General Discussion/Q&A on Coronavirus (COVID-19)

QF WP

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Some interesting information from an investment fund manager Dr Nick Cameron:

AntipodesPartners said:

Dear QF WP,

Just as the global economy appeared to be hitting its reopening stride it’s been stopped in its tracks with the news of a new COVID-19 variant.

First identified in Botswana, the Omicron variant spread to South Africa where scientists quickly raised the alarm on the 25th November. Initial investigations suggest the variant had been circulating for at least a few weeks. A week later Omicron has been confirmed in 21 other countries, with the first case recently identified in the US. Borders have started closing and social restrictions are being implemented in various countries around the world. With c. 60% of the global population fully vaccinated, the question is where to from here?

For this briefing, there is no better person to discuss the Omicron variant than Dr Nick Cameron – Antipodes Portfolio Manager, who has been on the front-foot of COVID-19 developments since January 2020.


Q. How does the Omicron variant differ from prior variants and is it more transmissible?
The Omicron variant contains more than 30 mutations in the Spike protein – the key protein responsible for the virus to enter/infect cells. While some mutations are known from previous variants the combination of these seen in Omicron plus its many novel mutations is what has scientists concerned. We have yet to encounter a variant with this number of mutations (known and new) in the critical areas of the Spike protein; the fear is that such mutations may render current vaccines less effective.
Data from the Gauteng province in South Africa (home to Johannesburg and Pretoria), where COVID-19 infections are spiking, suggests that the virus may have a transmission advantage - to what degree is too early to assess. Here, Omicron infections have largely been in younger unvaccinated people which generally have milder illness. At this stage, hospitalisations in the province appear muted and most admitted patients are unvaccinated - the vaccination rate in Gauteng is low with c. 40% fully vaccinated. Overall muted hospitalisations growth so far is encouraging, but far from definitive.
Borders between South Africa and many other countries have been open for some time, so it’s not surprising Omicron cases continue to be reported around the world - but it remains unclear whether it is more or less transmissible relative to Delta/other variants.


Q. Will existing vaccines provide protection against Omicron given the number of mutations?
We would not be surprised to see a marked reduction in the efficacy of current vaccines given the large number of mutations occurring in such critical areas of the Spike protein, but how this is reflected in the real world is difficult to predict. We should have more clarity in the next two weeks from laboratory studies.
Current vaccines have “trained” the immune system to look for a specific pattern on the Spike protein and that pattern has changed considerably. On the positive side there are many parts of the Omicron Spike protein that haven’t really changed, and the immune system (T-cells and neutralising antibodies) in the vaccinated and in those that have recovered from prior infection (“natural immunity”) should “remember” these unchanged parts to provide some protection. Importantly, longer lasting T-cell immunity may be sufficient to protect against more severe disease and death, especially for individuals that have both recovered from SARS-CoV-2 infection and been vaccinated.
On the data we have seen so far we’re yet to see evidence to suggest the severity of Omicron will be materially different.
Countries with high rates of vaccination and community infection from prior waves will likely be best protected e.g. US, UK, Europe and even in some emerging markets like India where Delta variant infection rates were very high.
mRNA vaccine makers have already commenced development of new booster vaccine candidates which are specific to the Omicron variant – we could see preliminary lab results in early 2022 and an Omicron-specific booster potentially becoming available in 100 days (subject to positive data and approvals) according to
Pfizer and BioNTech. Moderna is in a similar position.

Q. In the meantime, what can we expect next - back to lockdown?
Even if lab studies show reduced efficacy of current vaccines against Omicron this may not necessarily translate to reduced protection from severe disease in the real world. It could take a few months to collect enough data to determine whether the Omicron variant is a threat to overloading health systems and whether current vaccines and natural levels of immunity continue to provide protection against severe disease.
In the meantime, we expect Governments to push for higher vaccination rates and prioritise booster shots, especially for the at-risk population.
Merck and Pfizer’s new oral antiviral drugs are highly likely to remain effective against the Omicron variant. If taken within the first five days of showing COVID symptoms, these drugs can significantly reduce the risk of hospitalisation and death. This medication is an important breakthrough though initially it’s likely to be reserved for the at-risk. Pfizer expects to produce c. 80m treatment courses in 2022, with another 20m from Merck.
It will be key to closely monitor hospitalisation trends as the measure to assess the threat posed by Omicron, risk of lockdowns, and the potential for another wave of infections as the Northern Hemisphere winter kicks in.

 

Princess Fiona

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We have a black tie dinner next week. And I just bought lipstick. Occurred to me after I paid - what a waste. Masks.
We are going to our daughter’s high school grad dinner tomorrow in Sydney at a function Centre and have been advised that we don’t need to wear masks. It’s also a black tie event.
Kind of surprised me a bit and I’ll be bringing one anyway.
 

QF WP

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We are going to our daughter’s high school grad dinner tomorrow in Sydney at a function Centre and have been advised that we don’t need to wear masks. It’s also a black tie event.
Kind of surprised me a bit and I’ll be bringing one anyway.
I've got my son's graduation from Primary School tomorrow and I'm at the Ashes Test match, so have to hurry straight to school for the dinner. Not a black tie thankfully and no masks, but I'll have one with me in my bag. One can never be unprepared for the unexpected.
 

Pushka

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Your could always order some of the ones they sell for deaf people that have a clear panel over the mouth, so lips are visible ;)
Great idea for the hearing impaired. Must be so hard for them. I feel sorry for the kids who don’t see adults in public smiling at them anymore 🙁

I cannot imagine Sir Ian Botham in a mask. 😂 I’ll let you know how that goes. Assuming it’s not a zoom thing now.
 
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drron

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Some more ways of predicting bad outcomes. first post disharge blood clots.

And helping predict worse outcomes on admission to hospital.

And admission to hospital with Covid increases the chance of post discharge death.
 

tgh

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More than a million cases a day by Christmas Eve

London/UK Times this morning had this headline: “How bad will Omicron get?” with these highlights: “The World Health Organisation classified the B.1.1.529 Covid strain, Omicron, as a 'variant of concern' on November 26. That same day two travellers who had recently returned from South Africa — one in Brentwood, the other in Nottingham — took tests that would confirm them as the first cases in Britain. Omicron’s takeover needed under three weeks. On Tuesday it became the dominant variant in England. London has been an Omicron city since Sunday. For evidence of its daunting growth, look no further than daily case numbers. Since 'freedom day' in July, we have become used to tens of thousands of infections — but last week 59,610 daily cases became 78,610, then 88,376, then 93,045. For months cases were bumpy; now we are in exponential growth, where the language of 'doubling times' takes over. How high will infections get, and when will they peak? And more importantly, how many deaths will follow? Experts warned last week of doubling times as low as two days. The latest figures suggest that there were about 40,000 Omicron cases in England on Tuesday. By Saturday, doubling every two days, that figure would have been 160,000. More than a million cases a day by Christmas Eve

 

Lynda2475

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"A professorial fellow in epidemiology at The University of Melbourne, Professor Tony Blakely, agreed, theorising that the UK's current experience of Omicron may be because its population had AstraZeneca as the primary vaccination course.

"It is highly probable that what [the UK is] experiencing now [with Omicron] will be a forerunner of what happens in other countries," he told the ABC.

"Especially countries that have also used AstraZeneca, as [it's] less effective than the mRNA vaccines at preventing infection with Omicron."

Of course Tony belongs to the Mary-Louise panic brigade.
 

drron

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Lots of rubbish with absolutely zilch evidence being spread even by epidemiologists.
Maybe if it continues to pan out that Omicron is obviously far more infective than Delta but hospitalisations remain muted the article in the Times quoted by @tgh should probably be headed - "How good will Omicron get".
It has been shown by many studies that the most effective cause of immunity is vaccination plus natural infection.
So if the UK does get 1 million cases a day then ther almost certainly be little risk of catching Covid when I arrive in mid March.
Though the boffins here in Tassie are certain I will catch it well before then.
 

Lynda2475

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What % of hospital cases are omicron? By all reports Delta is still what is dominating hospitalizations and ICU, mostly unvaccinated too.

I have zero sympathy for anyone over the age of 12 in Australia, UK, US (places where vaccines readily available) who is not yet fully vaccinated nor for any adult due for a booster who have failed to get one. Vaccines are freely available and anyone refusing to get one, well they cant say they weren't warned.
 

Lynda2475

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find it surprising how little people are talking about boosters here

Getting quite a lot of coverage in NSW, mentioned continually at the pressers and the numbers of boosters given at state run clinics is reported daily.

The number one symptom now is headache and runny nose.

South Africans are reporting "feeling of a weight bearing down on her body, and found herself trying to fight uncontrollably itchy eyes and a drilling headache."

For most Omicron patients, it starts with a scratchy throat.

 
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