We are? Well, probably. Take a look at this twitter thread about the horrific surge that’s happening in Hong Kong right now. Apparently, they didn’t vaccinate the old people for some reason. (Why???)
NEW: I’m not sure people appreciate quite how bad the Covid situation is in Hong Kong, nor what might be around the corner.
First, an astonishing chart.
After keeping Covid at bay for two years, Omicron has hit HK and New Zealand, but the outcomes could not be more different.
After accounting for lag between infection & death, *1 in 20* cases in Hong Kong currently ends in death.
To put that into context, HK’s case fatality rate (NB different to infection fatality rate) is currently higher than England’s pre-vaccine peak. Two years into the pandemic.
Hong Kong doesn’t just look grim when compared to its Asia-Pacific peers.
In March 2020 we saw awful pictures from northern Italy. Last winter, UK & Portugal saw huge mortality spikes, and last summer it was Namibia, but Hong Kong has now set a new global record for daily deaths
The cumulative view almost looks like a glitch in the data.
Hong Kong’s total death toll has risen almost vertically in the last two weeks, shooting past not only its Asia-Pacific peers, but now European countries including Norway and Finland. And that line will keep rising.
Comparing Hong Kong to its peers, all of whom kept Covid largely at bay for the best part of two years, it’s extraordinary the extent to which it is an outlier in terms of the lethality of this wave.
So what’s driving this?
Vaccines.
Or more specifically: the elderly vaccination rate.
When Omicron hit, *more than two-thirds of people aged 80+ in Hong Kong were still unvaccinated*, compared to a couple of percent in New Zealand and Singapore. This was a year after vaccines became available.
Exacerbating this is that most of Hong Kong’s elderly vaccinees had China’s non-mRNA Sinovac shot, which is less effective than Pfizer etc at blocking infection.
Sinovac does fare better against severe disease, but overall this is likely to have contributed to the poor outcomes.
Now you might think, well, the over-80s are only a small share of the population, so surely this can’t have such an enormous impact on overall fatality rates?
But that would be to miss the fact that, all else being equal, older people are at far *far* higher risk of death from Covid than younger
So vax rates by age are better understood like this, with bars sized according to each age group’s baseline mortality risk.
That is a helluva lot of red, unvaxxed people. And in Zero Covid countries there are no prior infections, so these people are completely immuno-naive.
In a situation grimly reminiscent of England in March 2020, outbreaks have torn through Hong Kong’s care homes, killing more than 1,000 vulnerable residents in a matter of days.
Again, this is two years into the pandemic.
Here’s our full story, from @mroliverbarnes, @primroseriordan, @imandylin2 and me, on the crisis in Hong Kong and how it got there
But there’s more…
Earlier I warned about what might yet be around the corner.
Aside from Hong Kong itself, where the surge in cases in recent days is sure to have locked in hundreds more deaths, the looming crisis is mainland China, where elderly vaccination rates are only slightly better than HK
Around 15 million over-80s in mainland China are still unvaccinated. An astonishing number
In recent days China has locked down tens of millions in several cities, as it braces for a much worse wave than Jan 2020 where the bulk of infection was confined to Hubei province.
Story from @rwmcmorrow @primroseriordan @ruiyanggloriali @KathrinHille
https://www.ft.com/content/d59c7636-d895-4138-8e07-e9fbfdbd100f
Some concluding thoughts:
One thing I would hope people take away here is that this really underscores the importance of differentiating between Omicron’s intrinsic mildness and immunity-driven mildness.
In December, as Omicron took off in South Africa, many of us emphasised time and again that the observed reduction in severity in a population with lots of vax and infection was likely to be coming as much from that immunity as from intrinsic mildness
Originally tweeted by John Burn-Murdoch (@jburnmurdoch) on March 14, 2022.
Meanwhile, back in the states:
A wastewater network that monitors for Covid-19 trends is warning that cases are once again rising in many parts of the U.S., according to an analysis of Centers for Disease Control and Prevention data by Bloomberg.
More than a third of the CDC’s wastewater sample sites across the U.S. showed rising Covid-19 trends in the period ending March 1 to March 10, though reported cases have stayed near a recent low. The number of sites with rising signals of Covid-19 cases is nearly twice what it was during the Feb. 1 to Feb. 10 period, when the wave of omicron-variant cases was fading rapidly.
It’s not clear how many new infections the signs in the sewage represent and if they will turn into a new wave, or will be just a brief bump on the way down from the last one. In many parts of the country, people are returning back to offices and mask rules have been loosened — factors that can raise transmission. At the same time, warmer weather is allowing people to spend more time outside, and many people have recently been infected, which may offer at least temporary protection against getting sick again – factors which would keep cases down.
“While wastewater levels are generally very low across the board, we are seeing an uptick of sites reporting an increase,” Amy Kirby, the head of the CDC’s wastewater monitoring program, said in an email to Bloomberg. “These bumps may simply reflect minor increases from very low levels to still low levels. Some communities though may be starting to see an increase in Covid-19 infections, as prevention strategies in many states have changed in recent weeks.”
Bloomberg reviewed data for more than 530 sewage monitoring sites, looking at the most recent data reported during the 10-day window from March 1 to March 10. Out of those sites, 59% showed falling Covid-19 trends, 5% were roughly stable, and 36% were increasing. Rises or declines are measured over a 15-day period.
