Happy New Year! Buckle up for a rough two weeks.

We are now setting records for the number of Covid infections per day. Even then, due to issues with testing, we're likely greatly underestimated the number of infected. The seven-day average for hospitalized patients is about 85,000 people as of Friday. Our peak from last winter's wave was about 50% higher. I suspect we will surpass that number in the coming week or so.

The pressure on essential services will define the next few weeks. Over the last week, thousands of flights per day have been canceled due to Covid positive flight staff. Restaurants across the country are closed due for the same reason. Hospital workers, cops, and firefighters are all professions that the CDC is worried about.

We're about to witness the most extensive mass spread epidemiological event in American history. The average time to be infectious with Omicron is three days. Millions of people attended large New Years' parties and contracted it on Friday, and three days later, they'll be back at work and school. We were already at an all-time high, and the spread next week will create a truly unprecedented number of infections. Some estimates predicted that 25 million people could have active infections by this Friday.

Due to the holiday and weekend, we won't have a good feel for how bad things are till Tuesday or Wednesday at best.

This week the CDC became so worried about critical services breaking down due to staffing shortages they changed the guidance on how long people need to isolate. Now they ask that you isolate for five days instead of ten if you test positive. The reality is that plenty of people are still infectious on day five, and a rapid test would detect it. The CDC isn't asking people to test because, due to the CDC's own direct actions, we don't have enough available testing.

This reminds me of early in the pandemic, and the CDC stated that masks weren't effective when they knew that masks were necessary. They told that lie to the public to help preserve masks for the first responders who needed them. No one believed their lies and bought masks, so the CDC burned their reputation and didn't solve the problem.

The bottom line is that rapid tests are incredibly effective. If you have gatherings or have had Covid using them, it will significantly diminish the chance of spread.

I watched Don't Look Up this week, and as someone who has been writing a Covid newsletter for most of the pandemic, there were indeed moments that felt all too real.

Yes, Omicron is less fatal, but it is far more infectious, resulting in more people being sick and dying. 50,000+ people will likely die in January alone [as many in a month as the worst flu season]. Some hospital systems are already rationing care, and more will in the coming weeks. You're best positioned for a mild case if you've been boosted, but only 20% of the US population has gotten a booster. Additionally, hospitalizations for children are up significantly.

I'm not advocating for lockdowns or any of the more extreme measures. Still, it seems like many people in the US aren't willing even to acknowledge that there's a widespread infectious disease in the air. We should have rapid tests available everywhere. We should encourage those who can work from home for a week or two. Cloth masks don't cut it; everyone should be sent N95's. At risk, populations should be encouraged to be extra careful for the next few weeks. The Pfizer antiviral will be game-changing, but it's not widely available and won't be for a few weeks. Schools should all have HEPA filters in every classroom.

The "it's just the flu" crowd blow my mind. Flu is bad enough we do an annual shot campaign! Even with those shots, the flu can kill 50,000 people in a bad year! People in good health can get the flu, have a horrible case, and have effects for weeks [if not longer]!

Let's be clear. If I have a holiday party and you know you have the flu and come and infect a bunch of people, I will no longer invite you to my parties!

This week did bring good news as well. Omicron likely increases immunity against Delta, which strongly indicates that Delta will be eliminated. There were worries that we could end up with both strains active, one more infectious, one more fatal. Omicron becoming the only strain greatly helps us fight the overall epidemic.

Researchers this week also continue to show why Omicron seems to have innately less fatal. It can't infect the types of lung cells that cause extreme damage as easily. This is good because some concerns were that it was just less severe due to prior immunity, which will wane.

Over the next week or two, I don't plan to visit any indoor restaurants or bars. I'm ok hanging out with friends indoors but having everyone use a rapid test beforehand. I had planned for this to be a more meditative few weeks, so the change isn't significant for me, and I understand most people aren't in that position. The reality is that I think this wave will crest soon, mainly because Omicron will run out of people to infect. I assume I will get it at some point, but I'd rather not contribute to the stress on the medical system and essential services. Also, the amount of viral load you get when you get infected is probably important, so there will be less in the air post wave.

If you haven't gotten your booster or regular shots, I encourage you to get them. It can still make a difference, even today. As always, if you have any questions, please reach out.

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