The Omicron Variant and the Future of Covid-19

(disclaimer: I am not a epidimilogist or an expert in this field. My arguments are based on publicly available reports.)

The Omicron Variant of Covid-19 is now all over the world, and in a growing number of countries, it is already the dominant Covid variant.

Reports from South Africa, the United Kingdom and Denmark show that Omicron is more infectious than previous variants, but that at the same time it seems to make people less sick. It is still too recent for scientists to definitely say that less people will end up in hospitals, the ICUs (intensive care units) or die as a result of the Omicron variant. Another possible characteristic is that Omicron attacks more the upper respiratory tract (i.e. nose, throat) than the lower (i.e. lungs). This could mean that it could prove less deadly for older people; but at the same be more deadly to infants.

Omicron has exploded into the global scene, with cases growing exponentially (doubling weekly in many cases). It seems that it is on its way to becoming the predominant variant worldwide in weeks. If it does become so, there is the chance that infections will also quickly decline in country after country after reaching its peak.

What happens next? There are two possibilities. First, that Omicron could become so dominant that future variants will emerge from it. Or second, that a new variant could emerge from ‘nowhere’, just like Omicron did. (Experts think that the virus infected an animal, circulated among animals for a while, and eventually reinfected humans as Omicron.)
Let us look into both possibilities.

Mutations to the Omicron variant could be of 4 kinds:
1. those that increase the virus’ transmissibility.
2. those that decrease the virus’ transmissibility.
3. those that make people more sick.
4. those that make people less sick.

I think that all mutations will alter the virus to some extent, and thereby lower the chance of natural and vaccination-induced antibodies to detect previous versions.

#1 mutations will spread faster than the main Omicron variant, and will outcompete it.

#2 mutations will be lose out to the main Omicron variant, which will outcompete them.

#3 mutations will not result in faster hospitalizations, taking those infected with them out of circulation earlier than those without these mutations. As a result, they will have an evolutionary disadvantage when competing with the main Omicron variant.

#4 mutations would result in symptoms that are so mild that sick people will not know that they are sick, and potentially infect more people than the main Omicron variant.

Both #1 and #3 mutations will have a slight evolutionary advantage over the main Omicron variant, and will gradually replace it. This means that, over time, Omicron will become more transmitable and will get people less sick. We could call the result ‘Omicron+’.

And then, the second possibility is that there will be a surprise Covid-19 variant that emerges from pockets of people infected with other variants e.g. Alpha or Delta. For sure, the other variants of Covid-19 would be able to mutate as long as they are around. But they will need to be able to outcompete Omicron to become dominant; and this rather difficult and unlikely. Omicron emerged with more than 50 mutations; any new variants will need to have a combination of mutations with a stronger effect than that of Omicron. Also, the world population is becoming more and more immune against Covid-19; with time, this growth in immunity will make it more difficult for all Covid-19 variants to infect people.

No need to vaccinate?
In a relatively short time, the world will be faced with an increasingly dominant Omicron variant, and a smathering of other variants (which will be decreasing proportionately). And since Omicron tends to make less people very sick, some people (read: the anti-vaxxers) would say that there is no longer a need to get vaccinated for a sickness that is ‘mild’.

This is not true.
At this moment, Omicron is still quite dangerous – it still kills a lot of people. Its mildness is relative ( to Delta) and statistical. People still go to the hospital and ICUs, and even die, because of Omicron. But compared to the Delta variant, less people get very sick and die with Omicron. Vaccinated people could still be infected with Omicron, but they are much less likely to be infected or get very sick than unvaccinated people to do so.
Now is the most dangerous time to be unvaccinated. Omicron, Delta and other variants are spreading like wildfire among the unvaccinated. If they have not gained immunity from a previous Covid infection, they could become very sick or die from it. The overwhelming majority of those who die from Covid-19 will have been unvaccinated.

Delta vs Omicron
At this time, we should not forget that the Delta variant is still widespread. People who get infected with Delta will most likely be immune from getting very sick with Omicron, and vice versa. For the next months, governments will still need to consider both variants when they make policies to combat the pandemic.

Delta will have its own mutations. Similar to Omicron (see above), these mutations will tend to make Delta more transmissible and less harmful. If, by chance, Delta+ will overtake Omicron or Omicron+ in transmissibility, then the world will be faced with the spectre of both of them spreading.
I don’t think this will happen though, because Omicron is already near the maximum possible transmissibility for the virus, and because Omicron will also be mutating. Also, Omicron has a big headstart in spreading throughout the world.

Herd Immunity, sort of
Eventually, the overwhelming majority of people (say 97%) in the various countries will have developed some immunity for Covid-19, either through vaccinations or by having been infected. When this happens, people could still be infected by variants that differ from the one they got immune to; but only few of these would be hospitalized.

The large numbers of people in Africa and other Third World countries who remain unvaccinated could indeed cause mutations and variants. And these variants could in turn cause new Covid-19 waves in these countries. I am not too worried about this, though. Any such variants would be facing a wall of immunized populations in other countries and fizzle out.
Omicron has shown us that Covid-19 could also circulate for a long time among animals, before crossing over back to humans. This means that it could accumulate a lot of mutations before emerging. And the more mutations there are, the more likely the virus would have to infect people who were previously immunized against older variants. It takes time to develop this kind of variant though – perhaps two years or more. By that time, a lot more people would have been vaccinated, even in Africa. This means, a new variant of Covid-19 jumping over from an animal would be facing a more formidable wall of immunity in the human population.

Longer Term
In the longer term, there would be waves and peaks of Omicron infections especially in areas where many people are not vaccinated. Omicron would mutate to become Omicron+ or Omicron++ that would be even more transmissible and make people even less sick. Vaccinations will have then become more widespread – eventually reaching a minimum of 50% in Africa, and higher elsewhere. Countries may endure a few more waves of Covid-19, with each wave peak getting less each time as infections build more natural immunity with each round.

When this will happen, will depend to a large degree to how fast the Omicron variant spreads. The faster it spreads, the sooner it will be that Covid-19 will be less harmful.

I think that sometime in 2024, or earlier, the Covid-19 pandemic will be effectively over.

Lockdown in the Netherlands

Covid-19 lockdowns come in all forms. On one end are those in China, where people are literally not allowed out of their homes for weeks at a time. On the other extreme, we have Dutch lockdowns.
The Dutch government does not believe in confining people to their homes. In 2020, in its first and strictest lockdown, when all shops and institutions except for food stores and drugstores were closed, people were allowed (even encouraged) to exercise outdoors. Masks were never required outdoors.

On December 19, 2021, the Dutch government declared the country’s second Covid-19 lockdown.

How does this lockdown feel like? When I go to our nearby covered shopping center, I see that ‘non-essential ‘ shops such as hair and nail salons, and clothing shops are indeed closed. But many shops operate through ‘bell and collect’, where customers call the shop and come to collect the items they ordered. It is amusing, because some customers call the shop to place their orders through their cellphones while standing near the shop. Shops that do maintenance and repair work are also open, as well as collection/delivery points for online webshops. Libraries, government services are open; so are cafes and restaurants for take-out. And, typical of the Dutch, coffee shops (where cannabis is sold) are also open (take-out only). Flower shops seem to also be considered essential.
In short, most of the shops are open, in one way or another.

In other ways, though, the lockdown is serious. There is no night-life, and nobody can eat out – anywhere. Nobody can go to watch a football game, go to the movies or to museums. Train and bus services have been reduced, especially at night and rush-hours, for lack of passengers.

The people have adapted to the lockdown. The government-declared fireworks ban was largely ignored: you could not buy fireworks legally, but people just went to Belgium or Germany to buy them. And the police declared that they were not going to arrest people using fireworks. Lots of people go to Belgium or Germany to shop, or eat out.
Young singles have shifted from having dinner dates to ‘strolling’ dates (sometimes bringing gluhwein). Offices hold Zoom cocktails: where the participants are in a Zoom session, consuming wine/beer and finger food that was sent to their homes.

On January 10, primary and secondary schools reopen, as well as day-care centers. Tertiary education remains closed though. The lockdown will officially end on January 14. People expect it to be extended, but loosened a bit more.

2022

It is a few days into the New Year, and instead of making resolutions, I like to put out some predictions for the year – both for the Philippines, and globally.

I think the Covid-19 pandemic will largely be over by this time next year. I don’t mean that there will no longer be cases, or even waves in specific countries. I mean that Covid-19 will no longer be an impediment to travel; there will be no more lockdowns, nor panics when a new variant arrives. Covid-19 will just be one of those things, which are annoying, but no longer really dangerous.

The US elections in November will be won by Democrats, who will ride on the positive economic performance of the Biden presidency, and on the aversion to the pro-Trump wave sweeping the Republicans. This will be going against the prevailing wisdom that the party of a first-term president loses in midterm elections.
In the Philippines May election, I expect Leni Robredo to win. It will be a one-on-one race eventually, against Marcos Jr; one in which she will carry the masses against the superior funds of her opponent.

The Russian threat against Ukraine will fizzle out, inspite of all threats that Putin makes. The Ukrainian army is now much stronger than it was in 2014, and added to the threat of economic sanctions, and the difficulty of holding territory against a determined nationalist resistance movement will be enough to deter Russia from attacking.

The Beijing Winter Olympics will be a success, despite diplomatic boycotts and extreme Covid-19 measures. Later in the year, China will loosen its zero Covid-19 policy. And possibly also its XinJiang policies (by a little bit). Xi Jinping’s hold on power will have been consolidated by then, and the Chinese communist party could afford a little loosening.

The price of oil will probably end up the year where it began – at around $80/barrel for Brent crude. Opec+ will continue with its gradual increase in production for most of the year, but the US will not be able to increase production significantly.

I will review these predictions a year from now. I am curious how many of my predictions will hold out.

Gedogen

Gedogen (verb: gedoog) is a Dutch word which literally means ‘to allow’.  This is when the government declares that while something may be prohibited by law, the police will allow people to do it (to some extent). A prominent example of this is the case with drugs. People from other countries have the impression that drugs are legal in the Netherlands; but they are not – they are actually technically illegal. Parts of the Dutch Anti-Drug law are ‘gedogen’, i.e. tolerated. This include: carrying drugs for personal use (up to 5 grams), growing up to 5 marijuana plants at home for personal use, and the operation of coffeeshops which sell marijuana or hashish up to 5 grams per customer.  Stores that sell equipment for growing marijuana (‘grow shops’) are also gedogen.

Prostitution also used to be ‘gedogen’, where it was allowed in specified areas.  Now, prostitution has been legalized.

Why not just change the law?
The Dutch practice of having a law, and then gedoog parts of it, seem strange. Why not just pass a law that specifies what is legal or not, and then implement this strictly?
The practice of gedogen is actually a more effective way of handling public policy than simply having laws. It makes it possible to fine-tune or make swift adjustments to the law when necessary. And this is easier to do than adjusting the law every time.  Gedogen gives flexibility to local governments, some of them can be more restrictive of drugs, e.g. not allowing coffeeshops to operate there, while other municipalities could experiment with injection-centers, where addicts avail of heroin from the government, and in exchange adhere to a strict code of conduct (resulting in ‘well-behaved’ addicts).

Laws are made by the national parliament, while implementing rules are often made by the national and local executives (i.e. the cabinet, mayors).  The latter can act quickly, and can precisely tailor the gedoog policy.  Crafting a law is a relatively long and tedious process, while gedoog policy can be made much more quickly, and can be adjusted for specific occasions or periods.  For example, some municipalities prohibit (or, not gedoog ) the selling and use of the XTC drug during music festivals.

The parliament has recently passed a law prohibiting the use of the burqa (a Muslim full-face veil) in public buildings. Amsterdam, however, declared that burqas will be gedoogd in their city.  This means that burqas will be prohibited everywhere else.  If circumstances change in Amsterdam, they could quickly just change their policy.

The practice of gedogen started in the 17th century in Amsterdam. The country had strict laws against prostitution due to the Dutch’ Calvinist beliefs.  However, with the influx of lots of traders to the city at that time, the Amsterdam government decided to allow prostitution in order to keep the traders happy (and not molest their women). Rather than legalizing prostitution, the city then decided to just tolerate it.

 

 

 

Plastic Excess

The world is flooding in plastic, and people should do their best to avoid using too much plastic, especially because a lot of it ends up in the sea. This is true. However, over-zealous anti-plastic campaigners are making claims that are not true; and these could eventually water down the anti-plastic message.  Let us examine some of these:

Small pieces of plastic go up the ocean food chain, and eventually get eaten by people, harming us.
It is important to point out that plastic particles are undigestible by animals of all sizes. This means that animal bodies do not allow plastic particles to pass from the digestive tract into the blood stream. The plastic remains in the intestines, and get ejected together with other undigestibles as feces.

Small pieces of plastic do indeed get eaten by sea creatures. The vast majority of these get excreted as feces and drops to the ocean bottom. If fish eat pieces that are too big to be excreted, they get stuck in their digestive tract. If these accumulate, they will eventually make the creature sick due to lack of nutrition; they then die and sink to the ocean bottom. Fish that eat smaller fish (who could have plastic particles in their digestive tracts) will also eject the plastic as feces.
The great majority of plastic particles eaten by fish end up at the ocean bottom, one way or another.

Fish that get caught for human consumption most likely have small particles of plastic in their digestive tracts. Before being eaten, however, the intestines and other internal organs are thrown away. In case people eat fish with their intestines, the plastic there will be ejected as feces.

Chewing gum is made up of synthetic rubber, which is a form of plastic.
This is wrong in a number of ways.  First, not all gum is made from synthetic rubber. Synthetic rubber is made from petroleum, and whose price depends on the oil price. When the oil price is high, synthetic rubber becomes expensive – too expensive to be used for gum.
Second, rubber is NOT plastic. Synthetic rubber is chemically the same as natural rubber. Like plastic, rubber is made up of long molecular chains. But, unlike with plastic, the molecular chains of rubber break apart naturally; they are biodegradable.

Plastic will be floating in the sea for thousands of years.
This inaccurate and deceiving. Individual pieces of plastic floating in the sea will be gone (i.e. sink to the ocean bottom) in less than ten years. Floating plastic attracts algae and other plants and animals to attach to them.  In a couple of years, they get heavy and sink to the bottom of the ocean.  The exception to this would be plastic that are extra buoyant, e.g. closed gerrycans, floats for fishnets, etc.  which may take longer than 10 years before they sink or get swallowed by a big fish or whale. But within decades, these too will be gone.
The problem is that the supply of new floating plastic is growing much faster than nature can get rid of them. If suddenly, the supply of floating plastic stops; all floating plastic will disappear in a few decades.

At current rates, there will be more plastic than fish in the oceans by 2050. 
This is the spectacular claim made by the Ellen MacArthur Foundation during the 2018 World Economic Forum. They extrapolated data from a study by Jenna Jambeck, which made projections till 2025.
The projection is slippery because it depends a lot on what we mean by ‘fish’.  If we are comparing the number of plastic particles (no matter how small) with bony creatures swimming in the ocean, plastic pieces will outnumber fish even now.  To be more objective, perhaps we should compare their total weight. And, we should also count all marine animals as ‘fish’ – from marine mammals, fish and squid, to clams, corals, krill, copepods and zooplankton.
The Ellen MacArthur Foundation uses the figure of 750 million tons of plastic in the sea by 2050 (Note that Jenna Jambeck does not agree with is extrapolation of her data.). Marine biologists estimate that total marine fauna is between 2 billion and 10.4 billion tons.  So, there will always be more fish than plastic, that is clear.

The 2050 claim does not consider the dynamic nature of the ocean. For one, there is a growing rate of plastic sinking to the ocean bottom, because of biological processes (narrated above). Of course, one can be philosophical in saying that the plastic is still in the ocean then; but we all know that what really counts is plastic that is floating in the ocean. Floating plastic promotes life that attaches to it, and flourishes around it, similarly to the effect of artificial corals; floating plastic has become part of the ecosystem.

The 2050 prediction does not consider the price of producing plastic. Plastic is a petroleum product, and the cost of producing plastic is a function of the price of oil. The current price of oil is slightly less than US$ 70 per barrel. In the future, the price will fluctuate, but will not go below the present price anymore. The reason for this is that cheap sources of oil are running out, leaving the more expensive sources. So, the price of oil will slowly increase; and by 2050, it will be significantly higher than it is today. This means that plastic will be significantly more expensive to make by that time.
More expensive plastic would mean that substitutes for plastic will become more available and relatively cheap. It also means that recycling plastic would make more commercial sense. As a result, plastic production will be reduced, and so will the runoff of plastic to the ocean.

Plastic in the ocean is mainly a problem for humans, not nature.  We are bothered by litter on the beaches and when we swim at sea. ‘Cute’ animals e.g. whales wash up onshore with plastic in their stomachs. Plastic will hinder our ships in various ways. Later, plastic will become a growing part of the catch by fishing vessels. And perhaps, most important, plastic floating in the ocean is an enormous waste of resources; if they are recycled, we would save having to use petroleum to make plastic.

Campaigns to lessen plastic production should emphasize real problems for humans that result from lots of plastic floating in the oceans.  They should also point out that plastic dumping is wasting valuable resources; and that recycling plastic saves resources and lessens the amount of greenhouse gas produced.