If you guessed that the U.S. has an average of about 9 new COVID-19 cases per 100K per day, AND that this is more-or-less unchanged from a week ago, then you’re today’s big winner.
Data source for this and other graphs of new case counts: Calculated from The New York Times. (2021). Coronavirus (Covid-19) Data in the United States. Retrieved 3/31/2022, from https://github.com/nytimes/covid-19-data.” The NY Times U.S. tracking page 3may be found at https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
Maybe our response shouldn’t be binary
The U.K. seems to have made a secondary peak now. Note that their current rate is almost 20x the U.S. new case rate. It’s not that Omicron hit them particularly harder than it hit the U.S. Our peak rate was almost 250 new cases per 100K per day. It’s that it never really went away there. And now it’s back, as son-of-Omicron (BA.2).
Source: Johns Hopkins data via Google search
And yet, the U.K.’s response to COVID-19 — and our response to COVID-19 — seems to be an either-or, yes-no approach. Either yes, we’re in the middle of a pandemic, and precautions should be taken. Or no, we’re over it, go back to exactly what you were doing before this all happened. (Which is pretty much where the U.K is right now.)
And maybe that’s not the brightest approach. Maybe some modest permanent changes might be more efficient. Because maybe, just maybe, what we’re looking at for the forseeable future is a permanent change in the “disease environment”, for want of a better term.
Today’s Guardian has an insightful article about this. Really, it’s about what “endemic” is supposed to mean. As opposed to what they are actually experiencing in Great Britain.
I think it’s well worth the five minute read. Because, as I’ve said here before, I can’t quite get my mind around just how, exactly, Omicron/son-of-Omicrion is supposed to be come “endemic”, in the sense that the common cold is endemic. And that article explains that quite clearly.
Omicron/son-of-Omicron is ridiculously easy to spread, compared to other endemic diseases. The R-nought for BA.2 is estimated to be somewhere around 22, versus a typical value of 1.75 or so for seasonal flu. But immunity seems to fade rapidly, re-infections are now common, and the existing vaccines are mediocre, at best, at preventing any new infection. So, just like the flu, just because you had it last year doesn’t mean you can’t get it again this year. Flu shot or no flu shot.
When scientists use the term endemic, they mean something that a) is present in the population, and b) doesn’t flare up into huge outbreaks. We also think of it as implying something relatively mild, but the Guardian points out that (e.g.) tuberculosis and malaria are endemic in much of the world, and those most certainly kill a lot of people.
Well, take a look at Great Britain. Official policy now treats BA.2/son-of-Omicrion as if it’s endemic, but it currently meets none of the criteria. The U.K. hospital system is once again under strain from the volume of admissions for COVID.
So if I had one takeaway from the Guardian article, it’s that maybe we’re just not quite getting our minds straight about this. Everybody wants to return to the pre-COVID world. But that world no longer exists.
Right now, seasonality is in our favor. BA.2 or not, this is the time of year when conditions favor a reduction in spread of most or all airborne viral diseases. It’s the end of flu season. All other things equal, it ought to be the end of COVID season.
If we manage to get through BA.2, and into the summer, are we really just going to declare victory and pretend that this is all behind us, and nothing has changed? Yeah, probably, I’d guess we’re going to try to do that.
But I can’t quite get my mind around what a nice, politely-behaved endemic Omicron is supposed to look like. As the Guaradian points out, that’s probably a myth. It certainly looks like a myth for Great Britain, right now.
Basing policy on myth is generally not a good idea. But what set of rationally-thought-through permanent changes are we planning to implement? Sure looks like none, to me. E.g., at what new-case level would a Federal mask mandate on public transportation be re-instated (assuming it’s ever lifted)? Nobody can even ask that question without getting slapped down.
Which means that, in effect, we’re hoping there will never be another outbreak. Which really means that, with each new outbreak, we’ll just be winging it again.
Right now, COVID-19 presents less risk of hospitalization and death, for a vaccinated and boostered individual, than seasonal flu does. So, right now, nobody needs to think about the most ration response in the event of another outbreak. Which means that right now would be the right time to have some rational discussion about some forward-looking public health policy in this area.
Next time, maybe it would be better if our public health show was more scripted, and less improv.
