I’m scrambling between the Ukraine war, this absurd story of Matt Shea and the Ukrainian “orphans” in Poland and our membership drive (please become a member … it’s important!!!). But for a couple days I’ve been meaning to do a short post on the signs that COVID is coming back. Yep, I don’t mean to bum you out. But yeah. Not necessarily another wave. But a rise off the levels we’ve been relieved to have in recent weeks. One sign of this are increasing signals from wastewater analysis around country. They’ve started tipping higher in most of the country. (If you’re not familiar with this it’s what it sounds like: analysis of sewage for COVID levels. A bit icky, yes, but also a fascinating and incredibly important tool since it’s not dependent on testing levels or behavior or symptoms. It’s a critical early warning system.) Numbers have also been going up rapidly in Europe, which is often a precursor for rises in the United States.
As far as I have been able to learn there’s no clear sign of any new variant. There is Omicron’s subvariant BA.2, which most evidence suggests is somewhat more contagious. It’s growing at the expense of Classic Omicron. But not that fast. The biggest driver seems to be the rapid and dramatic reduction of non-pharmaceutical interventions. People have stopped wearing masks. They’re socializing indoors. Almost inevitably that will lead to more cases. Not necessarily wildly more cases but still, more cases. Much of the vaccinated and boosted country has come to the conclusion that this is the right balance given the relative non-severity of COVID in the vast majority of cases for the vaccinated and boosted. It is also important to remember that while daily mortality numbers are still quite high case levels are now quite low in most of the country. So if there’s an uptick it would be an uptick from a pretty low low.
I don’t think this is any reason to panic or necessarily change behavior. I think you know the risks and are making decisions on the basis of your own risk comfort. I say it just as a heads up.
One place where things seem quite different is in East Asia and especially in Hong Kong. For two years Mainland China has been pursuing an extremely successful zero COVID policy. The costs to civil liberties and human autonomy have been vast. But COVID levels have been super, super low on the Mainland since Wuhan. But now those strategies seem to be wilting under the extreme infectiousness of Omicron. That seems to be the change. Other countries in Asia who’ve done fairly well without the draconian policies in China are also seeing their tools wilt under the extreme infectiousness of Omicron and it’s subvariant BA.2.
But Hong Kong is a different story. What’s happening in Hong Kong is comparable to the initial outbreaks across the world in the Spring of 2020 in terms of spread and fatalities. It’s that bad. Some key drivers are clear. One is that COVID had largely been kept out of Hong Kong, though not as much as on the Mainland. So there’s much less naturally induced population immunity. The key additional factor is that vaccination rates among the elderly are quite low compared to most other countries. As of early March only 15% of the elderly in Hong Kong were vaccinated. As we’ve learned, that’s a recipe for catastrophe and they are in the midst of a catastrophe. The other factor is that those who are vaccinated are mainly vaccinated with the two Chinese-made vaccines. They’re simply not as effective as Moderna, Pfizer, Astra-Zeneca, etc.
Thankfully, there’s no sign anything like that is in the offing in the United States. But the numbers are likely going to start tracking up, at least somewhat. Just have it in mind.