Even if you’re asymptomatic, the coronavirus can do damage | Hacker News Reader

Even if you’re asymptomatic, the coronavirus can do damage

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143 pointssimonebrunozzi94 comments

I wouldn't be too cocky if you're healthy. I got hit with a nasty flu in the early 2000's and never recovered. It was like someone flicked a switch and I went from young perfectly healthy to a low grade off an on flu since then. This happened with SARs in 2003 and is well documented. For the first year you think you are just run down, but then it never improves for decades and you just sort of miss out on your whole life.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3071317/

Do you know whether it was actually influenza?

Have you tested for STDs?

This seems like kind of a left-field question. I'm sure if this person sought care any kind of active infection was ruled out. What are you angling for, neurosyphillis?

There are several more common STDs that do not resolve by themselves and cause on and off symptoms.

Interesting. Sorry to hear that. What are you experiencing? Lack of energy? Decreased lung capacity? Vertigo?

Doesn't lyme disease have similar long term issues? Do we know why certain disease cause these long term debilitating symptoms?

Another similar example is EBV, commonly known as mono, which is often associated with chronic fatigue syndrome and fibromyalgia. Viral infection occurs, followed by a prolonged period (sometime years and years) of flu symptoms.

I would guess there is nothing special about the virus aside from it being "high intensity". My best hypothesis is that the symptoms are the result of a maladaptive "freeze response" which results in the symptoms. Viruses don't actually cause pain, it is your body's response to it.

If you want to avoid this scenario with COVID, probably the best thing you can do is to reduce your stress level as much as possible, as I think that is a key risk factor. Exercise is good, but overdoing it is a form of stress!

Viruses can absolutely damage and destroy human cells. That alone can trigger a pain response.

But not influenza viri. They are harmless. What is problematic is the immunosystem overreaction, the T-cells destroying everything around. Called cykotine storm.

Also the bacterial infections caused by such rampage. Like pneumonia.

Just to point out ME/Chronic Fatigue Syndrome and Fibromylgia are not flu like sysmptoms, at their worst they are more debitating than MS. They both carry a hallmark problem not seen in anything else called Post Exterion Malaise, where the body will crash if mentally or physically overexerted often leaving the patient unable to lift their own body to eat for months along with a raft of significant systemic problems. They have extremely limited total energy. Flu doesn't work like that at all, CFS and Fibro are really bad and its a disgrace of the medical community that they have failed to research it and gaslight the sufferers for 70 years.

By "cocky" you basically mean not completely paranoid?

It is a strange word to use in this context.

"Please respond to the strongest plausible interpretation of what someone says, not a weaker one that's easier to criticize. Assume good faith."

https://news.ycombinator.com/newsguidelines.html

You might be interested in reading about the "virus as cause" theories of Chronic Fatigue Syndrome

http://simmaronresearch.com/simmaron-rising/

Also note that you're not lost, there are herbs/supplements that can work as antiviral (Echinacea, Cistus, ...)

Almost sounds like chronic fatigue type deal

The blase attitude towards influenza is more disturbing than SARS2. There is a reason we run a new vaccine every year and encourage people to take it.

Flu is dangerous

Another anecdote, I got bronchitis in my early 20s due to black mold in a slummy apartment I lived in and never fully recovered either. I still have really bad sinus issues, and whenever I surf I get horrible week-long inflammation in my sinuses unless I'm consistently snorting flonase.

Probably not nearly as bad as everlasting flu symptoms, but it's interesting there's a pattern of infections that never quite go away.

Look up an ENT and see if you're a candidate for a balloon sinuplasty. You can thank me later.

I also suffered from near chronic sinus infections. Got one, and haven't had to get anti-biotic to handle one in years.

Hey, so my ENT DID reccomend this, but ultimately said that if Flonase works, just keep doing it...

Can you tell me a bit about your post-ballon sinuplasty experience? I hear people complaining about lack of ability to smell and other things, but, like, my smell is already shot so how bad could it be? What was your recovery like, and did you have any new symptoms/conditions after?

Sure!

So I used to be damn near chronic to the point I was going through NeilMed saline like other people go through other white powders.

Went in, they did the procedure in office with whatever that anaesthetic is that makes you not remember. About the most eventful thing during the procedure was apparently I got a bit mushy, and when they were in my upper left sinus I might have kicked the doc. (They had to cauterize something up there, apprarently, and it was my most impacted area generally, as even on X-rays, you could hardly see a difference in density along the passage.)

After the recovery period was like... Well not night and day, but instead of measuring my saline rinsing in boxes per two weeks it'd be boxes per 3-6 months. I've not had to visit the doctor or regularly do Flonase since. When I do rinse, the crap I get out is never as bad as it used to be, and I don't end up with that horrible sinus breath or weird cheesy aftertaste anymore. On the rare occasions now I do feel like something is acting up, I can just do some Flonase and some hot tea and I'm set.

Can still smell just fine! Even better, really, and on a more regular basis.

My sinus headache frequency plummeted, (tension headaches went up though since I'm terrible at getting away from the computer regularly.) I can think more clearly, breathe better, and I'm not on antibiotics anymore every two months or laid out feeling like the front of my face wants off.

I still seem to have a little bit of nagging with left sinus on occasion, and the ear on that side tends to swell a bit more than the one on the other side, but that's really it. It is pretty safe (for you, can't speak for your doctor...).

I'm not big into pushing or trying to sell/evangelize things, but life is too short for sinus problems, and they're too debilitating in my opinion as a long time sufferer. I had great results, and I hope you will to!

Thanks so much for sharing your experience! I'm very much considering this procedure (have been on the fence for a while) so it's good to hear about how it helped you. It's great it helped your headaches too.

Thanks!

I’m sure there used to be this idea that content should be, or at least solidly start, above the fold. In this case, I observe two whole screenfuls of meaninglessness before the content begins. And on a 1920×1080 display with typical OS/UA chrome, it’ll be about 2½ screenfuls. This is grossly excessive.

The idea that every news article and blog post needs a cover image is one of the worst things to happen to the Web in terms of information density and bandwidth usage.

Physical news papers are laid out in terms of a specific design for readers. People tend to start in the same place on the page, and work in a predictable pattern around the page until they are done. It's like a backwards G, I think.

I wonder if this development, which is complete and utter crap, is based on something similar?

And the way this is typically done with banners breaks zoom! It's so bad.

It is my understanding that posts with images generate longer time on page and more engagement. People like pictures, and are afraid of “walls of text”.

I haven’t seen the data, but this is what I have been told, and it’s quite plausible. I don’t use header images on posts on my own site because I agree with you, but unfortunately oftentimes things that seem bad or ugly are such a way for a good reason.

It’s the same thing about big ugly pancake buttons and people’s close up faces on landing pages.

Yep. I hate stock imagery, because it’s 100% overhead and conveys nothing of value, and by dint of its uselessness and irrelevance, cases where imagery is relevant are less likely to be heeded; but because of human psychology, stock imagery works.

I guess that’s my point: if it works, it’s not irrelevant.

By “irrelevant” I mean irrelevant to the content, which is entirely accurate. It’s psychological trickery in the presentation of the article, not part of the content.

Could the longer linger times result from an impedance mismatch where people are trying to parse the page to find the actual content?

That would be doubly evil in my opinion. You're preying on people trying to understand something to get more impressions if that's the case.

The worst thing is that the image appears to bear absolutely no relevance to the article at all.

> In one of the studies included in the review, these lung abnormalities were present in 54% of asymptomatic people with Covid-19.

Do we know what the usual rates for GGOs in regular people?

That's by definition not "asymptomatic." It's extremely mild/unnoticeable symptoms, but it's still not asymptomatic

The author is using the term in the way that most laymen use it. In this context, asymptomatic means not showing any noticeable symptoms and/or being completely unaware that one has contracted the virus.

The author is not oblivious to this as he puts the word asymptomatic in quotes in the article.

As used in medicine, a symptom is by definition something that the patient notices and can report. If they don't notice, it's not a symptom, it's a "sign".

https://jamanetwork.com/journals/jama/fullarticle/341611

Not that this isn't important but it's certainly not robust research by any stretch of the term.

This type of panic selling--which this article is a light variation of--have forced me to be less and less willing to believe it when I read it. The boy who cried wolf is in full effect when it comes to covid.

“Ground-glass opacities are very common — we see it all the time and there are many things that can cause it,” says Adam Bernheim, MD, a cardiothoracic radiologist at Mount Sinai Hospital in New York City

But go ahead and throw a scary headline on it to drive clicks.

Why did you leave out the remainder of that paragraph?

"But while GGO’s are common, the ones that are turning up among Covid-19 patients are distinctive. “If we see this very round shape and peripheral distribution, that’s atypical of other types of infections but it’s something we frequently see with [Covid-19],” he explains."

If it's something that's common and "there are many things that can cause it", what exactly do I need to be worried about? Serious question, give me some context writer. For all I know GGO's are extremely common, come and go, and could be caused by something as routine as sitting around a campfire.

"We’ve seen patients with mild GGOs that heal completely, whereas others develop scar tissue almost like a skin injury, which is permanent"

Awesome. Zero help. But thanks for planting that seed of fear.

Calling fire when there is no fire is as bad as not calling fire if there is a fire.

Awesome. Zero help. But thanks for planting that seed of fear.

Well, to be fair, the Killer Asteroid and Murder Hornet aren't living up to the hype, so you gotta go back to the basics.

>>Awesome. Zero help. But thanks for planting that seed of fear.

It is a pandemic. We absolutely need to be fearful, because it will encourage us to take extra precautionary or avoidance measures we otherwise would not have taken.

This is why "they are just trying to scare people!" is not a valid criticism in this context. The entire reason the pandemic is re-surging is because people are not scared.

> This is why "they are just trying to scare people!" is not a valid criticism in this context.

It absolutely is.

Fear is not conducive to prudent decision-making. Fear is what brought us the inane toilet paper shortage a few months ago. No news outlet is being level-headed with its reporting -- whether on the left or on the right. This, combined with zero accountability for needless flame-fanning by pieces like the one linked, creates an environment where it's hard to discern what's true and what's not.

I agree, both sides are negligent. The only place you can go for real news is first and foremost the raw data. And second, Twitter.

A rapid shift from a toilet paper supply chain optimized for workplaces and retail to a sudden spike in demand on the home-focused supply chain caused the shortage. People actually needed that toilet paper because what they normally used was locked up at their workplace and they didn't have enough supply at home.

This is categorically untrue. It's well documented that people were hoarding[1] due to (and I quote) the "influence of perceived threat."

[1] https://journals.plos.org/plosone/article?id=10.1371/journal...

Two things can be true:

1: People were hoarding because of the media hype

2: The supply chain was strained from a sudden and completely reasonable shift given the circumstances

Does your link address 2 or compare the impact?

> Fear is what brought us the inane toilet paper shortage a few months ago.

FWIW, evidence is that the toilet paper shortage wasn't caused by hoarding. Rather, it was a combination of two supply-chain quirks:

1.) Toilet paper is bulky and low-margin, which means that supermarkets largely stock it just-in-time and keep low inventories of it in storerooms. This exacerbates any problems in the supply chain because existing inventories run out quickly and there's no buffer.

2.) The supply chains for consumer toilet paper (used in homes) and commercial toilet paper (used in businesses & public places) are almost completely different. They use different raw materials (commercial has higher recycled paper content), different manufacturing processes (commercial is usually single-ply), and of course different warehouses, transportation infrastructure, and procurement processes. When everybody stays home for 8+ hours that were previously spent at work and in public places, that causes a dramatic shift in demand from commercial to consumer toilet paper. The commercial stuff can't really be sold in supermarkets; even if you could fix the procurement and distribution processes, it's packaged in ways that won't fit on (or sell from) a retail rack.

Taken together, that resulted in large shortages of consumer toilet paper and large oversupplies of commercial toilet paper, all of which get exacerbated by the small inventories kept by supermarkets. There may have been some hoarding too, but there's no good evidence for it, and a lot of reasons (eg. purchase maximums, inability to carry more than 1 48-pack) to believe it wasn't a major factor.

>> Fear is what brought us the inane toilet paper shortage a few months ago.

That is not fear. That is panic. Relevant concept, but also very different.

Unless of course you believe reading this article you are criticizing will lead to people rushing to buy toilet paper again...

In the pursuit of making sure people are fearful you would encourage using the term "ground glass" when discussing the lungs of an asymptomatic case? Because if you had ground glass in your lungs you would absolutely feel it, and it would feel like ground glass. You would cough and spit blood.

Are they asymptomatic or do they have ground glass in their lungs? It can't be both.

It's not ok to fear monger like that.

>Are they asymptomatic or do they have ground glass in their lungs? It can't be both.

I think you're under the assumption that this term was just created to fear monger about COVID, but this is not a new term.

From 2013 for example:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367726/#:~:tex....

Ah ok, thanks for pointing that out. I was under that assumption.

you don’t really want to have extensive ground glass opacities from any cause. Happy lungs don’t have them. Here are some causes: https://radiopaedia.org/articles/ground-glass-opacification-...

Frankly, the discussion is imprecise. There is no indication that scarring GGOs ever accompany asymptomatic cases.

You’re implying that “common” means “not bad”.

I'm implying that common might mean not bad. That burden of proof is on the writer. The writer has failed to meet that burden regardless of which way it is, good or bad.

You described the article as a light variation of panic selling, and said that it throws a scary headline on the details to drive clicks. The headline is "Even If You’re Asymptomatic, the Coronavirus Can Do Damage", and regarding the 'ground glass opacities' it says "How big a deal is this? No one’s sure."

yeah, early on and even now, all Covid19 information was disseminated in a way to maximize emotional response. That guaranteed either news worse than the facts or news that was better than the facts. Everything, and i mean _everything_, was sensationalized in order to get you to click or register your outrage somewhere with a link back to the source.

Reality is reality and as time progressed it became clear what was happening with the information delivery and now no one trusts anything from anyone.

Covid19 is pretty bad but what happened to informing the public is near worst case scenario in my book.

Actually what you're saying comes across as scaremongering. You're trying to say that there are no legitimate sources, the legitimate sources like the New York times or major medical journals are not trustworthy. You're arguing in favor of what you said is a problem.

The NYT was definitely on the "news that was better than the facts" train for quite awhile in the early days of the pandemic. I would argue the media as a whole is still largely downplaying how bad things are, likely as a matter of serving the imperatives of their corporate owners, but this isn't an idea which finds any purchase with conservatives (who want not to be inconvenienced by COVID in any way) or liberals (who are allergic to most criticism of the news media or anything which can be painted with the "conspiratorial" brush).

Neither the NYT nor academic journals are a legitimately useful source of COVID-19 information for a layperson. The NYT's coverage has been full of scaremongering and speculation and the world would probably have been better off without it. And a layperson doesn't have the time and training to understand journal articles in context.

The best sources are public health authorities like the WHO and CDC. They have consistently made careful and measured statements, been fairly accurate, minimized scaremongering and speculation without understating the seriousness of the situation, and issued useful recommendations. Most people would be better off following these authorities directly and ignoring other coverage.

I mostly agree with you, but the WHO and CDC famously told people not to wear masks for way too long after data was distributed showing mask's effectiveness for preventing infection. I would not trust them.

The not wearing masks things was terrible, because it seems like they probably recognized there was some benefit but they wanted to reserve them for health workers. That what I always thought and I'm not alone. The WHO seems to have a series of flawed statements (like the one recently where they made a misleading comment about asymptomatic people). It's like the who needs to hire a competent pr agency. If only they had said "there's some protective affect by wearing masks but we want to prioritize health workers getting ppe while we ramp up manufacturing".

> but the WHO and CDC famously told people not to wear masks for way too long after data was distributed showing mask's effectiveness for preventing infection

Do you have links to that data? For you to make this claim you'd be able to link to a meta-analysis or a well run RCT.

As usual there is nuance to this story which the incendiary popular media failed to capture, because it doesn't bait clicks.

Early on the WHO's biggest concern was that panic buying would lead to mask shortages for health care workers. If you have to choose between an unmasked public and unmasked health care workers, having the public go without is definitely the better option.

So IIRC around March they issued the guideline - if you feel sick, wear a mask, otherwise don't. And it made sense in context, because after masks worn by health care workers, the infected are the next most effective place to deploy masks in terms of protecting public health.

Eventually mask supply increased because everybody started producing them. The WHO then changed its recommendation to "everyone should wear."

So I don't really think the WHO did anything wrong here. But because of the one-sided way it was portrayed in the media, the negatives got amplified and we ended up with "WHO NWO EXPOSED MILLIONS DEAD!! BILL GATES EUTHANIZES AFRICA CONTINENT GLOBAL ELITES KILLING VACCINE PEDOPHILIA" all over YouTube. Again.

WHO posted a tweet on March 28 saying "COVID 19 is not airborne" and downplaying any need for protective masks and it's still up: https://twitter.com/WHO/status/1243972193169616898

It's not airborne. It's spread by droplets and fomites.

This is definitely a distinction which WHO should rely upon its Twitter followers to parse accurately. /s

Any mention of masks is conspicuously absent from their "what you should do to protect yourself" list. More than that, they stamped a giant "INCORRECT" over a social media image which, although it probably did get some details wrong, was much more on the right track than WHO with "Wear a mask everywhere!"

Can you link to a meta-analysis or a well run RCT that shows benefits to mask wearing?

There are a few that don't show any benefit to wearing masks.

What should CDC / WHO / etc do then? They have evidence, it's good quality, but it doesn't show any benefits to masks wearing. Should they tell people to wear masks? We didn't know at the time whether this would cause people to drop social distancing or not. There was a real risk that people would wear masks, but drop isolation.

Wearing a mask can’t increase your risk of infection. Unless it blocks 0% of droplets, it can’t possibly have no net improvement. And if they really were that useless, why do we keep getting doctors to wear them?

I feel you should be linking to a study showing that telling people they must wear masks to go out would reduce social distancing. To me, the requirement to wear a mask only reinforces the danger.

Your first claim isn't true. A mask worn with good hygiene practices won't increase your risk. But taking a mask off, touching it, and then doing other things before washing your hands can.

If your mask got infected while wearing it, then you would have gotten infected had you not been wearing it anyways. So even if your poor hand hygiene renders the mask unhelpful, wearing the mask doesn’t overall increase your risk.

> You're trying to say that there are no legitimate sources, the legitimate sources like the New York times or major medical journals are not trustworthy.

Newspapers are at best a secondary source, not primary.

Academic journals are intended to disseminate articles to be subjected to peer review, which means they are intended to spark discussions over observations among researchers in the field. This means that, with the exception of academic fraud, it's expected that their content doesn't reflect solid understanding of the issues involved. Otherwise they would be pointless as scientific papers.

The doctor who is a radiologist probably means "common" from the patients he sees, not common amongst the general population. "Many things that can cause it" probably means many diseases that are probably not pleasant, especially if they have to see a radiologist for it and not, say, a GP.

For those of us in the US, the range of symptoms of Covid infection combined with the very real possibility of having insurance denied because of pre-existing conditions sounds like a really bad combination.

If insurers are allowed to not cover anything related to a pre-existing condition, it seems natural they would screen for Covid antibodies as part of any routine work. Then any condition that's been correlated to Covid infection would be denied.

Universal health care can't come fast enough to the US.

Huh?

Insurers in the US haven’t been able to deny coverage for preexisting conditions for some time.

That's because of the Affordable Care Act (Obamacare). There's an ongoing SCOTUS case that may lead to Obamacare being struck down in its entirety.

Because of the ACA insurance providers cannot deny people based off of pre-existing conditions [0]. There have been several challenges to this point coming from the right centering around how the individual mandate may make the entire law unsonstitutional [1]. But as far as I know this hasn't been decided yet in the court system.

[0] - https://www.hhs.gov/answers/affordable-care-act/can-i-get-co...

[1] - https://www.npr.org/sections/health-shots/2020/01/08/7940809...

The SCOTUS is about to hear a case brought by the administration and some states to strike down the ACA in its entirety, which would also remove that provision, so the parent has a point.

Millions of people with long-term chronic lung problems will lead to a variant of Medicare-for-all pretty damn fast, especially if the Supreme Court strikes down the ACA.

The pre-existing condition thing is no longer legal. https://www.hhs.gov/answers/affordable-care-act/can-i-get-co...

There's an ongoing SCOTUS case about this, so it's quite possible that it will soon be legal again.

I am curious to know the number and demographics of people who survive Covid and have no apparent after effects. Haven’t really seen this data anywhere.

Without widespread antibody testing, we'll never know.

Widespread antibody testing will not be sufficient to answer that question. It appears that a significant fraction of patients who recover from asymptomatic SARS-CoV-2 infections don't produce detectable levels of antibodies.

Source?

https://www.cdc.gov/coronavirus/2019-ncov/testing/serology-o...

Thanks for providing a link. For anyone else who comes along, the supporting statement isn't very prominent; you can find it in:

"If you test negative" > "You could still have a current infection." > 2nd sub-bullet

You may also have some level of antibodies without actually getting sick like what happens with tb. Besides if vaccine is eventually developed antibody test will be useless

There are enough people who were PCR positive that antibody tests aren't necessary for this kind of study.

Not that I have any knowledge of whether anyone is running PCR tests on valid random population samples, but I suspect the concern is that this isn't happening, and that any followup study you could do on these positives will have biases that are hard to correct for?

That won't work. There is a high false negative rate with those tests, and it's likely that false negatives are more common in those who have only mild infections. A study of patients with only positive tests would be a skewed sample.

It may be a few years before a study like this comes out. And it most certainly will.

The data and sample size needed to give a picture of not only this demographic, but all demographics is still a ways off.

It won't come out until the politicians decide what they want the report to say.

I love how Medium is bragging here about making a blog article available to read "for free" on the Internet.

"We act as a needlessly centralized hub for information on a medium which is traditionally decentralized, and we do it without charging you!!"

Wow, thanks so much...

Reply on news.ycombinator.com