11 ms·

There are a few important bits here: First: "The study by Discovery Health, South Africa’s largest health insurer, of 211,000 positive coronavirus cases, of wh

There are a few important bits here: First: "The study by Discovery Health, South Africa’s largest health insurer, of 211,000 positive coronavirus cases, of which 78,000 were attributed to omicron, showed that risk of hospital admissions among adults who contracted covid-19 was 29 percent lower than in the initial pandemic wave that emerged in March 2020." and second: "At the same time, the vaccine may offer 70 percent protection against being hospitalized with omicron, the study found, describing that level of protection as “very good.”" Yes the vaccine does improve outcomes BUT the hospitalization rate for unvaccinated people is still lower with Omicron than previous variants.

sjwalter 5y ago
> Yes the vaccine does improve outcomes BUT the hospitalization rate for unvaccinated people is still lower with Omicron than previous variants. Why "BUT"? Shouldn't the second part be, uh, a good thing?
trutannus 5y ago
It sounds from this like the diminished efficacy is being compensated for by the reduced lethality of the new virus.
- johnchristopher 5y ago
  Reduced lethality ? How many times can we catch covid ? Symptoms might be cold like in ~90% case but long term damage ?
croes 5y ago
Don't forget this part: "South Africa has a quite high seroprevalence of prior infection, particularly after delta, and in some parts of South Africa up to 80 percent of people were exposed to previous infection" So it could simply be that the mild cases were previously infected, what happens to an unvaccinated without prior infection is a different story.
- akamaka 5y ago
  South Africa’s excess deaths amount to 1 out of every 200 people. The most vulnerable have already been removed from the sample set. I’m going to wait for severity data from where I live, because that’s what matters.
  - tsol 5y ago
    Correction: SOME OF the most vulnerable have already been removed from the sample set. I'm still waiting on proper large scale studies as well, though. It'll probably be at least a week or two until we get that
  - anonfornoreason 5y ago
    every year more vulnerable people are added to that set as population ages, gets fatter, has more advanced coronary or metabolic disease, etc. not trying to contradict here I think it will be less each year. maybe governments will even start telling people their dirt and exercise choices are exacerbating this disease!
    - croes 5y ago
      After the pandemic the mortality could be lower for some years because some timed sooner because of COVID. At the same time the "normal" deaths from operations will be added when the postponed operations are rescheduled.
    - kansface 5y ago
      > every year more vulnerable people are added to that set as population ages, gets fatter, has more advanced coronary or metabolic disease, etc. The number added each season is not necessarily the same number as the ones removed in the previous year - see the prevalence of really bad flu seasons for instance, which occur every 2-3 years or so.
    - deleted 5y ago
      [deleted]
    - deleted 5y ago
chinathrow 5y ago
> Yes the vaccine does improve outcomes BUT the hospitalization rate for unvaccinated people is still lower with Omicron than previous variants. In this very specific demographic. Other countries will have different outcomes, as seen with the current state of the pandemic (looking at Europe, for example).
snarf21 5y ago
I think we have to be very careful with data from around the world. There are a lot of co-factors. We already know that generally being immuno-compromised makes covid a much riskier proposition for those groups. In a recent deep dive into the Ivermectin studies done around the world, it was shown and proven that in Bangladesh that Ivermectin reduced covid mortality. However, when digging deeper, Bangladesh has a 80%+ infection rate of worms with most people having 7-23. So taking Ivermectin helped save patients from covid mortality but only in the sense that it made them less immuno-compromised. The US population (e.g.) doesn't have worm infections like that. Any data from a specific geographic area/country/race/etc. may only have validity within that same group.
- gfodor 5y ago
  The worm hypothesis is a hypothesis, and a good one. But it is a hypothesis. assuming good sounding hypotheses are true and running with it have been the root of a lot of problems in this pandemic.
  - XorNot 5y ago
    I mean the other side of that punchline though is that Ivermectin is completely ineffective in clinical trials at reducing severity or mortality from COVID-19. The worm hypothesis is practically a curiosity to solve later.
    - gfodor 5y ago
      No, the reason the worm hypothesis is good is because it would explain the clinical trials where it appears to be effective. (If there were no such trials, as you claim, the entire discussion about worms would be moot.)
kansface 5y ago
I don't understand this study. Why not compare the hospitalization/fatality rates between _current_ omicron/delta infections between similar cohorts? Comparing to an earlier wave is hopelessly confounded on prior infections in the intervening time and similarly, on the most susceptible having already been killed off. Maybe they did what I'm suggesting and its mostly just bad reporting? edit from the summary :-/ : Vaccine effectiveness: The two-dose Pfizer-BioNTech vaccination provides 70% protection against severe complications of COVID-19 requiring hospitalisation, and 33% protection against COVID-19 infection, during the current Omicron wave. Reinfection risk: For individuals who have had COVID-19 previously, the risk of reinfection with Omicron is significantly higher, relative to prior variants. Severity: The risk of hospital admission among adults diagnosed with COVID-19 is 29% lower for the Omicron variant infection compared to infections involving the D614G mutation in South Africa’s first wave in mid-2020, after adjusting for vaccination status Children: Despite very low absolute incidence, preliminary data suggests that children have a 20% higher risk of hospital admission in Omicron-led fourth wave in South Africa, relative to the D614G-led first wave.
- drited 5y ago
  Thank you for removing the uncertainty on that! Agreed regarding the unspecific reporting. Seemed to me to be one of those areas where the author assumed you'd assume... I dislike that as it introduces the possibility of misinterpretation. Now the next question is what is the percentage reduction in deaths for Omicron vs prior variants. It seems like more than the 29 percent reduction in hospitalisation given the first death from Omicron was reported in Britain last week right?
  - londons_explore 5y ago
    Most countries are not doing very many full genome sequences, so confirmed cases of Omicron are very low. For this to coincide with a death is unlikely. Deaths also typically take ~3 weeks from infection. 3 weeks ago, there weren't many cases. Omicron cases are 'suspected' via a partial match in a PCR test (widely done), but this isn't definitive. End result: There are very few confirmed deaths.
  - 5y ago
bigodbiel 5y ago
it isn't apples to apples. Some studies show that SA has >70% seroprevalence [1], most of which from infection. If it holds that recovered immunity confers __better__ protection than naive vaccine immunity [2], then that 30% decrease might as well be from the protection conferred mostly by the former, and we have no idea how that would translate to vaccine naives, who are the majority in highly vaccinated developed countries. [1]: https://www.medrxiv.org/content/10.1101/2021.11.18.21266496v1 https://www.medrxiv.org/content/10.1101/2021.11.18.21266496v... [2]: https://www.medrxiv.org/content/10.1101/2021.12.04.21267114v1.full.pdf+html https://www.medrxiv.org/content/10.1101/2021.12.04.21267114v...
jiggawatts 5y ago
Just 29% lower is nothing. NOTHING. Of all people, the YC News crowd really ought to understand that O(exp(n)) overwhelms O(1) literally exponentially. Not figuratively. Literally. If a virus variant has a constant factor reduction in its side-effects, but a higher exponential factor in infectiousness, the latter will overwhelm the former in short order, and then continue to overwhelm it even more. Exponentially. Let me do some simple maths assuming that it spreads "just" twice as quickly as Delta.[1] Lets assume that at some point, Omicron will be the primary strain, and there are 29% less patients in hospital because of it. Assume the doubling-time of Delta is 1 month. (It's better or worse than this depending on circumstances, but start here.) The doubling time of Omicron is then 2 weeks. So with Delta you have: 1.0 == .71 * 2^(t/30d) which solves to about 15 days to get back to a full hospital. With Omicron the equation is 1.0 == .71 * 2^(t/14d) which means it'll be back to a full hospital in just 7 days. Then the hospitals will be at 200% capacity in 21 days, 300% capacity at 29 days, and 1000% of capacity in just 53 days. Of course, the full mathematical model is more complicated, typically something like SEIHRD, but the point is that a mere 29% reduction in mortality is next to nothing compared to an exponential increase in infectiousness. It would have to be more like 90% less dangerous for that to matter at all in the long run. [1] https://www.forbes.com/sites/masonbissada/2021/12/03/scientists-say-omicron-is-spreading-twice-as-quickly-as-delta-in-south-africa-and-could-be-more-likely-to-re-infect/?sh=1c87ec163c5f https://www.forbes.com/sites/masonbissada/2021/12/03/scienti...
- IAmGraydon 5y ago
  That was an incredibly verbose explanation for something very simple.
  - jiggawatts 5y ago
    It's a simple concept that about 95-99% of the general population does not understand at any level. This includes most politicians, civil planners, even scientists and medical staff. When the pandemic first started, people were flabberghasted about how FAST! the numbers were going up. Faster and faster, new records broken every day! Meanwhile, on a logarithmic plot, it was a dead straight line. It wasn't changing, not really. People don't "get" this. Even now, two years in, people are clinging to constant factors. I've had similar conversations with people who just don't understand Moore's law, Nielsen's Law, etc... I had to use pictures to explain to IT network professionals that upgrading a 15-year-old 2 Mbps site office link to 4 Mbps is hilariously under-specced when the mobile phone in my pocket can exceed 1 Gbps while I'm sitting at the bus stop. They just hadn't "grokked" that their mental models are off by orders of magnitude. They're used to x*2 instead of x*10^2.

sjwalter 5y ago

> Yes the vaccine does improve outcomes BUT the hospitalization rate for unvaccinated people is still lower with Omicron than previous variants. Why "BUT"? Shouldn't the second part be, uh, a good thing?

trutannus 5y ago

It sounds from this like the diminished efficacy is being compensated for by the reduced lethality of the new virus.

johnchristopher 5y ago
Reduced lethality ? How many times can we catch covid ? Symptoms might be cold like in ~90% case but long term damage ?

croes 5y ago

Don't forget this part: "South Africa has a quite high seroprevalence of prior infection, particularly after delta, and in some parts of South Africa up to 80 percent of people were exposed to previous infection" So it could simply be that the mild cases were previously infected, what happens to an unvaccinated without prior infection is a different story.

akamaka 5y ago
South Africa’s excess deaths amount to 1 out of every 200 people. The most vulnerable have already been removed from the sample set. I’m going to wait for severity data from where I live, because that’s what matters.
- tsol 5y ago
  Correction: SOME OF the most vulnerable have already been removed from the sample set. I'm still waiting on proper large scale studies as well, though. It'll probably be at least a week or two until we get that
- anonfornoreason 5y ago
  every year more vulnerable people are added to that set as population ages, gets fatter, has more advanced coronary or metabolic disease, etc. not trying to contradict here I think it will be less each year. maybe governments will even start telling people their dirt and exercise choices are exacerbating this disease!
  - croes 5y ago
    After the pandemic the mortality could be lower for some years because some timed sooner because of COVID. At the same time the "normal" deaths from operations will be added when the postponed operations are rescheduled.
  - kansface 5y ago
    > every year more vulnerable people are added to that set as population ages, gets fatter, has more advanced coronary or metabolic disease, etc. The number added each season is not necessarily the same number as the ones removed in the previous year - see the prevalence of really bad flu seasons for instance, which occur every 2-3 years or so.
  - deleted 5y ago
    [deleted]
  - deleted 5y ago

chinathrow 5y ago

> Yes the vaccine does improve outcomes BUT the hospitalization rate for unvaccinated people is still lower with Omicron than previous variants. In this very specific demographic. Other countries will have different outcomes, as seen with the current state of the pandemic (looking at Europe, for example).

snarf21 5y ago

I think we have to be very careful with data from around the world. There are a lot of co-factors. We already know that generally being immuno-compromised makes covid a much riskier proposition for those groups. In a recent deep dive into the Ivermectin studies done around the world, it was shown and proven that in Bangladesh that Ivermectin reduced covid mortality. However, when digging deeper, Bangladesh has a 80%+ infection rate of worms with most people having 7-23. So taking Ivermectin helped save patients from covid mortality but only in the sense that it made them less immuno-compromised. The US population (e.g.) doesn't have worm infections like that. Any data from a specific geographic area/country/race/etc. may only have validity within that same group.

gfodor 5y ago
The worm hypothesis is a hypothesis, and a good one. But it is a hypothesis. assuming good sounding hypotheses are true and running with it have been the root of a lot of problems in this pandemic.
- XorNot 5y ago
  I mean the other side of that punchline though is that Ivermectin is completely ineffective in clinical trials at reducing severity or mortality from COVID-19. The worm hypothesis is practically a curiosity to solve later.
  - gfodor 5y ago
    No, the reason the worm hypothesis is good is because it would explain the clinical trials where it appears to be effective. (If there were no such trials, as you claim, the entire discussion about worms would be moot.)

kansface 5y ago

I don't understand this study. Why not compare the hospitalization/fatality rates between _current_ omicron/delta infections between similar cohorts? Comparing to an earlier wave is hopelessly confounded on prior infections in the intervening time and similarly, on the most susceptible having already been killed off. Maybe they did what I'm suggesting and its mostly just bad reporting? edit from the summary :-/ : Vaccine effectiveness: The two-dose Pfizer-BioNTech vaccination provides 70% protection against severe complications of COVID-19 requiring hospitalisation, and 33% protection against COVID-19 infection, during the current Omicron wave. Reinfection risk: For individuals who have had COVID-19 previously, the risk of reinfection with Omicron is significantly higher, relative to prior variants. Severity: The risk of hospital admission among adults diagnosed with COVID-19 is 29% lower for the Omicron variant infection compared to infections involving the D614G mutation in South Africa’s first wave in mid-2020, after adjusting for vaccination status Children: Despite very low absolute incidence, preliminary data suggests that children have a 20% higher risk of hospital admission in Omicron-led fourth wave in South Africa, relative to the D614G-led first wave.

drited 5y ago
Thank you for removing the uncertainty on that! Agreed regarding the unspecific reporting. Seemed to me to be one of those areas where the author assumed you'd assume... I dislike that as it introduces the possibility of misinterpretation. Now the next question is what is the percentage reduction in deaths for Omicron vs prior variants. It seems like more than the 29 percent reduction in hospitalisation given the first death from Omicron was reported in Britain last week right?
- londons_explore 5y ago
  Most countries are not doing very many full genome sequences, so confirmed cases of Omicron are very low. For this to coincide with a death is unlikely. Deaths also typically take ~3 weeks from infection. 3 weeks ago, there weren't many cases. Omicron cases are 'suspected' via a partial match in a PCR test (widely done), but this isn't definitive. End result: There are very few confirmed deaths.
- 5y ago

bigodbiel 5y ago

it isn't apples to apples. Some studies show that SA has >70% seroprevalence [1], most of which from infection. If it holds that recovered immunity confers __better__ protection than naive vaccine immunity [2], then that 30% decrease might as well be from the protection conferred mostly by the former, and we have no idea how that would translate to vaccine naives, who are the majority in highly vaccinated developed countries. [1]: https://www.medrxiv.org/content/10.1101/2021.11.18.21266496v1 https://www.medrxiv.org/content/10.1101/2021.11.18.21266496v... [2]: https://www.medrxiv.org/content/10.1101/2021.12.04.21267114v1.full.pdf+html https://www.medrxiv.org/content/10.1101/2021.12.04.21267114v...

jiggawatts 5y ago

Just 29% lower is nothing. NOTHING. Of all people, the YC News crowd really ought to understand that O(exp(n)) overwhelms O(1) literally exponentially. Not figuratively. Literally. If a virus variant has a constant factor reduction in its side-effects, but a higher exponential factor in infectiousness, the latter will overwhelm the former in short order, and then continue to overwhelm it even more. Exponentially. Let me do some simple maths assuming that it spreads "just" twice as quickly as Delta.[1] Lets assume that at some point, Omicron will be the primary strain, and there are 29% less patients in hospital because of it. Assume the doubling-time of Delta is 1 month. (It's better or worse than this depending on circumstances, but start here.) The doubling time of Omicron is then 2 weeks. So with Delta you have: 1.0 == .71 * 2^(t/30d) which solves to about 15 days to get back to a full hospital. With Omicron the equation is 1.0 == .71 * 2^(t/14d) which means it'll be back to a full hospital in just 7 days. Then the hospitals will be at 200% capacity in 21 days, 300% capacity at 29 days, and 1000% of capacity in just 53 days. Of course, the full mathematical model is more complicated, typically something like SEIHRD, but the point is that a mere 29% reduction in mortality is next to nothing compared to an exponential increase in infectiousness. It would have to be more like 90% less dangerous for that to matter at all in the long run. [1] https://www.forbes.com/sites/masonbissada/2021/12/03/scientists-say-omicron-is-spreading-twice-as-quickly-as-delta-in-south-africa-and-could-be-more-likely-to-re-infect/?sh=1c87ec163c5f https://www.forbes.com/sites/masonbissada/2021/12/03/scienti...

IAmGraydon 5y ago
That was an incredibly verbose explanation for something very simple.
- jiggawatts 5y ago
  It's a simple concept that about 95-99% of the general population does not understand at any level. This includes most politicians, civil planners, even scientists and medical staff. When the pandemic first started, people were flabberghasted about how FAST! the numbers were going up. Faster and faster, new records broken every day! Meanwhile, on a logarithmic plot, it was a dead straight line. It wasn't changing, not really. People don't "get" this. Even now, two years in, people are clinging to constant factors. I've had similar conversations with people who just don't understand Moore's law, Nielsen's Law, etc... I had to use pictures to explain to IT network professionals that upgrading a 15-year-old 2 Mbps site office link to 4 Mbps is hilariously under-specced when the mobile phone in my pocket can exceed 1 Gbps while I'm sitting at the bus stop. They just hadn't "grokked" that their mental models are off by orders of magnitude. They're used to x*2 instead of x*10^2.