Louisville Medicine Volume 69, Issue 9 - Page 26

AIN ’ T NOBODY KNOW AUTHOR Mary Barry , MD
DOCTORS ' LOUNGE

DOCTORS ' LOUNGE

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The ways COVID-19 will flow ; ain ’ t nobody know who ’ s next to go . The rise of mutant variants coupled with the coming six-month anniversary of a lot of Americans ’ booster shots means a higher risk that the extremely infectious Omicron variant will continue to spread . If you got boosted in September , the Israelis tell us that your booster effect has waned already . Your shield is beginning to disintegrate . And what variant will be stalking you next ?

Public health authorities worry that deaths will increase because of the sheer number of infected people , despite the difference in severity of illness that many , but not all , of those infected with Omicron experience . As I write this , the New York Times ’ “ number of infections ” curves in in both New York City and Kentucky point straight up - sheer vertical off the chart up - while the line for number of people hospitalized is nearly level with the baseline , as is the line for new deaths . One day this week we topped 800,000 cases in this country : and that number does not include the people who test privately at home and never tell anybody . The only current silver lining is that fewer are dying from Omicron than from Delta . But will it hold ?
That favorite line of the former guy , “ Many people are saying ,” was borne out by recent data from India , published in Science on Jan . 6 ( a date that now resonates ). The actual death counts from Covid in India are likely six to seven times higher than previously reported , which makes sense in a country of 1.4 billion , where early pandemic images showed bodies stacked next to emptied open-air oxygen tanks . In 2020 , the United Nations Population Division estimated 10 million deaths from all causes in India , yet found that over 3 million were not registered and over 8 million had not
24 LOUISVILLE MEDICINE

AIN ’ T NOBODY KNOW AUTHOR Mary Barry , MD

undergone medical certification . India ’ s total official Covid cases as of 2022 run more than 35 million , second only to the U . S . where huge numbers of otherwise functioning adults ( still about a third of Americans ) refuse vaccines for themselves and their children . With the vast difference in population and the large percentage of significantly poor people in India , the relatively low numbers of cases never made sense to me . The researchers 1 used the CVoter phone survey launched in early 2020 , from an independent agency , designed to be nationally representative and conducted over the entire country daily , in 11 languages . The surveyors asked if anyone in each household knew a person who had died from Covid , and if so how many ? They compared that to government-released data on facility-based deaths and non-hospital registered deaths . They found a huge gap between the survey and the official data , coming up with six to seven times higher actual vs . reported death rate .
It ’ s not just India : Florida has not reported accurate case numbers since DeSantis , et al . fired Rebekah Jones , the woman who told the truth , back in May 2020 . After all , the governor has the tourist trade to consider .
Omicron cares not about tourists . It may cause symptoms beginning within three days after exposure . In Denmark , vaccinated household members of those infected with the Delta variant were only half as likely to become infected as the unvaccinated ones . 2 But with Omicron , the Danes must have had a booster shot plus the regular series to reduce the risk of infection , by about 30-40 %, from their household contacts . As for whether it is milder , in countries where vaccination rates remain minimal , hospitalization rates are now shooting up .
Virologists study every possible aspect of these beasts they can get their hands on : the spike proteins , the routes of entry , the rate of clearance , the evasion of immune response , the timeline of symptoms and progression . Omicron has tended to favor the upper