It is very interesting that the reported lingering long-term symptoms of SARS-CoV-2 align almost perfectly with major depressive disorder and generalized anxiety disorder.
Clinical depression and anxiety levels are through the roof right now. Shouldn’t that be considered an explanation for these post-viral symptoms?
I can only talk personally, and I have seen people with anxiety and depression before, and that isn't what my wife has (she has long covid).
She is part of the coverscan.com trial and has uncovered potential heart damage - which links to the way she's been feeling - heart rate all over the place, tachycardia etc. exhaustion, alongside breathing issues and physical issues such as numbness. She's 40 and before this incredibly active, working out a few days a week, running our house and looking after the kids plus involved in loads of other activities and groups. Since she got ill it can take all her energy to get downstairs to sit on the sofa - with her heart rate peaking at over 180 just walking to get a drink. Her old resting heart rate was around 62.
Similar medical responses have been seen with other viruses before. I understand why people want to disbelieve/find alternative ideas, but it is medically understood that viruses can cause serious responses like this. The question is why covid appears to cause more long cases than other viruses (SARS excepted).
That all said, I wouldn't be surprised if long covid sufferers END UP with anxiety and depression had 6 months plus of an unknown pathway through a new illness.
I am sorry to hear of this and I hope your wife (and you!) find answers and see improvement.
I want to be very clear that I am not dismissing long COVID. In fact, I am hoping that via a more accurate diagnostic environment (which it seems like you went through) we can better identify true long Covid vs. anxiety/depression.
The better we can (and forgive my terrible analogy) separate the wheat from the chaff and identify true long Covid patients the better we can help true sufferers
N=1 in this study. No mention of race, vitamin D levels or BMI, all of which are very useful data to have in the context of Covid-19.
All viral respiratory infections have the potential to have some side effects to varying degrees but I can't help but feel that this letter will be used to support the concept of "long covid" on an unsuspecting public.
Yes, covid is terrible but it's a different strain of a coronavirus (of which 20% of common colds are too), it's not something mystical. There's a strong chance we have substantial cross immunity to it though T-Cells defence. The literature is saying that if you're under 48 the flu has a higher mortality rate. We've mostly passed through the gompertz curve of the virus mortality as described by initial research by Hope Simpson regarding the seasonality of influenza viruses.
We can't base national health policy on individual health outcomes.
Covid has been turned into a religion completely lacking any scientific rigour and I feel this paper will be used as a tool to add to the fear.
> Covid has been turned into a religion completely lacking any scientific rigour
Yeah, many people are just using the virus to animate some other message for their own goals. One example of this seems to be power and control that governments are exploiting this time to increase, more so than is warranted for the situation.
Numerous authoritarian goverments have used the pandemic as an excuse to expand powers and suppress dissent, often invoking emergency powers to bypass the usual law making process.
Look at Hungary, Hong Kong, Cambodia, Venezuela etc. A quick search will bring up many examples.
Funny how nobody says this in relation to food safety : those power hungry bureaucrats with their nonsense E. coli meat recalls. But they _do_ say it in relation to anti-pollution regulations (e.g. smoking), and environmental protections. What's the difference I wonder... Oh yes, whether or not big business is disadvantaged. Big Meat needs strong food safety regulations otherwise everyone would buy their meat from local trusted sources.
That's the thing, though. Large meat packing plants and other huge agribusinesses absolutely do say that about food safety. What are you on about with that?
Please lay out how any government profits from this. Consequences of COVID measures currently include, among others:
- reduced tax income, vastly more debt
- frustration within the population
- revelation of systemic flaws
All of these make a government look bad. No matter how true or untrue, the current government will be held directly responsible.
I don't see any instance of emergency laws being abused in a way that was impossible or inconvenient beforehand. Terrorism has already done its part here.
Governments benefited because they learned how easily people will turn on each other and support sweeping restrictions with no end date. Any time someone questioned the lockdowns back in Spring, people would claim that they were being selfish and leading to the death of millions by not blindly giving away their freedom. I've seen much more animosity based on party lines, than towards the government at large.
So is classic SARS, which is known to cause a post-viral syndrome similar to the one the letter proposes. Indeed, the letter opens with a discussion of exactly that syndrome. So it seems a bit odd to be talking about mysticism and religion in this context.
This isn't a study. It's a letter to the editor that includes a case report.
It's odd to me that anyone would mistake it for a study, actually, seeing as it says "Letter to the Editor" right at the top and has no gross morphological features in common with a research paper. No one seems to be trying to represent it as something it makes no pretense of being, except for people who seem to want to discount it without any significant consideration. That's an odd correlation to observe, but there is a lot that's odd about how people have reacted to this pandemic, I suppose.
>No one seems to be trying to represent it as something it makes no pretense of being, except for people who seem to want to discount it without any significant consideration.
You're kidding, right? Anecdotes like this one are dominating the media coverage, especially with regards to 'extended' symptoms of covid.
This is a case report to professionals, and people are discussing it here as such. Invoking 'the media' to refute participants in this discussion is fallacious, because this discussion isn't based on a mainstream media report to begin with.
every day npr trots out doctors and other professionals parroting the (literal) party line stoking continued fear and panic for no benefit to the public, but much benefit to the media itself and their political leanings. being a professional doesn't mean you're immune to propaganda. in fact, a false sense of knowledge and control can lead to greater susceptibility via an elevated sense of self-esteem rather than the humility required to accept and examine wider perspectives openly and critically.
That's right, because the mainstream media report will reference this paper, not the other way around like you are insinuating here. That was, of course, the point of OPs comment:
>Covid has been turned into a religion completely lacking any scientific rigour and I feel this paper will be used as a tool to add to the fear.
Do you have any stats for that? The stats now seem very different from what was happening in April and May. The cumulative CFR is also dropping - but obviously time cohort data must be already much lower.
At the end of the day, this is a political decision. Science does not provide the answer on what to do, just the facts.
Politics must decide whether to subject a large fraction of the population to the risk of this disease or whether to convince or coerce people to not go to football games, movie theaters and cocktail parties for a year or two.
Luckily, we as individuals still have the choice of not getting infected, although the risks of everyday activities increase dramatically when there are high levels of transmission in the community.
Yes, every day activities such as going to the grocery store or going outside. Making this a political issue ignores the very real consequences for the people who don't want to risk getting COPD for the rest of their lives. Imagine not being able to get food without taking on that risk because a core group of other people have decided to sacrifice you on the altar of the economy.
> Do we restrict the community for the individual or the individual for the community?
The question is really: what legal grounds do we have for essentially indefinitely transgressing individual rights?
Surprisingly, by and large, the people who are in a frenzy about "the police" want to invoke near-unconstrained police power (a consequence of states' rights to ensure public safety) to confine everyone to their houses, ban social activity, destroy livelihoods...
Sure but I think we do ourselves a disservice when we step back from the actual issue and start talking philosophically. We need to focus on the specifics of what is being asked of us and what that is preventing. Otherwise we'll never agree on anything.
Mask use is an individual issue in that it protects other individuals around you. Your right to throw punches stops at my nose. Suppose that we did nothing and let it spread. There would inevitably be a whole lot of people going around spreading it to people who don't want to be infected. This would be the case regardless of how individuals chose to self-isolate. People would go to the grocery store sick and breathe on everyone else there. This is the normal MO when in Flu season.
So it is an individual issue in the sense that as an individual I need to be able to buy food safely, and your choice to spread this unimpeded would infringe on that fundamental right.
And at the end of the day we're weighing the inconvenience of wearing a mask and staying home when sick for a few months versus the inconvenience of wheeling an oxygen bottle around with you for the rest of your life. If you have a cogent argument for why I should be stricken to save you the inconvenience then I'll listen.
Your beliefs about masks aren't universally shared even by many scientists, let alone the public. To many people you have seized on an unsupported belief and now insist everyone around you makes their own lives worse, indefinitely, or else they are "bad people".
Please do show us the people who are now seeking an oxygen bottle around for the rest of their lives because of covid that could have been stopped by a mask.
That said - I would expect some extremely rare outcomes in a sample of 35 million people. We live in a connected world: https://www.gwern.net/Littlewood
I really want to see good stats.
Even for, the simple you would think, case of CFR - what are the current reliable numbers here? In https://ourworldindata.org/mortality-risk-covid I only see cumulative nubers - that is not very informative when we can see how the mortality now is incomparable with the mortality in April and May, we need monthly or weekly cohorts data!
Could you please stop posting unsubstantive comments to Hacker News? You've been doing it a lot, unfortunately, and we've already had to ask you once.
We're trying for a different sort of community here, in which people have thoughtful and curious conversation. If you don't think that's worth trying for, that's fine, but we'd be grateful if you'd at least not damage the experiment like this. I'm sure you wouldn't litter in a city park or dump motor oil in a lake...it's kind of like that.
Until there is a good study that controls for biases as well as expected side effects of severe disease like pneumonia, we can conclude nothing about the population
>Yes, covid is terrible but it's a different strain of a coronavirus (of which 20% of common colds are too), it's not something mystical. There's a strong chance we have substantial cross immunity to it though T-Cells defence. The literature is saying that if you're under 48 the flu has a higher mortality rate. We've mostly passed through the gompertz curve of the virus mortality as described by initial research by Hope Simpson regarding the seasonality of influenza viruses.
Sure. But COVID-19 is currently in pandemic mode, having now infected at least 10% of the worlds population with zero signs of slowing down. This is not an endemic virus with a known cap on seasonal infections like the flu or colds. The area under the curve is going to be massive in comparison. That's the issue. Yes, it may have many similarities to the long term effects of other viruses. But now we will have hundreds of millions of people dealing with this, rather than hundreds of thousands. Quantity has a quality all of its' own.
This isn't a study, and scientists have been paying increasing attention to "long COVID" for several months now. See, for example, this feature from The BMJ from July: https://www.bmj.com/content/370/bmj.m2815
Alternatively, data from the UK in June suggests that 10% of people with COVID have symptoms that last for more than three weeks: https://covid.joinzoe.com/post/covid-long-term
If the number really is 10%, that's significant. This letter is merely suggesting further research; I think it's far from fear-mongering.
just wanted to add there is also data from Bergamo that indicates long term affects for many people (and a study from Germany - see link buried in the WaPo post) https://news.ycombinator.com/item?id=24418561
0.2% of cold viruses are coronaviruses. Only off by a factor of 100x. You quote scientific literature then say it’s lacking any rigor. Kinda hard to listen to the rest of the post.
Do other respiratory viruses attack the blood and kidneys?Genuinely curious. My mother has Leukemia leading to kidney damage. Definitely some fear of contracting it and passing it to her.
I have a friend in the “long hauler” group that is 38yo. Of the people I am one or two steps from, 45% are dead, 45% had mild issues, and 10% long hauler.
So, low number of N is definitely a problem, for both my experience and the paper.
Since neither of you cited anything, webmd says parent is right. Looks like you're only off by a factor of 100x. If you're going to call someone out for inconsistencies, might want to get your data right?
> Coronavirus. These tend to do their dirty work in the winter and early spring. The coronavirus is the cause of about 20% of colds. There are more than 30 kinds, but only three or four affect people.
My mind was definitely in the mode of what number and kinds of viruses that a body is exposed to, not so much how contagious it is, but I see your point.
30? I thought there were over 100 HRV serotypes, not counting their mutations. And I thought those only accounted for around 35% of all. So 2% is probably a better number. I’m 10x off, just as bad as the parent. Sigh.
It's a novel coronavirus, not just any old coronavirus. It jumped from an animal species. What you are saying is equivalent to "The Spanish flu is just the flu. Thousands of people get the flu every year and we probably have some immunity to it. No big deal."
When does this one stop being novel? This naming convention just has "new coke" vibes to me.
I mean, when there is an other emergent virus of this type, it will take the name "novel". Which might typically be fine, but not when the name has become part of a public lexicon. It's all just a weird convention really. If another major novel type emerges soon it will be absurd if medical historians are looking back and trying to determine which virus articles are talking about. Coronavirus Classic.
Exactly this. People have latched on to the wrong meaning of "novel", ascribing meaning beyond just "not seen before", instead treating it something like "acts worse/differently from other coronaviruses".
The scientific community has a specific name they use for Covid-19 (SARS-CoV-2). Also, timing would also be a very good indicator of what virus the author is talking about. Novel is in relation to the human races exposure to it. For example, there are modern flu virus that trace back evolutionarily to the Spanish flu, but are not novel, they are just "the flu" today. When the Spanish flu jumped to humans it was a novel flu, hence how deadly it was. Again, scientists have clear distinctions between different kinds of flu's, e.g. H1N1, H1N3.
Handling of coronavirus was a failure of Politicians and Physicians.
From the US standpoint, the shutdown should have happened in January. After the first US case, there was no purpose in locking down the boarder. Politician fail.
Physicians stressed harsh lockdowns and played into the fear. This wasn't science or statistics, this was fear. Physician fail.
After hundreds of coronavirus cases in the US, governors created their own lockdowns, but had no control over traveling between state lines. This created no benefit but created poor economic conditions. Politician fail.
You know who has been correct but seemingly unheard during all of this? Scientists/epidemiologists.
They predicted the spread perfectly but Politicians, citizens, and Physicians did not listen.
"With regard to SARS-CoV-2, very recent studies described CD4+ and CD8+ T cell responses to viral peptide megapools in donors that had recovered from COVID-19 and individuals not exposed to SARS-CoV-2, the latter being indicative of potential T cell cross-reactivity21"
They seem to be saying there's value in peptide donors who had recovered from covid, a transfusion of which to those who've not had covid seem to be valuable. It does not say (AIUI) that there is "substantial cross immunity to it though T-Cells defence" in the sense of having a similar disease gives you cross immunity. If I'm wrong, which is likely, please point out the correct passage.
Not a doctor, but the treatment for "adverse effects resembling Chronic Fatigue Syndrome/Myalgic Encephalomyelitis" that was successful (N=1?) is surprising to me:
> Manual treatment was provided to aid central lymphatic drainage, improve mechanics and reduce the inflammation of the spine and reduce the allostatic load by improving the sympathetic tone.
> ... and the patient followed a self-massage routine to aid lymph drainage along with gentle exercises to improve thoracic spinal mobility.
It sounds like maybe osteopaths are something different overseas but in the US both a DO and MD degree are 99% the same now. There is a schedule for smoothing out the remaining differences and essentially they’ll become identical. The history of osteopathy as a branch of medicine is kooky, but a lot of mainstream allopathic medicine was just as kooky when osteopathy started too. Today I have absolutely no issues whether my doctor got a DO or MD and wouldn’t even know without looking at the initials after their name.
Chiropractors on the other hand are indeed completely dangerous quacks that routinely give people severe injuries. I know two people that have been disabled by chiropractors manipulating their necks and damaging the tissues and causes stenosis of the veins which has ruined their lives.
Throwaway due to worry about comment being linked back professionally. Early COVID case mid February. Took 5 weeks to recover but the acuity wasn’t too bad.
After just never really felt the same. Assumed adderall “wasn’t working”. Couldn’t explain the lethargy or sharp uptick in anxiety and general inability to work. Luckily with the world it’s been easier to lay low, but the symptoms generally track even the muscle piece.
Is there more research on this? Where does one get this “Fatigue Scale” test? The linked article suggests they tested at an osteopathic clinic but that doesn’t really make sense.
Anecdotal evidence about cases like yours have made me really weary about getting infected since February. I wish there was more scientific investigation into how often there are long term consequences of Covid disease so the public could make more informed decisions. In any case, thanks for sharing and hope you get better soon.
As someone who deals with pretty intense anxiety often, it’s worth just waiting for more general data.
Physical symptoms from anxiety are real and hard to separate from non-anxiety related symptoms. The current covid/election/general global craziness sets anxiety levels high.
I haven’t caught covid, but if I had I imagine I’d be similarly freaking out over every anxious feeling via hypervigilance.
None of this means that there aren’t real long term effects, but it’s worth being skeptical in context of anecdotes.
You can find anxious people going down rabbit holes of vague symptoms for basically every possible disease. People are not able to adequately assess themselves.
My wife has long covid, 6 months later and she's only recently able to look after our kids alone - she's just been too tired before. I've dipped in to the groups she's part of and my very rough guess from the numbers is that it is something like 1 in 1000 covid sufferers get long covid. That figure though could be totally out either way as the number of cases was unlikely to have been correctly reported back when she got ill, and the new long cases coming through now won't be 'long' for months yet.
Yes to both. Exercise generally helps. Yes to vitamin D (there’s a great long vitamin PDF on COVID for like $15). Yes to sunshine. Trying to walk with a mask daily.
Honestly the base hypothesis is that it’s the societal change, and not the n=1 study.
You're walking outside with a mask? How much mask wearing are you doing? A mask isn't going to help your energy levels at all, and you don't need to use them, especially if you had it already. Try losing the masks for a few months except when forced and see if it helps?
"Couldn’t explain the lethargy or sharp uptick in anxiety and general inability to work."
Not for nothing: all of these symptoms could also be caused by depression, which is not without precedent, considering that we've completely obliterated normal life in the last seven months.
Anyway, you should seriously consider seeing a therapist. There are a lot of other people who are feeling depressed and anxious and distracted right now.
I know a few people with similar symptoms. It is worrying.
I personally feel like I have intermittent shortness of breath. Comes and goes every few days. It also goes away within 10-20min of exercise. Never had anything like this before. Interestingly enough, there has been little impact on actual performance.
I have people close to me who didn't get infected but feel that way just by being in lockdown. Not downplaying your post covid symptoms but you should consider the psychological factor as well.
I feel like everyone right now should be watching the 1995 movie Safe. It is THE movie about ominous psychosomatic illness. Julianne Moore is amazing in it.
This year has been the most stressful time probably since the World Wars for a majority of the world. Besides the dark cloud of covid permeating everything, (in the the US) We are also are dealing with widescale civil unrest unseen since the 1960s, maybe even more than back then. Unemployment which for a good portion of the year tracked close to the great depression of the 30's. To top it off on the west coast we have had fires that have been on a level not seen in modern times with toxic smoke preventing any outside activities and contributing to misery to millions for months now. Oh, its also an election year with one of the most divisive presidential candidates in US history. Its ok to feel a little worn down, these are crazy times.
Doctors told patients that their Epstein Barr was psychosomatic for decades. I'm sure some percentage of people are developing similar symptoms as a non-viral consequence of lockdown. However, for me, my lifestyle didn't really change and I don't mind lockdown at all. I got sick quickly one day in mid-March, mostly recovered after a couple days, and then just never got all the way better. The only physical symptom I have to show for it are much larger dark circles then normal under my eyes. I can exercise hard and everything works, but I pay for it later with a week of worse fatigue afterwards. I can say with certainty my symptoms are related to whatever virus I came down with in March. One of many anecdotes for you.
I think a lot of people who didn't get covid are also experiencing more anxiety and lethargy than before. Maybe what you are experience is much more severe. But 2020 in general might be partly to blame for your symptoms.
Ironically, one of the challenges as a CFS patient is communicating that your fatigue is abnormal. Try telling someone you have a disorder that makes you always feel tired and too many people respond that "Hey, I'm always tired too!". It gets old fast, so most patients just quit talking to other people about it.
Trust me, post-viral fatigue is on a different level. The parent comment is likely feeling quarantine-related negative effects on top of the COVID recovery.
re: Osteopathic clinic, in the original article they outline treatment as follows:
"Manual treatment was provided to aid central lymphatic drainage, improve mechanics and reduce the inflammation of the spine and reduce the allostatic load by improving the sympathetic tone."
This indicates they are doing some sort of massage or physical therapy to induce drainage. This would be in line with osteopathic therapy.
Also a throwaway. I was hit by non-COVID pneumonia back around 2017 and haven't felt the same since.
"Post-viral fatigue syndrome" was a real thing long before COVID. There's heavy overlap with Chronic Fatigue Syndrome, which for many people starts after an infection.
I will warn you: The online forums and communities around post-viral fatigue syndrome and chronic fatigue syndrome are nightmarishly bad. Don't expect to get any real information out of them. They tend to be more about support groups turned vent sessions for people who are frustrated with their condition.
Personally, I've had decent success with a version of graded exercise therapy combined with psychiatric help. Ironically, these two interventions are despised by the online CFS community because people are afraid that seeking therapy or psychiatric help is an admission that their symptoms are purely psychological. It's not, and any good therapist will understand that.
I've taken the position that my energy levels are diminished, my stress tolerance is reduced, and therefore I need to do everything in my power to minimize stressors in my life. Therapy is perfect for that, so use it to your advantage.
As for graded exercise therapy: Pick a couple basic activities that are easily quantified. Something like walking a specific number of miles, doing a specific number of pushups, or other basic, repeatable tasks. Start an exercise routine with a very low number. Maybe 0.2 miles of walking, or doing 3 pushups in a day if you're really bad. Track your progress and slowly increase the amount over time, backing off immediately when you feel like you've over-exerted yourself. Keep your expectations realistic and resist the temptation to jump ahead of schedule if you're feeling particularly good.
Finally, stay out of the online CFS / post-viral fatigue / chronic illness forums. They're nightmarishly cynical. The good posters have all left, leaving what feels like the "suffering olympics" as people compete to one-up each other on the severity of their illness. It doesn't help, so don't go there.
Have you totally gave up finding a good online patient community? Recently I have been thinking about this a lot: https://medium.com/@zby/rational-patient-community-6d3617dff... What is not there yet is an account on how a family member cured Hashimoto with diet, this is something I would totally dismiss if I read about it on the internet - but I trust her and her judgement. It is possible that it was just a coincidence, but she promised to write a detailed report.
After the Boston Marathon bombing, Reddit users scoured images available on the internet looking for clues. They were absolutely convinced that they had found the perpetrator. In a self-congratulatory frenzy, people began looking for more and more photos to support their theory. Everyone was energized by this apparent wisdom of the crowds, a miraculous use of technology to convert readily available information into a conclusion that (they thought) traditional law enforcement couldn't figure out. Later, it turned out they were all completely wrong and the whole thing was a disaster. Police had been operating the entire time on data that wasn't available to the public, allowing them to come to the correct conclusion.
This is how many of those online health communities operate. They collect anecdotes and combine them with morsels of information from publicly available papers to give themselves a false impression that they're on the cutting edge of research. If you search their history, they've usually been doing it for years or even decades. Their past is littered with dead ends that everyone thought was the next big thing. Meanwhile, they're all convinced that the latest pet theories or the latest supplement hold the key to unlocking the secrets to their illness.
There's a minimum amount of online reading that can help direct your own treatment, but getting caught up in the endless posting, negativity, and dead-end theories becomes counterproductive very quickly. Unfortunately, the loudest voices and most frequent posters tend to be the least qualified to be dispensing information. There's an added complication where these people start building their online identities around their illness, which can result in weird turf wars intertwining of egos with discussions.
My hope is that after we learn the failure modes we can make better online forums. Science had a few centuries to build their model and it still fails in many ways (https://equilibriabook.com/).
There's something a bit weird about this article. I totally buy post-viral fatigue syndrome, and that there's certainly a possibility of it occurring post COVID-19, particularly since it is a virus. But alarm bells started ringing with the description of the lymphatic drainage, and the way the examination section is written is odd. You don't find mid thoracic spine inflammation on examination - an MRI would be used for that. They mention a conflict of interest in that the treatment for this condition is some kind of lymphatic drainage and is a technique devised by one of the authors. That author is an osteopath not a medical doctor. That in itself would not mean I'd automatically discount research, but as others have mentioned it really is n of 1, and I'd be surprised if these clinical signs and techniques have been validated in any large trial.
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[ 4.1 ms ] story [ 174 ms ] threadClinical depression and anxiety levels are through the roof right now. Shouldn’t that be considered an explanation for these post-viral symptoms?
She is part of the coverscan.com trial and has uncovered potential heart damage - which links to the way she's been feeling - heart rate all over the place, tachycardia etc. exhaustion, alongside breathing issues and physical issues such as numbness. She's 40 and before this incredibly active, working out a few days a week, running our house and looking after the kids plus involved in loads of other activities and groups. Since she got ill it can take all her energy to get downstairs to sit on the sofa - with her heart rate peaking at over 180 just walking to get a drink. Her old resting heart rate was around 62.
Similar medical responses have been seen with other viruses before. I understand why people want to disbelieve/find alternative ideas, but it is medically understood that viruses can cause serious responses like this. The question is why covid appears to cause more long cases than other viruses (SARS excepted).
That all said, I wouldn't be surprised if long covid sufferers END UP with anxiety and depression had 6 months plus of an unknown pathway through a new illness.
I am sorry to hear of this and I hope your wife (and you!) find answers and see improvement.
I want to be very clear that I am not dismissing long COVID. In fact, I am hoping that via a more accurate diagnostic environment (which it seems like you went through) we can better identify true long Covid vs. anxiety/depression.
The better we can (and forgive my terrible analogy) separate the wheat from the chaff and identify true long Covid patients the better we can help true sufferers
https://www.nature.com/articles/tp201327
https://www.nature.com/articles/nrn2297
All viral respiratory infections have the potential to have some side effects to varying degrees but I can't help but feel that this letter will be used to support the concept of "long covid" on an unsuspecting public.
Yes, covid is terrible but it's a different strain of a coronavirus (of which 20% of common colds are too), it's not something mystical. There's a strong chance we have substantial cross immunity to it though T-Cells defence. The literature is saying that if you're under 48 the flu has a higher mortality rate. We've mostly passed through the gompertz curve of the virus mortality as described by initial research by Hope Simpson regarding the seasonality of influenza viruses.
We can't base national health policy on individual health outcomes. Covid has been turned into a religion completely lacking any scientific rigour and I feel this paper will be used as a tool to add to the fear.
Yeah, many people are just using the virus to animate some other message for their own goals. One example of this seems to be power and control that governments are exploiting this time to increase, more so than is warranted for the situation.
Governments just love reducing tax dollars by shutting stuff down!
Look at Hungary, Hong Kong, Cambodia, Venezuela etc. A quick search will bring up many examples.
- reduced tax income, vastly more debt
- frustration within the population
- revelation of systemic flaws
All of these make a government look bad. No matter how true or untrue, the current government will be held directly responsible.
I don't see any instance of emergency laws being abused in a way that was impossible or inconvenient beforehand. Terrorism has already done its part here.
So where are your examples?
A quick search will bring up many examples. Perhaps you're only considering the US?
"Authoritarian governments are using coronavirus as an excuse to crush freedom of expression" [1]
"Would-be autocrats are using covid-19 as an excuse to grab more power" [2]
"How Authoritarians Are Exploiting the COVID-19 Crisis to Grab Power" [3]
"Cambodia is using coronavirus as an excuse for human rights abuse" [4]
[1] https://www.independent.co.uk/voices/coronavirus-free-speech...
[2] https://www.economist.com/international/2020/04/23/would-be-...
[3] https://www.hrw.org/news/2020/04/03/how-authoritarians-are-e...
[4] https://www.smh.com.au/world/asia/cambodia-is-using-coronavi...
So is classic SARS, which is known to cause a post-viral syndrome similar to the one the letter proposes. Indeed, the letter opens with a discussion of exactly that syndrome. So it seems a bit odd to be talking about mysticism and religion in this context.
It's odd to me that anyone would mistake it for a study, actually, seeing as it says "Letter to the Editor" right at the top and has no gross morphological features in common with a research paper. No one seems to be trying to represent it as something it makes no pretense of being, except for people who seem to want to discount it without any significant consideration. That's an odd correlation to observe, but there is a lot that's odd about how people have reacted to this pandemic, I suppose.
You're kidding, right? Anecdotes like this one are dominating the media coverage, especially with regards to 'extended' symptoms of covid.
>Covid has been turned into a religion completely lacking any scientific rigour and I feel this paper will be used as a tool to add to the fear.
I don't think that's correct. Covid is well above influenza mortality in every cohort except children, I believe.
https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...
Politics must decide whether to subject a large fraction of the population to the risk of this disease or whether to convince or coerce people to not go to football games, movie theaters and cocktail parties for a year or two.
Luckily, we as individuals still have the choice of not getting infected, although the risks of everyday activities increase dramatically when there are high levels of transmission in the community.
Do we restrict the community for the individual or the individual for the community?
Your feelings on this aren't universal and neither are mine.
The question is really: what legal grounds do we have for essentially indefinitely transgressing individual rights?
Surprisingly, by and large, the people who are in a frenzy about "the police" want to invoke near-unconstrained police power (a consequence of states' rights to ensure public safety) to confine everyone to their houses, ban social activity, destroy livelihoods...
Mask use is an individual issue in that it protects other individuals around you. Your right to throw punches stops at my nose. Suppose that we did nothing and let it spread. There would inevitably be a whole lot of people going around spreading it to people who don't want to be infected. This would be the case regardless of how individuals chose to self-isolate. People would go to the grocery store sick and breathe on everyone else there. This is the normal MO when in Flu season.
So it is an individual issue in the sense that as an individual I need to be able to buy food safely, and your choice to spread this unimpeded would infringe on that fundamental right.
And at the end of the day we're weighing the inconvenience of wearing a mask and staying home when sick for a few months versus the inconvenience of wheeling an oxygen bottle around with you for the rest of your life. If you have a cogent argument for why I should be stricken to save you the inconvenience then I'll listen.
Please do show us the people who are now seeking an oxygen bottle around for the rest of their lives because of covid that could have been stopped by a mask.
That said - I would expect some extremely rare outcomes in a sample of 35 million people. We live in a connected world: https://www.gwern.net/Littlewood
I really want to see good stats.
Even for, the simple you would think, case of CFR - what are the current reliable numbers here? In https://ourworldindata.org/mortality-risk-covid I only see cumulative nubers - that is not very informative when we can see how the mortality now is incomparable with the mortality in April and May, we need monthly or weekly cohorts data!
We're trying for a different sort of community here, in which people have thoughtful and curious conversation. If you don't think that's worth trying for, that's fine, but we'd be grateful if you'd at least not damage the experiment like this. I'm sure you wouldn't litter in a city park or dump motor oil in a lake...it's kind of like that.
https://news.ycombinator.com/newsguidelines.html
Until there is a good study that controls for biases as well as expected side effects of severe disease like pneumonia, we can conclude nothing about the population
Sure. But COVID-19 is currently in pandemic mode, having now infected at least 10% of the worlds population with zero signs of slowing down. This is not an endemic virus with a known cap on seasonal infections like the flu or colds. The area under the curve is going to be massive in comparison. That's the issue. Yes, it may have many similarities to the long term effects of other viruses. But now we will have hundreds of millions of people dealing with this, rather than hundreds of thousands. Quantity has a quality all of its' own.
If the number really is 10%, that's significant. This letter is merely suggesting further research; I think it's far from fear-mongering.
Do other respiratory viruses attack the blood and kidneys?Genuinely curious. My mother has Leukemia leading to kidney damage. Definitely some fear of contracting it and passing it to her.
I have a friend in the “long hauler” group that is 38yo. Of the people I am one or two steps from, 45% are dead, 45% had mild issues, and 10% long hauler.
So, low number of N is definitely a problem, for both my experience and the paper.
> Coronavirus. These tend to do their dirty work in the winter and early spring. The coronavirus is the cause of about 20% of colds. There are more than 30 kinds, but only three or four affect people.
https://www.webmd.com/cold-and-flu/cold-guide/common_cold_ca...
My mind was definitely in the mode of what number and kinds of viruses that a body is exposed to, not so much how contagious it is, but I see your point.
> There are more than 30 kinds, but only three or four affect people.
There aren't enough cold viruses around to allow for a 0.2% fraction.
From the US standpoint, the shutdown should have happened in January. After the first US case, there was no purpose in locking down the boarder. Politician fail.
Physicians stressed harsh lockdowns and played into the fear. This wasn't science or statistics, this was fear. Physician fail.
After hundreds of coronavirus cases in the US, governors created their own lockdowns, but had no control over traveling between state lines. This created no benefit but created poor economic conditions. Politician fail.
You know who has been correct but seemingly unheard during all of this? Scientists/epidemiologists.
They predicted the spread perfectly but Politicians, citizens, and Physicians did not listen.
The bigger takeaways were our options for how to handle the pandemic and expected outcomes.
You criticise the article but then post this without any backup.
> The literature is saying that if you're under 48 the flu has a higher mortality rate
ditto. Show us the figures please.
> N=1 in this study
It's not a study.
https://www.nature.com/articles/s41590-020-00808-x SARS-CoV-2-derived peptides define heterologous and COVID-19-induced T cell recognition
>ditto. Show us the figures please.
When I have more time I'll pull out this figure. Let me know if you find it in the meantime.
"With regard to SARS-CoV-2, very recent studies described CD4+ and CD8+ T cell responses to viral peptide megapools in donors that had recovered from COVID-19 and individuals not exposed to SARS-CoV-2, the latter being indicative of potential T cell cross-reactivity21"
They seem to be saying there's value in peptide donors who had recovered from covid, a transfusion of which to those who've not had covid seem to be valuable. It does not say (AIUI) that there is "substantial cross immunity to it though T-Cells defence" in the sense of having a similar disease gives you cross immunity. If I'm wrong, which is likely, please point out the correct passage.
> Manual treatment was provided to aid central lymphatic drainage, improve mechanics and reduce the inflammation of the spine and reduce the allostatic load by improving the sympathetic tone.
> ... and the patient followed a self-massage routine to aid lymph drainage along with gentle exercises to improve thoracic spinal mobility.
Chiropractors on the other hand are indeed completely dangerous quacks that routinely give people severe injuries. I know two people that have been disabled by chiropractors manipulating their necks and damaging the tissues and causes stenosis of the veins which has ruined their lives.
After just never really felt the same. Assumed adderall “wasn’t working”. Couldn’t explain the lethargy or sharp uptick in anxiety and general inability to work. Luckily with the world it’s been easier to lay low, but the symptoms generally track even the muscle piece.
Is there more research on this? Where does one get this “Fatigue Scale” test? The linked article suggests they tested at an osteopathic clinic but that doesn’t really make sense.
Physical symptoms from anxiety are real and hard to separate from non-anxiety related symptoms. The current covid/election/general global craziness sets anxiety levels high.
I haven’t caught covid, but if I had I imagine I’d be similarly freaking out over every anxious feeling via hypervigilance.
None of this means that there aren’t real long term effects, but it’s worth being skeptical in context of anecdotes.
You can find anxious people going down rabbit holes of vague symptoms for basically every possible disease. People are not able to adequately assess themselves.
Do you live in an area with a lot of sunshine in a low enough latitude or take vit D supplements before?
Honestly the base hypothesis is that it’s the societal change, and not the n=1 study.
I'm only speculating based on some articles I've read.
Best wishes!
Not for nothing: all of these symptoms could also be caused by depression, which is not without precedent, considering that we've completely obliterated normal life in the last seven months.
Anyway, you should seriously consider seeing a therapist. There are a lot of other people who are feeling depressed and anxious and distracted right now.
You’re likely correct. Psychological from social changes seems most likely thing.
I personally feel like I have intermittent shortness of breath. Comes and goes every few days. It also goes away within 10-20min of exercise. Never had anything like this before. Interestingly enough, there has been little impact on actual performance.
Anecdotal and so forth.
https://en.wikipedia.org/wiki/Safe_(1995_film)
It starts off a little slow but I promise you will never forget it.
Ironically, one of the challenges as a CFS patient is communicating that your fatigue is abnormal. Try telling someone you have a disorder that makes you always feel tired and too many people respond that "Hey, I'm always tired too!". It gets old fast, so most patients just quit talking to other people about it.
Trust me, post-viral fatigue is on a different level. The parent comment is likely feeling quarantine-related negative effects on top of the COVID recovery.
"Manual treatment was provided to aid central lymphatic drainage, improve mechanics and reduce the inflammation of the spine and reduce the allostatic load by improving the sympathetic tone."
This indicates they are doing some sort of massage or physical therapy to induce drainage. This would be in line with osteopathic therapy.
"Post-viral fatigue syndrome" was a real thing long before COVID. There's heavy overlap with Chronic Fatigue Syndrome, which for many people starts after an infection.
I will warn you: The online forums and communities around post-viral fatigue syndrome and chronic fatigue syndrome are nightmarishly bad. Don't expect to get any real information out of them. They tend to be more about support groups turned vent sessions for people who are frustrated with their condition.
Personally, I've had decent success with a version of graded exercise therapy combined with psychiatric help. Ironically, these two interventions are despised by the online CFS community because people are afraid that seeking therapy or psychiatric help is an admission that their symptoms are purely psychological. It's not, and any good therapist will understand that.
I've taken the position that my energy levels are diminished, my stress tolerance is reduced, and therefore I need to do everything in my power to minimize stressors in my life. Therapy is perfect for that, so use it to your advantage.
As for graded exercise therapy: Pick a couple basic activities that are easily quantified. Something like walking a specific number of miles, doing a specific number of pushups, or other basic, repeatable tasks. Start an exercise routine with a very low number. Maybe 0.2 miles of walking, or doing 3 pushups in a day if you're really bad. Track your progress and slowly increase the amount over time, backing off immediately when you feel like you've over-exerted yourself. Keep your expectations realistic and resist the temptation to jump ahead of schedule if you're feeling particularly good.
Finally, stay out of the online CFS / post-viral fatigue / chronic illness forums. They're nightmarishly cynical. The good posters have all left, leaving what feels like the "suffering olympics" as people compete to one-up each other on the severity of their illness. It doesn't help, so don't go there.
This is how many of those online health communities operate. They collect anecdotes and combine them with morsels of information from publicly available papers to give themselves a false impression that they're on the cutting edge of research. If you search their history, they've usually been doing it for years or even decades. Their past is littered with dead ends that everyone thought was the next big thing. Meanwhile, they're all convinced that the latest pet theories or the latest supplement hold the key to unlocking the secrets to their illness.
There's a minimum amount of online reading that can help direct your own treatment, but getting caught up in the endless posting, negativity, and dead-end theories becomes counterproductive very quickly. Unfortunately, the loudest voices and most frequent posters tend to be the least qualified to be dispensing information. There's an added complication where these people start building their online identities around their illness, which can result in weird turf wars intertwining of egos with discussions.