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COVID-19 2nd wave - Texas only - Stats and such


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So forever we’ve been told hospitalization lags infections by two weeks.  Right now we are told there may be less severe disease with Omicron but we have to wait out that lag to be sure.

As revised by the CDC a few days ago, when is that two weeks up?  It’s starting to feel like a moving target. 

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11 hours ago, CycleTex87 said:

Topped off my vax yesterday.  I’m sitting at the bar waiting on my to-go food talking to a guy, he says “yeah my wife is home sick and tested positive, but I’m negative, yet we sleep in the same bed”.   Am I going to die?

He should be asking who’s fucking his wife?

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59 minutes ago, Liquor and Poker said:

So forever we’ve been told hospitalization lags infections by two weeks.  Right now we are told there may be less severe disease with Omicron but we have to wait out that lag to be sure.

As revised by the CDC a few days ago, when is that two weeks up?  It’s starting to feel like a moving target. 

SA is even further along. This thread is encouraging. The numbers strongly suggest Omicron is not as severe. I think the key stat was median hospital stay duration was half of delta wave.

 

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What’s the vaccinated % in gauteng?  They didn’t parse any vax status data that I saw in that thread. 
 

ignoring that, it seems like the expectation would be the same total number of hospital admits as delta, possibly over a shorter time period, but still ok because the admission to discharge time will be halved.  And better outcomes. 

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43 minutes ago, Pato del Muerto said:

What’s the vaccinated % in gauteng?  They didn’t parse any vax status data that I saw in that thread. 
 

ignoring that, it seems like the expectation would be the same total number of hospital admits as delta, possibly over a shorter time period, but still ok because the admission to discharge time will be halved.  And better outcomes. 

About 30% of the adult population in early December. 

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2 minutes ago, Fondren & Main said:

We’ve got 5 in my family and most of my gf’s family (some on their second round in less than a year) that all just caught this.  Everyone was vaccinated.  Nobody hospitalized or feeling too bad.  My smell is fucked up.  Everything smells like smoky vinegar.

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2 hours ago, Telegraph_it said:

SA is even further along. This thread is encouraging. The numbers strongly suggest Omicron is not as severe. I think the key stat was median hospital stay duration was half of delta wave.

 

Okay, so I'm trying to do some back of envelope math, and I may be looking like this....

confused-math.gif

BUT....Because Omicron transmission is 4X Delta's, BUT, it's hospitalization is .25X Delta's, we end up with a hospitalized population equal to that of the Delta wave.

BUT, then the next number is "severe cases" (which I think should be our REAL metric -- not even hospitalizations, as people are apparently being admitted for monitoring, etc., when they don't have a severe case requiring ICU, vent, etc.).  And as patients are 73% likely to NOT have a severe case (meaning 27% do have a severe case), then we are going to see 1) a hospitalized population as big as the Delta wave, but 2) only 27% of that population will have a severe case.

So, the last data point that I'm missing....what percentage of Delta admissions were severe cases, so we can do an apples-to-apples comparison?  NEVERMIND -- I see it.

66.9% severe disease during Delta

28.8% severe disease during Omicron

So, the 73/37 numbers are relative to Delta's numbers?  Now I really am the confused math lady.

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4 minutes ago, Brisketexan said:

Okay, so I'm trying to do some back of envelope math, and I may be looking like this....

confused-math.gif

BUT....Because Omicron transmission is 4X Delta's, BUT, it's hospitalization is .25X Delta's, we end up with a hospitalized population equal to that of the Delta wave.

BUT, then the next number is "severe cases" (which I think should be our REAL metric -- not even hospitalizations, as people are apparently being admitted for monitoring, etc., when they don't have a severe case requiring ICU, vent, etc.).  And as patients are 73% likely to NOT have a severe case (meaning 27% do have a severe case), then we are going to see 1) a hospitalized population as big as the Delta wave, but 2) only 27% of that population will have a severe case.

So, the last data point that I'm missing....what percentage of Delta admissions were severe cases, so we can do an apples-to-apples comparison?

From the Lancet link:

image.thumb.png.4e43107bfd39af0d0517d2e0284bd3ee.png

 

Omicron (4th):  (133,551 * .049) * .288 = 1,885

Beta (2nd): (41,046 * .189) * .601 = 4,662

Delta (3rd): (33,423 * .137) * .669 = 3,063

 

This is an interesting table at the end of the paper:

image.thumb.png.13b59299c2bd5b12087b75a6b503db0e.png

 

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Thanks.....still trying to sort it out, but I'm honing in on the final numbers for severe disease.

End result was that SA saw 3,058 severe cases with Delta, and 1,276 severe cases with Omicron.  So, in the final metric that matters (severe cases), even though it was 4X more transmissible, it put less than HALF the number of cases that Delta did into the "severe disease" bucket.  So, if those numbers hold true, most places should see something like half the number of severe cases in this wave as we saw during the Delta wave.....am I reading that right?

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22 minutes ago, Brisketexan said:

Okay, so I'm trying to do some back of envelope math, and I may be looking like this....

confused-math.gif

BUT....Because Omicron transmission is 4X Delta's, BUT, it's hospitalization is .25X Delta's, we end up with a hospitalized population equal to that of the Delta wave.

BUT, then the next number is "severe cases" (which I think should be our REAL metric -- not even hospitalizations, as people are apparently being admitted for monitoring, etc., when they don't have a severe case requiring ICU, vent, etc.).  And as patients are 73% likely to NOT have a severe case (meaning 27% do have a severe case), then we are going to see 1) a hospitalized population as big as the Delta wave, but 2) only 27% of that population will have a severe case.

So, the last data point that I'm missing....what percentage of Delta admissions were severe cases, so we can do an apples-to-apples comparison?  NEVERMIND -- I see it.

66.9% severe disease during Delta

28.8% severe disease during Omicron

So, the 73/37 numbers are relative to Delta's numbers?  Now I really am the confused math lady.

The only variable you didn’t mention is I guess speed of the variant as it relates to hospitalizations.   Presumably this wave will have a sharper peak and shorter length based on its transmissibility.  But with the shorter duration of stay average and fewer urgent needs (icu beds, vents, supp ox) it still shouldn’t be too large a burden on the system. 

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3 hours ago, Liquor and Poker said:

So forever we’ve been told hospitalization lags infections by two weeks.  Right now we are told there may be less severe disease with Omicron but we have to wait out that lag to be sure.

As revised by the CDC a few days ago, when is that two weeks up?  It’s starting to feel like a moving target. 

Two weeks to slow the spread.

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2 minutes ago, Brisketexan said:

Thanks.....still trying to sort it out, but I'm honing in on the final numbers for severe disease.

End result was that SA saw 3,058 severe cases with Delta, and 1,276 severe cases with Omicron.  So, in the final metric that matters (severe cases), even though it was 4X more transmissible, it put less than HALF the number of cases that Delta did into the "severe disease" bucket.  So, if those numbers hold true, most places should see something like half the number of severe cases in this wave as we saw during the Delta wave.....am I reading that right?

That is my takeaway. The table is only showing known outcome cases, i.e., discharged alive or died. Right now in all age groups the percent admitted with severe disease is less event though case counts with Omicron is higher. That seems like really good news.

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1 minute ago, Pato del Muerto said:

The only variable you didn’t mention is I guess speed of the variant as it relates to hospitalizations.   Presumably this wave will have a sharper peak and shorter length based on its transmissibility.  But with the shorter duration of stay average and fewer urgent needs (icu beds, vents, supp ox) it still shouldn’t be too large a burden on the system. 

Yeah, I think that's what we're seeing right now.  Initial panic of doctors/hospital administrators based on waves of people coming in (particularly in the NE).  But hopefully it will subside as people are discharged quicker and fewer ICU admissions than what they have all experienced with the past waves.  Also, it seems like there was still a lot of Delta hospitalizations and death as that wave was still working through the NE when Omicron hit.  I wouldn't think much Delta left in Texas taking up hospital space.  

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Oh, and there's one other variable I'd like to see - among severe cases, what percentage is vaxxed vs. unvaxxed?  Boosted vs. not boosted would also be interesting, but keeping in mind that our goal ought can't be "Covid-zero," but rather should be "reduce the prevalence of severe disease to make COVID a social health issue on par with seasonal flu," I think vaxxed vs. unvaxxed is the better metric.

I'd like to know what percentage of the vaxxed population ends up with severe disease during this variant.  Then, we can extrapolate to severe disease burden based on overall vaccination rate.

For example, if Omicron infects X number of vaxxed people, and sends Y number of them to the hospital with severe illness, then we can get a feel for how many people we'd see with severe illness if the population was 50%, 70%, or 90% vaxxed.  And, if we end up with numbers that show us something like "with 90% of the population vaccinated, you would expect to see 500,000 severe cases and 50,000 deaths per year from COVID," then guess what.....COVID would just be "Flu II, Electric Boogaloo."

Which helps us build some real policy goals.  Things like 1) keep pushing vaccinations the best we can, get the overall rate up there, 2) localized outbreak monitoring to take TARGETTED local health measures as needed, 3) normalizing STAYING HOME WHEN YOU ARE SICK (and perhaps, you know, building real and available sick leave for everyone).  Shit like that.  We can then end up at a point where we talk about a good year/bad year of COVID the same way we talk about a good year/bad year of the flu.  Sometimes, it gets bad enough where you need to shut down a particular school for a week, or you need to ramp up hospital staffing and availability, but we have mechanisms in place to do that.  Otherwise, it's another background illness that we learn to live with.  Sometimes you catch it, and feel shitty for a week -- shit, I've lived with that sort of risk my whole life, so has everyone else.  I actually had a nasty cold EARLY in the existence of COVID that we actually posited might have been COVID (it wasn't)....but it still sucked.  Lots of congestion, headache, lingering cough for weeks.  And that shit was just "life."

Turn Covid into just "life," and we chalk that up as a W.

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58 minutes ago, Brisketexan said:

Okay, so I'm trying to do some back of envelope math, and I may be looking like this....

confused-math.gif

BUT....Because Omicron transmission is 4X Delta's, BUT, it's hospitalization is .25X Delta's, we end up with a hospitalized population equal to that of the Delta wave.

BUT, then the next number is "severe cases" (which I think should be our REAL metric -- not even hospitalizations, as people are apparently being admitted for monitoring, etc., when they don't have a severe case requiring ICU, vent, etc.).  And as patients are 73% likely to NOT have a severe case (meaning 27% do have a severe case), then we are going to see 1) a hospitalized population as big as the Delta wave, but 2) only 27% of that population will have a severe case.

So, the last data point that I'm missing....what percentage of Delta admissions were severe cases, so we can do an apples-to-apples comparison?  NEVERMIND -- I see it.

66.9% severe disease during Delta

28.8% severe disease during Omicron

So, the 73/37 numbers are relative to Delta's numbers?  Now I really am the confused math lady.

Ryan Reynolds Wtf GIF

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12 minutes ago, Brisketexan said:

 

Turn Covid into just "life," and we chalk that up as a W.

This.  I think the likely scenario in years to come is we'll end up with an annual booster hopefully hitting mutations that turns this into a cold/flu.  There is still going to be residual risk for unvaccinated and that's going to be their issue.  The big difference between this and the flu is that the flu knocks your ass out so quickly with high fever that there aren't many people heading into work regardless.   Covid just doesn't behave that way.  And eventually we have to get past the point we have all of these testing policies in place (whether for work, sports, school, etc.).   Sure, you can test if you go to the Dr. but if for most kids/healthy vaxed folks you really can't tell the difference between a cold and COVID, we're going to just have to treat it the same way we do a cold (stay home if you feel shitty but no "mandatory quarantine" etc.).  All this shit just isn't going to work long term once we've done the best we can from a natural immunity/vaccine combo where hospitals aren't at risk.   

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9 minutes ago, Skipper said:

we're going to just have to treat it the same way we do a cold (stay home if you feel shitty but no "mandatory quarantine" etc.)

One thing we HAVE to do is change our ethos around "working through an illness." And I have DEFINITELY been guilty of this in the past (pre-COVID).  NO.  If you are sick, stay home (and now that we all know that many of us can work from home, that's more viable).  But for those who can't work from home....we need real, legit sick leave.  If you put someone in a position of "if I don't show up and work, even with my 101 degree fever and nasty cough, I will lose out on money I desperately need to make the rent," then a shitload of them will choose to show up sick.

That's one thing, both in terms of how we think about it socially, AND what we do in terms of actual policy, that would  be a helpful change to come out of this experience.

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We to define what "sick" is.  If I have a fever, I'm usually out for the count.  But other symptoms I absolutely work though depending upon the severity.  Often, I can go for a 5 mile run with a cough and runny nose and not miss a beat.  And, in my mind, if I can go for a run, I can show up at work.

One thing I did not learn until very recently is that 30-50% cases of flu per year are asymptomatic.  Like Covid, do we define that as sick?  We certainly never have because we've never known or cared.

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9 minutes ago, Brisketexan said:

One thing we HAVE to do is change our ethos around "working through an illness." And I have DEFINITELY been guilty of this in the past (pre-COVID).  NO.  If you are sick, stay home (and now that we all know that many of us can work from home, that's more viable).  But for those who can't work from home....we need real, legit sick leave.  If you put someone in a position of "if I don't show up and work, even with my 101 degree fever and nasty cough, I will lose out on money I desperately need to make the rent," then a shitload of them will choose to show up sick.

That's one thing, both in terms of how we think about it socially, AND what we do in terms of actual policy, that would  be a helpful change to come out of this experience.

I agree with that.  What makes post-vaxed Covid tricky is for many people it can apparently be asymptomatic or very minor symptoms. I mean I wondered if I had it last week then saw the Cedar levels and started taking allergy meds which helped.  But yeah, whether COVID, Flu, or bad cold, we need to do better about going to work and sending kids to school clearly sick.

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4 minutes ago, Don Johnson said:

We to define what "sick" is.  If I have a fever, I'm usually out for the count.  But other symptoms I absolutely work though depending upon the severity.  Often, I can go for a 5 mile run with a cough and runny nose and not miss a beat.  And, in my mind, if I can go for a run, I can show up at work.

One thing I did not learn until very recently is that 30-50% cases of flu per year are asymptomatic.  Like Covid, do we define that as sick?  We certainly never have because we've never known or cared.

All good points.  I can "work through" a lot.  Shit, I chaired a heated dispute negotiation quite a few years ago when I KNOW I had ACTIVE flu (fever, everything -- yeah, not my best move, but everyone had traveled to be there, we had one shot....and I got the deal done).  But "can" work through it -- particularly around others, as opposed to WFH -- is different from "SHOULD work through it (and expose others)."

If you KNOW that you are sick (you are symptomatic), and you are within a known or likely window of being infectious for your particular illness, you should avoid contact with others, including at work.  We should have mechanisms in place that make that a viable and responsible choice for more people.

Because of the tricky nature of any given illness, we won't get it perfect.  But we can get it better.

Edited by Brisketexan
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5 minutes ago, Don Johnson said:

We to define what "sick" is.  If I have a fever, I'm usually out for the count.  But other symptoms I absolutely work though depending upon the severity.  Often, I can go for a 5 mile run with a cough and runny nose and not miss a beat.  And, in my mind, if I can go for a run, I can show up at work.

One thing I did not learn until very recently is that 30-50% cases of flu per year are asymptomatic.  Like Covid, do we define that as sick?  We certainly never have because we've never known or cared.

IMO, it's a combination of "sick" meaning that you can't do your work and "sick" meaning that you may get other people sick because you're contagious.

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36 minutes ago, Brisketexan said:

One thing we HAVE to do is change our ethos around "working through an illness." And I have DEFINITELY been guilty of this in the past (pre-COVID).  NO.  If you are sick, stay home (and now that we all know that many of us can work from home, that's more viable).  But for those who can't work from home....we need real, legit sick leave.  If you put someone in a position of "if I don't show up and work, even with my 101 degree fever and nasty cough, I will lose out on money I desperately need to make the rent," then a shitload of them will choose to show up sick.

That's one thing, both in terms of how we think about it socially, AND what we do in terms of actual policy, that would  be a helpful change to come out of this experience.

Luckily the work from home platform is built now.   Employers should be drifting towards the acceptance stage 

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The time to do something to stamp this out was 2 years ago right now. The following 7 months were a shit show globally led by the biggest of shit shows in the US so this is never going away. There's so many people with this new variant I don't see the point in getting tested if you feel sick but not hospital bad just assume you have it and stay away from people. 

Edited by blacklab
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2 hours ago, Hermanator said:

The time to do something to stamp this out was 2 years ago right now. The following 7 months were a shit show globally led by the biggest of shit shows in the US so this is never going away. There's so many people with this new variant I don't see the point in getting tested if you feel sick but not hospital bad just assume you have it and stay away from people. 

But we were somehow surprised by the lack of tests this go-round.   Thought we had a plan 

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Like Brisket said, there definitely is an ethos to change.  I don't think you can mandate it.  It has to be a case by case basis.  There have to be limitations.  There can no longer be any jobs without paid sick leave, but I also don't think that amount should be unlimited if its the type of job that can only be performed in person.  Something like 10 no questions asked sick days.  Anything more or less can lead to abuse, doubts, questioning, resentment, etc.  I once had a job where they just said we don't have vacation or sick days.  You get four weeks off, use them how you need them.  Beyond that, you don't get paid.

On the flip side, if I've flown in for a "heated dispute negotiation" with one shot to work it out, I do expect my attorney there unless he's on his deathbed.  And I imagine he expects himself to be there.  That's just the competitive aspect of business and key players on a team.  Lots of the time, there's isn't a wait until next week to close the deal, sign the contract, make the sale, etc.  Similar to sports.  If Quentin Ewers has a normal cold next year OU week, its expected that he will practice and play through it.  There is no maybe we can reschedule.

Those are ethos I don't see changing, and I personally don't want to change.  In those cases, everyone kind of agrees to accept the risks.

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45 minutes ago, Brisketexan said:

One thing we HAVE to do is change our ethos around "working through an illness." And I have DEFINITELY been guilty of this in the past (pre-COVID).  NO.  If you are sick, stay home (and now that we all know that many of us can work from home, that's more viable).  But for those who can't work from home....we need real, legit sick leave.  If you put someone in a position of "if I don't show up and work, even with my 101 degree fever and nasty cough, I will lose out on money I desperately need to make the rent," then a shitload of them will choose to show up sick.

That's one thing, both in terms of how we think about it socially, AND what we do in terms of actual policy, that would  be a helpful change to come out of this experience.

All of this, and add: if you’re sick, wear a mask if you have to be in public. That should just be common fucking courtesy now. Unfortunately, a whole bunch of assholes decided that politeness and caring for the well-being of their fellow man is tyranny. So the idea that Americans will take basic precautions to prevent infecting other people with whatever ails them is a pipe dream at this point.

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1 minute ago, BrickHorn said:

All of this, and add: if you’re sick, wear a mask if you have to be in public. That should just be common fucking courtesy now. Unfortunately, a whole bunch of assholes decided that politeness and caring for the well-being of their fellow man is tyranny. So the idea that Americans will take basic precautions to prevent infecting other people with whatever ails them is a pipe dream at this point.

If you don’t want to get sick, then YOU wear a mask!

says the group that also worked up a meme about sick people get quarantined, not healthy. 

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5 minutes ago, BrickHorn said:

All of this, and add: if you’re sick, wear a mask if you have to be in public. That should just be common fucking courtesy now. Unfortunately, a whole bunch of assholes decided that politeness and caring for the well-being of their fellow man is tyranny. So the idea that Americans will take basic precautions to prevent infecting other people with whatever ails them is a pipe dream at this point.

For many of us (but far from all of us), this has actually been a change that I think we've adjusted to.  I remember seeing Asian travelers wear masks at various times, and it struck me how at ease they were with it.  Now, having worn one with some regularity in public settings, I realize that it's not a big deal, and I can and should do it too when appropriate.  I think a lot of folks are like me in that respect.  At least, there's some reason to think so.

1 minute ago, Fudge Nuggets said:

If it was my decision to make it would be a no brainer.  Until dinosaur managers wise up it won’t change. 

I am functionally my own manager, and have been for a long time.  And I really used to try to come in and "work through" any illness (usually a cold for me).  Until one time my trusted assistant came into my office and said "you know....when you're sick and you come in, you are just exposing the rest of us, you aren't really taking care of yourself so you can get better, and in any case, you have a laptop -- so why don't you go home?"  The logic was that I shouldn't expose my co-workers, and for me, the only way I get better is with some real sleep, so stay home, sleep in, then put in a 3/4 workday on your laptop....makes perfect sense.

Of course, that's tough when you have a scheduled hearing, deposition, etc., but those don't happen all the time.

1 minute ago, Pato del Muerto said:

If you don’t want to get sick, then YOU wear a mask!

says the group that also worked up a meme about sick people get quarantined, not healthy. 

Again, it's not just inability, but rather angry refusal to do something that's simple, easy, and courteous blows my mind.  I presume these same people wouldn't yell at us and issue death threats if we simply said "hey, could you please cover your mouth when you sneeze/cough in public?"  But ask them to wear a covering for that exact same function, only when they are in public/around others.....and they react like you've herded them into the cattle cars headed for Auschwitz.  It's fucking mind-blowing.

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1 hour ago, Brisketexan said:

One thing we HAVE to do is change our ethos around "working through an illness." And I have DEFINITELY been guilty of this in the past (pre-COVID).  NO.  If you are sick, stay home (and now that we all know that many of us can work from home, that's more viable).  But for those who can't work from home....we need real, legit sick leave.  If you put someone in a position of "if I don't show up and work, even with my 101 degree fever and nasty cough, I will lose out on money I desperately need to make the rent," then a shitload of them will choose to show up sick.

That's one thing, both in terms of how we think about it socially, AND what we do in terms of actual policy, that would  be a helpful change to come out of this experience.

Showing up to work sick is an American right protected by the constitution 

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2 minutes ago, Fudge Nuggets said:

Great.  How does that work out for the other 99.9% of the work force?

Well, for a while, I set a shitty example and expectations.  And then when my assistant slapped me upside the head with reality, the expectations for my working group were similarly adjusted.  So, at least SOME of the folks out there who work for a dinosaur manager (me) know that they are expected to stay home if sick.

I had an ethos.  When presented with the impacts of that ethos, my ethos changed.  Maybe some others can change as well.

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Oh, and there's one other variable I'd like to see - among severe cases, what percentage is vaxxed vs. unvaxxed?  Boosted vs. not boosted would also be interesting, but keeping in mind that our goal ought can't be "Covid-zero," but rather should be "reduce the prevalence of severe disease to make COVID a social health issue on par with seasonal flu," I think vaxxed vs. unvaxxed is the better metric.
I'd like to know what percentage of the vaxxed population ends up with severe disease during this variant.  Then, we can extrapolate to severe disease burden based on overall vaccination rate.
For example, if Omicron infects X number of vaxxed people, and sends Y number of them to the hospital with severe illness, then we can get a feel for how many people we'd see with severe illness if the population was 50%, 70%, or 90% vaxxed.  And, if we end up with numbers that show us something like "with 90% of the population vaccinated, you would expect to see 500,000 severe cases and 50,000 deaths per year from COVID," then guess what.....COVID would just be "Flu II, Electric Boogaloo."
Which helps us build some real policy goals.  Things like 1) keep pushing vaccinations the best we can, get the overall rate up there, 2) localized outbreak monitoring to take TARGETTED local health measures as needed, 3) normalizing STAYING HOME WHEN YOU ARE SICK (and perhaps, you know, building real and available sick leave for everyone).  Shit like that.  We can then end up at a point where we talk about a good year/bad year of COVID the same way we talk about a good year/bad year of the flu.  Sometimes, it gets bad enough where you need to shut down a particular school for a week, or you need to ramp up hospital staffing and availability, but we have mechanisms in place to do that.  Otherwise, it's another background illness that we learn to live with.  Sometimes you catch it, and feel shitty for a week -- shit, I've lived with that sort of risk my whole life, so has everyone else.  I actually had a nasty cold EARLY in the existence of COVID that we actually posited might have been COVID (it wasn't)....but it still sucked.  Lots of congestion, headache, lingering cough for weeks.  And that shit was just "life."
Turn Covid into just "life," and we chalk that up as a W.

Lots of people are already there. Football games, concerts, movies, restaurants, travel, parties are all packed.
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2 hours ago, Brisketexan said:

One thing we HAVE to do is change our ethos around "working through an illness." And I have DEFINITELY been guilty of this in the past (pre-COVID).  NO.  If you are sick, stay home (and now that we all know that many of us can work from home, that's more viable).  But for those who can't work from home....we need real, legit sick leave.  If you put someone in a position of "if I don't show up and work, even with my 101 degree fever and nasty cough, I will lose out on money I desperately need to make the rent," then a shitload of them will choose to show up sick.

That's one thing, both in terms of how we think about it socially, AND what we do in terms of actual policy, that would  be a helpful change to come out of this experience.

Yeah, this. Before this fucking pandemic, one day I’m at the office and there’s somebody sneezing and coughing. I hear “are you OK?” to which he responds “yeah, I’m OK, I just have flu symptoms”. WTF? Puritan work ethic or whatever.

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