Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Omicron Post #12, published by Zvi on January 4, 2022 on LessWrong.
It involved a backlog, but the USA reported over 1 million cases yesterday. That’s a lot of cases, and we’re missing a ton more of them. Schools, hospitals and all businesses face massive disruptions from people unable to work, even with the new CDC isolation guidelines.
So far, we’re holding up well, better than I expected even after previous severity estimates were adjusted. Things are going to be severely disrupted for a while, but not as severely as we might have feared, and even if we get a median outcome that is much better than the mean outcome given the tail risk of true disaster.
Still, brace yourself, and choose how you want to handle the next month or two. If you’re serious about trying to avoid Omicron, now is the time to show it.
Vaccine Effectiveness
A Danish study from earlier found large negative vaccine effectiveness. Large negative effectiveness is not a thing, we would know about it and the world would look very different, but anti-vax people are of course jumping on it and the attempt to explain isn’t going all that well. Which it mostly shouldn’t, in my view, because when you get nonsense results that are clearly nonsense results but you don’t control properly and so you publish anyway, what else do you expect?
I looked at the paper. They control for the basics, including geographical region.
VE was calculated as 1-HR with HR (hazard ratio) estimated in a Cox regression model adjusted for age, sex and geographical region, and using calendar time as the underlying time scale.
I’ve heard reasons that make it possible for vaccine effectiveness to go negative, but those reasons don’t seem compatible with large positive effectiveness shortly after two doses, and large positive effectiveness again after a booster shot.
More than that, check the sections on severity and hospitalization below. They make it very clear that being vaccinated offers a lot of effective protection and is very much a good idea, and getting boosted is an even better idea.
Treatment
CDC lifts the pause on anti-Delta monoclonal antibodies, says they can be used if Delta is still in your region and there aren’t other options available. My guess is there are still some places in America where this makes sense, since even a small chance of getting the old effectiveness is better than doing nothing, but this window is ending rapidly.
Quarantine, Isolation and Travel
Instead of ending all travel-based quarantines because they no longer make any sense, many new travel restrictions are being imposed.
This is deeply stupid. It makes sense to make someone quarantine if they are at much higher risk than the surrounding population, and there’s some hope of stopping the spread. Two places having mutual travel restrictions usually means both are making a mistake. These quarantines are quite expensive (as are the required PCR tests, which given the need for reliable results often cost hundreds).
What prompted this was that I noticed that France added the United States to their ‘red list’, including the first comment as a ‘same energy’ to indicate the mindset.
France has twice as many cases per capita as the United States right now, and about two thirds of the death rate.
At this point, quarantines even for people with large known exposures seem questionable. If you learn you’ve been exposed to Covid-19, you have not received that many bits of information, and it’s not clear how much behavior change is justified. Not zero, especially if you’re going to potentially see vulnerable people, but if you used the old thresholds for quarantine you would (quite literally) never leave the house.
At least it’s better than universal isolation, such as the curfews in Quebec:
Whereas Princeton is telling its students they can’t leave the coun...