Thank you so much for writing this. I've had a lot of the same questions myself, and I really wanted to see someone's Fermi estimates on them. This is exactly the kind of thing I was hoping to see.

I appreciate you describing brain fog as psychological torment.

I think most severe/life-disrupting cases of long COVID are indistinguishable from ME/CFS. (I think it would be correct to say long COVID "causes" ME/CFS.) As someone living with ME/CFS: yes, the cognitive dysfunction is torture. And pushing to do stuff anyway just makes things worse -- this is called post-exertional malaise. 

The comparison to sleep deprivation is good, but I'll note that the brain fog I regularly experience due to ME/CFS is much worse than any sleep deprivation I had ever experienced in my life beforehand.

The cognitive dysfunction itself is awful. And the way it crushes your dreams is heartbreaking. Say goodbye to your career and all your intellectual interests. 

(I mean, say goodbye to your interests in general. Your physical stamina gets wrecked too. I rarely have the physical stamina to cook simple meals without post-exertional malaise.)

The social isolation stemming from the mental fatigue is threefold:

1) I feel stupid when talking to my friends, because I kind of *am* stupid now. Especially in the context of real-time conversations. My memory and processing speed is not good.

2) When I try calling friends anyway, I am punished by post-exertional malaise afterwards. e.g. I spend the following day very uncomfortable and unable to function well enough to even distract myself. In this state, even watching simple TV can be uncomfortably exhausting.

3) My healthy friends just don't understand what it's like to be going through such a horrible illness. I feel boring. They don't know what to say. It works out to be very alienating and bad for mental health.

On top of all that, so many people don't believe this illness is "real" in some sense. They think it's just laziness, or aging, or psychological. (FWIW, my illness started at 23, and I saw multiple psychologists who concluded there was no plausible psychological basis for my illness.)

Imagine being psychologically tortured, socially isolated, and gaslit by a ton of people arguing that you aren't even sick. Potentially with no light at the end of the tunnel. It's extremely upsetting.

Lots of healthy people argue that lockdowns are bad for their mental health. I'd argue that ME/CFS is orders of magnitude worse -- even in my case, which is relatively mild. Up to you to decide if the risk is worth it in your case.

I've skimmed a lot of long COVID prevalence studies, and unfortunately, they often have huge sample biases and don't ask the right questions to track ME/CFS incidence. Overall, I agree with Scott's range of "a few tenths of a percent to a few percent" as the risk of really bad long COVID symptoms.

Sounds like we feel similarly about a lot of this stuff. For a few years now, I've been trying to keep my phone notifications very low.  The devices I generally use for reading/writing do not get any notifications.

Despite these ideas mostly not being new to me, I got value from this post for two reasons:

1. This validates my own experience. It moves me away from believing "I am personally easily distracted, so I keep distractions low" and towards believing "maybe a lot of people are perpetually semi-distracted by their notifications." Although I'm not sure how big of an update to make there.

2. I'm glad you described the intellectual mosh pit thing. My feed is full of interesting, engaging stuff too. I think I experience approximately the same effect you're experiencing from that. I'll have to think about whether I want to do anything about this. Especially since I frequently check Facebook when I'm feeling low-energy.

(Side note: I wrote this comment while my partner was finishing up a phone call. I found myself pretty distracted by the feeling that they were going to enter the room and talk to me at any moment. Even if I was just going to have to say "give me 10 minutes alone, please," it feels distracting to anticipate that interruption. Hmm.)

Thanks for sharing!

Personally, I don't really blame you or think less of you for this screwup. I never got the impression that you are the sort of person who should be sent confidential book review drafts. Maybe you'd disagree, but that seems like a misunderstanding of your role to me.

It seemed clear to me that you made yourself available to confidential reports regarding conflict, abuse, and community health. Not disagreements with a published book. It makes sense that you didn't have a habit of mentally flagging those emails as confidential.

Regardless, I trust that you've been more careful since then, and I appreciate how clearly you own up to this mistake.

I want to offer my +1 that I strongly believe Julia's trustworthy for reports regarding Leverage.