(Aspiring) Existential risk researcher | President Effective Altruism Groningen

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Except that herd immunity isn't really a (permanent) thing; only temporary

I had not seen it, because I don't read this form these days. I can't reply in too much detail but here are some points:

I think it's a decent attempt, but a little biased towards the "statistically clever" estimate. I do agree that many studies are pretty done. However, I've seen good ones that include controls, confirm infection via PCR, are large, and have pre pandemic health data. This was in a Dutch presentation of a data set though, and not clearly reported for some reason. (This is the project, but their data is not publicly available:

It is really difficult to get a proper control group, because both PCR tests and antibody tests have significant false negative rates.

Furthermore, the Zvi asserts that self reports lead to an overestimate because they are inaccurate. I agree that self reports are inaccurate, but there will definitely be people with long COVID that think it's something else (e.g. burnout), so this can really go both ways.

In addition, we have biological data with a control group and prepandemic data: There were many significant differences in the brain scans of these groups. I can't do the digging to translate those data into frequency estimates though.

I also think that for outsiders, long COVID symptoms sound vague: fatigue, brain fog, etc. In fact, there's a lot of clear symptoms, such as orthostatic intolerance, post exertion al symptom exacerbation, heart palpitations, muscle tremors, oxygen saturation drops.

Lastly, I think we should be careful to assess future risk based on past risk: variants change, vaccine protection changes, and as I write above, there's some initial data suggesting reinfections are worse due to a weakened immune system.

Yes, vaccine injury is actually rather common - I've seen a lot of very credible case reports reporting either initiation of symptoms since vaccine (after having been infected), or more often worsening of symptoms. Top long COVID researchers also believe these.

I don't think the data for keto is that strong. Plenty of people with long COVID are trying it with not amazing results.

The 15% is an upper estimate of people estimating 'some loss' of health, so not everyone would be severely disabled.

Unfortunately, the data isn't great, and I can't produce a robust estimate right now

Uhm, no? I'm quoting you on the middle category, which overlaps with the long category.

Also, there's no need to speculate, because there have been studies linking severity and viral load to increased risk of long COVID.

You have far more faith in the rationality of government decision making during novel crises than I do.

Healthcare workers can barely or often not at all with with long covid.

Lowering infection rates, remaining able to work, and not needing to make high demands on the healthcare system seems much better for the economy. This is not an infohazard at all.

Awesome in depth response! Yes, I was hoping this post to serve as an initial alarm bell to look further into, rather than being definitive advice based on a comprehensive literature review.

I can't respond to everything, at least not at once, but here's some:

  • categories of 'at least 12 weeks' and 'at least 1 year' do overlap, right?
  • I think the different waves may have had different underreporting factors, with least underreporting during Delta, so we can't take those rates at face value, and I prefer using estimated cases whenever possible

See figure 2 of this large scale survey:

"As a proportion of the UK population, prevalence of self-reported long COVID was greatest in people aged 35 to 69 years, females, people living in more deprived areas, those working in health or social care, and those with another activity-limiting health condition or disability"

No, these problems are most probably cause by a lack of oxygen getting through to tissues. There's a large amount of patients reporting these severe symptoms in patients groups, and they're not elderly.

It honestly feels to me like you really want to believe long COVID isn't a big deal somehow.

In addition, we know that 100% of patients with long COVID have microclots, at least in this study:

Interestingly, they diagnosed patients not via PCR or antibodies, but based on exclusion and symptom diagnosis:

"Patients gave consent to study their blood samples, following clinical examination and/or after filling in the South African Long COVID/PASC registry. Symptoms must have been new and persistent symptoms noted after acute COVID-19. Initial patient diagnosis was the end result of exclusions, only after all other pathologies had been excluded. This was done by taking a history of previous symptoms (before and after acute COVID- 19 infection), clinical examinations, and investigations including: full blood counts; N-terminal pro b-type natriuretic peptide (NTproBNP) levels (if raised it suggests cardiac damage); thyroid-stimulating 7 hormone (TSH); C-reactive protein levels; the ratio between the concentrations of the enzymes aspartate transaminase and alanine transaminase (AST/ALT ratio) andelectrocardiogram (ECG) +/- stress testing. If the mentioned tests were in the normal ranges, the lingering symptoms that can be ascribed to Long COVID/PASC were then assessed and included shortness of breath; recurring chest pain; lingering low oxygen levels; heart rate dysfunction (heart palpitations); constant fatigue (more than usual); joint and muscle pain; brain fog; lack of concentration; forgetfulness; sleep disturbances and digestive and kidney problems. These symptoms should have been persistent and new symptoms that were not present before acute COVID-19 infection and persistent for at least two months after recovery from acute (infective) COVID-19." (P. 6-7)

I'd say this should be convincing evidence that as good as none of the patients that claim to have long covid have a psychosomatic issue. It's not like microclots are a common and harmless issue either.

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