This week felt like we finally lost the plot as a country, where our basic reality has split into groups who can't even see the other side.

There has always been a small but vocal group of people who pushed back against every measure to prevent spread. Today it seems like we're closer to 50 / 50 on the split of "Covid is over" and "Omicron is different."

Schools are showing this split across the country. In Chicago, the teachers union voted not to go into classrooms until more safety measures are taken. This was done with no notice, infuriating parents who had hours to find child care. In response, the mayor and superintendent have stated that teachers will not be paid unless they are in the classroom. I doubt this will be resolved before a few weeks leaving parents and students in the lurch once more.

In contrast, one school district in the Bay Area sent a note to parents that said they would no longer be issuing exposure notifications. The district was receiving so many that a parent should just assume that if they sent their child to school, their child was exposed to Omicron every day. In-person teaching would continue unabated.

All sides believe the other is denying the science. Everyone is angry. There is not a single correct answer in any of this.

This is against a backdrop of a record-setting number of cases and Covid hospitalizations.

In three days [Wednesday, Thursday, Friday], ~2.4 million Americans tested positive for Covid. This doesn't count at home rapid tests or the many people who couldn't access testing. Last week I said that I thought at the end of the week 25 million people would be infectious; seeing this data, I think that's a pretty accurate guess. Over 10% of the entire country likely contracted Covid last week.

This week we set a new record for patients hospitalized for Covid. Last night, it was over 130,000 patients and expected to continue to grow for some time. The only good news is that ICU admissions are not [yet] at a record. However, even regular hospital beds filling up takes the space and resources needed for the rest of the population. Worse still, due to the high infection rate of Omicron, if you break your arm and go to the hospital, you probably will now have a broken arm and Covid.

As I expected, we're starting to see serious effects of so many people catching Covid. Due to illness or mandatory isolation after a confirmed case, many industries struggle to provide basic services.

Vail ski resorts deal with a historic labor shortage [a combination of the great resignation and Covid cases]. Only 1/3 of the runs at some of their top resorts are open. In SF, 600 teachers were out early in the week due to confirmed Covid cases. Hospitals around the country are reporting labor shortages due to infected staff.

The grim good news is that the Omicron wave can't go on that long because it'll run out of people to infect. Scott Gottlieb, former FDA commissioner and on the board of Pfizer, says looking at the data, Omicron waves look to be about two months. This would suggest that New York will peak in the next two weeks and most of the rest of the country in the next four weeks.

Larry Hogan, the governor of Maryland, said that 92% of MD is vaccinated. The remaining 8% account for 75% of the people in the hospital. This is true across the county, but we have a lot of unvaccinated/unboosted people as a country. The next few weeks will continue to have extremely high case counts and significant stress on the hospital system.

The FDA asked Moderna to increase the enrollment of its vaccine study in children under 5, which will significantly delay a vaccine approval. This, combined with the poor initial read-out for Pfizer, means that we might have a vaccine for under 5-year-olds at the earliest in May. I know this is crushing news for parents with small children.

Emily Oster had a post from two weeks ago that included a portion on the risks of Covid for young children vs. other diseases. I've summarized some of the stats here:

In a given year, the risks for disease in young children are as follows:

RSV hospitalization risk for children under 6 months old is 2 in 100
Vomiting / Diarrhea hospitalization risk for children under 5 is ~0.3-1 in 100
Flu hospitalization risk for children 0-4 years old is ~0.75 in 100
Covid hospitalization risk for children under 5 [no comorbidities] is ~0.84 in 100

Early research suggests that young children are not suffering from long Covid. Still, as with all Covid research, we don't have any long-term data.

To be blunt, I don't know how anyone can protect their young kids from getting Omicron between now and a vaccine. I also think that most adults will also get Omicron in the coming months.

That said, I do think there is value in not getting it during the peak because initial viral load matters, and if there are complications, the hospitals won't be overloaded. But that said, I know that keeping kids /themselves isolated for weeks isn't an option for most. As with a lot during the pandemic, my only advice is to do your best in your circumstance and just understand there are no good options here.

Misinformation and fear-mongering abound. This week we had reports of a combo Delta / Omicron strain, called Deltacron, out of Cypress. After some breathless reporting about it, some scientists who looked at the information concluded it was just contamination. There were also some other fear-mongering reports about Flurona, where people are sick with flu and covid. This is not unexpected nor new; people have had co-infections since the beginning. We just didn't see many confections last year because, with the measures we took against Covid, we basically didn't have a flu season last year. As of today, I am not tracking any other variants that concern me.

The reality is that for the average person who is vaccinated and boosted, it's never been a safer time to contract Covid. The reality is also that our hospital system and services will be stressed at a level they have never experienced. All of the issues we are having deal with the collective problem vs. the personal one.

I don't expect any discourse or policy to become unified in the coming weeks. We will be experiencing two realities, each trying to impose their will on the other.

Personally, I'm still avoiding indoor bars and restaurants. I still am willing to hang out with friends if we all test beforehand.

As always, if you have any questions or concerns, feel free to reach out.

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