Lots of SARS-CoV-2 in wastewater. Far fewer hospitalizations than in early waves of this size.
Why?
Could be several (non-mutually-exclusive) things. We've talked about most of these at various times before, but here's a rundown of some hypotheses.
🧵
Why?
Could be several (non-mutually-exclusive) things. We've talked about most of these at various times before, but here's a rundown of some hypotheses.
🧵
H1. Hospitalizations lag wastewater, so it's just a matter of time.
I don't think this is it, to be honest. Hospitals haven't been overrun during waves for long time now and wastewater levels have been high for a while already.
I don't think this is it, to be honest. Hospitals haven't been overrun during waves for long time now and wastewater levels have been high for a while already.
H2. Acute severity is lower because of the immunity that most people now have to some degree, be it from vaccination, infection, or both.
I think this is a major factor, BUT this should be taken with cautious optimism.
See this thread:
I think this is a major factor, BUT this should be taken with cautious optimism.
See this thread:
https://x.com/TRyanGregory/status/1805213826830246136?t=--8naQRF1iQJRRNzNE5W6Q&s=19
H3. Different people are being infected.
If most of the shedding of virus into wastewater is being done by people with low risk factors for severe acute illness (young, otherwise healthy, etc.), this could decouple wastewater signal and hospitalizations.
If most of the shedding of virus into wastewater is being done by people with low risk factors for severe acute illness (young, otherwise healthy, etc.), this could decouple wastewater signal and hospitalizations.
H4. Current variants cause less severe respiratory illness because they infect different parts of the respiratory tract. This can affect acute respiratory severity.
For example:
ncbi.nlm.nih.gov/pmc/articles/P…
For example:
ncbi.nlm.nih.gov/pmc/articles/P…
H5. Current variants site greater tropism to the gut and are shed more in wastewater. That is, it's not necessarily more infections, but more virus being pooped out per infection.
H6. Hospitals aren't testing as much and COVID is being listed as something else.
H7. The virus is inherently less virulent now.
Maybe. But there's no obvious reason why this would be the case and there is no automatic tendency for viruses to become milder. Even if this is true, there's no guarantee it wouldn't evolve more virulence again later.
Maybe. But there's no obvious reason why this would be the case and there is no automatic tendency for viruses to become milder. Even if this is true, there's no guarantee it wouldn't evolve more virulence again later.
H8. We have robust, long-lasting, hybrid immunity that is totally non-waning and not escaped by evolving variants, so this is definitely the exit wave for serious this time.
Yes, there are "experts" who seem to truly believe this. 🤷♂️
Yes, there are "experts" who seem to truly believe this. 🤷♂️
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