Omicron is coming. We are not preparing for it. That is the news that matters.

In addition to that, Delta is a growing problem as we face a winter wave. Future problems don’t protect us from current problems, no matter how inevitable and predictable the current problems might be. Here’s where we round those things up.

Note that due to recent events, and the new data on what people actually benefit from and want to share, I think it increasingly makes less sense to focus on weekly posts, and to focus more on addressing particular issues when they appear, so I’ll be transitioning towards being more inclined to split things up.

Omicron Posts: #1, #2, #3, #4, #5 (today)

Last Week’s Weekly Post.

Executive Summary

  1. Omicron is coming.
  2. Boosters won’t be updated in time.
  3. Paxlovid remains illegal.

On Paxlovid, update is that final Pfizer data is expected in a few days, a perfect timeline gets the whole thing done by end of month, the 24% at Polymarket for that is probably somewhat low. Nothing’s going wrong, except for the total lack of urgency.

There’s various fights over masks and vaccine mandates, but game that matters is Omicron.

In the meantime, on with the show. Let’s run the numbers.

The Numbers

Predictions

Prediction from last week: 630k cases (+20%) and 8,000 deaths (+26%)

Results: 736k cases (+39%) and 8,355 deaths (+32%).

Prediction for next week: 750k cases (+2%) and 8,800 deaths (+5%).

I was being somewhat cowardly making my prediction. On reflection, I should have been more confident in what was obviously happening.

This week I’m predicting smaller increases because I expect that some of this week’s big increases were due to data dumps, and because I expect some amount of additional caution due to fear of Omicron, whether or not that yet makes physical sense.

Note that Omicron cases aren’t going to be noticeable this coming week.

Deaths

Cases

You’ll want to smooth out numbers over the last few weeks. Either way, it’s clear that the Delta situation continues to get worse in addition to the threat from Omicron. It won’t become a crisis before Omicron becomes primary.

Vaccinations 

Fear of Omicron is working, at least somewhat, and there have been reports of difficulty getting appointments. Getting an appointment for my son’s second shot took a week, whereas my own booster was in my arm an hour after I went online to book an appointment.

Some potentially good persuasion here.

Vaccine Mandates

Boosters work, and are important to protect yourself from both Delta and Omicron, and there isn’t time to wait for an Omicron booster. I got boosted and I suggest you do the same.

That doesn’t mean that I think vilifying those without boosters, or making them mandatory, is a good idea. On the contrary: This is going to make a lot of people very angry, and is widely regarded as a bad move. It’s a tough crowd out there.

Yet it’s going to happen anyway. Here’s a sample opening shot across the bow.

I realize that it’s a universal rule that the answer to any headline in the form of a question will ever and always be “NO!” but every rule has its exceptions. Yes, of course it’s safe to hang out with the ‘unboosted.’ It’s also safe to hang out with the unvaccinated, that’s the whole point (ok, fine, most of the the point) of getting boosted.

The other front is to continue applying the squeeze to the unvaccinated. In Europe this is taking the form of outright mandates. Germany is locking down the unvaccinated.

Here, we prefer to utilize our uniquely perverse system of charging people for medical care, where ‘pay out of pocket’ means ‘we treat you without telling you the price or letting you say no, then we charge you ten times what it actually costs and then take your house.’

The principle behind this makes sense to me. If you choose to accept a risk, you should have to pay the costs of that risk. That would be fine if it was in the form of somewhat higher health insurance premiums, or paying the actual costs involved. In Singapore, where they’re also doing it, it might even be a reasonable policy. But our system is broken so instead what we get is vindictiveness towards anyone who didn’t pay tribute in the form of Official Legible Insurance, which costs double or more if you don’t hold an Official Legible Job, and can’t be adjusted for pretty much anything.

Taleb has an observation.

It’s important to note that this is not an outlier. Vaccine mandates are popular. Even here in America, if you held a vote, every poll says they would pass. That doesn’t mean they don’t effectively constitute a power grab by government, or that they won’t increase government power over time. The follow below gets it indeed. The word “just” is emphasized here for a reason.

Thing is, if you’re worried that doing reasonable things to protect public health is unpopular, you probably shouldn’t worry about that. As a reminder:

Seriously, we’re the weird outlier and every time the yes side still wins.

On his way out, universally disliked New York mayor DeBlasio announced a vaccine mandate on private businesses and extended the vaccination requirements for indoor dining down to five year olds and increased them to two shots. I predict the door will hit him on his way out.

Whereas elsewhere, despite their general popularity, more politicians are souring on vaccine mandates, including democrats like Governor Whitmore of Michigan. What people support in theory and what would happen in practice can be, and usually are, very different things.

New Brunswick gives, among other places, grocery stores the choice to either enforce social distancing, which is not actually possible in practice, or mandating vaccinations. For buying groceries. Get the shot, or starve. I hope they have Instacart.

Also, it seems like Zeynep is reporting many elderly are having trouble scheduling their boosters? Seems like we should be getting on that. In a mitigation scenario, this is where most of the remaining value lies that we can still get to without getting the FDA to play ball.

NPIs Including Mask and Testing Mandates 

Debating whether to attend that holiday party? Let’s Ask Dr. Science, I mean Dr. Fauci, he knows more than you do. He says, if everyone is vaccinated, sure, go ahead. If not, maybe not. Thanks, Dr. Fauci. This logic doesn’t actually make any sense once there’s a lot of Omicron, and it didn’t make much sense before Omicron (a much better rule is that if you are vaccinated or especially if you are boosted, you’re fine, and others can worry about themselves), but it’s a way to maximize the get-vaccinated message, so it’s what gets said.

The testing situation is, shall we say, less than ideal.

What testing we do offer remains often so slow as to lost most of its value, such as in this example.

This is people executing a ‘get tested’ adaptation as a fetish, not people trying to improve outcomes.

Things are much better in New York City, where there are free test tents all around offering PCR with a 24 hour turnaround. I used one today because I was asked to provide a negative test, and it was quick and painless.

Notice, by the way, that the reason to wait to call is that they’re experiencing heavy call and email volume? Model this.

When Paxlovid is finally legal, getting testing that works is going to be that much more important, especially with Omicron on the way. If you have to wait 2-3 days minimum for your results it’s too late for Paxlovid.

Biden’s proposal is to let you then bill your insurance for the costs of your at-home tests, which very much has a “how do you do, fellow kids?” energy to it. If you want tests to be free, as you damn well should, you should make them free in the sense of not charging people money. Maybe some professionals should talk logistics? Crazy, I know.

Twitter had a quote retweet caption contest on this one, and pretty much everyone was a winner.

The reporter says “maybe” which is the exact definition of partial credit. Psaki then replies, “then every American has one test. Then what? How much does that cost?” And then her defense to why we can’t do what other countries do is that our tests are approved by the FDA.

All right then. So…

So… um… I… uh…

…and that’s the problem, maybe we should treat the FDA as damage and route around it?

FDA Delenda Est?

Slow Boring points out some of the obvious low-hanging fruit. If we’re not even willing to make an effort to use Fluvoxamine despite no one raising any actual objections to it that I can find, and we’re not even willing to approve tests widely used in Europe on any time scale, what are we even doing? Seems like our authorities don’t take this pandemic all that seriously as a physical thing in need of actual mitigation.

It seems Missouri commissioned a study of mask mandates, which found that they worked, so they decided to block publication and continue calling upon cities to the end their mask mandates. The study doesn’t seem like it actually proves anything due to design flaws, but that really is not an excuse here.

Think of the Children

Some people are noting that Covid prevention is causing a youth mental health crisis.

Meanwhile, in New York, along with vaccine mandates for five-year-olds, I realize the source is on a crusade but this still seems extreme.

Intellectually I’ve managed to put together how this happened. It still boggles me every time I let it hit me. Seriously. There Is a War.

The war also involves freezing our children, in places they are legally required to be. This is happening to my son as well, as the school is forced to keep their windows open. The example here is from Scotland.

Children are being forced to wear overcoats and blankets in bitterly cold classrooms because of a Government edict to keep windows open to limit the transmission of Covid.

One teacher said that temperatures plummeted to 11C, potentially putting children at risk of asthma attacks and other conditions linked to the cold.

Oliver Mundell, Scottish Conservative education spokesman, said: “We are only at the start of winter, and temperatures will drop. The SNP need to provide more support, so teachers and pupils are not left bearing the brunt of the freezing months ahead.”

As a relaxing nighttime activity, my wife and I are watching Season 2 of Buffy the Vampire Slayer. I’d say it holds up quite well and has been great fun. One thing she has pointed out multiple times is the whole how do children keep going to this school despite everything that’s happening there, and as the whole thing gets steadily less-well covered up as the year goes by. But we’re putting our kids into freezing conditions, making them wear masks all day, forcing them to eat lunch outside on the sidewalk, in addition to the traditional stuff like forcing them to get permission to go to the bathroom and be constantly taught that life is about following arbitrary orders. Also, see the school shooting incident this week, and our reaction to such things of literally forcing our kids to endure periodic ‘live shooter drills’ designed for maximum terror. None of that seems to bother all that many parents.

So my brain mostly no longer wonders why Sunnydale High School stays in business. Where else are you going to go, Detroit?

There’s also the question of windows. Schools commonly have windows that can’t open, also known as fake windows, or lack windows altogether, as it is, due to stupid safety paranoia. Now with laws saying any windows must be opened, I wonder if we’ll get something similar to what happened when ancient kings imposed window taxes, with attempts to destroy as many windows as possible so no one can force them to be opened.

Permanent Midnight

I think they’re more likely wrong, but it won the poll, might want to be worried.

There is a war. We are not winning.

In Other News

Did you know that if you get sick with Covid-19 we can treat you? As in, give you medicine, and we have those, even if Paxlovid remains illegal? Yet somehow no one talks about any of that?

I mean, yes, this does feel very punitive and like it is, as we called keeping Paxlovid illegal, another case of murderous madness. Simply saying nope, we’re not going to bother ensuring medicine gets to people when they need it, if we talk about that people won’t care enough about not getting sick. I mean, that’s their argument. It seems to be:

  1. We have life-saving medicine.
  2. But if we tell you about it, you might not get vaccinated or do enough prevention.
  3. So we won’t tell you about it much.
  4. And we won’t much use it.
  5. So there?
  6. Profit?

So we get responses akin to this actual reply:

Which is saying (aside from the usual hating on Florida without any good reason, which is also part of the pattern) is, yes, technically the thing you’re suggesting actually works, instead of the thing I’m continuing to misleadingly mock despite it not being relevant, but also if you get pneumonia we shouldn’t worry overly much about treating it because you probably went out in the cold and therefore you deserved it?

Does this remind you of anything else we tend to blame people for when they get hurt?

FDA extends monoclonal antibody treatment to infants and newborns just in time for monoclonal antibodies to stop working due to Omicron (until we get the new versions, assuming they’re permitted, I have no idea if that’s another graveyard we’re looking at or not). Should still be good for another month, might last two.

Paxlovid development benefited from previous work on SARS. A similar story to mRNA vaccines, we’re able to develop things quickly now because we already did a lot of the work. Research and development pays even better than you would think. Imagine what we could do if we got out of the way.

Credit where due. Hochul administration actually tries to get through to those who attended Anime NYC and urge them to get tested. Then will do nothing useful with that information, which is far too late to stop any infections or probably to even tell us anything useful about Omicron, but at least their head is in some game, somewhere, trying to win it, no matter how irrelevant to the playoffs.

Also credit for trying, even less reason to be trying, Italian man brings synthetic arm to vaccination to try and fake getting the jab.

A thread about the problems with third world vaccination campaigns. In many places including South Africa there aren’t near term supply shortages, but that’s because they didn’t ramp up their logistical capacity or attempt to generate demand due to a previous lack of supply and anticipated supply. The part that frustrates me most is where they ‘didn’t want to generate demand that exceeded supply,’ which is a way to be sure you won’t have enough demand once supply later increases. Thus, the supply is now sufficient, even if this supply wouldn’t have been sufficient had a larger supply been anticipated.

Thanks to the WHO and other muddled sources, there’s still a lot of sources going around saying Covid-19 isn’t airborne, such as this app from the Indian government, which calls Covid-19 being airborne a “myth.”

Finland’s Prime Minister, also Finland, living their best lives.

The case against Molnupiravir, based around the worry it will cause mutations. I’m largely convinced that this objection is big enough, but you still need to come out and say it. Instead, it seems like we’re holding the drug in limbo? Speculation that even if the FDA does approve Molnupiravir, very few patients will be given access.

Supply chain issues finally reach critical level requiring bold action, as New York bagel shops are running out of crème cheese. This time, you’ve gone too far. I told you, I told you, I told you, I told you.

Not Covid

I feel the need to say some words about this week’s school shooting.

Not because I have anything to say about gun control or am trying to make any traditional political point. I feel the need to mention it because it’s a clear illustration of the Law of Earlier Failure where things go wrong for far stupider reasons than the reasons you think they do.

Think less Law & Order where you pound the pavement let alone a Sherlock Holmes mystery, and more like Castle or Lucifer where the killer leaves obvious clues and confesses for no apparent reason, and the outsider whose mind isn’t even fully present with no actual training still figures it out half the time because they’re thinking at all rather than following procedure.

Rather than there being no fire alarm there’s usually an apartment actively on fire while you sit around drinking coffee saying “This is fine.”

Cause seriously, this is real life and how it works:

So, as the saying goes, let me get this straight.

The son bragged about having a gun on social media.

The mother posted about the gun on social media.

Son seen by teacher searching for ammunition on line; mom was contacted – Mother texted her son, “lol I’m not mad at you you have to learn not to get caught”

On morning of the shooting, teacher spots son’s drawings of gun, bullet and person shot, along with lines like “the thoughts won’t stop” “blood everywhere” “the world is dead” and a laughing emoji.

The parents were called in to get the son counseling. They resisted taking him home, so the school sent him back to class. The son had the gun with him in his backpack which was never checked, and the parents never thought to ask where the gun was or, as far as we can tell, point out that there was an actual gun.

That afternoon, son exists a bedroom, starts shooting and kills four people. Here’s a timeline of the whole thing. The parents have since been criminally charged, after ‘leaving town for their own safety’ according to their lawyer. I am not a lawyer but that seems highly appropriate.

As for whether we should blame the school, I mean, come on, these are hard questions.

“While we understand this decision has caused anger, confusion and prompted understandable questioning, the counselors made a judgment based on their professional training and clinical experience, and did not have all the facts we now know,” Throne said.

Determining whether a student’s behavior constitutes a threat is enormously challenging for school officials. Some experts said they could not blame Oxford school officials for not predicting the violence they would face.

“Hindsight is 20-20,” he said. “I’m sure everyone involved in this is deeply wishing they had made different decisions in this situation.”

What even is an expert?

Presumably all that is quite unfair, and aside from ‘the kids shouldn’t have been in a school in the first place’ I don’t have much in the way of solutions to offer. That’s not why I’m mentioning this.

The reason I mention all this is that this is how the world works. This is what history sounds like when it’s reported accurately. This is to help you, yes you, stop spinning stories where everyone is competent and things are done for sensible reasons, as opposed to (as Dominic Cummings describes it as actually literally happening, seriously, this is not me making this up) the Prime Minister of the United Kingdom deciding what policies to enact by turning to random 9am television programs and then letting the spirit move them. As opposed to no one thinking to check for a gun in the backpack, or thinking of it but deciding not to force the issue, and sending the child back to class to avoid social awkwardness, because the parents would get mad. Then again, hey. They have at least one gun and aren’t entirely stable.

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To me, the Oxford shooting is a cautionary tale of being too sensitive and getting in the habit of expecting everything to be a false alarm.

I have a hard time identifying which steps actually went wrong. Specifically, some of those red flags are only alarming in combination with others, but treating them like problems actually causes too many false alarms that the school has been implicitly trained to ignore. I'd include in this a teenager who is allowed to go shooting, talks about it, posts on social media about it. All of this is perfectly legal and not even unusual in some locations. The teenager having his own handgun is technically illegal depending on interpretation, but a parent buying a gun and keeping possession of it but designating it for the kids use is fine, and kids would refer to it as their gun. And here we see the payoff that the school has been forced to react to all these things over the years when it's as innocent as if the kid were engaged in any other pastime.

The parents were apparently negligent here. They knew at the time they were called into the office that the kid had access to the gun. That's information the school didn't have.

The school should have had it, though. I think when you find a kid drawing violent images, it isn't in itself a cause for discipline, but it is a reason to ask questions. And a few of those questions should have been "do you have a gun in the house?" "does your son have access to it?". Those might have been enough to motivate a search.

Even searching ammo online is one of those things against the rules for no good reason. The way zero tolerance policies are often implemented is that the picture of the gun is treated as if it's a danger. Someone could have been scared by that. The "safety issue" is not actually a safety issue, and everyone knows it but they have to pretend. But then once they've gone through the motions, they forget that a kid drawing pictures of killing people might also be an indicator of real violence, not just "I'm offended" violence.

The referendum in Switzerland was definitely not a vote for a "vaccine passport". It was a vote that approved the covid certificate (vaccinated, recovered or tested) in a bundle among many other covid measures (funding for impacted businesses etc).

I wonder about the minimum food quantity required to be present in order for the social norm to switch to "ok to take off mask". Could you just bring donuts to literally all social events and as long as everyone has a donut in hand, we can all not wear masks? Could all the kids get permanent lolipops and not have to worry about masks? Maybe widening and widening the no-masks-while-eating loophole is how we all get back to normal. 

How about one of those cider hats?

The war also involves freezing our children, in places they are legally required to be. This is happening to my son as well, as the school is forced to keep their windows open.

Even if we ignore all the obvious responses like "maybe don't freeze children", does this even help against Covid? Yes, ventilation obviously disperses aerosols faster, but when I keep a window open in winter my indoor humidity falls below 40%, which is very obviously Not Good for my health in various ways. Also, I haven't read the SSC post on disease seasonality yet, but IIRC humidity plays a likely role.

Random googled source for corroboration:

If the air we are breathing in is below 40%RH (relative humidity) over a prolonged period of time, this mucous membrane layer dries out. This can cause damage to the cilia, inhibits our ability to filter pollutants from the air we breathe and leave us susceptible to airborne infection.

"This is to help you, yes you, stop spinning stories where everyone is competent and things are done for sensible reasons.."

I'll take that and throw it right back your way. You will never be able to predict the actions of authority figures if you assume them to be incompetent instead of malicious. When malice is the best fit curve for the data, you should update your model. The purpose of school shooter interventions is to exercise authority and keep people afraid, not to prevent school shootings. Same for NPIs. Paxlovid is illegal because its legality would result in a decrease in power for authorities.

I think that Zvi has a pretty decent track record for predicting the actions of authority figures

Full approval of Evusheld by the FDA looks to be a real game changer for folks who are immunocompromised.

One cynical element of my mind wishes to register the advance prediction that most US COVID precautions will abruptly end exactly when the 2022 US election season begins to happen.

Do you have an analysis of why taking the vaccines is the correct decision somewhere in your history of posts that you can point me to?

I don’t think anything Zvi has written, or could write, could convince anyone that receiving a vaccine is the correct decision if they don’t already believe it.