Sometimes, it can take a while to notice confusion

by masasin7 min read10th Apr 202111 comments

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Covid-19Postmortems & RetrospectivesRationality
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Epistemic status: Anecdote.

tl;dr: I had multiple opportunities to notice my confusion, but failed every time until I actually thought about it. Ended up testing positive for COVID, despite expectations.

Background

I started preparing for the pandemic in January 2020. At the time, I was living alone. In January, my visa lapsed, and I moved in with someone else while waiting for a new visa to finish processing. Among all the people I know around the world, I think I was the single most cautious. Nobody had seen my face directly for almost a year, I was always masked (and, since October, double masked), I washed fastidiously, and never spent too long near others.

With the move, though, I was exposed to far more risk, which was the other person's activities. She's an immunologist, and wears a mask when she goes out (e.g., to work). She also got vaccinated a while ago, along with all her friends.

Symptoms begin

On Wednesday 31 March, I woke up with a dry throat. I had forgotten the window open, and I sleep with my mouth open when I'm tired, so I wasn't very concerned. This had happened before.

The next day, the window had been closed, but the dryness hadn't gone away yet, which I found strange, but ignored. (Mistake 1.) I did a work meeting, then went to rent a car for the long weekend, which was supposed to be my first vacation since before pandemic. The AirBnB was also booked. And so we went. (Mistake 2.)

That night, when my roommate and I arrived at our destination (a basement apartment; no interaction with the host), it was very cold, and I started coughing. I thought it might just be a cold. (Mistake 3.) The coughing persisted until the next morning. My SO asked me to take it easy that day, and to do a PCR test when I could. I tried to assuage her fears, and brushed it off as nothing serious. (Mistake 4.) However, partially because she was worried, and partially because the cough was not nothing, I did curtail our plans for the first day.

Symptoms subside

By the next morning, the cough had mostly subsided, but my SO heard it as well, and again asked me to take a break, and asked me to take a PCR test ASAP. I partially agreed this time around, because it was unusual for a cough to last this long (at least for my body). We took the day off, I bought a thermometer, and we stayed within a couple of kilometres of the AirBnB.

Even when the call ended, I was still against doing a PCR test because COVID felt too unlikely. (Mistake 5.) This is the part where I thought about it for a few minutes by the clock, and decided to do it anyway. I did check to see if I could make an appointment (since walk-ins aren't allowed). Unfortunately, because it was a holiday, none of the assessment centres in town were open until after we got back (and wouldn't have been open the day before, either).

The final day of the vacation was 4 April, and I was rested enough that we managed to do a long-ish hike through a forest. We went back home, and I returned the car the next day. The good thing in retrospect was that we had minimal interactions with anyone else. Any store I went into, I was out within 2 minutes. I kept my mask on, and kept my distance.

The test

I finally managed to book an appointment for the 8th of April, which was also when my visa was accepted, Today, I was told that I had a positive result, and that I should self-isolate for ten days. Until that call, I still thought that it was extremely unlikely to be COVID, because of all the precautions I'd been taking, and because of the lack of COVID symptoms. The cough was the only thing I had, and it was mild. I still have my sense of smell, and I never had a fever or the headache or fatigue usually associated with COVID. (Mistake 6.)

A review of the mistakes

  1. I ignored a dry throat that lasted much longer than normal. That should have been an early indication of something going wrong.
  2. We decided to go on our trip. It was very nice, and we stayed in the car for the most part in order not to risk getting close to others. Should I have stayed home? I'm not sure the symptoms at the time would have been enough to cancel, even in retrospect. (The first item on my pre-drive checklist is to check if I'm tired or sick or fatigued etc, and I didn't realize I was.)
  3. It's common (e.g. in my family) to get coughing fits in basements. That being said, attributing to "a cold or something" should never have happened. I know that colds, like COVID, are transmitted from human to human. Opening a window on an upper floor shouldn't allow/cause transmission. And any situation which exposed me to a cold virus would have also been able to expose me to COVID. And the rate for COVID right now is very high. I'm not sure how high it would be compared to the common cold, but I wouldn't be surprised if it's in the same order of magnitude.
  4. Go fever again (we're on vacation, and I feel fine!), plus a cached thought that everything is okay. I did cancel a lot of our harder hikes and stops, which isn't too bad, but this was my last major chance for putting it together before I did.
  5. I was still against a PCR test, even though it was free. Part of it was not wanting to bother the medical staff/waste their time over something that was almost definitely not COVID. But then, what is true is already so, so why not try and find out. I find that I use the Litany of Gendlin much more than I do Tarski, though in this case, it should have come to mind as well. That being said, it did end up spurring me into trying to (unsuccessfully) book an appointment.
  6. I'm not sure if this was bottom line reasoning, motivated reasoning, or both. Even in retrospect, things didn't align with what I'd expect of COVID. I even biked to the assessment. But there were possible mitigating factors, which I'll discuss below. The immunologist in the house saying the same thing probably didn't help either.

A retrospective

Within the week before the dry throat first appeared, I had two trips out of the house to somewhere other than the grocery store below the building. Some possible vectors:

  • Seven days before symptoms appeared, I went to two shops trying to take pictures for my visa (had to remove my mask for about 30 seconds), and then sent them to the consulate for processing.
  • Four days before symptoms appeared, I picked up lunch from a shop. There was a customer eating there (mask off) while waiting for her food. I chose to wait outside, but had to go to where she was in order to grab the order.
  • Somehow getting it from my roommate (who is extremely careful, and who is vaccinated, along with her coworkers/friends). If she doesn't have a positive PCR result tomorrow, then we can rule that out. If she does, I might have still gotten it from her, or it could have been me giving it to her because we share the house, and shared a car for 12+ hours during the peak infectivity period assuming a standard response. She ended up getting a negative test result. Evidence for it not coming from her, and of weak infection and infectivity.
  • Any of a bunch of people in the building who refuse to wear masks, yet use the elevator and cross in front of the door.
  • Passing by many unmasked people on the street.
  • Possible bad ventilation in the building.

All of these vectors are consistent with a very low dose which I probably received. It was low enough that my body seems to have been able to handle it even without a fever, but damaging enough to cause coughing, so not quite an inoculation. Hopefully, that's enough immunity that I should be protected enough doing what I've been doing before. At the very least, I would be less worried about passing people on the street or entering e.g. the post office or government offices.

As for the trip back, it's on hold until I get a negative PCR test, because otherwise, I wouldn't be allowed to board the plane. Positives can continue for 3+ months, but given my (hopefully) low dose, I'd expect it to pass in 2-4 weeks instead.

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11 comments, sorted by Highlighting new comments since Today at 6:35 PM
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Elevators that don't have a way to ventilate themselves might be very risky. A few days ago I was thinking. Well isn't it smelly in here. Sometimes it smells like someone smoked. It's possible that the exhald coronavirus stays a while in the air in the elevator. 

I think reading this I update towards using them less reading this. 

Mistakes

  1. Not wearing a respirator
  2. Living with people that don't wear respirators
  3. Assuming that if you don't have symptoms, you weren't infected
  4. Assuming that you won't get long covid because you've had minimal symptoms

What is the best way to correct mistake 3 on your list?

Assume you're both infectious and vulnerable to infection.

I disagree with their #3. I've had a prior that I had an asymptomatic infection at less than the background rate of asymptomatic infections in the population in general. So, no symptoms would definitely not cause me to think I have been infected, unless I had more information (e.g., a test result). I certainly wouldn't act as if I was immune. At the same time, the probability that I had been infected without symptoms was high enough that I always treated myself as infectious, just in case.

Even being conservative, I think 5% would be a big overestimate. When I was living on my own, it was less than 1%. When I moved in with my sister (who only interacts with people who keep their distance and take the same precautions she does), it went up a bit, and then went down a bit when she got vaccinated, because even if she would have increased her risk-taking, she'd be less likely to get infected, and less likely to be infectious, and, if she was infectious, it would be unlikely that my symptoms would be severe because of virus load.

(In the end, she tested negative, so...)

As for their #4, my symptoms (i.e., the cough) are already gone, and I didn't notice a decrease in e.g. breath holding ability, energy levels, or anything like that. I think the no long covid for me is 80+%.

I understand the assumption of vulnerability. But how does one assume that one is an asymptomatic or pre-symptomatic carrier if the chance of that is less than 10% on any given day? By itself it doesn't seem rational because if you assume you are pre-symptomatic you have to do something about it. Like testing. Testing very often for no reason comprehensible to the outside world.

Until I get symptoms, the highest probability was that I hadn't gotten COVID yet. On the other hand, even if there was a 1% chance that I was infectious (able to spread COVID to others) on any given day, it's not high enough to warrant a test, which is uncomfortable, and expensive unless it was positive or I had a confirmed exposure. At the same time, it was high enough that e.g. my neighbours (80+ years old) or the person at the supermarket might get sick from it, and be hospitalized, not to mention the secondary effects, so I made sure to breathe slowly around people, and wear masks and keep my distance. Most of my communication ended up being gestures (and even then it was mostly "thank you!") instead of words.

In other words, 99% chance that I'm vulnerable, take precautions to avoid getting infected if I'm not infected already. 1% risk of preventably murdering someone else, take precautions to avoid that consequence just in case I am infected already.

You severely overestimate your chance of actually murdering someone. Lets go through the numbers. Lets be generous and assume a 10% chance that you are an asymptomatic carrier. If you are, you have no more than 50% chance of infecting someone even if you don't wear a mask, so lets say with mask properly worn that is reduced to 30%. Now you are already down to 3% chance of infecting any person you encounter. Now, for you 80+ year old neighbor the chance of actually dying from infection is around 5%. So multiply your 3% chance of infecting the neighbor by 5% chance of death and you get 0.15% chance of murdering a person of advanced age. You'd need to encounter 7 of them to get to 1% chance of murder. 

Ignoring the fact this is then contagious from the people you infect (regardless of age) and also the number of people encountered doesn't seem like the most helpful napkin numbers for strategy against a contagious illness.

I really appreciate this comment. I just want that good cautious people quit thinking themselves already guilty of manslaughter let alone murder. Just continue to be good cautious people. 

Infecting a reckless superspreader who will give it to everyone he meets did not occur to me.

 Paraphrasing a famous writer, the evil may triumph but not through me.

Which is still a huge probability. That being said, the precautions to prevent murdering others are exactly the same precautions that would reduce my probability of getting sick in the first place.

Didn't really have much of a choice about #2. I was living alone, and didn't want to househunt in the middle of a pandemic. Ended up living rent-free.