You’ve likely seen a lot of reports in recent days about the disease severity of the Omicron wave. From some you hear increasing evidence that the Omicron wave is less severe, maybe much less severe, than previous COVID waves. Others claim there’s no solid evidence Omicron causes less severe disease. Who’s right? Some of the disconnect is differing degrees of caution. We’ve only known about Omicron for about six weeks. How much evidence do you need before you’re willing to say something is more mild, less lethal when probably hundreds of millions of people are about to get it and they need guidance about risk? But most of it is not that. Not anymore. Most of the seemingly contradictory claims are about different kinds of evidence and really different questions being asked.

Back on December 9th we discussed the quickening hunt for a Sarbecovirus vaccine. This is basically a vaccine that wouldn’t target this or that variant but the whole class of SARS-related coronaviruses. Basically the idea is you go upstream in the viral family tree to cover the whole class of contagions and potential future ones. Last night Army researchers at Walter Reed Army Institute of Research say they’ve developed just such a vaccine, or at least one that cover all current and potential variants of COVID19.

It is difficult to write about COVID today without immediately hearing people’s intense often knee-jerk reactions. There are people pushing masking and almost every other kind of restriction. Others with an equal intensity oppose almost any efforts to brace the country for the onset of Omicron. I was reminded of this (as if I’d had much chance to forget) in various conversations about the public schools in New York City this week. I do not put these differing attitudes – or any of the gradations between them – on an equal footing. I lean more to the former category. And, to be clear, I am only talking here about people who are broadly in a reality-based universe: People who have gotten vaccinated and encourage others to do so. People who recognize the horrible toll COVID has taken on the country. But there is a common driver of intensity across that spectrum. Which is that people have reserves of hurt, fear and anger after two years living through a global pandemic. That gets channeled into these reactions. This doesn’t make sentiments any less true. But they’re all powered by an erratic emotional fuel which is a product of the last two years. If you open yourself to it, you can feel it. It’s palpable and not always pretty. Everybody is a bit broken by it, even if their physical health is more or less unscathed.

These numbers almost beggar belief. But here they are. According to a Monday CDC report, 73% of COVID infections in the US are now Omicron. Specifically, that was the percentage for the week ending December 18th. The rate of growth of new cases in the New York City metropolitan area has been mind-boggling. So extremely high percentages of Omicron here don’t surprise me at all. (I’ve heard informally that the rates here are roughly 90%.) But nationwide it almost beggars belief, even though we’ve seen comparable trajectories in the UK and Denmark.

Here’s the chart from the CDC …

We’re getting a bit more sense here of the final blow up that led to the demise of the BBB. Apparently the real blow up was that the White House put out a statement last week in which the President said he believed he was making progress on finalizing a Build Back Better deal with Joe Manchin. The key apparently was that he named Manchin specifically rather than Manchin and Kyrsten Sinema or Manchin and the rest of the caucus or whatever else.

There will be various efforts to organize votes on individual parts of the BBB as demonstration votes. Yes, Manchin did say “this” legislation. So there will be various efforts to interpret this as a prelude to other possibilities or just another step in the process. But let’s not. This is no. That means the Build Back Better bill cannot and will not pass. I’ll note that Manchin decided to make this announcement on Fox News. And according to Ryan Lizza, who would know, he didn’t even personally inform the President or Chuck Schumer of what he was about to do. He had an aide make the call. That’s just cowardly, low class.

The White House just released this statement from Jen Psaki. While not saying it directly the statement very clearly says that Manchin has not been honest with the President, hasn’t been negotiating in good faith and has gone back on his promises to the President.

Keep an eye on an emerging discussion about the apparent peak of infections in Gauteng province in South Africa. That is the region where Omicron was first discovered and where its spread first caught fire. (We don’t actually know where it originated.) I don’t want to characterize what this means because I know nothing. But even the people who know a lot don’t appear to have a clear idea what it means. I note it here because even though it’s not clear what it means it does seem to be different enough to what was expected to require some explanation. And that explanation could deepen or change our understanding of what Omicron is.

Professor Shabir Madhi of University of the Witwatersrand notes that Omicron crested after 4 weeks compared to 8 weeks for the earlier two waves. In his thread Madhi provides other tentative but encouraging numbers on disease severity. But it’s the apparent plateau that seems to have people scratching their heads. Others, including Tulio de Oliveira who did the first lab work on Omicron, suggests caution, pointing to population shifts in Gauteng at this time of year.

Along with vaccines, masking has been one of the most solidaristic parts of the pandemic. If everyone masks up, then everyone’s risk goes down dramatically. That’s true and it should continue to inform our actions. But if you remain risk averse or are from a vulnerable population, you do have options if you live in a community with poor masking or simply want to up your odds. It wasn’t the case early in the pandemic. But today n95 and other related high filtration masks are pretty widely available. Not everyone finds these comfortable. It really depends on the person. I’m used to using them for woodworking and I wear them for long periods of time and don’t give it a second thought. Depends on the person.

Until perhaps as recently as yesterday the assumption was that the current run-up of cases, especially in the Northeast, is actually still Delta. Omicron is still to come. That no longer appears to be the case. We don’t know for certain yet because we don’t have the scope and speed of genomic sequencing that would allow us to know definitively. But the assumption now is that we’re already here, in Omicron. Almost two years into this pandemic we have managed to be at least partly caught off guard by another blowup of the disease.