The article doesn't give us quite enough information - what percentage of hospitalised Covid patients are over 70? 70 year olds are getting to the point where they spend a lot of time in hospital.
The "hospitalised for Covid" part of the sample group is introducing a lot of bias. Fit, young and healthy people are much less likely to end up in hospital. So it makes sense from the first that the group is suffering more problems than a general population control group.
Over a mean follow-up of 140 days, nearly a third of individuals who were discharged from hospital after acute covid-19 were readmitted (14 060 of 47 780) and more than 1 in 10 (5875) died after discharge, with these events occurring at rates four and eight times greater, respectively, than in the matched control group. Rates of respiratory disease (P<0.001), diabetes (P<0.001), and cardiovascular disease (P<0.001) were also significantly raised in patients with covid-19, with 770 (95% confidence interval 758 to 783), 127 (122 to 132), and 126 (121 to 131) diagnoses per 1000 person years, respectively. Rate ratios were greater for individuals aged less than 70 than for those aged 70 or older, and in ethnic minority groups compared with the white population, with the largest differences seen for respiratory disease (10.5 (95% confidence interval 9.7 to 11.4) for age less than 70 years v 4.6 (4.3 to 4.8) for age ≥70, and 11.4 (9.8 to 13.3) for non-white v 5.2 (5.0 to 5.5) for white individuals).
Worth mentioning that the control group wasn’t matched for hospital admission status, while the study group was solely people who ended up in the hospital. I’m guessing that the authors likely could have acquired the data to match a control group of people who had been admitted to the hospital, so I’d be curious to see what the results would’ve been there.
According to the paper, this control group was picked because, essentially, that’s what the authors wanted to choose:
> We selected controls from the general population rather than matching to non-covid hospital admissions to determine the increased risk after hospital admission for covid-19 versus no hospital admission for covid-19 (that is, compared with the expected risk for people with similar personal and clinical characteristics in the general population).
Yes, but that seems like a very relevant type of control group. If a person got COVID and ended up in the hospital, and that person wants to know what possible long-term harm that could cause them (that is, compared to had they not gotten COVID and not been hospitalized), then the article focused on exactly that.
Not really. The UK has been testing pretty much everyone who's admitted to hospital for COVID since the start of the outbreak regardless of why they were admitted, which means there's going to be quite a few people in the COVID and in hospital group who were actually admitted due to other, unrelated conditions. Particularly if they were being admitted to hospital regularly...
And throughout their stay. My father was vaccinated in January, went into hospital after a siezure (not unknown) a in mid febuary, he was tested on arrival, and was negative. Continued to be tested, and by early march (2 weeks after admittance) he tested positive.
That’s what they attempt to focus on, but inadvertently introduce bias in terms of people’s proclivity to show up at the hospital for any given severity of issue.
People who present once for one thing are probably more likely to present a second time: either because they have a lower threshold for seeking help, they have overall poorer health and so present more often, or because they have a referring primary doctor who is biased towards admitting over treating outpatient.
The most useful result here is to isolate the impact of covid hospital admission status on the probability of mortality, not the difference between covid and other hospitalizations.
Anyone who’s even dipped a toe in this policy area can tell you that when old people and hospitals meet, gaudy statistics follow. It’s common knowledge in the field. To not include that context or any points of comparison seems irresponsible to me given the publicity.
The excerpt from the study quoted above says "Rate ratios were greater for individuals aged less than 70 ... with the largest differences seen for respiratory disease (10.5 (95% confidence interval 9.7 to 11.4) for age less than 70 years v 4.6 (4.3 to 4.8) for age ≥70)"
Isn't that a clear indication that there's something besides "general trends in old people" going on here?
Age isn't the only factor, you need to control for underlying health conditions, which apparently they chose not to. Suppose you have COPD at age 50, for one you are less likely to live to 70, but also you are at a far greater risk with COVID. It would not be unexpected if such a person were readmitted to the hospital or die months later.
They did account for underlying health conditions. The control group was matched for relevant clinincal diagnoses, as well as general health factors like BMI and smoking (see "matching variables" section in the paper).
I see that they were matched now, still the control group wasn't hospitalized, which must skew the result.
Looking at the tables, you might get the idea that COVID hospitalization causes a lot of diabetes. The way they arrive at that is to count the diabetes diagnoses made after COVID admission.
However to me it seems far more likely that a diabetic without a diagnosis (which is common) gets hospitalized with COVID, then gets their diabetes diagnosis in the ensuing medical surveillance. Having an undiagnosed liver or heart issue is also common.
See the discussion above - it's very intentional that the control group wasn't hospitalized. It's the right approach for the question they are trying to answer, "how bad off is a person that got COVID and got hospitalized as a result of that".
(There are other good questions to ask too, of course.)
Given the discussion generated here and probably elsewhere, why do you believe the authors chose not to present a matched hospitalization control group alongside their control group? It’s pretty standard: that’s why they included a sentence saying they chose not to (albeit without any justification).
As mentioned in the discussion above, their control group answers the question "if a person got COVID and was hospitalized because of it, how much worse off are they than had those things not happened?"
They do justify their choice in the actual paper (e.g. see the end of the "Study population" section).
(It's also interesting to compare COVID hospitalizations to other ones, say from a heart attack or allergic reaction, but those are different questions. For example, maybe a COVID hospitalization is less bad than one due to a heart attack, or worse than an allergy. Or maybe any hospital visit is just bad period. But given many people got hospitalized by COVID this year - something that never happened in the past - we need to know what that event cost them, that's the point of this study.)
I read the paper. That is not a justification. If you are unwilling to entertain the idea that this is a low-quality report, go ahead. I can only contribute some prior experience on an Internet forum in an attempt to shed light on a politically fraught result from what appears to be a government scientist and some collaborators.
> "if a person got COVID and was hospitalized because of it, how much worse off are they than had those things not happened?"
How do you then control for those with a chronic condition that is undiagnosed? If somebody is hospitalized, they'll perform all sorts of tests on them, that's how many people get their diabetes diagnosis in the first place.
Looking at the charts, you might get the idea that there's a staggering increase in new-onset diabetes following COVID infection, which doesn't seem plausible to me. Yet, right next to that, you see damage in heart, liver and kidneys, and this gets picked up uncritically as an outcome of COVID. The hypothesis that COVID causes organ damage is already well-established, so this just confirms what we expect. What we don't expect, we just ignore, even though it might point to a flaw in our methodology.
You're right that that's a possibility. A completely undiagnosed underlying condition would be missed by that type of control group.
But we know that COVID admittances caused a big increase in the total number of people hospitalized - to the point of overwhelming some health care systems. That strongly suggests that underlying conditions would not have sent as many people to the hospital anyhow if COVID had never appeared and infected them.
It is possible you explain the mechanism, though. Perhaps there are lots of people with undiagnosed underlying conditions, and getting a serious case of COVID is enough to worsen those conditions into life-threatening ones. (Perhaps this only hastens the inevitable for some of them.) If this is the mechanism then both you and the article's hypotheses would be correct.
> The increase in risk was not confined to the elderly and was not uniform across ethnicities
> Rate ratios comparing patients with covid-19 and matched controls were greater in individuals aged less than 70 than those aged 70 or more for all outcomes
> An alternative approach might have involved comparing outcomes after covid-19 and other hospital admissions; such research has recently been conducted with similar data sources to those in our own study (although with a smaller covid-19 cohort), and comparable rates of organ dysfunction were found between patients with covid-19 and patients with pneumonia who were discharged from hospital in 2019.36 We believe that our study design, where comparisons were made with the expected risk in the general population, was more relevant to public health policy, and complementary to the study that used non-covid hospital admissions as the comparison group. Also, the use of non-covid hospital admissions as the comparison group does not allow estimation of excess morbidity because non-covid admission does not necessarily represent an appropriate counterfactual situation to admission to hospital for covid-19, and the size and direction of the inferences will depend on the choice of control admissions.
That’s the number this study went for, but it also is a number that doesn’t tell us anything about whether the increased chance of hospitalization and increased death rate are due to COVID, due to the first hospitalization, or due to those being hospitalized in the first place already being weaker than the general population.
I wouldn’t call it the most useful one.
If those who were admitted to a hospital with COVID already were less healthy than those who weren’t before they got COVID (and that’s a given. Higher lung capacity can keep you out of the hospital, for example), I don’t think it is a surprise they still aren’t as healthy when they leave the hospital.
"Rates of respiratory disease (P<0.001), diabetes (P<0.001), and cardiovascular disease (P<0.001) were also significantly raised in patients with covid-19, with 770 (95% confidence interval 758 to 783), 127 (122 to 132), and 126 (121 to 131) diagnoses per 1000 person years, respectively."
I could imagine COVID being causally implicated in respiratory disease or cardiovascular disease, but diabetes? That sounds to me like the control group wasn't representative.
I can see how you could read it that way, but I think they're just confirming the increased rates of covid with the three named pre-existing conditions. It never occured to me to understand it otherwise when I read it first.
> I can see how you could read it that way, but I think they're just confirming the increased rates of covid with the three named pre-existing conditions.
No, because that is in literally the objective: "To quantify rates of organ specific dysfunction in individuals with covid-19 after discharge from hospital compared with a matched control group from the general population."
I wouldn't even rule out that COVID causes diabetes, but at the same time diabetes is commonly underdiagnosed, as is heart or liver disease.
The full article says it is not only for the ICU, and most were not in the ICU:
> 47,780 patients with covid-19 (4,745 admitted to the intensive care unit and 43,035 not requiring admission to the intensive care unit) were included in the analysis
> At baseline, individuals with covid-19 had a mean age of 64.5 (standard deviation 19.2) and 54.9% were men. Compared with the general population, individuals in hospital with covid-19 were more likely to be: male, aged 50 or more, living in a deprived area, a former smoker, and overweight or obese (table 1). Individuals with covid-19 were also more likely to be comorbid than the general population, with a higher prevalence of previous admission to hospital and of all measured pre-existing conditions (most notably hypertension, major adverse cardiovascular event, respiratory disease, and diabetes).
> Individuals discharged from hospital after acute covid-19 had increased rates of multiorgan dysfunction (particularly respiratory and cardiometabolic) compared with a matched control group from the general population
> The rate ratio of multiorgan dysfunction (comparing individuals with covid-19 and matched controls) after discharge was greater in those aged less than 70 than in those aged 70 or more, and in ethnic minority groups than in the white population
> Our findings suggest that the diagnosis, treatment, and prevention of post-covid syndrome requires integrated rather than organ or disease specific approaches
I remember at the beginning of the pandemic, it seemed as though few current smokers were getting seriously ill, although former smokers were at high risk. Did anything come of that?
That has been observed, and nicotine proposed as a potential therapeutic aid. The mechanism could be because the SARS-CoV-2 spike protein binds to the same nicotinic acetylcholine receptors that nicotine binds to.
> A total of 5960 patients were included in the studies identified. The current smoking prevalence ranged from 1.4% (95% CI 0.0–3.4%) to 12.6% (95% CI 10.6–14.6%). An unusually low prevalence of current smoking was observed from the pooled analysis (6.5%, 95% CI 4.9–8.2%) as compared to population smoking prevalence in China. The secondary analysis, classifying former smokers as current smokers, found a pooled estimate of 7.3% (95% CI 5.7–8.9%). In conclusion, an unexpectedly low prevalence of current smoking was observed among patients with COVID-19 in China, which was approximately 1/4th the population smoking prevalence. Although the generalized advice to quit smoking as a measure to reduce health risk remains valid, the findings, together with the well-established immunomodulatory effects of nicotine, suggest that pharmaceutical nicotine should be considered as a potential treatment option in COVID-19.
> Based on the early observations of the lower than expected smoking prevalence in hospitalised COVID-19 patients, Changeux and colleagues suggested a role for nicotinic acetylcholine receptors (nAChRs) in the pathophysiology of COVID-19 via a direct interaction between these receptors and the viral spike (S) glycoprotein.11 This suggestion was based in the fact that the S protein from SARS-CoV-2 contains a sequence motif similar to known nAChR antagonists11 (Figure S1), such as α-bungarotoxin from Bungarus multicinctus and glycoprotein from Rabies lyssavirus (formerly Rabies virus). Changeux et al. also proposed that COVID-19 might be controlled or mitigated by the use of nicotine, if the latter can sterically or allosterically compete with the virus for binding to these receptors.9,11
what I find to be even more astonishing: "and about one in eight had died", so 1/8 of those who were in hospital for covid AND discharged afterwards, died within 4 months. We also had another article in the guardian that said that 1 million of people in the UK suffer from long covid ("Symptoms vary but include fatigue, muscle pain and difficulty concentrating."): https://www.theguardian.com/society/2021/apr/01/long-covid-s...
I've seen some pushback that a lot of hard-to-diagnose chronic syndromes are now being deemed "long covid." My assumption is that at least some of this is happening as it's the trendiest disease of the moment. Not to say there aren't a lot of people with clear-cut long covid syndromes.
There is some overlap and some similarities.. if long covid doesn't end perhaps it'll even be considered M.E[0]. Myalgic Encephalomyelitis sufferers have been ignored by mainstream medicine, maybe this will bring change.
Or maybe, people have been dealing with post-viral syndromes for a long time, our society is completely unequipped to understand and deal with them, and they see post-COVID syndrome as finally a chance to address this.
But taking that perspective requires correcting for the systematic underweighting of the testimonial evidence of patients of chronic illnesses.
A lot of post viral stuff seems to be autoimmune, and we don't treat autoimmune well. Chronic fatigue and fibromyalgia weren't even recognized as real things not that long ago. Others like RA or Hashi's we suppress the immune system and/or rely entirely on simple tests to determine medication levels instead of relying on patient testamony and testing instead for over medication symptoms. These feedback loops are amazingly complex and looking at a few numbers doesn't cut it. In addition we know diet and environmental triggers are a thing from many studies, but doctors don't say "eat more greens" anymore, they say lets do a test now take this pill.
I have chrohn's and the treatment for that is high dose steroids or chopping sections out.
Fortunately I'm on the mild end of the spectrum and flairs are infrequent but it'd be nice if we had something better to treat auto-immune disorders.
To control my chrohns I changed my diet by removing foods, keeping track of general well being for a few weeks then gradually introducing them to see what happened til I found a routine that worked, it's bland most of the time but I'll take the win - basically a Mediterranean diet which is fine.
There is however a bunch of things in the pipeline including things like targetted biologics to selectively target the immune system that are exciting.
Do you have any good wisdom on how you got diagnosed and what diets? I've always had GI issues and I have found some triggers like mushrooms, blackberries and cauliflower which poimt towards SIBO but my GI doc says there is no SIBO treatment or diet, and sometimes I have problems even on fodmaps. I did AIP diet with my wife who has Hashi's and I think that might have helped a little but not sure. Everything my GI prescribes just makes it worse. I can't eat sweet potatoes anymore after he put me on a round of fluconozole.
In my case my diagnosis was because they didn't know what was going on and the gastro doc ordered a camera both ends to rule things out - it showed up on the colonoscopy and the biopsies up til then I had no idea.
I'd lost a lot of weight worryingly fast - mostly because of massive reflux problems (barrets oesophagus), was having frequent bouts of vomiting and diarrhoea and was generally in a shit state all around - as for diet it's really hard to recommend anything to anyone else since it varies so much - what worked for me was keeping a detailed journal of what I ate, how I felt, how I slept, toilet habits, times etc then I cut out basically everything from my diet I could for a few weeks (think porridge, cottage cheese and mashed potato/oven cooked chicken breasts) and very gradually added things back still keeping the journal until I had actual data I could look at - for me there isn't really any one food or group that acts as a trigger red meat/processed meat comes the closest, it's large high fat/high carb (think Pizza) that do it - if I eat fresh foods/veggies/fish/cheese (hard not soft) and limited amounts of fruit I have it mostly under control but what works for me might wreck you.
Thanks! I don't loose weight easily, and everyone mentions that, so I don't think that is my problem. My gut does well on a western processed food diet, but that would kill me eventually. Greens and roots lean poultry and fish don't cause me discomfort, but diarrhea is common. I keep hoping I'll just adapt to it, but I think maybe I'm not built for that much fiber.
I know anecdotes are not evidence, but I knwo two personally. Both had covid and no troubles breathing before they had it. Afterwards not so much.
I am not a medical professional, but I know these people and how their bodies functioned beforehand. The way they are now is certainly not a hard-to-diagnose chronic syndrome that is unreleated to them catching the damn thing.
Some of the things that cause concern are studies finding depression, fatigue, brain fog, etc.
But if you screened any population of lower health you'd find a fair number of instances of these... and historical baselines are probably not valid because we've had a weird year. So-- the exact incidence of some of the milder end of long COVID is hard to pin down.
The fatigue here is not vaguely feeling fatigue. It is "I can't work full time as before and need to take nap twice a day fatigue. Same with brain fog and depression. Vaguely noticeable symptoms are basically ignored.
Again, the studies that have looked at cohorts of people infected to estimate incidence have not had this strict of a definition of fatigue or depression.
Certainly some people have these symptoms and they are very very likely to be from the COVID infection itself.
But other people have more minor symptoms and these are included in many estimates of post-COVID syndrome, and discerning whether they were related at all to COVID and caused by COVID itself is more complicated, because if you were to screen a normal population with these criteria you'd find a fair incidence of these symptoms.
Just to add to the post-viral syndrome chorus, this happened to me when I was 20. I caught what seemed like a pretty normal flu, but it eventually morphed into bronchitis and then pneumonia because I was an idiot who thought he was immortal and continued going out clubbing and staying out late with friends and it was four months before I finally saw a doctor and took the advice to rest and get blasted with high dose antibiotics.
I was down for about two additional months after that, in which I caught another flu twice, and could barely get out of bed for a while. And then I proceeded to have complications from colds and flus that evolved to bronchitis or pneumonia every single flu season for the next 8 years.
It took nearly a decade to really recover from that. I see no reason to think any sufficiently bad respiratory infection with high enough viral load wouldn't do the same thing, especially to people much less healthy than 20 year-old me, a two-time state champion cross country runner in high school.
yes, what we're seeing is the frenzy around covid latching onto any and all related phenomena and pulling them into it's orbit. it's reasonable to study those phenomena for their relationship to a particular infection, but not to conclude that relationship based on merely studying it, as is happening here.
post-infection complications are not uncommon, although specifics certainly vary. i'd also had a long tail of recovery from a flu->bronchitis->pneumonia cascade a few years ago (on the order of many months, not years).
I had persistent lung congestion for weeks. I did some research online and found this thing called a salt inhaler. That cleared it up in a couple of days.
Salt has a way of pulling infections out of tissues.
I'm not a physician, but intentionally inhaling salt particles into the respiratory tract to 'pull infections out of tissues' strikes me as an extremely bad idea.
The American Lung Association has this article on the topic. And there is no consensus about how much is effective, etc.
'"When fine salt particles are inhaled, they will fall on the airway linings and draw water into the airway, thinning the mucus and making it easier to raise, thus making people feel better," said Dr. Edelman.'
Someone please correct me if I'm wrong... but I don't think it's just trendy, its also profitable. Insurance claims with "covid" noted are, in my rational opinion, processed a lot more liberally, quickly, and without deeply looking at the details of the claim. The claimant could probably even charge insurance more for the same service if covid is noted in the claim notes.
The political/social powder-keg of denying a covid related insurance claim is not one that a health insurance corporation would probably be willing to take, at least for another year or 2.
> I've seen some pushback that a lot of hard-to-diagnose chronic syndromes are now being deemed "long covid." My assumption is that at least some of this is happening as it's the trendiest disease of the moment.
The "pushbacks" you see on social media are essentially the output of a random sentence generator. Covid is not real, covid escaped from a lab, covid is a conspiracy, etc. etc.
Be careful with that stuff. You are what you read (and believe).
> the guardian that said that 1 million of people in the UK suffer from long covid
There's varying severities. The 1/8 figure applies only to people who developed long-COVID after being hospitalized for acute COVID (i.e. most likely on a ventilator).
Minor COVID cases can still develop several long-COVID symptoms (the symptoms you pointed out) that aren't life-threatening. This is the long-COVID you generally hear about because surviving a minor or asymptomatic case of COVID isn't the end of your worries, and is why it is beyond idiotic to play fast and loose with the virus.
That's why the study looked at a control group, to try to account for that bias (as the abstract says, the control group was chosen to match "personal and clinical characteristics").
It's always possible they missed a factor, that's always a risk in such research, but they worked hard to address that possibility.
Not matching for hospital admission status is a pretty big factor given the bold, highly publicized top-line numbers:
> We selected controls from the general population rather than matching to non-covid hospital admissions to determine the increased risk after hospital admission for covid-19 versus no hospital admission for covid-19 (that is, compared with the expected risk for people with similar personal and clinical characteristics in the general population).
Essentially any contact with a hospital in that population produces eye-popping statistics. Having worked in this area, I’m of the opinion that the presentation of this work is misleading.
But the opposite would be misleading, too, in that the hospital contact was induced by COVID.
It's all confounded. If you compare to other hospital admits, you're finding an even-less-healthy population (because they had a reason to show up to the hospital -without- COVID). If you compare to the general populace, you risk inadequately controlling the comparison.
But if you want to know the increased risk people have subsequent to COVID hospitalization, perhaps the latter makes the most sense to measure.
My beef isn’t with the measurement, but with the presentation thereof. This problem you have recognized is so common that a framework was developed [1]. I don’t feel the work addresses all element of that framework satisfactorily. Others may disagree, and that’s okay.
But plenty of people who are similarly unhealthy (obese, smokers etc.) live for years with those problems..Covid seems to be pushing them over the edge.
Maybe a better question to ask would have been: typically do 1 in eight people who have been discharged from the hospital after non-covid issues and have the same co-morbidities as the group in the study die within 4 months?
What's the usually figure for (1) patients of flu admitted to hospital, (2) patients of flu with this sort of age breakdown?
Are their unusual or particular symptoms compared to other people with long term issues after viral infections?
I full believe "long covid" is a thing. But so much of covid news has been shitty "studies" that get a lot of press despite shedding very little light and go on to be rapidly disproven but still repeated (Vit D, Chloroquinine etc).
I had both vaccines shots and prob got covid last week. Had no nasal congestion, 100F low fever coming and going, little fatigue, night sweats. After I felt more normal, developed a little cough that I still have.
Those symptoms are consistent with the dozens of common cold viruses that haven't diseappeared. Consider that many people get COVID tests because they are symptomatic, yet most of them are negative.
Because the symptoms are so similar, it's possible it's still spreading but to the same people getting covid and people are only being diagnosed with covid.
Influenza is not the same as the common cold, which is also sometimes referred to as "the flu". Besides influenza-types, there are a couple of viruses that cause the common cold, among them the aptly named rhinoviruses but also other coronaviruses.
Indeed there's a suspicious drop in influenza-type cases, likely caused by all the social distancing and perhaps by SarS-COV-2 simply out-competing influenza-types in knocking people out.
Sounds close to my symptoms. Different than a cold because I had no nasal congestion, pain in my throat/neck, cough or the usual weird effects on my ears (sometimes one or the other feels "covered", an imbalance in hearing, when I have a cold).
Shouldn't the vaccine have helped, though? I don't know.
Yeah, I suspect it could've been a variant (I was traveling in Costa Rica just prior) and I had a lessened episode.
Exactly the same about the lack of congestion. That's something I've never had in my life, cold symptoms without congestion. That's the reason why I think it was covid. Plus a little fatigue and muscle soreness.
Overall it was light, medium at most. But def something.
Long Covid is real. I had a mild case back in August, but it took around 5 months to feel 'normal' again. Lots of inexplicable things: Minor heart palpitations, feeling of 'heaviness' behind my breastbone. When I exercised, even moderately like running a half mile, I would feel strangely exhausted for many hours later. All of this has gone away now, but I can easily see how someone who is hospitalized could have a relapse, either by overdoing it because they think they should be fully recovered, or through some other mysterious after-effect. Personally I believe it is caused by an immune system that is on 'high alert' after being attacked in every organ for multiple weeks (this is how Covid feels). It is logical to me that it might take multiple months for an immune system to gain back its equilibrium. Just guesses, I am not a doctor.
But temporary -- and not all that long compared to the hell we've all had to endure for more than a year now -- except in extremely rare cases. Evidence to the contrary is welcome, after more than a year there should be some.
> surveys conducted by patient groups indicate that 50% to 80% of patients continue to have bothersome symptoms three months after the onset of COVID-19 — even after tests no longer detect virus in their body.
You understand the burden of proof is on the person who's making a claim, not on people who disagree with the claim?
I've too suffered being stuck at home for more than a year, but in my book this is still better than me or somebody else getting sick with god-only-knows what long term complications, which we don't have data for one way or another, and won't for some time still.
> You understand the burden of proof is on the person who's making a claim, not on people who disagree with the claim?
Interesting idea, but false in this case unless you are arguing that lockdowns are and will be, in perpetuity, the status quo.
> this is still better than me or somebody else getting sick with god-only-knows what long term complications, which we don't have data for one way or another
Are you arguing your presence in society is outweighed by the mere possibility of you having a negative effect on it?
> unless you are arguing that lockdowns are and will be, in perpetuity, the status quo
I am not arguing either way, what I am saying is shouting "here's what I think, prove me wrong" is not how it works. "Here's what I think, and here is the evidence" is how it works.
Lack of data can't support any claim. If we don't have good data on whether lockdowns are effective, it doesn't mean they aren't. It means we don't know. In which case we do a risk analysis, taking our uncertainty and potential benefits/drawbacks into account.
> Are you arguing your presence in society is outweighed by the mere possibility of you having a negative effect on it?
I don't consider myself absent from society. I am talking to you now, am I not? And yes, I consider my temporary suffering to be outweighed by potentially permanent suffering of myself or someone else.
I completely agree that the burden of proof is on the one making the claim. The claim in question is that a significant percentage of those who get Covid will have permanent (or at least long-term) damage.
> which we don't have data for one way or another, and won't for some time still.
Exactly. There is no evidence for "long Covid" as a frequent phenomenon. The pandemic has been going on for 15 months. Yet those who believe in long Covid still only provide evidence that people aren't always fully recovered after timespans like 3 months.
If Covid frequently caused permanent damage, there would be a lot of people who were infected, say, a year ago, who haven't recovered and show no sign of doing so (their condition has plateaued). There would be studies showing that, there isn't exactly a shortage of scientists researching the topic. And, obviously, people would provide that evidence as it would support their point better. Yet they don't.
I wish to point out that the hell you're describing is also temporary, and would have possibly been much shorter if everyone had just gone along with it from the start.
> would have possibly been much shorter if everyone had just gone along with it from the start.
So what you are saying is, despite "the experts" saying exactly the opposite... by slowing the spread of covid we'd somehow be out of this sooner?
Do you guys realize how insane this logic sounds? The goal of these lockdowns was to intentionally slow down the spread. Not stop or eradicate covid. Harder lockdowns mean this goes on much longer.
How can people genuinely think otherwise? It's like basic math.
I fully agree with you. And considering the fact that a virus cannot be eradicated and will continue to mutate we will have to live with covid just like we do with the flu.
There is a minimum number of deaths that we should accept as a society just like we accept other causes of death.
> compared to the hell we've all had to endure for more than a year now
Speak for yourself!
My life was largely unchanged by covid beyond wearing a facial covering in public which I actually prefer. What a joy to not only walk into banks dressed like a bandit without getting arrested, but to be asked to do it and thanked for cooperating!
This certainly hasn't been any sort of hell for me, but catching covid let alone "long covid" seems likely to be quite awful and potentially life-changing for anyone.
Yeah, I ended up getting a shitload of projects done on my property instead of the usual summer vacation. It was probably the better path since I had been procrastinating many of those things for too long already.
Thanks for this. I had a mild case in January and have been feeling 'off' in multiple ways including the above. Glad to know there is light at the end of the tunnel.
Sounded like anxiety to me. I experience a number of those things on and off again and as far as I can tell they've always been because of anxiety. They can feel serious but it's often just your mind telling you something is wrong when it's not.
Not a doctor. Could be wrong. Just sound like anxiety symptoms from my experience.
I have anxiety and asthma that are well-controlled and I’ve never been afraid or worried about COVID-19. I got sick last March for four months with severe symptoms that were described above. I was having many anxiety and asthma attacks with no obvious cause.
I've had similar symptoms, and more, for the past 8 months. Heart palpitations, feeling of heaviness in the chest, strange exhaustion... I admit this does sound like anxiety. However, after suffering from anxiety for two decades, I've learned what my anxiety feels like. This is different. It's like comparing grits and runny oatmeal--I can understand why many descriptions are insufficient to distinguish between them, and even how one might be able to masquerade as the other, but having had both, it's clear they are not the same.
Is this after you had Covid? I've never been diagnosed with anxiety (though I have had pretty significant panic attacks around family) nor have I had Covid. I only started feeling these particular things since Covid became a world-wide event. Maybe it's a particular kind of anxiety caused by isolation?
So maybe I'm wrong and I haven't been experiencing anxiety when I have these symptoms. I agree it's a bit different than having a panic attack in my experience.
There is literature comparing many long covid cases with chronic fatigue syndrome. The medical establishment doesn't go out and say it outright, but I think the implication is that some of these symptoms may be anxiety driven.
I'll just add my own experience. I had almost no symptoms, no cough, no taste loss, not even sniffles. Likely infection date 15th of February. PCR test on the 24th of February.
No symptoms at that point. 2 days later, I started feeling more tired than usual. The next day I had a mild fever and was sweating more than usual when exercising. This lasted 3 days, after which I only felt the fatigue for another 5 days.
No lasting effects that I can name.
I'm 31, male.
I had a cold around 5th-10th of February. I take levothyroxine every day, multivitamin everyday, Gabapentin every day, Vitamin C 500mg twice a week. Light exercise everyday, a more thorough workout twice a week. I drink alcohol and smoke tobacco regularly, and everyday between 24th of February - 15th of March.
I mention all that because some research said the cold and CV viruses are competitive, plus having the immune system "battle ready" after a simple cold could've helped. Levothyroxine increases metabolism, vitamins and exercise probably help. Smoking has been linked to lesser symptoms, too. I wonder what the effects would've been without all that.
Anxiety over Covid (I scared myself reading reports on Reddit) and losing my job (unrelated, but bad timing) was by far a bigger problem than the virus itself.
I now personally know over a dozen people (ranging from mid-20s up through upper 40s) who have had Covid-19. All had minor illness and are now fine.
Which is not to say that others do not have lingering symptoms -- but if we're going to emphasize scary anecdotes, it seems like we should spend proportional time reporting the vastly larger number of anecdotes that are not scary, as well?
It would be great to have such a database of reports from anyone with a confirmed Covid infection. Like Erowid for Covid.
Most people (I read it's around 86%) having such mild symptoms that they don't even realize it's Covid must've contributed a lot to its rapid spread.
The more vulnerable people get the same virus and suffer much more. Perhaps vulnerable people should've been subjected to stricter lockdown measures, not sure what else could help reduce the deaths.
> but we're going to emphasize scary anecdotes, it seems like we should spend proportional time reporting the vastly larger number of anecdotes that are not scary, as well?
I haven't backed up my personal data in years and nothing nasty has happened, despite all those catastrophic data-loss stories you read online. I'm all for proportional reporting time, but strangely, no one reports on stories like mine - it's mostly in the vein of "Company shutters after accidental db deletion". I wonder why.
Similarly, I've been wearing my seatbelt my whole life and have never gotten into an accident while driving. My kid was placed on his back in the crib without any pillows or blankets, even though he hated it, but never once stopped breathing. I have health insurance but ... shit, there was that one time in high school where a kidney infection put me in the hospital and would've killed me had I not gone, was billed at a hundred grand or so, but insurance covered the whole thing.
There's a reason we pay attention to tail risks, where the low-probability negative consequences are far worse than the high-probability costs of averting them. The vast majority of people are not going to die in car crashes, or of SIDS, or of COVID, or from untreated kidney infections. They are lucky. But the consequences of death are so much worse than the costs of wearing a mask, or not seeing your friends in person, or dealing with anxiety, that it's worth taking some precautions even if the chance that you'll die from COVID is low.
Quite. Anecdata does have its place but only for the sample population (1).
I still hear people worrying about safety despite the fact that half the UK, a large part of the US and countless others have been jabbed. That's after the original trials. I can understand some people's reluctance wrt vaccination. Many countries have had examples of problematic vacc campaigns. In the UK the MMR jab had a major set back due to Andrew Wakefield's false article in the Lancet [1].
From what I gather the thrombosis risk from the Oxford/Astrazeneca jab is somewhat swamped by error bars and open to interpretation. However the risk from the pandemic is very real and demonstrably so. I had my jab last Tues and it was O/AZ but I wont ask anyone to extrapolate much from that!
> There's a reason we pay attention to tail risks, where the low-probability negative consequences are far worse than the high-probability costs of averting them. The vast majority of people are not going to die in car crashes, or of SIDS, or of COVID, or from untreated kidney infections. They are lucky.
No, by definition, they're the norm. They're not lucky, they're just normal. The expected outcome. The people who encounter the tail risks are unlucky.
Not too long ago, a part of a jet fell off over suburban Denver. I would be dismayed if someone -- engineers and investigators -- didn't obsess over this event. But if my brother wants to know if it's safe to get on an airplane, or live in suburban Denver, then my answer is not going to change.
I would also discourage anyone else from reading HN posts with obscure technical documents from Boeing and the FAA, and speculating about what it means for aviation in general. Or reading other peoples' posts on these topics, and sharing anecdotes about how "someone they knew" died in some ghastly aviation accident. And so on.
It is in our nature to exaggerate the importance of rare events. They are still rare.
> But the consequences of death are so much worse than the costs of wearing a mask, or not seeing your friends in person, or dealing with anxiety, that it's worth taking some precautions even if the chance that you'll die from COVID is low.
How did masks get swirled up into this? I swear...people will find any way to turn these things into a political debate. Can we agree that by this point, the debate about masks is fully baked, and no amount of discussion of Covid outcomes is going to change someone's mind?
You can find anecdotes on the internet to support literally any fear that you care to indulge. The point is, most of the time, these fears are not worth indulging, and what you read on the internet exaggerates the actual threat.
> I would also discourage anyone else from reading HN posts with obscure technical documents from Boeing and the FAA, and speculating about what it means for aviation in general.
Well, speak for yourself. I'm a commercially-rated pilotwho does maintenance test flights, and I study aerodynamics, so I can and do interpret obscure documents - in fact, it's my responsibility to know how airplane systems work.
The significance of the Denver accident is:
1) it's not being called an uncontained engine explosion, yet there's parts everywhere
2) the engine accessories kept burning after the fuel was shutoff. Apparently the engine fire suppression equipment doesn't work without the engine shroud - that sounds like a problem, especially since fuel is usually stored in wings.
I'm certainly not going to live through my life worrying about everything that could happen or go wrong. I've driven without a seatbelt a lot in my life (I once drove into a ditch at maybe 40-50 km/h without one, not even a scratch - lucky!).
Unless I'm misunderstanding what you're saying I quite disagree with you that death is so much worse than anything else. Why is death so bad? It's the only certainty you actually have in life. There's an average age of death but you're quite unlikely to die at that specific one. It's gonna come either expectedly (like a cancer diagnosis giving you X months to live) or unexpectedly (an accident). Just accept it and stop trying to fight it by trying to minimize the risk since it'll happen anyways. Instead think about whether there are things you want to prepare for those left behind when you do go. And then stop worrying and enjoy the ride while it lasts. It's just a dice roll anyways, try to have fun! Don't hold back. Challenge yourself, face your fears, jump into the unknown. Don't try to follow the recipe for a perfect harm-free life to the book. That sounds like an insanely boring life to me but I suppose YMMV.
Ok, but the UK has a large, integrated, health care system, with an office of national statistics that is following the disease and published this data.
It also talks about how poorer people, and those from non-white backgrounds are disproportionately likely to have worse outcomes.
Just because you don't see it happening in your circles, doesn't mean it's not happening in other ones.
The authors write in the BMJ: “The increase in risk was not confined to the elderly and was not uniform across ethnicities."
> Ok, but the UK has a large, integrated, health care system, with an office of national statistics that is following the disease and published this data.
Having an office of national statistics does not mean that this particular paper is being reported correctly by the mass media, it doesn't mean that the paper itself supports the discussion of "long covid" amongst otherwise healthy people, and it certainly doesn't mean that other people on this thread reporting personal stories are representative of the actual risk. That last bit is what I'm emphasizing here. Literally any scary anecdote is amplified, and the (many more) pedestrian anecdotes go undiscussed.
As other comments on this page have noted, there are a number of legitimate criticisms of this paper that should be considered carefully, and even if you don't agree with those, the paper is self-admittedly discussing a predominantly elderly, sick population who were hospitalized for the virus. It doesn't generalize to discussion of anecdotes of "long covid" from much healthier people.
> It also talks about how poorer people, and those from non-white backgrounds are disproportionately likely to have worse outcomes. Just because you don't see it happening in your circles, doesn't mean it's not happening in other ones.
You can go read their report yourself if you want and see that what you've claimed is factually incorrect. Plus, all the data is there, in CSV or XLS format if you want to check their maths:
To me, they seem to be trying to make it as accessible and clear as possible with most news articles taking the salient points directly from the ONS's own summary.
As you can see from figure 2, their data is not focused on old people as you erroneously claim, it does seem to show that more deprived = more symptoms, and that non-white are more likely to have symptoms.
We know that a majority of cases are asymptomatic or have minor symptoms. That's not news.
But the weird long-COVID cases are problematic - they're real, they affect a certain slice of the demographics, and can be pretty serious and long-term.
They are definitely real, and can be serious and long term, but they likely aren't novel; I suspect ME/CFS, "long lyme" and a variety of other conditions often dismissed as psychosomatic by practitioners who can't find a test for them - are post viral/post infectious syndromes, and they will be joined by "long covid".
Perhaps some good will come of this - those "long sequelae" diseases will get more and proper attention.
But none of the data I've seen so far about "long covid" puts it out of line with what we've known about post-viral sequalae for ages.
No purpose, I guess. Just took the opportunity to share my experience.
I am interested in reading about others' experiences, it's just that everything I could find (mostly on Reddit) depicted a much worse picture.
And yet statistics say that the vast majority of people have it easy like me.
I mentioned I would love a database like Erowid, with input from everyone who has had a confirmed infection. I'd read through all of it and make my own conclusions.
I was told to self quarantine and call an ambulance if I felt worse. The hospitals here are overwhelmed just like many other cities/countries.
95% of people (which is a "vast majority") could have normal mild to moderate post-viral symptoms which go away entirely in 12 months. If 5% have long term disabilities then with something like ~100M people in the USA having been infected that would be ~5M with long term disabilities. That would be 20 times more people than were affected by Gulf War Syndrome. That amounts to a 1.5% chunk taken out of the civilian labor force participation rate.
A small minority of people having serious difficulties with the virus can turn into a large medical issue when the denominator is 1/3 to 1/2 of the country getting infected.
You're right that the experience reports skew in favour of the more extreme. However, I have enjoyed perusing reddit.com/r/covid19positive nonetheless (with that understanding)
They are engaging in the currently obvious right-wing syndrome: if it didn't happen to me it's not important. Once it happens to me, it's of primary importance.
Maybe get your iron checked out? I have iron issues (overload) and noticed the spike after Covid was really intense. If your 'heaviness' is on the right side it could be liver swelling. All cold/flu will give you a spike like this because your body absorbs all the iron from the cells that died. It throws off your balance of circulating/stored iron for a while. Normal people won't notice it but if you have iron issues you will. But this is just a guess too, I am also not a doctor.
You may already be aware of this but there's an organ there called the thymus which is a core part of the immune system (especially in younger people)
Seems to be a symptom with relatively little discussion even in medical journals but can confirm I also had it for months after a relatively mild case, tending to reemerge due to tiredness or exercise.
There needs to be some kind of analysis to determine whether they have causality flipped- do they have these long term health problems because of severe COVID or did they get severe COVID due to these long term health problems?
The only reason you've had to endure this for over a year is because you never once tried to do it properly. 6 weeks of hard (proper) lockdown followed by sensible plans to manage outbreaks and boom you'd have been done. But no, Americans absolutely refuse to work together, to pull in the same direction, to achieve something.
If your plan requires 100% compliance to succeed, it failed before you even started. Good plans operate within the realities of human nature and respect people's inalienable human rights.
I'm not sure this is true. We did it right in Denmark and we're still in what is starting to feel like one long lockdown with no end in sight.
Our vaccination numbers are terrible: at the rate we are vaccinating all Danes will have started their first vaccination round by July 21st, 2022. [1]
We've had the Moderna vaccine since January 13th [2] of the previous year. This is not people failing, these are our leaders failing.
I was so gung ho about us coming together to make the sacrifices and beat this thing but now a year and a half later I'm done with the colossal failures of our leadership and the promulgation of fear everywhere.
Are you saying that an Wuhan-style lockdown would have been a better or even feasible approach?
I don't think humans anywhere are able to "pull in the same direction" to the extent that such a lockdown is possible without an authoritarian government. Italy imposed pretty draconian rules for at least six weeks, and has still had to deal with a second wave and additional lockdowns.
Personally, I think that the principles of personal freedom (that such an authoritarian government is largely incompatible with) are much more valuable in the long run. Working through the disease has been messier in the last year, but the economic system largely based on these principles was also able to produce novel vaccines. While the last year has been rough, I'm much happier overall that I don't live in a place where an authoritarian lockdown is even possible.
Lockdowns are not about islands. It helps, kinda, but not completely. Vietnam completely sacrificed the tourist industry, unlike US or Europe. Quarantine is at a designated facility, not at home, unchecked, like in US or Europe. And dissent is suppressed.
The last part is a bit unfortunate, but the former ones are really just a matter of decision. And it works.
Sincere congratulations, living in the US I think it's inspiring to see all the countries with incredible (and relatively equally distributed) health outcomes at costs that society can bear.
That said, I want people from island countries to stop saying "being an island country has nothing to do with it", when all evidence and logic says being an island country has a lot to do with it.
I'll happily take criticism from Vietnam, even if I think it's of questionable utility to say "you just did it wrong" when the overwhelming majority of countries seem to have "done it wrong"
Yes, overwhelming majority can easily be wrong. That's not surprising.
And islands still have to watch for random boats from any direction. Right now in Vietnam there is a little outbreak where a group of Vietnamese nationals illegally crossed the border by a fishing boat from Cambodia to Phu Quoc island, trying to avoid the mandatory two-week quarantine. Then they boarded a plane, arrived at their homeland and tested positive. Immediately their steps were traced by police, whole Phu Quoc is under a mask mandate, 3 levels of contacts are tested and in quarantine. It really isn't about being an island. That's a myth, you've been lied to. If you want an example closer to your home, look how hard it is to seal a land border with Mexico. They actually cross by rivers, so water makes it easier.
you're also an island. there's a strong multiscalar correlation between being an island and having good covid outcomes. NZ, Taiwan, South Korea (not technically an island, but might as well be), Australia, Japan. And at subnational levels too: The best us state is Hawaii. The best city in the bay area is Alameda.
you can't say it would have worked. There are places that locked down harder than the US and still fared worse. I'll remind you that the EU had 1.5x the population adjusted mortality of the US, before their immunization shenanigans; and that's despite the US having an irresponsible science-denier president.
"the population adjusted mortality." I don't know why this is so hard to understand, and I'd expect a HN audience to understand how proportions work instead of just parroting hyperbole.
It's not really cool to make nationalistic attacks like this here.
FWIW I'm from Australia (Melbourne), which mostly eradicated the virus last May, then had a resurgence in Jun-Aug, and it took hard lockdown from early August to November to get the outbreak fully under control - effectively four months of pretty strict lockdown. We managed to beat it but it was hugely costly.
Australia, like NZ, is an island with a relatively (compared to US and Europe) small, compliant population, so it's much easier for our governments to control our international borders and internal movement. But it was still incredibly hard, and slow.
We did it, which I'm pleased about, but I understand why what Australia and NZ have done is not possible in the US and Europe; they have much denser populations and many different jurisdictions and cultures all meshed together, so it's much harder to restrict movement and apply restrictions consistently enough from one place to another.
So, sure, take comfort that we live in places that were able to avoid major outbreaks, but resist preaching that any other country/continent could have done it just as easily, as it really isn't that simple.
How does being an island help? Are America's covid problems primarily caused by infected Mexicans crossing the border? Do the islands you listed not have much air travel?
Being an island that gets all its goods through cargo ships or planes allows a lockdown as strict as NZ’s. That cargo influx involves a small number of personnel. However, that isn’t the case in e.g. Europe, where countries have not been self-sufficient in foodstuffs etc. for long decades, and many people live on one side of a border and work on the other side. That means there is a steady flow of trucks across the continent, as well as commuting of at least workers judged essential.
Alameda is just enough of a pain in the ass to get to that nobody really goes there unless they need to. That's what helps. People WANT to go to hawaii, but it's pretty easy to cut off (and they did). Note if you are unfamiliar with the geography and look up "Alameda" numbers, you'll probably get Alameda County, which more than just Alameda the island. Alameda County is, interestingly, the worst county in the bay area.
The chance of stopping it early increases exponentially, if there are fewer ways into your country from countries that are themselves exploding with the virus.
In Europe, all countries broke down eventually and all these cases are ultimately imported from crisis areas. Many were never caught.
Keeping borders open - in the EU sadly not something that could have been realistically changed, if ever - is the reason.
Look at the facts:
NZ caught all cases early. Full stop. So did Germany - at the beginning. It worked in either case. But NZ also kept cases low by limiting travel. Germany did not do this - least of all because the EU literally sued Germany when it started (very recently) to lock borders.
Australia not only can limit travel easily, but is also huge and barely populated. When there was a significant outbreak, it was physically possible to cordon off the state in question.
In Europe, once the spread began, it was already present in every locality - since Europe is tiny and entire countries have higher population densities than Sidney or Melbourne! And, this is also important, there is significantly more travel of people and goods, and it is far less concentrated on a few areas. Many people in Europe go to work in a different country from where they live, every day.
There are literally no borders where you could test people. It is being tried. It does very little. Look at the spread in areas bordering high incidence regions. The borders are as closed as EU laws allows. It simply does nothing.
This is it. If you closed borders, then you made it. If you did not, then nothing much helps except trying to reduce incidence rate such that hospitals do not collapse.
We all dreamed of containing non-regionalized outbreak clusters by contact tracing. In reality all health services, even the very best ones in the world, eventually got rolled. Some sooner, some later. Sometimes contact tracing worked up until the mutation showed up. But it never worked consistently, except with closed borders.
Which countries contained the spread while having a high density and without being an island? Vietnam. However, cross border traffic between Laos and China is either strictly controlled or not economically significant - in either case, Vietnam is also an example of a country that managed to lock down borders - even tourism - almost entirely.
Conclusion: Covid has to be geographically contained with maximum force. If that is not realistic, for example if your country has the density of a city, then you need to stop it from getting in in the first place.
And unsurprisingly, being an Island and not 100% dependent and interconnected with daily border-less traffic helps a lot. Being a huge country with less population density or other ways to cordon off locally also helps.
In Europe, several countries were doing fine. They had lockdowns, contained local spreads and did contact tracing. They did not do less than NZ or Australia - except they were still surrounded by dozens of other highly populated areas with entirely different policies, all with different timings. The result was the same everywhere - eventually.
So, theoretically the EU could have been saved, if border would have been closed off immediately after the first cases appeared in Italy. Despite the fact that people believed contact tracing was viable - an option that does not shatter the political and economic fabric of the region.
This post is already too long, but you can read up on the discussions at the time and the political, geographical, economical and demographic situation in the EU to convince yourself that the chance of early border closings was close to zero.
I don’t really understand this argument in relation to the USA. A country like Germany, where they are in the Schengen Area, surrounded on all sides by multiple countries, with no hard border? Sure, I can see that being a factor. But the USA has only two land borders, both of them hard. If the USA had locked down properly, it would have resembled New Zealand a lot more closely than Germany.
it's more like between the states, not between the US and other countries. One should think of the US analogous to the EU and the state analgous to the countries within the EU, with schengen. The virus need only make a beachhead early on (which it did) and then it was inside of an unsealable domain that is wide enough to basically keep things going in perpetuity.
I'm sorry but I think this is hogwash. The idea that America could function for 6 weeks in a lockdown to the level described to actually stop the transmission, by the time transmission started, is not plausible to me, and I imagine many others. This would have entailed no one working at grocery stores, no deliveries, no travel, no global trade. I just don't buy that this was ever plausible for however long people suggest: 3 weeks, 6 weeks whatever. And to what end. When do we open up to the rest of the world. I think your sentiment is hindsight wishful thinking/blame assignment. Now, criticizing the fact that we did not try what I would term more effective measures to stop transmission are fair points. Wide-spread cheap testing, ramping up massive manufacturing of real N95 respirators for the entire country, I think these are more plausibly effective techniques we did not do that are worthy of criticism.
I don't like the xenophobic tone of the parent, but you are incorrect.
> This would have entailed no one working at grocery stores, no deliveries, no travel, no global trade. I just don't buy that this was ever plausible for however long people suggest: 3 weeks, 6 weeks whatever.
The experiences of (at least) New Zealand and Australia are clear evidence it is absolutely possible, without the absurd extremes you are talking about.
If I had to guess, I would guess that COVID can be transmitted by fomites, especially if kept cold, but that it’s extremely rare. In a place like the US or Europe, this is insignificant: your chance of getting seriously sick due to touching something is negligible, and the rate of additional cases due to this effect is inconsequential for public health. But in AU or NZ, where the background rate is essentially zero, a single reintroduction is a big deal.
Although I largely agree with you, they found a case in Norway where the most likely explanation was contact spreading from a person who had worked in that area 2 days prior. I feel there must be another explanation, but they do probably know the facts a lot better than me.
I think doing as well as NZ would be a laudable goal. If the whole world did that well, then I think COVID would be quickly eradicated.
But, beyond the fact that the US has large land borders, the US has a genuine problem. We are economically dependent on legal and illegal cross-border seasonal migration. I personally think that, with actual political will, the borders could be made a lot less porous, but this would involve attacking the supply and demand sides. Neither party is interested.
They are islands though, even if large ones. I don't think there are any large connected landmass that has managed to successfully take a New Zealand/Taiwan. Also US has different states with different rules, but no ability to restrict travel between the states. And lots of rural areas that potentially had small covid pocket before it got diagnosed.
I don't like the previous administration one bit, but this was a really hard problem. By the time covid was taken seriously I think it is confirmed it was a least spreading in Seattle and Bay Area.
This reads like Covid arrived in the US through uncontrolled land crossings from Canada or Mexico? I'm pretty sure like Australia and NZ, it came by land and sea mainly.
> Also US has different states with different rules, but no ability to restrict travel between the states
Also Australia never had seen states close borders before. Yet somehow each of the 6 states and 2 territories managed to get legislation passed to do this, get police mobilised, and just got community buy-in that was going to work.
USA is 330 million people. New Zealand is 1/2 the population of SF Bay Area.
Just because NZ can demonstrate good COVID control, it cannot just apply at a massive nation. China has done it with authoritarian enforcement. There is no solution to this for USA, EU or large countries. Asian nations such as Japan and Korea are culturally different than the west. It’s impossible to change the culture of 330 million overnight.
Trying to explain away every incidence of successful covid-squashing as not applicable isn’t very convincing given that there aren’t any examples of jurisdictions that failed at a real attempt at covid squashing - every one of them succeeded. And this list is quite varied - it includes jurisdictions that are islands, that have long land borders, that are countries, that are sub-country-level, that are in the Anglosphere, that are outside of the Anglosphere, that have small populations, that have large populations, that are on three different continents, etc.
And yet the massive USA clearly showed through COVID control that it is simply a collective of hundreds of fiefdoms (states, cities and even corporations) they for the most part were uncoordinated and did what was best for themselves, which turned out to be no good for no one.
That's a feature not a bug IMO. I'd like individual counties and states control their fate, not federal gov since enforcement and containment is extremely localized. Federal gov can help with shortage of beds, food supplies and vaccine development which they did through Operation Warpspeed. It is befitting for Fed and illfitted to local counties.
Here in Bay Area, there was much stricter control. Counties choose their fate, their path and their citizens want to trade off lockdowns vs. COVID rates. It's their call and I respect that kind of governance.
At the extreme - I would absolutely abhor China style lockdowns in the USA.
Did the USA fared well with COVID response? Not at all. Federal gov could have done a lot better to provide guidance (not enforcement) to states and counties.
Each country has different advantages and challenges. For example South Korea is incredibly dense and dependent on public transit. Germany has no hard border. China is massive, Australia's government is dysfunctional. We arent special, we just didnt meet our unique challenges
Hey, you know, if you ever get a bad disease, like an infection, here is your solution: just shut down your whole body for a while, completely stopping the blood supply carrying food and oxygen to your bacteria.
Then when all the infecting bacteria are dead, just restart your body again. Easy, no?
Similarly, we could defund the police if everyone would just stop doing crime. And think of what we could do with the defense budget if we made some agreements about war!
Any strategy which depends on complete cooperation of a large number of humans for success, well, I would short that stock.
When people claim that a country should have "done it properly", they usually mean closed borders, that end up having to stay closed for the long haul to prevent COVID from re-entering the country. Personally, I find the long-term risks of closed borders in terms of rekindling nationalist sentiment and eroding international solidarity, to be far more of a threat than COVID.
The pandemic will pass soon, but countries walling themselves off could have consequences that even our grandchildren might have to deal with.
That is patently false. The whole idea of lockdowns was to "flatten the curve" in order to prevent healthcare from collapsing. It was never, ever to stop outbreaks or stop covid. It was made quite explicit by "the experts" that everybody who was gonna get covid would do so and everybody who would die would do so. The area under the "death curve" was going to be exactly the same so long as healthcare didn't collapse. The goal was to literally slow the spread not stop it. Make it roll out slower to keep healthcare in check.
This idea that if we locked down harder or people "behaved" we'd be done with covid is a complete lie. That was never the intent of these restrictions. Ever.
I find it very curious how even after massive stockpiles of unused ventilators were donated and countless field hospitals were closed up after never seeing a single patient governors extended their stay-at-home orders. Despite it being shown that covid was never a true threat to healthcare, despite the sky-high IFR predictions being shown wrong (thankfully!), we let the goalpost shift to.... well... I still don't know what the goal is. We got very lucky having a vaccine delivered so quickly because without it, we'd have been drifting along aimlessly and things would have got very dark and ugly.
> Americans absolutely refuse to work together
Curious how many of the nations in Europe that "did it right" wound up getting major outbreaks regardless. Also curious how the curves of all regions basically mirror each other regardless of restrictions or "how serious they took it". Maybe, just maybe, humans aren't as in control of a widespread respiratory virus as they'd like to believe.
I believe it is peak human arrogance to think we could somehow control a respiratory virus in this manner. In my opinion history will look upon all this the same way we look at our ancestors performing rain dances and goat sacrifices. They are all examples of meaningless rituals humans perform in order to fool themselves into believing they have more control over mother nature than they actually do.
Please don't take HN threads into nationalistic flamewar, regardless of which nation you have a problem with. It's emphatically not what this site is for. Moreover, we've had to warn you about it at least once in the past (as well as about guidelines breakage in general). That's not cool; please don't do it again.
Edit: your account has been breaking the HN guidelines a ton lately. If you keep doing that we will have to ban you. Please review https://news.ycombinator.com/newsguidelines.html and fix this.
> one in eight of patients dies in the same period
Another nuanced and striking peculiarity of the English language that writers for this international paper may not have mastered yet!
"Eight of them" is grammatically unremarkable. "Eight of the patients" and "eight patients" are also unremarkable, although slightly different in meaning.
"Eight of patients" is jarring. It sounds like "four of clubs."
Vitamin D improves your uptake of calcium. Vitamin K2 makes sure calcium goes where it's supposed to go. You want your BONES calcified, not your arteries.
You are not wrong. Yes, scientific studies speak of some subset of patients experiencing symptoms weeks or months (but not necessarily longer) after COVID. However, the actual studies emphasize that severity of long-term symptoms strongly correlates with severity of illness. That means that young people are at very low risk (not zero, of course, but as low as with many other common illnesses). When the media has taken these research findings up, however, they typically leave out all the nuance, because that way it sounds like more dramatic, attention-catching news.
Also, last year some newspapers irresponsibly allowed some people to share their claims that they were dealing with tough long-term COVID symptoms even when they had never even tested positive for the disease in the first place. It was no different than giving a megaphone to the people who, before COVID, experienced some distress and, without any actual medical verification, were sure they were cases of "chronic Lyme disease".
Health officials in several countries have plainly fudged the truth or left out details when speaking to the public, for what they see as the greater good of maintaining restrictions for long enough to reach their public-health goals. One naturally suspects that they found the panic about long COVID useful for this.
I once had pneumonia, early 30s. It took months to feel 100% again. Its just your lungs get damaged, and takes time to heal. But if you have other health problems, its a spiral. One bad thing leads to the next. Hence, I feel that life is like a bumpy pothole filled road. For the most part, if you get past one, you will keep rolling down. The key is to avoid the big potholes. Some people in terrible physical shape get lucky, and missed a few. When reality is anyone of those previous ones could have taken them out. I learned this on a road from the airport to a hotel in Dominican Republic.
216 comments
[ 2.6 ms ] story [ 265 ms ] threadThe "hospitalised for Covid" part of the sample group is introducing a lot of bias. Fit, young and healthy people are much less likely to end up in hospital. So it makes sense from the first that the group is suffering more problems than a general population control group.
Over a mean follow-up of 140 days, nearly a third of individuals who were discharged from hospital after acute covid-19 were readmitted (14 060 of 47 780) and more than 1 in 10 (5875) died after discharge, with these events occurring at rates four and eight times greater, respectively, than in the matched control group. Rates of respiratory disease (P<0.001), diabetes (P<0.001), and cardiovascular disease (P<0.001) were also significantly raised in patients with covid-19, with 770 (95% confidence interval 758 to 783), 127 (122 to 132), and 126 (121 to 131) diagnoses per 1000 person years, respectively. Rate ratios were greater for individuals aged less than 70 than for those aged 70 or older, and in ethnic minority groups compared with the white population, with the largest differences seen for respiratory disease (10.5 (95% confidence interval 9.7 to 11.4) for age less than 70 years v 4.6 (4.3 to 4.8) for age ≥70, and 11.4 (9.8 to 13.3) for non-white v 5.2 (5.0 to 5.5) for white individuals).
According to the paper, this control group was picked because, essentially, that’s what the authors wanted to choose:
> We selected controls from the general population rather than matching to non-covid hospital admissions to determine the increased risk after hospital admission for covid-19 versus no hospital admission for covid-19 (that is, compared with the expected risk for people with similar personal and clinical characteristics in the general population).
> Individuals were included if they had a hospital episode from 1 January to 31 August 2020 with a primary diagnosis of covid-19
(from the full paper)
People who present once for one thing are probably more likely to present a second time: either because they have a lower threshold for seeking help, they have overall poorer health and so present more often, or because they have a referring primary doctor who is biased towards admitting over treating outpatient.
However, I don't think it can explain the far higher death rate.
Isn't that a clear indication that there's something besides "general trends in old people" going on here?
Looking at the tables, you might get the idea that COVID hospitalization causes a lot of diabetes. The way they arrive at that is to count the diabetes diagnoses made after COVID admission.
However to me it seems far more likely that a diabetic without a diagnosis (which is common) gets hospitalized with COVID, then gets their diabetes diagnosis in the ensuing medical surveillance. Having an undiagnosed liver or heart issue is also common.
(There are other good questions to ask too, of course.)
Why deviate?
They do justify their choice in the actual paper (e.g. see the end of the "Study population" section).
(It's also interesting to compare COVID hospitalizations to other ones, say from a heart attack or allergic reaction, but those are different questions. For example, maybe a COVID hospitalization is less bad than one due to a heart attack, or worse than an allergy. Or maybe any hospital visit is just bad period. But given many people got hospitalized by COVID this year - something that never happened in the past - we need to know what that event cost them, that's the point of this study.)
How do you then control for those with a chronic condition that is undiagnosed? If somebody is hospitalized, they'll perform all sorts of tests on them, that's how many people get their diabetes diagnosis in the first place.
Looking at the charts, you might get the idea that there's a staggering increase in new-onset diabetes following COVID infection, which doesn't seem plausible to me. Yet, right next to that, you see damage in heart, liver and kidneys, and this gets picked up uncritically as an outcome of COVID. The hypothesis that COVID causes organ damage is already well-established, so this just confirms what we expect. What we don't expect, we just ignore, even though it might point to a flaw in our methodology.
But we know that COVID admittances caused a big increase in the total number of people hospitalized - to the point of overwhelming some health care systems. That strongly suggests that underlying conditions would not have sent as many people to the hospital anyhow if COVID had never appeared and infected them.
It is possible you explain the mechanism, though. Perhaps there are lots of people with undiagnosed underlying conditions, and getting a serious case of COVID is enough to worsen those conditions into life-threatening ones. (Perhaps this only hastens the inevitable for some of them.) If this is the mechanism then both you and the article's hypotheses would be correct.
> Rate ratios comparing patients with covid-19 and matched controls were greater in individuals aged less than 70 than those aged 70 or more for all outcomes
> An alternative approach might have involved comparing outcomes after covid-19 and other hospital admissions; such research has recently been conducted with similar data sources to those in our own study (although with a smaller covid-19 cohort), and comparable rates of organ dysfunction were found between patients with covid-19 and patients with pneumonia who were discharged from hospital in 2019.36 We believe that our study design, where comparisons were made with the expected risk in the general population, was more relevant to public health policy, and complementary to the study that used non-covid hospital admissions as the comparison group. Also, the use of non-covid hospital admissions as the comparison group does not allow estimation of excess morbidity because non-covid admission does not necessarily represent an appropriate counterfactual situation to admission to hospital for covid-19, and the size and direction of the inferences will depend on the choice of control admissions.
I wouldn’t call it the most useful one.
If those who were admitted to a hospital with COVID already were less healthy than those who weren’t before they got COVID (and that’s a given. Higher lung capacity can keep you out of the hospital, for example), I don’t think it is a surprise they still aren’t as healthy when they leave the hospital.
I could imagine COVID being causally implicated in respiratory disease or cardiovascular disease, but diabetes? That sounds to me like the control group wasn't representative.
https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precaut...
https://www.thelancet.com/journals/landia/article/PIIS2213-8...
No, because that is in literally the objective: "To quantify rates of organ specific dysfunction in individuals with covid-19 after discharge from hospital compared with a matched control group from the general population."
I wouldn't even rule out that COVID causes diabetes, but at the same time diabetes is commonly underdiagnosed, as is heart or liver disease.
https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports
Page 29 has a chart for spread of age. Most people (88%) live without any assistance in day to day activity.
> 47,780 patients with covid-19 (4,745 admitted to the intensive care unit and 43,035 not requiring admission to the intensive care unit) were included in the analysis
https://www.bmj.com/content/372/bmj.n693
From the study:
> At baseline, individuals with covid-19 had a mean age of 64.5 (standard deviation 19.2) and 54.9% were men. Compared with the general population, individuals in hospital with covid-19 were more likely to be: male, aged 50 or more, living in a deprived area, a former smoker, and overweight or obese (table 1). Individuals with covid-19 were also more likely to be comorbid than the general population, with a higher prevalence of previous admission to hospital and of all measured pre-existing conditions (most notably hypertension, major adverse cardiovascular event, respiratory disease, and diabetes).
> Individuals discharged from hospital after acute covid-19 had increased rates of multiorgan dysfunction (particularly respiratory and cardiometabolic) compared with a matched control group from the general population
> The rate ratio of multiorgan dysfunction (comparing individuals with covid-19 and matched controls) after discharge was greater in those aged less than 70 than in those aged 70 or more, and in ethnic minority groups than in the white population
> Our findings suggest that the diagnosis, treatment, and prevention of post-covid syndrome requires integrated rather than organ or disease specific approaches
> A total of 5960 patients were included in the studies identified. The current smoking prevalence ranged from 1.4% (95% CI 0.0–3.4%) to 12.6% (95% CI 10.6–14.6%). An unusually low prevalence of current smoking was observed from the pooled analysis (6.5%, 95% CI 4.9–8.2%) as compared to population smoking prevalence in China. The secondary analysis, classifying former smokers as current smokers, found a pooled estimate of 7.3% (95% CI 5.7–8.9%). In conclusion, an unexpectedly low prevalence of current smoking was observed among patients with COVID-19 in China, which was approximately 1/4th the population smoking prevalence. Although the generalized advice to quit smoking as a measure to reduce health risk remains valid, the findings, together with the well-established immunomodulatory effects of nicotine, suggest that pharmaceutical nicotine should be considered as a potential treatment option in COVID-19.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210099/
> Based on the early observations of the lower than expected smoking prevalence in hospitalised COVID-19 patients, Changeux and colleagues suggested a role for nicotinic acetylcholine receptors (nAChRs) in the pathophysiology of COVID-19 via a direct interaction between these receptors and the viral spike (S) glycoprotein.11 This suggestion was based in the fact that the S protein from SARS-CoV-2 contains a sequence motif similar to known nAChR antagonists11 (Figure S1), such as α-bungarotoxin from Bungarus multicinctus and glycoprotein from Rabies lyssavirus (formerly Rabies virus). Changeux et al. also proposed that COVID-19 might be controlled or mitigated by the use of nicotine, if the latter can sterically or allosterically compete with the virus for binding to these receptors.9,11
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386492/
[0]: https://valerieeliotsmith.com/2021/02/19/a-short-post-on-lon...
But taking that perspective requires correcting for the systematic underweighting of the testimonial evidence of patients of chronic illnesses.
Less trendiness, more empathy, please.
Fortunately I'm on the mild end of the spectrum and flairs are infrequent but it'd be nice if we had something better to treat auto-immune disorders.
To control my chrohns I changed my diet by removing foods, keeping track of general well being for a few weeks then gradually introducing them to see what happened til I found a routine that worked, it's bland most of the time but I'll take the win - basically a Mediterranean diet which is fine.
There is however a bunch of things in the pipeline including things like targetted biologics to selectively target the immune system that are exciting.
I'd lost a lot of weight worryingly fast - mostly because of massive reflux problems (barrets oesophagus), was having frequent bouts of vomiting and diarrhoea and was generally in a shit state all around - as for diet it's really hard to recommend anything to anyone else since it varies so much - what worked for me was keeping a detailed journal of what I ate, how I felt, how I slept, toilet habits, times etc then I cut out basically everything from my diet I could for a few weeks (think porridge, cottage cheese and mashed potato/oven cooked chicken breasts) and very gradually added things back still keeping the journal until I had actual data I could look at - for me there isn't really any one food or group that acts as a trigger red meat/processed meat comes the closest, it's large high fat/high carb (think Pizza) that do it - if I eat fresh foods/veggies/fish/cheese (hard not soft) and limited amounts of fruit I have it mostly under control but what works for me might wreck you.
I am not a medical professional, but I know these people and how their bodies functioned beforehand. The way they are now is certainly not a hard-to-diagnose chronic syndrome that is unreleated to them catching the damn thing.
But, also, you'll find people with long COVID who are finally paying attention to other symptoms and ascribing them to the C-19 infection.
But if you screened any population of lower health you'd find a fair number of instances of these... and historical baselines are probably not valid because we've had a weird year. So-- the exact incidence of some of the milder end of long COVID is hard to pin down.
Certainly some people have these symptoms and they are very very likely to be from the COVID infection itself.
But other people have more minor symptoms and these are included in many estimates of post-COVID syndrome, and discerning whether they were related at all to COVID and caused by COVID itself is more complicated, because if you were to screen a normal population with these criteria you'd find a fair incidence of these symptoms.
I was down for about two additional months after that, in which I caught another flu twice, and could barely get out of bed for a while. And then I proceeded to have complications from colds and flus that evolved to bronchitis or pneumonia every single flu season for the next 8 years.
It took nearly a decade to really recover from that. I see no reason to think any sufficiently bad respiratory infection with high enough viral load wouldn't do the same thing, especially to people much less healthy than 20 year-old me, a two-time state champion cross country runner in high school.
post-infection complications are not uncommon, although specifics certainly vary. i'd also had a long tail of recovery from a flu->bronchitis->pneumonia cascade a few years ago (on the order of many months, not years).
Salt has a way of pulling infections out of tissues.
'"When fine salt particles are inhaled, they will fall on the airway linings and draw water into the airway, thinning the mucus and making it easier to raise, thus making people feel better," said Dr. Edelman.'
https://www.lung.org/blog/promising-placebo-salt-halotherapy...
There is salt in the air at the beach, so I'd stay away from the ocean if you think inhaling salt is a bad idea.
The political/social powder-keg of denying a covid related insurance claim is not one that a health insurance corporation would probably be willing to take, at least for another year or 2.
The "pushbacks" you see on social media are essentially the output of a random sentence generator. Covid is not real, covid escaped from a lab, covid is a conspiracy, etc. etc.
Be careful with that stuff. You are what you read (and believe).
There's varying severities. The 1/8 figure applies only to people who developed long-COVID after being hospitalized for acute COVID (i.e. most likely on a ventilator).
Minor COVID cases can still develop several long-COVID symptoms (the symptoms you pointed out) that aren't life-threatening. This is the long-COVID you generally hear about because surviving a minor or asymptomatic case of COVID isn't the end of your worries, and is why it is beyond idiotic to play fast and loose with the virus.
It's always possible they missed a factor, that's always a risk in such research, but they worked hard to address that possibility.
> We selected controls from the general population rather than matching to non-covid hospital admissions to determine the increased risk after hospital admission for covid-19 versus no hospital admission for covid-19 (that is, compared with the expected risk for people with similar personal and clinical characteristics in the general population).
It's all confounded. If you compare to other hospital admits, you're finding an even-less-healthy population (because they had a reason to show up to the hospital -without- COVID). If you compare to the general populace, you risk inadequately controlling the comparison.
But if you want to know the increased risk people have subsequent to COVID hospitalization, perhaps the latter makes the most sense to measure.
[1]: https://en.m.wikipedia.org/wiki/Strengthening_the_reporting_...
in public health medical science? you don't say.
Maybe a better question to ask would have been: typically do 1 in eight people who have been discharged from the hospital after non-covid issues and have the same co-morbidities as the group in the study die within 4 months?
Are their unusual or particular symptoms compared to other people with long term issues after viral infections?
I full believe "long covid" is a thing. But so much of covid news has been shitty "studies" that get a lot of press despite shedding very little light and go on to be rapidly disproven but still repeated (Vit D, Chloroquinine etc).
https://news.harvard.edu/gazette/story/2017/02/study-confirm...
Last week of January reported 55 vs 23,972 on average any other season.
Indeed there's a suspicious drop in influenza-type cases, likely caused by all the social distancing and perhaps by SarS-COV-2 simply out-competing influenza-types in knocking people out.
https://www.health.govt.nz/our-work/diseases-and-conditions/...
Shouldn't the vaccine have helped, though? I don't know.
Exactly the same about the lack of congestion. That's something I've never had in my life, cold symptoms without congestion. That's the reason why I think it was covid. Plus a little fatigue and muscle soreness.
Overall it was light, medium at most. But def something.
But temporary -- and not all that long compared to the hell we've all had to endure for more than a year now -- except in extremely rare cases. Evidence to the contrary is welcome, after more than a year there should be some.
https://www.health.harvard.edu/blog/the-tragedy-of-the-post-...
Search for the term "covid long haulers" to get more information.
> Search for the term "covid long haulers" to get more information.
No. https://thelogicofscience.com/2016/09/27/dont-tell-people-to...
You understand the burden of proof is on the person who's making a claim, not on people who disagree with the claim?
I've too suffered being stuck at home for more than a year, but in my book this is still better than me or somebody else getting sick with god-only-knows what long term complications, which we don't have data for one way or another, and won't for some time still.
Interesting idea, but false in this case unless you are arguing that lockdowns are and will be, in perpetuity, the status quo.
> this is still better than me or somebody else getting sick with god-only-knows what long term complications, which we don't have data for one way or another
Are you arguing your presence in society is outweighed by the mere possibility of you having a negative effect on it?
I am not arguing either way, what I am saying is shouting "here's what I think, prove me wrong" is not how it works. "Here's what I think, and here is the evidence" is how it works.
Lack of data can't support any claim. If we don't have good data on whether lockdowns are effective, it doesn't mean they aren't. It means we don't know. In which case we do a risk analysis, taking our uncertainty and potential benefits/drawbacks into account.
> Are you arguing your presence in society is outweighed by the mere possibility of you having a negative effect on it?
I don't consider myself absent from society. I am talking to you now, am I not? And yes, I consider my temporary suffering to be outweighed by potentially permanent suffering of myself or someone else.
> which we don't have data for one way or another, and won't for some time still.
Exactly. There is no evidence for "long Covid" as a frequent phenomenon. The pandemic has been going on for 15 months. Yet those who believe in long Covid still only provide evidence that people aren't always fully recovered after timespans like 3 months.
If Covid frequently caused permanent damage, there would be a lot of people who were infected, say, a year ago, who haven't recovered and show no sign of doing so (their condition has plateaued). There would be studies showing that, there isn't exactly a shortage of scientists researching the topic. And, obviously, people would provide that evidence as it would support their point better. Yet they don't.
So what you are saying is, despite "the experts" saying exactly the opposite... by slowing the spread of covid we'd somehow be out of this sooner?
Do you guys realize how insane this logic sounds? The goal of these lockdowns was to intentionally slow down the spread. Not stop or eradicate covid. Harder lockdowns mean this goes on much longer.
How can people genuinely think otherwise? It's like basic math.
There is a minimum number of deaths that we should accept as a society just like we accept other causes of death.
Speak for yourself!
My life was largely unchanged by covid beyond wearing a facial covering in public which I actually prefer. What a joy to not only walk into banks dressed like a bandit without getting arrested, but to be asked to do it and thanked for cooperating!
This certainly hasn't been any sort of hell for me, but catching covid let alone "long covid" seems likely to be quite awful and potentially life-changing for anyone.
Living in US, NJ FWIW
Not a doctor. Could be wrong. Just sound like anxiety symptoms from my experience.
I still haven’t gotten fully back on my feet.
I've had similar symptoms, and more, for the past 8 months. Heart palpitations, feeling of heaviness in the chest, strange exhaustion... I admit this does sound like anxiety. However, after suffering from anxiety for two decades, I've learned what my anxiety feels like. This is different. It's like comparing grits and runny oatmeal--I can understand why many descriptions are insufficient to distinguish between them, and even how one might be able to masquerade as the other, but having had both, it's clear they are not the same.
So maybe I'm wrong and I haven't been experiencing anxiety when I have these symptoms. I agree it's a bit different than having a panic attack in my experience.
https://pubmed.ncbi.nlm.nih.gov/26027689/
No symptoms at that point. 2 days later, I started feeling more tired than usual. The next day I had a mild fever and was sweating more than usual when exercising. This lasted 3 days, after which I only felt the fatigue for another 5 days.
No lasting effects that I can name.
I'm 31, male.
I had a cold around 5th-10th of February. I take levothyroxine every day, multivitamin everyday, Gabapentin every day, Vitamin C 500mg twice a week. Light exercise everyday, a more thorough workout twice a week. I drink alcohol and smoke tobacco regularly, and everyday between 24th of February - 15th of March.
I mention all that because some research said the cold and CV viruses are competitive, plus having the immune system "battle ready" after a simple cold could've helped. Levothyroxine increases metabolism, vitamins and exercise probably help. Smoking has been linked to lesser symptoms, too. I wonder what the effects would've been without all that.
Anxiety over Covid (I scared myself reading reports on Reddit) and losing my job (unrelated, but bad timing) was by far a bigger problem than the virus itself.
Which is not to say that others do not have lingering symptoms -- but if we're going to emphasize scary anecdotes, it seems like we should spend proportional time reporting the vastly larger number of anecdotes that are not scary, as well?
Most people (I read it's around 86%) having such mild symptoms that they don't even realize it's Covid must've contributed a lot to its rapid spread.
The more vulnerable people get the same virus and suffer much more. Perhaps vulnerable people should've been subjected to stricter lockdown measures, not sure what else could help reduce the deaths.
I haven't backed up my personal data in years and nothing nasty has happened, despite all those catastrophic data-loss stories you read online. I'm all for proportional reporting time, but strangely, no one reports on stories like mine - it's mostly in the vein of "Company shutters after accidental db deletion". I wonder why.
There's a reason we pay attention to tail risks, where the low-probability negative consequences are far worse than the high-probability costs of averting them. The vast majority of people are not going to die in car crashes, or of SIDS, or of COVID, or from untreated kidney infections. They are lucky. But the consequences of death are so much worse than the costs of wearing a mask, or not seeing your friends in person, or dealing with anxiety, that it's worth taking some precautions even if the chance that you'll die from COVID is low.
I still hear people worrying about safety despite the fact that half the UK, a large part of the US and countless others have been jabbed. That's after the original trials. I can understand some people's reluctance wrt vaccination. Many countries have had examples of problematic vacc campaigns. In the UK the MMR jab had a major set back due to Andrew Wakefield's false article in the Lancet [1].
From what I gather the thrombosis risk from the Oxford/Astrazeneca jab is somewhat swamped by error bars and open to interpretation. However the risk from the pandemic is very real and demonstrably so. I had my jab last Tues and it was O/AZ but I wont ask anyone to extrapolate much from that!
[1] https://en.wikipedia.org/wiki/MMR_vaccine_and_autism
No, by definition, they're the norm. They're not lucky, they're just normal. The expected outcome. The people who encounter the tail risks are unlucky.
Not too long ago, a part of a jet fell off over suburban Denver. I would be dismayed if someone -- engineers and investigators -- didn't obsess over this event. But if my brother wants to know if it's safe to get on an airplane, or live in suburban Denver, then my answer is not going to change.
I would also discourage anyone else from reading HN posts with obscure technical documents from Boeing and the FAA, and speculating about what it means for aviation in general. Or reading other peoples' posts on these topics, and sharing anecdotes about how "someone they knew" died in some ghastly aviation accident. And so on.
It is in our nature to exaggerate the importance of rare events. They are still rare.
> But the consequences of death are so much worse than the costs of wearing a mask, or not seeing your friends in person, or dealing with anxiety, that it's worth taking some precautions even if the chance that you'll die from COVID is low.
How did masks get swirled up into this? I swear...people will find any way to turn these things into a political debate. Can we agree that by this point, the debate about masks is fully baked, and no amount of discussion of Covid outcomes is going to change someone's mind?
You can find anecdotes on the internet to support literally any fear that you care to indulge. The point is, most of the time, these fears are not worth indulging, and what you read on the internet exaggerates the actual threat.
Well, speak for yourself. I'm a commercially-rated pilotwho does maintenance test flights, and I study aerodynamics, so I can and do interpret obscure documents - in fact, it's my responsibility to know how airplane systems work.
The significance of the Denver accident is:
1) it's not being called an uncontained engine explosion, yet there's parts everywhere
2) the engine accessories kept burning after the fuel was shutoff. Apparently the engine fire suppression equipment doesn't work without the engine shroud - that sounds like a problem, especially since fuel is usually stored in wings.
Unless I'm misunderstanding what you're saying I quite disagree with you that death is so much worse than anything else. Why is death so bad? It's the only certainty you actually have in life. There's an average age of death but you're quite unlikely to die at that specific one. It's gonna come either expectedly (like a cancer diagnosis giving you X months to live) or unexpectedly (an accident). Just accept it and stop trying to fight it by trying to minimize the risk since it'll happen anyways. Instead think about whether there are things you want to prepare for those left behind when you do go. And then stop worrying and enjoy the ride while it lasts. It's just a dice roll anyways, try to have fun! Don't hold back. Challenge yourself, face your fears, jump into the unknown. Don't try to follow the recipe for a perfect harm-free life to the book. That sounds like an insanely boring life to me but I suppose YMMV.
It also talks about how poorer people, and those from non-white backgrounds are disproportionately likely to have worse outcomes.
Just because you don't see it happening in your circles, doesn't mean it's not happening in other ones.
The authors write in the BMJ: “The increase in risk was not confined to the elderly and was not uniform across ethnicities."
Having an office of national statistics does not mean that this particular paper is being reported correctly by the mass media, it doesn't mean that the paper itself supports the discussion of "long covid" amongst otherwise healthy people, and it certainly doesn't mean that other people on this thread reporting personal stories are representative of the actual risk. That last bit is what I'm emphasizing here. Literally any scary anecdote is amplified, and the (many more) pedestrian anecdotes go undiscussed.
As other comments on this page have noted, there are a number of legitimate criticisms of this paper that should be considered carefully, and even if you don't agree with those, the paper is self-admittedly discussing a predominantly elderly, sick population who were hospitalized for the virus. It doesn't generalize to discussion of anecdotes of "long covid" from much healthier people.
> It also talks about how poorer people, and those from non-white backgrounds are disproportionately likely to have worse outcomes. Just because you don't see it happening in your circles, doesn't mean it's not happening in other ones.
You're making assumptions.
https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...
To me, they seem to be trying to make it as accessible and clear as possible with most news articles taking the salient points directly from the ONS's own summary.
As you can see from figure 2, their data is not focused on old people as you erroneously claim, it does seem to show that more deprived = more symptoms, and that non-white are more likely to have symptoms.
But the weird long-COVID cases are problematic - they're real, they affect a certain slice of the demographics, and can be pretty serious and long-term.
They are definitely real, and can be serious and long term, but they likely aren't novel; I suspect ME/CFS, "long lyme" and a variety of other conditions often dismissed as psychosomatic by practitioners who can't find a test for them - are post viral/post infectious syndromes, and they will be joined by "long covid".
Perhaps some good will come of this - those "long sequelae" diseases will get more and proper attention.
But none of the data I've seen so far about "long covid" puts it out of line with what we've known about post-viral sequalae for ages.
The hard part is unless you have diabetes or similar, it seems random to me. And I don’t see good accounting of long term symptoms.
The political bullshit is such that we won’t really know what’s up for a few years.
I am interested in reading about others' experiences, it's just that everything I could find (mostly on Reddit) depicted a much worse picture.
And yet statistics say that the vast majority of people have it easy like me.
I mentioned I would love a database like Erowid, with input from everyone who has had a confirmed infection. I'd read through all of it and make my own conclusions.
I was told to self quarantine and call an ambulance if I felt worse. The hospitals here are overwhelmed just like many other cities/countries.
A small minority of people having serious difficulties with the virus can turn into a large medical issue when the denominator is 1/3 to 1/2 of the country getting infected.
https://news.ycombinator.com/newsguidelines.html
You may already be aware of this but there's an organ there called the thymus which is a core part of the immune system (especially in younger people)
Seems to be a symptom with relatively little discussion even in medical journals but can confirm I also had it for months after a relatively mild case, tending to reemerge due to tiredness or exercise.
The thymus (the favourite organ of a friend of mine) is quite unusual, being replaced by regular boring fatty tissue after childhood.
Our vaccination numbers are terrible: at the rate we are vaccinating all Danes will have started their first vaccination round by July 21st, 2022. [1]
We've had the Moderna vaccine since January 13th [2] of the previous year. This is not people failing, these are our leaders failing.
I was so gung ho about us coming together to make the sacrifices and beat this thing but now a year and a half later I'm done with the colossal failures of our leadership and the promulgation of fear everywhere.
[1] https://hvorlangtervi.dk/english
[2] https://nymag.com/intelligencer/2020/12/moderna-covid-19-vac...
I don't think humans anywhere are able to "pull in the same direction" to the extent that such a lockdown is possible without an authoritarian government. Italy imposed pretty draconian rules for at least six weeks, and has still had to deal with a second wave and additional lockdowns.
Personally, I think that the principles of personal freedom (that such an authoritarian government is largely incompatible with) are much more valuable in the long run. Working through the disease has been messier in the last year, but the economic system largely based on these principles was also able to produce novel vaccines. While the last year has been rough, I'm much happier overall that I don't live in a place where an authoritarian lockdown is even possible.
Absolutely infuriating, look at a map dude
inb4 vietnam
Yeah, it's landlocked. Great job Vietnam, we should learn from how they did it. Doesn't change the fact that it's a major outlier.
Lockdowns and people immediately willing be a part of the contract tracing part.
https://www.businessinsider.com/vietnam-coronavirus-measures...
Lockdowns are not about islands. It helps, kinda, but not completely. Vietnam completely sacrificed the tourist industry, unlike US or Europe. Quarantine is at a designated facility, not at home, unchecked, like in US or Europe. And dissent is suppressed.
The last part is a bit unfortunate, but the former ones are really just a matter of decision. And it works.
That said, I want people from island countries to stop saying "being an island country has nothing to do with it", when all evidence and logic says being an island country has a lot to do with it.
I'll happily take criticism from Vietnam, even if I think it's of questionable utility to say "you just did it wrong" when the overwhelming majority of countries seem to have "done it wrong"
And islands still have to watch for random boats from any direction. Right now in Vietnam there is a little outbreak where a group of Vietnamese nationals illegally crossed the border by a fishing boat from Cambodia to Phu Quoc island, trying to avoid the mandatory two-week quarantine. Then they boarded a plane, arrived at their homeland and tested positive. Immediately their steps were traced by police, whole Phu Quoc is under a mask mandate, 3 levels of contacts are tested and in quarantine. It really isn't about being an island. That's a myth, you've been lied to. If you want an example closer to your home, look how hard it is to seal a land border with Mexico. They actually cross by rivers, so water makes it easier.
One of the hardest challenges of leadership is resisting the urge to DO SOMETHING when crisis happens.
> Fair to say what you're doing didn't work.
And yet western nations keep trying the same failed policies over and over again and getting the same results.
https://91-divoc.com/pages/covid-visualization/countries-nor...
FWIW I'm from Australia (Melbourne), which mostly eradicated the virus last May, then had a resurgence in Jun-Aug, and it took hard lockdown from early August to November to get the outbreak fully under control - effectively four months of pretty strict lockdown. We managed to beat it but it was hugely costly.
Australia, like NZ, is an island with a relatively (compared to US and Europe) small, compliant population, so it's much easier for our governments to control our international borders and internal movement. But it was still incredibly hard, and slow.
We did it, which I'm pleased about, but I understand why what Australia and NZ have done is not possible in the US and Europe; they have much denser populations and many different jurisdictions and cultures all meshed together, so it's much harder to restrict movement and apply restrictions consistently enough from one place to another.
So, sure, take comfort that we live in places that were able to avoid major outbreaks, but resist preaching that any other country/continent could have done it just as easily, as it really isn't that simple.
The chance of stopping it early increases exponentially, if there are fewer ways into your country from countries that are themselves exploding with the virus.
In Europe, all countries broke down eventually and all these cases are ultimately imported from crisis areas. Many were never caught.
Keeping borders open - in the EU sadly not something that could have been realistically changed, if ever - is the reason.
Look at the facts: NZ caught all cases early. Full stop. So did Germany - at the beginning. It worked in either case. But NZ also kept cases low by limiting travel. Germany did not do this - least of all because the EU literally sued Germany when it started (very recently) to lock borders.
Australia not only can limit travel easily, but is also huge and barely populated. When there was a significant outbreak, it was physically possible to cordon off the state in question.
In Europe, once the spread began, it was already present in every locality - since Europe is tiny and entire countries have higher population densities than Sidney or Melbourne! And, this is also important, there is significantly more travel of people and goods, and it is far less concentrated on a few areas. Many people in Europe go to work in a different country from where they live, every day. There are literally no borders where you could test people. It is being tried. It does very little. Look at the spread in areas bordering high incidence regions. The borders are as closed as EU laws allows. It simply does nothing.
This is it. If you closed borders, then you made it. If you did not, then nothing much helps except trying to reduce incidence rate such that hospitals do not collapse.
We all dreamed of containing non-regionalized outbreak clusters by contact tracing. In reality all health services, even the very best ones in the world, eventually got rolled. Some sooner, some later. Sometimes contact tracing worked up until the mutation showed up. But it never worked consistently, except with closed borders.
Which countries contained the spread while having a high density and without being an island? Vietnam. However, cross border traffic between Laos and China is either strictly controlled or not economically significant - in either case, Vietnam is also an example of a country that managed to lock down borders - even tourism - almost entirely.
Conclusion: Covid has to be geographically contained with maximum force. If that is not realistic, for example if your country has the density of a city, then you need to stop it from getting in in the first place.
And unsurprisingly, being an Island and not 100% dependent and interconnected with daily border-less traffic helps a lot. Being a huge country with less population density or other ways to cordon off locally also helps.
In Europe, several countries were doing fine. They had lockdowns, contained local spreads and did contact tracing. They did not do less than NZ or Australia - except they were still surrounded by dozens of other highly populated areas with entirely different policies, all with different timings. The result was the same everywhere - eventually.
So, theoretically the EU could have been saved, if border would have been closed off immediately after the first cases appeared in Italy. Despite the fact that people believed contact tracing was viable - an option that does not shatter the political and economic fabric of the region.
This post is already too long, but you can read up on the discussions at the time and the political, geographical, economical and demographic situation in the EU to convince yourself that the chance of early border closings was close to zero.
The average for island nations like New Zealand was 0.
https://www.cbp.gov/newsroom/stats/typical-day-fy2019
https://www.cbp.gov/newsroom/stats/southwest-land-border-enc...
How is this a fair comparison?
> This would have entailed no one working at grocery stores, no deliveries, no travel, no global trade. I just don't buy that this was ever plausible for however long people suggest: 3 weeks, 6 weeks whatever.
The experiences of (at least) New Zealand and Australia are clear evidence it is absolutely possible, without the absurd extremes you are talking about.
If I had to guess, I would guess that COVID can be transmitted by fomites, especially if kept cold, but that it’s extremely rare. In a place like the US or Europe, this is insignificant: your chance of getting seriously sick due to touching something is negligible, and the rate of additional cases due to this effect is inconsequential for public health. But in AU or NZ, where the background rate is essentially zero, a single reintroduction is a big deal.
Right, so why would the US - with much more porous borders - somehow do better?
But, beyond the fact that the US has large land borders, the US has a genuine problem. We are economically dependent on legal and illegal cross-border seasonal migration. I personally think that, with actual political will, the borders could be made a lot less porous, but this would involve attacking the supply and demand sides. Neither party is interested.
I don't like the previous administration one bit, but this was a really hard problem. By the time covid was taken seriously I think it is confirmed it was a least spreading in Seattle and Bay Area.
This reads like Covid arrived in the US through uncontrolled land crossings from Canada or Mexico? I'm pretty sure like Australia and NZ, it came by land and sea mainly.
> Also US has different states with different rules, but no ability to restrict travel between the states
Also Australia never had seen states close borders before. Yet somehow each of the 6 states and 2 territories managed to get legislation passed to do this, get police mobilised, and just got community buy-in that was going to work.
Just because NZ can demonstrate good COVID control, it cannot just apply at a massive nation. China has done it with authoritarian enforcement. There is no solution to this for USA, EU or large countries. Asian nations such as Japan and Korea are culturally different than the west. It’s impossible to change the culture of 330 million overnight.
And yet the massive USA clearly showed through COVID control that it is simply a collective of hundreds of fiefdoms (states, cities and even corporations) they for the most part were uncoordinated and did what was best for themselves, which turned out to be no good for no one.
Here in Bay Area, there was much stricter control. Counties choose their fate, their path and their citizens want to trade off lockdowns vs. COVID rates. It's their call and I respect that kind of governance.
At the extreme - I would absolutely abhor China style lockdowns in the USA.
Did the USA fared well with COVID response? Not at all. Federal gov could have done a lot better to provide guidance (not enforcement) to states and counties.
Then when all the infecting bacteria are dead, just restart your body again. Easy, no?
Any strategy which depends on complete cooperation of a large number of humans for success, well, I would short that stock.
The pandemic will pass soon, but countries walling themselves off could have consequences that even our grandchildren might have to deal with.
This idea that if we locked down harder or people "behaved" we'd be done with covid is a complete lie. That was never the intent of these restrictions. Ever.
I find it very curious how even after massive stockpiles of unused ventilators were donated and countless field hospitals were closed up after never seeing a single patient governors extended their stay-at-home orders. Despite it being shown that covid was never a true threat to healthcare, despite the sky-high IFR predictions being shown wrong (thankfully!), we let the goalpost shift to.... well... I still don't know what the goal is. We got very lucky having a vaccine delivered so quickly because without it, we'd have been drifting along aimlessly and things would have got very dark and ugly.
> Americans absolutely refuse to work together
Curious how many of the nations in Europe that "did it right" wound up getting major outbreaks regardless. Also curious how the curves of all regions basically mirror each other regardless of restrictions or "how serious they took it". Maybe, just maybe, humans aren't as in control of a widespread respiratory virus as they'd like to believe.
I believe it is peak human arrogance to think we could somehow control a respiratory virus in this manner. In my opinion history will look upon all this the same way we look at our ancestors performing rain dances and goat sacrifices. They are all examples of meaningless rituals humans perform in order to fool themselves into believing they have more control over mother nature than they actually do.
We detached this subthread from https://news.ycombinator.com/item?id=26673398.
Edit: your account has been breaking the HN guidelines a ton lately. If you keep doing that we will have to ban you. Please review https://news.ycombinator.com/newsguidelines.html and fix this.
"Eight of them" is grammatically unremarkable. "Eight of the patients" and "eight patients" are also unremarkable, although slightly different in meaning.
"Eight of patients" is jarring. It sounds like "four of clubs."
Here's an interesting explanation of how Vitamin D helps the immune system.
https://www.youtube.com/watch?v=cT1CaTv5-e4
Vitamin D improves your uptake of calcium. Vitamin K2 makes sure calcium goes where it's supposed to go. You want your BONES calcified, not your arteries.
Person A: 'We should open up' Person B: 'Have you not heard most people have serious health problems after covid?'
When we talk about proportional reporting I think of the book 'Thinking fast and slow'.
Also, last year some newspapers irresponsibly allowed some people to share their claims that they were dealing with tough long-term COVID symptoms even when they had never even tested positive for the disease in the first place. It was no different than giving a megaphone to the people who, before COVID, experienced some distress and, without any actual medical verification, were sure they were cases of "chronic Lyme disease".
Health officials in several countries have plainly fudged the truth or left out details when speaking to the public, for what they see as the greater good of maintaining restrictions for long enough to reach their public-health goals. One naturally suspects that they found the panic about long COVID useful for this.
Folks needing hospitalization are pretty sick. If they're older, this seems a normal result. I'd have to see some statistics to call it remarkable.