Sure, no problem.
https://jamanetwork.com/journals/jama/fullarticle/2771111.
10% of confirmed covid patients (not total infections), but how is that 10% distributed among demographics? The article you linked above says:
"As with SARS, many COVID-19 long haulers are health care workers who had massive exposure to the virus early in the pandemic, neuroimmunologist Avindra Nath, MD, of the National Institute of Neurological Disorders and Stroke (NINDS), noted in a recent editorial."
"The older the patients, the more likely they were to say they their pre–COVID-19 health hadn’t come back."
Those people have now had opportunities to protect themselves via vaccination pretty much everywhere in the US.
We know that this impacts people who were perfectly healthy before having covid, and we know that it impacts younger people. I wouldn't be surprised if it turned out that older patients and those with health problems were more seriously effected by it - this is true of most diseases.
We know that there's a problem and that it isn't rare. We know that it impacts young, healthy people and older people - but older people in greater numbers. We know that it impacts people who did not have severe cases of covid. I don't believe that we have enough data at this point to be making the sweeping statements you're claiming above - that this is only an issue of concern for elderly people.
Not sure I said that it's only a concern for old people. You're clearly concerned about it, and not that old. But old people (in the US) have been given every opportunity to protect themselves via the vaccine. They're most likely to suffer severe illness, and per your links also most likely to suffer lengthy covid symptoms. If they've taken the opportunity to vaccinate, then all of that is pretty much off the table isn't it?
And what kind of long term issues are we talking about? Again from the article you linked:
"In the study of Italian patients, the most common symptoms reported at follow-up were fatigue, shortness of breath, joint pain, and chest pain, in that order. None of the patients had a fever or other sign or symptom of acute illness, but about 44% of them had a worsened quality of life. As the authors pointed out, though, patients with community-acquired pneumonia can also have persistent symptoms, so the findings might not be exclusive to COVID-19."
"A recent survey by the grassroots group COVID-19 “Survivor Corps” found that fatigue was the most common of the top 50 symptoms experienced by the more than 1500 long haulers who responded, followed by muscle or body aches, shortness of breath or difficulty breathing, and difficulty concentrating."
So we're talking about a minority of confirmed patients that might suffer from things like fatigue, muscle ache or difficulty concentrating for a few weeks. Many of these are also common lingering affects from other illnesses that we mostly ignore as a society too. None of these qualify as more than a nuisance to me. I don't see that these are widespread enough or severe enough to justify society wide restrictions.
I think that you're minimizing the impacts of some of these symptoms here in order to dismiss them. The fatigue you mentioned can seriously impact the ability of a person to work, or a child to learn at school. I've had issues with insomnia in the past, and can tell you first hand . . . fatigue is a real problem that seriously impacts quality of life for a person. It's not something I'd wish on another.
I'm not minimizing the impacts those can have on an individual. Given the choice between not having those symptoms and having them, we obviously would like to avoid them. I just don't think it falls on all of society to continue to sacrifice so that a minority of people can avoid some minor discomfort, brain fog, etc. It's worth it to prevent widespread death and overloading the medical system. It's not worth it to prevent a few people from feeling fatigued after doing the dishes (my wife was easily fatigued for a week or so during her bout with the virus).
Despite protestations to the contrary, your comments above are again minimizing the impacts that this can have on individuals.
Do you really find wearing a mask in public and some attempt at distancing while out of the home an unreasonable ask to prevent symptoms of this disease that we don't currently understand yet?
I don't know the full extend of this problem yet. Prudence indicates that it is reason to
not rush back into pre-pandemic routine, at least until the full extent is better known. There are many people researching this, we'll have answers soon.
You're also mentioning 'a few weeks'. As I previously pointed out . . . that's a bit dismissive:
Patients with Long COVID report prolonged multisystem involvement and significant disability. Most had not returned to previous levels of work by 6 months. Many patients are not recovered by 7 months, and continue to experience significant symptom burden.
https://www.medrxiv.org/content/10.1101/2020.12.24.20248802v2
I mention "a few weeks" because most of the studies in the article that you linked have timeline under 36 days. The one source that you've provided (the link directly above) that indicates symptoms several months down the line doesn't happen to quantify how many of the self-selected respondents actually still have those symptoms after several months. It only uses "many". It's the same ambiguous language that you're critisizing Walt for. There's no way to tell if this occurs in 1% of cases, or .00001%
You think that it's unreasonable for us to accommodate a minority of people who might have serious quality of life problems from this? How do you feel about providing annoying beeping at crosswalk signs for blind people? That's a cost borne by the majority to accommodate a very small minority . . . because we want to try to allow the blind ways to be more productive members of society. Pretty much the same thing.
The various studies that I linked are part of the ongoing process of researching the long term damage that covid does. You seem to be under the impression that because a study has concluded in 36 days, that means the disease being studied has also run it's course. This is not the case. The disease is still being studied. We don't know how many months or years the long haulers will be impacted, or what percentage of people it will include.
FWIW - My primary criticism of Walt was not with ambiguous language - it was with the clear and unambiguous falsehood that covid is a magnitude of order less dangerous than the flu.
We're still studying the long term impacts of this disease. My point is certainly not to say that having had covid is the end of the world and doom . . . but it is to indicate a reason why we should temper our exuberance to return to normal as quickly as possible. While we certainly need to proceed with opening things back up, we also should continue to take annoying but necessary common sense precautions (mask mandates, social distancing, handwashing) until our experts tell us that we've achieved herd immunity.
And what if we never achieve herd immunity (70% vaccination or more)? What if we get to a point where something like 60% of the population is vaccinated and that's it? Old people have the most to lose from COVID and the most to gain from a vaccine. They also happen to have the least amount of life remaining to worry about long term impacts. The math is different for a young person that's far less likely to suffer severe illness from the virus, and has far more life remaining for long term vaccine effects to surface. What if we get to a point where the people that want the vaccine have all had it, and those who don't aren't willing to take it, and we're still below the 70% estimate that experts say is needed for herd immunity? What if in that same scenario case numbers, hospitalizations, and test positivity all continue to decline? If there's no indication of local spread, but the experts don't think we're at herd immunity, then what?
If people are too stupid to take the vaccine, then the disease will continue to mutate and more dangerous forms will likely be common. There's nothing saying that future mutations of covid will continue to attack the elderly, it could just as easily become a bigger problem for the young and not be controlled by available vaccines. Likely we'll have to see semi-permeant use of masks and social distancing in public and potential future years just like this previous one where death tolls and hospitalizations mount as we scramble to find a way out. That would be a pretty terrible outcome, and one that I'd prefer to avoid.
This study directly opposes Walt's earlier claim that Covid is like the flu but an order of magnitude less important:
Not returning to usual health within 2–3 weeks of testing was reported by approximately one third of respondents. Even among young adults aged 18–34 years with no chronic medical conditions, nearly one in five reported that they had not returned to their usual state of health 14–21 days after testing. In contrast, over 90% of outpatients with influenza recover within approximately 2 weeks of having a positive test result
https://www.cdc.gov/mmwr/volumes/69/wr/mm6930e1.htm?s_cid=mm6930e1_w
From that study:
"Overall, 141 of 264 (53%) with available data reported one or more chronic medical conditions."
"Among the 270 of 274 interviewees with available data on return to usual health,† 175 (65%) reported that they had returned to their usual state of health a median of 7 days (IQR = 5–12 days) from the date of testing (Table 1). Ninety-five (35%) reported that they had not returned to their usual state of health at the time of interview. The proportion who had not returned to their usual state of health differed across age groups: 26% of interviewees aged 18–34 years, 32% aged 35–49 years, and 47% aged ≥50 years reported not having returned to their usual state of health (p = 0.010) within 14–21 days after receiving a positive test result. Presence of chronic conditions also affected return to health rates; among 180 persons with no or one chronic medical condition, 39 with two chronic medical conditions, and 44 with three or more chronic medical conditions, 28%, 46%, and 57%, respectively, reported not having returned to their usual state of health (p = 0.003) within 14–21 days after having a positive test result. Among respondents aged 18–34 years with no chronic medical condition, 19% (nine of 48) reported not having returned to their usual state of health. Adjusting for other factors, age ≥50 versus 18–34 years (adjusted odds ratio [aOR] = 2.29; 95% confidence interval [CI] = 1.14–4.58) and reporting three or more versus no chronic medical conditions (aOR = 2.29; 95% CI = 1.07–4.90) were associated with not having returned to usual health (Table 2). Obesity (body mass index ≥30 kg per m2) (aOR 2.31; 95% CI = 1.21–4.42) and reporting a psychiatric condition§ (aOR 2.32; 95% CI = 1.17–4.58) also were associated with more than twofold odds of not returning to the patient’s usual health after adjusting for age, sex, and race/ethnicity."
Again, long term impacts don't seem very likely or very severe for most people, particularly young, healthy ones. If a person has concerns about these long term impacts, then I fully support them taking the necessary steps to limit their exposure. I'll continue to mask up and social distance as required by local governments or businesses. But I'm not seeing anything here that might indicate that loosening restrictions on society in general is wildly irresponsible in the current environment.
OK - so we're agreed that this is very different than the flu, correct? :P
You mention that this is a lesser problem for people in perfect health, and that those who have pre-existing conditions do worse. One of the pre-existing chronic conditions mentioned in the study is obesity. 40% of Americans are obese. That's a pretty large percentage of the population that has increased risk for long-covid, wouldn't you agree?
Again, I'm not saying that this is a death sentence for anyone. The main reason to bring it up is to point out that there are concerns other than death and hospitalization associated with covid-19. We have seen deaths go down and hospitalizations reduce - both are excellent. But we can't drop all safety measures as Walt has proposed - doing so will expose more people to this poorly understood other aspect of covid.
Again, I don't wish some of these symptoms on anybody. But to what lengths should society go in order to avoid any negative impact on an individual? I'll sacrifice to keep people out of hospitals and alive. I'm a lot less likely to comply if my sacrifice only means a few people don't have to feel exhausted after exertion, or have sharper mental focus for a few weeks. We're at a point where those most at-risk of severe illness and death can choose to protect themselves via vaccination. In my state, anybody over 16 will be eligible for the vaccine in about a week. At that point I think the burden of sacrifice shifts from society at large, to the individual. If you don't want to risk getting the virus, and possibly encountering some of these long haul symptoms, then it's your responsibility to take steps to protect yourself. Let others be done sacrificing if they're not at risk, and/or don't care about catching the virus. If it's not putting tons of people in the hospital or in the ground, then it's just another virus, and as a society I think it's fair to act the same way that we would for any other viral infection (which is to say "wash your hands, keep your immune system as healthy as you can and don't go out if you feel sick").
Again, this is minimizing and seriously mischaracterizing the symptoms that are being reported in an attempt to dismiss them. I believe I understand your point of view - you care if someone is in critical condition or if they are dead. You don't care at all about other outcomes - fuck 'em.
The problem with this kind of thinking is, we really are in this together. If a large percentage of the population doesn't vaccinate then we end up with covid continuing to spread. And the more it spreads the more new variants will emerge. As mentioned, that could easily lead to a variant that isn't as benign as your assumptions and that isn't prevented by the vaccines available. Which leads us back to a similar scenario as a year ago.
Then you start to think about the about economic impact of people who experience long covid and end up with chronic conditions. Your assumption is that this isn't a big deal for people of working age and children. But the science isn't really in on that yet. Maybe it will all turn out to be nothing (I hope that this is the case). We just don't have enough data at the moment to be making these calls with any kind of confidence - so it seems prudent to err on the side of caution (wearing masks and distancing in public) for the time being.
Topic: How long can we wait while flattening the curve? (Read 677183 times)
