Interstate COVID dashboard: first, preliminary report for the week of January 19

  - by New Deal democrat

In one of his first acts in office, T—-p effectively shut down the entire US public health apparatus, for all intents and purposes turning this country into a third world backwater lagging such developing countries like India and South Africa. 

Despite this termination, a workaround exists by using the combined information generated by the States, many of which still have their own public health “dashboards,” as well as reference to similar statistics still kept by Canada. 

This is my first, bare-bones “Interstate COVID Dashboard” which I hope to update at least biweekly, using the above to estimate the data that is missing due to the termination of CDC information.

For this initial installment, the last CDC estimate of wastewater levels, which somehow did get published last Friday, is still helpful in estimating deaths for the next few weeks, since deaths follow infections by about 4 weeks. In that regard, I should note that - ominously - BIobot has also “paused” its reports due to “maintenance,” which very much looks like it is bending the knee to avoid retaliation from T—-p.

This first, preliminary report only covers COVID deaths and makes use of data generated by a total of 9 States: CO, IN, MA, MI, NJ, NY, OH, OR, and TX. Only 4 of these States have data available for each week for the past 2 years. Some have data for the last year only. One State - OH - lags the others by 2 weeks, but should continue to update. And one - CO - only keeps death *rates* per 100,000 for the past 12 months, but that is still useful for calculating trends. Additionally, I suspect that like the CDC, data for the last few weeks may be preliminary. I will watch over the next few weeks to see if that is the case or not.

With all that out of the way, here is the data:

In week three of 2023, the 4 States which have kept weekly statistics available since 2023, reported 66 deaths. This compares with 79 in week 2 of this year, and 105 in week 1. One year ago in week 3 of the year, these same States reported 238 deaths, a 72% decline YoY. The CDC reported that nationally there were 2,364 deaths in week 3 of last year. This suggests about 700 deaths nationwide in week 3 of this year.

In week 3 of 2024, CO reported 1.8 deaths per 100,000. This year so far it is running at only 0.2 per 100,000, a nearly 90% decline.

A further comparison can be made with this past summer’s wave. At that peak, deaths in reporting States totaled 183. Since we know that infections peaked during the first week of January at a level only 64% of that peak, and per the CDC’s prior reports deaths peaked at 1361 within the next month, that suggests a peak in the next several weeks of roughly 870 deaths nationwide.

Additionally, the last preliminary number reported by the CDC, for the week of January 11, was 445 deaths. Final totals have typically been 2* to 2.5* that number. That suggests the final number for that week will be 900-1100 deaths.

Finally, Canada’s national infection and death data showed that in the past 6 months, the rate of infections has been close to that we know of from the US, i.e., a spike in late summer to 9 deaths per 100,000, and a smaller spike right after the holidays to approximately 6, and only 4 per 100,000 in week 3 of this year. This also suggests a death toll of less than 50% of one year ago; which translated to the US is approximately 1,050 deaths.

Putting all of the sources together, the most likely range of deaths in the US during the week ending January 19 was between 900-1000. Which means that the death toll from COVID during the entire 12 month period through then was about 45,000-46,000.

Finally, as I wrote at the outset, this is a preliminary, bare-bones report to show proof of concept. Several of the States I already checked also publish updates on variant proportions, wastewater data, and hospitalizations. So I hope to expand this report to include that information. In the meantime, I hope that any readers in “Blue” States, or at least States with Democratic governors like KY, who previously discontinued their data reporting, will contact their representative and other officials and ask them to reinstate their respiratory disease dashboards.

For Indigenous Peoples’ Day: on the centrality of mass migrations to human history

 

 - by New Deal democrat

I just finished reading Susan Wise Bauer’s “The History of the Ancient World,” which in a little under 800 pages summarizes an almost endless string of kings and battles from the earliest written records kept by the Sumerians around 3000 BC through the accession of Constantine as Roman Emperor in 306 AD. 

It is timely to consider it in reference to Indigenous Peoples’ Day in the US, as what both have in common is the centrality of big migrations of humanity to conflict and the rise and fall of civilizations. The migration of many millions of people primarily from Europe, but also some from Asia, and also the involuntary importation of slaves from Africa to the Americas, is one of the largest such displacements ever, but large movements of people have been going on since the dawn of humanity, and continue now (as, for example, the migrations from Latin to North America, and from North Africa and the Middle East to Europe) - and with similar problems.

Indeed, the history, and indeed pre-history of humanity seems largely centered on such migrations.

About half a year ago I completed and reviewed “The Dawn of Everything,” an extensive review of human prehistory for the past 30,000 or so years, contrasting it with Yuval Noah Harari’s “Sapiens.” Here is a little of what I wrote then:

“Why did “civilization” begin? I think Harari has the better argument. Graeber and Wengrow think that civilization drives population growth; but the evidence is most consistent with the reverse causation, i.e., population growth drove the necessity for more organized and permanent food production, and for denser and permanent  living arrangements. Harari notes just how exponential long term human population growth has been. Only 2500 years ago, during the golden age of Athens or the first Chinese dynasty, human population was only about *1%* of what it is now.

“In any event, [“The Dawn of Everything” makes] a good argument that historically the default government for most human populations hasn’t been dynasty or autocracy, but rather small-scale Republics, with pre-set rules and public participation (Vindication for John Rawls!).”

Bauer picks up just about where “The Dawn of Everything” leaves off. The latter uses archeology and anthropology to sketch what human civilization looked like before writing came into use. Bauer explicitly uses writing as her dividing line between pre-history and history. She starts with, and almost exclusively bases her narrative upon, written records, the first of which were made by the Sumerians about 5000 years ago. Because she explicitly limits discussion to those cultures with written records, there is no discussion of life in the Americas, Australia, or sub-Saharan Africa, nor of the northern tribes of Eurasia. Rather, the focus of the book expands as the use of writing expands, from ancient Mesopotamia to Egypt to India and China, then to the Jews, Greeks, Macedonians and Romans.

I do wish she had partnered with an archeologist, because apparently what ancients most wrote about (probably paid by their sovereigns) was the rise of and battles won by their kings, and the losses of everybody else’s kings. Cities are founded, rise, apparently prosper, and then are seized, sacked, or razed, in some cases such as Babylon many times over (one Assyrian goes so far as to not just raze Babylon, but to divert river water through the remains to turn it back into the swamp it was before it was founded. And then within 100 years it is built again). One is left to wonder why humans continued to found, and live in, cities, since they were such targets for the kingdom next door. Presumably because they were better than the wandering, nomadic alternative for most people. They must have been *relatively* prosperous and secure. A fuller fleshing out from the available archeological evidence would have been a very welcome addition.

But among the ceaseless battling, rising, and falling, there are some overarching themes in “The History of the Ancient World:”

1. There have always been large migrations of humanity.

2. They seem to be driven by both increased population and climate change.

3. Also because, in groups, humans are a**holes.

Almost all of these migrations during the period examined by Bauer are from the north. Wandering tribes found kingdoms to the north of China, northwest of India in Central Asia, in the Caucasus mountains, Asia Minor, Macedonia, and north of the Alps, and then migrate - or at least attempt to migrate - south into the “more civilized” established polities. The only instance of a threat from the South during the entire 3300 year period covered by Bauer is when the Nubians of modern day Ethiopia attack an Egyptian dynasty to their north.

Bauer does allude to climate change, partly in terms of the ability to practice agriculture in certain areas, and partly as to changing coastlines over time, e.g., the gradual increase in the size of the northern Persian Gulf, the flooding of the freshwater Black Sea, and the isolation of Great Britain from the European continent. There is also an element of over-farming, as ancient fields in the Tigris and Euphrates plains gradually salt up and fail.

But this pattern of migrations and invasions from the North is so universal that there is likely a dominant explanation. Perhaps the warming of the climate over time allowed for a *relative* bigger population increase in the sub-Arctic areas. And that increased population had to spread out somewhere. Indeed, the population on the island of Crete became so dense that 1/2 of those just reaching maturity were chosen by lot and ordered to leave the island on boats to found colonies elsewhere. The more established and fertile lands to the South seem to have been the answer - and created endless conflict as those established civilizations sought to keep the northern invaders out. And if they didn’t, they too migrated, as when some Phoenicians allied with the biblical Jezebel fled to North Africa and founded the city of Carthage. Or when the Goths and other Germanic tribes fled south into the Roman Empire in response to the Vikings’ incursions south from Scandinavia.

Also, the increased population gave rise to larger and larger empires, as successful systems of bureaucracies evolved.  The first recorded empires covered northern Mesopotamia and north and south Egypt. Similarly, the first big kingdom in China only covered a portion of the northern interior. But by 300 AD, three large empires span the Eurasian continent from west to east: Rome, Persia, and China; and the Silk Road moved money and goods among them.

There is very little evidence of peaceful co-existence, or absorption of the new settlers into existing society. When population pressures get too much, or when a faction is subject to repeated violence, they leave, and try to re-settle in areas at a sufficient distance away to avoid contact with their former neighbors. I.e., in societal groups, by and large humans are a**holes. Shades of Trumpists today! 

When successful, these conquests give rise to new civilizations, such as the Hittites of Asia Minor, or the Bactrian Greeks (from Alexander’s conquests) in eastern Persia, and northwest India. And of course, the same explanation for the migration of European religious minorities and those seeking new fortunes to the Americas after 1492, founding a new civilization and displacing and committing near genocide against the existing inhabitants, the Indigenous Americans that were honored by the holiday yesterday.

One final note: we owe a historical debt of gratitude to one ancient nerd in particular: the Assyrian King Ashurbanipal of Nineveh, in what is now northern Iraq, who reigned from 668-626 BC. Apparently alone among ancient monarchs, he made the collecting and copying all sorts of written clay tablets from across his empire a priority. These included “spells, prophecies, medical remedies, astronomical observations, stories and tales (including … the ancient hero Gilgamesh).” These were all put together in an imperial library at Nineveh, which according to Bauer held “almost thirty thousand tablets.”

Just like every other civilization, ultimately Nineveh fell, and was put to the torch. But unlike papyrus scrolls, such as those thousands destroyed in the burning of the library of Alexandria in Egypt, when clay tablets are burned, they turn to brick stone. Buried in the rubble, they remained largely intact, to be discovered during an archeological excavation during the 19th century. And available to historians like Bauer and ultimately to us, an empire of the mind that forms most of the written record of what we now know about the ancient civilizations from the beginnings of Sumeria 5000 years ago.

Coronavirus dashboard for September 19: no, the pandemic is *not* over

 

 - by New Deal democrat

Contrary to the statement by President Biden last night, the coronavirus pandemic is *not* over.

First, here’s the long term look at infectious particles in wastewater by Biobot, compared with confirmed cases:

Levels of COVID in wastewater continue to be as high as at any point before last winter’s original Omicron onslaught. And confirmed cases are at levels that were moderate - but not terribly low - before Omicron as well.

Hospitalizations have decreased by slightly over 1/3rd, from 46,000 to 30,000, from their peak in June, but are not as low as they were in summer 2020, summer 2021, or this past spring:

Where there is a definite abatement from earlier times during the pandemic is in deaths:

In the past 6 months, deaths have generally averaged between 300 and 500 a day, and are presently a little over 400 This is lower than at any previous point during the pandemic except for June and July 2021.

Deaths among the elderly continue to be about 3/4’s off all deaths from COVID:

But the mortality rate for hospitalizations due to COVID has declined dramatically:

Weekly excess deaths have waned to an extreme minimum:

Together, these statistics suggests that a large share of people who die from COVID are the elderly who were already in poor health with compromised immune and other systems, who likely would have died from other causes in the immediate future.

Although I won’t bother with a graph, it is also true that the likelihood of dying from COVID skews heavily in the direction of those who are either not fully vaccinated, or are entirely unvaccinated.

Meanwhile, the CDC has updated its variant information. A  week ago there appeared to be an anomalous increase in the original BA.2 variant. When we last saw something like that, it turned out that it was really new variants BA.4&5. and for the first time in several months. This has been the case again, as several new variants are making headway:

The two new variants that have appeared in the analysis are BA.2.75.2 and BF.7, also known at BA.5.2.1.7.

BA.2.75.2 is a subvariant of a strain that originally caused an outbreak in India several months ago. BF.7 is one of the many subvariants of BA.5 that have appeared globally. While I haven’t found a lot of analysis of the two in the past several weeks, I did find this:

The below article on the progress of BA.2.75.2 and BF.7 in other countries compared with BA.4.6 in particular states:

GISAID data shows that in many other countries where BA.4.6 has made significant inroads, it quickly faded in the face of another heavily-mutated new Omicron variant, dubbed BA.2.75. It was first sequenced in May in India, where it has spread rapidly.

In countries like Spain, Germany, the U.K., Ireland and Italy where BA.4.6 initially made way against near-uniform dominance by BA.5, BA.2.75 has beat back both of those predecessors and become dominant.

 The article quotes biology Professor Tom Wenseleers of the Catholic University of Leuven, Belgium (author of the above tweet), who stated: 

Omicron BA.4.6 was short-lived: virtually everywhere it will be outcompeted by the fitter BA.2.75 & BF.7 / BA.5.2.1.7 that emerged in the meantime.

In short, the pandemic is by no means over. At the current rate of 400 deaths daily, there will be nearly 150,000 deaths annually from COVID. And at the rate of 300,000 new infections per week, about 1/3rd of all Americans will be infected during the year.

If you go maskless indoors, you are likely to catch COVID sometime soon. Depending on your age, the state of your immune system, and vaccination, your outcome will be better or worse. Yes, the pandemic is gradually transitioning to an endemic disease. But by no means are we there yet.

Coronavirus dashboard for July 22: the BA.4&5 wavette has (probably) peaked

 

 - by New Deal democrat

No economic news today, so let’s update the COVID situation.

As of yesterday, nationwide (dotted line below) cases declined slightly to 123,000. Cases have been slightly elevated from their previous 100-110,000 range for several weeks, but appear to have peaked. Deaths (sold line) rose slightly to 429, and are roughly 100 above their average for the prior 3 months:

The above graph for the past year shows that the death rate per infection has steadily declined, particularly when you take into account the massive number of cases in the past 6 months where people rely on home testing and so the cases are never confirmed (probably around 2.5x the number of confirmed cases). Note that since the beginning of February almost 6 months ago, the US has weathered the BA.2, BA.2.12.1, and now BA.4&5 variants without a big (compared with original Omicron) increase in cases, and in general the case levels have been below even Delta at its peak. Nor did any of the new variants in the past 6 months substantially increase the number of daily deaths.

Cases in all four census regions of the US are either flat or declining (the West, thanks to California):

That isn’t just the case for the US. The below graphs by Trevor Bedford for various countries all norm deaths to infections at 1:1 for the initial 2020 wave. In all countries there are many multiples more infections for each death by now:

The situation isn’t quite so good as to hospitalizations, which have continued to rise in the US, to 45,200:

Dr. Eric Topol has highlighted a study out of Denmark that found worldwide higher hospital admissions due to BA.5, indicating it has more pathogenicity:

In the US, this may also reflect that most seniors have failed to get their second booster shot, so their protection has been fading even as the evidence has accumulated of the effectiveness of a second booster against this variant.

Speaking of variants, BA.4&5 constituted 91% of all new cases in the US by last Saturday, the remainder being almost all BA.2.12.1:

There was not much variation regionally:

Globally the BA.4&5 wave appears to have peaked in the large majority of big countries, and I suspect we are at or just past peak in the US (note: wastewater reporting has not been updated in the past 9 days, so it’s impossible to confirm with that data). In South Africa, where BA.4&5 first appeared, cases actually are currently *below* their pre-Omicron levels.

Finally, BA.2.75 continues to appear in more countries on an isolated basis, with no evidence of any waves outside India. If it proves to be a damp squid, the US could get another respite.

Coronavirus dashboard for July 11: BA.4&5 now over 80% of cases without creating a new wave, as COVID heads toward endemicity

 

 - by New Deal democrat

The CDC’s variant proportions data for this past week is out, and it shows that combined BA.4&5 made up slightly over 80% of all infections. BA.5 was at 65%, and BA.4 at 16%. BA.2.12.1 now only makes up 17% of all cases:

Regional disparities among the variants have all but disappeared with the slight exception of the Mid-Atlantic, where BA.4&5 make up a slightly lower percentage of cases, and BA.2.12.1 still makes up a slightly higher percentage:

The 12 week view of confirmed infections and deaths shows that the two new variants have almost completely supplanted both the original BA.2 variant as well as BA.2.12.1, but without giving rise to any new “wave” of increased infections or deaths at all:

Cases have been in the range of 100,000-110,000 for over 8 weeks, and deaths in the range of 275-350 for 10 weeks.

[Note: Oklahoma had a big data dump of deaths a few days ago; without that deaths would not have increased at all in the past week until yesterday, which was likely a result of comparison with non-reporting on July 4 one week prior.]

There has been plenty of information that, due to home testing, confirmed cases are undercounting actual cases by a large amount. But when we turn to BIobot’s graph of nationwide wastewater testing results, we see that, while “actual” cases as indicated by wastewater are 2.5x the number of “confirmed” cases, the trend of the two is similar:

In other words, between mid-May and the end of June, there was no increase in cases whatsoever. Since then wastewater has indicated that cases have increased by roughly 10%.

Since cases have almost always peaked by the time a variant reaches 90% of the total, which is likely to occur in about one week, BA.4&5 are not likely to be creating so much of a wave as a ripple.

The longer term view of deaths (solid line) compared with cases (dotted line) continues to show that each new variant has resulted in fewer deaths compared with cases than the previous variant:

Similarly, below is a graph from Trevor Bedford, an epidemiologist who has been invaluable in estimated the impact of each variant as it has appeared. The graph shows that new variants are appearing with more rapidity, and is replaced by the next variant at lower levels of penetration by the previous variant:

What I see is a disease heading towards endemicity. Last year I was hopeful that, between vaccinations and previous infections, some approximation of herd immunity would be reached and the disease would fade into the background. Instead it is clear that the disease is evolving towards the ability to repetitively infect survivors.

Consider the following: if the first line defense of the immune system, antibodies, fade over (for example) 6 months; and there are two similarly infectious variants beginning to circulate; then the variant that is least like the variants circulating in the past 6 months is the one that is going to predominate. Because the variants most like the ones circulating in, say, the last 3 months, are going to be most susceptible to being neutralized by existing antibodies still active in peoples’ immune systems. The variant least likely to be neutralized by those antibodies, vs. antibodies that have already faded away over time, is the one that is going to take over.

And so we see a fairly rapid turnover of variants; but on the other hand, because B-cells and T-cells are relatively permanent, those lines of defenses are increasingly able to blunt serious disease among those whose immune systems are not weak or compromised. So the death rate is much lower than before, but remains concentrated among the elderly (of course, those elderly most susceptible to COVID probably already died of it in 2020 or 2021).

The next variant of concern appears to be BA.2.75, which started in India in May and has spread to many countries since, but has not yet become dominant in any other country. If it follows the pattern of BA.2.12.1 and BA.4&5, it will take over dominance in the next several months, but there will not be a big spike in the number of infections, as had been the case in 2020 and 2021.

Coronavirus dashboard for July 5: no sign of a BA.4&5 wave in cases yet, as the next variant has appeared in India

 

 - by New Deal democrat

I haven’t done a Coronavirus dashboard in a couple of weeks, and there have been a few developments, so let’s take a look.

First of all, the BA.4&5 variants continue to increase their share of infections in the US, now at 70% of all cases:

Regionally, BA.4&5 are most prevalent in the South Central States, including Texas, where they make up 75% of all cases; vs. the Northeast and Mid-Atlantic regions, where they make up just short of 60% of all cases, with BA.2.12.1 almost all of the remaining 40%:

Although there has been some alarm among the medical punditry, cases have not significantly increased at all from their 100-110,000 range established back in March. As of today, the seven day average of cases is 102,400, and only once in the past 4 weeks has the average exceeded 120,000. Similarly as of today deaths average only 276/day in the past week, in line with their range since the beginning of May as well:

Some of today’s particular data has to do with lack of reporting over the 4th of July holiday weekend. Nevertheless even before the weekend the trend was flat.

But if BA.4&5 haven’t made a dent in cases or deaths, they absolutely have caused a continued rise in hospitalizations:

Hospital admissions bottomed in early April at just over 10,000. They appeared to be plateauing in June at roughly 30,000, but in the past two weeks have climbed to over 36,000.

This suggests that BA.4&5 are more severe than BA.2 or BA.2.12.1 were, but that medical treatments for more severe cases are much better than they were one year ago, thus preventing any significant increase in deaths.

Although I won’t bother with a graph, in South Africa where these first variants appeared, the upside of the wave lasted 3 weeks with a quintupling of cases, until those variants constituted 90% of all cases; and then the wave rolled all the way back out over the next 5 weeks. Deaths followed with roughly a 2 week lag. Notably there was no BA.2.12.1 wave in South Africa during the spring.

At their current rate of growth, BA.4&5 are going to constitute 90% of cases in the US in only about 2 more weeks. Wastewater site Biobot shows no nationwide increase of cases through June 29, and regionally cases actually decreasing in the South and West, and only increasing in the Northeast:

The worst case scenario may be represented by Texas, where BA.4&5 infections are at the highest level of any region in the US. In that State cases and deaths have both tripled, with deaths lagging by about 2 weeks, just as in South Africa, suggesting that these variants are more virulent than BA.2 or BA.2.12.1:

A tripling of cases nationwide would be roughly 350,000 cases at peak. But Texas, like South Africa, never had that much of a BA.2.12.1 wave, and that seems to make a big difference.

Thus, because the rest of the nation has not followed this trajectory, a more conservative trajectory might be that in the next few weeks perhaps cases increase to 140,000-150,000 per day. But based on current nationwide evidence they may even remain in their current range and never increase beyond 120,000.

And then what? By now I have come to expect that continued mutations that optimize transmissibility will continue to appear. Since BA.4&5 are well into their course, I went looking to see if the next variant is on the horizon.

And it is. Variant BA.2.75 appears to have begun in India, and is now spreading to other countries such as New Zealand. According to local medical authorities in India, it is the most transmissible variant yet. That’s presumably what we will all be dealing with this autumn.

Coronavirus dashboard for March 28: I’ll take the “under” for the severity of any BA.2 wave

 

 - by New Deal democrat

Very few US States reported over the weekend. The decline in new cases has stalled at roughly 30,000 per day. Deaths are still declining, and currently just below 800 per day.

Since the BA.2 variant continues to generate new headlines, with just about everybody warning of a new wave in the US, let’s take a look at what actually happened in Europe (and remember: there was no new BA.2 wave in South Africa, the Philippines, India, and a number of EU countries where BA.2 took over from BA.1 early).

BA.2 started a new wave in Europe beginning in the last week of February through the first week of March:

A week or two ago, the poster children for Europe’s big outbreak included countries like the UK, Germany, Belgium, Austria, the Netherlands, and Greece. Here’s what they (plus the other major countries of Italy and Spain, plus Portugal), look like now:

Declines everywhere. Italy just peaked earlier during last week, and the UK probably did as well (there was a data dump last Monday which will go out of the average tomorrow).

Here is where BA.2 is still increasing in Europe:

In short, four weeks after Europe’s BA.2 wave started, cases are already declining everywhere except France, Ireland, Luxembourg, Cyprus, and Malta. The last 4 countries have a combined population of 6.5 million. There may be a few small countries I’ve missed, but they wouldn’t materially affect the result.

Last Tuesday, the CDC reported that the BA.2 variant was a majority of new cases in the Northeastern Census region, 40% along the West coast and the upper Midwest, and 30% or below everywhere else. Here’s what cases in the US Census regions look like as of now:

Remember that the appropriate comparison with the CDC report is cases one week ago. Since then, the percentage of BA.2 infections has probably risen by about 15% (but we won’t know until at least tomorrow). One week ago cases were flat to declining everywhere except for the Northeast, where they were up 10%. Cases are still declining in the West, flat in the Midwest, and rising in the South and Northeast now.

For the EU as a whole, cases rose 50% from their bottom since then, and appear to have peaked in the last week. In the US, that would translate to 45,000 cases per day in about 2.5-3 weeks. The worst case countries saw their cases roughly double, which in the US would be 60,000. I’m more inclined to go with the former estimate than the latter.

And since, as of now, there is no new variant on the horizon, I expect a fast decline from peak just as we are seeing in the European countries now.

Coronavirus Dashboard for March 21: the likely course of BA.2 in the US

 

 - by New Deal democrat

[Note: I am having a major issue with formatting photos today, which will be readily apparent. I will fix this as soon as I am able.]

This is the second part of my discussion of the likely US trajectory of the BA.2 Omicron subvariant. Part one was Friday, and if you missed it, here is the link.

First, a brief update. Cases in the US are now slightly below 30,000. This is the lowest since last August except for two days after Thanksgiving. Deaths have declined to 866. If deaths, like cases, decline over 96% from their Omicron peak, that will mean there will be only about 100 deaths per day in about a month.

To quickly refresh, there have been many warnings about the new BA.2 wave which has overtaken much of Europe, specifically including the UK, and warning that the same is in store for the US. 

The truth appears to be more complicated.  As I wrote on Friday, “the data she has collected demonstrate that BA.2 is very much an Omicron, rolling in and out like a tsunami. Like BA.1, the BA.2 variant causes peak infections by or very shortly after it approaches 100% of all infections.” To cut to today’s chase, the course of BA.2 in any given area depends on the level of previous infection by BA.1:

- Where BA.2 overtook BA.1 very quickly, there was only 1, more intense and longer lasting, wave. 

 - Where BA.2 only overtook BA.1 after a long time, there were relatively few people left who BA.2 could reach, resulting in a “long tail” of declining cases, but no new wave.

 - Only where BA.2 overtook BA.1 after its peak, but - probably because of better mitigation efforts - there were lots of people left who BA.2 could reach, has there been a new wave. The 

Let’s start with the 26 countries in the EU. Like me, you’ve probably seen the graph showing cases rising sharply in some EU countries. Here’s what the entire Union, plus the UK, looks like:

1. There are a number of countries in the EU - Norway, Sweden, Denmark, Poland, Lithuania, Latvia, Estonia, Hungary, Bulgaria, Czechia, and Spain - where no increase has happened at all, and in fact cases are decreasing.

2. There are 15 countries where cases bottomed and started increasing between February 24 and March 9, the majority of which were between March 1 and March 3.

3. Of those 15, 6 - Ireland, Belgium, the Netherlands, Cyprus, Finland, and Portugal - appear to have already peaked, generally about 2 to 2.5 weeks after the increase began. Their increases varied but generally were in the range of a 75% to 100% increase from a low level (I.e., don’t freak out over the percentages).

4. That leaves 9 of 20 European countries still increasing, less than 3 weeks after the new “waves” began. In several of those - the UK, Germany, Austria, Greece - the rate of increase appears to have slowed substantially. In the remaining 5, notably in France and Italy, the wave is continuing in full force.

So let’s be clear: BA.2 has not started a new “wave” everywhere. And where it has caused a new wave, it appears to be short, as in 2 to 4 weeks from trough to new peak.

Like Friday, I am indebted to Emma Hodcraft, Ph.D. of the Institute of Social and Preventive Medicine at the  University of Bern, Switzerland, on whose data of infection prevalence by variant for many countries and for all jurisdictions in the US is found at Covariant.org, for the below information, including graphs.

Let’s start with Scenario 1: Where BA.2 overtook BA.1 very quickly, there was only 1, more intense and longer lasting, wave.

Here is a graph for Denmark, in which the BA.2 variant almost completely replaced BA.1 no later than the end of February, after only a short time (about 1 month) during which BA.1 was dominant:

 

Now, here is the graph of cases in Denmark:

As you can see, the uptrend lasted longer than in most countries. But Denmark has had an uninterrupted downtrend since.

Similarly, here is her graph of the US territory of Guam in the Mariana Islands:

 

And here is Guam’s case graph (note that Guam only peaked at the end of January, and its peak lasted 3 weeks, vs. the shorter, sharper peaks in states that will be discussed below):

G

Similar trends occurred in the Nordic countries of Sweden and Norway, and in India and the Philippines.

But perhaps the poster child for this is South Africa, which famously was the first country in which BA.1 was identified. The wave lasted a slightly longer time, but was supplanted by BA.2 two months ago:

Here are cases for South Africa:

South Africa hasn’t experience a new wave, either; just a “long tail” of a slow decline in cases which remains significantly above their level before BA.1 struck.

This brings us to Scenario 2: Where BA.2 only overtook BA.1 after a long time, there were relatively few people left who BA.2 could reach. A good example of this is Spain:

Spain’s experience with BA.1 has lasted over 3 months, and BA.2 is only gradually taking over:

Here is Spain’s level of cases:

Spain is still experiencing a slow decline, with no sign of a BA.2 wave, even though BA.2 currently makes up over 1/3rd of all cases.

Next, let’s look at Scenario 3: where BA.2 overtook BA.1 after its peak, but - probably because of better mitigation efforts - there were lots of people left who BA.2 could reach, has there been a new wave.

This is best demonstrated by one of the present scary examples, the UK. According to the most recent UK government data I have seen, BA.2 accounts for 90% or more of all new COVID infections. It should be essentially 100% within about a week. Here is the relevant graph:

And here is the UK’s case count:

Here is the week over week change in average daily cases:

As you can see, the rate has slowed already in the past few days. In the last 5 days, cases are only up 10%, vs. 50% 5 days ago.

In other words, the countries of Europe where there is a new, identifiable BA.2 wave are ones where the BA.1 wave did not last as long, or was not as intense, as others. BA.1 had peaked, but had not yet burned through the vulnerable population.

In contrast, the original Omicron wave began in the UK only about 5 days before that in the US. But the UK’s peak began 8 days before the US, and lasted only about 6 days before beginning a sharp decline, vs. 15 days in the US:

And here is the US’s graph of the prevalence of BA.1 and BA.2:

BA.1 hit hard and lasted 3 months before BA.2 started to kick in. In other words, the US’s graph looks closest to Spain’s, where there has been no BA.2 wave, just a long tail of slow decline.

Let’s look at a few US States. BA.2 is already a majority of cases in Connecticut:

After a brief uptick almost two weeks ago, Connecticut has fewer cases than at anytime except for summer 2020 and summer 2021.

Currently BA.2 is running over 33% in NY:

New York has begun to show an increase in cases over the past week:

Finally, here is Florida:

BA.2 has barely begun there, and cases continue very low:

Put this together and I am expecting BA.2 to result in an experience between that of the UK and South Africa: an increase in cases, but not so pronounced as in the UK, where cases doubled in the first half of March. Once BA.2 becomes virtually 100% of all US cases, probably around late April, cases will recede again.