Personal Response to Omicron

by jefftkjefftk2 min read30th Dec 20217 comments

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Covid-19
Personal Blog

Throughout the pandemic, our household has been on the careful end. We started preparing in February 2020, isolated thoroughly from March to July, moderately over the summer, and then thoroughly again from October until all the adults in our house were vaccinated. Because I was immunocompromised, we had a newborn, and kids under five couldn't get vaccinated yet, however, our family's 2021 was still a lot like 2020. Then, in doing Christmas holidays with family I was very careful individually in the two weeks leading up to it and I was the one working on precautions and making sure we had enough tests: some of the people I really wanted to spend Christmas with are at elevated risk.

I wrote last week about how there are a range of paths we could take with Omicron as a society, but now that Christmas is over what am I going to do personally?

Well, what's the weather out there?

That's a lot of covid in the sewer, 5x the previous peak and still going up.

I think if it were critical that I or a housemate didn't get Omicron, it would be possible, but very difficult. We would need to go back to isolating the way we were in Fall 2020, treating vaccinated people as about as risky as unvaccinated people, pulling the kids out of school, and never going indoors anywhere. Given the likely effects of contracting covid as a child or boosted adult, this is not worth it for us or I suspect most people.

Instead, I expect that I, the people in my house, and pretty much everyone who doesn't take intense and careful effort to avoid it will be exposed to Omicron at some point in the next ~month. It's not a good thing, but it is what it is. Afterward, people's immune systems will have had yet another covid exposure, and I expect cases to go low until next fall. So I'm not going to stress about it: I'll follow official guidance and mask regulations, cheerfully go along with precautions others need, and test+isolate when sick, but I'm not going to go above and beyond to attempt to reduce spread the way I did for earlier parts of the pandemic.

I'm thinking of Omicron as the first wave of the endemic phase of covid-19. While "it's just the flu" was completely wrong in 2020, in 2022 the situation has changed enough of that "what would I do in flu season" is now a good guide.

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Thanks for continuing to write about this.  That said, I feel like a lot of the links in reasoning are left implicit here, and I’d rather not be making assumptions about your rationale.  What, specifically, do you think changed to make the situation more similar to typical flu season?  How much of that change is rooted in factors that affect society at large, versus being rooted in your own house’s success at reducing your risks for particularly severe outcomes (less immunocompromised; newborn is now older), versus being rooted in your increasing pessimism about our ability to manage tradeoffs in a nuanced way as a society?  Also, are you intending a distinction between “exposed to Omicron“ and “getting Omicron”?  (looking at “if it were critical that I or a housemate didn’t get Omicron” vis-a-vis your prediction that “pretty much everyone who doesn’t take intense and careful effort to avoid it will be exposed to Omicron at some point in the next ~month”)

What, specifically, do you think changed to make the situation more similar to typical flu season?

A very large portion of the population now has exposure to covid, either directly or via vaccination. It's not enough to keep people from getting it (or variants) again, but it is strongly protective against death. The high death rate of covid in an immunonaive population was what got us to take it seriously and lock down in the first place.

How much of that change is rooted in factors that affect society at large, versus being rooted in your own house’s success at reducing your risks for particularly severe outcomes (less immunocompromised; newborn is now older), versus being rooted in your increasing pessimism about our ability to manage tradeoffs in a nuanced way as a society?

My comment at the end of my post about flu season maybe didn't belong in a post under this title; I was thinking there much more about how it made sense for people in general to behave than our household in particular. So almost all the first one, via people's immune systems.

Are you intending a distinction between “exposed to Omicron“ and “getting Omicron”? (looking at “if it were critical that I or a housemate didn’t get Omicron” vis-a-vis your prediction that “pretty much everyone who doesn’t take intense and careful effort to avoid it will be exposed to Omicron at some point in the next ~month”)

My model here is something like, everyone who does not take serious precautions is very likely to be exposed enough to Omicron that they will get it if that is something their immune system will let happen right now?

The high death rate of covid in an immunonaive population was what got us to take it seriously and lock down in the first place.

I remember Eliezer back then writing about how long-COVID concerns were a bigger reason then the death rate to lock down.

How clear are you about the death rate having being more significant in our community?

I think he's conditioning heavily on being fully vaxxed and boosted when making the comparison to the flu. Which makes sense to me. I also suspect long Covid-19 risk is much lower if you're vaxxed & boosted, based on the theory that Long Covid is caused by an inflammatory cascade that won't shut off (there's a lot of debate about what biomarkers to use but many long Covid patients have elevated markers of inflammation months later). If your symptoms are mild, you won't have that inflammatory cascade. Here's Zvi on one of the latest Long Covid papers : "To the extent that Long Covid is a non-placebo Actual Thing, this seems to strongly suggest that it will indeed scale with the severity of infection, so vaccinations and booster shots will help a lot..." 

That's about where I am too.

My friendly amendment here is I’m ready to go back to normal once there’s a lot of paxlovid, fluvoxamine, etc in circulation. Then, with vaccination and treatment, it’s basically the flu by my guess.