7 ms·

There's plenty of evidence of long-term damage even in young and barely symptomatic cases - it's not a binary "dead/not dead" outcome. What if the virus causes

by lima 6y ago

There's plenty of evidence of long-term damage even in young and barely symptomatic cases - it's not a binary "dead/not dead" outcome. What if the virus causes substantial disease burden years to decades down the road? We can't know, and should take every precaution to prevent its spread.

logicchains 6y ago
For example? I haven't seen a single paper showing such long-term consequences in healthy people are significantly more likely than from other viral infections. We'd especially expect to be seeing a large number of such cases in Sweden, should it be common, given they had no lockdown and a large number of infections.
- lima 6y ago
  It doesn't even have to be worse than post-viral syndrome caused by other severe viral infections for it to be a problem. There's little immunity to COVID-19 and it's highly contagious. This is like saying "COVID isn't worse than the flu" - even if it was true, having another flu-sized disease burden would already be bad, so it's a bit of a weird goalpost. That being said, there's a lot of literature describing post-covid symptomes and hypothesized mechanisms of action, like [1]. The virus has been around for less than a year, so a quantitative comparison with something we have studied for decades makes no sense. [1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320866/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320866/
  - logicchains 6y ago
    >It doesn't even have to be worse than post-viral syndrome caused by other severe viral infections for it to be a problem. There's little immunity to COVID-19 and it's highly contagious. But it does make it highly inconsistent to adopt policies so extremely destructive to economic and mental health when the same wasn't done for other viruses with similar long-term effects.
    - lima 6y ago
      We have a chance at eradicating COVID-19, unlike other viruses that have been endemic for decades.
      - nradov 6y ago
        How would we eradicate a virus that has animal hosts? If the prevailing origin hypothesis is correct then the virus is presumably still circulating among horseshoe bats.
        SomeoneFromCA 6y ago
        SARS-1 has been eradicated in humans;its precursor still probably is circulating among bats.
  - nradov 6y ago
    That depends on what you mean by "little immunity". Many people appear to have some immunity based on prior exposure to similar coronaviruses. That won't prevent infection but tends to reduce disease severity. https://www.jci.org/articles/view/143380 https://www.jci.org/articles/view/143380
    - SomeoneFromCA 6y ago
      That "some immunity" is clearly insufficient, because people who actually got infected with Covid itself and then again with Covid, in many if not most cases have more severe symptoms. In fact, the scarce evidence suggests Covid might be a subject to Antibody Enhancement; that would mean that every next infection will get worse and worse. In any case, Coronaviruses have long be known to cause very short term immunity. Even more importantly, constant reinfection may debilitate the organism so much, that even a healthy person will eventually fall into the risk group.
      - nradov 6y ago
        That is unscientific fear mongering. As with any virus there will be some outliers. But in general there is no evidence of widespread antibody enhancement. Reinfections are rare, and most reinfected cases have minor symptoms. https://www.jimmunol.org/content/early/2020/09/03/jimmunol.2000839 https://www.jimmunol.org/content/early/2020/09/03/jimmunol.2...
        SomeoneFromCA 6y ago
        > That is unscientific fear mongering. Please be careful with your words. What I said is clearly scientific, because it can be falsified. > most reinfected cases have minor symptoms. This is clearly not true. See https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30783-0/fulltext https://www.thelancet.com/journals/laninf/article/PIIS1473-3... The article you linked is extremely old, July 17, when there was no reinfections known. Besides, it is already known, that MERS and SARS both cause Antibody enhancement in animals, with paradoxical results - lower viral load, but severe damage https://en.wikipedia.org/wiki/Antibody-dependent_enhancement#Betacoronavirus https://en.wikipedia.org/wiki/Antibody-dependent_enhancement...
- rndgermandude 6y ago
  Of course you haven't seen papers describing long-term effects, simply because the virus hasn't been around long enough for any long-term conclusions. Therefore there are no studies saying there are NO long term effects either. There are clues that long term effects/permanent effects even in mild cases may exist. E.g. some six scuba divers with mild symptoms/asymptomatic progression were checked afterwards (Innsbruck, Austria) and had what looked like permanent lung damage. Then again, the sample size here is far too small and the cohort far to "exotic" to draw any conclusions yet.
  - logicchains 6y ago
    > Of course you haven't seen papers describing long-term effects, simply because the virus hasn't been around long enough for any long-term conclusions. So you'd support locking down based on something for which we don't have any evidence yet?
    - rndgermandude 6y ago
      We have seen evidence that the virus kills. That alone warrants action. In the beginning, the general lockdowns were fine, simply because we didn't know enough yet to come up with better solutions, and frankly didn't really have the time to rectify this before taking any action. Now whether or not to lockdown and what to lockdown can be applied more fine-grained. Of course, everything is still in flux, and some decisions will turn out to be wrong later. The entire response is trial-by-error, for lack of alternatives In regards to potential long term effects, those should be a concern as well when making decisions, yes. Not the only concern of course, but not something to be ignored either.
      - logicchains 6y ago
        >That alone warrants action. In only warrants action if we're sure the negative consequences of the action won't be greater than the negative consequences of the viral deaths.
        6y ago
- dx87 6y ago
  I haven't seen any evidence, but there was a paper published recently that said that the lung damage dealt by covid is usually healed in ~3 months.
rndgermandude 6y ago
This is a very important point. We don't know enough about long term effects yet. In the same vein, we do not even know if herd immunity really is a thing here, and what thing it would be. E.g. the guy from Hong Kong who got reinfected (first time severe symptoms, second time no symptoms) was probably infectious the second time again. Herd immunity only works if the people who are immune are not infections and therefore cannot (re-(infect each other and more importantly the vulnerable population.
- latchkey 6y ago
  Herd immunity has never happened without a vaccine.
  - ceejayoz 6y ago
    https://en.wikipedia.org/wiki/Herd_immunity https://en.wikipedia.org/wiki/Herd_immunity > Herd immunity was first recognized as a naturally occurring phenomenon in the 1930s when A. W. Hedrich published research on the epidemiology of measles in Baltimore, and took notice that after many children had become immune to measles, the number of new infections temporarily decreased, including among susceptible children. (To be clear, though, I don't think the herd immunity strategy is a good one for COVID-19.)
    - chillwaves 6y ago
      The concept makes no sense. As soon as a carrier hits a group that does not have widespread immunities, you will get a disease cluster. Not only do you have to have a huge portion of the population exposed to the disease, you need to maintain that proportion indefinitely AND will still deal with occasional flair ups among vulnerable communities. That's not what most people think when they hear the word "immunity".
      - deleted 6y ago
        [deleted]
    - 6y ago
rich_sasha 6y ago
While I agree, we must always consider the impact of lockdown. This is what is missing to me in the current strategies. For example, how do the rare, and very significant, long-term health issues compare to the fairly prevalent mental health issues caused by lockdown, unemployment etc? I'm in no position to make that call, maybe lockdown is still the right answer. But we absolutely must do this analysis seriously, publicise the results and debate it widely.
jdminhbg 6y ago
> What if the virus causes substantial disease burden years to decades down the road? We can't know, and should take every precaution to prevent its spread. This is the precautionary principle selectively applied, and it’s what’s so wrong with the “lockdown” debate. What if lockdowns cause substantial health problems years to decades down the road? We can’t know that either. Acting like Covid is the only thing whose aftereffects might be worse than we can tell right now is ignorance.

by lima 6y ago

logicchains 6y ago

For example? I haven't seen a single paper showing such long-term consequences in healthy people are significantly more likely than from other viral infections. We'd especially expect to be seeing a large number of such cases in Sweden, should it be common, given they had no lockdown and a large number of infections.

lima 6y ago
It doesn't even have to be worse than post-viral syndrome caused by other severe viral infections for it to be a problem. There's little immunity to COVID-19 and it's highly contagious. This is like saying "COVID isn't worse than the flu" - even if it was true, having another flu-sized disease burden would already be bad, so it's a bit of a weird goalpost. That being said, there's a lot of literature describing post-covid symptomes and hypothesized mechanisms of action, like [1]. The virus has been around for less than a year, so a quantitative comparison with something we have studied for decades makes no sense. [1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320866/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320866/
- logicchains 6y ago
  >It doesn't even have to be worse than post-viral syndrome caused by other severe viral infections for it to be a problem. There's little immunity to COVID-19 and it's highly contagious. But it does make it highly inconsistent to adopt policies so extremely destructive to economic and mental health when the same wasn't done for other viruses with similar long-term effects.
  - lima 6y ago
    We have a chance at eradicating COVID-19, unlike other viruses that have been endemic for decades.
    - nradov 6y ago
      How would we eradicate a virus that has animal hosts? If the prevailing origin hypothesis is correct then the virus is presumably still circulating among horseshoe bats.
      - SomeoneFromCA 6y ago
        SARS-1 has been eradicated in humans;its precursor still probably is circulating among bats.
- nradov 6y ago
  That depends on what you mean by "little immunity". Many people appear to have some immunity based on prior exposure to similar coronaviruses. That won't prevent infection but tends to reduce disease severity. https://www.jci.org/articles/view/143380 https://www.jci.org/articles/view/143380
  - SomeoneFromCA 6y ago
    That "some immunity" is clearly insufficient, because people who actually got infected with Covid itself and then again with Covid, in many if not most cases have more severe symptoms. In fact, the scarce evidence suggests Covid might be a subject to Antibody Enhancement; that would mean that every next infection will get worse and worse. In any case, Coronaviruses have long be known to cause very short term immunity. Even more importantly, constant reinfection may debilitate the organism so much, that even a healthy person will eventually fall into the risk group.
    - nradov 6y ago
      That is unscientific fear mongering. As with any virus there will be some outliers. But in general there is no evidence of widespread antibody enhancement. Reinfections are rare, and most reinfected cases have minor symptoms. https://www.jimmunol.org/content/early/2020/09/03/jimmunol.2000839 https://www.jimmunol.org/content/early/2020/09/03/jimmunol.2...
      - SomeoneFromCA 6y ago
        > That is unscientific fear mongering. Please be careful with your words. What I said is clearly scientific, because it can be falsified. > most reinfected cases have minor symptoms. This is clearly not true. See https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30783-0/fulltext https://www.thelancet.com/journals/laninf/article/PIIS1473-3... The article you linked is extremely old, July 17, when there was no reinfections known. Besides, it is already known, that MERS and SARS both cause Antibody enhancement in animals, with paradoxical results - lower viral load, but severe damage https://en.wikipedia.org/wiki/Antibody-dependent_enhancement#Betacoronavirus https://en.wikipedia.org/wiki/Antibody-dependent_enhancement...
rndgermandude 6y ago
Of course you haven't seen papers describing long-term effects, simply because the virus hasn't been around long enough for any long-term conclusions. Therefore there are no studies saying there are NO long term effects either. There are clues that long term effects/permanent effects even in mild cases may exist. E.g. some six scuba divers with mild symptoms/asymptomatic progression were checked afterwards (Innsbruck, Austria) and had what looked like permanent lung damage. Then again, the sample size here is far too small and the cohort far to "exotic" to draw any conclusions yet.
- logicchains 6y ago
  > Of course you haven't seen papers describing long-term effects, simply because the virus hasn't been around long enough for any long-term conclusions. So you'd support locking down based on something for which we don't have any evidence yet?
  - rndgermandude 6y ago
    We have seen evidence that the virus kills. That alone warrants action. In the beginning, the general lockdowns were fine, simply because we didn't know enough yet to come up with better solutions, and frankly didn't really have the time to rectify this before taking any action. Now whether or not to lockdown and what to lockdown can be applied more fine-grained. Of course, everything is still in flux, and some decisions will turn out to be wrong later. The entire response is trial-by-error, for lack of alternatives In regards to potential long term effects, those should be a concern as well when making decisions, yes. Not the only concern of course, but not something to be ignored either.
    - logicchains 6y ago
      >That alone warrants action. In only warrants action if we're sure the negative consequences of the action won't be greater than the negative consequences of the viral deaths.
      - 6y ago
dx87 6y ago
I haven't seen any evidence, but there was a paper published recently that said that the lung damage dealt by covid is usually healed in ~3 months.

rndgermandude 6y ago

This is a very important point. We don't know enough about long term effects yet. In the same vein, we do not even know if herd immunity really is a thing here, and what thing it would be. E.g. the guy from Hong Kong who got reinfected (first time severe symptoms, second time no symptoms) was probably infectious the second time again. Herd immunity only works if the people who are immune are not infections and therefore cannot (re-(infect each other and more importantly the vulnerable population.

latchkey 6y ago
Herd immunity has never happened without a vaccine.
- ceejayoz 6y ago
  https://en.wikipedia.org/wiki/Herd_immunity https://en.wikipedia.org/wiki/Herd_immunity > Herd immunity was first recognized as a naturally occurring phenomenon in the 1930s when A. W. Hedrich published research on the epidemiology of measles in Baltimore, and took notice that after many children had become immune to measles, the number of new infections temporarily decreased, including among susceptible children. (To be clear, though, I don't think the herd immunity strategy is a good one for COVID-19.)
  - chillwaves 6y ago
    The concept makes no sense. As soon as a carrier hits a group that does not have widespread immunities, you will get a disease cluster. Not only do you have to have a huge portion of the population exposed to the disease, you need to maintain that proportion indefinitely AND will still deal with occasional flair ups among vulnerable communities. That's not what most people think when they hear the word "immunity".
    - deleted 6y ago
      [deleted]
  - 6y ago

rich_sasha 6y ago

While I agree, we must always consider the impact of lockdown. This is what is missing to me in the current strategies. For example, how do the rare, and very significant, long-term health issues compare to the fairly prevalent mental health issues caused by lockdown, unemployment etc? I'm in no position to make that call, maybe lockdown is still the right answer. But we absolutely must do this analysis seriously, publicise the results and debate it widely.

jdminhbg 6y ago

> What if the virus causes substantial disease burden years to decades down the road? We can't know, and should take every precaution to prevent its spread. This is the precautionary principle selectively applied, and it’s what’s so wrong with the “lockdown” debate. What if lockdowns cause substantial health problems years to decades down the road? We can’t know that either. Acting like Covid is the only thing whose aftereffects might be worse than we can tell right now is ignorance.