As reminders…

Alpha–Variant first identified in the UK

Beta–Variant first identified in South Africa

Gamma–Variant first identified in Brazil

Delta–Variant first identified in India

Omicron–Variant first identified in South Africa

Updating the chart above:

Ancestral: B.1.1.529 Omicron

Transmissibility: All the +

Immune Evasiveness: All the +

Vaccine Effectiveness: Check (for hospitalization)

Also as a reminder:

–Leading off, on omicron BA.2… I held off covering this to give the situation a little more time to develop, in spite of a couple scare headlines here and there. This is a new very close cousin to omicron, and like omicron, is a highly contagious variant of SARS-CoV-2. Denmark believes it to be responsible for a majority of cases in their country right now. It’s already everywhere though. As of the time I am writing this section, there are over a hundred identified cases in the US in at least 23 states. The early report from Denmark is that BA.2 may be 1.5 times more infectious than omicron. Like omicron though, it is not as severe as previous variants. While in the US it has not displaced the parent omicron strain significantly, it certainly has the potential to do so. On the other hand, if you are recovered from omicron (or already by vaccination and/or prior exposure less susceptible to omicron), chances are really tiny that BA.2 is going to do much, if anything, to you.

Thus far, it is keeping to the expected trend of mutation in a pandemic to become more contagious, less severe over time. While there is a risk that a new highly contagious variant could emerge that is as, or more, severe than previous variants, that risk is actually dwindling. If only because omicron is already so mutation heavy in the spike protein versus previous variants. Again, there are only a finite number of ways the virus can tweak the spike protein and still have the protein bind the ACE2 receptor to invade a human cell. The more variations of spike protein your immune system “sees”, the higher the hurdle for SARS-CoV-2 to find a new one that is different enough to still bind ACE2 and escape the immune system. The selection pressure is on to become more contagious, if only, again, because the number of susceptible hosts is dropping as people become more broadly immune (at least to severe, hospitalizing disease) and its chances to be around those reduced numbers of hosts when the virus is maximally infectious are dropping too. So the virus has to become something more like omicron–clinically innocuous enough that an infected host doesn’t notice they are sick until omicron has had a chance to hop to a new host.

I would expect a few more like this, and at least one more omicron like freak out (where a new infectious variant emerges and the main media and some governments vastly overestimate its severity out of the gate) until comfort with this “more contagious but less severe” trend gets established. If we are really lucky, BA.2 is the last gasp and the end of the road for the virus to find more infectious spike protein variations that still work, and evade the immune system just enough to replicate just long enough to jump to a new host.

You can find quotes from virologists and other doctors about the SARS-CoV-2 mutation pattern and implications here.

–Around the horn, cases in the US continue to fall, and rather precipitously versus previous waves. Japan continues to climb a growing omicron wave. Parts of Europe are climbing or near a peak, such as Denmark and Switzerland. One UK based reader sent along a report in the Telegraph analyzing the CFR and IFR of COVID in the UK, as the Telegraph notes to its apparent surprise given its prior reporting at the beginning of the omicron outbreak that omicron’s CFR and IFR are no worse than the flu. And not even a particularly severe flu.

–You can find our first in depth update about omicron here, which was about a week after the great Day After Thanksgiving freakout by pretty much every major news organization everywhere. Meanwhile, here’s a picture of South Africa still waiting for a well deserved apology from a lot of very serious people for a lot of early, draconian travel bans and a lot of incredulity about the South African clinical data that suggested that omicron was far less severe, although more contagious :

–The political reaction in Europe deserves some additional comment. Switzerland is seeing record high new cases of COVID right now (predominantly omicron). In spite of this, Switzerland has announced plans to lift COVID restrictions like contact quarantines with the health minister announcing that we have “reached the endemic phase.” Sweden is expected to announce it is lifting restrictions even as it, too, hits a peak in cases (again, mostly due to omicron). Italy, Finland, Ireland and Norway are all removing restrictions as well. The UK backed off of firing NHS workers who remain persistently unvaccinated, although now there is some consternation about the 40,000 home health care workers who were fired before Christmas for not being vaccinated in time.

–I have been asked, sometimes directly, at what point do a lot of the restrictions end and life get back to something closer to the pre-2020 days as SARS-CoV-2 follows the “more contagious, less severe” trajectory typical of pandemic agents. Especially as it clearly settles into something more flu like, and we have the ability to keep people out of the hospital with vaccines and/or early treatment even if they do catch a symptomatic case. You may be asking the same question, Hypothetical Reader, and my answer is always:

For those are political questions.

But I add that at some point, and I don’t know when, and “when” will vary greatly depending on your “where”, these medical facts will start to permeate the consciousness of the political leadership.

And you will see the kind of policy changes now being rolled out in the UK, Denmark, Sweden, and Switzerland. So the ice may be starting to thaw just a little.

–Emphasizing that the “when” varies by the “where,” of course, is the juxtaposition of those policy changes with the ongoing trucker strike in Canada over persistent vaccine mandates and restrictions (which has led to new protests in Australia as well). In the wake of the ongoing protest, Quebec has scrapped a plan to tax the unvaccinated and announced an end to a COVID curfew. Other provinces are moving to remove some current restrictions as well. The leader of the Canadian conservative party was removed by his own party on Wednesday; coverage also mentions Trudeau’s falling poll numbers mean the current PM might not run again.

–“Consent of the governed” will be fresh in the mind of a lot of voters in upcoming elections in democracies worldwide–and at all levels from local to national.

–There was a group that ranked US states based on percent of schools that managed to stay open, minimized excess all cause deaths, and weeks of systemic healthcare strain as a rough examination of how the wide variety of COVID lockdowns, restrictions and enforcement across the various states performed. Here’s what they came up with:

Avoid reading too much into that though. Same for the new papers out this week on the effectiveness of lockdowns done by meta-analysis of published studies. One from a group at Johns Hopkins has been getting a lot of # action on social media, but little play in the main media. It suggests that lockdowns were not effective. Again, don’t get too excited. There is too much variation in the population, environment (urban vs rural, developed vs not, climate), timing and type of restrictions and how well they were really enforced (just think of all the politicians and celebrities worldwide caught on camera flagrantly violating some restriction or other), to come to ANY kind of definitive conclusion. Other than excess all cause deaths still happened (the main reason I present the table above).

That said, what is equally obvious is that there is NO slam dunk evidence in favor of lockdowns either.

In fact, given the very Federal approach with widely disparate social restrictions, timing, and degree among the states listed in the table above, with largely similar all cause excess deaths, and it’s hard to argue that anyone had a clear cut policy winner.

My own take is that a lockdown similar to “two weeks to stop the spread” makes sense in very limited geographic regions and ONLY in that very time limited constraint, and then ONLY if your healthcare system really was about to be overwhelmed. Everything else risks either losing the healthcare system to wildly rampant spread of the pandemic agent, with an acute bump in all cause deaths, or the kind of slow and steady increase in all cause deaths from the socioeconomic fallout (overdoses, incompletely treated chronic conditions etc.) of prolonged and strict restrictions. But that’s my opinion, and keep in mind, no matter what data gets cherry picked for arguments on either side, it’s a lot of feelingsball.

–We would have done better to remember the whispers of our forebearers who have lived through similar pandemic challenges before.

“We tried some of that. But the Black Death will always get to England in the end.”

“We had the full range of policies too. Some tried to isolate, running from the plague. Some barricaded themselves at home, in self imposed lockdown. Some went on with their lives, with reasonable precautions. Others threw all caution to the wind, figuring they would get sick eventually anyways. In the end, none of their choices made a difference. Every option in the Black Death Choose Your Own Adventure had the same mortality rate. Once a pandemic agent has gone pandemic, and especially once it hits your town, you will be exposed eventually.”

I’m not sure we listened as well as we should have.

–I think rapid development of effective vaccines and treatments, if able, are the only means to really turn the tide on a pandemic…

–In vaccine news, the Swedish Public Health Agency declined to recommend the vaccine for kids age 12 and under. Specifically, they stated that the expected clinical benefit with the variants around right now is small, and while they will continue to monitor expected benefit (read: in case a new variant shows up that changes things), that benefit is not enough to move their risk:benefit needle.

When we stated when the US made its recommendation on vaccines for the under 12 that the risk:benefit ratio was getting a lot more narrow than for other age groups (i.e. 65+ where vaccination is a no brainer benefits greatly exceed risks), and that where one stands on if the benefits exceed the risks would be a lot more “eye of the beholder”, this is the kind thing I was talking about. Very understandable that different health agencies will look at their population, the risk:benefit calculations, and decide it doesn’t ping their risk meter quite enough.

–Timely, considering Pfizer submitted data on vaccinations in the under 5 age group (which will -also- have a narrow risk:benefit ratio) and expects an FDA decision in “a few weeks.”

–Moderna’s vaccine has finally gotten full, official FDA approval this week.

–The CDC published a few papers on booster efficacy versus severe COVID. The first is here. Two doses of vaccination during the delta-omicron wave in the US showed 82% effectiveness against hospitalization (approximately 10 fold reduction) versus unvaccinated patients. Two doses and a booster showed 97% effectiveness against hospitalization, again versus unvaccinated patients. The difference in those percentages is statistically significant. However, it would have been useful to see the hospitalization rate of the 2 doses (no booster) group and the 2 doses plus a booster group compared heads up, because it is not obvious to me from the 95% CI of the efficacies versus the unvaccinated that the heads up difference will be statistically different.

The absence of that analysis is palpable, as one presumes it would have been an obvious comparison to make as well, particularly if one wants to hammer home the benefits of a booster versus just a completed two vaccine series.

Even more useful would have been to get antibody titers on these groups, and see if there is a level of antibody titer that predicts resistance to symptomatic and/or severe COVID.

We somehow still don’t have that study.

–The other major booster paper is here. Key findings are that for those over 50, a booster reduced the rate of COVID mortality in the delta predominant fall phase (and earliest part of the omicron wave) by 6 fold for those over 65 and in half for those 50-64. There were not enough deaths from COVID among the vaccinated and the vaccinated and boosters for meaningful analysis in those 49 and under. For the raw numbers, the chance of death from COVID (age adjusted) was 7.8 per 100,000 for the unvaccinated, 0.6 with two doses of vaccine (so 10 fold reduction), and down to 0.1 with two doses plus a booster.

So again, if you are high risk, a booster dose is a good idea, and will minimize your chances of death due to COVID.

–Still waiting to see publication of Corbevax’s phase 3 data (that’s the patent-free vaccine developed by private funding of a group in the Texas Medical Center). Also no update yet on the whistleblower alleging some irregularities in the Pfizer vaccine Phase 3 study at one participating contract research organization.

Socioeconomic:

–Supply chain disruptions and new inflation risks are no surprise at this point. Heinz and other food producers are announcing major increases in the price of their products. Some Heinz products (I want to say it was ketchup, in fact) are jumping an eye-popping 30%. Cotton prices are expected to increase due to supply issues, so clothing may start to take a jump. This week’s surveys show about 3/4s of surveyed US adults expect inflation to persist this year. As of this morning, factory orders in the US took a dip. That may be related to the US government and the Federal Reserve mentioning that this month’s job numbers may be “adversely affected” by the large amount of sick call offs and quarantines during the omicron wave in the US. That may also be due to continued difficulty sourcing widgets and getting them via just in time logistics given the persistent shipping traffic jams, omicron closures in China, and COVID call offs. Regardless, if factory orders are down, while producers like Heinz are raising prices, that argues for a supply constrained inflation.

–Otherwise, a few think piece quotes and links this week.

–First, it is subscriber content, but in great minds thinking alike Grant Williams also looked at Bernays and the influence of propaganda in the modern era in his most recent newsletter. He also has an excellent podcast this week with “Doomberg” the anonymous Substack author (whose content is also very useful) with some useful discussion on that newsletter. In particular, they discuss the current trend of propaganda, and the turn towards censorship when propaganda meets its persuasive limits. The “Doomberg” crew (there is more than one chicken writing the notes) has -extensive- scientific training and specifically background in various forms of the energy industry from renewables to more traditional energy sources. They have been prescient on recent market turns in energy markets as a result, and their comments towards the middle and end are worth your consideration. No, Grant is not a cheap subscription any more (thank God for grandfathering), but you may find it useful and worth the price. And no, before you ask, I get nothing for traffic or new sign ups from Grant : )

–Next up, Joe Rogan addressed the continuing controversy over some of his guests. Here’s a YouTube link (which will hopefully stay up) in case you don’t want to sign in or sign up for Instagram, where Joe posted this video originally. Worth a listen. We covered the two controversial episodes of the podcast that apparently triggered this reaction here and here (latter was the one in significant depth). I would encourage you to review those if you are reading articles covering the current “misinformation” controversy about Joe’s podcast, because it’s not obvious to me that some of the mainstream media reporters covering it have listened to those interviews based on their descriptions of them. And I am saying that someone who disagreed with some of the things those guests said on the podcast! The other guests that Joe mentioned who he had on the podcast previously to talk COVID who have NOT been cited for “misinformation”, ranging from Dr. Sanjay Gupta to Dr. Michael Osterholm (who was, indeed, on the Biden Administration COVID-19 advisory panel for the presidential transition), we have NOT reviewed in an update. Mostly because I just haven’t listened to those episodes, and gravitated towards reviewing the ones that were prompting (or likely to prompt) reader questions!

–Updating a link to a previous RaboBank note discussing the shipping quandary snarling supply chains is the following (taken from one of their more recent notes). They know more about this stuff than me, so for your contemplation:

“Potentially the second most significant news after the “inevitability” of war was this shipping headline: “US to get an open register based out of the Virgin Islands”. 2021’s ‘In Deep Ship’ focused on the geopolitical drivers of the global shipping/supply-chain crisis and, by looking at maritime history/grand strategy, proposed logical US actions as the ‘ship of things to come’ if it wanted to match its military control of the oceans with commercial power:

1. Raise tariffs
2. Use the US market to force global carriers to change pricing/practices to its benefit
3. Build a rival to China’s marine Belt and Road with others
4. Force vessels to re-flag to the US
5. Build a new US merchant marine
6. Refuse to take goods from some carriers or ports
7. Charter private firms to bring home key materials (i.e., privateering); and
8. The US Navy stops protecting certain sea lanes, forcing cost onto others

We already saw #1 a few years ago; the Ocean Shipping Reform Act before Congress addresses #2; there is a lot of talk about #3; and the headline above now speaks to #4.

The rationale for the new US shipping flag/registry is firmly aimed at the established biggest names in the business, noting they have grown too large for true compliance oversight:

‘50% of the ships that traverse our international waterways are registered in just three jurisdictions –Panama, Liberia, and the Marshall Islands– where loosely enforced regulations and lack of due diligence and oversight has created enormous risk to the US and global shipping industry and facilitated illicit activity on the high seas.‘

It seems the US will soon ‘incentivise’ vessels to reflag to where they can be better regulated – to US needs/purposes. Having a regulatory hand on the maritime wheel is a necessary but not sufficient condition to take back control of supply chains. Also note this comes at a time when the US already admits it couldn’t fight a major war if it needed to as it couldn’t get the military cargo to do so there via Sealift.” –Michael Avery, Rabobank, “Prepare For Impact”

–A reader sent this regarding the bonfire of the institutional credibilities and the blow back just getting started, as the sellsword of Varys’ riddle starts to reflect on the decision before them. It’s worth reading, although I think the chances of the author’s preferred solution are basically zero.

So much for my optimism bias, huh?

On the other hand, you look at Jeff Zucker this week and the somewhat sus story behind the surprise resignation as CEO of CNN (other executives have survived worse scandals), and you wonder.

–In the last “think piece” link, Substack itself makes a statement on freedom of speech in the time of coronavirus, specifically citing concepts we have discussed a lot–bonfire of the credibilities and schismogenesis (although not in those terms). You can read the leadership of Substack’s take here.

–Finally, in 1993, an intrepid group of researchers set out to determine if blondes really -do- have more fun, and published in the scientific literature. You can find the peer reviewed paper here, where it has been cited 44 times since publication. “How did they seek to answer such a profound and challenging question about the very nature of the universe, using the tools and methods of the scientific method?” I hear you ask, Hypothetical Reader. Well, it was simple. They had a bunch of volunteers evaluate 750 pictures of women in articles and advertisements in Women’s Home Journal, Vogue and Playboy from the 1960s and 1970s.

Yes, we’re sure that the 750 pictures from magazines including Playboy was absolutely, thoroughly, and conclusively evaluated by the statisticians to ensure an adequately powered sample size.

Then our researchers checked to make sure they were reliably evaluating and recording the hair color of the women in these images.

Reliability studies are important, folks! Have to make sure they were fully trained to evaluate hair color of women in the pictures of magazines…

…including Playboy…

Anyways, they found that the proportion of blonde women exceeded the proportion of women who are genetically blonde in the population. Basically, if hair color was being selected at random by the editors, and there was not some conscious or unconscious bias in favor of blonde women in the articles, advertisements, and centerfolds, then the hair colors should be represented approximately at the level of blonde-brunette-red-black etc. in the population. Instead, the incidence of pictures of blondes was higher. For Playboy in particular, the rate of blondes in centerfolds especially was 3 times higher than would be expected for blondes in the general population.

From this they draw conclusions about the perception, or really, the managed perception of beauty by this bias towards blondes.

Now, the reason that this paper has been cited only 44 times in about 30 years (beyond the obvious) may also be due to its grievous methodological flaw here. Which is that within the various publications, Playboy and Vogue had specific incentives to alter these proportions in targeted ways. After all, Vogue was trying to constantly shift perceptions of fashion, and beauty, to help its advertisers sell more product–women’s clothes, women’s cosmetics, and hey… just a thought… but if you were a hair dye company and wanted more hair dye to get sold, maybe you skew the models in the adverts to something like blonde (a less common hair color in the population), to subtly shift women to considering a change with your products.

The inclusion of Playboy’s centerfolds in the study was egregious, unavoidably introducing a major source of bias that impacts the results and conclusions drawn.

Hugh Hefner, founder and long time editor of Playboy magazine (especially during the 60s and 70s where they sourced the images studied for “hair color”), famously had final call on the model who would be the centerfold in every issue.

Although yes, the results do show that the incentivized editorial decisions of Vogue and Playboy, their target markets and purpose, undoubtedly skewed perceptions of female beauty and beauty standards. Unfortunately, this study has been cited to state that it may reveal a broader evolutionary preference towards blondes among the readers though, through a flawed logic that posits that Hef and the Vogue editors were providing their audience what the audience wanted–when really it was just as likely to be vice versa.

So a valiant effort, but a Great Moment in Science like the study on the detection of cocaine and cocaine metabolites from second hand crack cocaine exposure we mentioned previously this isn’t.

However, your chances of catching coronavirus in much of the world are equivalent to the chances that this study was the -first time in history- that someone was NOT reading Playboy “for the articles”, but was deliberately looking at the pictures, especially the centerfolds…

…for SCIENCE!

<Paladin>