5 ms·

Just because a percentage of the population is "non vulnerable" doesn't mean getting Covid is harmless. There are measurable impacts on cognitive ability: https

Just because a percentage of the population is "non vulnerable" doesn't mean getting Covid is harmless. There are measurable impacts on cognitive ability: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00324-2/fulltext https://www.thelancet.com/journals/eclinm/article/PIIS2589-5...

timr 5y ago
This is self-reported data. Self-reported data is garbage. There's simply too much risk of bias. To illustrate the point, a large study out of France found that the only "long covid" symptom that actually correlates with confirmed illness was loss of smell. But there were multiple "long covid" symptoms that correlated with self-reported illness. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2785832 https://jamanetwork.com/journals/jamainternalmedicine/fullar... We have to be careful to separate populations by severity of disease, hospitalization, etc., but "long covid" is at least partly psychosomatic.
- halpert 5y ago
  The data was from a cognitive assessment, not self-reported. There were some self-reported components, like do you have depression, anxiety, etc. But the measurement of cognition was not self reported.
  - timr 5y ago
    The question of whether or not the respondent actually had Covid-19 was self-reported: > People who indicated that they had suspected having COVID-19 were presented further questions including whether they had breathing difficulties, what happened as a consequence of their breathing difficulties, and whether there had been positive confirmation via a biological test (Table S1). Also, this was a web-based test, conducted at home, where the participants self-selected into the survey. There is no universe in which this should be considered unbiased data.
    - halpert 5y ago
      Sure, the data isn't perfect, but data rarely is. You're also assuming that, because the data isn't perfect, that the effect measured would go away with better data. I actually think the opposite would happen. There is a correlation between the severity of self-reported sickness and cognitive decline. Those who ended up in a hospital show the most severe signs of cognitive decline. If they were actually in a hospital, they likely know for sure whether or not they were positive, compared to those who recovered at home and only suspected they had covid. There have also been visible changes to the brain when looking at MRIs before / after a person has covid.
    - disgruntledphd2 5y ago
      > Also, this was a web-based test, conducted at home, where the participants self-selected into the survey. There is no universe in which this should be considered unbiased data. You know, I was kinda in agreement with you until you said this. Please read the paper (which had absolutely no information about the Covid stuff in the docs or signup forms.) Like, one could argue that the major selection factor was whether or not the subject watched TV, which would be fair but not germane to this particular argument. In fact, the Covid stuff was added after the study had started, and they did a follow-up survey in December 2020 and of the people who reported later Covid, they were indistinguishable from the overall population. Like, I agree that this would have been much much better if they'd had access to the NHS data and could have joined with the cognitive test data and I personally am not convinced of their modelling approaches, but there's a tradeoff between enough data to estimate important effects, and the accuracy of said data, especially when it comes to medical conditions. Is your argument that people would preferentially report Covid-19 and throw the intelligence test? Or something else? Like, this paper has a bunch of problems, but the main effect is not that surprising. The real question is how generalisable the findings are to other viral infections. That's something that hopefully will get investigated more over time.
      - timr 5y ago
        > In fact, the Covid stuff was added after the study had started, Not relevant to my point. They didn't verify infection. The people being surveyed knew that they were being surveyed about Covid-related things. Also, even if you separate the intelligence-test part from the covid-results part by time, now you have two problems: self selection bias for the intelligence part (i.e. people who are more likely to be worried about cognitive decline take the time to participate in tests of cognitive skills), and for the covid test part (i.e. people who are worried about Covid will be more likely to respond to the Covid test part). There are so many sources of bias here, it's impossible to de-combobulate them all. It's simply a mess. > and they did a follow-up survey in December 2020 and of the people who reported later Covid, they were indistinguishable from the overall population. You can attempt to control for bias by doing this sort of thing, but it's not enough. Just because the sample population looked like the control population on summary parameters B, C and Z doesn't mean that they weren't biased on the primary endpoint of the study -- and remember. the participants knew they were being surveyed related to Covid (because again, they were being asked). Also, the procedure they used also leaves open the possibility that (for example) study participants could have self-selected by finding the survey from "long covid" forums, and the like. We can't rule it out. > Is your argument that people would preferentially report Covid-19 and throw the intelligence test? Or something else? I have a number of problems with this study (and I've enumerated a few) but most of them fall under the category of "self-reported data is garbage", which is why I led with that. As the French CONSTANCES study (a much better study) I linked showed: when people are allowed to self-report even just their covid status, they mess up the results. A better (but still not good) study of this sort would at least take the intelligence test and cross-check it against testing results to get an objective result on one of the parameters of interest. But there would still be too many sources of bias to enumerate -- open-ended, web-based surveys like "The Great British Intelligence Test" are simply garbage, and should not be taken seriously by anyone, anywhere.
  - deleted 5y ago
    [deleted]
okeuro49 5y ago
The sole rationale for mandatory health measures, is to prevent healthcare systems from being overwhelmed. Other than that, when Covid becomes endemic, vaccinations should be offered to those who wants them, as has always been the case with winter flu.
- halpert 5y ago
  Is that really the sole rationale? What about polio vaccination? I believe that vaccine is mandated in schools to protect children, not to keep healthcare systems from becoming overwhelmed.
  - heurisko 5y ago
    I would clarify the sole rationale for the Covid situation. Covid is not particularly dangerous to the young and healthy. The danger is that the small percentage of people who become seriously ill is still enough to overwhelm a health system, as it is so contageous.
    - halpert 5y ago
      You’re assuming that it’s the only rationale for the Covid situation, but whether or not that is true is exactly what we’re discussing :)
      - okeuro49 5y ago
        I'm referring to the situation in the UK. The sole rationale for restrictions and vaccinations has been to stop our healthcare system from being overwhelmed. That's the way it was presented by the government to the public. It wasn't the rationale, for example, to wait for a vaccine to reduce the chances of some individuals from getting longer term symptoms of the disease, given there are any proven. If our healthcare system was somehow able to handle every case, there would have been no rationale for restrictions.
vmception 5y ago
All major markets are completely open, the boosters lack the same veracity as initial vaccination and infection. We are going to learn to live with that. The goal is to keep ICUs available for general emergencies. Stanford, of course, is just a private institution, but is foreshadowing the predilections of influential policy makers.
- thepasswordis 5y ago
  >The goal is to keep ICUs available for general emergencies. Can anybody back this up with actual data? Looking at my own state's dashboard doesn't seem to suggest that there has ever been even a remote risk of ICUs being overwhelmed. It also doesn't really stand up to basic scrutiny: hospitals were recently firing medical staff who refused vaccines. That doesn't seem like the behavior of a system which is on the brink of being overwhelmed.
  - alphabettsy 5y ago
    Are you looking at the numbers as a whole or county by county? If 800/1000 beds are available in the state and 19/20 in your county that’s a problem. That’s ignoring that few systems are designed to operate at capacity for any extended period of time. Maybe the analysis should be above the level of basic scrutiny.
  - octopoc 5y ago
    I have family members who work in a hospital in the US and they said that their hospital is overwhelmed with asymptomatic individuals saying "I think I might have COVID!" and panicking. The correct response to that is to refer these people to their primary care physician. But yeah ICUs have never been close to being overwhelmed by COVID at this hospital.
ekianjo 5y ago
> There are measurable impacts on cognitive ability: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5 https://www.thelancet.com/journals/eclinm/article/PIIS2589-5... Good luck driving anything with this garbage paper. Not all published literature is reliable. (Remember the Lancet last year?)
- halpert 5y ago
  Do you have a specific criticism of this study?
- disgruntledphd2 5y ago
  What's your justification for not rating this paper? Having just read the Methods and Results sections, I see a reasonably well conducted study, which does suffer from some of the characteristic flaws of quantitative social sciences (an over-reliance on normality assumptions, a fetish for normality and sphericity tests and a somewhat credulous notion of analysing the residuals, and a hatred for visual displays) but the work itself is pretty solid (speaking as someone with actual domain experience in this field). But I'd love to hear more about your problems with the paper, in the hope that I will learn something.

timr 5y ago

This is self-reported data. Self-reported data is garbage. There's simply too much risk of bias. To illustrate the point, a large study out of France found that the only "long covid" symptom that actually correlates with confirmed illness was loss of smell. But there were multiple "long covid" symptoms that correlated with self-reported illness. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2785832 https://jamanetwork.com/journals/jamainternalmedicine/fullar... We have to be careful to separate populations by severity of disease, hospitalization, etc., but "long covid" is at least partly psychosomatic.

halpert 5y ago
The data was from a cognitive assessment, not self-reported. There were some self-reported components, like do you have depression, anxiety, etc. But the measurement of cognition was not self reported.
- timr 5y ago
  The question of whether or not the respondent actually had Covid-19 was self-reported: > People who indicated that they had suspected having COVID-19 were presented further questions including whether they had breathing difficulties, what happened as a consequence of their breathing difficulties, and whether there had been positive confirmation via a biological test (Table S1). Also, this was a web-based test, conducted at home, where the participants self-selected into the survey. There is no universe in which this should be considered unbiased data.
  - halpert 5y ago
    Sure, the data isn't perfect, but data rarely is. You're also assuming that, because the data isn't perfect, that the effect measured would go away with better data. I actually think the opposite would happen. There is a correlation between the severity of self-reported sickness and cognitive decline. Those who ended up in a hospital show the most severe signs of cognitive decline. If they were actually in a hospital, they likely know for sure whether or not they were positive, compared to those who recovered at home and only suspected they had covid. There have also been visible changes to the brain when looking at MRIs before / after a person has covid.
  - disgruntledphd2 5y ago
    > Also, this was a web-based test, conducted at home, where the participants self-selected into the survey. There is no universe in which this should be considered unbiased data. You know, I was kinda in agreement with you until you said this. Please read the paper (which had absolutely no information about the Covid stuff in the docs or signup forms.) Like, one could argue that the major selection factor was whether or not the subject watched TV, which would be fair but not germane to this particular argument. In fact, the Covid stuff was added after the study had started, and they did a follow-up survey in December 2020 and of the people who reported later Covid, they were indistinguishable from the overall population. Like, I agree that this would have been much much better if they'd had access to the NHS data and could have joined with the cognitive test data and I personally am not convinced of their modelling approaches, but there's a tradeoff between enough data to estimate important effects, and the accuracy of said data, especially when it comes to medical conditions. Is your argument that people would preferentially report Covid-19 and throw the intelligence test? Or something else? Like, this paper has a bunch of problems, but the main effect is not that surprising. The real question is how generalisable the findings are to other viral infections. That's something that hopefully will get investigated more over time.
    - timr 5y ago
      > In fact, the Covid stuff was added after the study had started, Not relevant to my point. They didn't verify infection. The people being surveyed knew that they were being surveyed about Covid-related things. Also, even if you separate the intelligence-test part from the covid-results part by time, now you have two problems: self selection bias for the intelligence part (i.e. people who are more likely to be worried about cognitive decline take the time to participate in tests of cognitive skills), and for the covid test part (i.e. people who are worried about Covid will be more likely to respond to the Covid test part). There are so many sources of bias here, it's impossible to de-combobulate them all. It's simply a mess. > and they did a follow-up survey in December 2020 and of the people who reported later Covid, they were indistinguishable from the overall population. You can attempt to control for bias by doing this sort of thing, but it's not enough. Just because the sample population looked like the control population on summary parameters B, C and Z doesn't mean that they weren't biased on the primary endpoint of the study -- and remember. the participants knew they were being surveyed related to Covid (because again, they were being asked). Also, the procedure they used also leaves open the possibility that (for example) study participants could have self-selected by finding the survey from "long covid" forums, and the like. We can't rule it out. > Is your argument that people would preferentially report Covid-19 and throw the intelligence test? Or something else? I have a number of problems with this study (and I've enumerated a few) but most of them fall under the category of "self-reported data is garbage", which is why I led with that. As the French CONSTANCES study (a much better study) I linked showed: when people are allowed to self-report even just their covid status, they mess up the results. A better (but still not good) study of this sort would at least take the intelligence test and cross-check it against testing results to get an objective result on one of the parameters of interest. But there would still be too many sources of bias to enumerate -- open-ended, web-based surveys like "The Great British Intelligence Test" are simply garbage, and should not be taken seriously by anyone, anywhere.
- deleted 5y ago
  [deleted]

okeuro49 5y ago

The sole rationale for mandatory health measures, is to prevent healthcare systems from being overwhelmed. Other than that, when Covid becomes endemic, vaccinations should be offered to those who wants them, as has always been the case with winter flu.

halpert 5y ago
Is that really the sole rationale? What about polio vaccination? I believe that vaccine is mandated in schools to protect children, not to keep healthcare systems from becoming overwhelmed.
- heurisko 5y ago
  I would clarify the sole rationale for the Covid situation. Covid is not particularly dangerous to the young and healthy. The danger is that the small percentage of people who become seriously ill is still enough to overwhelm a health system, as it is so contageous.
  - halpert 5y ago
    You’re assuming that it’s the only rationale for the Covid situation, but whether or not that is true is exactly what we’re discussing :)
    - okeuro49 5y ago
      I'm referring to the situation in the UK. The sole rationale for restrictions and vaccinations has been to stop our healthcare system from being overwhelmed. That's the way it was presented by the government to the public. It wasn't the rationale, for example, to wait for a vaccine to reduce the chances of some individuals from getting longer term symptoms of the disease, given there are any proven. If our healthcare system was somehow able to handle every case, there would have been no rationale for restrictions.

vmception 5y ago

All major markets are completely open, the boosters lack the same veracity as initial vaccination and infection. We are going to learn to live with that. The goal is to keep ICUs available for general emergencies. Stanford, of course, is just a private institution, but is foreshadowing the predilections of influential policy makers.

thepasswordis 5y ago
>The goal is to keep ICUs available for general emergencies. Can anybody back this up with actual data? Looking at my own state's dashboard doesn't seem to suggest that there has ever been even a remote risk of ICUs being overwhelmed. It also doesn't really stand up to basic scrutiny: hospitals were recently firing medical staff who refused vaccines. That doesn't seem like the behavior of a system which is on the brink of being overwhelmed.
- alphabettsy 5y ago
  Are you looking at the numbers as a whole or county by county? If 800/1000 beds are available in the state and 19/20 in your county that’s a problem. That’s ignoring that few systems are designed to operate at capacity for any extended period of time. Maybe the analysis should be above the level of basic scrutiny.
- octopoc 5y ago
  I have family members who work in a hospital in the US and they said that their hospital is overwhelmed with asymptomatic individuals saying "I think I might have COVID!" and panicking. The correct response to that is to refer these people to their primary care physician. But yeah ICUs have never been close to being overwhelmed by COVID at this hospital.

ekianjo 5y ago

> There are measurable impacts on cognitive ability: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5 https://www.thelancet.com/journals/eclinm/article/PIIS2589-5... Good luck driving anything with this garbage paper. Not all published literature is reliable. (Remember the Lancet last year?)

halpert 5y ago
Do you have a specific criticism of this study?
disgruntledphd2 5y ago
What's your justification for not rating this paper? Having just read the Methods and Results sections, I see a reasonably well conducted study, which does suffer from some of the characteristic flaws of quantitative social sciences (an over-reliance on normality assumptions, a fetish for normality and sphericity tests and a somewhat credulous notion of analysing the residuals, and a hatred for visual displays) but the work itself is pretty solid (speaking as someone with actual domain experience in this field). But I'd love to hear more about your problems with the paper, in the hope that I will learn something.