POST 220 December 13, 2021. CORONAVIRUS. Dr. Osterholm. “You cannot outrun the game clock with this pandemic. This virus will find you… We’ve seen health care systems virtually broken by this pandemic. They just couldn’t provide critical care to non-Covid patients.” (A)

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“New data from South Africa and Europe hint that Omicron cases are poised to explode in the U.S….  

• But the variant is less likely to lead to hospitalization in adults than the original version.

Why it matters: A dramatic surge in cases could overwhelm our burnt-out health system, if even a small percentage require hospital care.

“Everything points to a large wave,” a senior Biden administration official told Axios. “A large wave is coming.”

• “It will be fast. It won’t be as severe, but regrettably, there will be plenty of hospitalizations,” the official added.

The bottom line: We don’t have enough data yet to make firm predictions. But there’s a strong possibility a lot of Americans are about to get sick.” (A)

“The British government raised the country’s official coronavirus threat level on Sunday, warning the rapid spread of the omicron variant had pushed the U.K. into risky territory.

The chief medical officers of England, Scotland, Wales and Northern Ireland said the emergence of the highly transmissible new strain “adds additional and rapidly increasing risk to the public and health care services” at a time when Covid-19 is already widespread. They recommended raising the alert level from 3 to 4 on a 5-point scale. The top level, 5, indicates authorities think the health-care system is about to be overwhelmed.

The doctors said early evidence shows omicron is spreading much faster than the currently dominant delta variant, and that vaccines offer less protection against it. British officials say omicron is likely to replace delta as the dominant strain in the U.K. within days.

“Data on severity will become clearer over the coming weeks but hospitalizations from omicron are already occurring and these are likely to increase rapidly,” they said.”” (B)

“BERGEN: You predicted in April 2020 that there could be 800,000 deaths in the United States in 18 months, and we’re now at 790,000-plus deaths right around that 18-month time frame. How did you make that prediction?

OSTERHOLM: I based my estimates at the time on historic data from previous pandemics.

What is troubling to me is our fascination with modeling. I think modeling, particularly when it’s erroneous, can be very detrimental. I’ve watched so many different estimates of case numbers from these models taken literally by policymakers and the public and particularly the media.

The reality is you can’t model beyond 30 days out. Just look at what is happening right now. We can’t even predict why these surges occur or when they occur. Who, 30 days ago, could have developed a model that would accurately predict what we’re seeing right now with Omicron? Who could have predicted that?…

BERGEN: Two percent of the population of low-income countries has had one shot versus 65% for high income countries. does that portend for the future?

OSTERHOLM: Two things: One is that this pandemic has really provided a window into our global vaccine capacity in a way nothing else has ever done before.

I think that there’s been some red herrings in terms of what the issues are. For example, we keep hearing about technology transfer and giving these countries the ability to make their own vaccines, and yet the expertise needed to make these vaccines is really at a premium. It’s very difficult to find people who know how to do this. So, it’s not enough to transfer technology to a low-income country if you don’t provide the expertise to make these vaccines. It’s not as simple as making chicken soup.

Also, our focus has been almost solely on getting vaccines to people around the world, which is surely important. But we haven’t been thinking nearly enough about what it would take to turn a vaccine into a vaccination, that needle into the arm. We have seen the challenges in this country with administering vaccinations, and those challenges also exist around the world.

So, just shipping a couple of pallets of vaccines to a low-income country may be a useless effort if, in fact, they don’t have the infrastructure to deliver the vaccine and they don’t have a means for helping the population understand how and why they should want to be vaccinated. What this whole situation has highlighted, is the fact that we have a lot more work to do to understand not just how to make vaccines, but also how to turn vaccines into vaccinations.” (C)

“A MEMBER OF the Scientific Advisory Group for Emergencies (Sage) has said Omicron is “much more infectious” than Delta and all previous strains.

Professor Andrew Hayward told LBC: “Maybe somewhere between twice and possibly three times as infectious.”

An additional 633 confirmed cases of the Omicron variant were reported across the UK yesterday, bringing the total number of confirmed cases to 1,898.

“What we can also see is that the vaccine, two doses of the vaccine, has relatively little impact on stopping that transmission.

“So putting those two together, and the fact that it’s already increasing, doubling every two or three days, what we can be pretty sure of is a very, very large wave of infections, bigger than the waves of infections that we’ve had before, so really the uncertainty is in how that’s going to translate into hospitalisations and deaths.”

Hayward said the hospital system is already “on its knees” and there is a “big problem” ahead.

It was put to him that people may think ministers feel they have to put extra restrictions in place “based on modelling and theories”. He said: “There’s a very, very strong theoretical possibility here. It’s not just an off-chance that we’re talking about.

“And certainly we’re talking about a hospital system that is already pretty much on its knees with the current level of activity, and that level of activity is going to go up dramatically and much worse than a normal winter.

“So you know, there is going to be a big problem. The question is how much we’re prepared to do to stop that as a society.”” (D)

“Doctors in Minnesota took the unusual step of pleading in a full-page newspaper ad for people to get vaccinated against Covid-19 and take other precautions to curb the pandemic.

“We’re heartbroken. We’re overwhelmed,” the top of the Sunday ad in the Minneapolis Star Tribune said in large type.

“Our emergency departments are overfilled, and we have patients in every bed in our hospitals,” the ad said. “This pandemic has strained our operations and demoralized many people on our teams.”

The ad was signed by nine executives of health care systems. Seven doctors, including the president and CEO of the Mayo Clinic, Gianricco Farrugia, and Marc Gorelick, president and CEO of Children’s Minnesota, signed it.

According to data compiled by Johns Hopkins University, the number of hospitalizations in Minnesota for the past 30 days is 14.5% higher than the previous 30-day period. The number of Covid-19 deaths has increased by 36.4%.

Minnesota Hospital Association President and CEO Rahul Koranne told CNN in a statement “the full-page ad that some of Minnesota’s hospital and health system leaders signed is a dire yet accurate summary of the situation here in Minnesota. Our health care heroes are exhausted, heartbroken, and overwhelmed after running this relentless ultramarathon for 22 months each day, evening and night.” (E)

“The hospitals warn that because their capacity is strained, care for non-coronavirus medical events, like heart attacks, is also threatened.

“Now, an ominous question looms: will you be able to get care from your local community hospital without delay? Today, that’s uncertain,” they write in the ad, which is running in major newspapers across the state.” (F)  

“Britain is facing a “tidal wave” of infections from the new Omicron coronavirus variant, ministers have warned, as they sound the alarm on rapid transmission rates in London and across the country…

“While Omicron represents over 20% of cases in England, we’ve already seen it rise to over 44% in London and we expect it to become the dominant Covid-19 variant in the capital in the next 48 hours,” Javid told Parliament on Monday.

Earlier on Monday, he told Sky News: “It’s spreading at a phenomenal rate, something that we’ve never seen before — it’s doubling every two to three days in infections.””  (G)

“The Omicron variant of the coronavirus is spreading swiftly and will become the dominant variant in the British capital in the next 48 hours, Health Secretary Sajid Javid said on Monday.

“No variant of COVID-19 has spread this fast,” Javid told parliament.

“While Omicron represents over 20 percent of cases in England, we’ve already seen it rise to over 44% in London and we expect it to become the dominant COVID-19 variant in the capital in the next 48 hours.”” (H)

“The omicron variant appears to cause less severe disease than previous versions of the coronavirus, and the Pfizer vaccine seems to offer less defense against infection from it but still good protection from hospitalization, according to an analysis of data from South Africa, where the new variant is driving a surge in infections.

While the findings released Tuesday are preliminary and have not been peer-reviewed — the gold standard in scientific research — they line up with other early data about omicron’s behavior, including that it seems to be more easily transmitted.

A two-dose Pfizer-BioNTech vaccination appeared to provide just 33 percent protection against infection during South Africa’s current omicron wave, but 70 percent protection against hospitalization, according to the analysis conducted by Discovery Health, South Africa’s largest private health insurer, and the South African Medical Research Council.

The data were gathered from Nov. 15 to Dec. 7, during which time omicron was first spotted by scientists in South Africa and Botswana, and may change as time passes. Experts now say that omicron accounts for more than 90 percent of all new infections in South Africa, according to Discovery Health chief executive Dr. Ryan Noach.

Researchers around the world are rushing to figure out what omicron will mean for the coronavirus pandemic now well into its second year. More information came Tuesday from Pfizer, which announced that its experimental pill to treat COVID-19 — separate from it its vaccine — appears effective against the new variant.” (I)

“Omicron is spreading at a rate we have not seen with any previous variant,” said Dr. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization.

“We underestimate this virus at our peril,” he said in a news conference Tuesday from Geneva. “Even if omicron does cause less severe disease, the sheer number of cases could once again overwhelm unprepared health systems.”..

Even if omicron does prove to be milder, delta remains a threat.

“We are caught between two elephants, the delta and the omicron,” he said. “These are massive, angry elephants.”” (J)

“Scientists have moved quickly since the World Health Organization designated Omicron a variant of concern in late November. Observations arrive in rapid succession, often posted straight to social media without peer review or the caveats and uncertainties that would be noted in published papers. Watching science unfold in real time can be confusing and misleading.

“We are going to see a couple of weeks of every day, new information, new studies,” said Dr. Soumya Swaminathan, chief scientist at the W.H.O. “One study is not going to really prove anything.”

So what do researchers need to do in the weeks and months ahead to better understand Omicron — and any future variants — and how should we gauge their progress? Here’s a guide for following along.

1.Sequence and track cases

2.Pinpoint the variant’s transmissibility

3.Investigate protection afforded by prior infections and vaccines

4.Determine the variant’s severity”  (K)

“When scientists discovered the highly mutated Omicron variant of the coronavirus last month, it set off an eerily familiar chain of events.

Health experts held somber news conferences that raised more questions than answers. Officials imposed travel bans that very likely came too late. Virus trackers filled in their maps as the variant was reported in country after country. And the rest of us waited, with increasing unease, to learn more about the threat we were facing.

The same sequence unfolded nearly two years ago when the novel coronavirus, SARS-CoV-2, was first discovered. In those early weeks of 2020, the United States proved to be woefully unprepared for the challenges ahead, starting with the most fundamental of tasks: detecting the virus.

“We had a delay of one to two months before we were even able to identify the presence of the virus,” said Dr. Charles Chiu, an infectious disease specialist and microbiologist at the University of California, San Francisco. “And by that time, it had already circulated widely between multiple states and from coast to coast.”

These failures have been well-chronicled, and Omicron is one more sign that the current pandemic, which has now claimed the lives of nearly 800,000 Americans, is not over.

But Omicron is also a dress rehearsal for the next pandemic. The work before us now — detecting, tracking and slowing the spread of a health threat we do not fully understand — is the same work that will be required to stop a future outbreak in its tracks…

Many of these problems can be traced to the nation’s failure to invest in testing early in the pandemic. The Trump administration created Operation Warp Speed to turbocharge vaccine development. The country needed a similar effort for diagnostic tests, experts said.

Diagnostic testing may not be as tantalizing as vaccines, but in any future pandemic, they said, it should be a priority from the start.

The next vital link in the surveillance chain is routine, widespread genomic sequencing. This kind of surveillance helps experts keep tabs on how a pathogen is mutating and how new variants are spreading.

In the United States, this effort got off to a very slow start. “Many of the public health labs were, frankly, just overwhelmed by the initial testing volume and competing obligations,” said Duncan MacCannell, the chief science officer at the C.D.C.’s office of advanced molecular detection….

Some of the progress the country has made could leave us better positioned for the next pandemic. For instance, public health laboratories have new equipment and expertise, which they can now use to track the flu, food-borne illnesses and whatever the next great global health threat turns out to be.

But solidifying these gains will require a continuing commitment and funding after the immediate crisis has passed. “The historical pattern is, we surge and then we forget and we neglect,” Dr. Bright said.

Many exhausted health officials have already left their jobs, and legislators have passed more than 100 laws limiting the public health powers of state and local authorities, a New York Times review found.

Some of the problems that the pandemic has highlighted are deeply rooted. For example, a highly coordinated genomic surveillance program like Britain’s, which is frequently held up as an exemplar, was always going to be a heavy lift in the United States.

“We have this Balkanized health care system, and the system is a giant mess,” said Jeremy Kamil, a virologist at Louisiana State University Health Sciences Center Shreveport.

And pandemic preparedness does not happen in a vacuum. Just as a more equitable distribution of vaccines might help squelch the next variant of concern, preventing the next big global outbreak will require ensuring that every country has the resources to detect and respond to emerging pathogens.

The United States is a large and fractured country — politically polarized and burdened with glaring inequities, rampant misinformation and disinformation, and a considerable distrust of public officials. These are enormous, thorny problems and are much harder to address than ensuring that labs have the capacity to detect Omicron or any new pathogen.

“I’m confident in our ability to detect the variant,” Dr. Fauver said. “What I’m not confident in is our ability to do anything about it. We’re detecting the Delta variant every single day, every time we sequence.”

Even before the Omicron news broke, another Delta-driven surge had already begun. Scientists are finding more Omicron cases every day, and the variant could soon overtake Delta. What comes next — what we should aim for, even — is less clear. Should we spend the winter trying to stop every infection? Protecting the highest risk people from severe disease and death? Ensuring that hospitals are not overrun?

“One thing that we’ve lacked continuously through the pandemic is a goal,” said Emily Gurley, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health. “We still don’t have that. Certainly, we don’t have that for Omicron.” (L)

• A.“New data from South Africa and Europe hint that Omicron cases are poised to explode in the U.S….  , AXIOS, December 14,2021
• B.UK hikes its coronavirus threat level as omicron variant surges, https://www.cnbc.com/2021/12/12/uk-hikes-its-coronavirus-threat-level-as-omicron-variant-surges.html
• C.The infectious disease expert who warned us 800,000 Americans would die of Covid-19, by Peter Bergen, https://www.cnn.com/2021/12/09/opinions/infectious-disease-expert-warned-covid-19-deaths-bergen/index.html
• D.Omicron could be three times more infectious than previous strains, says UK expert, https://www.thejournal.ie/omicron-infectious-uk-5627798-Dec2021/
• E.’We’re heartbroken:’ Minnesota doctors plead in newspaper ad for people to get vaccinated, By Theresa Waldrop, https://www.cnn.com/2021/12/13/us/minnesota-doctors-covid-newspaper-ad/index.html
• F.Minnesota hospitals warn they are ‘overwhelmed’ in full-page ad, by: Peter Sullivan, https://www.kxnet.com/news/national-news/minnesota-hospitals-warn-they-are-overwhelmed-in-full-page-ad/
• G.Britain battles Omicron ‘tidal wave,’ as infections double every two to three days and first death from variant is recorded, By Rob Picheta, https://www.cnn.com/2021/12/13/uk/uk-omicron-infections-tidal-wave-gbr-intl/index.html
• H.Omicron to be dominant variant in London in next 48 hours – health minister, https://www.reuters.com/world/uk/omicron-be-dominant-variant-london-next-48-hours-health-minister-2021-12-13/
• I.Data analysis shows omicron variant less severe, better at evading vaccines, by Andrew Meldrum, https://www.pbs.org/newshour/health/data-analysis-shows-omicron-variant-less-severe-better-at-evading-vaccines
• J.’Spreading at a rate we have not seen’ – Omicron more resistant to COVID-19 vaccines, by Karen Weintraub and Elizabeth Weise, https://www.usatoday.com/story/news/health/2021/12/14/covid-omicron-south-africa-study/6502201001/
• K.What It Takes to Understand a Variant, By Amy Schoenfeld Walker and Lazaro Gamio, https://www.nytimes.com/interactive/2021/12/14/science/omicron-variant-science.html
• L.Omicron Is a Dress Rehearsal for the Next Pandemic,  By Emily Anthes, https://www.nytimes.com/2021/12/14/health/coronavirus-omicron-next-pandemic.html?referringSource=articleShare