41 ms·
I am happy to provide sources; as I explained elsewhere, I've had a crazily high number of encounters where I provide a bunch of sources and then get flagged or
by __blockcipher__ 6y ago
I am happy to provide sources; as I explained elsewhere, I've had a crazily high number of encounters where I provide a bunch of sources and then get flagged or downvoted etc, which is very demoralizing so I've gotten into the habit of waiting until people bite to pull out sources.
Let me start by out-lining my beliefs about long-term damage or the other classic complications of blood clotting, stroke, or pediatric multi-inflammatory syndrome:
(1) Any time the body enters a state of pathological cytokine release syndrome, basically any runaway inflammatory cascade, a lot of really bad shit happens. Blood clotting, strokes, etc. What's important to understand is that (a) this is not at all unique to COVID, we see it with flu and any of the other dozen classes of virus that can make you sick, and (b) statistically, they happen in incredibly small numbers.
(2) Medium-term damage in the sense of your lungs taking a month or rarely, even longer, to recover absolutely can happen, we see it with SARS-1. But at the 1 year mark, for example, people's lungs look totally normal. I tend to use SARS-1 infections as a model for what severe COVID-19 (caused by SARS-2 just as a reminder) looks like. So I think SARS-1 gives us a great upper bound.
There is a narrative specifically that people who don't have bad symptoms will have hidden long term damage, that's just complete bullshit and there isn't much for me to debunk. As far as the real severe COVID-19 cases that do have some type of complication, again they might have damage for a few months, certainly not beyond the 1 year mark.
Let's talk about strokes. The "strokes in young people narrative" (which I can't resist mentioning was heavily pushed by CNN, who as you can tell I have an incredible disgust for, because until this year I truly didn't realize how far they had fallen) AFAICT stems entirely from this series of case studies:
["Large-Vessel Stroke as a Presenting Feature of Covid-19 in the Young"](https://www.nejm.org/doi/full/10.1056/NEJMc2009787 https://www.nejm.org/doi/full/10.1056/NEJMc2009787) - April 28, 2020
Normally with scientific stuff, what happens is that news orgs take the study, misrepresent/oversimplify the conclusions and twist its meaning. Well, that did happen to an extent here, but actually the actual title of the article ends with "in the Young". Now, maybe there's some medical definition of young that I am not aware of, but this study does not look at young people, it looks at non-elderly people. So, in my opinion, there are a lot of scientists that are basically editorializating their own work. In other words, there is a large faction of people so incredibly concerned about COVID-19 that their bias is seeping into their scientific work. Anyway, I actually love this paper, because of the buried lede about lockdown/hysteria actually making things worse, which the authors seemingly tried to not draw attention to.
* "Social distancing, isolation, and reluctance to present to the hospital may contribute to poor outcomes. Two patients in our series delayed calling an ambulance because they were concerned about going to a hospital during the pandemic."
* (for those concerned about stroke in the young, note the occurrence is rare in those without comorbidities. And "young" here means "not old" [youngest was 33, oldest was 49, 3/5 had serious risk factors])
My commentary: So, the first irony is that people who actually had COVID-19, and had it severely enough that they literally ended up developing strokes, were afraid to seek medical attention for quite some time, because they didn't want to catch COVID-19. My interpretation is that the media hysteria, etc has/had hit such a point, that even though they were probably feeling sick and like total garbage, they thought to themselves "well, this is bad, but not as bad as COVID-19 is from what I've heard". (Yes, this is me reading WAY between the lines so feel free to disagree, but I just had to point out the delicious irony).
The second irony is that, as they say, social distancing and isolation may have contributed to poor outcomes. Personally I believe this is self-evident, but take it as you will.
Finally, the title says "young" but the youngest was 33 and oldest was 49. I would think young would at the most mean people in their 20's.
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Before I go back to long-term damage, since the prior study touched (however briefly) upon possible externalities of lockdown, I also wanted to point out the obvious impact on mental health:
["Patients with mental health disorders in the COVID-19 epidemic"](https://www.thelancet.com/journals/lanpsy/article/PIIS2215-03662030090-0/fulltext https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...) - Published April 01 2020:
* "Third, the COVID-19 epidemic has caused a parallel epidemic of fear, anxiety, and depression. People with mental health conditions could be more substantially influenced by the emotional responses brought on by the COVID-19 epidemic, resulting in relapses or worsening of an already existing mental health condition because of high susceptibility to stress compared with the general population."
* "Finally, many people with mental health disorders attend regular outpatient visits for evaluations and prescriptions. However, nationwide regulations on travel and quarantine have resulted in these regular visits becoming more difficult and impractical to attend."
I'll let those bullets speak for itself.
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> despite loads of evidence it's far more dangerous than the seasonal flu
Can you give me some ballpark numbers here? My estimates are that the IFR is maybe 3x the flu, although I think it would be lower if we weren't cooking the books as far as deaths go (note: my argument does not hinge upon the assumption that deaths are overstated/misclassified, indeed I believe if deaths were 5x as high relatively speaking as they currently are, that lockdown/etc would still be horribly counterproductive)
As I stated in my parent comment, though, once you amortize across multiple years, even with a 3x IFR of the flu, COVID-19 will kill far less than any individual strain of Influenza.
Also, briefly:
> https://www.quora.com/How-can-a-disease-with-1-mortality-shu.. https://www.quora.com/How-can-a-disease-with-1-mortality-shu....
The question says 1% mortality, "mortality" is vague but note that the IFR is much likelier to be .3%. And the IFR actually makes it sound worse because we have evidence now that many people basically can't get infected or are highly resistant to it without ever having been exposed (see the submission we're discussing).
> is that it results in less societal countermeasures.. prolonging this for all of us, and endangering those at-risk or with at-risk family members.
Actually, the societal countermeasures you are referring to, insofar as they actually work, are the source of this thing being prolonged. The way to not prolong it is not to artificially interfere with the spread of SARS-2 in the general population, which is the position I advocate for full-stop. (I used to be a bit more like "okay well maybe banning large gatherings makes sense", but the more evidence stacks up the more I'm convinced that we should not accept any mandatory countermeasures, period)
> Keep in mind that going to the hospital can be financially ruinous.
Of course it can be. I also urge you to keep in mind that the vast majority of people will never go to a hospital for COVID-19. And indeed that many hospitals around the country have been nearly empty due to a combination of fear of going to the hospital (which has been huge) and suspension of elective surgeries, leading to an unprecedented scale down of our medical capacity via furloughs.
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Back to the quora link - sorry for jumping around like a maniac here BTW - it just links to a lot of scientific-sounding news articles. It doesn't actually link to real papers, and the reason for that is because when you look at the actual statistics we have, it becomes pretty apparent that these are just what happens with "cytokine storm" (a better term for this is "pathological cytokine release syndrome" and thus I use that term), etc. It happens very rarely, but it does happen. There's nothing super unique about it with COVID-19, as far as I can tell thus far.
I owe you a few studies about these effects occurring in Influenza and other illnesses as well, I know I have them buried in my clipboard history or a stray sublime tab, so I'll try to circle back here in a bit with those. But hopefully I gave you enough to chew on / fight back on for now.
- deleted 6y ago[deleted]
- tln 6y ago> I owe you a few studies As do I. It's been a day at work, I'll see if I can dig into this soon. In the meantime, thanks for the thoughtful response.