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Coronavirus and You - Page 671

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Any and all updates regarding the COVID-19 will need a source provided. Please do your part in helping us to keep this thread maintainable and under control.

It is YOUR responsibility to fully read through the sources that you link, and you MUST provide a brief summary explaining what the source is about. Do not expect other people to do the work for you.

Conspiracy theories and fear mongering will absolutely not be tolerated in this thread. Expect harsh mod actions if you try to incite fear needlessly.

This is not a politics thread! You are allowed to post information regarding politics if it's related to the coronavirus, but do NOT discuss politics in here.

Added a disclaimer on page 662. Many need to post better.
JimmiC
Profile Blog Joined May 2011
Canada22817 Posts
December 13 2022 13:56 GMT
#13401
--- Nuked ---
Acrofales
Profile Joined August 2010
Spain17993 Posts
December 13 2022 16:06 GMT
#13402
On December 13 2022 18:45 Razyda wrote:
Show nested quote +
On December 13 2022 16:36 Acrofales wrote:
On December 13 2022 15:36 Artisreal wrote:
You're unfortunately citing a paywalled opinion piece.
Can you link the study the author relies upon?
Seems clear that it's this one. Seems pretty clear cut. However, the result is both preliminary and there is a considerable risk of selection bias in the study setup, both of these things are emphasized in the article.

The authors obviously buffer all their conclusions in statistics that basically say "we didn't find anything, but the power of the study is not powerful enough to preclude their existence".

https://www.acpjournals.org/doi/10.7326/M21-4905

Finally, my own take on this (as a statistician, not an MD), is that it's an interesting study. But I agree it is not enough on its own to conclude much, but rather to indicate how to conduct follow-up studies. One thing in particular did strike me as odd and that is that all these symptoms are being lumped together. Possibly because they are all rare. However if a minor subset of a minor subset of your participants reports shortness of breath, but you then test lung capacity for everybody in your test cohort, including those who don't have shortness of breath but are in the long covid test group because of memory impairment, you won't find statistically significant differences. Same for the cognitive tests and including those with breathing problems. You'd need to treat all of these different symptoms of long covid as different issues, something the authors didn't do, and that to me seems remarkable, but might be common practice in medicine where a single pathology can manifest in many different ways in different individuals.


This is really nice study, thank you for the link. I really like inclusion of control group and sheer amount of various tests they made there.

Bolded: I actually think it was correct of them. All those symptoms are attributed to long covid and authors weren't looking at particular symptoms, but at long covid as a whole.



As I said, not a doctor. That may very well be the accepted way of doing things, and my rather more direct statistical approach would miss the forest through the trees. However, my basic understanding is that you'd want to model this as a Bayesian Network, in which Long Covid apparently causes various different things. You want to know which ones of those are real and which ones are spurious. So you set up a study to test that. Similar to how you might have a Bayesian Network with, for instance, an accident. The accident apparently co-occurs with a bunch of different observable variables.
1. A traffic jam piling up behind it
2. A serious injury to the driver
3. A spill of 10 pallets of yoghurt that were in the accidented truck.
4. Wetness on the highway and grass
5. A carjacking

So you set up a cohort study in which you check times with accidents and comparable times without accidents. You see that indeed, traffic jams appear to occur more frequently with accidents than with non-accidents. And so do injuries. However, (3) (4) and (5) appear statistically insignificant. In particular, out of all the accidents you looked at, only three had a yoghurt spill, and there were no yoghurt spills at all in the no-accident cohort. Either way, it's too rare and too infrequent to really consider.

Meanwhile if you had taken a little bit more information and studied accidents involving only yoghurt trucks, you'd see that yes, yoghurt spills are correlated with accidents considerably more than with non-accidents. That's because yoghurt can't spill out of a chemical tanker or a passenger car, but only occurs when the accident involves a yoghurt truck.

A similar thing appears to be happening in this study. Long Covid is poorly defined (as per the authors' own intro) and groups together a whole bunch of symptoms, all of which are somehow apparently correlated with Covid. So to study them, they set up a bunch of tests. But is there really any point in assessing the memory of someone who doesn't report that Long Covid is causing memory problems? Or are you now trying to figure out if yoghurt spills are caused by accidents involving banana trucks? To me it seems you're doing the latter, which just means you're reducing the power of any statistical tools you use (and would therefore need FAR more data).

But once again, if you are looking for a single biomarker that unites all these different symptoms (e.g. the traffic jam piling up behind the accident in the example above), then this is the correct approach. And I don't know if that is the usual way of doing things in the field. It seems like a totally valid approach, especially with new diseases of which very little is known yet: cast as wide a net as possible and hope you find something interesting. It just needs the caveat that maybe you missed what you are looking for because you cast too wide a net.
Magic Powers
Profile Joined April 2012
Austria4111 Posts
Last Edited: 2022-12-13 19:14:19
December 13 2022 19:14 GMT
#13403
There are many people who have to live with long covid symptoms (the best current estimate is 30% of recovered) and many of them aren't getting the help they need. They need a way to get through the tough times until they regain their full health. Even less impactful symptoms can significantly impact someone's ability to get through the day. Being stringent with the list of symptoms, when we haven't yet figured out what belongs on the list, doesn't help people very much, but it sure does quite the opposite.
Symptoms vary right now, and they may become even more variable in the future as the infection changes. This is one of a number of reasons why casting a wide net is good. Mistakes will be made either way, and especially right now it's more productive to err on the side of the sick.

Long covid can also not be understood as a one-dimensional list of symptoms. Physical or mental activity for example may worsen someone's condition. So it may seem people are quite healthy when relaxing, but then they come down hard when they're put under stress. This can also make it seem to an observer that someone is "simulating". Such things make it even harder to determine what exactly constitutes a long covid symptom, and it's all the more important to not be dismissive. In the worst case people might even dismiss their own symptoms.

"Symptoms of Long COVID often come in waves or “episodes” that can last for days or months before reducing again. Patients regularly report that if they are too physically or mentally active, it causes them to “crash” which is characterized by extreme fatigue and a worsening of many of their symptoms simultaneously."

"As mentioned earlier, many patients have had trouble getting medical professionals to believe them, or they have been dismissed as mentally ill."

https://cornerstonephysio.com/resources/long-covid/

If even medical professionals dismiss people with long covid, imagine how difficult it'll be to get credit from non-experts. Those who don't have long covid have it easy ignoring the issue. But their mind will change if they don't get health coverage or they have to jump through many unnecessary hoops to get coverage.

My dad has recovered from covid four times, and he's a strict anti-vaxxer. In a recent phone call he told me that he sometimes gets dizzy when he gets up after sitting for a while, and it's apparently happening more often these days. I don't know if this is from covid or otherwise, but if he slips through the cracks of the system it could become a serious problem, because he's not getting any fitter or younger, and he doesn't have a lot of money. Frequently recovering from covid doesn't give us powers, if anything we should expect it to chip away at our defenses.
If you want to do the right thing, 80% of your job is done if you don't do the wrong thing.
evilfatsh1t
Profile Joined October 2010
Australia8656 Posts
December 14 2022 04:42 GMT
#13404
yeah im calling bullshit on 30% of people experiencing long covid
Slydie
Profile Joined August 2013
1920 Posts
December 14 2022 08:48 GMT
#13405
On December 14 2022 04:14 Magic Powers wrote:
There are many people who have to live with long covid symptoms (the best current estimate is 30% of recovered) and many of them aren't getting the help they need. They need a way to get through the tough times until they regain their full health. Even less impactful symptoms can significantly impact someone's ability to get through the day. Being stringent with the list of symptoms, when we haven't yet figured out what belongs on the list, doesn't help people very much, but it sure does quite the opposite.
Symptoms vary right now, and they may become even more variable in the future as the infection changes. This is one of a number of reasons why casting a wide net is good. Mistakes will be made either way, and especially right now it's more productive to err on the side of the sick.

Long covid can also not be understood as a one-dimensional list of symptoms. Physical or mental activity for example may worsen someone's condition. So it may seem people are quite healthy when relaxing, but then they come down hard when they're put under stress. This can also make it seem to an observer that someone is "simulating". Such things make it even harder to determine what exactly constitutes a long covid symptom, and it's all the more important to not be dismissive. In the worst case people might even dismiss their own symptoms.

"Symptoms of Long COVID often come in waves or “episodes” that can last for days or months before reducing again. Patients regularly report that if they are too physically or mentally active, it causes them to “crash” which is characterized by extreme fatigue and a worsening of many of their symptoms simultaneously."

"As mentioned earlier, many patients have had trouble getting medical professionals to believe them, or they have been dismissed as mentally ill."

https://cornerstonephysio.com/resources/long-covid/

If even medical professionals dismiss people with long covid, imagine how difficult it'll be to get credit from non-experts. Those who don't have long covid have it easy ignoring the issue. But their mind will change if they don't get health coverage or they have to jump through many unnecessary hoops to get coverage.

My dad has recovered from covid four times, and he's a strict anti-vaxxer. In a recent phone call he told me that he sometimes gets dizzy when he gets up after sitting for a while, and it's apparently happening more often these days. I don't know if this is from covid or otherwise, but if he slips through the cracks of the system it could become a serious problem, because he's not getting any fitter or younger, and he doesn't have a lot of money. Frequently recovering from covid doesn't give us powers, if anything we should expect it to chip away at our defenses.


"Long covid" is one of those mysterious diseases.
-How much is about physical effects of the initial infection?
-Psychogical effects of having been infected?
-Psychological and physical issues not related to the infection at all?

Don't get me wrong, "long covid" is very real for the people experiencing it, like "fatigue" or depression.

"Long covid" can actually be a very good reason to step down on the rigorous testing. If I get covid, I think I am much better off not knowing about it. People around me are vaccinated, have been infected or both, so I am not worried for them either.
Buff the siegetank
BlackJack
Profile Blog Joined June 2003
United States10506 Posts
Last Edited: 2022-12-14 23:41:47
December 14 2022 23:41 GMT
#13406
Anecdotally my COVID was super mild and went away pretty quick. At end of October I got sick on a flight and tested negative for COVID, I still feel fatigued from that illness a month and a half later and I had a nagging cough that lasted for weeks. Is it that uncommon to have residual symptoms lasting weeks or months after a viral illness?

One thing that a lot of the studies on long-COVID lack is a control group. Here's one study published a couple weeks ago that tried to compare people with symptomatic illness that tested positive for COVID vs those that tested negative for COVID.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2799116

Findings In this cohort study of 1000 US adults with symptomatic illness, poor well-being scores at follow-up were common in both those who tested positive and negative for SARS-CoV-2 infection. Despite some improvements over time, 39.6% of COVID-19–positive and 53.5% of COVID-19–negative patients reported residual symptoms.


[image loading]

I think it's not rare for people to continue to feel bad following a viral illness whether it's COVID or cold/flu/RSV/EBV or any number of other viruses. Long-COVID being an unprecedented catastrophe that will reverberate on our society for decades is a pretty strong claim.
ChristianS
Profile Blog Joined March 2011
United States3188 Posts
December 15 2022 00:15 GMT
#13407
Alternatively, maybe we’ve all been under-rating the damage being done by other diseases’ sequelae, because they’re confusing and we’re bad at calibrating our sense of low-probability risks. My not-remotely-quantitative impression is that Covid sequelae really are more severe and common (haven’t heard anything post-flu as much as I’ve heard people missing smell or taste for months), but also, I think some of the semi-rare long-term effects of the flu really are pretty gnarly.
"Never attribute to malice that which is adequately explained by stupidity." -Robert J. Hanlon
Lmui
Profile Joined November 2010
Canada6213 Posts
December 15 2022 00:17 GMT
#13408
Personally, I had a sore throat for a week or so past the 10 day mark, and a cough for a month or so. I also had ~3 weeks of reduced physical ability (noticeable in aerobic activities) where I'd hit a wall the second I got past anaerobic, and just gasp for air.

It did subside for me, but it was basically a bad week followed by a miserable month.
JimmiC
Profile Blog Joined May 2011
Canada22817 Posts
December 15 2022 01:36 GMT
#13409
--- Nuked ---
BlackJack
Profile Blog Joined June 2003
United States10506 Posts
December 15 2022 05:06 GMT
#13410
On December 15 2022 09:15 ChristianS wrote:
Alternatively, maybe we’ve all been under-rating the damage being done by other diseases’ sequelae, because they’re confusing and we’re bad at calibrating our sense of low-probability risks. My not-remotely-quantitative impression is that Covid sequelae really are more severe and common (haven’t heard anything post-flu as much as I’ve heard people missing smell or taste for months), but also, I think some of the semi-rare long-term effects of the flu really are pretty gnarly.


Yes, agreed
pmh
Profile Joined March 2016
1352 Posts
December 15 2022 06:40 GMT
#13411
On December 15 2022 09:15 ChristianS wrote:
Alternatively, maybe we’ve all been under-rating the damage being done by other diseases’ sequelae, because they’re confusing and we’re bad at calibrating our sense of low-probability risks. My not-remotely-quantitative impression is that Covid sequelae really are more severe and common (haven’t heard anything post-flu as much as I’ve heard people missing smell or taste for months), but also, I think some of the semi-rare long-term effects of the flu really are pretty gnarly.


The flu knocked me out for 2 weeks in 2018. It was a very bad flu and months later i did still notice certain effects like getting exhausted from physical activitys quickly. But the flu i had only once in my entire adult live,at least i can remember only that single time.
JimmiC
Profile Blog Joined May 2011
Canada22817 Posts
December 15 2022 18:24 GMT
#13412
--- Nuked ---
castleeMg
Profile Blog Joined January 2013
Canada761 Posts
December 15 2022 18:39 GMT
#13413
LOL I guess I’m an anomaly, I do a lot of driving and I have a nice driving record, I’m a big fan of the seatbelt too. Hopefully my rates don’t go up because that would be pretty discriminatory wouldn’t it?
AKA: castle[eMg]@USEast/ iCCup
JimmiC
Profile Blog Joined May 2011
Canada22817 Posts
December 15 2022 19:35 GMT
#13414
--- Nuked ---
Lmui
Profile Joined November 2010
Canada6213 Posts
December 15 2022 23:24 GMT
#13415
On December 16 2022 03:39 castleeMg wrote:
LOL I guess I’m an anomaly, I do a lot of driving and I have a nice driving record, I’m a big fan of the seatbelt too. Hopefully my rates don’t go up because that would be pretty discriminatory wouldn’t it?


Insurance works on the average person. You may not follow the trend, but if something applicable to you is statistically significant, you can bet the insurance companies have their best bean counters making sure they take the risk into account in their calculations.
GoTuNk!
Profile Blog Joined September 2006
Chile4591 Posts
Last Edited: 2022-12-16 00:05:26
December 16 2022 00:03 GMT
#13416
On December 16 2022 04:35 JimmiC wrote:
Show nested quote +
On December 16 2022 03:39 castleeMg wrote:
LOL I guess I’m an anomaly, I do a lot of driving and I have a nice driving record, I’m a big fan of the seatbelt too. Hopefully my rates don’t go up because that would be pretty discriminatory wouldn’t it?

Not if there is massive data to support it. I think if a life, health insurer wanted to add a rating they could, and I do not think there would be much blowback, or at least the blowback would be from the people they do not want to insure at their best rates. I think it would be a hard sell for an auto insurance company to do. Maybe a discount for those who did vaccinate??? Before an auto insurance company did it they would likely need a lot more specific studies like this. The health and life can use it with all the other data that is out there on vaccination to just further their case.

I do not think either is imminent though, insurance companies are not known for moving fast or taking any sorts of risk. This study is mostly just something to file in the old "isn't that interesting but there is not much to be done with it" file.


So it's ok for insurance providers to discriminate against overweight people? People on anti depressants?
JimmiC
Profile Blog Joined May 2011
Canada22817 Posts
December 16 2022 00:31 GMT
#13417
--- Nuked ---
BlackJack
Profile Blog Joined June 2003
United States10506 Posts
December 16 2022 00:50 GMT
#13418
The traffic study also shows the unvaccinated group was more likely to have alcohol abuse and depression. But one thing they weren't more likely to have was COVID. 4.1% of the vaccinated group had COVID compared to 3.6% of the unvaccinated group.
JimmiC
Profile Blog Joined May 2011
Canada22817 Posts
Last Edited: 2022-12-16 01:29:06
December 16 2022 00:59 GMT
#13419
--- Nuked ---
Razyda
Profile Joined March 2013
732 Posts
December 16 2022 01:28 GMT
#13420
On December 16 2022 03:24 JimmiC wrote:
There is a study out that shows that vaccine hesitsitant individuals are more likely to be in car accidents. I had mentioned earlier that an actuary had told me that vaccine hesitant people die of all sorts of things more often because they do not follow the advice of health professionals. This goes even further to show that this group also likely does not follow traffic rules and I would say likely do not follow all sorts of expert advice and societal rules. I expect more and more data and studies like this to follow.

More and more evidence could cause insurers to add ratings on unvaccinated individuals. Yes those unvaccinated people would go elsewhere, but that would still be better for the company as the people they have would live longer with less health challenges and it would be good for the peoole they have because they would not be supporting those making less optimal choices. Smoker ratings and all sorts of others are already common place.

The disapointing part is I do not think this is helpful in converting the vaccine hesitant people.

https://globalnews.ca/news/9345291/covid-vaccine-hesitancy-ontario-crashes/



Just remember this are the experts you trust .

I am not taking this study seriously so I wont even bother with details, but...

Apparently dementia makes you fantastic driver,
Having unvaxed passanger makes you more likely to crash,
Being vaccinated with moderna makes you more likely to crash,
Under no circumstances you should drive between first and second dose,
Being unvaxed makes you less likely to fall...

This is my favourite though:

"[...]because our data do not explore potential causes of vaccine hesitancy or risky driving. One possibility relates to a distrust of government or belief in freedom that contributes to both vaccination preferences and increased traffic risks. A different explanation might be misconceptions of everyday risks, faith in natural protection, antipathy toward regulation, chronic poverty, exposure to misinformation, insufficient resources, or other personal beliefs"

Apparently unvaxed believe they have natural protection for car crashes...

It genuinely baffles me that anyone could take this study seriously.


User was temp banned for this post.
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