Summary:

• Between Omicron, vaccines, and treatments, the risk of COVID is down by 10x to 1000x.

• This Omicron wave is likely to be the last we should be cautious around. As a result, we should officially end the pandemic soon, probably in a month or so, unlike some new, pretty unlikely new information appears.

• The biggest risk is that you don’t internalize this and keep as usual instead of realizing we’ve entered the end state of COVID. The next few months will be like the next few years. Act accordingly.

• This is especially true for governments. They need to know when to stop.

We did it. We flattened the curve.

Last month, I wrote in The Omicron Question:

If you haven’t had COVID before, you’re going to get it. 

You can only escape it while you lock yourself out. The moment you come back into society, you will get exposed to it. Paradoxically, this can be good.

This is the final battle for COVID. It’s throwing everything it has at us and will overwhelm the world. But in doing so, it might have weakened itself. And it’s attacking at a moment when the world is well-armed with vaccines and prior infections.

In this final battle, many people will die. But they might be few in comparison to what it could have been.

This all hangs on one data point, the Omicron Question: the fatality rate

• With vaccines

• With previous infection

• Without vaccine or previous infection

It will take us a few weeks to get that data. Only when we get that will we be able to tell if Omicron is good or bad.

Hopefully we’ll emerge on the other side of this wave in a world where our immunity to COVID is so strong that we don’t need to worry about it beyond getting our booster shots every now and then.

Now we know.

How fast it spreads has been confirmed: like lightning. You can catch it even with some immunity, you can spread it even asymptomatic.

Between existing immunity and Omicron’s superspreading, the spread is so fast that waves can start going down quickly after kicking in.

And its virulence has been properly estimated now1, at approximately:

• Hospitalizations: -50% compared to Delta.

• Death: -90% compared to Delta, or ~75% less than the original variant, making Omicron just about 2x as virulent as a normal flu2.

In Simpson’s Paradox vs. Upper Respiratory Tract Hypothesis, I stated that we didn’t know yet whether the lower virulence was due to a milder virus or simply more people immune through vaccines and natural infection. It turns out it was both, and the reduction of virulence is dramatic. Which can now be seen in South Africa:

Add to that the fact that good vaccines reduce fatality rates by ~90%, and that a Paxlovid treatment also reduces fatality rates by ~90%, and COVID’s fatality rate has gone down three orders of magnitude, by 99.9%3.

This makes now COVID more than ten times less lethal than a normal flu4.

In Coronavirus: Why You Must Act Now, I sounded the alarm on COVID.
In Coronavirus: The Hammer and the Dance, I explained what we had to do about it.
Today, in Coronavirus: Game Over, I’d like to explain why this means the end of the pandemic phase, and the beginning of the end(emic) phase.

On the 10th of March 2020, the world had not realized what was coming. It was important to share how what had happened to Italy and Iran was going to happen everywhere else if they didn’t shut down their countries. That proved to be true.

One week later, when I published The Hammer and the Dance, I explained why we needed to apply shutdowns: to buy ourselves time, so we could

• Prepare the healthcare system

• Learn to do testing and tracing

• Produce masks we needed at scale (and other things, like ventilators)

• Understand the virus

• Understand the cost-benefits of tackling it

• Find treatments

• Get vaccines

Check, check, check, check, check, check, check.

After the Omicron wave, we’ll be in a world where most people will have some sort of immunity, either through natural infections, vaccines, or both. We now know how to get vaccines fast (we should approve them faster for new variants), and we have treatments too. The value of time for learning has dropped: we know most of what we need to know about it. So the benefits of social measures to stop COVID are much lower.

Meanwhile, the costs of stopping COVID are much higher, because Omicron escapes immunity and is extremely transmissible. It’s much, much harder to stop a COVID wave now than it was two years ago. Look at how China is desperately trying to stop the virus but can’t without drastic lockdowns.

Lower benefits, higher costs: the ROI (return on investment) of tackling COVID with social measures has reversed. And from now on, it’s not going to get any better:

• Will we get better treatments and vaccines? Maybe, but the improvements will be marginal. They’re close to as good as we’ll get.

• Will its virulence suddenly increase dramatically? Over the long term5, coronaviruses tend to reduce their virulence. Very few do the opposite. So it’s unlikely to happen.

• Will it get any easier to stop the virus? Extremely unlikely: it is unlikely to mutate to be less transmissible.

If the benefits of social measures are as low as they’ll ever be, and their costs as high as they’ll ever be, the cost/benefit of fighting COVID won’t change much anymore in the next few years.

So unless a new variant appears with lots of immune escape and higher virulence, we should start relaxing a