<div dir="ltr">We are vaxxed, boosted, masked indoors (I was the only one at UPS yesterday on Capitol Dr with a mask on, including employees!), and cautious. Avoiding gatherings where we are unsure of attendees. This variant was described in today's New York Times as transmitting more quickly, similar to the ways of a cold virus. Makes me wonder if we need to be more careful about surfaces again.....<div>Be well, take care.</div><div>Paula<br><div><br></div></div></div><br><div class="gmail_quote"><div dir="ltr" class="gmail_attr">On Sat, Dec 4, 2021 at 9:49 AM philip smith via Lekooks <<a href="mailto:lekooks@lekook.org">lekooks@lekook.org</a>> wrote:<br></div><blockquote class="gmail_quote" style="margin:0px 0px 0px 0.8ex;border-left:1px solid rgb(204,204,204);padding-left:1ex"><div dir="ltr"><div class="gmail_default" style="font-size:large">Great article summarizing the latest Omicron data from South Africa. Short summary, esp for those of us older folks- get your booster now!</div><div class="gmail_default" style="font-size:large">phil</div><br><div class="gmail_quote"><div dir="ltr" class="gmail_attr">---------- Forwarded message ---------<br>From: <strong class="gmail_sendername" dir="auto">Mae</strong> <span dir="auto"><<a href="mailto:c.maesmith@gmail.com" target="_blank">c.maesmith@gmail.com</a>></span><br>Date: Sat, Dec 4, 2021 at 9:10 AM<br>Subject: Fwd: Omicron Update: Dec 4<br>To: lynne smith sister <<a href="mailto:lynnethetwin@gmail.com" target="_blank">lynnethetwin@gmail.com</a>>, Phil Smith <<a href="mailto:psmithw318@gmail.com" target="_blank">psmithw318@gmail.com</a>>, Jesse Myerson <<a href="mailto:jesse.a.myerson@gmail.com" target="_blank">jesse.a.myerson@gmail.com</a>><br></div><br><br><div dir="auto"><div dir="ltr">FYI I’m subscribed to these updates from an epidemiologist who does a great job breaking down latest data — especially useful for quickly evolving omicron. <br><br>Begin forwarded message:<br><br></div><blockquote type="cite"><div dir="ltr"><b>From:</b> Katelyn Jetelina from Your Local Epidemiologist <<a href="mailto:yourlocalepidemiologist@substack.com" target="_blank">yourlocalepidemiologist@substack.com</a>><br><b>Date:</b> December 4, 2021 at 9:38:36 AM EST<br><b>To:</b> <a href="mailto:c.maesmith@gmail.com" target="_blank">c.maesmith@gmail.com</a><br><b>Subject:</b> <b>Omicron Update: Dec 4</b><br><b>Reply-To:</b> Katelyn Jetelina from Your Local Epidemiologist <<a href="mailto:reply%2Bqrkmt%26e5h8c%26%264e04ce5b63bef2ca2e04248a030b712951c59794027669a3064c7555e7ea9ebc@mg1.substack.com" target="_blank">reply+qrkmt&e5h8c&&4e04ce5b63bef2ca2e04248a030b712951c59794027669a3064c7555e7ea9ebc@mg1.substack.com</a>><br><br></div></blockquote><blockquote type="cite"><div dir="ltr"><img src="https://mailgun.substack.com/api/v1/email/open?token=eyJtIjoiPDIwMjExMjA0MTQzNzI0LjIuNzY0ZWQ5YmZiZTNlMDg0Yi5uaXBubDJsbEBtZzIuc3Vic3RhY2suY29tPiIsInUiOjIzNzcwMjM2LCJyIjoiYy5tYWVzbWl0aEBnbWFpbC5jb20iLCJkIjoibWcyLnN1YnN0YWNrLmNvbSIsInAiOjQ0OTU2NDY5LCJzIjoyODEyMTksImMiOiJwb3N0IiwiZiI6dHJ1ZSwiaWF0IjoxNjM4NjI4NjgwLCJpc3MiOiJwdWItMCIsInN1YiI6ImVvIn0._gxBdZ4FffSrEnhQ1VlH_sY5V8Vwn-FxH3jAP8QbCEo" alt="" width="1" height="1" border="0" style="height: 1px; width: 1px; border-width: 0px; margin: 0px; padding: 0px;"><div style="display:none;font-size:1px;color:rgb(51,51,51);line-height:1px;max-height:0px;max-width:0px;opacity:0;overflow:hidden">It’s hard to believe it’s been one week since Omicron broke the news. While we continue to wait on lab evidence, we’re getting a substantial amount of epidemiological data every day. Here’s an update since my last… 1. Reinfections are high against Omicron </div><table role="presentation" width="100%" border="0" cellspacing="0" cellpadding="0"><tbody><tr><td></td><td width="550"></td><td></td></tr><tr><td></td><td align="left" width="550"><div style="font-size:16px;line-height:26px;margin:0px auto;max-width:550px;width:100%"><div style="font-size:16px;line-height:26px;padding:9px 0px"><div style="font-size:16px;line-height:26px"><h1 style="color:rgb(26,26,26);font-family:"SF Compact Display",-apple-system,BlinkMacSystemFont,"Segoe UI",Roboto,Helvetica,Arial,sans-serif,"Apple Color Emoji","Segoe UI Emoji","Segoe UI Symbol";font-size:2em;font-weight:bold;line-height:130%;margin:0.378em 0px 0px"><a href="https://email.mg2.substack.com/c/eJx1ksFyozAMhp8m3MKAcQwcfNhNNi3bkjbbTCb0whhbJE6MTcE0hadfNzntYWcka8aypPH_iTMLR9ONtDW99b6P0o4tUA3XXoG10HlDD10pBUVRHAcoIp6gWITJIvFkX9YdQMOkorYbwGuHSknOrDT6VpGEKEy9Ew05YRylBCcpcFYTElciZDhJwgUKQ0bug9kgJGgOFD6hG40GT9GTtW0_i37M0NrZaIZOGc4UtFJAI40yR9lbvx-q3jJ-8blp3LPWuWkk74yeD61wX5wL4HM8i9bWXEDPohWMv0OO9uMBqUt2NmM-8ShfZdNGXiV_SCexTtv3ZUY2q-1isyuCzfnSZ406CXeX74rpZVWMznG-vEp22Eyuh-SPe_m8y3C-y75e3rI-05uwkBnJ9M9PHm0tb_anIvrTVgjLeuuXfHr6eNDzt-Fcv46H7vnXx848PS7xpW3lap3LGr_3yTktXjNPUhQ4pVCAQxzFCPvIjwkGkVZ1BREECa58LVutkFIzHDRH9I8mXke53zDoG2lPLn_8RnZLOGKli82gpR1L0KxSIO4w7X0nbnjLI2jonJCiZJaGJEoISkgSJGl8Z-doY5wuCCap5yYL46o0_Q-vv5ur1xw" style="color:rgb(26,26,26);text-decoration:none" target="_blank">Omicron Update: Dec 4</a></h1><table style="margin:1em 0px"><tbody><tr><td><div style="font-size:16px;line-height:26px"><a href="https://email.mg2.substack.com/c/eJxNUMtuwyAQ_JpwqwVrjPGBQy_9DYvH4tBgsAC38t-XJJdKq31oNJqdsbrhlsuljlwbeba1XQeqhL81YmtYyFmxrMEpGOeZwiiIU9wxOUkS6uoL4q5DVK2cSI7TxGB1Czm9GJIBW8hdCZTMc0DjPBfGO-2lnywTZmYAkzRvYX26gMmiwh8sV05Iorq3dtTb-HmDr171NLVp-xhs3vt5lOxDxL7BDDBTCh-P7ide6eMb-wxJk6CAAmNAOePjDHyAYRYc3WK8wRGp5GZI4UgRYrxxum8w_FchRdlh11j30O4d355mX0D3uva5nym0a8WkTUT3jqG903wFs26YsPSv3KqbYmKUAqSQVC7z23XPifNlElwspCu73FlJXfksMVsd8QgO95Bj3kJtfyMpkrM" target="_blank"><div style="font-size:16px;line-height:26px"><img src="https://cdn.substack.com/image/fetch/w_90,h_90,c_fill,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F0d83e8ba-8e88-44b6-b3cf-8b1dfbcba4e5_2162x2260.jpeg" height="45" width="45" alt="" style="border-radius: 50%; display: block; height: 45px; max-width: 550px; vertical-align: middle; width: 45px; border: none;"></div></a></div></td><td><div style="font-size:16px;line-height:1em;margin-left:12px"><div style="color:rgb(118,118,118);font-family:Helvetica,Arial,sans-serif;font-size:14px;line-height:17px"><a href="https://email.mg2.substack.com/c/eJxNUMtuwyAQ_JpwqwVrjPGBQy_9DYvH4tBgsAC38t-XJJdKq31oNJqdsbrhlsuljlwbeba1XQeqhL81YmtYyFmxrMEpGOeZwiiIU9wxOUkS6uoL4q5DVK2cSI7TxGB1Czm9GJIBW8hdCZTMc0DjPBfGO-2lnywTZmYAkzRvYX26gMmiwh8sV05Iorq3dtTb-HmDr171NLVp-xhs3vt5lOxDxL7BDDBTCh-P7ide6eMb-wxJk6CAAmNAOePjDHyAYRYc3WK8wRGp5GZI4UgRYrxxum8w_FchRdlh11j30O4d355mX0D3uva5nym0a8WkTUT3jqG903wFs26YsPSv3KqbYmKUAqSQVC7z23XPifNlElwspCu73FlJXfksMVsd8QgO95Bj3kJtfyMpkrM" style="color:rgb(26,26,26);text-decoration:none" target="_blank">Katelyn Jetelina</a></div><table cellpadding="0" cellspacing="0" style="margin:4px 0px 0px"><tbody><tr><td title="2021-12-04T14:37:37.171Z" style="color:rgb(118,118,118);font-family:-apple-system,BlinkMacSystemFont,"Segoe UI",Roboto,Helvetica,Arial,sans-serif,"Apple Color Emoji","Segoe UI Emoji","Segoe UI Symbol";font-size:14px;font-weight:400;height:14px;line-height:14px;padding:0px 12px 0px 0px;text-decoration:none;vertical-align:middle;white-space:nowrap">Dec 4</td><td style="color:rgb(118,118,118);font-family:-apple-system,BlinkMacSystemFont,"Segoe UI",Roboto,Helvetica,Arial,sans-serif,"Apple Color Emoji","Segoe UI Emoji","Segoe UI Symbol";font-size:14px;font-weight:400;height:14px;line-height:14px;padding:0px 12px 0px 0px;text-decoration:none;text-indent:3px;vertical-align:middle;white-space:nowrap"><span><a href="https://email.mg2.substack.com/c/eJx1UkuPmzAQ_jXhVgS2eR04tJtmRdSQptoNTS_I2AMxGEzBJCG_vibZHnqoZM_Invnm-TGqoVLDHPdq1NYicj33EHdwHSVoDYM1jTDkgscIB4GDsG_xmHA39EJLjHk5ALRUyFgPE1j9VEjBqBaqeyBCF7mRdY4J8ZCPUVgiQpnn05A7HqdRGeAoDDgKnonpxAV0DGK4wDCrDiwZn7XuxxX-vEIbc2Y1DVIxKqEXHFqhpKrEqO1xKkZNWWMz1Ro32gsjL64RS2CjHjV-GoCypbYV3mjVgNFrmLcuQ8f5J5JNUqt5d2d4t07uqbgK9hrd-Sbqf70kfro-eOnbyUnrZky6rTxlqUOzaDIYQXrUJMafZhvHvG9pvSNpnZhbXb-9bHsTUezF9sqzRO_q6rarv3qLP8NHseBZezyf8I--QESUB7s-sbRk4j4Gt_L93T1-V9Px4uw2NFOv7Lovmt-HL29esZfZYYX8Sbf5aMbCwHTzdw4f_y1wMbVLl0v7loiRg1wXOcQlOEDERnbgE-BRURaAwQlJYXei7ySSckWctkL_DNYaYma3FMZW6LOxV0vQh8GsPTe6nTqh5xw6WkjgT0boJ7EeBeQVdDAYwvGc6tj1ceij0A-dMPoggKEMIZHnEz-yTGauDKqL_7P0P_wu8C4" style="color:rgb(118,118,118);display:block;text-decoration:none" target="_blank"><img src="https://cdn.substack.com/image/fetch/w_28,c_scale,f_png,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Ficon%2FHeartIconRounded%3Fv%3D3%26height%3D28%26fill%3D%2523757575%26stroke%3D%2523757575%26strokeWidth%3D2" width="14" height="14" style="float: left; height: 14px; max-width: 14px; vertical-align: middle; width: auto; border: none;" alt=""></a></span></td><td style="color:rgb(118,118,118);font-family:-apple-system,BlinkMacSystemFont,"Segoe UI",Roboto,Helvetica,Arial,sans-serif,"Apple Color Emoji","Segoe UI Emoji","Segoe UI Symbol";font-size:14px;font-weight:400;height:14px;line-height:14px;padding:0px 12px 0px 0px;text-decoration:none;text-indent:3px;vertical-align:middle;white-space:nowrap"><a href="https://email.mg2.substack.com/c/eJx1UktzmzAQ_jXmZgaEeB04tHad0AQnbjwekwsD0mLL1oMgEQd-fWW7PfTQGa1mZx_fPr4ltYGD6sesU9o4168yYweZhIvmYAz0zqChrxjNUBDHHgoih2aY-kmYOExXbQ8gasYz0w_gdEPDGakNU_KWkfjIT51j1kAcEhoGbZyGVk-s4pGWoBYjWlMc3QvXA2UgCWTwCf2oJDg8OxrT6VnwbYZW9o1q6LkiNYeOURBMcXVg2rh6aLSpydklStiwzooSjPRKzoeO2hHnFMgcW7MNECCNhVwZdQY5C5Yw_vQJ2o17xM_5SY3FRIJimU9rdmHkIZ3oKu3eF3m0Xm7C9bb01qezzgU_UmsrtuX0sixHK7hYXFi9X08Wg5HHHXve5rjY5l8vb7nO5dovWR7l8vsnCTaGiN2xDH51DcKs3bgVmZ4-HuT8bTi1r-O-f_7xsVVPjwt87jq2XBWsxe86OaXlaz5D0WBEpe0mCNju_47-xy6AskFcp7qy4rAMecj3kYd9HMQIu8iNIww0bdoGAvAS3LiSdZIjzmfYEwf0zy6dPiOuqEELZo7Wf7iC3hyW6eq6y0EyM1Yg64YDvR-Bud_SrYHqABJ6SwCtapP5UZBEKIkSL0njO-f2SjBOwwhHqWMrU2WzZPYfnn8D2mjsIg" style="color:rgb(118,118,118);display:block;text-decoration:none" target="_blank"><img src="https://cdn.substack.com/image/fetch/w_28,c_scale,f_png,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Ficon%2FCommentIconRounded%3Fv%3D3%26height%3D28%26fill%3D%2523757575%26stroke%3D%2523757575%26strokeWidth%3D2" width="14" height="14" style="float: left; height: 14px; max-width: 14px; vertical-align: middle; width: auto; border: none;" alt="Comment"></a></td><td style="color:rgb(118,118,118);font-family:-apple-system,BlinkMacSystemFont,"Segoe UI",Roboto,Helvetica,Arial,sans-serif,"Apple Color Emoji","Segoe UI Emoji","Segoe UI Symbol";font-size:14px;font-weight:400;height:14px;line-height:14px;margin-right:0px;padding:0px;text-decoration:none;text-indent:3px;vertical-align:middle;white-space:nowrap"><span><a href="https://email.mg2.substack.com/c/eJx1Uk2P2jAQ_TXkRpTYJiSHHFoou-ku7NJFCPYSOfYEDP7Ixs7S8OvrQCu1h0oeS34zb0bz_Bh1cDBtnzfGumC4Stc3kGu4WAnOQRt0FtpS8Bzh6TRCOAl4TnicTtJA2LJuARQVMndtB0HTVVIw6oTRN0YaozgLjjmrkxpNppgSHnHGY57GMWdJFDGcVjVL74NpxwVoBjl8QtsbDYHMj841doS_jNDCn950rTSMSmgEByWMNAdhXWi7yjrKziEzypc1PowSrDV63DXcrzjmwMZkhBedU6X1XRiM8PwPbYSSAVfARac8ftvoN8iMdqDdUH2kLXiUsmG_vwBnzjC8of8eM7Ttd0iei5Ppl1eGl_PiuhIXwR6yK19kzfusSFbz9WS12Uer09kWSh65x5ab_fVlvu99kOXsIuhudfU9BHvciudNQZab4ufLW2ELvYr3okgK_fWT4bVjanvc4x9NhYio12HJrk8fD3r81p3q137XPn_72Jinxxk5N42YL5aiJu82PWX71yIQOYpQHKOIxARPEQlROE0I8KyqK8AQpaQKtWi0RFKOSKQO6B-dgzZnoaJglXBHnz8Mot0S3gVeNqU6LVxfgqaVBH43iLv77CZweQANrf8cXlKXxwlOE5QmaZRm07sfvIMIySYJSbLAT-bGs3T-Hw_8AvB99aw" style="color:rgb(118,118,118);display:block;text-decoration:none" target="_blank"><img src="https://cdn.substack.com/image/fetch/w_36,c_scale,f_png,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Ficon%2FRecommendIconRounded%3Fv%3D2%26height%3D36%26fill%3D%2523757575%26stroke%3Dnone%26strokeWidth%3D2" width="18" height="18" style="float: left; height: 18px; max-width: 550px; vertical-align: middle; width: 18px; border: none;" alt="Share"></a></span></td></tr></tbody></table></div></td></tr></tbody></table></div></div><div style="font-size:16px;line-height:26px;padding:9px 0px"><div style="font-size:16px;line-height:26px;margin-bottom:12px;word-break:break-word"><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em">It’s hard to believe it’s been one week since Omicron broke the news. While we continue to wait on lab evidence, we’re getting a substantial amount of epidemiological data every day. Here’s an update since my <a href="https://email.mg2.substack.com/c/eJx1kLuu4yAQhp8mdLEMJoALitPsa1gYxg5aboJhj_z2hyTbbLHSXIq5_p81CGeuly65IXmFDa8COsF3C4AIlfQGdfNOs0XKmS2COM0dVQ9FfNuOChCNDxprB1L6Hrw16HN6TyjK6Eqe-uDHfJhDSrPAA2bFrVTUGhBgBaxcfg6b7jwkCxr-QL1yAhL0E7G02_J1Y7-GXbnXkK0JULyD6HPIp284tb43NPb3ZHMcbWV4jt7WnO69uCHx7sDeGfGazYxSNnPKF8n4xCYpOLh1P3ZYXo_tU_IlBRbCjc_xZP-sJlXbKRpo0eNz1M-X8ndhCN9Gjj15vDZIZg_gPkzwg_ZNaTshQR3_uM2gpmJRgimhZrX-RTCgcb4-BBcrGZddHlNJ_0f2D-b3mU4" rel="" style="color:rgb(0,104,239);text-decoration:none" target="_blank">last</a>…</p><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em"><strong><code>1. Reinfections are high against Omicron</code></strong></p><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em">We got our first piece of solid scientific evidence yesterday (<a href="https://email.mg2.substack.com/c/eJwlkM2OrCAQhZ-mWRIoEXHBYjbzGgahtMkgGMD2-vYX26RSdVI_OanPmoprypfeU6nkTlO9dtQRzxKwVszkKJgn7zR0w8Cgk8Rp4bjqFfFlWjLiZnzQNR9I9mMO3prqU_xeKA58JG9tpBVSLeA6YND34zhYKZd-VmDMgHZ8jM3hPEaLGj-YrxSRBP2udS-v7ucFvy3O86QbuvzPf2jKa-vYFCvG2hRnlHPGm2oevOk7gIOUTKoP0OUIge5uIV7fCxyY4KIbQFCggxToxnmZsUOmxEyj32OAEF6CbSvQcsylGvtHbdpI1pZuBsvm67vN1_v976B9P7W6HdHXa8Jo5oDuAVMfvl9U04oRc-PuJlM1l52SoKRiahweDo2cEGMvhRxJc3apXUV9pSOHZE3A3TvcfApp9aX-B6HglKA" rel="" style="color:rgb(0,104,239);text-decoration:none" target="_blank">here</a>). A group of South African scientists leveraged a national dataset of all positive COVID19 tests over time. This dataset includes data regardless of the reason for testing or type of test (PCR or antigen). Using this dataset, they assessed the reinfection rate in South Africa from March 2020 to November 27 2021. </p><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em">The key findings of their analysis are in Panels A and C in the figure below. Both graphs are infections plotted over time. Panel A is <em>primary </em>infections, so someone who never had a positive test ever before. Panel C is <em>re</em>infections, so someone who had a positive test (at least 90 days) before. The colored background corresponds to different waves. This is what we see:</p><ul style="margin-top:0px"><li style="margin:3.75px 0px 3.75px 7.5px"><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px">Purple was South Africa’s first COVID19 wave. This was all primary infections, as reinfections were impossible at this stage. </p></li><li style="margin:3.75px 0px 3.75px 7.5px"><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px">During the Pink and Orange wave, primary infections and reinfections largely reflected each other. They had a similar pattern but at different magnitudes. </p></li><li style="margin:3.75px 0px 3.75px 7.5px"><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px">Then you get to Omicron at the tail end of these graphs. While primary infections are increasing, reinfections have substantially more exponential growth. In fact, that blue line is almost as high as the previous Delta wave.</p></li></ul><div style="font-size:16px;line-height:26px;margin-bottom:16px;text-align:center"><table width="100%" border="0" cellspacing="0" cellpadding="0" style="margin:8px auto"><tbody><tr><td style="text-align:center"></td><td align="left" width="510" style="text-align:center"><a href="https://email.mg2.substack.com/c/eJxVUk2P3CAM_TXJpUoEBAgcOGy36rU_IeLDk6FLIAtkp9NfXyY5VUL2ky37PWxbXWFN-an2VGr_Mkt97qAiPEqAWiH3R4G8eKfINM-ITLx3ijosmOh9WW4ZYNM-qJoP6PfDBG919SmeFQITLPu7wkgCM0TOs0OYWU64tAKwdgRJIbW8iPXhPEQLCr4gP1OEPqh7rXvppreO_GzPujiWw5Sq7cdo09ZCftMrNH-Dau_NP5aOfU_mN9j67dfpOvajI-92CX7ztaFbI6qpgc8LTG9rSu6VCMue05qhFP8FLV4qwN56XiIIe8lgLyHNmMN-QMvnARAzxgo6GK2ngU4zDJJhMWhnJmJgnqWgY5lGvem_KepHuZS3Hte4Tnh-o5wQG-MIRWQAx_hAEaeDFJMZNDjsJCMYz3KZOf4jCR73uPZeEdSiBFHc2AkdyThzCk6am4EJkKBmjH6PgYTQUbSt5L8h9lnZcdNQ2njuLb--9nkmmr6l-e2Ivj4XiNoEcNem63Uw5-6XFSLkdkhu0VVhPglOBBdIyPlabDsFSiXjlMu-MbvUqqJ6piOHZHWA3TvYfApp9aX-AxIz1vs" rel="" style="border:none;display:block;height:auto;margin:0px;padding:0px;text-decoration:none;width:auto" target="_blank"><img alt="" width="510" src="https://cdn.substack.com/image/fetch/w_510,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F1bbd2402-ed56-4064-983b-aed1d9521179_761x921.png" style="display: block; height: auto; margin: 0px auto; max-width: 100%; vertical-align: middle; width: auto; border: none;"></a></td><td style="text-align:center"></td></tr></tbody></table>Pulliam et al., Increased risk of SARS-CoV-2 reinfection associated with emergence of the Omicron variant in South Africa. Preprint <a href="https://email.mg2.substack.com/c/eJwlkM2OrCAQhZ-mWRIoEXHBYjbzGgahtMkgGMD2-vYX26RSdVI_OanPmoprypfeU6nkTlO9dtQRzxKwVszkKJgn7zR0w8Cgk8Rp4bjqFfFlWjLiZnzQNR9I9mMO3prqU_xeKA58JG9tpBVSLeA6YND34zhYKZd-VmDMgHZ8jM3hPEaLGj-YrxSRBP2udS-v7ucFvy3O86QbuvzPf2jKa-vYFCvG2hRnlHPGm2oevOk7gIOUTKoP0OUIge5uIV7fCxyY4KIbQFCggxToxnmZsUOmxEyj32OAEF6CbSvQcsylGvtHbdpI1pZuBsvm67vN1_v976B9P7W6HdHXa8Jo5oDuAVMfvl9U04oRc-PuJlM1l52SoKRiahweDo2cEGMvhRxJc3apXUV9pSOHZE3A3TvcfApp9aX-B6HglKA" rel="" target="_blank">here</a>. </div><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em">This is the first evidence to show us that the rate of reinfection with Omicron is high—3 times higher than Delta. In other words, infection-induced immunity is not doing a great job at stopping Omicron. </p><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em">We now know this is the preliminary evidence WHO based their <a href="https://email.mg2.substack.com/c/eJwlkEuOrDAMRVdTmYFICCEMMujJ2wbKx0VFnQ9KzEPsvkMhWb6yriz7HqsRtlwuteeK5G4rXjuoBGcNgAiFHBXK6p1i4zwPbBTEKe6onCTxdX0XgKh9UFgOIPthgrcafU7fDUkZXchHWWsWOw96omIcpzc4rR1lUtPJGjdb8RzWh_OQLCj4D-XKCUhQH8S9vsafF_vX6jzP_vzk3ids0_1jE48QmzDZUdqxgdHu2F2L1eXU5ehtyYl4dRuUDZzycWa8Z_0sOLjFvA2MMEhu-uT3FFgILz7EjfX1MBW1_e1tjqQo20cNNXr8NH-7I3-NlnhtGo_k8VohaRPAPTDwYfrFs26QoLSn3KpRNQpSMCnkIJf5yd5ocb5MgouFtMsut62krnyUkK0OsHsH0eeQN1_xD_b1lAg" rel="" style="color:rgb(0,104,239);text-decoration:none" target="_blank">recommendation </a>on earlier this week: <em>People who have previously had COVID-19 could become reinfected more easily with Omicron</em>. This is also another example of South Africa’s incredibly swift work at finding early signals so the rest of the world can prepare. </p><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em"><strong><code>2. South Africa State of Affairs </code></strong></p><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em">South Africa is having explosive spread. Yesterday they had <a href="https://email.mg2.substack.com/c/eJxFUcuOhCAQ_JrhplFAxQOHvexvGB49TmcRDOC4ztcvo5vdhECoqk51VxuVYQ7xkGtImbyvKR8rSA97cpAzRLIliBNaSdkwNJT1xEpuW9EJgmm6R4BFoZM5bkDWTTs0KmPwZ4VoaTuShzRgBRs6To0WXI_irpVmbOhNN9yBdsNlrDaL4A1IeEI8ggfi5CPnNd3Yx41-lrPve-3R2FqZ-qUKYDGBSpAqVb0q9Ba-_8HrX5nwRFu1YyHSFp-AzqliUkVYQ8ypwP5sWLk_aWXLRMevoggIStrQtqUNbzkbKK9pPfQc7KjvGhg0ZajS1-odde7Gm2Wmddp0ysp81SYsJEpTLwrSgvlR-Pmd2EmUwKbyLpvHfEzglXZgryzztZIz3WkGD7Gsyk4qy7ZnoqeiF40Yf6MrYXM-dj3vR1KcbShVXh5hiy4Y5WBFCwsGF2ZM-Qdfl6u3" rel="" style="color:rgb(0,104,239);text-decoration:none" target="_blank">16,055</a> new cases in one day. Using Delta’s doubling rate, we <a href="https://email.mg2.substack.com/c/eJwlUMuOhSAM_ZrLbgwizwWL2cxvGB7VSwbBAI7x7wevSdOmbdrzcKbBmsul91wbutPcrh10grNGaA0KOiqUOXhNJiEwmTjymvpRMolCnZcCsJkQdSsHoP2wMTjTQk6fCzmSUaG3XrCQGMTiLGUYK-bsxBT3njlBzMLgATaHD5AcaPiDcuUEKOp3a3t9Td8v8tPjPM_BWje4vPXu5ngPc4n-yyylI38xRfkkhUJBE0zGkWA60kkQOpBBcApe2cXCBFhSO6Swp0hifFG8rWSoh63NuN_7PSraDZuBuoX27vv1FvlZdI1zr9uRQrtmSMZG8I_89rj4MWReIUHp7vrZND12UpxILrFU4lHb_aFUMU65Qh3Z536V9JWPErMzEfbgYQs55jXU9g-IhY7h" rel="" style="color:rgb(0,104,239);text-decoration:none" target="_blank">hypothesized </a>South Africa would break 10,000 daily cases by next week. Omicron has far outpaced this. The test positivity rate in South Africa is 24%, which is bad as Omicron is spreading faster than we can detect it. </p><div style="font-size:16px;line-height:26px;margin-bottom:16px;text-align:center"><table width="100%" border="0" cellspacing="0" cellpadding="0" style="margin:8px auto"><tbody><tr><td style="text-align:center"></td><td align="left" width="550" style="text-align:center"><a href="https://email.mg2.substack.com/c/eJxVUsuO3SAM_ZpkUyUKrwALFtNW3fYTIh5OLh0CKZCZ3n59ucmqErKPbNnnYNvqClvKT3WkUvuXWerzABXhswSoFXJ_FsiLdwoTzidM5t4p6pBgovdlWTPArn1QNZ_QH6cJ3urqU7wqBMJI9g_lmOESOzCr5JiLWbp15gJRx4VmlNCbWJ_OQ7Sg4APyM0Xog3rUepSOvHX4R3vWxbGcplRt30eb9hbyu96g-RWqfTT_uXTsazK_wNYvPy_Xse8d_maX4HdfG1obUU0N_L4BedtScq9EWI6ctgyl-A9o8VIBjtbzFoHZSwZ7CWnGnPYdWj4PMDFjrKCD0ZoMlHAYJENi0M4QbIBzKehYyKh3_TdF_Vlu5a3HPa4LXt8oF5SgkeMzHZBmbKBWwiAInwdtVyIcATmvchFo-sMmOh5x673CE0YITxQ1dkxHPLZycNKsBghMgpox-iMGHEJHp33D_w2xz8qOu4bSxvNo-e21zyvR9C3N72f09blA1CaAuzdd74O5dr9sECG3Q3KLrgrNRMxYzGISkt-LbadAqWQznWXfmF1qVVE905lDsjrA4R3sPoW0-VL_AR5I170" rel="" style="border:none;display:block;height:auto;margin:0px;padding:0px;text-decoration:none;width:auto" target="_blank"><img alt="" width="550" src="https://cdn.substack.com/image/fetch/w_1288,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F9ea1d764-1a55-4c9e-8376-acf38d3e96f9_810x504.png" style="display: block; height: auto; margin: 0px auto; max-width: 550px; vertical-align: middle; width: 100%; border: none;"></a></td><td style="text-align:center"></td></tr></tbody></table>(NCID -Source <a href="https://email.mg2.substack.com/c/eJxFUcuOhCAQ_JrhplFAxQOHvexvGB49TmcRDOC4ztcvo5vdhECoqk51VxuVYQ7xkGtImbyvKR8rSA97cpAzRLIliBNaSdkwNJT1xEpuW9EJgmm6R4BFoZM5bkDWTTs0KmPwZ4VoaTuShzRgBRs6To0WXI_irpVmbOhNN9yBdsNlrDaL4A1IeEI8ggfi5CPnNd3Yx41-lrPve-3R2FqZ-qUKYDGBSpAqVb0q9Ba-_8HrX5nwRFu1YyHSFp-AzqliUkVYQ8ypwP5sWLk_aWXLRMevoggIStrQtqUNbzkbKK9pPfQc7KjvGhg0ZajS1-odde7Gm2Wmddp0ysp81SYsJEpTLwrSgvlR-Pmd2EmUwKbyLpvHfEzglXZgryzztZIz3WkGD7Gsyk4qy7ZnoqeiF40Yf6MrYXM-dj3vR1KcbShVXh5hiy4Y5WBFCwsGF2ZM-Qdfl6u3" rel="" target="_blank">Here</a>)</div><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em">If we zoom into South Africa’s epicenter—Gauteng—case acceleration for this new wave (black line) is just unbelievable. The spread is near vertical compared to other waves.</p><div style="font-size:16px;line-height:26px;margin-bottom:16px;text-align:center"><table width="100%" border="0" cellspacing="0" cellpadding="0" style="margin:8px auto"><tbody><tr><td style="text-align:center"></td><td align="left" width="546" style="text-align:center"><a href="https://email.mg2.substack.com/c/eJxVUsuunDAM_ZphU4FCHpAssri3Vbf9BJSHYXJvSCgJdzr9-npgVSmyj2z5-MS2MxWWvD_1lkttXmaqzw10gkeJUCvszVFgn4LXlI0joWxovOa-l0I2oUzzDrCaEHXdD2i2w8bgTA05nRWyp71q7loIMVgCAhwZDVFiVLOfjXCE8N76QVyNzeEDJAcavmB_5gRN1Pdat3Jjbzf6E5_zqSuHLdW4z87lFUNhNQugn6G6O_rHdBPv2X6Aq99-ne4mftzodzfFsIaKaMZGNSP4fQH2tuTsX4k4bXtediglfAHGSwXYkPMSQcVLhngJQWMP9wmY31sgwloneWuNYS1nI7RK9LI13jJqYRyV5F1hnVnN35zMo1zKkeMa1wnPb5QTKtUDYUglrUI-SngrOUBLCDVg7MBnBRNG5Z9esKH72GBpgqaE9j1GexRAeUe7ceDglZ0tMCCS2y6FLUUa442TdaH_zbHZtetWAwUndMf88lrpmUCJE_r1SKE-J0jGRvDXsut1M-f6pwUS7HhLfjJV9wOTA5WDJFKN127xGjhXYuCDarCzz1iV9DMfe8zORNiChzXkmJdQ6j-UVNhy" rel="" style="border:none;display:block;height:auto;margin:0px;padding:0px;text-decoration:none;width:auto" target="_blank"><img alt="" width="546" src="https://cdn.substack.com/image/fetch/w_546,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F991e03a3-8b93-4204-84ee-002aeab64f9e_2048x1536.jpeg" style="display: block; height: auto; margin: 0px auto; max-width: 100%; vertical-align: middle; width: auto; border: none;"></a></td><td style="text-align:center"></td></tr></tbody></table>Twitter: <a href="https://email.mg2.substack.com/c/eJwlkMGOhCAMhp9mOBpARDxw2Mu8hkHoOM0iGKg78e0Xx6Rp0zTt3-_3jmDN5bR7rsSuNNO5g03wqRGIoLCjQpkxWNmPI5e9ZsGqIMxgGNb5VQA2h9FSOYDtxxLRO8KcvhtGSDGxt1XQe5g4n7waHAjNnXzJwWslBQevzS3sjoCQPFj4g3LmBCzaN9FeH_3PQz5b0Aevlzqft9YVDII-AFQZWsmlEJIrofpRqk52o1YQpuW1QA_cqKVLuKcoY3wovq2yq8dSyfnf6xgr1nebg7ohvdt8vZC-g0Y0t7odCemcIbklQrhh6fbsiz-vkKA0L8PsyArdGy2NNtxM483W3FBqGrTSE2vKIbetZM98lJi9i7BjgA1zzCtW-gdu04nd" rel="" target="_blank">Ridhwaan Sulliman</a></div><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em">Hospitalizations in South Africa have started to slowly rise. Because hospital trends lag case trends by 3-4 weeks, we still don’t know if, and how, Omicron impacts severe disease and death. We are at the mercy of time.</p><div style="font-size:16px;line-height:26px;margin-bottom:16px;text-align:center"><table width="100%" border="0" cellspacing="0" cellpadding="0" style="margin:8px auto"><tbody><tr><td style="text-align:center"></td><td align="left" width="550" style="text-align:center"><a href="https://email.mg2.substack.com/c/eJxVUsuOnTAM_RrYVCDyIIRFFtNW3fYTUB6Gm05IaBJmevv19YVVpcg-smX7xMdWV9hSfqojldq-zFKfB6gInyVArZDbs0BevFOUTdNAmWid4o7IUba-LGsG2LUPquYT2uM0wVtdfYpXhSSUzO1DESOMhFFSwQY6ETrIWcA6cmr5QIy292B9Og_RgoIPyM8UoQ3qUetRGvbW0B_4rIt9OU2p2r73Nu0Y8rveAP0K1T7Qfy7N-DWZX2Drl5-Xa8bvDf1ml-B3XxGtOKgmBL9vwN62lNwrEZYjpy1DKf4DMF4qwIE9bxJ0fNEYX0TQmNO-A-ZzB8NojJW8M1qzjrMJunkkstPOMGpgmmbJ-8J6veu_KerPcjPHHve6Lnh9o1yQzXoyYE1nRw4dF052Utq102yWs9VMODIvdODyD-Fc9EfcWq_oQAnulROcT3lP-0lwcLNZDTAYJDd99EcMNISGD_tG_1tjm5Xtdw0FF_TA_PZS9EogwwX9fkZfnwtEbQK4W-t6n8yl_rJBhIyn5BZdFRFMCiqFRJmnW1o8Bs7nUXAxtzjZJayK6pnOHJLVAQ7vYPcppM2X-g8e_dgl" rel="" style="border:none;display:block;height:auto;margin:0px;padding:0px;text-decoration:none;width:auto" target="_blank"><img alt="" width="550" src="https://cdn.substack.com/image/fetch/w_1148,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F39a7becb-c54e-46d8-88cf-a3989ca36d19_2048x1446.png" style="display: block; height: auto; margin: 0px auto; max-width: 550px; vertical-align: middle; width: 100%; border: none;"></a></td><td style="text-align:center"></td></tr></tbody></table></div><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em">We got a little peak into these hospitalizations during a <a href="https://email.mg2.substack.com/c/eJwlkMuOhCAQRb-mWRooEWXBYjaT-YbZGB7VNhkEA9jGvx9ak0pVpR65ucfqikvKp9pSqeST5npuqCIeJWCtmMleMM_eKejHkUIviFPcsWmYiC_zMyOu2gdV845k203wVlef4vUxMWCSvJTkkmpumdQDoACQDuUgjeN2kJxrewvr3XmMFhW-MZ8pIgnqVetWHv3XA75bHMfRPbVFk9JfZ9PaRj-oQ339fg7e3mEqrQHaj4LKps2EENAmxCugwBhQzng_Au-gGwVHJ83TYI904qaLfosBQnhwui7Qld2Uqu0lRLKy3aqxrL6-2n75eL4WzfLc6rpHX88ZozYB3U2j3lAvPvOCEXOD7WZdFRP9JGASE53keJtvuDiXg-BCkqbsUvuK6kx7DsnqgFszt_oU0uJL_QdRhpID" rel="" style="color:rgb(0,104,239);text-decoration:none" target="_blank">brief</a> yesterday hosted by the National Department of Health (South Africa). South Africa is actively investigating the vaccination status of patients in hospitals. Unfortunately there is still lot of “unknown” data, but the data they do have shows that among 1,351 hospitalized 23% patients are unvaccinated and 2% of patients vaccinated. Until we can get more complete data, I wouldn’t come to sweeping conclusions with this. But it’s welcoming news that the vaccinated aren’t piling up at the hospital. </p><div style="font-size:16px;line-height:26px;margin-bottom:16px;text-align:center"><table width="100%" border="0" cellspacing="0" cellpadding="0" style="margin:8px auto"><tbody><tr><td style="text-align:center"></td><td align="left" width="550" style="text-align:center"><a href="https://email.mg2.substack.com/c/eJxVUsuOnTAM_RrYVCDIg4RFFtNW3fYTUB6Gm05IaBJmevv19YVVpcjnyJbtE9tWV9hSfqojldq-zFKfB6gInyVArZDbs0BevFOECjEQOrVOMTdKLltfljUD7NoHVfMJ7XGa4K2uPsUrQ45knNuHEhKkhWmgIEZKRkktIWK1IPQwyFXTu7E-nYdoQcEH5GeK0Ab1qPUoDX1ryA981sW-nKZUbd97m3Z0-V1vgLhCtQ_Ez6XhX5P5BbZ--XlBw7835Jtdgt99RbZio5qQ_L4JfdtScq9AWI6ctgyl-A9Af6kAB9a8RRD-ksFfQtCY074DxnMHAzfGStYZrWnHqIBu5qPstDOUGBBilqwvtNe7_pui_iy3cqxxj-ui1zfKRYcVx0L51HGjScckVtbMmY46vs6ToNKZaUH4Q-XYH3FrvSIDGUcysBG7E9aTXkwM3GxWAxQGyUwf_REDCaFhw76R_4bYZmX7XUPB8Twwvr32eQVQ34K4n9HX5wJRmwDu3nS9D-ba_bJBhIyH5BZd1ThRORE5yUHO4l4sngJjM5_YNLfY2SXMiuqZzhyS1QEO72D3KaTNl_oP9PLXjw" rel="" style="border:none;display:block;height:auto;margin:0px;padding:0px;text-decoration:none;width:auto" target="_blank"><img alt="" width="550" src="https://cdn.substack.com/image/fetch/w_1324,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F0f7a0356-5ba2-4884-a4db-3d5f96738db6_738x381.png" style="display: block; height: auto; margin: 0px auto; max-width: 550px; vertical-align: middle; width: 100%; border: none;"></a></td><td style="text-align:center"></td></tr></tbody></table>National Department of Health (South Africa)</div><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em">During the briefing, South Africa also presented the age distribution of hospitalized patients. It’s apparent that younger people are going to the hospital at a higher rate during this Omicron wave (orange bars below) compared to the Delta wave (blue bars below). This pattern is specifically apparent with kids less than 5 years old. </p><div style="font-size:16px;line-height:26px;margin-bottom:16px;text-align:center"><table width="100%" border="0" cellspacing="0" cellpadding="0" style="margin:8px auto"><tbody><tr><td style="text-align:center"></td><td align="left" width="550" style="text-align:center"><a href="https://email.mg2.substack.com/c/eJxVUsuunDAM_RrYVKCQB4RFFve26rafgPLwMLk3JDQJdzr9-npgVSmyj2zZ58S21RXWlJ9qT6W2L7PU5w4qwqMEqBVyexTIi3eKsmkilI2tU9wNUsjWl-WWATbtg6r5gHY_TPBWV5_iWSEHOsztXVkwkzSESD1bLh0IydCOXIz6ZgQnF7E-nIdoQcEX5GeK0AZ1r3UvDXtr6E981sW-HKZUbT97mzYM-U2vgP4G1d7RP5ZGvCfzAbZ--3W6Rvxo6He7BL_5iuiGRDUh-H0B9ram5F6JsOw5rRlK8V-A8VIBdux5iaDiJUO8hKAxh_0EzOcOiDDGSt4ZrVnH2QTdLAbZaWcYNTBNs-R9Yb3e9N8U9aNcyrHHNa4Tnt8oJ4SJCzbNpuOjJB3XDPtRCx1YQgRILqXmyzyOfwRn_ccOa-sVJXQYKOED0lPe034aObjZ3AwwIJKbPvo9BhpCw8m20v-m2GZl-01DwfncMb--FnomUOCCfjuir88FojYB3LXqel3MufxlhQgZL8ktuqphZHKkEsXLebo2i7fA-SxGPs4tMruEVVE905FDsjrA7h1sPoW0-lL_AZzV2DY" rel="" style="border:none;display:block;height:auto;margin:0px;padding:0px;text-decoration:none;width:auto" target="_blank"><img alt="" width="550" src="https://cdn.substack.com/image/fetch/w_1300,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Fe745379b-4680-4a3e-92ce-ec005e8488a4_966x543.jpeg" style="display: block; height: auto; margin: 0px auto; max-width: 550px; vertical-align: middle; width: 100%; border: none;"></a></td><td style="text-align:center"></td></tr></tbody></table>National Department of Health (South Africa)</div><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em">South Africa is actively investigating <em>why</em>. I think there are a few things that could be explaining this:</p><ol style="margin-top:0px"><li style="margin:3.75px 0px 3.75px 7.5px"><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px">Kids aren’t vaccinated and may be the last group for the virus to reach. Parents may have avoided infection by altering behaviors until now.</p></li><li style="margin:3.75px 0px 3.75px 7.5px"><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px">Adults around these kids aren’t vaccinated. Infection-induced immunity doesn’t protect well against Omicron while it largely did before. So parents could be bringing the virus home and infecting kids.</p></li><li style="margin:3.75px 0px 3.75px 7.5px"><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px">Because so little is known about Omicron, kids may be hospitalized out of precaution at a higher rate than before. </p></li><li style="margin:3.75px 0px 3.75px 7.5px"><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px">Omicron induces more severe disease for kids than previous variants.</p></li><li style="margin:3.75px 0px 3.75px 7.5px"><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px">A combination of all of the above.</p></li></ol><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em">My guess is a combination of #1-3. Keep in mind what happens in one country doesn’t always happen in others. Landscapes between countries are very different: vaccination rates, behaviors, environment, genetics, and unknown unknowns. We need to carefully track epidemiological data by age to see if this is a generalizable signal. As a parent, I don’t really want to wait to find out though. </p><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em"><strong><code>3. United States State of Affairs</code></strong></p><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em">This virus is well on its way as it has reached more than 11 states. Some cases have no ties to South Africa travel indicating (and confirming) that Omicron is spreading throughout our communities. The key question we have in the States is: <em>Does Omicron outcompete Delta?</em> We need more data to see whether this is happening. </p><div style="font-size:16px;line-height:26px;margin-bottom:16px;text-align:center"><table width="100%" border="0" cellspacing="0" cellpadding="0" style="margin:8px auto"><tbody><tr><td style="text-align:center"></td><td align="left" width="550" style="text-align:center"><a href="https://email.mg2.substack.com/c/eJxVUsuOnTAM_RrYVCDIm0UW01bd9hOiPAw3nZDQJMz09uubC6tKkX1kyz4ntq2usKX8lEcqtX8ZVZ8HyAifJUCtkPuzQFbeSYQ5nxBmvZPEzYKK3he1ZoBd-yBrPqE_ThO81dWneFWIGc1L_5B40cwZxAxDsCIhOMWa8xms1hOlzt3E-nQeogUJH5CfKUIf5KPWo3T4rUM_2rMujuU0pWr7Ptq0t5Df9QbNr1Dto_lP1dGvyfwCW7_8vFxHv3fom1XB7742tDaimhr4fQP8tqXkXomgjpy2DKX4D2jxUgGO1vMWgehLBn0Jacac9h1aPg8wUWOsIIPRGg8EcxgWOotBO4ORAc4XQcaCR73rvynqz3Irbz3ucV3w-ka5IFiqiWV2WLCmA2GABt1mNQiD8GrNMvGVq4WRPwyL8Yhb7yWa0DyjicyNHZERjZwRcItZDWCYBDFj9EcMKISOTPuG_htin6Uddw2ljefR8ttrn1ei6VPN72f09akgahPA3Zuu98Fcu1cbRMjtkJzSVc5NFkOCiUks_F5sOwVCFsoIW_rG7FKrivKZzhyS1QEO72D3KaTNl_oPUd7YhQ" rel="" style="border:none;display:block;height:auto;margin:0px;padding:0px;text-decoration:none;width:auto" target="_blank"><img alt="" width="550" src="https://cdn.substack.com/image/fetch/w_1196,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Fec5a4c6c-93a5-46e2-a71e-8b23fcb907f7_964x638.png" style="display: block; height: auto; margin: 0px auto; max-width: 550px; vertical-align: middle; width: 100%; border: none;"></a></td><td style="text-align:center"></td></tr></tbody></table>(<a href="https://email.mg2.substack.com/c/eJwlkE2OwyAMhU9Tdo2AUJIsWMxmrhERcBJr-InAaZXbD20lhAH78Z4-Zwm2XC5z5Ersvc10HWASvGoAIijsrFBm9Eb2w8Blr5k3yovxMTKs81oAosVgqJzAjnMJ6CxhTh_FKKSY2G4ePYATg-Va8kWvsFohpnVpXc3XQfZfY3t6hOTAwBPKlROwYHaio976n5v8bev1enXpIoxQO5dje8HUIlpH-IR2k1yKVnawgfZ2cLnkZJ9Yznp_2oI20Z3a-B-UbqcYGJq3REiuhOoHqTrZDVqBn5Z1gR74qJYu4ZGCDOGmeNxkV8-lUvviHYAV47pooUZsfopvbxSfRiMxtxrPhHTNkOwSwH8h0Zf1B9u8QWr5CfxsyQjdj1qOeuTjNHyZNIpKTQ-t9MSas89NlcyVzxKyswEO9BAxh7xhpX_BPp4N" rel="" target="_blank">NYT</a>)</div><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em">Nonetheless, we’re seeing case growth across the nation with <a href="https://email.mg2.substack.com/c/eJwlUEuOrDAMPE1nNwhCCGGRxWzeNVBIDG1NPigxjbj9C41k2bLLVrnKGoIt5UvvqRC700zXDjrCWTwQQWZHgTyj07wfx5b3kjktXKcGxbDMawYIBr2mfADbj8WjNYQpfi9Ux7uJvbUAO4CTgxsEGKhTwzmoFVYjzdrK4SE2h0OIFjR8IF8pAvP6TbSXV__74v9qnOfZxIswQGlsCnWCsb5oLOEHasdb3tVylJps-qD7sabU3TcFz1DfcMdb0Yl-5KLhzSgFuGlZF-ihVWJpIu7Rc-9fog0bb8qxFDL27yZjWdsmGCgB6V3x7Zb9BarqudZwRKRrhmgWD-4xhB5fvxbNG8T6K4GbDelO9kpyJVWrpvHRXx0TYhqkkBOrzC7Vq6ivdGSfrPGwo4OAyacNC_0HkvOWrw" rel="" style="color:rgb(0,104,239);text-decoration:none" target="_blank">94,926</a> new cases per day. Hot spots are clustered in the Northern states who were largely untouched by Delta during the summer, but all geographic areas in the United States are increasing. </p><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em">Delta and the Thanksgiving holiday are largely driving spread right now. Omicron may be adding a little fuel, but certainly not a main factor yet. </p><div style="font-size:16px;line-height:26px;margin-bottom:16px;text-align:center"><table width="100%" border="0" cellspacing="0" cellpadding="0" style="margin:8px auto"><tbody><tr><td style="text-align:center"></td><td align="left" width="550" style="text-align:center"><a href="https://email.mg2.substack.com/c/eJxVUsuOnTAM_RrYVKCQB4RFFtNW3fYTUB6Gm05IaBJmevv19YVVpcg-shWf44fVFbaUn-pIpbYvs9TnASrCZwlQK-T2LJAX7xRl00QoG1unuBukkK0vy5oBdu2DqvmE9jhN8FZXn-L1Qw50mNuH4mBA0pU7Nq7TalZnmLRC6NUNk6MDv4n16TxECwo-ID9ThDaoR61HadhbQ3_gsy725TSlavve27RjyO96A_QrVPtA_7k04msyv8DWLz8v14jvDf1ml-B3XxGtSFQTgt83YG9bSu6VCMuR05ahFP8BGC8V4MCatwgqXjLESwgac9p3wHzugAhjrOSd0Zp1nE3QzWKQncYuqYFpmiXvC-v1rv-mqD_LrRxr3OO64NVGuaAgTo6E8I5ISzo-C9rNzvGOGsokHwFg4stAZ_Jn5KQ_4tZ6RQkdBkr4gPSU97SfRg5uNqsBBkRy00d_xEBDaDjZN_rfFNusbL9rKDifB-a310KvBApc0O9n9PW5QNQmgLtXXe-LuZa_bBAh4yW5RVc1jEyOVI6SyHm6N4u3wLGRkY9zi8wu4a-onunMIVkd4PAOdp9C2nyp_wApV9ga" rel="" style="border:none;display:block;height:auto;margin:0px;padding:0px;text-decoration:none;width:auto" target="_blank"><img alt="" width="550" src="https://cdn.substack.com/image/fetch/w_2580,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F50d86004-08c0-4952-9dd4-2b23846eee74_1290x640.png" style="display: block; height: auto; margin: 0px auto; max-width: 550px; vertical-align: middle; width: 100%; border: none;"></a></td><td style="text-align:center"></td></tr></tbody></table></div><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em">Not nearly enough people are fully protected going into the Winter months. Only <a href="https://email.mg2.substack.com/c/eJw1kN3OpCAMhq9mONMoMIgHHHwn322YAh2HLIKBOhvvfhnNJk2b_uVtHweEay6n2XMl9nULnTuahH9rRCIs7KhYluANF9M0cKGYN9KP-qlZqMurIG4QoqFyINsPG4MDCjldG3rk48zeRozCcnAT6KcEP00wD5MdnqiUQG3B3sJw-IDJocEPljMnZNG8ifb6ED8P_tvM5U_wvfOuX_Pnf955IOiogPuD5ZoTH3AupOuOunyTjjJB7MBvIXWl_XwXWDB84OPIBzlKMXHZ835SEv1sXxYFDlraPoU9RR7jQw7byvt62EpNq3d5Y8W4fgOsW6B3669fFFejkVha3I4U6FwwgY3ob0h0s76wLSsm_N7jFyAzKqEV10oPep5uJo2ilPNTSTWzpuxz20rmzEeJ2UHEPXjcQo55DZX-AR4Rnmc" rel="" style="color:rgb(0,104,239);text-decoration:none" target="_blank">59.7%</a> of the United States is fully vaccinated (which the CDC defines as <em>not</em> having a booster, which really needs to change). Only <a href="https://email.mg2.substack.com/c/eJw1kN3OpCAMhq9mONMoMIgHHHwn322YAh2HLIKBOhvvfhnNJk2b_uVtHweEay6n2XMl9nULnTuahH9rRCIs7KhYluANF9M0cKGYN9KP-qlZqMurIG4QoqFyINsPG4MDCjldG3rk48zeRozCcnAT6KcEP00wD5MdnqiUQG3B3sJw-IDJocEPljMnZNG8ifb6ED8P_tvM5U_wvfOuX_Pnf955IOiogPuD5ZoTH3AupOuOunyTjjJB7MBvIXWl_XwXWDB84OPIBzlKMXHZ835SEv1sXxYFDlraPoU9RR7jQw7byvt62EpNq3d5Y8W4fgOsW6B3669fFFejkVha3I4U6FwwgY3ob0h0s76wLSsm_N7jFyAzKqEV10oPep5uJo2ilPNTSTWzpuxz20rmzEeJ2UHEPXjcQo55DZX-AR4Rnmc" rel="" style="color:rgb(0,104,239);text-decoration:none" target="_blank">22%</a> of 18+ are boosted and, even more concerning, only 46% of those aged <a href="https://email.mg2.substack.com/c/eJw1kN3OpCAMhq9mONMoMIgHHHwn322YAh2HLIKBOhvvfhnNJk2b_uVtHweEay6n2XMl9nULnTuahH9rRCIs7KhYluANF9M0cKGYN9KP-qlZqMurIG4QoqFyINsPG4MDCjldG3rk48zeRozCcnAT6KcEP00wD5MdnqiUQG3B3sJw-IDJocEPljMnZNG8ifb6ED8P_tvM5U_wvfOuX_Pnf955IOiogPuD5ZoTH3AupOuOunyTjjJB7MBvIXWl_XwXWDB84OPIBzlKMXHZ835SEv1sXxYFDlraPoU9RR7jQw7byvt62EpNq3d5Y8W4fgOsW6B3669fFFejkVha3I4U6FwwgY3ob0h0s76wLSsm_N7jFyAzKqEV10oPep5uJo2ilPNTSTWzpuxz20rmzEeJ2UHEPXjcQo55DZX-AR4Rnmc" rel="" style="color:rgb(0,104,239);text-decoration:none" target="_blank">65+</a>. I found the <a href="https://email.mg2.substack.com/c/eJwlkc2OrCAQhZ-m2WkAEXXBYjb3NQxCqWT4C-A1vv1UdyekKjmVQ518ZXSDI5VH5VQbeZe1PRlUhLt6aA0KuSqU1VnFh2mifJDEKmHZPM7E1XUvAEE7r1q5gORr887o5lL8OGbG2UJOBXqf2KYNhYlqThksHKycxnGXRggpvov1ZR1EAwr-Q3lSBOLV2Vqur-Hnxf_hu--7B5NiCq623qSA2lF0Pp3pLDTMgQKnnGFjHAsdsJzp7nKBrAvYbk-lQ7spKXYodDpAwcidjraDq6QMxKn3F4xTwcQwcdHzfpIC7LLtGwxAZ7H10eXoufcvQcPB-3pttWnz-85EijJ90FCDayfOjzefzwDxrNjDFV17Voh682C_5Nr3AB-W6wERCh7GrropJodZ8lnOdF6mLyhEK8QySiEXgpttQldUT7qKT0Z7yM5CcMmnAzH9AcWpo-w" rel="" style="color:rgb(0,104,239);text-decoration:none" target="_blank">graph </a>below useful in displaying poor booster coverage in the United States. If you know someone that’s 65+, call them right now and encourage them to get a booster if they don’t already have one. It’s not too late. </p><div style="font-size:16px;line-height:26px;margin-bottom:16px;text-align:center"><table width="100%" border="0" cellspacing="0" cellpadding="0" style="margin:8px auto"><tbody><tr><td style="text-align:center"></td><td align="left" width="550" style="text-align:center"><a href="https://email.mg2.substack.com/c/eJxVUsuO3SAM_ZpkUyVKeLNgMW3VbT8h4uHk0iGQApnp7deXm6wqIfvIFj7HD6srbCk_1ZFK7V9mqc8DVITPEqBWyP1ZIC_eKYQ5nxBmvVPEzYKK3pdlzQC79kHVfEJ_nCZ4q6tP8fohZjTL_qEcZysHMEZrzlfDKJ7sLKVkBjHQbL6J9ek8RAsKPiA_U4Q-qEetR-nwW4d-tGddHMtpStX2fbRpbyG_6w2aX6HaR_OfS0e_JvMLbP3y83Id_d6hb3YJfve1obUR1dTA7xvgty0l90qE5chpy1CK_4AWLxXgaDVvEYi-ZNCXkGbMad-h5fMAEzXGCjK07vBAMIdB0lkM2hmMDHAuBRkLHvWu_6aoP8utvNW4x3XBq41yQTEZO7lpHYTjdCBCokFwjAYqMdhJoFU7WASRfyjF4xG33is0oXlGE5kbOyIjGjkj4KRZDWCYBDFj9EcMKISOTPuG_htin5Uddw2ljefR8ttrn1ei6Vua38_o63OBqE0Ad2-63gdz7X7ZIEJuh-QWXdXMsGBIMDEJye_FtlMgRFJGmOwbs0vtV1TPdOaQrA5weAe7TyFtvtR_UcXYNQ" rel="" style="border:none;display:block;height:auto;margin:0px;padding:0px;text-decoration:none;width:auto" target="_blank"><img alt="" width="550" src="https://cdn.substack.com/image/fetch/w_1224,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F80bc0d0f-8d75-4892-8732-593ec082fade_849x553.png" style="display: block; height: auto; margin: 0px auto; max-width: 550px; vertical-align: middle; width: 100%; border: none;"></a></td><td style="text-align:center"></td></tr></tbody></table>(Economist)</div><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em"><strong><code>Bottom Line</code></strong>: Previous infections are largely not protective against Omicron. Omicron is in the United States and spreading quickly. Let’s take advantage of this warning from South Africa to mount a proactive (rather than reactive) response.</p><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em">Love, YLE </p><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em">P.S. I typically get many messages asking what I’m doing with my girls who are under 5. We haven’t changed our behaviors with Omicron news just yet. We are already boosted, wear masks inside, and avoid large indoor events. The girls are still going to child care (but all teachers are fully vaccinated and wear masks). We still have our plane tickets to CA for Christmas. But my husband and I got on the same page last night and both agreed that we need to closely watch how this unfolds in the coming weeks. This may mean cancelling Christmas plans with unvaccinated family members or cancelling plane tickets last minute. The name of the game is flexibility. </p><div style="font-size:16px;line-height:26px"><hr style="background:rgb(223,233,246);border:none;height:1px;margin:24px 0px;padding:0px"></div><p style="color:rgb(26,26,26);font-size:16px;line-height:26px;margin:0px 0px 1em"><em>“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, MPH PhD— an epidemiologist, biostatistician, professor, researcher, wife, and mom of two little girls. During the day she has a research lab and teaches graduate-level courses, but at night she writes this newsletter. Her main goal is to “translate” the ever-evolving public health science so that people will be well-equipped to make evidence-based decisions, rather than decisions based in fear. This newsletter is free thanks to the generous support of fellow YLE community members. 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</blockquote></div><br clear="all"><div><br></div>-- <br><div dir="ltr" class="gmail_signature">Paula Hillmann<br><a href="mailto:paula.hillmann@gmail.com" target="_blank">paula.hillmann@gmail.com</a><br>cell: 262-366-5991</div>