8 ms·

> Long-covid is an increase in prevalence, and also does seem to present some unique symptoms. Is it though? That data is exactly what the commenter above is a

> Long-covid is an increase in prevalence, and also does seem to present some unique symptoms. Is it though? That data is exactly what the commenter above is asking for, and I've also not seen any data comparing prevalence of long covid to long-lasting side effects of other diseases. > I feel like it might be more that we weren’t concerned I’m about post-viral symptoms enough in the past than that we are overly concerned with them now. ME and Chronic Fatigue and similar can be life changing (in a bad way) Being in a car crash can be life changing in a bad way (if not life ending) and yet most of us choose to get in cars on a regular basis. My point is that the severity alone is not useful: you can only make an informed decision knowing both severity and the probability of a particular outcome. Nowadays we are constantly bombarded with things fighting for our attention. Everyone is "raising awareness" for something, but as humans we are very limited in the things we can be constantly vigilent about. The only rational response is to prioritise the things that most warrant consideration, and ignore everything else. Long covid is a particularly pointless thing to be aware of, because it's not like any sane person chooses to get covid, so the risk calculation is already two steps divorced from the actions we can actually take to avoid it.

nicoburns 5y ago
Even if prevalence per case is the same as flu; covid would still at least double the overall societal prevalence due to it being in addition to flu. Regarding awareness, I meant more societal awareness such that we might direct funding towards it as we have done with cancers.
- __blockcipher__ 5y ago
  > Even if prevalence per case is the same as flu; covid would still at least double the overall societal prevalence due to it being in addition to flu. This sounds true if you don’t think long and hard about it, but actually the mechanics of viral spread are not quite that simple. For example there’s the phenomenom of interferon-mediated “viral interference” where infection with virus X wards off infection from virus Y (say, the influenza strain de jeur), which is thought to be attributable to acute upregulation of the innate immune system. So, it’s not always quite so simple.
  - throwanem 5y ago
    Pedant's note: the phrase is "du jour", French for "of the day".
- sokoloff 5y ago
  I sure hope that medical research funding decisions are driven by medical experts looking at data, not by any level of societal awareness (positive or negative).
  - nicoburns 5y ago
    A lot of medical funding is from charities like Cancer Research which get their money from the general public. Public awareness plays a big part in which of these charities get funding.
ihodes 5y ago
In case you're curious about Long Covid vs Long Flu https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003773#sec016 https://journals.plos.org/plosmedicine/article?id=10.1371/jo...
- logicalmonster 5y ago
  Thank you. Analyzing this kind of data is the kind of thing I'm talking about to try and get to grips with the risk-management calculation involved. But even if there's no medical flaws with this study, it doesn't necessarily answer the question to me because this overall point might really be more of a psychological question mark than a medical question. If you tell people they had Covid, some portion of people who have been stressed out by the media focus may panic and mentally exaggerate post-viral symptoms based solely on the fear they feel with Covid over the flu, even if the actual medical conditions they experienced would not cause them to panic if they were told they had the flu. I think a study that would actually illuminate here is to tell half the patients who had Covid that they actually had the flu, and telling half the patients that had the flu that they actually had Covid, and then doing a comparison on how peoples' perception of which illness they had impacted how frequently they reported symptoms. (I don't know, but I doubt that would be considered medically ethical though.) My guess is that the media focus on Covid is impacting how people choose to go to the doctor regarding post-viral symptoms and there's no real way to measure this without some unusual experimental design.
  - svnt 5y ago
    You’re not wrong, I don’t know why you’re being voted down. You’d need a double-blind study for these results to be reliable.
    - nicoburns 5y ago
      I think the question is: in the absence of solid experimental evidence why would you assume that the effect is psychological when post-viral effects are well documented across multiple viruses, and have been confirmed by clinical diagnoses by Doctors in thousands of covid cases. Being skeptical until proven unequivocally is a good approach to scientific enquiry, but it is not good public policy where we must take decisions and act despite uncertainty.
alfor 5y ago
The major problem we have is that covid affect many organs including the heart. This lead to cell death and regeneration all over, but with the aging of the organs affected. In the case of the heart, there is almost no regeneration, mostly scarification. That mean the even young persons not feeling bad from covid could lose years of heart health. The same apply to the mRNA vaccine if it is injected in a vein by error and goes to the heart. Omicron seems to stay more in upper respiratory and thus being of less concern. There is a bunch of things people can do to increase their chances of it being mild: https://www.youtube.com/watch?v=2Zzo4SJopcY https://www.youtube.com/watch?v=2Zzo4SJopcY https://www.youtube.com/watch?v=vN30emwcNS4 https://www.youtube.com/watch?v=vN30emwcNS4
- peter422 5y ago
  There is no strong evidence that an mRNA vaccine going into a vein causes any long term damage to anything. And when the vaccine starts in your arm it eventually gets to the heart anyways.
  - nradov 5y ago
    We don't have strong evidence, but one animal study found that injecting the vaccine into a vein increased the risk of heart damage. https://pubmed.ncbi.nlm.nih.gov/34406358/ https://pubmed.ncbi.nlm.nih.gov/34406358/
    - logicalmonster 5y ago
      This isn't scientific evidence, but a possible relevant anecdote that potentially explains some of this. I had a very close friend working some kind of support role at one of the big Covid injection sites in a big US city. I was told that at least some portion of the many nurses hired to do the vaccine injections appeared to have very little experience with that type of injection and weren't following the set procedures setup by the head doctor of the center. Because of the rushed nature of setting up the vaccination center, the hiring was rushed and the training was limited and the quality control and supervision was pretty bad. I have a feeling that at least some of the reports of vaccine injuries may have just been caused by improper injection technique due to the rushed process.
kelnos 5y ago
> Long covid is a particularly pointless thing to be aware of, because it's not like any sane person chooses to get covid, so the risk calculation is already two steps divorced from the actions we can actually take to avoid it. I disagree. While I certainly would prefer to not get COVID, I'm vaccinated and boosted, so if I do get it, my (primary) symptoms will likely be mild or nonexistent. So from the perspective of primary symptoms, I am at the point where I want to just live my life, not have restrictions, and if I get it... ok, well, I get it, no big deal. Essentially I will treat it like a cold or the flu: I would prefer not to get it, but I'm not going to change my day-to-day life in order to avoid it. But the possibility of long COVID changes that. If long COVID is both prevalent and severe, I would choose to avoid crowds, stay home more often, continue masking and social distancing even when/where my local health guidelines don't require it, etc.
dTal 5y ago
>the risk calculation is already two steps divorced from the actions we can actually take to avoid it. This is wrong. Many of us are in a position to avoid getting covid with high probability, at the heavy cost of a complete sacrifice of an offline social life. Long covid heavily affects the expected QALY loss calculation, so it's of enormous material interest. >it's not like any sane person chooses to get covid I know lots of insane people then. They say things like "Omicron is mild so I decided it was a good time to get it" - by which they meant they would stop paying the cost to avoid it (and predictably contracted it immediately). They might have decided differently if it turns out that long covid is a) common and b) life-wrecking.

nicoburns 5y ago

Even if prevalence per case is the same as flu; covid would still at least double the overall societal prevalence due to it being in addition to flu. Regarding awareness, I meant more societal awareness such that we might direct funding towards it as we have done with cancers.

__blockcipher__ 5y ago
> Even if prevalence per case is the same as flu; covid would still at least double the overall societal prevalence due to it being in addition to flu. This sounds true if you don’t think long and hard about it, but actually the mechanics of viral spread are not quite that simple. For example there’s the phenomenom of interferon-mediated “viral interference” where infection with virus X wards off infection from virus Y (say, the influenza strain de jeur), which is thought to be attributable to acute upregulation of the innate immune system. So, it’s not always quite so simple.
- throwanem 5y ago
  Pedant's note: the phrase is "du jour", French for "of the day".
sokoloff 5y ago
I sure hope that medical research funding decisions are driven by medical experts looking at data, not by any level of societal awareness (positive or negative).
- nicoburns 5y ago
  A lot of medical funding is from charities like Cancer Research which get their money from the general public. Public awareness plays a big part in which of these charities get funding.

ihodes 5y ago

In case you're curious about Long Covid vs Long Flu https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003773#sec016 https://journals.plos.org/plosmedicine/article?id=10.1371/jo...

logicalmonster 5y ago
Thank you. Analyzing this kind of data is the kind of thing I'm talking about to try and get to grips with the risk-management calculation involved. But even if there's no medical flaws with this study, it doesn't necessarily answer the question to me because this overall point might really be more of a psychological question mark than a medical question. If you tell people they had Covid, some portion of people who have been stressed out by the media focus may panic and mentally exaggerate post-viral symptoms based solely on the fear they feel with Covid over the flu, even if the actual medical conditions they experienced would not cause them to panic if they were told they had the flu. I think a study that would actually illuminate here is to tell half the patients who had Covid that they actually had the flu, and telling half the patients that had the flu that they actually had Covid, and then doing a comparison on how peoples' perception of which illness they had impacted how frequently they reported symptoms. (I don't know, but I doubt that would be considered medically ethical though.) My guess is that the media focus on Covid is impacting how people choose to go to the doctor regarding post-viral symptoms and there's no real way to measure this without some unusual experimental design.
- svnt 5y ago
  You’re not wrong, I don’t know why you’re being voted down. You’d need a double-blind study for these results to be reliable.
  - nicoburns 5y ago
    I think the question is: in the absence of solid experimental evidence why would you assume that the effect is psychological when post-viral effects are well documented across multiple viruses, and have been confirmed by clinical diagnoses by Doctors in thousands of covid cases. Being skeptical until proven unequivocally is a good approach to scientific enquiry, but it is not good public policy where we must take decisions and act despite uncertainty.

alfor 5y ago

The major problem we have is that covid affect many organs including the heart. This lead to cell death and regeneration all over, but with the aging of the organs affected. In the case of the heart, there is almost no regeneration, mostly scarification. That mean the even young persons not feeling bad from covid could lose years of heart health. The same apply to the mRNA vaccine if it is injected in a vein by error and goes to the heart. Omicron seems to stay more in upper respiratory and thus being of less concern. There is a bunch of things people can do to increase their chances of it being mild: https://www.youtube.com/watch?v=2Zzo4SJopcY https://www.youtube.com/watch?v=2Zzo4SJopcY https://www.youtube.com/watch?v=vN30emwcNS4 https://www.youtube.com/watch?v=vN30emwcNS4

peter422 5y ago
There is no strong evidence that an mRNA vaccine going into a vein causes any long term damage to anything. And when the vaccine starts in your arm it eventually gets to the heart anyways.
- nradov 5y ago
  We don't have strong evidence, but one animal study found that injecting the vaccine into a vein increased the risk of heart damage. https://pubmed.ncbi.nlm.nih.gov/34406358/ https://pubmed.ncbi.nlm.nih.gov/34406358/
  - logicalmonster 5y ago
    This isn't scientific evidence, but a possible relevant anecdote that potentially explains some of this. I had a very close friend working some kind of support role at one of the big Covid injection sites in a big US city. I was told that at least some portion of the many nurses hired to do the vaccine injections appeared to have very little experience with that type of injection and weren't following the set procedures setup by the head doctor of the center. Because of the rushed nature of setting up the vaccination center, the hiring was rushed and the training was limited and the quality control and supervision was pretty bad. I have a feeling that at least some of the reports of vaccine injuries may have just been caused by improper injection technique due to the rushed process.

kelnos 5y ago

> Long covid is a particularly pointless thing to be aware of, because it's not like any sane person chooses to get covid, so the risk calculation is already two steps divorced from the actions we can actually take to avoid it. I disagree. While I certainly would prefer to not get COVID, I'm vaccinated and boosted, so if I do get it, my (primary) symptoms will likely be mild or nonexistent. So from the perspective of primary symptoms, I am at the point where I want to just live my life, not have restrictions, and if I get it... ok, well, I get it, no big deal. Essentially I will treat it like a cold or the flu: I would prefer not to get it, but I'm not going to change my day-to-day life in order to avoid it. But the possibility of long COVID changes that. If long COVID is both prevalent and severe, I would choose to avoid crowds, stay home more often, continue masking and social distancing even when/where my local health guidelines don't require it, etc.

dTal 5y ago

>the risk calculation is already two steps divorced from the actions we can actually take to avoid it. This is wrong. Many of us are in a position to avoid getting covid with high probability, at the heavy cost of a complete sacrifice of an offline social life. Long covid heavily affects the expected QALY loss calculation, so it's of enormous material interest. >it's not like any sane person chooses to get covid I know lots of insane people then. They say things like "Omicron is mild so I decided it was a good time to get it" - by which they meant they would stop paying the cost to avoid it (and predictably contracted it immediately). They might have decided differently if it turns out that long covid is a) common and b) life-wrecking.