Coronavirus Weekly Update

[habanero]

My province is rapidly scaling back all restrictions too, largely a political decision due to protests, it appears.  Doctors are saying it's too much too quickly.  The next couple of months should be interesting.  There's little testing now, and positivity rates haven't been reported in about a month, because it's impossible.  Hospitalizations have decreased a bit, but still pretty high and there are anywhere from 2 -12 deaths daily in a population of 1.3 million.  I expect things to worsen for a while after the restrictions lift in mid-March, so I'm still going to be very cautious until I see how things play out.  If another worse variant comes along, things will get hairy, because no one is going to want to go back to any kind of restrictions, so I'm a little concerned about that.

Overall impression over here is that the scrapping was too late and previous round of tightening was unneccessary in the end (but you didnt know that beforehand). They are not at all worried about health care capacity anymore but more that key functions might come to a halt due to many being off sick a few days at the same time. They estimate that 50% of sick leave is due to actual sickness and the remaining 50% is due to previous rules regariding isolation periods etc. Our deaths numbers are also elevated relative to earlier (but they have always been among the lowest in the world). Key difference is noone gives a flying fuck anymore and harsh as it might sound, rightly so, as its very old people in care homes and they have a very short remaining life expectancy and will soon die from something in the end.

I went to the grocery store this afternoon and mask-wearing was down from maybe 80% to 20%. Kind of hard to see what the remaining 20% think they achieve by wearing it in shops at peak hours, but that's not my problem. I expect it to drop to close to zero pretty very soon once the new reality sinks in.

Base case is that "everyone" will get it sooner or later and they have realized that there is no point in keeping any restrictions in place as it will spread everywhere anyways. By keeping futile restrictions you only prolong problems with no real benefit to show for it. Other places might of course come to other conculsions based on local conditions. At least we have a fairly rational population so vaxx rates are very high and never really had any social unrest to speak of due to restrictions. Disagreements and frustrations yes, but hardly ayone took to the streets to make a point and those few who did are viewed as morons.

We have no vaccine mandate (never seriously considered), no covid-pass (was a topic of discussion and we sort of had it for a few weeks about a year ago) and if you for some reason should choose not to get the jabs you've faced no restrictions for months as long as you don't leave or enter the country. With roughly 0.5% of the population officially registered as infected on a daily basis border controls obviously make no sense at all as there is plenty of virus to go around domestically.

[RetiredAt63]

Our province will be easing up soon.  I have given up on masks in public, I have moved to wearing an N95 all the time instead - it protects me as well as others.  Right now we are all still masked.  My last survey (of 3 people I saw leaving the grocery store) was 2 N95s and one cloth mask that fit well.

Our case numbers are totally inaccurate since testing is now hit and miss.  Hospital cases and wastewater numbers are more useful.  Our hospital numbers are separated between came in because of covid  and  came in for something else, found out they had covid when tested on entering the hospital. 

[habanero]

Our case numbers are totally inaccurate since testing is now hit and miss.  Hospital cases and wastewater numbers are more useful.  Our hospital numbers are separated between came in because of covid  and  came in for something else, found out they had covid when tested on entering the hospital.

Noone here care about case numbers anymore, they are high and vastly underreported due to no PCR test required and a self-test requires registering yourself (I, my GF and one of my kids tested positive last week and I haven't bothered registering any of us as there is no point in it). They cared about hospitalizations and ICU admisstions, but now they see those are fine they don't care about that anymore.

The times they are a-changin. Lets hope it lasts.

[habanero]

Story in the local news today about our health minister (a newbie and not a great one, but thats a different story) meeting her european collegues for the first time in person. They are generally surprised that we can open up completely. The german health minister is advised against going to the south of Germany due to protests. We have a 90% vaxx rate without ever making it mandatory to take a vaccine and employers have no right to know if you're vaccinated or not Curretly Scandinavia is probaly the place in the civilized world with the least amount of covid restrictions in addition to the UK. Our athorities are aware of the fact that it might make life harder for other European countries but that's their problem. Our legislation, which admittingly has probably been broken repeatadly over the last two years, only allows for a mimimum of restrictions and no preemptive measures.

[Abe]

Hospitalization and new cases are falling fairly quickly across the US, and most states are abandoning mask policies. I anticipate continued drop in case rates across the country regardless. Hopefully the omicron variant is sufficiently different from prior to give us all a broad range of antibodies against this coronavirus! We will see if this becomes seasonal or not. It will be interesting to see, if that happens, how long the anti-vaccine crowd holds out.

[PeteD01]

Omicron appears not to be a milder form of the virus when compared to variants other than Delta:


Challenges in Inferring Intrinsic Severity of the SARS-CoV-2 Omicron Variant
List of authors.
Roby P. Bhattacharyya, M.D., Ph.D., and William P. Hanage, Ph.D.

https://tinyurl.com/e97vhhy7

[JGS1980]

US Covid 19 Hospitalizations Update:

Previous USA peak in Covid Hospitalizations was:
January 14 2021 -133,268
---------------------------------
January 11 2022 -135,559 and rising >200% in the last 2 weeks
January 20 2022 -158,638 and beginning to flatten out. This is great news. Hopefully not just a blip.
January 25 2022 -148,521 and appears to have peaked at about 161,000 over the weekend.
February 2 2022 - 136,753 nice trend!
February 9 2022 - 107,623 yay!! 50% down from peak.
February 17 2022 -81,822 keeps dropping

Deaths per day (anticipate 2 week delay from hospitalizations):
Previous USA peak in Covid Deaths was:
January 26 2021 -3342 deaths per day per 7 day average
----------------------------------
January 11 2022 -1750 deaths per day per 7 day average
January 21 2022 -2162 deaths
January 25 2022 -2181 deaths --> this is still likely to rise in the next couple weeks
February 2 2022 -2636 -1 week or so from peak hospitalizations, daily deaths have not peaked yet for Omicron. At this rate, we will his 1,000,000 official deaths in about 30-40 days.
February 9 2022 -2565 -still pretty high [one Sept 11th attack per day]
February 17 2022 -2328 -slowly coming down. Typical Covid19 death shoulder, not a cliff.

https://www.nytimes.com/interactive/2021/us/covid-cases.html

Unvaccinated : Vaccinated Covid19 death ratio remains 20:1

[Phenix]

Unvaccinated : Vaccinated Covid19 death ratio remains 20:1

Is there an updated figure somewhere?  The NYT page still shows that figure is from late November/early December.

[bacchi]

Unvaccinated : Vaccinated Covid19 death ratio remains 20:1

Is there an updated figure somewhere?  The NYT page still shows that figure is from late November/early December.

Data from LA County through 01/08/22:

As of January 8, 2022, during Omicron predominance, these rate ratios were lower for both comparisons, with infection and hospitalization rates among unvaccinated persons 3.6 times and 23.0 times, respectively, those in fully vaccinated persons with a booster, and 2.0 and 5.3 times, respectively, those in fully vaccinated persons without a booster.

It doesn't break out the death ratio for the Omicron period, however.

[former player]

Excess deaths in the US during the pandemic are now over one million -

https://public.tableau.com/app/profile/dataviz8737/viz/COVID_excess_mort_withcauses_02162022/NumberOfExcessDeaths

[JGS1980]

Excess deaths in the US during the pandemic are now over one million -

https://public.tableau.com/app/profile/dataviz8737/viz/COVID_excess_mort_withcauses_02162022/NumberOfExcessDeaths

Yeah, I may of looking at this was acknowledging the total number of deaths per year in 2020 and 2021 as compared to previous baselines. I have a post somewhere way back in this thread about this issue.

2017 2.8 millions deaths of all causes in USA
2018 2.8 million deaths
2019 2.8 million deaths
2020 3.4 million deaths
2021 3.4 million deaths (? -CDC data not compiled yet)
2022-2023 -will be go back to the 2.8 million baseline, or will it drop even lower than baseline for a few years as a lot of the most medically vulnerable folks have already passed?

So there's your million excess deaths right there. Terrible news overall.

https://www.prb.org/usdata/indicator/deaths/chart/

[PeteD01]

A study looking at mental health outcomes in US veterans after Covid-19 was just published in the BMJ. As is typical for studies in the VA population, the numbers are impressively large, but as the population studied is comprised in part of a large majority of older white males, the results may not be applicable to the general population.
In particular, older white males tend to be overrepresented in politically conservative circles where Covid denial and antivaxxerism is actively encouraged by certain media and politicians. Such an environment may not be optimal for patients with Covid related brain injury and subsequent neuropsychiatric syndromes in terms of mental health outcomes. Thus, there is reason to suspect that the reported incidence of mental health disorders after Covid is somewhat of an overestimate (but that might just be wishful thinking).
The other caveat is that this is a big data investigation and comes with the usual complex modeling that renders the statistical analysis largely opaque for the non-expert. Here we have to rely on the British Medical Journal (BMJ) and their reviewers (the record of BMJ in this regard is very good - so there is that).


Risks of mental health outcomes in people with covid-19: cohort study
BMJ 2022; 376 doi: https://doi.org/10.1136/bmj-2021-068993 (Published 16 February 2022)
Cite this as: BMJ 2022;376:e068993

"In this study totaling 13 052 788 person years of follow-up of 153 848 people with covid-19, 5 637 840 people in the contemporary control group, and 5 859 251 people in the historical control group, we found that beyond the first 30 days of a positive test result for SARS-CoV-2 infection, people with covid-19 show an increased risk of incident mental health disorders, including anxiety disorders, depressive disorders, stress and adjustment disorders, opioid use disorder, other (non-opioid) substance use disorders, neurocognitive decline, and sleep disorders."

https://www.bmj.com/content/376/bmj-2021-068993


And a short commentary:

Mental health in people with covid-19
BMJ 2022; 376 doi: https://doi.org/10.1136/bmj.o415 (Published 17 February 2022)
Cite this as: BMJ 2022;376:o415

https://www.bmj.com/content/376/bmj.o415
 

[2Birds1Stone]

Wowza, thanks for sharing

Sent from my SM-N950U using Tapatalk

[PeteD01]

And here is a chilling review of Long Covid neurologic complications:


Nervous system consequences of COVID-19
 • 20 Jan 2022 • Vol 375, Issue 6578 • pp. 267-269 • DOI: 10.1126/science.abm2052

https://www.science.org/doi/10.1126/science.abm2052

[GuitarStv]

And here is a chilling review of Long Covid neurologic complications:


Nervous system consequences of COVID-19
 • 20 Jan 2022 • Vol 375, Issue 6578 • pp. 267-269 • DOI: 10.1126/science.abm2052

https://www.science.org/doi/10.1126/science.abm2052

I really, really, really want more data and info about this.  What the risks are, who is most at risk, what the prevalence is, etc.  You would think that this would be very important to know before opening everything up and exposing people to this potential issue.

[PeteD01]

And here is a chilling review of Long Covid neurologic complications:


Nervous system consequences of COVID-19
 • 20 Jan 2022 • Vol 375, Issue 6578 • pp. 267-269 • DOI: 10.1126/science.abm2052

https://www.science.org/doi/10.1126/science.abm2052

I really, really, really want more data and info about this.  What the risks are, who is most at risk, what the prevalence is, etc.  You would think that this would be very important to know before opening everything up and exposing people to this potential issue.

It is not a potential issue but something that is actually going on as we speak.
These papers came out in the last 72 hours and going forward one can expect a massive increase in published research and more accurate estimates will surely emerge over time.
The current estimate of sustained neurological dysfunction after Covid is between 5 and 30% (I think it will turn out to be at the lower end but that is just a guess). We are talking about millions of cases even in the best case scenario.

[PeteD01]

And here is a chilling review of Long Covid neurologic complications:


Nervous system consequences of COVID-19
 • 20 Jan 2022 • Vol 375, Issue 6578 • pp. 267-269 • DOI: 10.1126/science.abm2052

https://www.science.org/doi/10.1126/science.abm2052

I really, really, really want more data and info about this.  What the risks are, who is most at risk, what the prevalence is, etc.  You would think that this would be very important to know before opening everything up and exposing people to this potential issue.

I look at many scientific papers and these days a good number are about Covid. I don´t think more than a fraction of a percent is of interest to the general public.
Covid induced brain injury, its neuropsychiatric consequences and possible development of mental health problems are of public interest and I am going to give you four reasons off the top of my head:

1) in brain injury, there is a window of time during which rehabilitation taking advantage of neuroplasticity is essential to optimize functional outcomes and possibly improve mental health outcomes

2) people with behavioral, mental health or cognitive issues face some of the most difficult to overcome obstacles in gaining access to health care in the US

3) Long Covid is by definition a chronic illness. US medicine is generally very good with management of acute illnesses but far less so with chronic illnesses affecting individuals who are less useful economically because of said illness

4) no matter what happens, the cost of neurologic Long Covid is going to be astronomical and now is the time to address the issue proactively. The alternative would be waiting until action becomes reactive by necessity and even more expensive with even worse outcomes


I see that you are interested in exercise and might be interested in the most interesting paper I read today - not of general public interest but very interesting nevertheless.
They studied 10 patients with Long Covid and exercise intolerance with invasive cardiopulmonary exercise testing. The main finding is that there was a deficiency in extracting oxygen from the blood.
Without going into the details too much, the most likely explanation is not cyanide poisoning or similar but a shunting away (bypassing) of circulating blood from muscle tissue that is being starved of oxygen. In other words, the heart is pumping but the blood comes back with most of its oxygen undelivered while some muscles are under severe oxygen deprivation.
Interestingly, that is a pattern of shock called distributive shock which again is the typical pattern of resuscitated septic shock.
The issue is most likely caused by a Covid induced small fiber neuropathy (another example of Covid induced neurologic disease), that is, the small nerves controlling the distribution of blood flow by either constricting or relaxing small blood vessels to optimize oxygen delivery, are gone or do not function anymore. Think of rice fields and little canals and gates to regulate flow, and a situation were the little gates stop functioning and heavy rains are coming.
So these patients develop a sort of shock state as soon as they start exerting themselves - no wonder that they feel terrible and sometimes require days to recover from exertion.


Persistent Exertional Intolerance After COVID-19
Insights From Invasive Cardiopulmonary Exercise Testing

Chest. 2022 Jan; 161(1): 54–63.
doi: 10.1016/j.chest.2021.08.010
PMCID: PMC8354807
PMID: 34389297

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8354807/pdf/main.pdf

[wenchsenior]

Welcome, Millions, to the joys of persistent but vague, mostly 'undiagnosable' autoimmune misery.  We who live here already salute you.

At least this will likely force the American medical establishment to get better at dealing with it, b/c they are pretty shit right now.

That small fiber neuropathy is interesting; I wonder if that type of mechanism could account for my development of Reynaud's and persistent torso-based paresthesias, among many other autoimmune troubles that appeared a few years ago.

[PeteD01]

Welcome, Millions, to the joys of persistent but vague, mostly 'undiagnosable' autoimmune misery.  We who live here already salute you.

At least this will likely force the American medical establishment to get better at dealing with it, b/c they are pretty shit right now.

yes

That small fiber neuropathy is interesting; I wonder if that type of mechanism could account for my development of Reynaud's and persistent torso-based paresthesias, among many other autoimmune troubles that appeared a few years ago.

[GuitarStv]

And here is a chilling review of Long Covid neurologic complications:


Nervous system consequences of COVID-19
 • 20 Jan 2022 • Vol 375, Issue 6578 • pp. 267-269 • DOI: 10.1126/science.abm2052

https://www.science.org/doi/10.1126/science.abm2052

I really, really, really want more data and info about this.  What the risks are, who is most at risk, what the prevalence is, etc.  You would think that this would be very important to know before opening everything up and exposing people to this potential issue.

It is not a potential issue but something that is actually going on as we speak.

I meant 'potential' in that not everyone who survives covid will develop it.  Not trying to imply that this isn't a serious problem right now.

How come nobody talks about this when we discuss 'living with covid' and removing all restrictions?

[jrhampt]

Is the exercise intolerance something that resolves itself over time?  Is there any way to treat it?

[lost_in_the_endless_aisle]

And here is a chilling review of Long Covid neurologic complications:


Nervous system consequences of COVID-19
 • 20 Jan 2022 • Vol 375, Issue 6578 • pp. 267-269 • DOI: 10.1126/science.abm2052

https://www.science.org/doi/10.1126/science.abm2052

I really, really, really want more data and info about this.  What the risks are, who is most at risk, what the prevalence is, etc.  You would think that this would be very important to know before opening everything up and exposing people to this potential issue.

It is not a potential issue but something that is actually going on as we speak.

I meant 'potential' in that not everyone who survives covid will develop it.  Not trying to imply that this isn't a serious problem right now.

How come nobody talks about this when we discuss 'living with covid' and removing all restrictions?

Because only the most absurdly strict restrictions (shutting down entire cities for weeks, e.g., China) is going to keep Omicron out. Given that is not a viable option, it is a plain fact we will be living with covid.

[GuitarStv]

And here is a chilling review of Long Covid neurologic complications:


Nervous system consequences of COVID-19
 • 20 Jan 2022 • Vol 375, Issue 6578 • pp. 267-269 • DOI: 10.1126/science.abm2052

https://www.science.org/doi/10.1126/science.abm2052

I really, really, really want more data and info about this.  What the risks are, who is most at risk, what the prevalence is, etc.  You would think that this would be very important to know before opening everything up and exposing people to this potential issue.

It is not a potential issue but something that is actually going on as we speak.

I meant 'potential' in that not everyone who survives covid will develop it.  Not trying to imply that this isn't a serious problem right now.

How come nobody talks about this when we discuss 'living with covid' and removing all restrictions?

Because only the most absurdly strict restrictions (shutting down entire cities for weeks, e.g., China) is going to keep Omicron out. Given that is not a viable option, it is a plain fact we will be living with covid.

I'm not saying that we need to maintain pandemic protocols indefinitely.  I'd like to hear a lot more discussion of the problem and to see some plans in place to deal with it though.  The current approach of 'fuck it, we're bored of covid' doesn't seem to address this.

[lost_in_the_endless_aisle]

And here is a chilling review of Long Covid neurologic complications:


Nervous system consequences of COVID-19
 • 20 Jan 2022 • Vol 375, Issue 6578 • pp. 267-269 • DOI: 10.1126/science.abm2052

https://www.science.org/doi/10.1126/science.abm2052

I really, really, really want more data and info about this.  What the risks are, who is most at risk, what the prevalence is, etc.  You would think that this would be very important to know before opening everything up and exposing people to this potential issue.

It is not a potential issue but something that is actually going on as we speak.

I meant 'potential' in that not everyone who survives covid will develop it.  Not trying to imply that this isn't a serious problem right now.

How come nobody talks about this when we discuss 'living with covid' and removing all restrictions?

Because only the most absurdly strict restrictions (shutting down entire cities for weeks, e.g., China) is going to keep Omicron out. Given that is not a viable option, it is a plain fact we will be living with covid.

I'm not saying that we need to maintain pandemic protocols indefinitely.  I'd like to hear a lot more discussion of the problem and to see some plans in place to deal with it though.  The current approach of 'fuck it, we're bored of covid' doesn't seem to address this.

Maybe that is the lower quality argument, but the higher quality argument is that we are not going to meaningfully control a virus with R0 of 8 or 10, or whatever, through hygiene-theater.

[GuitarStv]

Maybe that is the lower quality argument, but the higher quality argument is that we are not going to meaningfully control a virus with R0 of 8 or 10, or whatever, through hygiene-theater.

Sure, and I agree that.  The argument used doesn't matter.

My concern is . . . why don't we have plans in place for the (seems like large number of) people who will end up with long covid / long lasting health problems?  The number of these people won't go down as restrictions are removed.

[lost_in_the_endless_aisle]

Maybe that is the lower quality argument, but the higher quality argument is that we are not going to meaningfully control a virus with R0 of 8 or 10, or whatever, through hygiene-theater.

Sure, and I agree that.  The argument used doesn't matter.

My concern is . . . why don't we have plans in place for the (seems like large number of) people who will end up with long covid / long lasting health problems?  The number of these people won't go down as restrictions are removed.

Ah, understandable, and I agree. But we've never had good plans, so why start now?

[PeteD01]

And here is a chilling review of Long Covid neurologic complications:


Nervous system consequences of COVID-19
 • 20 Jan 2022 • Vol 375, Issue 6578 • pp. 267-269 • DOI: 10.1126/science.abm2052

https://www.science.org/doi/10.1126/science.abm2052

I really, really, really want more data and info about this.  What the risks are, who is most at risk, what the prevalence is, etc.  You would think that this would be very important to know before opening everything up and exposing people to this potential issue.

It is not a potential issue but something that is actually going on as we speak.

I meant 'potential' in that not everyone who survives covid will develop it.  Not trying to imply that this isn't a serious problem right now.

How come nobody talks about this when we discuss 'living with covid' and removing all restrictions?

Well, if everyone was already talking about it there would be no need for me to bring it up.
Actually, I am bringing it up because not many are talking about it yet - and when you go back in my posts you will find that I have pointed out the developing crisis several times before and also quite a while back.
On the other hand, people in the field have paid attention to the sequelae of Covid ever since the new disease emerged and the problem has been studied ever since. There is now a body of research that is expanding rapidly, but there is just not the same sense of urgency as with acute Covid because patients with Long Covid do not overload the acute care facilities.
Going forward though, it will become increasingly difficult to ignore the problem.

[PeteD01]

Is the exercise intolerance something that resolves itself over time?  Is there any way to treat it?

Obviously, we have no way to know for sure because the disease has not been around long enough.
Unfortunately, it is rather plausible that the disability will be permanent in many cases.

[jrhampt]

Is the exercise intolerance something that resolves itself over time?  Is there any way to treat it?

Obviously, we have no way to know for sure because the disease has not been around long enough.
Unfortunately, it is rather plausible that the disability will be permanent in many cases.

Of the long Covid effects, I am most concerned about the exercise intolerance and the brain damage.  I’ve seen both of these and they are appalling.  One of my spouse’s biking partners is still easily tired from an infection around the holidays and doesn’t seem to be improving…he was double vaccinated and 40, not sure if boosted.  I remember early in the pandemic a coworker’s aunt was told she’d have drastically reduced lung capacity for the rest of her life…which turned out not to be very long…I think the Covid just weakened her body too much and she died around a year later.  These are the things I worry about.

That said, I’m tired of it too.  I got boosted in November but cut out gym and restaurants for 2 months during the omicron wave but now I’m back at the gym…at community spread levels which I would have deemed too risky before omicron…but I just don’t see an end.

[RetiredAt63]

We get used to things they way they are.  Measles is a leading cause of childhood blindness in areas where vaccination rates are low and nutrition is poor.  Do we worry about that here?  Even in areas where vaccination rates are low?  Measles is very contagious.

Canada is not all that much better than the US for chronic issues.  We have universal health care, true, but if the resources are not in place or the local medical system is not aware of a situation, it isn't too helpful.  Look at the lack of awareness therefore horrible lack of treatment/ for Lyme Disease* until recently. Let's not get too complacent.


* Lyme Disease has gone from almost nonexistent to serious in southeastern Ontario.  2 years ago at a local hiking area near Ottawa (Carp) 50% of ticks sampled carried Lyme.  A decade ago that would have been 0% or close to 0%.  Easy to treat if caught early, nasty chronic disease if not.

[SunnyDays]

We get used to things they way they are.  Measles is a leading cause of childhood blindness in areas where vaccination rates are low and nutrition is poor.  Do we worry about that here?  Even in areas where vaccination rates are low?  Measles is very contagious.

Canada is not all that much better than the US for chronic issues.  We have universal health care, true, but if the resources are not in place or the local medical system is not aware of a situation, it isn't too helpful.  Look at the lack of awareness therefore horrible lack of treatment/ for Lyme Disease* until recently. Let's not get too complacent.


* Lyme Disease has gone from almost nonexistent to serious in southeastern Ontario.  2 years ago at a local hiking area near Ottawa (Carp) 50% of ticks sampled carried Lyme.  A decade ago that would have been 0% or close to 0%.  Easy to treat if caught early, nasty chronic disease if not.

There's a difference though, in that Lyme has an easy, and most importantly, cheap treatment.  The cost of treating serious long Covid effects will be huge, so there might be some willingness in the Canadian medical system to ignore it as long as possible or downplay it if acknowledged.  We just can't afford it.

[RetiredAt63]

We get used to things they way they are.  Measles is a leading cause of childhood blindness in areas where vaccination rates are low and nutrition is poor.  Do we worry about that here?  Even in areas where vaccination rates are low?  Measles is very contagious.

Canada is not all that much better than the US for chronic issues.  We have universal health care, true, but if the resources are not in place or the local medical system is not aware of a situation, it isn't too helpful.  Look at the lack of awareness therefore horrible lack of treatment/ for Lyme Disease* until recently. Let's not get too complacent.


* Lyme Disease has gone from almost nonexistent to serious in southeastern Ontario.  2 years ago at a local hiking area near Ottawa (Carp) 50% of ticks sampled carried Lyme.  A decade ago that would have been 0% or close to 0%.  Easy to treat if caught early, nasty chronic disease if not.

There's a difference though, in that Lyme has an easy, and most importantly, cheap treatment.  The cost of treating serious long Covid effects will be huge, so there might be some willingness in the Canadian medical system to ignore it as long as possible or downplay it if acknowledged.  We just can't afford it.

I used Lyme as an example because until extremely recently it was not recognized, and so people did end up with chronic Lyme.  Borrelia diseases are sneaky.  How well diagnosed is rocky Mountain Spotted Fever?  But there are lots of obvious historical examples.  People used to end up with heart damage from Scarlet fever so often it was also called rheumatic fever, until antibiotics made it a non-issue.  Or older adults who had mild cases of polio as children and are now seeing unexpected muscle weakness.  Or babies were damaged in utero from German measles.

My impression is that society in general has forgotten how common it is for a disease to have long-term effects, since so many of the long-term issue diseases are not major problems now.  Our long-term health issues are now things like kidney disease, diabetes, cardiovascular issues.  It is definitely going to take a shift in thinking and planning.  And it needs to be done.

[Taran Wanderer]

Oddly, I know a person who got Covid, felt sick enough to go to his doctor, was also diagnosed with Lyme Disease, was treated, recovered from both, and now feels the best they’ve felt in years. Covid ended up being a wonderful thing. I’m sharing this not to say that Covid is good, but to illustrate how poorly recognized Lyme disease is. Recurring symptoms over several years were never diagnosed, but somehow the diagnostic process for Covid finally identified it.

We’re going to need to get better and recognizing and managing the long term effects of these illnesses.

[JGS1980]

Oddly, I know a person who got Covid, felt sick enough to go to his doctor, was also diagnosed with Lyme Disease, was treated, recovered from both, and now feels the best they’ve felt in years. Covid ended up being a wonderful thing. I’m sharing this not to say that Covid is good, but to illustrate how poorly recognized Lyme disease is. Recurring symptoms over several years were never diagnosed, but somehow the diagnostic process for Covid finally identified it.

We’re going to need to get better and recognizing and managing the long term effects of these illnesses.

I know a guy who had a severe reaction to a Covid vaccine that led to hospitalization. Now these are fairly rare, but do occur.  He had liver inflammation on labs, which led to imaging, which led to a diagnosis of [early] kidney cancer that would never have been found unless he was hospitalized. So in my book, his Covid vaccine was a smashing success.

[FIRE Artist]

Oddly, I know a person who got Covid, felt sick enough to go to his doctor, was also diagnosed with Lyme Disease, was treated, recovered from both, and now feels the best they’ve felt in years. Covid ended up being a wonderful thing. I’m sharing this not to say that Covid is good, but to illustrate how poorly recognized Lyme disease is. Recurring symptoms over several years were never diagnosed, but somehow the diagnostic process for Covid finally identified it.

We’re going to need to get better and recognizing and managing the long term effects of these illnesses.

Long COVID is being heralded as normalizing the diagnosis of long term chronic disease from viral infections to the point that research money may actually be channeled into it, and hopefully make life better for a lot of people.

[Travis]

Oddly, I know a person who got Covid, felt sick enough to go to his doctor, was also diagnosed with Lyme Disease, was treated, recovered from both, and now feels the best they’ve felt in years. Covid ended up being a wonderful thing. I’m sharing this not to say that Covid is good, but to illustrate how poorly recognized Lyme disease is. Recurring symptoms over several years were never diagnosed, but somehow the diagnostic process for Covid finally identified it.

We’re going to need to get better and recognizing and managing the long term effects of these illnesses.

I know a guy who had a severe reaction to a Covid vaccine that led to hospitalization. Now these are fairly rare, but do occur.  He had liver inflammation on labs, which led to imaging, which led to a diagnosis of [early] kidney cancer that would never have been found unless he was hospitalized. So in my book, his Covid vaccine was a smashing success.

Both cases make me wonder how often those two individuals went to see their doctors for preventative medicine or screenings? Is a serious case of something the only thing that would have got them in the door?

[PeteD01]

Welcome, Millions, to the joys of persistent but vague, mostly 'undiagnosable' autoimmune misery.  We who live here already salute you.

At least this will likely force the American medical establishment to get better at dealing with it, b/c they are pretty shit right now.

That small fiber neuropathy is interesting; I wonder if that type of mechanism could account for my development of Reynaud's and persistent torso-based paresthesias, among many other autoimmune troubles that appeared a few years ago.

You might find this article interesting:


How Covid changed medicine for the future

Covid’s lightbulb moment: the search for a vaccine could impact the treatment of obesity, cancer and even malaria. Illustration: Pete Reynolds/The Observer
The global pandemic sparked a huge superhuman effort to control coronavirus. But the billions spent have also had an unexpected impact on medicine and science

https://www.theguardian.com/world/2022/feb/20/how-covid-created-a-vision-for-treating-disease

[RetiredAt63]

Both cases make me wonder how often those two individuals went to see their doctors for preventative medicine or screenings? Is a serious case of something the only thing that would have got them in the door?

Depends on the doctor.  I am in Ontario (Canada) so OHIP covers my blood tests.  I have to push like mad to get regular blood tests for things I need regular feedback on.  I pushed for a complete blood panel when I turned 70, to match the complete blood panel my old doctor did automatically when patients hit 50.  If I left it to him? 

However, he has made sure I have had the bone density test for osteoporosis/osteopenia (I mostly fit the risk factors).

[Taran Wanderer]

My understanding was the doctor just didn’t catch it earlier.

[JGS1980]

Nope. Kidney cancers are often "silent" until caught way too late to do anything about it. Because you have a second well functioning kidney, labs won't catch any dysfunction. Often times kidney cancers are only found when someone has blood in their urine or unexplained abdominal pain.

[OtherJen]

Nope. Kidney cancers are often "silent" until caught way too late to do anything about it. Because you have a second well functioning kidney, labs won't catch any dysfunction. Often times kidney cancers are only found when someone has blood in their urine or unexplained abdominal pain.

Yes. My cousin, late 40s, physically active and healthy, was completely asymptomatic and unaware until he spotted a bit of blood in his urine, went to urgent care for an assumed kidney stone, and found out that he had renal cell carcinoma. He had the kidney surgically removed and was back to running a few weeks later, but the 6-month follow-up revealed aggressive metastases that didn’t respond to treatment. He died just under 1 year after diagnosis.

[jrhampt]

Nope. Kidney cancers are often "silent" until caught way too late to do anything about it. Because you have a second well functioning kidney, labs won't catch any dysfunction. Often times kidney cancers are only found when someone has blood in their urine or unexplained abdominal pain.

Yes. My cousin, late 40s, physically active and healthy, was completely asymptomatic and unaware until he spotted a bit of blood in his urine, went to urgent care for an assumed kidney stone, and found out that he had renal cell carcinoma. He had the kidney surgically removed and was back to running a few weeks later, but the 6-month follow-up revealed aggressive metastases that didn’t respond to treatment. He died just under 1 year after diagnosis.

So is there any recommended kidney cancer screening (like mammograms, pap smears, or colonoscopies)?

[JGS1980]

Nope. Kidney cancers are often "silent" until caught way too late to do anything about it. Because you have a second well functioning kidney, labs won't catch any dysfunction. Often times kidney cancers are only found when someone has blood in their urine or unexplained abdominal pain.

Yes. My cousin, late 40s, physically active and healthy, was completely asymptomatic and unaware until he spotted a bit of blood in his urine, went to urgent care for an assumed kidney stone, and found out that he had renal cell carcinoma. He had the kidney surgically removed and was back to running a few weeks later, but the 6-month follow-up revealed aggressive metastases that didn’t respond to treatment. He died just under 1 year after diagnosis.

So is there any recommended kidney cancer screening (like mammograms, pap smears, or colonoscopies)?

https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-and-b-recommendations

In brief, no there is no recommended screening. This means any form of screening is so low-yield as to be useless. Same reason we don't get MRIs of everyone's brains to look for Glioblastomas.

Sorry about your cousin OtherJen

[JGS1980]

US Covid 19 Hospitalizations Update:

Previous USA peak in Covid Hospitalizations was:
January 14 2021 -133,268
---------------------------------
January 11 2022 -135,559 and rising >200% in the last 2 weeks
January 20 2022 -158,638 and beginning to flatten out. This is great news. Hopefully not just a blip.
January 25 2022 -148,521 and appears to have peaked at about 161,000 over the weekend.
February 2 2022 - 136,753 nice trend!
February 9 2022 - 107,623 yay!! 50% down from peak.
February 17 2022 -81,822 keeps dropping
February 24 2022 -60,155

Deaths per day (anticipate 2 week delay from hospitalizations):
Previous USA peak in Covid Deaths was:
January 26 2021 -3342 deaths per day per 7 day average
----------------------------------
January 11 2022 -1750 deaths per day per 7 day average
January 21 2022 -2162 deaths
January 25 2022 -2181 deaths --> this is still likely to rise in the next couple weeks
February 2 2022 -2636 -1 week or so from peak hospitalizations, daily deaths have not peaked yet for Omicron. At this rate, we will his 1,000,000 official deaths in about 30-40 days.
February 9 2022 -2565 -still pretty high [one Sept 11th attack per day]
February 17 2022 -2328 -slowly coming down. Typical Covid19 death shoulder, not a cliff.
February 24 2022 -1960

https://www.nytimes.com/interactive/2021/us/covid-cases.html

[Taran Wanderer]

February 9 2022 - 107,623 yay!! 50% down from peak.

Shouldn’t that be 33%?

[JoJo]

Nope. Kidney cancers are often "silent" until caught way too late to do anything about it. Because you have a second well functioning kidney, labs won't catch any dysfunction. Often times kidney cancers are only found when someone has blood in their urine or unexplained abdominal pain.

my sister's 10 lb kidney tumor was discovered the evening after visiting an amusement park, apparently one of the rides ruptured the tumor and she had internal bleeding.  she said it was the worst pain in her life, way worse than childbirth.  She still had to wait many hours in the emergency room before being seen by a dr. 

[former player]

Nope. Kidney cancers are often "silent" until caught way too late to do anything about it. Because you have a second well functioning kidney, labs won't catch any dysfunction. Often times kidney cancers are only found when someone has blood in their urine or unexplained abdominal pain.

my sister's 10 lb kidney tumor was discovered the evening after visiting an amusement park, apparently one of the rides ruptured the tumor and she had internal bleeding.  she said it was the worst pain in her life, way worse than childbirth.  She still had to wait many hours in the emergency room before being seen by a dr.

Perhaps an annual medical checkup should include a visit to an amusement park.

[JGS1980]

US Covid 19 Hospitalizations Update:

Previous USA peak in Covid Hospitalizations was:
January 14 2021 -133,268
---------------------------------
January 11 2022 -135,559 and rising >200% in the last 2 weeks
January 20 2022 -158,638 and beginning to flatten out. This is great news. Hopefully not just a blip.
January 25 2022 -148,521 and appears to have peaked at about 161,000 over the weekend.
February 2 2022 - 136,753 nice trend!
February 9 2022 - 107,623 yay!! 50% down from peak.
February 17 2022 -81,822 keeps dropping
February 24 2022 -60,155
(2 weeks later) March 8 2022 -37,118 hospitalizations

Deaths per day (anticipate 2 week delay from hospitalizations):
Previous USA peak in Covid Deaths was:
January 26 2021 -3342 deaths per day per 7 day average
----------------------------------
January 11 2022 -1750 deaths per day per 7 day average
January 21 2022 -2162 deaths
January 25 2022 -2181 deaths --> this is still likely to rise in the next couple weeks
February 2 2022 -2636 -1 week or so from peak hospitalizations, daily deaths have not peaked yet for Omicron. At this rate, we will his 1,000,000 official deaths in about 30-40 days.
February 9 2022 -2565 -still pretty high [one Sept 11th attack per day]
February 17 2022 -2328 -slowly coming down. Typical Covid19 death shoulder, not a cliff.
February 24 2022 -1960
(2 weeks later) March 8 2022 -1473 deaths per day per 7 day average

https://www.nytimes.com/interactive/2021/us/covid-cases.html

[JGS1980]

Sobering New Yorker article about Covid19 1st Wave in Ecuador in early 2020.

Our memories have a way of protecting us from the worst things sometimes. As things open up in the world again, it may serve us well to see how far we've come, and how thankful we should be that most of us live in a 1st world country with 1st world resources and 1st world medical care.

https://www.newyorker.com/magazine/2022/03/14/a-pandemic-tragedy-in-guayaquil

JGS

[OtherJen]

I was just remembering today that this week, 2 years ago, was when the governor made an emergency 11 pm press conference on Thursday night to announce that all schools would close indefinitely from the following Monday. That was such a surreal moment, and these past two years have been bizarre and often tragic.