I was going to make the headline “Biden doesn’t sound good ” but he never really sounds “good.”

He sounded under the weather at this morning’s presser, and he is. Fortunately, it’s not COVID.

Unfortunately, given the way things are going in South Africa, it probably will be COVID soon enough for him and everyone else.

Q: "Your voice sounds a little different. Are you okay?"

President Biden: "I'm okay. I have a test every day to see, a COVID test…What I have is a 1-and-a-half-year-old grandson who had a cold who likes to kiss his pop…it's just a cold." pic.twitter.com/1PmzaUd5LU

— CSPAN (@cspan) December 3, 2021

That’s a lot of congestion. His doctor says he’s been tested for the coronavirus, though, as well as for a slew of other viruses and came up negative on everything.

I guess I’ll take them at their word, although this is the wrong week to ask people to believe a president’s blithe assurances that he doesn’t have COVID when he appears unwell.

Peter Doocy asked a fair question at Jen Psaki’s briefing afterward:

"Are the rules different for the president?"

— Fox News' Peter Doocy, citing President Biden's cough/voice, asks WH Press Sec. Jen Psaki why he didn't stay home from work today pic.twitter.com/Lz5vSTfpEn

— The Recount (@therecount) December 3, 2021

If in fact he was tested before interacting with staff, we’re okay with him showing up to work with a cold, right? Quarantine rules in American schools and workplaces are already draconian enough in the age of COVID that we don’t need to be folding the common cold into them.

Biden’s illness is a silly distraction from the real news today, which I wrote about earlier and which is picking up this afternoon. Public health experts have been knocked throughout the pandemic by righties for being alarmist about COVID but the ones I follow on social media have been admirably calm so far about the Omicron variant. The universal refrain has been “There’s no reason to panic when we don’t have any real data yet. Despite the scary mutations on its spike protein, there’s no hard evidence so far that Omicron is super-transmissible or that it’s capable of overcoming immunity.”

Their tone has begun to change in the past 24 hours, though. The study I blogged this morning suggests that the variant really is much better at reinfecting people than earlier variants were. And the latest case count from South Africa has experts feeling sweaty:

Two weeks ago we were in 200-300 cases a day, a week ago in the 1000s and now > 15,000. In addition 1 of 4 tests are positive in South Africa. Amazing increasing of #OmicronVarient https://t.co/YtNruFnZET

— Tulio de Oliveira (@Tuliodna) December 3, 2021

Or it's somewhere in between these. But neither alternative is good. I retained some hope that the new variant was lifted to dominance by superspreading events, but seeing the same rise replicated in other regions, and now in the UK… 😩https://t.co/I4f3XrQJoR

— Natalie E. Dean, PhD (@nataliexdean) December 3, 2021

Two days ago there were 8,500 new cases, Yesterday there were 11,500. Today there were 16,000+. The daily total is increasing by roughly 50 percent each day. The curve in Gauteng province, the hot spot, is vertiginous:

I really hate this graph! 🚀#Gauteng #COVID19 #4thWave #Omicron #OmicronVariant pic.twitter.com/HaCduVOIaK

— Ridhwaan Suliman (@rid1tweets) December 3, 2021

All of that would be okay, possibly even beneficial, if hospitalizations weren’t also increasing, but they are. And remember, even a variant that’s less virulent than its predecessors can produce a higher body count if it’s vastly more transmissible. If Omicron is puncturing the immunity of people who’ve been vaccinated or had COVID before then everyone is at some small risk of a bad outcome, not just the non-immune.

But maybe Omicron isn’t puncturing immunity as much as we think?

Now, if one is wondering why hospitalizations are going up, according to their MOH, 90% of hospitalizations in South Africa are unvaccinated individuals (zero doses), 10% remaining are mostly partially vaccinated (one dose) Low vaccination rates (less than 30% fully vaccinated).

— Chise 🧬🧫🦠💉🔜 MFF (@sailorrooscout) December 3, 2021

We’ll have to see what happens in countries where a much larger share of the population is vaccinated. It may be that South Africa is suffering because it’s only 25 percent vaxxed; most of its citizens may have acquired natural immunity last winter and that immunity has now worn off, leaving them vulnerable. A country that’s heavily vaxxed and boosted, like the UK, might do better. Although it’s worth noting that cases of Omicron are beginning to pick up there too:

So my main take-away is that growth looks fast in a country with immunity mostly from vaccines, rather than previous infection (and with a big ongoing Delta wave). We'll know a lot more soon, but this is not reassuring.

— Jeffrey Barrett (@jcbarret) December 3, 2021

One more worrisome detail. Not only are hospitalizations increasing in Gauteng province, the share of young children needing hospital care is larger than it’s been in previous waves. “We’ve seen quite a sharp increase [in hospital admissions] across all age groups but particularly in the under 5s,” said one South African official this morning. “The incidence in those under 5 is now second highest, second only to those over 60.” Of the children under 12 who’ve been hospitalized so far, she said, all but three had parents who were unvaccinated. Her advice: Mom and dad need to get jabbed to protect the little ones in the household who can’t be immunized yet. Expect to hear the White House emphasize that soon too.