[slab_happy]

Do they carry the EN 149:2001 and. CE marking?

FWIW, I've been using https://thefacemaskstore.co.uk/online-store/ffp2-face-masks/ -- they seem pretty solid in terms of showing the specs on what they're selling.

Also, my top FFP2 hack: Get a bit of narrow elastic and tie it in a loop joining the two ear loops, so you can fit it behind your head (positioning it so the join sits on the crown of my head works well for me).

Better fit (just pulling the mask a bit tighter seems to solve a lot of fit issues), less ear stress.

[Durbs]

I’m down to 55% functionality after a Moderna booster ( 2 x Pf previously).

Word. Both me and Mrs got the Moderna booster on Friday. Saturday was just about manageable with a steady stream of paracetamol, Sunday still not 100%.

I was team AZ, she's Pfizer, both also had Covid in August - wonder if it's the latter that made the booster so brutal?

[36chambers]

I’m down to 55% functionality after a Moderna booster ( 2 x Pf previously).

Word. Both me and Mrs got the Moderna booster on Friday. Saturday was just about manageable with a steady stream of paracetamol, Sunday still not 100%.

I was team AZ, she's Pfizer, both also had Covid in August - wonder if it's the latter that made the booster so brutal?

I had Pfizer previously and a Moderna booster on Friday. Felt grim on Saturday, achey body and bad headache, certainly worse than the original two shots. Just about managed to climb on Sunday evening and feel normal today (well, my arm still aches if I prod it). Not had covid as far as I'm aware.

[Rocksteady]

I’m down to 55% functionality after a Moderna booster ( 2 x Pf previously).

Word. Both me and Mrs got the Moderna booster on Friday. Saturday was just about manageable with a steady stream of paracetamol, Sunday still not 100%.

I was team AZ, she's Pfizer, both also had Covid in August - wonder if it's the latter that made the booster so brutal?

I had Pfizer previously and a Moderna booster on Friday. Felt grim on Saturday, achey body and bad headache, certainly worse than the original two shots. Just about managed to climb on Sunday evening and feel normal today (well, my arm still aches if I prod it). Not had covid as far as I'm aware.

I think I am lucky re: reactions to the vaccines, I have had 2 Pfizer and got boosted with Moderna and had no reactions to any of them other than a sore arm, and with the booster, mild insomnia - found it oddly difficult to get to sleep. This was however irritating as I have a 7-month old baby and am averaging about 5 hours broken sleep. So losing 2 1/2 hours due to inability to go to sleep 'ain't great.

Does anyone know any link between reaction to vaccines and their effectiveness? I wonder whether a bigger reaction = bigger immune response = better protection?

[chris j]

I’m down to 55% functionality after a Moderna booster ( 2 x Pf previously).

Word. Both me and Mrs got the Moderna booster on Friday. Saturday was just about manageable with a steady stream of paracetamol, Sunday still not 100%.

I was team AZ, she's Pfizer, both also had Covid in August - wonder if it's the latter that made the booster so brutal?

I think Moderna can just be pretty brutal, I was flat on my back with intermittent fever etc for 5 days after my second jab (after just a sore arm with the first). Hoping to not get it again for the booster next week...

[petejh]

The 'we see no evidence' fallacy is rearing its head with this omicron wave then...
As it emerges (if it wasn't already apparent!) that much of the rationale for increased restrictions and lockdowns originates in two factors:

1. A sentence in the Imperial report #49 that says 'we find no evidence for omicron having different severity to Delta..'
2. The modelling of worst case scenarios by Imperial. It doesn't take a mathematician to work out why that modelling therefore shows high cases leading to high hospitalisations and deaths.

The models on which the worst case scenarios are based and which are being used for justifying tighter restrictions: Don't use the available data from South Africa's real-world experience of Omicron in a population - which show Omicron doesn't have the same severity of outcome as Delta.

No evidence of different severity to Delta? Really??? How pedantic do people want to be, and for what reason. I can't comprehend why modellers tasked by government wouldn't include available real-world evidence of omicron in a population that shows it doesn't have the same severity of outcome as Delta. Maybe at the time they didn't have much information from South Africa? They do now, and could change the inputs.

https://www.cityam.com/modellers-exclude-south-africa-data-indicating-omicron-is-milder-than-delta-variant-reveals-sage-expert/

Modellers have not included data from South Africa suggesting the Omicron variant is milder than previous strains of Covid-19, according to Graham Medley, chair of SAGE’s modelling committee and professor infectious disease modelling at the London School of Hygiene and Tropical Medicine (LHST).

In a Twitter exchange with The Spectator editor Fraser Nelson, Medley explained that best-case scenarios where Omicron is less lethal than the Delta variant are unnecessary.

He said modellers have been told to establish data to inform governments in case of more severe outcomes.

He said “decision-makers are only interested in scenarios where decisions have to be made” and that modellers “model what we are asked to model” by lawmakers.

This follows LHSTM publishing modelling last week calling for more restrictions.

Nelson contrasted this outlook with an investor note from JP Morgan pointing out if the Omicron variant adjusted in line with data from South Africa – bed occupancy from Covid-19 patients at the end of January would be a third of the peak seen in January 2021, which would be manageable without further restrictions this winter.

When questioned about its lack of inclusion in current UK models, Medley tweeted: “What would be the point of that?”

He argued best-case scenarios “do not inform anything.”

Here's that excellent piece again on why using ''we see no evidence for/against'' is useless for communicating (or a very useful rhetorical tool..): https://astralcodexten.substack.com/p/the-phrase-no-evidence-is-a-red-flag

South Africa's experience so far doesn't give cause to be especially fearful of this omicron wave:
https://www.bloomberg.com/news/articles/2021-12-17/s-africa-says-hospitalizations-in-omicron-wave-much-lower
https://www.ft.com/content/c366d311-e8ac-488d-9907-4ddb81a9bcd0
https://www.npr.org/sections/goatsandsoda/2021/12/17/1065315661/omicron-may-be-less-severe-in-south-africa-that-may-not-be-the-case-for-the-u-s

-  1.7% of cases resulting in hospitalisation in the second week of the Omicron wave, versus 19% of cases ending up in hospital in the same week of the previous wave for Delta.
-  90% of hospitalised are unvaccinated.
-  Highly transmissive. 20,000 case per day in this wave compared to 4,400 cases per day in same week of Delta wave.
-  Capacity within healthcare to take routine patients, so as a result many cases of recorded infections are caught while in hospital (where testing is carried out daily) and so are captured within category of 'hospitalised'. But not hospitalised 'due to covid'.
-  Cases rose fast and are falling fast.
-  Southern hemisphere summer doesn't account for the lower severity of outcome, previous waves also occurred in summer and had worse outcomes than this wave.
It seems the public are now in a moral panic about the NHS, cases, hospitalisations. The media is spreading a mass delusion.

Given SA's experience I'm trying to understand the thought process in media and government. Is it really the thinking that S.A.'s increased sun exposure and its population being on average 13 years younger - the difference in median population age between SA and UK - somehow changes the outcome of Omicron from the mild outcomes experienced there, into a highly virulent virus that according to worst-case modelling is going to cause the UK huge numbers of severe illness that cripples the health service and causes a huge numbers of deaths?

That doesn't appear to be plausible. Unless omicron has mutated into a strain that can selectively target by nationality.

The rhetoric of fear going on around this omicron wave smells strongly of bullshit. It appears that the modellers have been incentivised to paint the worst case picture and this has been run with by virtually the whole media because it's by far the best bad-news story going. I don't know the incentive to panic the population by briefing a narrow picture of the severity of this wave - cover up partygate? Ultra cautious precautionary principle after poorly handling previous waves? Pressurise vaccine compliance in the population? Make the government appear they took action and controlled the omicron wave? Cover up the news, or compound the impact of the slow-to-emerge news, that the commons select committee heard evidence on Wednesday last week that a human-engineered virus and lab leak theory is now considered the most likely origin of covid. (notable that this didn't make the BBC or most of the other main media outlets)?

Alternative theory:
Elsewhere, this wave is giving mild outcomes with much lower impact on healthcare than Delta, even considering its far higher speed of transmission. This in a population which, according to another recent Imperial study(...), has much less robust immunity to omicron than the UK. Reasons for lower impact are unclear but whatever the reasons, it's realistic to forecast Omicron causing not anywhere near the numbers of hospitalisations or deaths as the Delta wave.
If something doesn't change, then due to this moral panic around cases the NHS is going to go short of staff due to people told to isolate with what amounts to a mild cold. This will cause massive self-inflicted damage on these organisations, leading to short-sighted people calling for further restrictions to protect the NHS. Ad infinitum.
In the slightly longer term (i.e. January onward) manufacturing supply chains, production and transport are also about to suffer massive numbers of people told to isolate with what amounts to a mild cold. The worst global stagflation in over a century risks being the result.

[Fiend]

Interesting post Pete. I'm sure Offwidth and Nigel will be tripping over each other in the race to reply to it.

One possible concern might be non-isolating covid+ve NHS staff transmitting Omicron to vulnerable people (as patients often are)??

[petejh]

I like the term used in a torygraph article today:

'not evidence-based policymaking, but policy-based evidence-making'

Interesting post Pete. I'm sure Offwidth and Nigel will be tripping over each other in the race to reply to it.

Before they do they should consider what I'm not saying. I'm not saying there won't be increases in hospitalisations and deaths. I'm not saying there won't be lots of people needing to be off work with covid. What I am saying is the government and media response to the situation doesn't look to me to be at all proportional to the risk, and actually creates a bigger risk (vicious cycle of restrictions - creating isolations - creating pressure - creating restrictions - creating isolations - creating pressure). Along with the massive social damage of restrictions.

[Ged]

The 'we see no evidence' fallacy is rearing its head with this omicron wave then...
As it emerges (if it wasn't already apparent!) that much of the rationale for increased restrictions and lockdowns originates in two factors:

1. A sentence in the Imperial report #49 that says 'we find no evidence for omicron having different severity to Delta..'
2. The modelling of worst case scenarios by Imperial. It doesn't take a mathematician to work out why that modelling therefore shows high cases leading to high hospitalisations and deaths.

The models on which the worst case scenarios are based and which are being used for justifying tighter restrictions: Don't use the available data from South Africa's real-world experience of Omicron in a population - which show Omicron doesn't have the same severity of outcome as Delta.

No evidence of different severity to Delta? Really??? How pedantic do people want to be, and for what reason. I can't comprehend why modellers tasked by government wouldn't include available real-world evidence of omicron in a population that shows it doesn't have the same severity of outcome as Delta. Maybe at the time they didn't have much information from South Africa? They do now, and could change the inputs.

https://www.cityam.com/modellers-exclude-south-africa-data-indicating-omicron-is-milder-than-delta-variant-reveals-sage-expert/

Modellers have not included data from South Africa suggesting the Omicron variant is milder than previous strains of Covid-19, according to Graham Medley, chair of SAGE’s modelling committee and professor infectious disease modelling at the London School of Hygiene and Tropical Medicine (LHST).

In a Twitter exchange with The Spectator editor Fraser Nelson, Medley explained that best-case scenarios where Omicron is less lethal than the Delta variant are unnecessary.

He said modellers have been told to establish data to inform governments in case of more severe outcomes.

He said “decision-makers are only interested in scenarios where decisions have to be made” and that modellers “model what we are asked to model” by lawmakers.

This follows LHSTM publishing modelling last week calling for more restrictions.

Nelson contrasted this outlook with an investor note from JP Morgan pointing out if the Omicron variant adjusted in line with data from South Africa – bed occupancy from Covid-19 patients at the end of January would be a third of the peak seen in January 2021, which would be manageable without further restrictions this winter.

When questioned about its lack of inclusion in current UK models, Medley tweeted: “What would be the point of that?”

He argued best-case scenarios “do not inform anything.”

Here's that excellent piece again on why using ''we see no evidence for/against'' is useless for communicating (or a very useful rhetorical tool..): https://astralcodexten.substack.com/p/the-phrase-no-evidence-is-a-red-flag

South Africa's experience so far doesn't give cause to be especially fearful of this omicron wave:
https://www.bloomberg.com/news/articles/2021-12-17/s-africa-says-hospitalizations-in-omicron-wave-much-lower
https://www.ft.com/content/c366d311-e8ac-488d-9907-4ddb81a9bcd0
https://www.npr.org/sections/goatsandsoda/2021/12/17/1065315661/omicron-may-be-less-severe-in-south-africa-that-may-not-be-the-case-for-the-u-s

-  1.7% of cases resulting in hospitalisation in the second week of the Omicron wave, versus 19% of cases ending up in hospital in the same week of the previous wave for Delta.
-  90% of hospitalised are unvaccinated.
-  Highly transmissive. 20,000 case per day in this wave compared to 4,400 cases per day in same week of Delta wave.
-  Capacity within healthcare to take routine patients, so as a result many cases of recorded infections are caught while in hospital (where testing is carried out daily) and so are captured within category of 'hospitalised'. But not hospitalised 'due to covid'.
-  Cases rose fast and are falling fast.
-  Southern hemisphere summer doesn't account for the lower severity of outcome, previous waves also occurred in summer and had worse outcomes than this wave.
It seems the public are now in a moral panic about the NHS, cases, hospitalisations. The media is spreading a mass delusion.

Given SA's experience I'm trying to understand the thought process in media and government. Is it really the thinking that S.A.'s increased sun exposure and its population being on average 13 years younger - the difference in median population age between SA and UK - somehow changes the outcome of Omicron from the mild outcomes experienced there, into a highly virulent virus that according to worst-case modelling is going to cause the UK huge numbers of severe illness that cripples the health service and causes a huge numbers of deaths?

That doesn't appear to be plausible. Unless omicron has mutated into a strain that can selectively target by nationality.

The rhetoric of fear going on around this omicron wave smells strongly of bullshit. It appears that the modellers have been incentivised to paint the worst case picture and this has been run with by virtually the whole media because it's by far the best bad-news story going. I don't know the incentive to panic the population by briefing a narrow picture of the severity of this wave - cover up partygate? Ultra cautious precautionary principle after poorly handling previous waves? Pressurise vaccine compliance in the population? Make the government appear they took action and controlled the omicron wave? Cover up the news, or compound the impact of the slow-to-emerge news, that the commons select committee heard evidence on Wednesday last week that a human-engineered virus and lab leak theory is now considered the most likely origin of covid. (notable that this didn't make the BBC or most of the other main media outlets)?

Alternative theory:
Elsewhere, this wave is giving mild outcomes with much lower impact on healthcare than Delta, even considering its far higher speed of transmission. This in a population which, according to another recent Imperial study(...), has much less robust immunity to omicron than the UK. Reasons for lower impact are unclear but whatever the reasons, it's realistic to forecast Omicron causing not anywhere near the numbers of hospitalisations or deaths as the Delta wave.
If something doesn't change, then due to this moral panic around cases the NHS is going to go short of staff due to people told to isolate with what amounts to a mild cold. This will cause massive self-inflicted damage on these organisations, leading to short-sighted people calling for further restrictions to protect the NHS. Ad infinitum.
In the slightly longer term (i.e. January onward) manufacturing supply chains, production and transport are also about to suffer massive numbers of people told to isolate with what amounts to a mild cold. The worst global stagflation in over a century risks being the result.

Maybe.

Or maybe the shit will hit the fan due to sheer numbers getting a mainly mild illness meaning there still ends up being loads of hospitalisations.

Who knows.

[remus]

I can't comprehend why modellers tasked by government wouldn't include available real-world evidence of omicron in a population that shows it doesn't have the same severity of outcome as Delta. Maybe at the time they didn't have much information from South Africa? They do now, and could change the inputs.

I can think of plenty of reasons, most of them to do with data quality and studying these things being hard (because there are still a lot of unknowns).

[petejh]

Because the data modelling and the ease of studying how Omicron causes the worst-case impacts (despite these outcomes never having actually happened with this variant and despite real world outcomes saying the opposite) is obviously so high-quality and easy to study that it makes the bad case scenarios the most probable outcomes, right Remus? 

Probability estimates notable by their absence here.

[Ged]

But the consequences of assuming its all going to be fine are a lot worse than the consequences of assuming it's all going to be OK. If both sets of data are equally unreliable, and we needs to chose which one to listen to, I know what I'd be plumping for.

[abarro81]

The 'we see no evidence' fallacy is rearing its head with this omicron wave then...

I'm not sure it makes sense to class it as a "fallacy", rather than a mediocre way of communicating with the general public, especially the less well educated/less thoughtful.

'we find no evidence for omicron having different severity to Delta..'

It's not clear to me from a skim how they did their analysis, but from what I heard on R4 I was under the impression that this statement related to inherent severity of the variant, which may not necessarily correlate with impact from a public health POV. i.e. it may be the same severity, but while previous infection with delta, or 2x vaccination, isn't a good blocker against reinfection it might still alter outcomes significantly without inherent severity being different. The NPR article you linked also covers this. I may have misinterpreted what Imperial are trying to say though. It's not the clearest communication, that's for sure.

Assuming my interpretation is correct, it seems like a broadly sensible approach to assume equal severity and model for different levels of vaccine efficacy against hospitalization.. unless the SA data is good at showing the inherent severity is lower. (Is it? I assume not given how tricky that would be if almost everyone there has had some kind of infection before?) I assume this is what Imperial and others have done in their models? If so I'm not sure quite what the objection is; if not then can someone dig out what they actually did?

Given SA's experience I'm trying to understand the thought process in media and government.

Well the vast majority of the media don't have a freakin' clue about anything to do with science, so I wouldn't worry too much about their thought process! Same is true of gov, but they have more advisers so would agree/argue that decisions are more likely to be informed/nefarious.

Is it really the thinking that S.A.'s increased sun exposure and its population being on average 13 years younger - the difference in median population age between SA and UK

Presumably you'd also need to include % of pop with other comorbidities. I don't know whether this would significantly impact the model (I assume it's built into the proper ones?) but it makes thought experiments/back-of-envelope harder.

One possible concern might be non-isolating covid+ve NHS staff transmitting Omicron to vulnerable people (as patients often are)??

Ripe for lawsuits if nothing else I'd expect.

[abarro81]

Because [...] the ease of studying how Omicron causes the worst-case impacts [...] is obviously so [...] easy to study

An aside perhaps, but setting high/low boundaries when forecasting./modelling is indeed often much easier than setting a most likely case!

[Bonjoy]

An aside perhaps, but setting high/low boundaries when forecasting./modelling is indeed often much easier than setting a most likely case!

As in it's easier to say your route is between 8c+ and 9b, as opposed to saying it's most likely 9a.

[remus]

An aside perhaps, but setting high/low boundaries when forecasting./modelling is indeed often much easier than setting a most likely case!

As in it's easier to say your route is between 8c+ and 9b, as opposed to saying it's most likely 9a.

We obviously need slash grades for assessing the impact of covid variants. I reckon omicron is around we're fucked/we're totally fucked.

[abarro81]

Definitive Hardly-Very-Screwed/Extremely-screwed?

[Nigel]

Interesting post Pete. I'm sure Offwidth and Nigel will be tripping over each other in the race to reply to it.

One possible concern might be non-isolating covid+ve NHS staff transmitting Omicron to vulnerable people (as patients often are)??

Not in the slightest, instead I'll have a look at the links Pete has provided. I felt my posts in the other thread which simply pointed to the actual LSHTM modelling paper Gov were using were caveated and hedged all over the place, but you've obviously taken a different message from it! Am I concerned? Yes, for personal reasons related to your second point. I have a vested interest in Pete / JP Morgan / the Spectator being right on this so I'm not in the business of cheap point scoring.

Some of the reasoning can be dismissed straight away though e.g. a cover up for partygate - were the Dutch / Irish governments invited? As they've introduced similar restrictions. The rest I'll take on its merits.

[Will Hunt]

I don't know whether omicron is more/less/just as severe as delta, but Pete's post does have an air of desperation about it.

Just a couple of the points which can be challenged:

South Africa's experience so far doesn't give cause to be especially fearful of this omicron wave:
-  1.7% of cases resulting in hospitalisation in the second week of the Omicron wave, versus 19% of cases ending up in hospital in the same week of the previous wave for Delta.

I thought Delta doesn't grant complete immunity from Omicron but does confer a degree of immunity? So if you're looking at a population that just had a big Delta wave then you would expect to see reduced hospitalisations because a lot of the people that omicron would have hospitalised are either recovered with some immunity or dead.

-  90% of hospitalised are unvaccinated.

Not unsurprising when the country's vaccination record is piss poor (they've administered enough doses that about a quarter of the population could be double vaccinated. The reality is that a smaller percentage will be double vaxxed with some single vaccinated as well).

[spidermonkey09]

 Whether a population has immunity from infection via Delta (as in the SA case) or by vaccination (as in the UKs case), the effect is surely much the same? If anything the consensus seems to be that vaccine immunity is preferable to infection immunity.

If the above is true (and I may well be missing something), surely we can sensibly look at SA outcomes because whilst not *exactly* the same situations the UK, it is broadly the same and therefore worth looking at? If SAs Omicron experience has been manageable because they have a lot of prior immunity from Delta infection, why wouldn't ours be manageable when we have a lot of prior immunity from vaccinations, including boosters?

[Will Hunt]

I don't know, but I'm skeptical of Prof. Pete because I wonder whether his libertarian tendencies might influence his opinion.

[tommytwotone]

I see that rather than dealing with the issue head-on, and taking an informed decision, Downing Street has now called off the 2pm briefing from Chris Whitty (due to a "scheduling problem", whatever that is), and now, as parliament is on recess, there won't be time to introduce any new changes to the law before Xmas anyway.

So will now doubtless be a longer, potentially harder period of restrictions than if they had bitten the bullet and acted now.

I'd be really angry but it's not exactly like they don't have previous for this dithering and delay.

[Paul B]

https://twitter.com/PoliticsForAlI/status/1472941687001522176?s=20

Looks like restrictions incoming from the 27/12.

[Offwidth]

Because the data modelling and the ease of studying how Omicron causes the worst-case impacts (despite these outcomes never having actually happened with this variant and despite real world outcomes saying the opposite) is obviously so high-quality and easy to study that it makes the bad case scenarios the most probable outcomes, right Remus? 

Probability estimates notable by their absence here.

Well I'll join Nigel. I'm not a fan of the medium to long terms models, not because the science is bad but because a clear position in a range of outcomes is almost impossible to unravel. Short term models are good but not good news.

Pete's detail on SA is not quite right... the omicron hospitalisation peak is about a third of the previous peak (size for size) but that's to be partly expected as population immunity levels are higher than last time (from jabs and infections). They have a very different demographic and they are in summer. It is great news for us that their cases seem to be dropping.

We still don't know reliable hospitalisation data for the UK for our very different immunity profile, demographic differences and our  much higher percentage of the vulnerable. The UK's biggest problem is we have been running hot on covid in the middle of a building crisis in patient throughput, and staff levels. We have very little slack for increased admissions. The good news is we have the best levels of population immunity from jabs and  infections in Western Europe.

Anyone taking covid science from The Spectator has a screw loose but equally some of the more apocalyptic extrapolations doing the rounds seem impossible to me (we already have at least tens of percent of London's young adults infected so it can't double more than twice more in that age group).

Restrictions are happening by self imposition anyhow, irrespective of government policy (just as I said before, it doesn't matter some people think differently, as most were always going to be careful and knew this will last into January). I just hope Sunak gives hospitality etc some financial relief to keep good businesses from going under, if they stick with no extra formal restrictions.

[spidermonkey09]

I don't know, but I'm skeptical of Prof. Pete because I wonder whether his libertarian tendencies might influence his opinion.

I'm pretty skeptical too, but I don't know what I'm missing which means you can't, to all intents and purposes, compare SA and the UK given they both have high immunity, albeit from different sources.

The UK's biggest problem is we have been running hot on covid in the middle of a building crisis in patient throughput, and staff levels. We have very little slack for increased admissions. The good news is we have the best levels of population immunity from jabs and  infections in Western Europe.

I agree with this, but that would seem to imply that we would be locking down because our healthcare system is shit, not because Omicron is particularly bad. Also, surely the UK healthcare system is at least comaprable to SAs, which seemed to manage ok?

Anyone taking covid science from The Spectator has a screw loose but equally some of the more apocalyptic extrapolations doing the rounds seem impossible to me (we already have at least tens of percent of London's young adults infected so it can't double more than twice more in that age group).

Thats playing the man not the ball, which you've accused me of in the past with some justification. I instinctively distrust the Spectator on almost everything but I'd be interested to know how their analysis is factually wrong. Also interesting that we agree that some of the apocalyptic modelling is ridiculous.