Omicron is a good thing
Let's hope it out-competes its cousins.
Government data suggests that there have been 11,708 confirmed Omicron "cases" in the UK:
I put "cases" in quotation marks because these aren't cases. The definition of a "case" is someone who presents with symptoms and is then diagnosed by a medical professional.
That's not what this number is. This number is the quantity of people who have tested positive in PCR tests. A large proportion of these may be completely asymptomatic, and therefore don't fit the definition of a "case". This distinction is important, since we need to use a consistent approach for different pathogens in order to be able to compare them fairly. If we don't make this distinction here, we end up with an artificially low Case Fatality Rate, which makes comparison tougher. In other words, SARS-CoV-2 would end up looking less severe than it actually is, and this would be misleading.
It's also worth highlighting that this is simply the number of people with confirmed positive tests. The real number of people in the UK who have some detectable amount of bits of the Omicron sequence in their body will of course be higher than this.
If we were to class all of these as infections, and the deaths numbers don't change, we might try to calculate the Infection Fatality Rate (IFR) as follows:
(1 / 11,708) * 100 = 0.0085%
Of course, this number is utterly meaningless for a number of reasons:
We're not sure whether this one death was even an Omicron death. It may well be that this person died of something else, and that they simply happened to have some detectable Omicron RNA in their body at the time.
Critically, we haven't accounted for the time lag. If we assume it takes 3 weeks for someone to die, on average, following initial infection, then we should not be using the numbers above. We should be doing (number of deaths now / number of confirmed infections 3 weeks ago). As we can see from the chart in the source above, the number of people testing positive 3 weeks ago was tiny compared to the current level. This means the approach above is completely flawed.
As alluded to above, the real number of infections will be far higher than the 11k, since we are not testing everyone.
So based on UK data alone, the picture is inconclusive, but looks very encouraging so far. Omicron looks less scary than a bad seasonal flu - a lot less scary.
The bad news is that the vaccines aren't as effective for Omicron. Some estimates suggest the neutralising effect will be 4 times lower than for delta, and the effect for delta is already lower than for the "original Wuhan sequence”. The article I’ve linked to here is slightly misleading. It should really make clearer that the “hundred-fold” increase for the booster is only temporary - it will likely peak around 14 - 21 days after the shot and then wane rapidly.
I think this lower effectiveness could be good news personally; it might make people question the justification for “vaccine passports” and quarterly boosters with the same RNA sequence. Thankfully, because it's quite mild, I don't think the lower vaccine effectiveness for this variant will lead to significant real-world harms.
The bellwether for this is South Africa. Since they've been seeing Omicron growth for a longer period, we have more data. There is a new interview with Pieter Streicher, an engineer who has been keeping a close eye on the situation over there. I referenced his Twitter thread in a recent post here:
The interview is with Freddie Sayers from Unherd - highly recommended:
This narrative appears to be backed up by other sources:
Only 1.7% of identified Covid-19 cases were admitted to hospital in the second week of infections in the fourth wave, compared with 19% in the same week of the third delta-driven wave, South African Health Minister Joe Phaahla said at a press conference.
Anecdotally, I know a few people who have tested positive recently who think it's Omicron because of the timing and the symptom profile. This is just their speculation - S-gene dropout is unconfirmed. All say it's incredibly mild and some have no symptoms. They're all vaccinated, so vaccination doesn't stop you catching or spreading it, as we suspected.
Lots of people are changing their Christmas plans in response to the latest Omicron news. If they’re doing this for strictly legal reasons this is understandable - though non-compliance is likely a faster to route to getting us out of this mess.
If people are changing their plans for health reasons though, and genuinely believe they're at risk, the question has to be: would you be doing the same for influenza? And if not, why the inconsistency?
EDIT: Since this comment was posted, more evidence has emerged to support it. https://www.biorxiv.org/content/10.1101/2021.12.17.473248v1 is the paper, summarised by Prof. Francois Balloux here:
