Live from Omicron Central

New York City is seeing a surge unlike anywhere. But neighborhoods with highest positivity rates have lowest hospitalizations. Seemingly odd, but good news.

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Happy Holidays to all!

I write you from a zip code that is among the most Omicron-saturated in America, and perhaps the world. New York City is seeing a surge that has been astounding.

“I have never seen an organism as infectious as Omicron,” Dr. Tom Frieden, a former New York City health commissioner and former Centers for Disease Control director, told The New York Times, describing what is happening in New York City as more of a “flash flood” than a “wave.”

Forbes @Forbes

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I liken it more to a blizzard, as it just seems omnipresent in the air.

And my neighborhood of Chelsea in lower Manhattan is among the top ten places in New York City where the Omicron storm is brewing fastest and most furiously, along with other lower Manhattan neighborhoods, including Greenwich Village, the Meatpacking District, the Flatiron District, Soho and Tribeca, all with positivity rates in the double digits and rising by the day.

What is most notable about this is that lower Manhattan has had the lowest positivity rates in New York City — and, at times, even compared to most of the U.S. — throughout the entire pandemic, as I’ve written about previously. This was true from the very darkest first days of Covid through the spring of 2021 as vaccinations soared and positivity rates in these neighborhoods dropped to near zero.

The places in New York where vaccination uptake has always remained low, such as Staten Island and South Brooklyn, always have had much higher positivity rates than Manhattan. But now it’s all backwards, with highly-vaccinated Manhattan leading, and those places among the lowest.

This seems not only bizarre but, on the surface, ominous. Except that it’s easily explained and very good news — about vaccines but also about testing.

If Delta painfully taught us that being double-vaxxed was a matter of life and death (and if you had a breakthrough as a vaxxed person, that you’d almost definitely have a mild infection), Omicron is showing the importance not only of boosters but of access to tests, and how testing must be integral to how we manage the pandemic.

And yes, the pandemic is something we can and will manage. I know a lot of people who’ve tested positive just in the past week as the Omicron blizzard bore down. But all of them, vaxxed and boosted, are doing fine — even better than those vaxxed people who had breakthroughs of Delta.

Noah Michelson, editorial director at HuffPost Personal, who comes on my SiriusXM program weekly, tested positive this week. He told us on the show that he had a headache that lasted for a day, followed by some congestion that comes and goes. Others have talked about more prominent cold symptoms, even feeling as if they had a mild flu. But I’ve heard no reports from vaxxed and boosted people of serious illness. The good news could be that, as I reported in early November, Covid-19 could be evolving, with the help of vaccines, to be less severe and more like the cold.

“Covid-19 could develop into a virus that favors the upper respiratory tract,” epidemiologist John M. Barry, distinguished scholar at Tulane University’s School of Public Health and Tropical Medicine and author of The Great Influenza: The Story of the Deadliest Pandemic in History, explained, “and in that case you end up with the common cold.”

What is very significant about these Manhattan neighborhoods with the highest positivity rates is that they are both among the most highly vaccinated zip codes — some well over 90% — and have the lowest hospitalization rates. In fact, several have “0” people in the hospital per 100,0000 people. While hospitalizations have slightly spiked in New York City, they haven’t spiked commensurate with the rise in infection.

And the places where hospitalizations are up are in those low-vaccination parts of the city, including Staten Island and South Brooklyn, whose zip codes show several dozen people hospitalized per 100,000 people. The vast majority of people being hospitalized are unvaccinated.

But why then are the positivity rates so high in Manhattan? That gets to the testing element. It’s clear that more people are testing in these neighborhoods— and the lines all around testing sites in my neighborhood are a testament to that. Sure, some tested because they weren’t feeling well, or were asymptomatic and planning to travel. But many others knew they were exposed and might be asymptomatic and wanted to do the right thing and quarantine if they test positive. The New York City Department of Health’s data shows the increased testing: The Manhattan neighborhoods with the highest positivity rates also have the highest test rates.

These are also highly dense urban neighborhoods where people have been out and about, responsibly, eating out at restaurants or attending entertainment venues where there are vaccine mandates. But as we’ve learned, Omicron gets around the vaccines.

In many places, in New York and beyond, there’s a critical shortage of testing. Sites had closed down because there was no traffic by late summer. Manufacturers of instant at-home tests had cut down on production, as the tests were laying on store shelves well into the fall — only to sell out in recent weeks. (Abbott Laboratories had even destroyed millions of tests because they weren’t selling, incurring the ire of the White House.) And now the companies can’t produce enough of them quickly enough.

The Biden administration announced this week that it will distribute half a billion tests by mid-January, as government had to step in. But they will go quickly, as the number is not nearly enough for all Americans to test often and as new variants emerge.

Covid-19 is here to stay, and masks and vaccines are critical, but so is testing. We’re once again seeing the science denialists even condemning testing now — and we all remember when Donald Trump as president said “slow the testing down” because he didn’t want numbers reported — as Ben Carson this week idiotically said we should stop testing asymptomatic people, as if we should just put our heads in the sand about who’s positive.

Acyn @Acyn

Ben Carson: I personally think we should seriously give thought to not testing people who are asymptomatic

Those of us who believe in science must be prepared, and should be engaged in all mitigations, because we know a subset of people won’t engage in any of them — and will keep this pandemic perpetuating. At this point, we’re all managing the pandemic by protecting ourselves not so much from the virus, but from those who deny science.