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Is Omicron really a mild version of COVID-19?

I keep hearing that Omicron is milder than Delta, and that seems to be true for people who have been vaxxed and boosted. But overall, it's hard to square this with the numbers we're seeing. Hospitalizations peaked at a far higher number than last year, when no one at all was vaccinated. The death rate is still lower than last year so far, but not by much.

Looking at these charts, Omicron looks like it peaks quickly and then declines rapidly. That's great! But while it's around it sure doesn't seem especially mild.

71 thoughts on “Is Omicron really a mild version of COVID-19?

  1. Justin

    For whatever reason, the breakthrough cases are happening. Lots of vaccinated people at my workplace have been out. 7 people in my circle of friends and extended family got sick since December. My nephews 4 year old had the worst case. Unvaccinated. No one is in hospital except unvaccinated and otherwise seriously ill or immune compromised.

    At this stage, it really is just a bad cold for most vaccinated. I’m content to see the willfully unvaccinated suffer and die. Way to own the liberals! Keep it up.

      1. Justin

        I’m a complicated person. And an actual person too.

        If you think I’m some anti-vax fanatic, you are way off base. I do more to bring vaccines to the world than any of you can imagine.

      1. Vog46

        ^^^^THIS^^^^^THIS^^^^^^a thousand times ^^^^^THIS^^^^^

        It matters not to anti vaxxers that mutations happen. ALL that matters is that Omicron is milder on a per capita basis. Yet, Omicron has surpassed Delta for total deaths.
        Why is the argument changed? We use per capita as a means to JUSTIFY the argument that more populous nations are best compared this way but leave out the fact that WE are supposed to be exemplary, WE are supposed to be exception Americans and WE with our market based medical care is the BEST in the world.

        The anti vaxxers are pushing per capita because it makes the numbers look smaller - which justifies their lame attempts at disguising the real issues here.
        First - a COVID death is a death it happened here, in the US of A and was totally Unnecessary. Doesn't matter is they were originally older folks. It was a death that didn't happen naturally.
        Ask yourself this. Why did the total deaths become so UNimportant?
        We play fun with statistics all the time on Drums posts yet in doing so we down play "DYING".
        But the main concern here is not that Omicron is "miler" or causes more total deaths.
        The fact is that Omicron happened at all. Why? It co-existed with Delta and over whelmed our capacity to deal with it. Now we have, less than 60 days since Omicron first took hold a new "step sister" to Omicron and that is Ba -2. Already called a VOC by WHO. 60 days. Thats all it took.
        The ability of Ba2 to evade protections provided by previous infection and/or vaccination is stunning.
        We SHOULD have developed Delta specific vaccines but we decided NOT to. The protection they provided was "good enough". Turns out when you assume things are gonna stay the same something comes along and makes it worse.
        There is absolutely NOTHING to belie the argument that new variants will get less dangerous. NOTHING.
        UNLESS you start saying "Well Vog on a per capita basis we're showing less deaths" OR "On a per hospitalization basis less folks are dying"
        Both statements are true but both disguise the real issue here. We are downplaying number of deaths in what ever way possible to make it look like we KNOW what we are talking about.
        Covid is still "ping-ponging" around the globe and mutating faster than we can produce and distribute vaccines for the differing variants.
        I hope the new vaccines being develop by Walter Reed and Japan come to market soon.
        A death no matter WHAT the cause, is tragic. We need to slow it down so as to slow the mutating down

  2. TheWesson

    Since it's much more contagious, the same number of serious cases will be concentrated in a shorter period resulting in a higher peak.

    The opposite of "flattening the curve".

    1. Pittsburgh Mike

      Exactly. With home tests being available, many cases aren't even been reported, and the official case numbers are immense anyway. The 25-30% unvaxed in the country times the incredibly large # of people who are sick, is responsible for the relatively large number of deaths.

      That being said, I've seen at most one study indicating that omicron is less severe, controlling for vaccination status. So, considering how many more people are vaccinated, and how many have already been already exposed and may still have antibodies or T cells, compared to the last peak, it is really hard to compare the severity of omicron vs. Covid classic or delta.

      1. SamChevre

        The home tests are critical to remember when trying to make sense of numbers: my anecdata would point toward only half of symptomatic Omicron cases being reported anywhere-the others took a home test that came back positive, and just stayed home to avoid exposing anyone else.

  3. stilesroasters

    Kevin, I took la count hospital data & plotted admissions vs icu% of admissions, and omicron stood out with a lower percentage consistently, but it’s like 13-16% vs 20-24% for delta. Definitely lower, but not radically lower.

    1. cmayo

      And with a larger denominator simply from there being more breakthrough cases, it's going to APPEAR like it's less severe, but actually it's just as severe for the unvaxxed and the higher breakthrough rate means that there will be more people with breakthrough cases that are serious enough to seek medical attention as well. But the vast majority of those folks won't die from it, even if they are hospitalized for a short time.

  4. jte21

    The only people I've known to contract omicron have been friends and colleagues who are all fully vaccinated and boosted. Several were entirely asymptomatic -- routine testing caught their infection. Others tested positive after feeling slightly unwell (sore throat, fatigue, cough), but basically said it was like a mild cold and recovered fairly quickly.

    None have come anywhere close to being hospitalized. Our local ICUs are maxed out with unvaccinated or very infirm/elderly who had been vaccinated, but not boosted. Omicron can be nasty for those who were vaccinated a year ago, but haven't bothered to get a booster, particularly if you have diabetes, COPD, or similar health issues.

    1. winterbourne_se

      As a young, active, and boosted lad who's in the midst of recovering from a COVID-19 infection, I will just say there is a lot of space between feeling "slightly unwell" and not having to "come anywhere close to being hospitalized." While my infection was "mild," it also gave me the worst sore throat I've ever experienced and knocked me out for a solid three days.

      Without the sore throat, I would have compared my infection to a bad cold. The sore throat made it quite a bit worse than most colds I've had. I know other vaxxed+boosted folks who also experienced a sore throat that makes swallowing feel like you're trying to swallow broken glass.

      Anyway, I don't disagree with anything you said, but I would just add that omicron can be nasty for anyone—even boosted individuals. On the other hand, I haven't been sick for two years, so I can't really complain. Glad to have it over worth!

    2. Joseph Harbin

      Omicron can be nasty for anyone. Don’t kid yourself.

      I tested positive earlier this month. Triple vaxxed, no known comorbidities, healthy, active (run 50-75 mi/mo), 64. No apparent symptoms. No fever, no coughing or sneezing, no sore throat, no fatigue. All good, right?

      No. Three days after testing positive, I woke up in the middle of the night not sure if I was going to live to see daylight. I went to the hospital. Luckily, not a heart attack. But I had a bad EKG. Getting more tests, inc an echo, to see what’s going on.

      Never had a heart problem before, no history of heart disease in our family. Until Omicron.

      Stop thinking that getting Omicron is nothing to worry about.

      1. Steve_OH

        post hoc ergo propter hoc

        At age 62, I developed atrial fibrillation out of the blue. This was in late 2019, coincidentally a short time before the End of the World as We Knew It.

      2. Vog46

        Joe I hope you recover.

        My daughter is fully vaxxed and boosted. We worried about Omicron affecting her ability to breathe because it does manifest itself in the bronchial tracts. (she is a smoker)
        She got Omicron, but HER worst symptom was SEVERE body aches. She said it was the worst she's EVER felt. Had some fever and stuffiness in her nose but the aches were horrible.

        1. J. Frank Parnell

          Matches the general feeling, Delta kills by hitting the lungs hard. Delta doesn't hit the lungs as hard, but is still serious.

  5. damgo2

    The claim is that it's milder per case, so your odds of getting hospitalized / going to ICU / dying, conditional on becoming infected as an immune-naive person, are lower than previous variants. It doesn't appear this effect is that large though, from the numbers I've seen.

    Separately, there's a quite a bit of immune avoidance, so a lot more people are re-infected or infected after vaccination than with prior variants. These cases tend to quite mild, unsurprisingly.

  6. dontcallmefrancis

    I had a mild covid case, in the Omicron wave. Vaxxed and boosted.

    A cousin had a covid case in the Omicron wave. Not vaxxed, she was cremated.

  7. Jasper_in_Boston

    We know Omicron is extremely infectious. So, there doesn't seem to be any inconsistency between higher hospitalization numbers and the claim that this variant is milder than its predecessors: it could simply be that the much larger number of cases swamps any advantage provided by the milder nature of Omicron.

    Also, while the seven day death average is now a bit higher than the peak of the Delta wave, it's still well below the peak we reached in January, 2021 (Trump's last week in office).

  8. jdubs

    Is Omicron less serious for individuals with low levels of immunity (combo of recent infection and/or vaccines) ?

    Or is it more serious for individuals with high levels of immunity so that we see more breakthroughs but fewer deaths per positive case? If this is true could we see higher risks for unvacced, higher risks for fully vacced, but lower overall risk for the total pool of positive cases?

    I haven't seen good analysis that identifies the change in severity to the different pools of people.....

  9. sonofthereturnofaptidude

    If Covid keeps making the rounds, expect more mutations and more surprises, probably including some very unpleasant ones.

  10. reino2

    This post should also show the number of cases. The omicron wave hit 800,000 cases per day. The other waves had at most 250,000. We're getting roughly the same number of deaths with over three times as many cases.

  11. mudwall jackson

    my theory: we as a society are taking fewer precautions than we did. less mask-wearing, less social distancing, more open generally. it means more exposure for all of us, for the vaccinated it means mostly mild or relatively mild breakthrough cases; for the obstinate who never have taken covid seriously, it means a greater chance of contracting a more severe case of the disease.

    1. J. Frank Parnell

      There may be something to what you say. CDC data shows the level number of cases is exploding among all age groups except the elderly, where it is increasing more modestly. This is the group that takes the risk of COVID most seriously, has the highest level of vaccination, and presumably takes social distancing and masking more seriously.

  12. golack

    Cases are dropping, but still mainly at bat shit crazy levels...
    DC, MD, Philly, northern NJ, NYC--part of the Acela corridor/I95--shows numbers dropping down to just insane levels.
    MLK holiday artifacts have worked thru the system.
    Looks like rate of drop in number of cases slowing down. In PA, Harrisburg, Pittsburgh, Erie, W-B/Scranton have numbers that look to be leveling off if not rising---hopefully just a blip in the decline...
    Colleges are opening up after Christmas break. Even with kids vaccinated and boosted, you can expect an increase in spread. If we're lucky, they'll just be little hiccups in the decline in cases. Which means we may have to wait until after Valentine's day for case rate to drop to moderate levels.

  13. golack

    I was going to blame testing--compare positive test rate during different waves...and from CovidActNow....this latest wave as a worse positive test rate....
    Anyway, slightly higher hospitalizations, but lower ICU per 100K with current wave.
    We've gotten better at treating people, especially since the initial wave. We have new antiviral treatments, which is good since the mono-clonal antibodies don't work on omicron.

  14. mostlystenographicmedia

    If Omicron is causing higher death rates among unvaccinated yahoos, Biden should consider giving Omicron a pardon.

  15. Jerry O'Brien

    Take this with a grain of ivermectin, but omicron cases seem to have less than half the fatality rate of delta. Just looking at some charts at the N.Y. Times.

    Average daily U.S. case count for week ending:

    Dec. 11: 119 k (almost all delta)
    Jan. 8: 656 k (almost all omicron)

    Shift three weeks forward and look at the average daily deaths:

    Jan. 1: 1240 (mostly delta cases, I presume)
    Jan. 29: 2570 (mostly omicron)

    So what do we see for omicron relative to delta? Five and a half times as many cases on the dates compared, but only twice as many deaths on the corresponding compared days.

  16. bmore

    My daughter had covid just before Christmas. She was vaxxed and boosted, was sick for about 10 days with teeth chattering chills, night sweats, sore throat, fatigue, headache. She said it was like a bad flu. If she was not vaxxed and boosted, it could have been a lot worse. I have read a few articles saying we should not call omicron "mild" as it discourages vaccination and boosters. It is so contagious that it can overwhelm hospitals. https://www.deseret.com/coronavirus/2022/1/7/22871956/omicron-variant-mild-symptoms-death

    1. Special Newb

      It's yet another medical term that bears almost no relation to what the word actually means.

      Mild means "survive without hospital care."

    2. haddockbranzini

      That's what happened to me. Fully vaxed and got boosted in November. About two weeks ago I woke up freezing and thought my wife opened the windows or something. Next morning she felt the same. Was about 7 days of 104 degree fever and night sweats so bad I had to change clothes three times a night. I'd say it was like a bad flu, but never had a flu that bad. Oddly, the only symptom was the fever and body aches that felt like I was physically assaulted.

      And, despite feeling somewhat normal I can't say I am 100% yet.

  17. gesvol

    Covid-19 is currently going through the office I work at like wildfire. The vaccination rate is supposedly 80% though I don't know how many are boosted. Also currently working at the office is voluntary. So I don't know if the percentage vaccinated/unvaccinated still holds at 80/20 or if perhaps the unvaccinated are more likely to go in.

    I've been working from home except for one afternoon where my internet was acting up and I had to go in for an afternoon. (Fortunately I came into contact with very few people and was wearing my mask, though I don't think I saw anyone else wearing one.)

    But regardless, Omicron seems to be crazy contagious and just the sheer number of cases is going to do something to overcome any advantages of it being "milder". Generally when look at cases versus hospitalizations/deaths, it does seem to support the idea that it's milder. But it's hard to parse out how much of that is the effectiveness of the vaccines versus how much of that is the variant itself. (The only person at work who has caught it so far where I know his vaccination status was vaccinated and has experienced only mild symptoms.)

  18. gvahut

    Less lethal is not the same as "milder" or "mild." I am sure that cases are far undercounted now more so than before because of home tests, asymptomatic cases, unavailable or unaffordable testing, and those who simply aren't getting tested because it's obvious what they have and it doesn't affect their own management of their illness. And deaths are substantial, though as a percentage of actual cases (not just documented ones) I think Omicron will turn out to be less lethal. It is hard to judge what hospitalization rates mean because there are a lot of people with coincidental Covid that was less prevalent in the past surges - knock off 20-40% of all hospitalized. But not sure how that relates to ICU cases or intubated cases. I thought perhaps the last two years would cull the herd in a significant way, but it turns out there are still a lot of susceptible people (fully vaxxed) as well as the unvaccinated nimrods (mostly 50 and older) who should know better. All those folks will likely remain on the hot seat when the next variant emerges.

  19. D_Ohrk_E1

    If the rate of hospitalization is ~50x higher for those who are unvaccinated, it's fair to characterize the vast majority of the hospitalized as unvaccinated.

    If that's the case, then we can compare Delta with Omicron by looking at ICU / hospitalization -- bad apples to bad apples, amirite?

    It's not close. CDC and some states do not track ICU beds publicly, just so that you know if you wish to take that journey into looking at the data.

  20. SecondLook

    The number of "breakthough" cases may overstated to some extent by those who are faking vaccinations via fake cards - which apparently is a burgeoning business.

    A New Jersey woman calling herself the AntiVaxMomma on Instagram sold several hundred fake COVID-19 vaccination cards at $200 a pop to New York City-area jab dodgers, including people working in hospitals and nursing homes, prosecutors said Tuesday.

    For an extra $250, a second scammer would then enter a bogus card buyer's name into a New York state vaccination database, which feeds systems used to verify vaccine status at places they're required, such as concerts and sporting events, prosecutors said.

    This was war from last September, it is only getting worse.

      1. MontyTheClipArtMongoose

        With a coupla counterfeit Benjamins, maybe, or a leftover Mc Cain 2008 campaign credit card.

        Ain't no way Glen Rice's Secret Lover paid real money for something.

  21. lisagerlich

    I find it interesting that the most vaxxed country in the world, Israel, is reporting record numbers (per 100,000 population) of people getting the Covid. I believe that statistically, getting the shot and boost reduces your chances of hospitalization and death. Still, as far as preventing the spread of the disease, you can get boosted until the cows come home, but it does not mean you are less likely to get the virus. Governments worldwide have used the pandemic as an excuse to extend the power of the state. Officials have lied, and people realize this. Therefore, people are less likely to trust institutions, for good or ill.

    1. royko

      "Still, as far as preventing the spread of the disease, you can get boosted until the cows come home, but it does not mean you are less likely to get the virus."

      The vaccines did a good job of preventing infection (although this wasn't their primary benefit) but that waned after ~6 months, and waned even more against Delta, which was why they introduced the booster. The booster extended the effectiveness against becoming sick, but it doesn't work nearly as well against Omicron. But even with Omicron, being recently boosted brings some protection against infection, it's just a lot less.

    2. SecondLook

      Odd, one of the basic functions of modern government is public health.

      I swear, watching Ibsen's "An Enemy of the People" should be near obligatory if not, ahem, mandatory...

    3. skeptonomist

      A lot of people have "realized" that governments have lied, but the the same people don't seem to realize that Trump and Fox News lie most of the time.

    4. pack43cress

      " Governments worldwide have used the pandemic as an excuse to extend the power of the state. Officials have lied, and people realize this."

      Thar's just plain baloney.

  22. Special Newb

    Are we really going to start the week with "charts allow Kevin Drum to speak truth to the power of the global medical complex"? Really?

  23. royko

    The relationship between cases and hospitalization/death has changed. They still go up together, but hospitalizations/deaths not spiking as high.

    The question is: is that happening because more of the cases involve vaccinated people, or because Omicron is milder? It's probably a combination. One of the South African studies estimated it was 25% milder, controlling for everything else. But that's one paper.

    Whatever the cause, increased contagiousness makes up for a lot of the reduced severity, although thank God it's not worse.

  24. buckyor

    I guess the term "mild" is doing a lot of work here. I tested positive on Christmas eve (despite being fully vaxxed), and that night I was miserable. I didn't even have enough energy to eat, and if you knew me you'd know how unusual that is. My wife was pretty pissed (even more pissed when she tested positive a few days later). I was in bed for several days without doing anything; much worse than any cold I've had. More along the line of pneumonia. And getting better was a long process; I had no energy at all for over 3 weeks, and even now more than 5 weeks later am working to get my energy back up to where it was before.

    I guess I didn't die nor was I put on a ventilator, so I guess it was "mild."

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