8 ms·

Someone made an interesting point that Omicron might become the most virulent disease ever. So I like how the bar has shifted, because everybody is so fed up w

Someone made an interesting point that Omicron might become the most virulent disease ever. So I like how the bar has shifted, because everybody is so fed up with the disruptions to their daily life. Understandably so. But most virulent disease every is still pretty bad. Just from a logistical standpoint. For me, the real problem is what comes after Omicron. HIV is a completely different disease with a different etiology but it never went away. Treatments just got better with time. I suspect the pandemic will force a lot of adaptations and legislation. I’m most excited about rapid testing at home though. I feel like that’ll do a lot to stifle the pandemic.

adam_arthur 5y ago
Ease of spread is only notable if it causes bad health outcomes. Policy should only be made in response to actual outcomes, not case counts or other inaccurate proxies. Historians will look very poorly on the authoritarian type policies being implemented that are, in fact, ignoring the science (actual data, second order effects), not following it.
- weaksauce 5y ago
  > Policy should only be made in response to actual outcomes the problem with that kind of lagging reaction to policy is that if you wait for the results of the variant you may have a situation where you are unable to contain or curtail the virus enough to not overwhelm the hospital systems. deaths and hospitalizations are a very lagging indicator of the effects
  - adam_arthur 5y ago
    It's been weeks since the variant started to spread. If outcomes were noticeably worse than Delta, it would be evident by now. It being milder or the same is better supported by the evidence. You can think of any hypothetical worst case and make irrational policy on the basis. Maybe next year's flu strain will cause any who catch it to die one year from infection?
    - matthewmacleod 5y ago
      I don’t think I’ve seen any suggestion that outcomes are worse, or policies made with that assumption. At the moment, the evidence we have available suggests that Omicron is much more transmissible than Delta, and between 0-30% less likely to result in hospitalisation. It certainly seems like policy is being made with that in mind.
      - adam_arthur 5y ago
        Most evidence I see suggests it's many fewer hospitalizations. Stats from a recent Denmark study show 60% fewer https://twitter.com/BallouxFrancois/status/1472691431336726535?t=jydMaZAfg4DVB7rjS4pqCg&s=19 https://twitter.com/BallouxFrancois/status/14726914313367265... But people don't want good news with covid. They want to fearmonger as if we can eliminate 100% of cases through authoritarian policy. Which think I don't need to state, will never happen, regardless if 100% of society is vaccinated with a booster and we perpetually lockdown. It's an endemic disease, that's life. Zero heed is paid to the extremely costly second order effects of these extreme policies. One of which was a massive increase in wealth inequality, by the way
        freemint 5y ago
        fewer then what in what population?
        adam_arthur 5y ago
        Why don't you read the link in the post?
        rsfern 5y ago
        You mentioned a study, but there’s no DOI, journal, or preprint link… do you mean the blog post linked in the Twitter thread? Edit: I guess I don’t see why there would be time for a DOI or peer review, but I could see there being time for a preprint. Why wouldn’t you just link to the primary source when it’s ambiguous like this?
  - phkahler 5y ago
    >> the problem with that kind of lagging reaction to policy... We know that vitamin D helps prevent this kind of thing. We know that most (Americans) are deficient in the winter months. There is evidence to support the idea that it is protective against Covid-19. It is also very safe to take even if you're not deficient. I have yet to see a PSA or recommendation on this. That could have been proactive rather than lagging. What I have seen is newer research suggesting that vit D doesnt help, but always with some caviotte like "in people who are not deficient" or one where they administered high doses to people already on ventilators.
    - ineedasername 5y ago
      Evidence on vitamin D is equivocal. [0][1] Experts disagree on how to interpret the various studies that have come out that do not all show the same results. On the other hand, an official proclamation that people should ensure their vitamin D levels are okay would cause a rush on it with many people taking much more than they should. We've seen this with other medications that have not been systematically shown to help COVID but still obtain meme-like status. Ivermectin for example also has only equivocal evidence for its use, but has resulted in overdoses [2] and a spike in calls to poison control centers over its use [3] Maybe there's a middle ground there on something like vitamin D, which as you say is often deficient. But it's a fine line to walk when the evidence is uncertain about its impact on COVID. [0] https://www.covid19treatmentguidelines.nih.gov/therapies/supplements/vitamin-d/ https://www.covid19treatmentguidelines.nih.gov/therapies/sup... [1] https://www.mayoclinic.org/diseases-conditions/coronavirus/expert-answers/coronavirus-and-vitamin-d/faq-20493088 https://www.mayoclinic.org/diseases-conditions/coronavirus/e... [2] https://www.newsweek.com/man-covid-overdoses-ivermectin-doctors-warn-ineffective-not-safe-1625340 https://www.newsweek.com/man-covid-overdoses-ivermectin-doct... [3] https://www.npr.org/sections/coronavirus-live-updates/2021/09/04/1034217306/ivermectin-overdose-exposure-cases-poison-control-centers https://www.npr.org/sections/coronavirus-live-updates/2021/0...
      - weaksauce 5y ago
        > Ivermectin for example also has only equivocal evidence for its use well it was actually pretty promising in some countries data early on. the problem is when you extrapolate that data to the world at large you have problems with populations. so yes, ivermectin is useful in areas that have parasites that can cause the host to die from when in a weakened state due to the immunosupressing drugs that they give to stop the cytokine storms that kill covid patients, exactly the populations that the data showed a benefit from and also standard course in those countries. when done in places without a high risk of secondary parasitic infection the data was that it was not useful. There were/are some studies done now because it's so cheap but it's not really all that effective outside of it being an secondary treatment in those parasitic prone countries. But since it showed promise there the antivaxxers were hell bent on using it regardless of the why because it wasn't a vaccine and here we are. Too much vitamin D is bad too and you definitely don't want that and without data supporting it being highly effective against covid it's not useful as a prophylactic. That said, vitamin D is generally correlated with a better immune system response against respiratory illness. supplementing a reasonable amount is not usually considered harmful but it's wise to talk to a doctor.
- culi 5y ago
  health outcomes vary widely by location. South Africa seems to be particularly less severe than in other places (suggesting population and environmental factors may play a big role). The fact is that in other countries death rates are still rising so there's a lot of unknowns and the science says this could be really bad
  - adam_arthur 5y ago
    The science says destroying the global economy with lockdowns is bad too. Do we make all policy on the basis of one variable, or do we look at the multivariate system holistically? Majority of countries are doing the former, which is not "following the science" but cherry picking a subset of the science that reinforces your view. I can assure you everybody on earth catching covid would be less severe and painful than the GFC was for global population. Which is pretty easily borne out by the data (the science). A second global lockdown would have pretty similar results to the GFC, given that ammo for stimulus is spent.
    - culi 5y ago
- ineedasername 5y ago
  It's probably better to ratchet up precautions slightly for the additional 2-3 weeks from now that it will take to get more data. I don't think history will look poorly on a scenario of "A more infectious version of COVID emerged, so for the following 6-8 weeks we asked people to increase social distancing and mask wearing". If the mandate was "Cancel Christmas and arrest people found at holiday parties" then yes, "authoritarian" history would look poorly on that. As it stands, I haven't seen any governments take drastic steps towards more lockdowns due to Omicron. It's all "urging more caution".
  - volker48 5y ago
    The Dutch are entering a pretty strict lockdown https://www.bbc.com/news/world-europe-59713503 https://www.bbc.com/news/world-europe-59713503. Strict limits will be placed on the number of people who can meet - a maximum of two guests aged 13 and over will be allowed in people's homes, and four on 24-26 December and on New Year's Eve and New Year's Day. This sounds pretty unenforceable though to be honest.
    - ineedasername 5y ago
      That seems unecessarily excessive, but in the face of a surge combined with a short deadline (expires Jan 9th) I would be hard pressed to write that down in the history books as and authoritarian atrocity.
- michaelbrave 5y ago
  I'm not so sure, some countries that clamped down very hard("Authoritarian type policies") like Singapore, Korea or New Zealand have done quite well, while countries who did half measures ("USA, Italy") or very little ("Brazil") seem to be struggling.

adam_arthur 5y ago

Ease of spread is only notable if it causes bad health outcomes. Policy should only be made in response to actual outcomes, not case counts or other inaccurate proxies. Historians will look very poorly on the authoritarian type policies being implemented that are, in fact, ignoring the science (actual data, second order effects), not following it.

weaksauce 5y ago
> Policy should only be made in response to actual outcomes the problem with that kind of lagging reaction to policy is that if you wait for the results of the variant you may have a situation where you are unable to contain or curtail the virus enough to not overwhelm the hospital systems. deaths and hospitalizations are a very lagging indicator of the effects
- adam_arthur 5y ago
  It's been weeks since the variant started to spread. If outcomes were noticeably worse than Delta, it would be evident by now. It being milder or the same is better supported by the evidence. You can think of any hypothetical worst case and make irrational policy on the basis. Maybe next year's flu strain will cause any who catch it to die one year from infection?
  - matthewmacleod 5y ago
    I don’t think I’ve seen any suggestion that outcomes are worse, or policies made with that assumption. At the moment, the evidence we have available suggests that Omicron is much more transmissible than Delta, and between 0-30% less likely to result in hospitalisation. It certainly seems like policy is being made with that in mind.
    - adam_arthur 5y ago
      Most evidence I see suggests it's many fewer hospitalizations. Stats from a recent Denmark study show 60% fewer https://twitter.com/BallouxFrancois/status/1472691431336726535?t=jydMaZAfg4DVB7rjS4pqCg&s=19 https://twitter.com/BallouxFrancois/status/14726914313367265... But people don't want good news with covid. They want to fearmonger as if we can eliminate 100% of cases through authoritarian policy. Which think I don't need to state, will never happen, regardless if 100% of society is vaccinated with a booster and we perpetually lockdown. It's an endemic disease, that's life. Zero heed is paid to the extremely costly second order effects of these extreme policies. One of which was a massive increase in wealth inequality, by the way
      - freemint 5y ago
        fewer then what in what population?
        adam_arthur 5y ago
        Why don't you read the link in the post?
        rsfern 5y ago
        You mentioned a study, but there’s no DOI, journal, or preprint link… do you mean the blog post linked in the Twitter thread? Edit: I guess I don’t see why there would be time for a DOI or peer review, but I could see there being time for a preprint. Why wouldn’t you just link to the primary source when it’s ambiguous like this?
- phkahler 5y ago
  >> the problem with that kind of lagging reaction to policy... We know that vitamin D helps prevent this kind of thing. We know that most (Americans) are deficient in the winter months. There is evidence to support the idea that it is protective against Covid-19. It is also very safe to take even if you're not deficient. I have yet to see a PSA or recommendation on this. That could have been proactive rather than lagging. What I have seen is newer research suggesting that vit D doesnt help, but always with some caviotte like "in people who are not deficient" or one where they administered high doses to people already on ventilators.
  - ineedasername 5y ago
    Evidence on vitamin D is equivocal. [0][1] Experts disagree on how to interpret the various studies that have come out that do not all show the same results. On the other hand, an official proclamation that people should ensure their vitamin D levels are okay would cause a rush on it with many people taking much more than they should. We've seen this with other medications that have not been systematically shown to help COVID but still obtain meme-like status. Ivermectin for example also has only equivocal evidence for its use, but has resulted in overdoses [2] and a spike in calls to poison control centers over its use [3] Maybe there's a middle ground there on something like vitamin D, which as you say is often deficient. But it's a fine line to walk when the evidence is uncertain about its impact on COVID. [0] https://www.covid19treatmentguidelines.nih.gov/therapies/supplements/vitamin-d/ https://www.covid19treatmentguidelines.nih.gov/therapies/sup... [1] https://www.mayoclinic.org/diseases-conditions/coronavirus/expert-answers/coronavirus-and-vitamin-d/faq-20493088 https://www.mayoclinic.org/diseases-conditions/coronavirus/e... [2] https://www.newsweek.com/man-covid-overdoses-ivermectin-doctors-warn-ineffective-not-safe-1625340 https://www.newsweek.com/man-covid-overdoses-ivermectin-doct... [3] https://www.npr.org/sections/coronavirus-live-updates/2021/09/04/1034217306/ivermectin-overdose-exposure-cases-poison-control-centers https://www.npr.org/sections/coronavirus-live-updates/2021/0...
    - weaksauce 5y ago
      > Ivermectin for example also has only equivocal evidence for its use well it was actually pretty promising in some countries data early on. the problem is when you extrapolate that data to the world at large you have problems with populations. so yes, ivermectin is useful in areas that have parasites that can cause the host to die from when in a weakened state due to the immunosupressing drugs that they give to stop the cytokine storms that kill covid patients, exactly the populations that the data showed a benefit from and also standard course in those countries. when done in places without a high risk of secondary parasitic infection the data was that it was not useful. There were/are some studies done now because it's so cheap but it's not really all that effective outside of it being an secondary treatment in those parasitic prone countries. But since it showed promise there the antivaxxers were hell bent on using it regardless of the why because it wasn't a vaccine and here we are. Too much vitamin D is bad too and you definitely don't want that and without data supporting it being highly effective against covid it's not useful as a prophylactic. That said, vitamin D is generally correlated with a better immune system response against respiratory illness. supplementing a reasonable amount is not usually considered harmful but it's wise to talk to a doctor.
culi 5y ago
health outcomes vary widely by location. South Africa seems to be particularly less severe than in other places (suggesting population and environmental factors may play a big role). The fact is that in other countries death rates are still rising so there's a lot of unknowns and the science says this could be really bad
- adam_arthur 5y ago
  The science says destroying the global economy with lockdowns is bad too. Do we make all policy on the basis of one variable, or do we look at the multivariate system holistically? Majority of countries are doing the former, which is not "following the science" but cherry picking a subset of the science that reinforces your view. I can assure you everybody on earth catching covid would be less severe and painful than the GFC was for global population. Which is pretty easily borne out by the data (the science). A second global lockdown would have pretty similar results to the GFC, given that ammo for stimulus is spent.
  - culi 5y ago
ineedasername 5y ago
It's probably better to ratchet up precautions slightly for the additional 2-3 weeks from now that it will take to get more data. I don't think history will look poorly on a scenario of "A more infectious version of COVID emerged, so for the following 6-8 weeks we asked people to increase social distancing and mask wearing". If the mandate was "Cancel Christmas and arrest people found at holiday parties" then yes, "authoritarian" history would look poorly on that. As it stands, I haven't seen any governments take drastic steps towards more lockdowns due to Omicron. It's all "urging more caution".
- volker48 5y ago
  The Dutch are entering a pretty strict lockdown https://www.bbc.com/news/world-europe-59713503 https://www.bbc.com/news/world-europe-59713503. Strict limits will be placed on the number of people who can meet - a maximum of two guests aged 13 and over will be allowed in people's homes, and four on 24-26 December and on New Year's Eve and New Year's Day. This sounds pretty unenforceable though to be honest.
  - ineedasername 5y ago
    That seems unecessarily excessive, but in the face of a surge combined with a short deadline (expires Jan 9th) I would be hard pressed to write that down in the history books as and authoritarian atrocity.
michaelbrave 5y ago
I'm not so sure, some countries that clamped down very hard("Authoritarian type policies") like Singapore, Korea or New Zealand have done quite well, while countries who did half measures ("USA, Italy") or very little ("Brazil") seem to be struggling.