ICU numbers in my area are going up. 1/2 my unit is Covid now. All unvaccinated. However, the number on the floors is not so high, which is interesting cause they usually all go together which lends to the thought that this is mild for the vaccinated and not requiring hosp but those who are sick and in ICU are really in trouble. One of my attendings entire load was covid patients in the ICU and all unvaccinated.
Also, keep in mind, our numbers are going to be much higher in the public because so many people are testing at home and not everyone runs to the doctor right away. Quite a few areas are already out of testing kits so based on human nature, people are going to figure they got something, may or may not conclude they have it and not inform their doctor so it will go unaccounted for.
Following info is from someone I follow and get some of my Covid info. She has a masters in public health, a PhD in Epidimiology and BioStatistics and has been accurate throughout this pandemic. She has an email that comes out 1 or 2x a week that you sign up for if interested. Name is Dr. Katelyn Jetelina. (No peer papers
either). 100% science driven and peer reviewed info. She also has a second gig teaching med students.
Your Local Epidemiologist | Katelyn Jetelina | Substack. Her goal is to translate data and give it to the public.
Vaccine Effectiveness
We now have 8 lab studies all largely saying the same thing: Omicron significantly reduces the number of neutralizing antibodies from a 2-dose mRNA series compared to previous variants.
Importantly, a “reduction in neutralizing antibodies” is not the same thing as “reduction in vaccine effectiveness”. This is because immune systems are adaptive and diverse thanks to other types of antibodies, B-cells (antibody factories), and T-cells (secondary line of defense). So it’s important to look at other data too.
In the UK, we got our first glimpse of “real world” vaccine effectiveness against Omicron. On Friday, the UK Health Security Agency released a comprehensive
report in which they compared 56,439 cases of Delta to 581 cases of Omicron from Nov 27 to Dec 6, 2021. Vaccine effectiveness against Omicron infection was 30-40% after two shots of Pfizer. After a booster, effectiveness increased to 70-80%. This is nothing short of phenomenal. This also probably means that boosters continue to reduce viral transmission.
The number of COVID19 hospitalizations in South Africa is remaining low. But we’re coming up on the 3-4 week lag we typically see with hospitalizations, so coming to a conclusion is haphazard.
If hospitalizations continue to be low, then there is a clear indication that one of two things are happening:
- Immunity works against severe disease (like we hypothesized above); or,
- Omicron induces more mild disease.
We really need a more generalizable sample in order to differentiate between the two:
How do older people fare with Omicron? How about those with no prior infection? Unvaccinated? We still don’t know.
UKHSA Source
Here
In the past week we also had 3 T-cell
studies come out. T-cells are critical to our immune system because they are our second line of defense. If neutralizing antibodies can’t catch the virus before it infects our cells, then T-cells kick in. T-cell protection is harder for viruses to escape because their
protection spans virtually the entire spike protein, whereas antibody responses tend to focus on relatively few regions. As hypothesized, the results from the studies look great— T-cells continue to work against Omicron. So even though the number of infections will substantially increase, we will largely stay out of the hospital.
With this data, the case for an Omicron-specific vaccine is becoming less and less apparent. This will be
highly debated in the coming months, so it will be interesting to hear both sides of the argument.
Infection-induced Immunity
A
study over the weekend showed that neutralizing antibodies among people previously infected with Alpha (panel E), Beta (panel F), and Delta (panel G) completely failed to attach to Omicron. Those that were infected + vaccinated (or vaccinated + infected) had a strong response to Omicron (panel H).
But just like vaccines, neutralizing antibodies isn’t the full story. So it’s important to look at “real world” data. A week ago, a South African study found reinfection rates were 3 times higher with Omicron compared to Delta. This past Friday the UK confirmed with their own analysis: Of 329 individuals identified with an Omicron infection in this period, 17 (4.9%) were linked to a previous confirmed infection.
This equates to an Omicron reinfection rate of 3-8x higher than Delta.
Yesterday 1,288 souls died from COVID19. As Kaiser Family Foundation reported, 163,000 COVID-19 deaths since June 2021 would have been prevented with vaccinations. A true national tragedy.