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: My Current Model, published by Zvi on December 28, 2021 on LessWrong.
A year and a half ago, I wrote a post called Covid-19: My Current Model. Since then things have often changed, and we have learned a lot. It seems like high time for a new post of this type.
Note that this post mostly does not justify and explain its statements. I document my thinking, sources and analysis extensively elsewhere, little of this should be new.
This post combines the basic principles from my original post, which mostly still stand, with my core model for Omicron. I’ll summarize and update the first post, then share my current principles for Omicron and how to deal with and think about it.
There’s a lot of different things going on, so this will likely be incomplete, but hopefully it will prove useful. The personally useful executive summary version first.
Omicron has already taken over, most cases are being missed, crunch time is now. Crunch time will likely last 1-2 months.
First two shots don’t protect against infection, boosters do somewhat (60%?).
Vaccination and natural infection protect against severe disease, hospitalization and death (best guess ~80% reduction in death for double vaccination, 95%+ reduction in death for boosters but too soon to know).
Tests work, but when delayed are mostly useless for preventing infection especially when delayed, as Omicron can spread within 1-2 days after exposure. Rapid tests mostly test for infectiousness, not being positive.
Omicron probably milder than Delta (~50%) so baseline IFR likely ~0.3% unless hospitals overload, lower for vaccinated or reinfected.
Being young and healthy is robust protection against severe disease and death, being not that means a lot more risk. Long Covid risk small but real for all age groups, vaccination likely helps a lot.
Medical system is under strain, could be overwhelmed soon, should be better again in a few months at most if it gets bad. Delaying infection has value but stopping it fully is likely not worth the cost. If you care about real prevention, the tools that matter are vaccination, good masks (N95 or even better P100+), social distancing and air ventilation.
Vitamin D and Zinc, and if possible Fluvoxamine, are worth it if you get infected, also Vitamin D is worth taking now anyway (I take 5k IUs/day). Paxlovid is great (~88%) if available right after you test positive, but in very limited supply for now.
Default action on positive test is 5 days isolation at home as per new CDC guidelines, if possible is good to get a negative rapid test before ending isolation. If things get bad, especially if you have trouble breathing, call your doctor, seek treatment and so on.
Here are the old principles that still apply, with adjustments as appropriate:
Risks follow Power Laws. Focus on reducing your biggest risks.
Sacrifices to the Gods are demanded everywhere. Most intervention effort treats Covid-19 as a morality in which the wicked must be punished, rather than aiming physical interventions to achieve physical results.
Governments Most Places Are Lying Liars With No Ability To Plan or Physically Reason. They Can’t Even Stop Interfering and Killing People. There is a War, and the WHO, FDA and CDC, and most similar agencies abroad, and most elected officials, are not on our side of it. Instead they focus mostly on getting in the way, protecting their power and seeking to avoid blame on a two week time horizon.
Silence is Golden. Talking or singing greatly increases infection risk, and the directions people face matter too. You’re still not safe or anything, but it helps.
Surfaces are Mostly Harmless. Mostly don’t worry about them.
Food is Mostly Harmless. Mostly don’t worry about it.
Outdoor Activity Is Relatively Harmless. It’s a huge relative risk reduction.
Masks Are Effective. I’m less excite...