I continue to travel, and I continue to make travel plans. But I’m doing the best I can to use miles whenever possible, and book cancellable itineraries. The next couple of months couple be touch and go. I’m not making a prediction of what happens, but I live my life on probabilities and make the best decisions I can given the knowledge I have at the moment. And right now I’m giving myself as much optionality as possible.
What I’m really saying is that many people seemed to have calmed after the initial scare over Thanksgiving about the Omicron variant, when they still seemed to think banning travel from South Africa could somehow prevent it from spreading (it was already spreading in the U.S. at that point). And I don’t think we’re really internalizing what the next couple of months could (not will) look like.
I stress could because we still don’t know exactly what to make of Omicron. But we’ll only know what to make of it when it’s already happened, so…
- We know it spreads incredibly rapidly, with some estimates of doubling every 2 days
- We know that it infects people with immunity from prior infection and vaccination
- We know that it seems to hospitalize fewer people
- And we know that early indications are it’s already peaked and is in decline around Johannesburg where it was first identified.
Confirmed #COVID19 cases in Gauteng 🇿🇦 now on a decline, having peaked at case incidence of ~67 new cases per 100k, ~90% of delta wave peak, and currently showing a halving time of ~11 days 📉#Omicron #OmicronVariant #Gauteng #Covid_19 pic.twitter.com/XLQbHZ1XaI
— Ridhwaan Suliman (@rid1tweets) December 18, 2021
Omicron has taken over in the U.K. and Denmark. It’ll likely be the dominant variant across Europe next week, though the European CDC predicts early January. In the U.S. we already don’t have enough tests, we do a lot more sequencing than we used to do but not nearly as much as the U.K. and Denmark. It’ll be here in a dominant way soon enough.
Even if the variant is less severe, and even with all of the background immunity in the community, the sheer number of infections could still overwhelm hospitals. The hope of course is that South African data which suggests the hospitalization rate for Omicron is 1/10th (~2%) that of Delta (~20%) holds.
Even so with the flu shot especially poorly matched to the virus actually circulating this year there could be extra hospital stress there, too. In the Northeast and California, your kids may be going back to Zoom School.
Maybe it comes on quickly and ends quickly. It’s unclear why things seem to be turning there so quickly, maybe everyone was infected already (and it was subclinical, no testing) or maybe not everyone is susceptible, maybe it runs through a connected network and there’ll be another wave. But when it infects 1% or more of a population every day, it can’t keep going for that long mathematically unless immunity to the specific variant doesn’t last.
- Most of us will wind up fine. Especially if we’ve been boosted. But infect enough people and the total number of people not fine will wind up very large. And at this point we’re not preparing for that, with policies that are mostly to be able to make excuses later (‘see? I tried’).
We’ve effectively given up on the idea of a variant-specific booster before the big wave comes, even for the most vulnerable populations. Dr. Fauci says it’s only something the FDA might consider if the effectiveness of boosters drops below ~ 50%. And it hasn’t done that. Of course once it’s already done that it’s too late.
I’m boosted. I continue to travel. I live in Central Texas so I continue to dine outdoors. I was disappointed to learn that the 1/10th (3 microgram) dose being tested for children under 5 doesn’t produce a robust enough immune response, so we’re months further from being able to protect children, who of course are at lower risk than adults from the virus.
Given the risks here the questions for travel are,
- What new border restrictions might be put into place, such that you won’t be able to visit?
- What new activity restrictions (lockdowns) might be put into place, such that it won’t make sense to go?
- What places will have the greatest concentration of virus, such that they’re beyond your risk tolerance to visit?
It seems like for about the next 8 weeks there’s a ton of uncertainty.