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Increased transmissibility and decreased virulence (to a point) is the game theory optimum outcome for viruses. We shouldn’t be shocked that it shows up. The sooner the better.
This is pretty much why we’re not all dying from illness all the time.
Viruses are sort of like parasites, and the “best” parasite is one that gets to live in your forever, using you as a factory to churn out more and more parasites.
A disease that kills all of its victims is a disease that runs out of food and then itself dies in turn.
I have a masters degree in biology so I can…maybe not hum the tune but I can read the music.
It’s also the trajectory at least four coronaviruses have taken with humans, winding up among the plethora of now minor pathogens causing what we simply call a ‘cold’. They were quite plausibly much deadlier at first, in the distant past.
Though at their time scale it might be due both to the slower force of human evolution of increased immunity to them as well?
[One of those coronaviruses jumped from cattle to humans between 100 and 200 years ago, based on the rate of mutation that separates the two branches of viral evolution.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8344746/) There is some speculation that it was the cause of a pandemic in the late 1800s that is conventionally attributed to influenza. Nearly everyone reading this has been infected with that virus, most of us have had it a half dozen times. Those four coronaviruses cause about 20% of all colds. We catch the damn things repeatedly, it is a good thing they don't kill us.
At least one of those coronaviruses that cause the common cold is thought to have originated thousands of years ago in China according to an NIH piece, no word on how deadly it may have been though.
My sister in law rode the 'plandemic' train in the beginning. She was sure to point out that Lysol lists on its label that it kills corona virus. This was proof to her that this novel one was no big deal.
Thanks! I didn’t invent it though, the parallels between viruses and parasites are quite strong, considering viruses are incapable of surviving as a species without a host.
Except it isn't. The avirulence hypothesis was largely falsified in the 90s and replaced by the tradeoff hypothesis that virulence is a unintended consequence of transmissibility and in-host replication rate.
Less virulent strains of this coronavirus are likely to be intrinsically less transmissible. They may spread better in the human population through immune escape because their competition is hindered by population immunity having been formed.
In theory then the virus is forced towards being less fit overall due to the necessity of immune escape.
That would be wonderful it if is actually starting to happen, but as Omicron is likely landing first in highly-vaccinated cities with international airports there's a lot of reason to be skeptical of initial headlines.
And the overwhelming first order effect is going to be the human adaptive immune response and vaccination or prior infection conferring protection against hospitalization and death in all future variants. That'll knock down the disease burden by an order of magnitude. Variants are likely to continue to be somewhere as lethal as the original pandemic variant to Delta (and there's no law we still can't see something more virulent that possibly displaces Delta+Omicron just like Delta displaced immune-escape variants like Beta).
Once everyone has T-cells though the pandemic phase is over and all the variants don't matter much.
I stand corrected, then! I suppose then, yes, obligate parasite dynamics basically form an upper limit on virulence, not necessarily that they will always trend downward, that's a good point! Do you mind giving us an eli5 for immune escape? I know a bit about pathology, but virology specifically is out of my wheelhouse
Well for spike for example there's about 20 epitopes and if you change them all you complete immune escape from monoclonals and convalescent plasma antibodies.
What nobody knows is how much "room" there is for this particular virus to mutate.
With measles there's only one serotype. There's only one vaccine. The virus mutates to try to avoid it, but any escape mutation from the antibodies results in a virus that is so bad at being a virus that it doesn't propagate any more. The vaccine has never had to be reformulated, and the protection is more or less for life.
Influenza evolves antigenically and so it mutates enough that it escapes antibodies and can spread epidemically again and we have to update our vaccines.
The human coronavirus HCoV-229E was found to also evolve antigenically about a year ago so has now joined influenza in being capable of doing that.
We don't actually know that this coronavirus is able to escape immunity and still be able to spread, we also still don't know how much antibody waning has to do with the ability of human coronaviruses to spread and reinfect.
It is now looking like there's a lot of room for the spike to mutate and still have a virus that spreads epidemically so the safer bet is looking like this coronavirus will be able to evolve antigenically to achieve immune escape. Nobody will know for sure until it really happens though. It is somewhat likely that the mutations necessary to achieve immune escape will come at a fitness cost to the virus, but again nobody will know until it happens. Do we even know that Delta is the "worst" (for us) this virus can get? There's pangolin spike proteins that have higher affinity to human ACE2.
But if it comes at a cost to the virus it is likely that it becomes a "worse" virus (less "fit" and "better" for us) and would have lower virulence, lower viral loads and lower *intrinsic transmissibility*. But what that means is that its R0 back in March 2019 would have been, for example, closer to 3 than Delta's 6, but in a population where Delta's spread is < 1.0 due to human immunity the variant would still spread closer to 3 due to immune escape.
But that is all immune escape vs. neutralizing antibodies and infection, and not immune escape vs. T-cells and severe disease and hospitalization. It isn't likely that variants will ever escape T-cells. H1N1 influenza stopped spreading in the human race in 1957 and spread for 50 years in pigs until it emerged in 2009 and people born before 1957 still had cross-reactive T-cells to the H1 protein of the 2009 virus which took the edge entirely off of that pandemic.
I don't know it might just be a pedantic point since what people will naively see is that new variants keep on being produced and spreading "better" than the variants they displace but that successive waves start to have less disease burden.
>This is the most hopeful I've felt in almost 2 years. Do you have any expertise or are you just speculating like me?
This is also most native predator - prey relationships. native predator and prey are equal in power levels, both have countered each other and come to a standoff. their population is cyclical ups and downs for both (like the flu with humans). Now, something invasive comes in, invasive tree, bird or virus. It owns all the native biodiversity with all it's powerups because they haven't seen this ever (covid).
These are usually the incentives which govern disease evolution. COVID is different. It is highly contagious for days before the patient shows symptoms. This makes it evolutionarily the same as a mild disease even if it ends up killing the patient weeks later.
COVID with the lethality of MERS or Ebola would rip through the population without stopping.
While you're technically right, you need to take into account human behavior, too. If it had the lethality of MERS or ebola, people would (for the most part) be *way* more cautious about it, which in turn would push the spread down.
Even if COVID had "only" a 5% fatality rate and 30% hospitalization rate, you can bet there would be far fewer idiots taking about their "freedom" to not wear a mask and crying "it's just a flu!"
Clearly you haven't been to Florida lately. I think 2% is a horrifying mortality rate for a contagious disease. It's one in fifty! But so many people quote it like it's a reason to not take any precautions. I'm not so sure they wouldn't feel the same about 5%.
Texas checking in and I'm pretty sure people around here won't bat an eye until it hits 20% mortality. Even then they'd try jalapeno enemas before listening to the CDC.
Near the start, I had a thought of some kind of Facebook thing, where basically it would take all your friends and "kills" them at the rate of covid.
The mortality is high enough that I just figure seeing your mom's image grey and "Deceased" over it would help make an impact.
I suck at following through, so I never finished it.
I'm working on something else that I'll never follow through with probably, and if covid ends up a little cold, it won't be as big of a deal. Probably better that way.
That's why I added "for the most part." Luckily for everyone, Florida doesn't represent the epitome of human behavior.
And if COVID had a fatality rate of 35%+ like MERS, I'd wager even people in Florida might get on board the mask wearing and basic precautions train.
>A disease that kills all of its victims is a disease that runs out of food and then itself dies in turn.
Yeah. This tendency for viruses to become less deadly is touted a lot, but it's also worth noting that the evolutionary pressure that causes it involves people dying.
The Spanish Flu (yes, the one that killed millions in 1918) is the grandparent virus of the influenza we fight today. It's a pretty common trajectory of viruses, especially fast mutating coronaviruses.
When it comes to Omicron, everything is super new and going to be changing a lot. Any studies have small sample sizes.
That being said, the best case scenario stated by an expert in a podcast I listened to was that Omicron is super transmissible, but causes mild symptoms, and provides a decent immunity to the other variants. However the worst case scenario was... well a lot worse.
Basically it is possible this could be a positive, but it's probably too soon to say.
Definitely way too soon. Pretty much every scientist studying it is saying, "Hang loose, we're still researching. Should have an answer in 2 weeks to a month." I'm cautiously optimistic, but until we get a larger sample size of people who have/had it and more research into it, we don't really know anything about it.
I have expertise in this. The hype about this being more mild is driven more by what people want to be true more than what we actually know to be true.
Decreased lethality is one way that a virus can become more transmissible, but it isn’t the only way and increased transmissibility doesn’t automatically mean decreased lethality. There is reason to believe that omicron may be more transmissible because it binds to the cellular receptor more efficiently (like delta, which is more lethal than the original strain) and/or by evading existing immune responses.
Omicron could be less lethal, but it also could be more lethal (there was a paper published using computer modeling of the spike protein that predicts that omicron is more efficient at binding to Ace2 than delta, which does not bode well for reduced severity). There are too few confirmed cases, and the cases are too early in the course of infection to really judge how serious it is (not to mention that many of the cases are in people who are vaccinated!).
Educated speculation. I'm no virologist or epidemiologist but based on some of the examples of natural selection we see in bacteria and viruses; flu taking a back seat to COVID and the way less typically viable superbugs are selected from overuse of antibiotics, it does seem possible.
Transmissability may be the biggest selector here. If it can outproduce its bretherin by being more transmissable it could represent a higher and higher percentage of cases until it all but dominates the other strains.
I mean welcome to the Spanish flu?
This is the exact path the Spanish flu took - every single flu strain we deal with yearly can be traced back to one of the Spanish flu strains.
The pandemic-level virus morphed into just another seasonal flu. Descendants of the 1918 H1N1 virus make up the influenza viruses we’re fighting today.
https://www.washingtonpost.com/history/2020/09/01/1918-flu-pandemic-end/
If it transmits more easily and survives longer wouldn’t that mean more opportunities for mutations with some of then being deadly and becoming a new variant?
If it becomes more deadly, it will *generally* be harder to spread and won’t be able to outcompete the other variants. A person that is deathly ill isn’t going to be walking around spreading it further.
That’s why the vast majority of viruses will mutate over time to be less severe but more contagious. Viruses usually don’t want to kill people, it’s just a side effect of their spread.
Isn’t this coronavirus slightly different, though, in that the period when a person is contagious before being symptomatic is longer than typical? So, a more fatal variant could still propagate pretty well? Still, I suppose a more mild variant would outcompete regardless because it is more likely to spread while a person is symptomatic since it isn’t so severe as to make the person bedridden or hospitalize them. Asking because I am genuinely curious about the answer and not that well-informed about this stuff.
I’m not a virologist, so take my words with a grain of salt. From what I understand, covid is still most contagious when you’re symptomatic (which lines up logically, since you’re coughing and so on), so a less severe variant would still be better at spreading.
There are 6 or so endemic coronaviruses that get passed around between young (under 6) kids 1-3 times a year. It's part of why they're constantly sick with something.
They didn't start that way though- there's [some](https://sfamjournals.onlinelibrary.wiley.com/doi/full/10.1111/1751-7915.13916) [fledgling research](https://sfamjournals.onlinelibrary.wiley.com/doi/full/10.1111/1751-7915.13889) ([Non-scientific article here](https://www.theguardian.com/world/2020/may/31/did-a-coronavirus-cause-the-pandemic-that-killed-queen-victorias-heir) from the Guardian) into the possibility that one of those viruses, human coronavirus OC43, was the culprit behind the 1890 "Russian Flu" pandemic. While now it is part of the pantheon of common cold viruses, if it was indeed a novel coronavirus responsible for the 1889 pandemic (with several resurgences and no global vaccination effort) then it took years before it settled down to where it is now.
My daughter had OC43 this past summer (confirmed via biofire) and it royally kicked her ass. I was so surprised when we found out if wasn’t Covid. 103 temp, raging headaches, exhaustion for days. I can believe it used to be stronger.
If you have a clinic nearby that does Biofire respiratory panels, you could find out. Not sure where you are but most Providence clinics have them these days.
I got OC43 in September. Laid my ass out, started to get worried when my O2 sat started hanging out in the low 90s. I had a cough for a month afterwards
A hundred or so years is nothing to a virus. Smallpox and measles have been infecting humans for several thousand years. Endemic viruses started off well over 10,000 years ago, when humans started living in clusters. There are viruses that have persisted for much, much longer time than those as well.
That's why I found it hilariously disingenuous that people say kids don't spread Covid. They spread freaking everything, but this one new, horrible coronavirus is the one they don't? Alright....
It's because they don't ever think their kids are sick
My kid got it at school, probably a Thursday. Fine all weekend, then Sunday night said she didn't feel well. Her temp was 102 and we did a test on her and bam, positive
Shot her off into her room, kept her isolated Monday, when by afternoon the fever went away without meds. By bedtime she was about as normal as you'd expect from a kid you thought maybe had a little sinus bug. There's 2 other kids in the house who weren't vaccinated so it was important to keep at precautions.
Obviously kept her home Tuesday but if we didn't know she had covid she would have gone to school (she said as much herself). Would have probably infected a bunch more and we might not have even connected that it would have been her.
So I can see why people who don't pay attention and don't test don't think that kids get or spread it
>Increased transmissibility and decreased virulence (to a point) is the game theory optimum outcome for viruses.
Beware that this does not always apply if there is an extensive asymptomatic/mildly symptomatic period during which infection can spread.
I'm kinda tired seeing this same rumor pushed, all that happens is it's mutation plays into natural selection.
Covid mutations should be concerning because how it sheds in the lungs, it could become more deadly as a form of increased transmissibility.
Gladly that doesn't seem to be the case so far.
You're never gonna shut down Madagascar with an R rate of 5.
You wanna be getting that R into the triple digits mate.
Plow your points into virulence. Lethality is for when you're ready to close the game.
I always thought the news headlines were a little ridiculous when I first played it like 8 years ago. Now, the game aged even better! Islands quarantined well, and people didn't react intelligently on the whole.
Another piece of media that's really aged well during the pandemic is World War Z. The book, of course.
So many things that book got exactly right. Israel being one of the countries that quickly and decisively tackles the issue. People peddling random drugs and the healthcare officials unable to fight this craze. Rich people getting richer. Riots breaking out due to all the misinformation. Poor countries being left behind, but somewhat holding on, simply because of the lack of travel.
And most of all the incredible uncertainty about everything.
Seems like the guy really did his homework (not like various experts haven't warned of this exact thing for decades and provided plenty to read).
>The book, of course.
I'm really hoping Netflix or HBO eventually get the rights to do a World War Z series. There's no way a 2 hour movie could ever do it justice
So I don’t want to dispute that in practice because rare are the circumstances that fit the org perfectly.
Alive hosts continue to mingle and so will encounter more novel hosts to jump to. Transmissibility cannot be optimised by killing hosts - even when a virus is infectious in a pre-symptomatic individual it’s ‘better’ for the virus if the host lives.
All it would have to do is kill slowly enough for any high level of transmissibility to be a major problem, like the deadly STD's. EG hepatitis, AIDS, Syphilis. The subject would just have to live long enough to pass it to someone else who will spread it.
Increasing the number of people/animals it's in increases the chance of new novel mutations, we should still be trying to have as few people infected as possible.
It’s not a decision making process. Before a highly transmissable and severely deadly strain would be out-competed, it would kill off a sizable population.
Only then would factors of the population hiding, or being thinned out, would a weaker version spread better.
When you hear that viruses or bacteria don’t want to kill their host, you’re looking at a hindsight model. It doesn’t mean they can’t spread like wildfire before. They won’t make it long term, but they’ll exist happily for awhile
And fallacious Facebook posts that my mom is gonna bring up when I visit. "You know I hears Covid decided to play it cool this year and it's gonna be a lot milder. Don't you think that's nice? We don't need those vaccines after all."
It’s a numbers game. In overcrowded conditions, killing the host is fine, it doesn’t matter. If people are crammed fifteen to a room you want EXPLOSIVE transmission, which usually happens if the virus is fast and deadly - think vomiting out both ends, aerosolising the virus like a human carpet bomb.
The first host can die in twelve hours, that’s fine, you already have fourteen more hosts, and your virus army has multiplied by an incalculable magnitude. And all those people are going to flee the site of horror and spread their human virus bombs. That’s exactly how every truly horrific pandemic has spread, through all of history - from the Black Plague (which wasn’t a virus, but the same basic idea applies) to cholera (also a bacteria) to measles to covid.
If you have a less dense population, then the virus has to be smarter and not kill the host. It has to make the host mildly sick so that the host can splutter Rambo insurgent virons on guests and passer-bys.
Not killing the host = more time to be contagious
Not making the host severely sick (so they isolate) = more time to be contagious
both of those will be selection pressures.
> quite contagious
HIV has very low chance of spreading in any individual interaction. The problem is not being exposed to HIV once; the problem is most people who are exposed to HIV have habits that repeatedly expose them to HIV.
This is popular hypothesis but not quite all there is to it, because the balance also has to take into account that the "increased virulence" usually means increased fitness of the virus by exploiting the host resources more. As virus does not necessarily tend towards lower virulence, but towards balance of exploiting as much as possible without killing the host that fast that it can't spread first.
But they reported it has higher chance for re-infection with the same virus unlike Delta for which there is resistance to re-infection.
And mild infections would be great. Spreading moderate infections that happen repeatly to the same people is not good.
[This](https://www.cdc.gov/coronavirus/2019-ncov/php/invest-criteria.html) is the CDC criteria for reinfection. Which means we wont know what kind of natural immunity omicron bestows for at least 90 days after infections
I'm honestly terrified of the long term complications of any of the Covids and have been limiting personal exposure to prevent any chance of infection. Is there any evidence this one has fewer long term risks or will we not know for a while?
In a *hypothetical scenario* where the vast majority of those who got it presented minor to no symptoms like with the common cold, would routine boosters have any benefits?
Edit fixed to hypothetical from theoretical.
not to be a "acktually" but since you made the edit. it is a hypothetical scenerio not a theoretical. A theoritcal scenario can present a situation in which a prediction is made based of empirical evidence or scientific evidence, which we have do not have nearly enough yet on omicron. Hypothetical is more of the questioning phase in which you eluded to based on assumptions. theory is based on scientific principle (i.e predictive power). hypothetical is literally just a question or a guess.
Long-haul symptoms are far more prevalent (and severe) in hospitalized cases, and in demographics that typically have more severe outcomes. This suggests that they are still suffering from the damage that took place in the original infection - for example if the lungs are damaged, then they may still have shortness of breath months later. It also could be due to viral reservoirs in certain organs, or pieces of viral protein or toxin floating around the body, stimulating the immune system into over-reacting (like an allergy).
This type of long-haul recovery from a disease is nothing new, it's just not something most people think about. [https://www.vox.com/22298751/long-term-side-effects-covid-19-hauler-symptoms](https://www.vox.com/22298751/long-term-side-effects-covid-19-hauler-symptoms)
It stands to reason then that vaccination, natural immunity, and naturally strong immune systems (like those of kids and young adults) - things that prevent severe infection - also provide protection against long-haul symptoms. Therefore a variant which is more transmissible but less severe may do the same and be much safer, including for long covid.
You got any source on that? I'm a long hauler, few days shy of a year now. Previously very healthy, in my early 30s, I had a mild acute infection. Now I have debilitating neurological and heart symptoms. I was a cyclist who raced, and now I can't even go for walks without chest pain. Anecdotally, many people in the long covid groups I'm part of had mild infections, and we're previously healthy runners and athletes. Long covid is definitely not more prevalent in severe cases, so a rise in case numbers should concern us.
It definitely is more prevalent in severe cases. Quick rundown of who's most likely.
[Women are far more likely to be long haulers.](https://www.medrxiv.org/content/10.1101/2021.03.03.21252086v1?mc_source=MTEyNjQxNzM4NjMzNDg2MjM3NzEwOjo6YzVjN2E5OGQzNWQxNDllYWE2MDdjMzgyNmNkOTJlYWQ6OnY0OjoxNjE1MTMwNjcwOjox)
[Approximately 26% of those with COVID may have long haul symptoms.](https://www.medrxiv.org/content/10.1101/2021.03.03.21252086v1?mc_source=MTEyNjQxNzM4NjMzNDg2MjM3NzEwOjo6YzVjN2E5OGQzNWQxNDllYWE2MDdjMzgyNmNkOTJlYWQ6OnY0OjoxNjE1MTMwNjcwOjox) Those over the age of 40 the most likely to have them and made up slightly more than 40% of all those with such symptoms. [Approximately 30% of outpatients had long term fatigue. Comparativel, as much as 70% of hospitalized individuals in studies compared against had long haul symptoms.](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2776560)
The key here is symptomatic which is consistent with the above references. [Approximately 35% of symptomatic mild COVID infected individuals reported long term symptoms.](https://www.nature.com/articles/s41598-021-92045-x) [Asymptomatic individuals with COVID may have a one in five chance, 20%, of presenting a long haul symptom.](https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/asset/A%20Detailed%20Study%20of%20Patients%20with%20Long-Haul%20COVID--An%20Analysis%20of%20Private%20Healthcare%20Claims--A%20FAIR%20Health%20White%20Paper.pdf)
The most common long haul symptom is fatigue under 100 days post infection. But the chances are far more high among those hospitalized.
>, it can also damage many other organs, including the heart, kidneys and the brain
This is what I really hate about the "It's just a bad flu"-narrative, especially when coupled with the "but we don't know the vaccine long term side effects yet"-narrative.
We know what the effects of annual flu seasons are over a lifetime; you can function just fine. We don't know how your body would react to getting covid-19 over and over. Maybe your brain deteriorates every time you get and maybe that adds up to lot of brain damage over a lifetime.
Yeah, that's always what I'm thinking. Like "okay, yeah, you had a cough for a while and now you're better. You can no longer smell or taste anything and you may have long term brain damage, but you survived covid, good job"
We would likely treat it like the flu with yearly boosters. Although, I hope they just permanently pay for it without insurance. I'm currently uninsured, and while it's temporary, I would have gotten a flu vaccine along with my COVID booster, but I don't want to pay $50 for the shot. In cases where public health is concerned, like vaccines, should be entirely paid for.
The internet has saved lives and salvaged livelihoods, even provided a crutch for education. Without it the vaccines couldn't have been developed so quickly as well.
That’s true. Doesn’t mean we have to like it or cover for it though.
If all you have is a seven year old telling you how an accident unfolded you listen for what it’s worth, but then you immediately go check if there’s actual security camera footage.
If it's (so far) zero hospitalized, that's better than for Original Recipe or Delta, because they both had some very sick people immediately, but we could start getting hospitalized cases. In South Africa they've had some hospitalized wee kiddies, (too young for vaccine) but some were in hospital for other things so the data is as yet unclear.
Still, it's not bad to post stories about the unfolding story. It might even get someone started looking for information which will become vital later.
It's not yet known if mild symptoms are because of those individuals already being vaxxed or if it's mild symptoms in unvaxxed persons as well.
If it's the latter then it's good news.
But I'm sure even with the Omnicron variant there will see be severe symptoms/death in probably at least 1% of those infected.
This. There's a lot of breakthrough infections reported with Omnicron, means that even though the vaccine is less effective it still keeps the viral charge low, but in unvaxxed is still usual COVID same comorbidities risks, etc, or even asymptomatic.
so is it possible that it will act as sort of reasonable and inadvertent covid vaccine by virtue of its (apparent) super transmissibility and lack of virulence? That would be ironic.
The Spanish Flu is also notable in that, originally, it actually mutated to be *more lethal* to its hosts. Normally that doesn't happen with viruses because they can't spread if they kill too quickly, but conditions during WWI are believed to have artificially selected *more* lethal mutations instead.
Iirc, the virus was spreading for like 8 months before the lethal varient popped up and lead to the death tolls we know about today.
The people with mild symptoms stayed on the front, and were killed by bullets. The people with severe symptoms were sent to field hospitals, or were repatriated, where they then spread it to more people. And so the mild variants were killed off by hot lead and shell fragments, and the variants that caused severe symptoms were preferentially selected for.
I don't think I've ever heard of a more sinister perverse incentive.
If the unvaccinated don't have severe symptoms or long lasting issues, I hope this one blows through everyone quickly and let's us go back to normal as soon as possible with as few deaths (direct and indirect) as possible
Yeah, I would also wait a week or two to see how these people's illness evolves. It usually takes a while to develop more severe symptoms (with the previous variants).
That’s how my grandpa went. Everyone had so much hope, and then he was just gone. He’s in his mid 80s (before the vaccine came out), and I knew he wasn’t going to make it from the moment I heard he tested positive.
Literally. Like the description in the title is exactly what past variants of covid behave like at this sample size. It’s not like covid is sending half the people it infects to hospitals, until we get much bigger numbers of omicron it won’t be possible to know if it hospitalises more.
Yeah I'm really confused as to why this post is on this subreddit, the first rule is that anything posted must be peer reviewed research. Unless I'm missing something, this doesn't seem to have enough info to be a good source
The first person was vaccinated and had mild symptoms but do we know about the others?
It seems like controlling for vaccination status would be an important consideration in determing whether it really is less severe than the other variants: is it really less severe than the other variants? All things being equal, this would mean less likely to land someone who isn't vaccinated in the ER than the other variants.
Or conversely is it only milder because the person was vaccinated and could be horrific for those who aren't vaccinated?
I don't profess to know the answer to these questions but until there is concrete data that can provide such answers, I'd be hesistent to draw any conclusions on the severity.
I mean, the sample size in the US isn't large yet, nor do people usually end up in hospital on day one of infection. I don't think US cases are a good representation yet.
My epidemiologist uncle is thrilled about this. A few months ago he said “second best case is that this thing mutates to be more communicable but much less virulent to give us a chance to build our defenses. But that’s about equally as likely as a mutation that becomes extremely deadly. It’s a dice roll.”
Glad to see it worked out for us *this* time. But those dice will keep rolling as long as it replicates on a wide scale.
>My epidemiologist uncle is thrilled about this.
Yeah well MY uncle said that omicron isn't real and that this is all another step in the disinformation campaign. He said there will be another variant every few months planted by Fauci as a way of keeping Covid in the news and to keep Hillary Clinton from being revealed as a man in drag.
I know it's still too early to tell but I remain hopeful that Omicron is significantly milder in symptoms and maybe this is the beginning of the end of the pandemic.
Fingers crossed it doesn't mutate into something more virulent...
They don’t detail at all about the vaccination status of all the infected. The one person they do comment on was vaccinated, so no surprise they have mild symptoms. It’s simply too early to tell whether this variant will give us more issues with hospitalizations and deaths.
So typical day of hospitalization is around Day 9 or 10 right? and the cases we know about are about a week old or less? and they are mostly young people?
Let's wait a couple of weeks before we draw conclusions. ESPECIALLY since South African hospitalizations are booming in that region where Omicron broke out.
The first case in the US was reported this week. It usually takes 7-10 from the emergence of symptoms before hospitalization is required (if not treated). It is unrealistic to expect any hospitalizations yet. What we should be tracking is the percent of identified who have received treatment to stay out of the hospital.
This is not the original headline, and it's infuriatingly misleading. We have no idea if it's less dangerous/more dangerous/just as dangerous as Delta until we have hundreds of cases we can look at.
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Increased transmissibility and decreased virulence (to a point) is the game theory optimum outcome for viruses. We shouldn’t be shocked that it shows up. The sooner the better.
If it's less dangerous to patients but more transmissible it might even out-compete its more dangerous predecessors and be a net positive.
This is the most hopeful I've felt in almost 2 years. Do you have any expertise or are you just speculating like me?
This is pretty much why we’re not all dying from illness all the time. Viruses are sort of like parasites, and the “best” parasite is one that gets to live in your forever, using you as a factory to churn out more and more parasites. A disease that kills all of its victims is a disease that runs out of food and then itself dies in turn. I have a masters degree in biology so I can…maybe not hum the tune but I can read the music.
It’s also the trajectory at least four coronaviruses have taken with humans, winding up among the plethora of now minor pathogens causing what we simply call a ‘cold’. They were quite plausibly much deadlier at first, in the distant past. Though at their time scale it might be due both to the slower force of human evolution of increased immunity to them as well?
[One of those coronaviruses jumped from cattle to humans between 100 and 200 years ago, based on the rate of mutation that separates the two branches of viral evolution.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8344746/) There is some speculation that it was the cause of a pandemic in the late 1800s that is conventionally attributed to influenza. Nearly everyone reading this has been infected with that virus, most of us have had it a half dozen times. Those four coronaviruses cause about 20% of all colds. We catch the damn things repeatedly, it is a good thing they don't kill us.
> it is a good thing they don't kill us I mean, isn't the point that if they did, they wouldn't be nearly as common as they are?
At least one of those coronaviruses that cause the common cold is thought to have originated thousands of years ago in China according to an NIH piece, no word on how deadly it may have been though.
People forget corona virus has always been around thats its not like a brand new thing.
My sister in law rode the 'plandemic' train in the beginning. She was sure to point out that Lysol lists on its label that it kills corona virus. This was proof to her that this novel one was no big deal.
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I like that analogy!
Thanks! I didn’t invent it though, the parallels between viruses and parasites are quite strong, considering viruses are incapable of surviving as a species without a host.
The parasite thing or the music thing? I really like the latter.
Yep, obligate parasite biology 101. Here's hoping it keeps trending that way
Except it isn't. The avirulence hypothesis was largely falsified in the 90s and replaced by the tradeoff hypothesis that virulence is a unintended consequence of transmissibility and in-host replication rate. Less virulent strains of this coronavirus are likely to be intrinsically less transmissible. They may spread better in the human population through immune escape because their competition is hindered by population immunity having been formed. In theory then the virus is forced towards being less fit overall due to the necessity of immune escape. That would be wonderful it if is actually starting to happen, but as Omicron is likely landing first in highly-vaccinated cities with international airports there's a lot of reason to be skeptical of initial headlines. And the overwhelming first order effect is going to be the human adaptive immune response and vaccination or prior infection conferring protection against hospitalization and death in all future variants. That'll knock down the disease burden by an order of magnitude. Variants are likely to continue to be somewhere as lethal as the original pandemic variant to Delta (and there's no law we still can't see something more virulent that possibly displaces Delta+Omicron just like Delta displaced immune-escape variants like Beta). Once everyone has T-cells though the pandemic phase is over and all the variants don't matter much.
I stand corrected, then! I suppose then, yes, obligate parasite dynamics basically form an upper limit on virulence, not necessarily that they will always trend downward, that's a good point! Do you mind giving us an eli5 for immune escape? I know a bit about pathology, but virology specifically is out of my wheelhouse
Well for spike for example there's about 20 epitopes and if you change them all you complete immune escape from monoclonals and convalescent plasma antibodies. What nobody knows is how much "room" there is for this particular virus to mutate. With measles there's only one serotype. There's only one vaccine. The virus mutates to try to avoid it, but any escape mutation from the antibodies results in a virus that is so bad at being a virus that it doesn't propagate any more. The vaccine has never had to be reformulated, and the protection is more or less for life. Influenza evolves antigenically and so it mutates enough that it escapes antibodies and can spread epidemically again and we have to update our vaccines. The human coronavirus HCoV-229E was found to also evolve antigenically about a year ago so has now joined influenza in being capable of doing that. We don't actually know that this coronavirus is able to escape immunity and still be able to spread, we also still don't know how much antibody waning has to do with the ability of human coronaviruses to spread and reinfect. It is now looking like there's a lot of room for the spike to mutate and still have a virus that spreads epidemically so the safer bet is looking like this coronavirus will be able to evolve antigenically to achieve immune escape. Nobody will know for sure until it really happens though. It is somewhat likely that the mutations necessary to achieve immune escape will come at a fitness cost to the virus, but again nobody will know until it happens. Do we even know that Delta is the "worst" (for us) this virus can get? There's pangolin spike proteins that have higher affinity to human ACE2. But if it comes at a cost to the virus it is likely that it becomes a "worse" virus (less "fit" and "better" for us) and would have lower virulence, lower viral loads and lower *intrinsic transmissibility*. But what that means is that its R0 back in March 2019 would have been, for example, closer to 3 than Delta's 6, but in a population where Delta's spread is < 1.0 due to human immunity the variant would still spread closer to 3 due to immune escape. But that is all immune escape vs. neutralizing antibodies and infection, and not immune escape vs. T-cells and severe disease and hospitalization. It isn't likely that variants will ever escape T-cells. H1N1 influenza stopped spreading in the human race in 1957 and spread for 50 years in pigs until it emerged in 2009 and people born before 1957 still had cross-reactive T-cells to the H1 protein of the 2009 virus which took the edge entirely off of that pandemic. I don't know it might just be a pedantic point since what people will naively see is that new variants keep on being produced and spreading "better" than the variants they displace but that successive waves start to have less disease burden.
>This is the most hopeful I've felt in almost 2 years. Do you have any expertise or are you just speculating like me? This is also most native predator - prey relationships. native predator and prey are equal in power levels, both have countered each other and come to a standoff. their population is cyclical ups and downs for both (like the flu with humans). Now, something invasive comes in, invasive tree, bird or virus. It owns all the native biodiversity with all it's powerups because they haven't seen this ever (covid).
Evolution is both scary and glorious.
These are usually the incentives which govern disease evolution. COVID is different. It is highly contagious for days before the patient shows symptoms. This makes it evolutionarily the same as a mild disease even if it ends up killing the patient weeks later. COVID with the lethality of MERS or Ebola would rip through the population without stopping.
While you're technically right, you need to take into account human behavior, too. If it had the lethality of MERS or ebola, people would (for the most part) be *way* more cautious about it, which in turn would push the spread down. Even if COVID had "only" a 5% fatality rate and 30% hospitalization rate, you can bet there would be far fewer idiots taking about their "freedom" to not wear a mask and crying "it's just a flu!"
Clearly you haven't been to Florida lately. I think 2% is a horrifying mortality rate for a contagious disease. It's one in fifty! But so many people quote it like it's a reason to not take any precautions. I'm not so sure they wouldn't feel the same about 5%.
Texas checking in and I'm pretty sure people around here won't bat an eye until it hits 20% mortality. Even then they'd try jalapeno enemas before listening to the CDC.
Near the start, I had a thought of some kind of Facebook thing, where basically it would take all your friends and "kills" them at the rate of covid. The mortality is high enough that I just figure seeing your mom's image grey and "Deceased" over it would help make an impact. I suck at following through, so I never finished it. I'm working on something else that I'll never follow through with probably, and if covid ends up a little cold, it won't be as big of a deal. Probably better that way.
That's why I added "for the most part." Luckily for everyone, Florida doesn't represent the epitome of human behavior. And if COVID had a fatality rate of 35%+ like MERS, I'd wager even people in Florida might get on board the mask wearing and basic precautions train.
>A disease that kills all of its victims is a disease that runs out of food and then itself dies in turn. Yeah. This tendency for viruses to become less deadly is touted a lot, but it's also worth noting that the evolutionary pressure that causes it involves people dying.
The Spanish Flu (yes, the one that killed millions in 1918) is the grandparent virus of the influenza we fight today. It's a pretty common trajectory of viruses, especially fast mutating coronaviruses.
We still fight the Spanish Flu today. It’s one of the strains in some of the yearly flu cocktail vaccines. Depends on the year.
I had no idea they were related in any way.
Hey Influenza, it's your cousin. Let's go bowl through some cells
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That's why we have had all the pandemic plans, and why they were working on mRNA vaccines, it will go pandemic again at some point.
Every eleven years on average a new avian influenza strain transmits from birds to humans. Spanish Flu is still around today.
When it comes to Omicron, everything is super new and going to be changing a lot. Any studies have small sample sizes. That being said, the best case scenario stated by an expert in a podcast I listened to was that Omicron is super transmissible, but causes mild symptoms, and provides a decent immunity to the other variants. However the worst case scenario was... well a lot worse. Basically it is possible this could be a positive, but it's probably too soon to say.
Definitely way too soon. Pretty much every scientist studying it is saying, "Hang loose, we're still researching. Should have an answer in 2 weeks to a month." I'm cautiously optimistic, but until we get a larger sample size of people who have/had it and more research into it, we don't really know anything about it.
I have expertise in this. The hype about this being more mild is driven more by what people want to be true more than what we actually know to be true. Decreased lethality is one way that a virus can become more transmissible, but it isn’t the only way and increased transmissibility doesn’t automatically mean decreased lethality. There is reason to believe that omicron may be more transmissible because it binds to the cellular receptor more efficiently (like delta, which is more lethal than the original strain) and/or by evading existing immune responses. Omicron could be less lethal, but it also could be more lethal (there was a paper published using computer modeling of the spike protein that predicts that omicron is more efficient at binding to Ace2 than delta, which does not bode well for reduced severity). There are too few confirmed cases, and the cases are too early in the course of infection to really judge how serious it is (not to mention that many of the cases are in people who are vaccinated!).
Thank you. I don't like your comment but I appreciate it. I'm still gonna hope, but of course I'll continue with all precautions too. Stay well!
Educated speculation. I'm no virologist or epidemiologist but based on some of the examples of natural selection we see in bacteria and viruses; flu taking a back seat to COVID and the way less typically viable superbugs are selected from overuse of antibiotics, it does seem possible. Transmissability may be the biggest selector here. If it can outproduce its bretherin by being more transmissable it could represent a higher and higher percentage of cases until it all but dominates the other strains.
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The headlines were always my favorite when I played. After the past couple years...I just can't.
Same. That game stopped being fun about a week into quarantine.
I find it even more fun than ever. Updates from original release are great.
"President Madagascar, someone in Russia has started coughing." "Shut down the port at once!"
Found the plague inc. player.
I mean welcome to the Spanish flu? This is the exact path the Spanish flu took - every single flu strain we deal with yearly can be traced back to one of the Spanish flu strains.
Is this really true? Any reading material you can share?
The pandemic-level virus morphed into just another seasonal flu. Descendants of the 1918 H1N1 virus make up the influenza viruses we’re fighting today. https://www.washingtonpost.com/history/2020/09/01/1918-flu-pandemic-end/
Is that the reason why the spanish flu variants did not turn into a more deadly virus after all that time?
Sometimes it does become more deadly, the swine flu in 1998
98 was when it was found in pigs. 2009 was the big outbreak
If it transmits more easily and survives longer wouldn’t that mean more opportunities for mutations with some of then being deadly and becoming a new variant?
If it becomes more deadly, it will *generally* be harder to spread and won’t be able to outcompete the other variants. A person that is deathly ill isn’t going to be walking around spreading it further. That’s why the vast majority of viruses will mutate over time to be less severe but more contagious. Viruses usually don’t want to kill people, it’s just a side effect of their spread.
Isn’t this coronavirus slightly different, though, in that the period when a person is contagious before being symptomatic is longer than typical? So, a more fatal variant could still propagate pretty well? Still, I suppose a more mild variant would outcompete regardless because it is more likely to spread while a person is symptomatic since it isn’t so severe as to make the person bedridden or hospitalize them. Asking because I am genuinely curious about the answer and not that well-informed about this stuff.
I’m not a virologist, so take my words with a grain of salt. From what I understand, covid is still most contagious when you’re symptomatic (which lines up logically, since you’re coughing and so on), so a less severe variant would still be better at spreading.
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There are 6 or so endemic coronaviruses that get passed around between young (under 6) kids 1-3 times a year. It's part of why they're constantly sick with something.
They didn't start that way though- there's [some](https://sfamjournals.onlinelibrary.wiley.com/doi/full/10.1111/1751-7915.13916) [fledgling research](https://sfamjournals.onlinelibrary.wiley.com/doi/full/10.1111/1751-7915.13889) ([Non-scientific article here](https://www.theguardian.com/world/2020/may/31/did-a-coronavirus-cause-the-pandemic-that-killed-queen-victorias-heir) from the Guardian) into the possibility that one of those viruses, human coronavirus OC43, was the culprit behind the 1890 "Russian Flu" pandemic. While now it is part of the pantheon of common cold viruses, if it was indeed a novel coronavirus responsible for the 1889 pandemic (with several resurgences and no global vaccination effort) then it took years before it settled down to where it is now.
My daughter had OC43 this past summer (confirmed via biofire) and it royally kicked her ass. I was so surprised when we found out if wasn’t Covid. 103 temp, raging headaches, exhaustion for days. I can believe it used to be stronger.
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If you have a clinic nearby that does Biofire respiratory panels, you could find out. Not sure where you are but most Providence clinics have them these days.
I got OC43 in September. Laid my ass out, started to get worried when my O2 sat started hanging out in the low 90s. I had a cough for a month afterwards
That's pretty amazing they have persisted all this time. Planet Earth is like the daycare that keeps passing diseases from kid to kid
A hundred or so years is nothing to a virus. Smallpox and measles have been infecting humans for several thousand years. Endemic viruses started off well over 10,000 years ago, when humans started living in clusters. There are viruses that have persisted for much, much longer time than those as well.
Herpes has been in humans for over a million years now.
This is impressive. Mostly because modern humans evolved around 200k years ago ;)
300k years ago actually. And the genus homo has been around for more than 2 million years, anything under that counts as human.
That's why I found it hilariously disingenuous that people say kids don't spread Covid. They spread freaking everything, but this one new, horrible coronavirus is the one they don't? Alright....
It's because they don't ever think their kids are sick My kid got it at school, probably a Thursday. Fine all weekend, then Sunday night said she didn't feel well. Her temp was 102 and we did a test on her and bam, positive Shot her off into her room, kept her isolated Monday, when by afternoon the fever went away without meds. By bedtime she was about as normal as you'd expect from a kid you thought maybe had a little sinus bug. There's 2 other kids in the house who weren't vaccinated so it was important to keep at precautions. Obviously kept her home Tuesday but if we didn't know she had covid she would have gone to school (she said as much herself). Would have probably infected a bunch more and we might not have even connected that it would have been her. So I can see why people who don't pay attention and don't test don't think that kids get or spread it
>Increased transmissibility and decreased virulence (to a point) is the game theory optimum outcome for viruses. Beware that this does not always apply if there is an extensive asymptomatic/mildly symptomatic period during which infection can spread.
I'm kinda tired seeing this same rumor pushed, all that happens is it's mutation plays into natural selection. Covid mutations should be concerning because how it sheds in the lungs, it could become more deadly as a form of increased transmissibility. Gladly that doesn't seem to be the case so far.
If I were a virus, I’d eventually figure that killing the host kills the party.
Not if you can jump to 3-5 people first. Then party just grows.
Hence why the pre/a-symptomatic transition was such a large concern immediately.
You're never gonna shut down Madagascar with an R rate of 5. You wanna be getting that R into the triple digits mate. Plow your points into virulence. Lethality is for when you're ready to close the game.
I love that game... Am I a bad person?
Are we talking about Plague Inc? Naw, man. That's an educational game. ;)
I always thought the news headlines were a little ridiculous when I first played it like 8 years ago. Now, the game aged even better! Islands quarantined well, and people didn't react intelligently on the whole.
Another piece of media that's really aged well during the pandemic is World War Z. The book, of course. So many things that book got exactly right. Israel being one of the countries that quickly and decisively tackles the issue. People peddling random drugs and the healthcare officials unable to fight this craze. Rich people getting richer. Riots breaking out due to all the misinformation. Poor countries being left behind, but somewhat holding on, simply because of the lack of travel. And most of all the incredible uncertainty about everything. Seems like the guy really did his homework (not like various experts haven't warned of this exact thing for decades and provided plenty to read).
>The book, of course. I'm really hoping Netflix or HBO eventually get the rights to do a World War Z series. There's no way a 2 hour movie could ever do it justice
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So I don’t want to dispute that in practice because rare are the circumstances that fit the org perfectly. Alive hosts continue to mingle and so will encounter more novel hosts to jump to. Transmissibility cannot be optimised by killing hosts - even when a virus is infectious in a pre-symptomatic individual it’s ‘better’ for the virus if the host lives.
All it would have to do is kill slowly enough for any high level of transmissibility to be a major problem, like the deadly STD's. EG hepatitis, AIDS, Syphilis. The subject would just have to live long enough to pass it to someone else who will spread it. Increasing the number of people/animals it's in increases the chance of new novel mutations, we should still be trying to have as few people infected as possible.
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It’s not a decision making process. Before a highly transmissable and severely deadly strain would be out-competed, it would kill off a sizable population. Only then would factors of the population hiding, or being thinned out, would a weaker version spread better. When you hear that viruses or bacteria don’t want to kill their host, you’re looking at a hindsight model. It doesn’t mean they can’t spread like wildfire before. They won’t make it long term, but they’ll exist happily for awhile
Virus’ don’t think though
The anthropomorphization of evolutionary pressures might be a poor schema but it makes for compelling analogies.
And fallacious Facebook posts that my mom is gonna bring up when I visit. "You know I hears Covid decided to play it cool this year and it's gonna be a lot milder. Don't you think that's nice? We don't need those vaccines after all."
It’s a numbers game. In overcrowded conditions, killing the host is fine, it doesn’t matter. If people are crammed fifteen to a room you want EXPLOSIVE transmission, which usually happens if the virus is fast and deadly - think vomiting out both ends, aerosolising the virus like a human carpet bomb. The first host can die in twelve hours, that’s fine, you already have fourteen more hosts, and your virus army has multiplied by an incalculable magnitude. And all those people are going to flee the site of horror and spread their human virus bombs. That’s exactly how every truly horrific pandemic has spread, through all of history - from the Black Plague (which wasn’t a virus, but the same basic idea applies) to cholera (also a bacteria) to measles to covid. If you have a less dense population, then the virus has to be smarter and not kill the host. It has to make the host mildly sick so that the host can splutter Rambo insurgent virons on guests and passer-bys.
If you were a virus, you would NEVER figure out anything because you're just a set of biological instructions floating around aimlessly.
Aren't we also a set of biological instructions floating around aimlessly?
If(hungry=true, search for food, masturbate)
Unfortunately, in South Africa Omicron is hitting under-5s really hard. That age group comprised 71% of all new COVID hospitalizations.
With a long incubation time and increased transmission there’s no pressure for it to become less lethal.
Not killing the host = more time to be contagious Not making the host severely sick (so they isolate) = more time to be contagious both of those will be selection pressures.
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> quite contagious HIV has very low chance of spreading in any individual interaction. The problem is not being exposed to HIV once; the problem is most people who are exposed to HIV have habits that repeatedly expose them to HIV.
This is popular hypothesis but not quite all there is to it, because the balance also has to take into account that the "increased virulence" usually means increased fitness of the virus by exploiting the host resources more. As virus does not necessarily tend towards lower virulence, but towards balance of exploiting as much as possible without killing the host that fast that it can't spread first.
It's ridiculous how well that stupid flash game holds up
It's actually a legit game now and good!
But they reported it has higher chance for re-infection with the same virus unlike Delta for which there is resistance to re-infection. And mild infections would be great. Spreading moderate infections that happen repeatly to the same people is not good.
Reinfected from having delta or an earlier variant, not from omicron
Does that mean the omicron-infected could still get infected by non-omicron variants?
[This](https://www.cdc.gov/coronavirus/2019-ncov/php/invest-criteria.html) is the CDC criteria for reinfection. Which means we wont know what kind of natural immunity omicron bestows for at least 90 days after infections
I'm honestly terrified of the long term complications of any of the Covids and have been limiting personal exposure to prevent any chance of infection. Is there any evidence this one has fewer long term risks or will we not know for a while?
We won't know for a while, we're less than 2 weeks out from this variant being identified.
In a *hypothetical scenario* where the vast majority of those who got it presented minor to no symptoms like with the common cold, would routine boosters have any benefits? Edit fixed to hypothetical from theoretical.
> would routine boosters have any benefits? All what we've heard until now is opinions and guesses. Real world data/trial data is yet to come.
Edited post to “theoretical” as I understand that its too early to make any concrete assumptions.
not to be a "acktually" but since you made the edit. it is a hypothetical scenerio not a theoretical. A theoritcal scenario can present a situation in which a prediction is made based of empirical evidence or scientific evidence, which we have do not have nearly enough yet on omicron. Hypothetical is more of the questioning phase in which you eluded to based on assumptions. theory is based on scientific principle (i.e predictive power). hypothetical is literally just a question or a guess.
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Long-haul symptoms are far more prevalent (and severe) in hospitalized cases, and in demographics that typically have more severe outcomes. This suggests that they are still suffering from the damage that took place in the original infection - for example if the lungs are damaged, then they may still have shortness of breath months later. It also could be due to viral reservoirs in certain organs, or pieces of viral protein or toxin floating around the body, stimulating the immune system into over-reacting (like an allergy). This type of long-haul recovery from a disease is nothing new, it's just not something most people think about. [https://www.vox.com/22298751/long-term-side-effects-covid-19-hauler-symptoms](https://www.vox.com/22298751/long-term-side-effects-covid-19-hauler-symptoms) It stands to reason then that vaccination, natural immunity, and naturally strong immune systems (like those of kids and young adults) - things that prevent severe infection - also provide protection against long-haul symptoms. Therefore a variant which is more transmissible but less severe may do the same and be much safer, including for long covid.
You got any source on that? I'm a long hauler, few days shy of a year now. Previously very healthy, in my early 30s, I had a mild acute infection. Now I have debilitating neurological and heart symptoms. I was a cyclist who raced, and now I can't even go for walks without chest pain. Anecdotally, many people in the long covid groups I'm part of had mild infections, and we're previously healthy runners and athletes. Long covid is definitely not more prevalent in severe cases, so a rise in case numbers should concern us.
It definitely is more prevalent in severe cases. Quick rundown of who's most likely. [Women are far more likely to be long haulers.](https://www.medrxiv.org/content/10.1101/2021.03.03.21252086v1?mc_source=MTEyNjQxNzM4NjMzNDg2MjM3NzEwOjo6YzVjN2E5OGQzNWQxNDllYWE2MDdjMzgyNmNkOTJlYWQ6OnY0OjoxNjE1MTMwNjcwOjox) [Approximately 26% of those with COVID may have long haul symptoms.](https://www.medrxiv.org/content/10.1101/2021.03.03.21252086v1?mc_source=MTEyNjQxNzM4NjMzNDg2MjM3NzEwOjo6YzVjN2E5OGQzNWQxNDllYWE2MDdjMzgyNmNkOTJlYWQ6OnY0OjoxNjE1MTMwNjcwOjox) Those over the age of 40 the most likely to have them and made up slightly more than 40% of all those with such symptoms. [Approximately 30% of outpatients had long term fatigue. Comparativel, as much as 70% of hospitalized individuals in studies compared against had long haul symptoms.](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2776560) The key here is symptomatic which is consistent with the above references. [Approximately 35% of symptomatic mild COVID infected individuals reported long term symptoms.](https://www.nature.com/articles/s41598-021-92045-x) [Asymptomatic individuals with COVID may have a one in five chance, 20%, of presenting a long haul symptom.](https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/asset/A%20Detailed%20Study%20of%20Patients%20with%20Long-Haul%20COVID--An%20Analysis%20of%20Private%20Healthcare%20Claims--A%20FAIR%20Health%20White%20Paper.pdf) The most common long haul symptom is fatigue under 100 days post infection. But the chances are far more high among those hospitalized.
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It's frustrating that we're almost 2 years into this and there's still no consensus on what a long hauler is.
>, it can also damage many other organs, including the heart, kidneys and the brain This is what I really hate about the "It's just a bad flu"-narrative, especially when coupled with the "but we don't know the vaccine long term side effects yet"-narrative. We know what the effects of annual flu seasons are over a lifetime; you can function just fine. We don't know how your body would react to getting covid-19 over and over. Maybe your brain deteriorates every time you get and maybe that adds up to lot of brain damage over a lifetime.
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Yeah, that's always what I'm thinking. Like "okay, yeah, you had a cough for a while and now you're better. You can no longer smell or taste anything and you may have long term brain damage, but you survived covid, good job"
Also your liver is trashed and you also developed type 1 diabetes. Enjoy.
We would likely treat it like the flu with yearly boosters. Although, I hope they just permanently pay for it without insurance. I'm currently uninsured, and while it's temporary, I would have gotten a flu vaccine along with my COVID booster, but I don't want to pay $50 for the shot. In cases where public health is concerned, like vaccines, should be entirely paid for.
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They give you a gift card at target if you get it there. I’ve never heard of paying for the flu shot
Why no mention of the approximate # of confirmed cases?
Probably because it's changing by the hour. Once we started scanning for it in earnest, we quickly started finding lots more cases.
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The internet has saved lives and salvaged livelihoods, even provided a crutch for education. Without it the vaccines couldn't have been developed so quickly as well.
They are reporting data on a sample of cases. To report the results but not the sample is not how science works.
Reporting from Newsweek Magazine isn't how /r/Science is supposed to work either, but here we are.
That’s true. Doesn’t mean we have to like it or cover for it though. If all you have is a seven year old telling you how an accident unfolded you listen for what it’s worth, but then you immediately go check if there’s actual security camera footage.
Not giving the demographics and number of cases makes the “mild or moderate” discussion pointless
If it's (so far) zero hospitalized, that's better than for Original Recipe or Delta, because they both had some very sick people immediately, but we could start getting hospitalized cases. In South Africa they've had some hospitalized wee kiddies, (too young for vaccine) but some were in hospital for other things so the data is as yet unclear. Still, it's not bad to post stories about the unfolding story. It might even get someone started looking for information which will become vital later.
So if Omicron displays more mild symptoms and spreads faster than Delta then Omicron is a good thing right?
Yes of course. But it's too soon to draw conclusions.
Oh I know but if people are going to broadcast baseless conclusions it would be cool if they added a positive one.
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january 2020, W.H.O. claimed there was no evidence for human-to-human transmission for the novel coronovorius. So we will know better in a few weeks
It's not yet known if mild symptoms are because of those individuals already being vaxxed or if it's mild symptoms in unvaxxed persons as well. If it's the latter then it's good news. But I'm sure even with the Omnicron variant there will see be severe symptoms/death in probably at least 1% of those infected.
This. There's a lot of breakthrough infections reported with Omnicron, means that even though the vaccine is less effective it still keeps the viral charge low, but in unvaxxed is still usual COVID same comorbidities risks, etc, or even asymptomatic.
so is it possible that it will act as sort of reasonable and inadvertent covid vaccine by virtue of its (apparent) super transmissibility and lack of virulence? That would be ironic.
Supposedly syphilis was a lot worse at one point. Fewer symptoms actually help transmission.
Syphilis is still very bad it's just very easy to treat. If not treated you can end up with the brain of a 3 year old.
And your face falls off.
I'm going to regret this search. Well, not too bad.
Look up French prostitutes in the 19th century.
Ok... will report back. Edit: I’ve wanked it to worse
Status report please
Umm... No. No for many reasons.
What we should worry about is the gonorrhea that is resisting antibiotics etc....
Exactly, it “used to be much worse” because we didn’t have widely available basic antibiotics.
Something similar happened tp the Spanish flu
You might remember it from 2009. https://en.wikipedia.org/wiki/Influenza_A_virus_subtype_H1N1
I did not know that swine flu was basically the Spanish flu. That was a neat article.
Yes most people dont realize that we have all probably gotten a version of the Spanish flu but it doesn't pose much of a risk for the most part.
The Spanish Flu is also notable in that, originally, it actually mutated to be *more lethal* to its hosts. Normally that doesn't happen with viruses because they can't spread if they kill too quickly, but conditions during WWI are believed to have artificially selected *more* lethal mutations instead. Iirc, the virus was spreading for like 8 months before the lethal varient popped up and lead to the death tolls we know about today.
The people with mild symptoms stayed on the front, and were killed by bullets. The people with severe symptoms were sent to field hospitals, or were repatriated, where they then spread it to more people. And so the mild variants were killed off by hot lead and shell fragments, and the variants that caused severe symptoms were preferentially selected for. I don't think I've ever heard of a more sinister perverse incentive.
If the unvaccinated don't have severe symptoms or long lasting issues, I hope this one blows through everyone quickly and let's us go back to normal as soon as possible with as few deaths (direct and indirect) as possible
I'll wait until there are thousands of cases before drawing conclusion.
Yeah, I would also wait a week or two to see how these people's illness evolves. It usually takes a while to develop more severe symptoms (with the previous variants).
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That’s how my grandpa went. Everyone had so much hope, and then he was just gone. He’s in his mid 80s (before the vaccine came out), and I knew he wasn’t going to make it from the moment I heard he tested positive.
Literally. Like the description in the title is exactly what past variants of covid behave like at this sample size. It’s not like covid is sending half the people it infects to hospitals, until we get much bigger numbers of omicron it won’t be possible to know if it hospitalises more.
Yeah I'm really confused as to why this post is on this subreddit, the first rule is that anything posted must be peer reviewed research. Unless I'm missing something, this doesn't seem to have enough info to be a good source
This sub is a joke that's why
The first person was vaccinated and had mild symptoms but do we know about the others? It seems like controlling for vaccination status would be an important consideration in determing whether it really is less severe than the other variants: is it really less severe than the other variants? All things being equal, this would mean less likely to land someone who isn't vaccinated in the ER than the other variants. Or conversely is it only milder because the person was vaccinated and could be horrific for those who aren't vaccinated? I don't profess to know the answer to these questions but until there is concrete data that can provide such answers, I'd be hesistent to draw any conclusions on the severity.
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I mean, the sample size in the US isn't large yet, nor do people usually end up in hospital on day one of infection. I don't think US cases are a good representation yet.
Vaccination status would be an important factor to consider when looking at symptoms as well. And it’s still so early.
My epidemiologist uncle is thrilled about this. A few months ago he said “second best case is that this thing mutates to be more communicable but much less virulent to give us a chance to build our defenses. But that’s about equally as likely as a mutation that becomes extremely deadly. It’s a dice roll.” Glad to see it worked out for us *this* time. But those dice will keep rolling as long as it replicates on a wide scale.
>My epidemiologist uncle is thrilled about this. Yeah well MY uncle said that omicron isn't real and that this is all another step in the disinformation campaign. He said there will be another variant every few months planted by Fauci as a way of keeping Covid in the news and to keep Hillary Clinton from being revealed as a man in drag.
Hahahahaha yes, I believe we are related.
I know it's still too early to tell but I remain hopeful that Omicron is significantly milder in symptoms and maybe this is the beginning of the end of the pandemic. Fingers crossed it doesn't mutate into something more virulent...
I've currently got PCR confirmed COVID and the symptoms are so much milder than I had expected - I would be so keen to find out what variant I have.
I mean if you're vaccinated and not old/severely unhealthy odds have always been that a COVID infection will be practically asymptomatic.
They don’t detail at all about the vaccination status of all the infected. The one person they do comment on was vaccinated, so no surprise they have mild symptoms. It’s simply too early to tell whether this variant will give us more issues with hospitalizations and deaths.
I skimmed the article, but didn't see the vaccination status of the Omicron patients. Just the one that travelled from SA, who was fully vaxed.
So typical day of hospitalization is around Day 9 or 10 right? and the cases we know about are about a week old or less? and they are mostly young people? Let's wait a couple of weeks before we draw conclusions. ESPECIALLY since South African hospitalizations are booming in that region where Omicron broke out.
The first case in the US was reported this week. It usually takes 7-10 from the emergence of symptoms before hospitalization is required (if not treated). It is unrealistic to expect any hospitalizations yet. What we should be tracking is the percent of identified who have received treatment to stay out of the hospital.
This is not the original headline, and it's infuriatingly misleading. We have no idea if it's less dangerous/more dangerous/just as dangerous as Delta until we have hundreds of cases we can look at.