Inside Medicine. What Are You Seeing? [COVID-19 medical news]

It would be great if Omicron turns out to be milder than Delta. But WE DON’T KNOW THAT YET! And yes I’m yelling because there are so many posts on this board making that assumption. Yes, in South Africa it looked that way. In Denmark, however, hospitalizations are going up more rapidly than they did with other variants. We will find out but right now I wouldn’t make decisions based on that assumption. And that’s all it is right now.

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Do you have a link to the hospitalization actually going up in Denmark with Omicron? I’m very interested, but can only find predictions that it will go up as Omicron spreads more quickly than other variants.

I appreciate your warning because so many of us want to be optimistic but we need to be realistic. I’m optimistic, but we haven’t changed our protective behavior one bit and won’t until we have a lot more information.

I’m wondering if omicron isn’t causing the spike in the northern VA area. Our state isn’t doing as badly as some, but we are rising again. And here’s the weird thing. My area which is usually 2-3x the state average is hovering slightly below the state average. S’ area (Nova) which is usually great compared to us is at or higher than the state average. And they’ve risen fast. They are higher already than any point with the delta wave in August-september. But! They haven’t had a hospitalaztion since 11/29 with a population of around 250K. They are a young population and highly vaxd but they were too during the delta wave, and they had a fair number of hospitalaztions then

Nova hasn’t been worse then us per capita since the initial wave in spring 2020. But they also have lots of international travel or tourism of any kind. Nobody comes here. It took awhile for covid to get a foothold here. So I would be surprised if omicron has gotten to us yet.

Anyhow, random in the middle of the night musings.

Yes I just read an article that explained that South Africa may have higher levels of immunity toward Omicron than some other countries, accounting for the apparent mildness. The UK is a better model for us so we will see.

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Yes! And even if it IS milder, it is still VERY concerning.

Which is why I said

in my post if mine is the one that got you yelling.

But to stay in the realm of realism, I doubt Covid is going to go away. I know H and I aren’t going to get any younger. Right now we’re still in our mid 50s which isn’t great, but isn’t as bad for “odds” as when we continue aging. We’re fully vaccinated with boosters - also significantly helping our odds. IF they determine one gets best immunity from a combo of both vaccinations and having had Covid AND they determine Omicron is less deadly than other variants we have out there, to us, it only makes sense to take the jump.

There are two big “ifs” in our consideration along with the one known (we’re aging) and one likely (Covid isn’t going away).

We continue to monitor while still enjoying life not quite up to “normal,” but getting closer since we just went to our first buffet restaurant for our son’s birthday Sunday (his request - all of us vaccinated).

We’ve never been the type to want to sit on our couch all day to try to remain safe from the world’s accidents (cars or otherwise). Covid is getting into that range for us with vaxxes and some caution (similar to seat belts - but still venturing on crowded interstates with our car - passing accidents many times).

YMMV

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I am planning on sort of pulsing my life so that caution increases with the current surge in my area (back to curbside pickup!), and then when there is a trough I can relax a little. I am older and have some conditions so there are some things I just can’t see myself doing, in the near future anyway. (However, for an important event in my kid’s life, I am going to fly even amidst the surge!)

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Note, most, myself included, use the caveat if in our statements.

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Good news:

Paxlovid, Pfizer’s pill to treat Covid-19, retained its 89% efficacy at preventing hospitalization and death in the full results of a study of 2,246 high-risk patients, the company said Tuesday.

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The US government will be buying Pfizer’s Paxlovid at $529 per course, and Merck’s molnupiravir at $700 per course.

The US government has been paying $10 to $20 per dose ($10 to $40 for full vaccination) for COVID-19 vaccines (in addition to the earlier R&D subsidies).

Seems the pricing for the two antiviral pills should be reversed, as Pfizer’s looks more effective than Merck’s, regardless won’t be cheap.

Here’s the Merck info, the product was recommended for approval by the FDA advisory committee 13-10, no word yet on when the FDA will decide. New data, analyses take some of the shine off Merck’s Covid pill

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Not sure if this was posted yet:

https://www.nature.com/articles/d41586-021-03667-0

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Vaccines or not, assuming Covid sticks around sooner or later all of us will be in high risk categories due to age if nothing else. I’m glad they have more treatment options.

I’d also vote for those unvaxxed without a medical reason to cover the cost between the free vaccines and treatments they need though, hospital costs as well as medicines. Those with breakthrough cases should still be free - at least they tried.

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So some good and bad news. Our hospital has had multiple omicron admissions. About half are vaccinated, half unvaccinated. 2 received boosters greater than 14 days ago. Length of stay is 3.5 days (5.5 days with Delta).
MAb have no effect on omicron.
Our institution first identified Delta the first week of April, but it didn’t take off until after July 4th. Omicron was first identified 10 days ago, as of this weekend it was 13% of cases, projected to be 20% on the next batch, and projected to be 90% Christmas-New Year’s.

What I saw regarding Denmark was a tweet based on this document – https://files.ssi.dk/covid19/omikron/statusrapport/rapport-omikronvarianten-13122021-i30w
I recognize that it’s still very early and this was based on a limited number of cases. So we all are waiting to see what Omicron is really like. It’s crazy how fast it spreads and how many of those with 2 dose vaccinations are getting infected.

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How serious, in terms of how intensive treatment was needed (including whether ICU or ventilator was needed)? Was intensity of treatment and length of stay correlated with vaccination (or previous verified COVID-19 infection)?

European countries accept natural immunity from a proven covid infection until 6 months out, when a single vaccine dose is required as a „booster“.

Doesn’t make a flying bit of difference to anti vaxxer ranting.

Noted frequency for those with two shots, and also with age group 20-29.

All good questions. I don’t know the answer to those. But the decreased average length of stay implies decreased disease severity for some (don’t know if they are the vaxxed or unvaxxed). But severe disease and death will lag by maybe 2 weeks. People will progress, move to the ICU/ventilator, stay there for (too) long, and death numbers follow. So still too soon to know for sure.
Interesting how you mention previous verified infection (natural immunity). No one ever seems to report on that, just vaccine status. I don’t know why that is. Maybe a manpower issue or something else?

Most of the few studies on the subject from the pre-vaccine era found that infection had about 80-95% protection against future infection, although one found just under 50% for age 65+. Of course, things could have changed with variants.

Perhaps it is not well tracked because many COVID-19 infections are not individually verified, and some claimed COVID-19 infections that are unverified may have been something else. It may depend on whether the patient had a previous infection and sought medical care or testing for it, and the patient’s medical record is accessible to the current hospital.