For those of you who already know how viruses work, great.
For those who don't, also totally fine. No one is 100 percent.
And what we ostensibly know is often counterintuitive and not something everyone needs to spend time on. I don't know how carburetors or crockpots work. It's better that I don't. Let people do their thing. We work better together that way.
But it also leaves us all with blind spots. Is this a dangerous crockpot? What about this? Oh, that's not a crockpot at all? Interesting. I wouldn't know.
I'll write more in this week's usual weekly letter. But in the meantime, I wanted to note that this is an ongoing thing to be aware of ...
And it's not just this guy.
There's a rumor going around that the newly emerging omicron variant—about which relatively little is known—simply can't be a big deal because the smattering of early reports describing people infected with it didn't get extremely sick.
It's also true that most cases of COVID-19, caused by any strain, involve a totally survivable flu-like illness. There's usually some coughing, lethargy, etc, and then you're back at it. Most people are ultimately fine. They're left to think: Wait, that was it? What was all the fuss?
That's unfortunately exactly what makes it dangerous ... that mix.
Viruses that almost always hospitalize or kill people are actually easier to contain. ("Hey, whoa, that guy is bleeding from his eyes. He's coughing like crazy and bleeding from his eyes. Please don't let him into choir practice thx!")
At the other end of the spectrum, the viruses that almost never hospitalize or kill people are similarly easy to let go. It's just a cold. You can still come to work. (If you care enough about corporate profit to infect your coworkers?)
But, so ... this one lets most people go. While also critically sickening or killing tens of millions.
(I realize I'm ascribing agency to the virus. It's not even alive. That's just a metaphorical thing. It's a force of nature.)
Point being: The fact that this virus usually doesn't kill people is also exactly why it's killed millions of people.
That's also what raised alarms for me in February of 2020. It's almost the "perfect" (worst) pandemic virus.
I'm not here to say I told you so. Only noting that to avoid self-plagiarizing by constantly repeating the same fundamental thing because it feels like no one is listening.
If I were to draw out another tortured metaphor: the most dangerous people aren't the ones who are constantly sending off red flags. They're the ones who usually seem pretty normal.
But they also have the capacity to be extremely abnormal. That's what makes them truly dangerous.
It remains possible (if unlikely) that this variant doesn't spread widely. It remains possible that this variant does spread widely, but causes a slightly less aggressive illness, and so the net effect is neutral. Viruses often evolve to become more transmissible but less deadly.
Of course, I seriously hope the danger posed by this virus attenuates over time. I hope it causes less harm than did delta. It plausibly may. And, unlikely as it may be, if the dude above were somehow serendipitously correct, I'd be thrilled.
But, based on a rudimentary understanding of what viruses are and how they evolve to survive within hosts and evade systems of immunity, a sudden transition from pretty-often-serious illness to a "mild cold" is not at all my expectation.
And the evolutionary process—based on everything we know about virology so far—almost certainly wouldn't unfold so instantaneously and draconianly as described above. Viruses, like people, don't suddenly transform into entirely new things.
If this variant changes the arc of the pandemic—as delta did—it wouldn't be via a gaping gash. It wouldn't be a draconian reversal. It would be through a billion tiny cuts.
At an individual level, the experience of being infected by the omicron variant is very likely to be unremarkably similar to infection with prior variants. We don't know yet, but, most likely, our diagnostics and therapeutics will continue to be of very effective help. Of course, the basics—masks, ventilation, distance—will continue to add further help for those who choose to deploy them.
The big issues arise as you step back. At the global scale we're dealing with, a 2% increase or decrease in transmissibility or virulence, say, could amount to an enormous deal. The effects compound like interest. All other things being equal, at an 8-billion-person scale, a "minor" change could mean hundreds of thousands of additional deaths.
I'm following this story with great interest and very little sleep. I'll write more in the regular weekly letter—specifically about the status of our vaccines. If you haven't subscribed, you're welcome to here.