back
947 comments
Moderna is working on a vaccine targeting the Omicron variant for 2022.[1]

The mRNA vaccine technology is "agile". There's a workflow from sequencing a virus to generating a candidate vaccine. It only took two days to generate the original COVID-19 vaccine. It's the clinical testing in small, then large groups that's the time consuming part.

Also, the inhaled vaccines are entering clinical testing.[2] It's not like we're stuck with the original vaccines.

[1] https://www.cnbc.com/2021/11/28/moderna-says-an-omicron-vari...

[2] https://www.thetimes.co.uk/article/e1637976-5c3f-11ec-90d0-c...

> The mRNA vaccine technology is "agile".

Yes and this means governments can quickly adapt to new variants by reformulating the vaccine, dumping old stock by "donating" it to developing nations, or dumping it, and buying new stock from big pharma.

Since developing nations will always have far lower vaccination rates than first world countries, the virus will continue to mutate and proliferate outside of America and Europe, ensuring new opportunities for revving the vaccine.

That's a sustainable business model for the first world.

According to reports, the original BioNTech vaccine was developed in a matter of hours: https://www.businessinsider.com/pfizer-biontech-vaccine-desi... Moderna's was done in two days.
Moderna CEO equity sales for the last couple years. Nothing to see here, no reason to distrust them pushing endless boosters:

https://finance.yahoo.com/screener/insider/BANCEL%20STEPHANE...

Meanwhile, the Biontech CEO thinks that a fourth booster may be needed. For all the agility of mRNA, the reality looks like we are indeed stuck with the original vaccines.

And I suspect that countries which want to implement mandatory vaccination like Austria and perhaps Germany will force people to get the now worthless first and nearly worthless second doses of the original vaccine, because anything else won't be available.

Yay, more injections of experimental vaccines!
There are a few important bits here:

First: "The study by Discovery Health, South Africa’s largest health insurer, of 211,000 positive coronavirus cases, of which 78,000 were attributed to omicron, showed that risk of hospital admissions among adults who contracted covid-19 was 29 percent lower than in the initial pandemic wave that emerged in March 2020."

and second: "At the same time, the vaccine may offer 70 percent protection against being hospitalized with omicron, the study found, describing that level of protection as “very good.”"

Yes the vaccine does improve outcomes BUT the hospitalization rate for unvaccinated people is still lower with Omicron than previous variants.

I don't understand this study. Why not compare the hospitalization/fatality rates between _current_ omicron/delta infections between similar cohorts?

Comparing to an earlier wave is hopelessly confounded on prior infections in the intervening time and similarly, on the most susceptible having already been killed off.

Maybe they did what I'm suggesting and its mostly just bad reporting?

edit from the summary :-/ :

Vaccine effectiveness:

    The two-dose Pfizer-BioNTech vaccination provides 70% protection against severe complications of COVID-19 requiring hospitalisation, and 33% protection against COVID-19 infection, during the current Omicron wave. 

    Reinfection risk: For individuals who have had COVID-19 previously, the risk of reinfection with Omicron is significantly higher, relative to prior variants.

    Severity: The risk of hospital admission among adults diagnosed with COVID-19 is 29% lower for the Omicron variant infection compared to infections involving the D614G mutation in South Africa’s first wave in mid-2020, after adjusting for vaccination status

    Children: Despite very low absolute incidence, preliminary data suggests that children have a 20% higher risk of hospital admission in Omicron-led fourth wave in South Africa, relative to the D614G-led first wave.
Don't forget this part: "South Africa has a quite high seroprevalence of prior infection, particularly after delta, and in some parts of South Africa up to 80 percent of people were exposed to previous infection"

So it could simply be that the mild cases were previously infected, what happens to an unvaccinated without prior infection is a different story.

Just 29% lower is nothing. NOTHING.

Of all people, the YC News crowd really ought to understand that O(exp(n)) overwhelms O(1) literally exponentially. Not figuratively. Literally.

If a virus variant has a constant factor reduction in its side-effects, but a higher exponential factor in infectiousness, the latter will overwhelm the former in short order, and then continue to overwhelm it even more. Exponentially.

Let me do some simple maths assuming that it spreads "just" twice as quickly as Delta.[1] Lets assume that at some point, Omicron will be the primary strain, and there are 29% less patients in hospital because of it. Assume the doubling-time of Delta is 1 month. (It's better or worse than this depending on circumstances, but start here.) The doubling time of Omicron is then 2 weeks.

So with Delta you have: 1.0 == .71 * 2^(t/30d) which solves to about 15 days to get back to a full hospital.

With Omicron the equation is 1.0 == .71 * 2^(t/14d) which means it'll be back to a full hospital in just 7 days. Then the hospitals will be at 200% capacity in 21 days, 300% capacity at 29 days, and 1000% of capacity in just 53 days.

Of course, the full mathematical model is more complicated, typically something like SEIHRD, but the point is that a mere 29% reduction in mortality is next to nothing compared to an exponential increase in infectiousness. It would have to be more like 90% less dangerous for that to matter at all in the long run.

[1] https://www.forbes.com/sites/masonbissada/2021/12/03/scienti...

I think we have to be very careful with data from around the world. There are a lot of co-factors. We already know that generally being immuno-compromised makes covid a much riskier proposition for those groups. In a recent deep dive into the Ivermectin studies done around the world, it was shown and proven that in Bangladesh that Ivermectin reduced covid mortality. However, when digging deeper, Bangladesh has a 80%+ infection rate of worms with most people having 7-23. So taking Ivermectin helped save patients from covid mortality but only in the sense that it made them less immuno-compromised. The US population (e.g.) doesn't have worm infections like that. Any data from a specific geographic area/country/race/etc. may only have validity within that same group.
Did anyone notice the comparison of vaccine-based immunity to natural immunity in the findings within the source PR [0]? With a little work, you can compare them.

If we convert the measure used in finding 2 (relative risk of reinfection) to finding 1's (relative protection), then the study found that natural immunity from Delta variant gives 60% protection against Omicron; roughly double the vaccine's protection.

Unfortunately, no stat was given for natural immunity's protection against hospitalization.

From finding 1: individuals who received two doses of the Pfizer-BioNTech vaccine had 33% protection against infection, relative to the unvaccinated

From finding 2: People who were infected with COVID-19 in South Africa’s third (Delta) wave face a 40% relative risk of reinfection with Omicron

Am I reading this right? Wonder why they used different metrics?

0: https://www.discovery.co.za/corporate/news-room#/pressreleas...

I have a question for anyone who has a serious level of knowledge on virus evolution: As viruses evolve over time is there any correlation to severity - do they have trade offs as they evolve?

I am hoping that it would be some kind of trade off that the virus makes in that it can spread more easily but not be as severe (I understand that it is unlikely nature requires a trade-off). I ask as my concern is that while this variant might be much more effective at spreading and hopefully less severe in its disease - are we not just making a massive breeding ground for the variant after this one that could potentially be as quick spreading but with a greater severity of disease?

I would imagine that a virus would eventually adapt/evolve to a point to where it co-exists harmoniously with the host organism. I've heard somewhere that herpes simplex virus used to have terrible symptoms, like genital blisters, but over the years the most common variant has no symptoms, and most people have no idea they have it.... and a huge proportion of human have it.

I would imagine all viral contagions would eventually go that route. Because a virus cannot propagate if the host organism goes extinct, or for whatever reason the host organism is itself not fit for survival, or diminished in any way.... anything that might impact virus propagation.

I've read some where the common cold was probably a pandemic virus originally, and it mutated to a common cold we have today, and we mutually evolved to deal with the common cold. Something like that...

“ The study by Discovery Health, South Africa’s largest health insurer, of 211,000 positive coronavirus cases, of which 78,000 were attributed to omicron, showed that risk of hospital admissions among adults who contracted covid-19 was 29 percent lower than in the initial pandemic wave that emerged in March 2020.”

29% LOWER THAN OG COVID

In other words, a bad cold or the flu. This is possibly our way out of this mess if it can become the dominant strain, why are we still peddling fear about omnicron instead of hope?

Out of curiosity, do we really require these studies? Like it is good to have more and more sources, but wouldn't the expected outcome to be the following:

- vaccines that replicated the spike protein will be less effective since omicron has a modified spike protein, because the immune system only was trained to notice the spike protein and not the payload

- naturally induced immunity from prior exposure to Sars-Cov-2 will be more effective because the body made immunity to the payload alongside the total viral shape

Omicron doesn't change fundamentally where we were with Delta. Its infection enough that everyone will get it. Vaccines protect you (they are banned for kids under 5). Pfizer's treatment (Paxlovid) is a very effective cure (currently banned). The death rate for vaccinated individuals is extremely low, at its current rate its about 26 per 100,000. The flu killed 24 per 100,000 in california.

We are at the endgame. These are the last things left to "end the pandemic", and they are all policy decisions: (1) allow peditricians and parents to decide if they want to vaccinate their under 5 year olds. (2) Stop banning Paxlovid (3) Stop any mandates, there just isn't the numbers to justify them. (4) Ensure people have reasonable rights to keep wearing masks or something in public.

Missing link to the original research (not in the article): https://discovery-holdings-ltd.mynewsdesk.com/pressreleases/...
Prediction - nerds will drum up any FUD related to omicron to postpone return to the office. I am seeing it in my company already - in the today's tech virtual townhall "omicron is going to hit hard, so why go back to the office in Jan" was the most upvoted comment in the stream.
This is pretty good news imo. A mild version of Covid is in a way like a vaccine. Maybe this is how COVID fizzles out.

* all disclaimers apply: I am not a doctor, you should still take care of yourself if you're immunocompromised / old / diabetic / overweight / unhealthy etc.

"Less severe" as in less hospitalizations and death. The long-term effects of comorbidities are still being hashed out. A fair amount of the literature surrounding pulmonary megakaryocytes, platelets, and covid, is pretty alarming.
Is it just me or does it make perfect sense that the selection pressure would push the virus to do this? After all, it’s competing against other variants, as well as counter measures by other human beings.

I imagine even that the cold and flu may have started out thousands of years ago as much more deadly, even fatal, but that over the millennia the same process occurred.

Perhaps in the case of COVID the process is just greatly accelerated due to air travel, as well as existential threats to the virus’s well being, like vaccines and lockdowns.

Is there some kind of law in biology that predicts contains become more virulent and less deadly over time?

Quote: The study by Discovery Health, South Africa’s largest health insurer, of 211,000 positive coronavirus cases, of which 78,000 were attributed to omicron, showed that risk of hospital admissions among adults who contracted covid-19 was 29 percent lower than in the initial pandemic wave that emerged in March 2020.
Omicron is an evolution in the spike, which is what the mRNA exclusively focused on (and assumed would not evolve).

That’s why the mRNA vaccines aren’t super effective for it.

Is the "less severe" part just from a roll of the dice? I wonder what's the likelihood of something more severe / extremely severe appearing in the next few years. Be it a variant of Covid, or something new altogether.

That should be the main take-away from this whole thing ... there needs to better healthcare, even in the "strongest" of countries. A comment here a few days ago really drove that point home. Germany, the EU powerhouse with 80 million people is on its knees (lockdowns again, despite good vaccination rates) because it can't handle a few thousand individuals needing ICU beds. That's just unacceptable. Until now we've been pretty lucky but that luck might run out soon.

I wonder if there is comparative research on the mutations of SarsCov2 compared to other betacoronaviruses. Is it mutating similarly, or do the vaccines /self-isolation and distancing cause a different mutation pattern
I am going to go against the grain here and ask someone more knowledgeable than myself if the large number of changes in this variant is typical in virus evolution? Because as an outsider, it appears to me that studying the history of past pandemics would present a road map as to what must be modified to attenuate the damage potential in a virus. I suppose my question really is, why are we chancing GOF research, if not to use in this situation?
The data on severity is still difficult to transfer across countries. What seems reasonably certain is that vaccinations and previous infections do protect reasonably well against hospitalization and death. It is still not clear how the unvaccinated and not infected will fare.

And the speed of this variant is enormous. We're seeing a doubling time between 2 to 3 days in several countries like Denmark or the UK. That is far faster than any previous variant.

The 'big flaw' in the SA observations lie in in the fact that they have huge seropositivity rates, I believe well over >50% of the population has had COVID, many of them contracted multiple strains. And - they've had quite a lot of people die already from it.

So that Omicron is not hugely lethal among a population with 'natural' tolerance and where a good swath of the ill have been killed ... is maybe not so surprising.

Maybe there is a good answer to this but the SA reports I have seen don't seem to directly speak to this issue.

FYI CDC's seroprevelance data for SA [1]

[1] https://wwwnc.cdc.gov/eid/article/27/12/21-1465_article

What good are “studies” when a majority of government seems to be ruling by the seat of their pants?
This is honesty good news. The best case scenario is a new less deadly highly contagious strain that become the most dominant and spreads worldwide.

Way too many comments and articles that try and keep the fear train running full steam.

A mild strain of covid that is contagious, leads to natural immunity and doesn’t require a vaccine is an absolute win win for the world.

It remains to be seen if the reduction in severity is offset by the increase in infectiousness.

Just as an example, if a new virus is only 1/2 as deadly but 3x as infectious the mortality rate would climb by 50%.

Not an expect in this subject matter and not even an anti-vaxxer but do wonder: If I were the COVID organism, its beneficial for me not to be lethal to the host I infect. Initially I would but other mutations and time I'd learn not be. My host is useless to me if I kill it.

The point: perhaps we're hyper focused on "COVID is out to kill us senseless"

Almost no vaccines prevent infection (e.g., rotavirus vaccine). But most reduce/prevent symptoms. In fact, it's still not proven that existing COVID vaccines 'prevent infection'--that is, provide sterilizing immunity.

Unless I'm missing something, this 'study' seems to do little more than support that understanding.

Has there ever been serious research on the safety of "contagious vaccines"? I'm thinking of strains of problematic infectious diseases engineered to be super mild in terms of symptons, and relatively contagious.

Ethical problems and risk of mutations make this a non-starter I guess, but I'm genuinely curious.

I won't deny that this is good news, but considering Omicron is much more transmissible than other variants (I've seen numbers saying 4x more transmissible, though I don't have a source right now), wouldn't that still mean higher hospitalizations and healthcare overwhelm?
IIRC, this was predicted, which is hopeful and good thing. I remember reading an article last summer that generally diseases become less severe over time.
Omicron is apparently very unstable and as such may not be with us very long before another variant emerges from it: https://twitter.com/_b_meyer/status/1470124417749557248?s=20
The title is misleading. It is possible that Omicron is just as severe and that the effect in the study is because a large percentage of the population had some immunity from a previous infection or vaccine.

> South Africa has a quite high seroprevalence of prior infection, particularly after delta, and in some parts of South Africa up to 80 percent of people were exposed to previous infection. We don’t think it’s a question of virulence, but more a question of exposure to vaccination and prior infection, so we would be cautious to try and interpret that this is a less virulent strain. We’ll have to see what happens in other parts of the world before we make a call on this.

a) we don't know, and

b) we are about to find out, and find out hard.

Yes. Covid will continue to mutate to become more contagious and less deadly. This is the natural progression of endemic viruses, they don't want to kill their hosts and they want to spread.
I can't believe this is the top comment on hacker news but I guess I shouldn't be surprised anymore.