UK Weekly - Week 4

Mostly as predicted - Admissions/Mortality still climbing in 2 Dose group

It’s Saturday, 3 days after I tested positive for COVID and I’m feeling pretty normal. My son who had Alpha in January of 2021 and my daughter who didn’t are both sick today. My daughter seemed fine but her test came back absolutely positive in nearly no time flat. Almost certainly Omicron which in the US is the vast majority of what is going around. Of course there are two Omicron “strains” BA.1 and BA.2 which aren’t really strains, they are pretty hugely different and shouldn’t even be both considered Omicrons really. In any case BA.2 looks to be replacing BA.1 in countries that already burned hot on BA.1 (Denmark seems to think it has a 1.5x transmission advantage) so I’m guessing this statement won’t be true for long.

If you want to learn more about BA.1 and BA.2 I suggest some reading:

Omicron is Not Normal

or

BA2 Omicron Variant is Worth Discussing

or really the source of a lot of these charts, but the very dense Ethical Skeptic. Seriously it s a super dense VERY long article but it covers things in crazy depth. If you have some time, it’s a VERY worthwhile read.

In any case, let’s get to this weeks results. I think this is probably the last week I can just add another week of results to the display and have it look okay, so I’m guessing 3 weeks at a time is what we will see on these charts. Cases continues to fall as expected

Interestingly - and in line with the Immortal Time Bias theory, the only category that is going UP is the Boosted category! (also the lines this time cover 3 weeks of change to the boosted percentage, not just the last 2). Why does this make sense? As fewer and fewer new cases get counted against 2 Dose vaccinated cohorts, they accrue to their proper boosted cohort instead. This is kind of a wave in a tank. If you tilt the tank it will build up on one side, then if your drop it quickly back to level, it will slosh back the other way before leveling out to it’s final levels (assuming no leaks or added liquids). We are in the rebound moment here with wave of cases sloshing into the boosted cohorts. It’s important to note that case rates while very useful can be a very distorted picture of the world, the number of cases in the tallest columns might be tiny if the population that makes up the denominator is very small, so what appears to be a mismatch in move sizes could be a similar number of cases.

Also a good note is that boosted rates are STILL higher than unvaccinated in all but the 18-29 age cohorts (but in that one a clear minority of the population have been boosted).

Admissions on the other hand are still showing increases nearly across the board.

By that I mean vaccinated rates. Well really the younger ages (by which I mean kind of under 60) are all pretty flat in general with unvaccinated on a slight downtrend from 40-60, flat in the 70s and on a slight upslope in the 80s. It is important to remember than older 2 Dose vaccinated cohorts are very small. So the vast majority of admissions are in the boosted. That being said, those who stopped at 2 doses are not doing well in terms of admissions. I suspect this is very much like the bias against the unvaccinated elderly. If you aren’t boosted now it’s because there is a reason you cannot be boosted and that is likely due to you not being very frail.

While the changes are small, it still is interesting to note that there is a CLEAR uptrend in boosted admissions even if it’s generally small.

Mortality is very similar except that it doesn’t look like there is as much increase except in 80+. This makes sense given the time lag for these signals. Admissions likely has 1 more slightly up week, mortality one more large up week before they too start to tip over unless BA.2 is enough different from BA.1 to allow for rapid reinfection. This might be happening in a few places with the standard Gompertz Curve gets arrested on the way down and starts to spike again above the previous maximum. That is not normal single virus behavior. It’s pretty much the hallmark of multiple diseases. One starts to fade and the other takes over. This rather amazing Twitter thread goes all sorts of great places but ends up with this:

PLC @Humble_Analysis

The only other possible explanation is that Asia and Africa have sort of omicron-specific "prior immunity" that is not found in Europe or the Americas.

Which - ties into The Ethical Skeptic’s post I linked above in which he Posits by standard practice that Omicron is at least 18 months OLDER than Wuhan Strain COVID-19. He also indicates that it ran through China and Chinese connected communities but largely not throughout the Western world, in the year or two preceding 2020 giving them a measure of immunity against COVID-19, as well as against Omicron - only Delta evaded the protection. It’s a LOT of moving pieces and both major theories make sense, but tied with the flu data in PLCs thread, I’m leaning towards the “already seen it” theory.

Okay and now some counter narrative news. I think we would have to call this Good News. I am extremely fond of this CS Lewis statement “Of all tyrannies a tyranny sincerely exercised for the good of its victims may be the most oppressive.” wait, no no that one, “Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience." no…not that one either - it’s this one

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“Suppose one reads a story of filthy atrocities in the paper. Then suppose that something turns up suggesting that the story might not be quite true, or not quite so bad as it was made out. Is one's first feeling, 'Thank God, even they aren't quite so bad as that,' or is it a feeling of disappointment, and even a determination to cling to the first story for the sheer pleasure of thinking your enemies are as bad as possible? If it is the second then it is, I am afraid, the first step in a process which, if followed to the end, will make us into devils. You see, one is beginning to wish that black was a little blacker. If we give that wish its head, later on we shall wish to see grey as black, and then to see white itself as black. Finally we shall insist on seeing everything -- God and our friends and ourselves included -- as bad, and not be able to stop doing it: we shall be fixed for ever in a universe of pure hatred.”

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What does this have to do with anything? Well the admissions and mortality charts by positive test sure look like vaccines working against serious disease and death.

It’s hard to avoid that in all of these cases, the unvaccinated rates are much higher (around 2X over 2 Dose and much more over boosted). Remember we are looking at small cohorts with small amounts of cases, but it seems like if you GET SICK at 80+ and are unvaccinated, you have about a 25% mortality rate and it is increasing.

There is clear data here of efficacy against severe disease and death (not 90% maybe for the 2 Dose vaccinated). But we should want this to be true. This still carries rather large caveats regarding selection bias in unvaccinated 60+, but it must be confronted. It also doesn’t deal with vaccine driven mortality. But it does seem to show there might still be some benefit to the vaccines, especially in the older population. And honestly, with so much of the western world vaccinated, we should WANT this. We should want the vaccines to work at least some. I kind of find myself not wanting to even post these graphs because they go counter my personal narrative of vaccine failure. But they are real. Now because of the very recent switchover to the boosted column, I can’t do a meaningful delay (since admissions today were caused by cases 1-2 weeks ago etc) but I did check them and they look BETTER for vaccines.

Hope everyone has a great week.