). The initial tweet is very misleading. The information should be provided along with its statistical uncertainty, which is not provided. 5/
Also, study ICU, mortality & p-value for mechanical ventilation may be biased—significantly so—because, as reported in the study, omicron hospitalizations are younger & healthier compared to delta (perhaps due to these hospitalizations arising from initial set of omicron cases,6/
..which may differ in demographics from later cases), but ICU, mortality, & mechanical ventilation analyses, unlike hospitalization analysis, didn’t correct for demographic differences (the paper notes they didn’t have data to make multivariate corrections on these numbers). 7/
Current data from South Africa indicates continuing increase in mortality long after they would be expected to decline from the peak of cases. This suggests Omicron may have a longer delay to mortality than Delta, undermining the claims of this study. 8/
“Living with the virus” has failed. The wishful thinking, the regression to allowing biology to dominate society, the idea of normality of widespread disease has not worked. No way to justify the damage as health, economy and freedom are lost. Its advocates should reassess. 1/
Let us stop justifying the failure by claiming nothing else was possible, that we couldn’t have known, that we couldn’t have succeeded anyway. It is not becoming of our identities, it is not respectful of our ancestors, it is not a way to build our futures. 2/
Society, through medical systems, transportation systems, manufacturing, construction of homes, industries, cities, and scientific knowledge, links us in a shared destiny, MLK's "inescapable network of mutuality". Together, we transcend individual biological destiny. 3/
"More than 1,000 healthcare workers from across the state signed an open letter urging proactive COVID-19 mitigation measures, including enforcing mask mandates in classrooms and expanding testing sites."
Emanuel, Osterholm, Gounder (EOG) propose that, in contrast to a zero COVID policy, we surrender to the pandemic, setting an acceptable level of deaths as policy success.
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In an accompanying article Michales, Emanuel, and Bright propose this can be achieved by improved vaccination, testing, surveillance, masking, ventilation and distancing.
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Survivors of SARS-CoV-2 frequently experience lingering neurological symptoms: impairment in attention, concentration, speed of information processing and memory.
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This long-COVID cognitive syndrome shares many features with the syndrome of cancer therapy-related cognitive impairment (CRCI).
Neuroinflammation, and dysregulation of hippocampal neurogenesis is central to CRCI.
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