The Omicron BA.2 variant is now reversing the trend in Europe

This is a reminder of this past week's BA.2 effect in Hong Kong. Dave, what have you been seeing?

https://twitter.com/DrEricDing/status/1500987022168764417?s=20&t=-HVSJ8j9dLq7ebWMJ8ynyw

Eric Feigl-Ding

Eric Feigl-Ding

SURGING - Hospitalizations for #COVID19 is surging sharply 15.6% in England again—across **ALL AGE GROUPS**, elderly to kids. Notably, hospitalizations up  26% in kids 6-17 in just 1 week. This is #BA2 subvariant + no mitigations that we warned about.

https://twitter.com/DrEricDing/status/1500983875207680006?s=20&t=uAVDGSWuHd9_KZIlo5-ULw

Remember last year when we thought we could relax the protective measures only to see the delta variant appear and cause problems as it crept around the world? We rode out the omicron variant but here are two different locations that have seen BA.2 cause a reversal in the stats. Will it take hold here? It is much more easily transmitted than omicron BA.1. And remember all that talk about how omicron isn't so bad? In the US it has caused more deaths than the delta wave. Vaccinated people can still get it and even though they can fight it off, evidence is accumulating that even mild cases are causing linger neurological and cardiovascular harm.

PLEASE WEAR A MASK

COVID leaves behind unpredictable consequences. Not getting it at all is the best-case scenario but even if a person has had COVID before, not getting it again is best. Please get vaccinated. Natural immunity helps but it is not enough to protect you. If you do contract COVID having your immune system primed to get rid of it as quickly as possible gives you the best chances to avoid harm down the road.

But not getting it (or again) is best and masks help prevent COVID infections.

One case in our building was taken to hospital and has since recovered and is in quarantine alone in a hotel. Focus is turning more to treating extreme cases rather than hospitalizing everyone.   City is really quiet with about 1 in 10 shops closed.  Everyone wearing masks as always. We've upgraded to N-95s.  Those who can  are working from home.  Govt plans to test everyone 3x over a week, but I'm not sure this is advisable or even tenable.  A self reporting system for RAT (ART) tests has gone online today and there is a queue of about 70k for isolation, but they'll likely recover before facilities are ready.   Lots of confusing and conflicting information created a run on groceries, which ended after a few days of panic buying.  Another round of govt stimulus of HK$10,000 for everyone kicks in in April to help local businesses an those in some retail sectors who were put on leave or lost jobs.

Oh my, it sounds tense over there. I cannot imagine living in a place as crowded as Hong Kong, much less with COVID.

Hang in there.

Central govt has mandated that 50% of all public hospital beds be dedicated to covid patients and is leaning toward mandating private hospitals do the same, though that  becomes legally tricky unless it's declared a national security issue; anything is possible, but I do agree that private hospitals should step up.

PeterWick said:

Oh my, it sounds tense over there. I cannot imagine living in a place as crowded as Hong Kong, much less with COVID.

Hang in there.

Thanks. Hanging.  We're not in a really dense area or development, fortunately.  Work is either at home or a short walk to the office if required.  And have a good supply of N-95s.

UPDATE—#BA2 is now 11.6% in US, up from 8.3% last week. It’s definitely increasing, as warned. #COVID19 still dropping, but BA2 is growing in underbelly—it’s a matter of when (not ‘if’) case drop plateaus, then reverses. Likely late April, early May.

https://twitter.com/DrEricDing/status/1501232919683104776?s=20&t=l8cZtTgPNbrPrcsbiAC1iQ

Here's a handy site with ongoing data and you can track anywhere you want in the US by county.

https://covid.cdc.gov/covid-data-tracker/#county-view?list_select_state=New+Jersey&data-type=Risk&list_select_county=34013

It's growing as a percentage of cases, but what about as a total number of cases?

I'm not sold on the threat of BA2.  It's far from new at this point and we are in a period of extreme loosening, both in terms of government policy and personal behavior.  Yet I check numbers everyday from the towns in Essex County, to the state, to various nations and nothing I've seen reflects a variant that is more transmissible than Omicron 1 or even remotely close to its RT.  The numbers overall have been quite good for a long time now.  Perhaps we should say theoretically transmissible because  there are obviously variables keeping it in check.  The new case curve  upward for Omicron 1 one was astounding (as was its rapid downfall).   If this thing is even more transmissible than Omicron 1, where is/was the explosion?

bub said:

 The new case curve  upward for Omicron 1 one was astounding (as was its rapid downfall).   If this thing is even more transmissible than Omicron 1, where is/was the explosion?

Look at Hong Kong's graph

Several observations about HK.  One is that HK seems to have largely evaded the virus altogether until the recent past and its first catching up to them now.   Second, even with a recent upturn, HK has largely been on a downward trend for the past week, per the bar chart I'm looking at.  Also, from an article, an explanation for the current HK numbers that does not involve the supposed superpower of the sub variant:

https://www.aljazeera.com/news/2022/3/9/in-zero-covid-hong-kong-deaths-smash-global-records

And if you're going to say look at HK, you have to look at other place too, particularly places that have been ID'd in gloom and doom articles as hot spots of the sub variant.  For example, take a look at Denmark's 30 day chart.  Indeed, given how long the sub variant has been around, look at the local numbers.  The NJ hospitalization and ventilator rates are the lowest they've been since about mid November.  They are almost a tenth of what they were at peak Omicron,  The Essex County numbers have also been excellent for weeks.  Most towns have tended to have zero to low single digit daily cases for weeks now.  During peak Omicorn, I recall that Millburn

had 92 new cases in one day.  More recently, the whole County often has a lower daily new case count than that.  .

Hong Kong seems to be plateauing (adding PCR and RAT test results together now and it's been roughly 55,000 cases a day.  We can assume it's a bit more, but the surge seems to be ending, as we're testing sewerage water from buildings and that's showing lower levels.  Deaths, a lagging indicator, are increasing still, mostly > 80 and unvaccinated, but also two children; in fact hospitalized children has been the main disturbing feature of Omi B2. Mandatory testing of the entire population has been postponed to April (and I'm guessing indefinitely).  

I wish more people learned the lessons we were given in earlier waves.

Dude - you sound disappointed that the numbers are so low.

PeterWick said:

I wish more people learned the lessons we were given in earlier waves.

No, not at all. I guess some people don't understand. I'm really encouraged by the local trend. What I am concerned about is what has happened in other locations.

We got burned by letting our guard down and not giving credence to the possibility that a new variant could cause a resurgence. Happened last spring only to see the delta variant take hold and kill thousands a day despite the vaccines.

A similar pattern happened as we saw the fading cases and deaths last November only to see the omicron variant kill just as many as the delta variant.

Continuing to be careful and wearing a mask in public indoor spaces will keep our numbers low. 

Have you read any of the reports of sustained harm even after surviving COVID? I don't want those things to keep happening. Even mild cases where the person says it was nothing to be concerned about are potentially a problem down the road. COVID may seem like the flu but it is not the same. It causes more unpredictable damage due to blood clotting and vascular irritation. BA.2 is infectious even in vaccinated and boosted people.

Please wear a mask and keep our numbers low.

PeterWick said:

No, not at all. I guess some people don't understand. I'm really encouraged by the local trend. What I am concerned about is what has happened in other locations.

We got burned by letting our guard down and not giving credence to the possibility that a new variant could cause a resurgence. Happened last spring only to see the delta variant take hold and kill thousands a day despite the vaccines.

A similar pattern happened as we saw the fading cases and deaths last November only to see the omicron variant kill just as many as the delta variant.

Continuing to be careful and wearing a mask in public indoor spaces will keep our numbers low. 

Have you read any of the reports of sustained harm even after surviving COVID? I don't want those things to keep happening. Even mild cases where the person says it was nothing to be concerned about are potentially a problem down the road. COVID may seem like the flu but it is not the same. It causes more unpredictable damage due to blood clotting and vascular irritation. BA.2 is infectious even in vaccinated and boosted people.

Please wear a mask and keep our numbers low.

Stop being afraid of the world. 

algebra2 said:

Stop being afraid of the world. 

It's about concern for people who cannot fend off a virus that they would be more likely to avoid with the cooperation of those who could do a simple thing like wearing a mask.

Among the unfortunate deaths in Hong Kong being attributed to Covid are several well into their second century of life.  There wasn't enough of a push to get the elderly vaccinated and many elderly didn't want the Chinese made Sinovac due to lifelong suspicions of mainland pharmaceuticals (also BioNTech wasn't available from the public system until a bit later, but even then many didn't opt for it, as Hong Kong had so few cases at the time and many thought we'd dodged the bullet).  More concerning in this wave is the easy spread among children, so classes remain virtual. 

The story in the NYT today seems a little behind the times, but that's because communications are changing every day here and the food shortage noted in the story lasted all of two days (and restaurants were still open for take-out and delivery).  Interviewing Zeman as an advisor to Chief Executive Carrie Lam was funny. He's a bar and nightclub owner who is advising handouts to businesses like his.  I think they should get them, but that he's an advisor is a stretch.  The people advising the leaders here live far to the north.

The Hong Kong Hospital Authority (in conjunction with HKU) has indicated this wave of covid peaked some time between  March 5-7 and that new cases should be < 1000 per day by the end of April. Half of the beds at Queen Elizabeth Hospital have been dedicated to Covid patients and the central government is leaning on private hospitals to do their part, as well as building new temporary facilities at lightning speed.  Even at that speed there won't be enough room to house all +ve cases, so most will be asked to recover and quarantine at home if they are not in a dense living environment. 

Steve said:

It's growing as a percentage of cases, but what about as a total number of cases?

@PeterWick - do you know the answer to this question?  Thanks.

No. I don't have data on the raw number of omicron BA.2 cases in NJ. This is from 3/9/2022

https://www.independent.co.uk/news/world/americas/ba2-omicron-variant-new-york-b2031743.html

The Omicron sub-variant BA.2 makes up for 11.6 per cent of Covid-19 variants in the United States as of 5 March, the Centers for Disease Control and Prevention said on Tuesday.

The cases of BA.2 variant have been doubling each week, CDC data from last week initially showed. However, the numbers were revised to a slightly lower degree on Tuesday.

Revised estimates from the CDC showed that the “stealth” Omicron sub-variant accounted for more than 6 per cent of the cases in the US in the week that ended on 26 February, and nearly four per cent in the week before that.

In New York, which is among the major regions where Covid mandates are being lifted, the cases of BA.2 variant have soared about four times in the past month.

Data showed that the sub-variant accounted for 3.3 per cent of the total cases in New York for the week ending 12 February. But this was as high as 12.4 per cent for the week ending 26 February, signalling a steady increase in the cases.

Thanks.  I would be more concerned if the number of BA2 cases were rising exponentially.  I'm less concerned with the percentage of cases if the total number of cases is dropping as it could mean that the gross number of BA2 cases is not necessarily rising (or rising rapidly).

Today's numbers from NJ and Essex County are astoundingly good.

bub said:

Today's numbers from NJ and Essex County are astoundingly good.

the better figure is hospitalizations and deaths....number of positive tests can be misleading as it  may be that people just stopped testing or are just using home tests that aren't reported...but the fact the the hospital and death numbers are still improving is a hopeful sign

jmitw said:

bub said:

Today's numbers from NJ and Essex County are astoundingly good.

the better figure is hospitalizations and deaths....number of positive tests can be misleading as it  may be that people just stopped testing or are just using home tests that aren't reported...but the fact the the hospital and death numbers are still improving is a hopeful sign

yes.  The NJ hospitalization number is the lowest it's been since July. 

Can't know what tomorrow will bring but this prolonged period of good numbers, happening at a time of dramatic loosening of mandates and personal behavior, has me feeling optimistic.   

Eric Topol@EricTopol    Why are many countries in Europe starting to ascend again?

✓ Relaxed mitigation measures   <<<========  We are doing the very same thing here in the US.

✓ BA.2's higher transmission

✓ Waning of immunity

There's no clear or consistent pattern to determine which (or all) of these factors are driving it; no new variants have been implicated

=======================

They said omicron wasn't going to be serious.

They're saying the same thing about BA.2 now. I guess we'll have to wait for the lagging indicators before anyone will take this variant seriously.

I recall someone trying to dunk on me about the potential for a change to increased surface transmission when I posted about omicron in November. This is a pre-print so no, these data have not been peer-reviewed yet. Washing your hands was what we were all about in the early days. It turns out those renditions of COVID weren't as easily transmitted from surfaces. Not so with the omicron variant. 

 https://www.biorxiv.org/content/10.1101/2022.03.09.483703v1

So if you’re going to share a drinking straw with a stranger, make sure it’s paper?

Okay I am kidding of course. I am concerned about the next few weeks. We had dinner with my in laws yesterday with the thought that we would need to take a break from seeing them until we can assess what actually happens as restrictions are lifted. They are in their 80s and we have a kid in middle school. If all goes well maybe we’ll have them over for Easter.  

I have been diligent about hand washing since the beginning as my dry and cracked knuckles can attest. 

I agree. I am not sure what to think. I really do hope that we won't have another wave come at us. I won't shut up about what I see developing elsewhere though.