7 ms·

Less virulent, less dangerous than delta by far, according to the South African medical authorities who first identified and reported it. It's been a long esta

by JPKab 5y ago

Less virulent, less dangerous than delta by far, according to the South African medical authorities who first identified and reported it. It's been a long established medical fact that viruses evolve to become less severe over time, due to selective pressures of being able to spread easier if you don't incapacitate your host. Micheal Crichton's Andromeda Strain featured this as a key plot point, written in the 70s. For some reason, the international community treated South African scientists like third-world know-nothings, and overreacted, ignoring the fact that it's less severe. https://www.washingtonpost.com/world/2021/12/14/south-africa-omicron-coronavirus/ https://www.washingtonpost.com/world/2021/12/14/south-africa... Most everyone is vaxxed that is high-risk. Let the rest deal with their consequences. We have a few treatments that are highly effective, including monoclonal AB and the new Pfizer pill that has been shown in clinical trials to be absurdly effective: https://www.cnn.com/2021/12/14/health/pfizer-paxlovid-pills-covid-treatment/index.html https://www.cnn.com/2021/12/14/health/pfizer-paxlovid-pills-... Let's move on from this fear and get back to living instead of just existing.

dombesz 5y ago
100% agree with you. If it turns out that it’s so much less deadly than the other strains, we should definitely be positive about it and stop the fear mongering. But all you can hear these days, is that how so much contagious Omicron is, without mentioning the chance of being a lot less harmful. This biased representation in the news turns me into being a skeptic of all the media outlets, regardless of their political agenda. On the good side, even the inventor of mRna vaccines, Karikó Katalin says that Omicron could end the pandemic if it proves to be less harmful.[1] 1. https://hungarytoday.hu/kariko-omicron-pfizer-coronavirus/ https://hungarytoday.hu/kariko-omicron-pfizer-coronavirus/
- rsynnott 5y ago
  > But all you can hear these days, is that how so much contagious Omicron is, without mentioning the chance of being a lot less harmful. We _know_ that it's spreading very quickly (there is some legitimate question over how much of this is inherent spreading ability vs immunity evasion). The idea that it's "a lot less harmful" is largely speculative; there just isn't the data to say that right now. Now, it may emerge that it is, and that would be great, but it would be extremely dangerous to assume it at the moment.
  - yostrovs 5y ago
    Judging by the response of the authorities, the new strain is highly dangerous. There's a lot of panicking going on.
    - rsynnott 5y ago
      The authorities don't have any special secret knowledge here; they're responding to the (reasonably likely) possibility that it's as dangerous as Delta but will spread much more easily. Honestly, given the rate of spread, even if it had half the hospitalization risk of Delta it's _still_ terrifying.
      - JPKab 5y ago
        What's the hospitalization rate of delta in the vaccinated? It's pretty low. At this point, the vast majority of the unvaxxed are younger, lower risk people. The high risk people who aren't vaxxed (fucking idiots) are now highly treatable. We've got at least two, but a third coming soon, potent treatment options that radically reduce hospitalization. The new Pfizer pill is a true game changer, and we already have the monoclonal ABs. It doesn't appear that the public health authorities or the media are updating their policies based on these new realities. 90% of the people most at risk are vaxxed, and for those who are hospitalized (vaxxed or not) we now have treatments shown in clinical trials to further reduce hospitalization rates by roughly 88-90%. Translation: the hospitals aren't going to get overwhelmed anymore. Science won, even with a sizable chunk of the populace not wanting the vaccine. People can debate the moral hazard of treating unvaxxed with these new therapeutics, but that's a moral argument, not a practical one. Give them the pill or the infusion, keep them out of an ICU bed, and wag your finger at them later. This pandemic is over, and the fear needs to go with it.
        rsynnott 5y ago
        The pills won't be available in large quantities for a couple of months. In countries with high vaccination rates, most ICU beds are now occupied by youngish, largely unvaccinated people. In Ireland, for instance, 60% of covid patients in ICU over the last 5 months have been under 65, and this is _growing_. They have a decent survival rate, but they're still taking up ICU beds, and the pandemic isn't over until they stop doing that. The pills _may_, if they work as advertised, be the point where we can just stop caring about unvaccinated people. But there are another couple of months to go, even assuming they work as well as expected. (Also, I think there's at least a decent risk that many anti-vaxers will just refuse to take the pill anyway)
- JPKab 5y ago
  I stopped trusting the media's reporting on covid when it became blatantly obvious that they were completely ignoring and obfuscating the risk stratification by age. It was clear to me that they were motivated to do this by elevating the desire to influence the behavior of the public over the duty to inform them with the actual facts. They cynically assumed, just like the public health authorities did, that if the average Joe didn't personally feel at risk, they wouldn't change their behavior and would cause high-risk/elderly people to die out of negligence. Academics, I've noticed in my career working with them, are far more prone to view the public in this way. I'm sure a few of that variety will respond to this and tell me that yes, they can't be trusted.
vpavicic 5y ago
As I understand it, the SA population is quite young and we are waiting for more data to come in on the effects of omicron (says so in the link you provided as well)... let's not forget we dismissed the whole virus as "just a common cold" at the beginning of the whole story as well. The problem with letting others deal with their consequences is that they are overworking the medical staff, and are disregarding the population that cannot be vaxxed due to medical reasons. I agree we should move from this fear, but I understand how for some the fear is still too real.
- SideburnsOfDoom 5y ago
  > the SA population is quite young Quite young, and quite highly likely to already have had COVID-19: over 3/4 of the population has had it. https://www.bloomberg.com/news/articles/2021-08-18/deaths-data-shows-80-of-south-africans-may-have-had-covid https://www.bloomberg.com/news/articles/2021-08-18/deaths-da...
  - JPKab 5y ago
    Isn't this the case in the US, but in a slightly different manner? We're talking about a majority of adults being vaccinated, and then according to seroprevalence tracking over time, it's estimated that a large percentage of the population (both vaxxed and unvaxxed) have already recovered from an infection as well. But there is one delta on top of the age difference: We have a high rate of obesity, and the latest research shows that adipose tissue contributes to bad outcomes due to the virus infecting it and the cells then being a potent source of cytokines that dramatically and dangerously increase inflammation. The great irony is that as much as we focus (rightly) on unvaxxed clogging the healthcare system, the obese who have been increasingly clogging it over the last few decades are the ones clogging the ICUs when they catch covid. All for a chronic condition that, for most, can be alleviated with voluntary lifestyle changes.
gnat 5y ago
Mutating to lower virulence isn't a law of nature. https://medium.com/a-microbiome-scientist-at-large/do-viruses-get-stronger-or-weaker-over-time-a0091b185fe2 https://medium.com/a-microbiome-scientist-at-large/do-viruse... Crichton wrote interesting books but not all his science was robust.
unmole 5y ago
> It's been a long established medical fact that viruses evolve to become less severe over time HIV, Smallpox and Rabies would like a word.
- ethanbond 5y ago
  Sorry by “long established medical fact” I think what he meant was “pop science heuristic that is maybe true at t = infinity.”
SideburnsOfDoom 5y ago
> It's been a long established medical fact that viruses evolve to become less severe over time, Is it? The evolutionary pressure is only that reproductive success, succeeds. A virus that spreads better, well, spreads more. There is no real reason why COVID-19 would have to get less severe to be more successful, as most transmission is pre-symptomatic or asymptomatic already. If the host is more likely or less likely to die later on in the disease, is irrelevant to the virus' fitness. https://twitter.com/zeynep/status/1468225625764814859 https://twitter.com/zeynep/status/1468225625764814859 https://twitter.com/Devilstower/status/1465332043005501448 https://twitter.com/Devilstower/status/1465332043005501448
- JPKab 5y ago
  Could you please cite a source that says most transmission is pre-symptomatic or asymptomatic? Is that new with the delta variant? The studies I've seen have more recently concluded that asymptomatic transmission is far lower than previously thought. Although it probably doesn't matter, since the plurality of symptomatic people below the age of 55 are going to have symptoms hard to distinguish from a cold. Regardless, you make a fair point, but for a virus to kill you, it's going to be more severe in earlier phases, and less likely to be transmitted by a person in a bed than one walking around. Sure, they might have spread while they were walking around, but the proportion of time they are infected and mobile (higher spread) is lower than if the virus is milder. Covid hawks seem to have only one answer for all news items: be more afraid, lock down more. It's tiring, and reminds me of the right-wing equivalent after 9/11: Everything was terror, or potential terror, and you need to be afraid, and if you aren't afraid, it's because you are unpatriotic, stupid, or both.
  - SideburnsOfDoom 5y ago
    > Could you please cite a source that says most transmission is pre-symptomatic or asymptomatic? Both links above say as much. Please don't waste our time with "cite a source" when the sources are right there. No it is not new with Covid-Delta.
    - 5y ago
rsynnott 5y ago
> according to the South African medical authorities who first identified and reported it Well, according to the doctor who did. Other South African medical authorities have been a lot more cautious. > Most everyone is vaxxed that is high-risk. Let the rest deal with their consequences. The trouble is, the consequences for the rest involve filling up hospitals, ICUs (and ultimately morgues, though this is less disruptive). That impacts everyone. People are dying unnecessarily because their routine medical care is canceled or because they can't get an ICU bed due to pressure on hospital systems created primarily by unvaccinated patients.
- raxxorrax 5y ago
  Unvaccinated people under the age of 60 certainly do not put any significant pressure on ICUs. Saying otherwise is a blatant lie and demonizes people. Doing so and searching blame in others is a symptom of severe inferiority complex which is dangerous to other people, so take care what you say.
  - n8henrie 5y ago
    Where are you getting this from? I bet they have taken at least 50% capacity on average of our 4 bed ICU over the last few months.
    - raxxorrax 5y ago
      That would make sense then. In that case I am firmly for throwing these two rascals in prison.
      - SideburnsOfDoom 5y ago
        Please don't demonise them.
      - n8henrie 5y ago
        Not sure I understand this comment. Unfortunately each of these cases often occupies an ICU bed for weeks. As a result we transfer dozens of other patients hundreds of miles away, and often after >24 hours boarding in the emergency department, because every other ICU bed is full as well (in addition to mandatory down time for the flight crews, which are also working overtime). With help from my ~5 person ED staff, I've called as many as 50 hospitals in a night (spanning 6 of the largest states) trying to find an open ICU bed. Some relevant conversation on a thread I started in r/medicine: <https://www.reddit.com/r/medicine/comments/r6bl1u/not_accepting_transfers_from_out_of_state/ https://www.reddit.com/r/medicine/comments/r6bl1u/not_accept...>
credit_guy 5y ago
> We have a few treatments that are highly effective, including monoclonal AB and the new Pfizer pill Monoclonal antibodies are not highly effective and Paxlovid is not FDA approved yet (oe EUA”d). > Let the rest deal with their consequences Let me fix this for you: let all of us deal with their consequences.
- JPKab 5y ago
  Where did you get the idea that monoclonal antibodies aren't highly effective? Do you have any data to back this up? They are an FDA approved, clinically proven first-line treatment for anyone with symptoms showing them at risk of hospitalization. Your statement is misinformation, scientifically inaccurate, and irresponsible. You are painting a scientifically proven and life-saving therapuetic as "not highly effective" when the data shows it absolutely is. Here's a quote from a peer reviewed study in a little blog called the New England Journal of Medicine. Maybe you've heard of it? "A total of 3 of 291 patients in the sotrovimab group (1%), as compared with 21 of 292 patients in the placebo group (7%), had disease progression leading to hospitalization (for >24 hours) for any cause or death (relative risk reduction, 85%; 97.24% confidence interval [CI], 44 to 96; P=0.002) (Table 2). The primary reasons for the 24 hospitalizations were consistent with progressive Covid-19 (Table 3), with one probable exception: 1 patient in the sotrovimab group who had a notable medical history of small-intestinal obstruction presented 22 days after infusion with a small-intestinal obstruction." https://www.nejm.org/doi/full/10.1056/NEJMoa2107934?query=featured_coronavirus https://www.nejm.org/doi/full/10.1056/NEJMoa2107934?query=fe... Hope you will stop spreading misinformation. It's not acceptable when people shit on the vaccines due to their right wing partisan echo chamber induced ignorance, and it's not helpful when people shit on effective treatments due to their left wing partisan echo chamber induced ignorance.

by JPKab 5y ago

dombesz 5y ago

100% agree with you. If it turns out that it’s so much less deadly than the other strains, we should definitely be positive about it and stop the fear mongering. But all you can hear these days, is that how so much contagious Omicron is, without mentioning the chance of being a lot less harmful. This biased representation in the news turns me into being a skeptic of all the media outlets, regardless of their political agenda. On the good side, even the inventor of mRna vaccines, Karikó Katalin says that Omicron could end the pandemic if it proves to be less harmful.[1] 1. https://hungarytoday.hu/kariko-omicron-pfizer-coronavirus/ https://hungarytoday.hu/kariko-omicron-pfizer-coronavirus/

rsynnott 5y ago
> But all you can hear these days, is that how so much contagious Omicron is, without mentioning the chance of being a lot less harmful. We _know_ that it's spreading very quickly (there is some legitimate question over how much of this is inherent spreading ability vs immunity evasion). The idea that it's "a lot less harmful" is largely speculative; there just isn't the data to say that right now. Now, it may emerge that it is, and that would be great, but it would be extremely dangerous to assume it at the moment.
- yostrovs 5y ago
  Judging by the response of the authorities, the new strain is highly dangerous. There's a lot of panicking going on.
  - rsynnott 5y ago
    The authorities don't have any special secret knowledge here; they're responding to the (reasonably likely) possibility that it's as dangerous as Delta but will spread much more easily. Honestly, given the rate of spread, even if it had half the hospitalization risk of Delta it's _still_ terrifying.
    - JPKab 5y ago
      What's the hospitalization rate of delta in the vaccinated? It's pretty low. At this point, the vast majority of the unvaxxed are younger, lower risk people. The high risk people who aren't vaxxed (fucking idiots) are now highly treatable. We've got at least two, but a third coming soon, potent treatment options that radically reduce hospitalization. The new Pfizer pill is a true game changer, and we already have the monoclonal ABs. It doesn't appear that the public health authorities or the media are updating their policies based on these new realities. 90% of the people most at risk are vaxxed, and for those who are hospitalized (vaxxed or not) we now have treatments shown in clinical trials to further reduce hospitalization rates by roughly 88-90%. Translation: the hospitals aren't going to get overwhelmed anymore. Science won, even with a sizable chunk of the populace not wanting the vaccine. People can debate the moral hazard of treating unvaxxed with these new therapeutics, but that's a moral argument, not a practical one. Give them the pill or the infusion, keep them out of an ICU bed, and wag your finger at them later. This pandemic is over, and the fear needs to go with it.
      - rsynnott 5y ago
        The pills won't be available in large quantities for a couple of months. In countries with high vaccination rates, most ICU beds are now occupied by youngish, largely unvaccinated people. In Ireland, for instance, 60% of covid patients in ICU over the last 5 months have been under 65, and this is _growing_. They have a decent survival rate, but they're still taking up ICU beds, and the pandemic isn't over until they stop doing that. The pills _may_, if they work as advertised, be the point where we can just stop caring about unvaccinated people. But there are another couple of months to go, even assuming they work as well as expected. (Also, I think there's at least a decent risk that many anti-vaxers will just refuse to take the pill anyway)
JPKab 5y ago
I stopped trusting the media's reporting on covid when it became blatantly obvious that they were completely ignoring and obfuscating the risk stratification by age. It was clear to me that they were motivated to do this by elevating the desire to influence the behavior of the public over the duty to inform them with the actual facts. They cynically assumed, just like the public health authorities did, that if the average Joe didn't personally feel at risk, they wouldn't change their behavior and would cause high-risk/elderly people to die out of negligence. Academics, I've noticed in my career working with them, are far more prone to view the public in this way. I'm sure a few of that variety will respond to this and tell me that yes, they can't be trusted.

vpavicic 5y ago

As I understand it, the SA population is quite young and we are waiting for more data to come in on the effects of omicron (says so in the link you provided as well)... let's not forget we dismissed the whole virus as "just a common cold" at the beginning of the whole story as well. The problem with letting others deal with their consequences is that they are overworking the medical staff, and are disregarding the population that cannot be vaxxed due to medical reasons. I agree we should move from this fear, but I understand how for some the fear is still too real.

SideburnsOfDoom 5y ago
> the SA population is quite young Quite young, and quite highly likely to already have had COVID-19: over 3/4 of the population has had it. https://www.bloomberg.com/news/articles/2021-08-18/deaths-data-shows-80-of-south-africans-may-have-had-covid https://www.bloomberg.com/news/articles/2021-08-18/deaths-da...
- JPKab 5y ago
  Isn't this the case in the US, but in a slightly different manner? We're talking about a majority of adults being vaccinated, and then according to seroprevalence tracking over time, it's estimated that a large percentage of the population (both vaxxed and unvaxxed) have already recovered from an infection as well. But there is one delta on top of the age difference: We have a high rate of obesity, and the latest research shows that adipose tissue contributes to bad outcomes due to the virus infecting it and the cells then being a potent source of cytokines that dramatically and dangerously increase inflammation. The great irony is that as much as we focus (rightly) on unvaxxed clogging the healthcare system, the obese who have been increasingly clogging it over the last few decades are the ones clogging the ICUs when they catch covid. All for a chronic condition that, for most, can be alleviated with voluntary lifestyle changes.

gnat 5y ago

Mutating to lower virulence isn't a law of nature. https://medium.com/a-microbiome-scientist-at-large/do-viruses-get-stronger-or-weaker-over-time-a0091b185fe2 https://medium.com/a-microbiome-scientist-at-large/do-viruse... Crichton wrote interesting books but not all his science was robust.

unmole 5y ago

> It's been a long established medical fact that viruses evolve to become less severe over time HIV, Smallpox and Rabies would like a word.

ethanbond 5y ago
Sorry by “long established medical fact” I think what he meant was “pop science heuristic that is maybe true at t = infinity.”

SideburnsOfDoom 5y ago

> It's been a long established medical fact that viruses evolve to become less severe over time, Is it? The evolutionary pressure is only that reproductive success, succeeds. A virus that spreads better, well, spreads more. There is no real reason why COVID-19 would have to get less severe to be more successful, as most transmission is pre-symptomatic or asymptomatic already. If the host is more likely or less likely to die later on in the disease, is irrelevant to the virus' fitness. https://twitter.com/zeynep/status/1468225625764814859 https://twitter.com/zeynep/status/1468225625764814859 https://twitter.com/Devilstower/status/1465332043005501448 https://twitter.com/Devilstower/status/1465332043005501448

JPKab 5y ago
Could you please cite a source that says most transmission is pre-symptomatic or asymptomatic? Is that new with the delta variant? The studies I've seen have more recently concluded that asymptomatic transmission is far lower than previously thought. Although it probably doesn't matter, since the plurality of symptomatic people below the age of 55 are going to have symptoms hard to distinguish from a cold. Regardless, you make a fair point, but for a virus to kill you, it's going to be more severe in earlier phases, and less likely to be transmitted by a person in a bed than one walking around. Sure, they might have spread while they were walking around, but the proportion of time they are infected and mobile (higher spread) is lower than if the virus is milder. Covid hawks seem to have only one answer for all news items: be more afraid, lock down more. It's tiring, and reminds me of the right-wing equivalent after 9/11: Everything was terror, or potential terror, and you need to be afraid, and if you aren't afraid, it's because you are unpatriotic, stupid, or both.
- SideburnsOfDoom 5y ago
  > Could you please cite a source that says most transmission is pre-symptomatic or asymptomatic? Both links above say as much. Please don't waste our time with "cite a source" when the sources are right there. No it is not new with Covid-Delta.
  - 5y ago

rsynnott 5y ago

> according to the South African medical authorities who first identified and reported it Well, according to the doctor who did. Other South African medical authorities have been a lot more cautious. > Most everyone is vaxxed that is high-risk. Let the rest deal with their consequences. The trouble is, the consequences for the rest involve filling up hospitals, ICUs (and ultimately morgues, though this is less disruptive). That impacts everyone. People are dying unnecessarily because their routine medical care is canceled or because they can't get an ICU bed due to pressure on hospital systems created primarily by unvaccinated patients.

raxxorrax 5y ago
Unvaccinated people under the age of 60 certainly do not put any significant pressure on ICUs. Saying otherwise is a blatant lie and demonizes people. Doing so and searching blame in others is a symptom of severe inferiority complex which is dangerous to other people, so take care what you say.
- n8henrie 5y ago
  Where are you getting this from? I bet they have taken at least 50% capacity on average of our 4 bed ICU over the last few months.
  - raxxorrax 5y ago
    That would make sense then. In that case I am firmly for throwing these two rascals in prison.
    - SideburnsOfDoom 5y ago
      Please don't demonise them.
    - n8henrie 5y ago
      Not sure I understand this comment. Unfortunately each of these cases often occupies an ICU bed for weeks. As a result we transfer dozens of other patients hundreds of miles away, and often after >24 hours boarding in the emergency department, because every other ICU bed is full as well (in addition to mandatory down time for the flight crews, which are also working overtime). With help from my ~5 person ED staff, I've called as many as 50 hospitals in a night (spanning 6 of the largest states) trying to find an open ICU bed. Some relevant conversation on a thread I started in r/medicine: <https://www.reddit.com/r/medicine/comments/r6bl1u/not_accepting_transfers_from_out_of_state/ https://www.reddit.com/r/medicine/comments/r6bl1u/not_accept...>

credit_guy 5y ago

> We have a few treatments that are highly effective, including monoclonal AB and the new Pfizer pill Monoclonal antibodies are not highly effective and Paxlovid is not FDA approved yet (oe EUA”d). > Let the rest deal with their consequences Let me fix this for you: let all of us deal with their consequences.

JPKab 5y ago
Where did you get the idea that monoclonal antibodies aren't highly effective? Do you have any data to back this up? They are an FDA approved, clinically proven first-line treatment for anyone with symptoms showing them at risk of hospitalization. Your statement is misinformation, scientifically inaccurate, and irresponsible. You are painting a scientifically proven and life-saving therapuetic as "not highly effective" when the data shows it absolutely is. Here's a quote from a peer reviewed study in a little blog called the New England Journal of Medicine. Maybe you've heard of it? "A total of 3 of 291 patients in the sotrovimab group (1%), as compared with 21 of 292 patients in the placebo group (7%), had disease progression leading to hospitalization (for >24 hours) for any cause or death (relative risk reduction, 85%; 97.24% confidence interval [CI], 44 to 96; P=0.002) (Table 2). The primary reasons for the 24 hospitalizations were consistent with progressive Covid-19 (Table 3), with one probable exception: 1 patient in the sotrovimab group who had a notable medical history of small-intestinal obstruction presented 22 days after infusion with a small-intestinal obstruction." https://www.nejm.org/doi/full/10.1056/NEJMoa2107934?query=featured_coronavirus https://www.nejm.org/doi/full/10.1056/NEJMoa2107934?query=fe... Hope you will stop spreading misinformation. It's not acceptable when people shit on the vaccines due to their right wing partisan echo chamber induced ignorance, and it's not helpful when people shit on effective treatments due to their left wing partisan echo chamber induced ignorance.