Hacker News Reader

Comment by eiji | Hacker News Reader

And we still only have 31 confirmed death by Covid19 on children under 14 years.

> https://data.cdc.gov/NCHS/Provisional-COVID-19-Death-Counts-...

And we have no idea what the long-term impacts of Covid-19 might be.

Just as a for-instance, I had the Chickenpox, like most people my age. No biggie. Then I later developed Shingles, because the Chickenpox virus can be dormant in your body for decades. Shingles can be debilitating.

I highly doubt that Covid-19 will have long-term health impacts like that for children. But we absolutely don't know for sure, yet.

Chickenpox is a retrovirus, which is why it can linger in your body for decades, as it transcribes itself into selected portions of your genome to hide and then later re-emerge. SARS-CoV-2 is not a retrovirus.

Right, but it likes to hide out in rather remote areas of your body.

> Right, but it likes to hide out in rather remote areas of your body

Covid “hangs out” in your body? I have not heard this, is there any source you can link?

I must have been confused, or the presumed information source I remembered is much harder to find than expected.

The issue isn't the virus lingering, it's apparently blood clots throughout various organs, which can cause problems years after they come to be. A friend of my family died from unexpected bleeding/brain crushing after a small blood vessel in his brain popped. This was many months after the issue was first noticed, and a few months after one of to-be-two operations was done to prevent that clogged blood vessel from bursting due to over-pressure.

Varicella-zoster virus (chickenpox/shingles), while it does create latent infections, is not a retrovirus. Retroviruses like HIV actually insert a copy of the viral genome into the host cell's DNA. VZV and other herpesviruses have a different latency mechanism[1] than retroviruses. SARS-CoV-2 probably does not cause latent infections, but could potentially cause a chronic infection similar to other RNA viruses like Hepatitis C. I would suspect it probably doesn't, but it is certainly possible.

1: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3118253/

How odd, this is not what I was taught decades back. I suppose I will have to refresh. This is like finding out that Mercury is not tidally locked to the Sun, despite that being in textbooks forever.

Are you sure you aren't just misremembering?

Of all of the things you can be sure of, misremembering isn't one of them.

Anything could happen!

This is such an empty argument. Name me a coronavirus that has ever exhibited these mysterious long term impacts everyone is blindly conjecturing.

Even SARS-1, which is way more serious than SARS-2 (the virus that causes COVID-19), doesn’t cause long term damage (lungs, etc) in actual adults.

What we should be concerned about is the long term impacts of poor socialization, weakened immune systems due to suppression of natural pathogen exchange, an environment of fear and hysteria, widened educational attainment gaps due to non-scientifically-grounded refusal to allow in-person instruction etc. Virtually all the uncertainty is on the “pro lockdown” side IMO.

BTW I recognize you weren’t saying that long term damage does happen but rather that we just don’t know. But I reject that entire argument. We have no evidence it happens and plenty of evidence it doesn’t happen with more serious viruses.

There is a growing body of evidence of longer term effects in adults. Obviously the picture is still developing because this is a novel coronavirus, but I think there is plenty of reason to be very concerned.

https://www.theatlantic.com/health/archive/2020/06/covid-19-...

It's technically true that it's a novel coronavirus, but functionally it is incredibly similar to SARS-1 (what we used to just call SARS).

SARS-1 is much more deadly and much more symptomatic. But structurally they resemble each other; they share the characteristic spike protein and a bunch of other features.

Immunity to SARS-1 confers immunity to SARS-2.

Now, SARS-1 being a more severe version of SARS-2, serves as a great model of what severe COVID-19 might look like.

And we know that in SARS-1, there are not these supposed long-term effects. You can get lung damage that lasts for a few months, but is undetectable at the 1 year mark. That's not long-term damage.

I also want to mention that the "long-hauler" narrative does not have real evidence behind it, except for those who are immunocompromised and therefore would be a "long-hauler" for literally any virus they got infected with.

Unfortunately, and I am worried that saying this will trigger reflexive downvotes, almost all US mainstream media has an incredible leftist bias (see: recent events in the NYT, WaPo etc). Therefore anything coming from the atlantic, vox, CNN, is very transparently trying to perpetuate the "doom" narrative. That's why they don't report on any of the incredibly positive/surprising facts, such as the widespread T-cell cross-reactivity in those who have never been exposed to either SARS-1 or SARS-2, or the fact that children surprisingly don't seem to spread it to adults in any real numbers, or the logical conclusion of the fact that SARS-2 kills the very old but not the very young, which is that recurring deaths (deaths in subsequent years) from COVID-19 will be virtually nonexistent.

---

Back to the long-term effects. The article you linked is not scientific at all and just rattles off a serious of anecdotes. So I don't really know what there is for me to argue against.

There was a great study of SARS-1 lung imaging that I love to cite, and yet I can't find where my notes on it are. So take this random one I just came across:

https://onlinelibrary.wiley.com/doi/full/10.1046/j.1440-1843...

> Lung function studies carried out on 258 patients from Xiaotangshan Hospital in Beijing 2 months after discharge showed that 21% patients (54 of 258 patients) had evidence of impaired diffusion (DLCO < 80%pred) while 6% (16 of 258 patients) had restrictive ventilatory defect (VC < 80%pred).18 Fifty‐one of 54 patients had lung function tests repeated one month later. DLCO was found to improve in 80.4% patients (41 of 51 patients), and FVC in 81.3% patients (13 of 16 patients) (Table 3). These findings suggest that lung function abnormality caused by SARS might improve spontaneously over time.

(BTW, long-term damage and the "long-hauler" meme are technically referring to two different things)

As a counter-point to myself, the following study identified abnormalities (although keep in mind abnormality doesn't mean it's necessarily a massive problem) at the 6 month mark:

https://thorax.bmj.com/content/59/10/889.abstract

The study I'm looking for but can't find showed abnormalities at the 3 month mark but no abnormalities at the 1 year mark, so that study I just linked doesn't actually contradict my own expectations.

Finally remember that we're using SARS-1 here as a model of what really bad SARS-2 looks like. For anyone who doesn't have invasive-ventilation-level COVID-19, the expectation that they might experience long term damage is completely unfounded.

Thank you for the detailed responses.

But please consider:

At the one extreme, someone says "31 confirmed death by Covid19 on children under 14 years." As though death is the only possible negative consequence, and since 31 is a very small number, that should put to rest any concerns.

At the other extreme end, we're worried about the teachers, the staff, and the families of the students. We're worried about children who get sick, don't die, and develop chronic conditions.

The real danger level is probably in-between those two extremes, is it not?

There is abundant evidence that children do not play a serious role in transmission, so concerns about the teachers are unfounded:

[COVID-19 Transmission and Children: The Child Is Not to Blame](https://pediatrics.aappublications.org/content/early/2020/07...) - July 2020

As far as negative consequences, there is no theoretical basis for long-term consequences of COVID-19. There is basis for medium-term lung abnormalities which happens in general with pneumonia, but that doesn't apply to children except the incredibly small fraction that actually have bad outcomes, which is so rare that we should literally treat it as a rounding error.

Even pediatric multi-inflammatory syndrome is incredibly rare.

No, most people are dramatically overestimating COVID-19 risk and dramatically underestimating risk of lockdown, universal masking, etc

What risk do you see in universal mask use? Lots of people have worn masks routinely for many years (medical staff, cleanroom operators, East Asians, etc.), without obvious bad consequences. Lockdowns are indeed expensive, but mask use seems pretty cheap to me.

You're an interesting person. In the same comment you say "most people are dramatically overestimating COVID-19 risk," and then cite an article which says,

"Coronavirus disease (COVID-19) presents arguably the greatest public health crisis in living memory."

In other comments, you've claimed there's no long-term risk to children, while the article you cite says,

"emerging reports of a novel Kawasaki disease–like multisystem inflammatory syndrome necessitate continued surveillance in pediatric patients"

Then you just plain went to far, when you said "there is no theoretical basis for long-term consequences of COVID-19." Sorry, but "there is no theoretical basis" is an over-statement. If you had said, "The evidence indicates there are no long-term consequences," you would have maintained your aura of authority. But "there is no theoretical basis" is too far, especially since you cited an article that specifically mentions novel Kawasaki disease–like multisystem inflammatory syndrome. That's not just a theoretical basis, that's an example of a concrete basis. "There is no theoretical basis" doesn't mean, "the theory is incorrect," it means, "it's impossible for the theory to be correct," and that's a statement the evidence YOU CITED shows is not true.

I think you're more informed on the subject than average, but I am no longer convinced you have a good grasp of even the evidence you cite, let alone the body of available research. You Google well, but you don't really understand.

(1) Kawasaki-disease is not long-term risk. It's a disorder that goes away.

(2) Given your only argument against my statement of there being no theoretical basis is what I addressed in (1), there's not much for me to address here. So I'll throw it back at you: What long-term pathology has been observed in SARS-1?

It may be that we are using "long-term" in different senses. I don't consider 3 months to be "long-term". AFAIK most people raising alarm about (unfounded) long-term damage are implying either lifelong or at least years+, right?

(3)

> In the same comment you say "most people are dramatically overestimating COVID-19 risk," and then cite an article which says,

>> "Coronavirus disease (COVID-19) presents arguably the greatest public health crisis in living memory."

I don't see how these statements are mutually incompatible. It's possible for COVID-19 to be the most serious pandemic in over a century - which it is - and for people to still be overestimating the risk.

There is a study that surveyed people for their estimated COVID-19 risk which supports my claim; people in the 20-29 age group estimated their risk of death if infected at 2%. Think about that. That's at minimum a 50x overestimate.

Humorously, the older someone was the less they estimated their risk in absolute terms; young people reported higher chance of death than older people.

https://www.nbcnews.com/health/health-news/monumental-acknow...

> There is abundant evidence that children do not play a serious role in transmission

Seems like there's evidence to the contrary:

Older children, 10-19, spread the Coronavirus just as much as adults, large study finds.

https://wwwnc.cdc.gov/eid/article/26/10/20-1315_article

That would be great if children under 14 then didn't have any interaction with anyone over the age of 14. So while it is good that kids are not dying at the same rate as others it doesn't mean they shouldn't be tested or doing the same things everyone else is to prevent the spread.

It's kind of odd.

People will get all upset over a report of a squirrel with bubonic plague, even though they never come anywhere near squirrels. Or they will hide because a raccoon walks through their yard in the daytime and they are afraid of rabies (even if they live in western Washington, where there has never been a known case of rabies in raccoons...). (The reason the raccoon is out in daytime is most likely that she has babies at home and needs to gather more food than she can with just her usual nocturnal foraging).

But children...which we actually allow to get close to us, even going so far as letting them into our buildings and vehicles? Meh.

Plague and rabies are much more deadly diseases. Plague kills about 10% of victims with the best treatment, and rabies can be vaccinated against post-infection but is basically unsurvivable once symptoms start.

Every time I see someone focus only on COVID deaths, I remember the millions of people infected by polio who "survived" but spent the rest of their lives crippled or in iron lungs.

Not dying does not mean 100% OK.

That effect does not happen with COVID-19. Most cases are asymptomatic, paucisymptomatic, or comparable to a cold in severity. Doubly so for children. There is no evidence of serious “long-term” harm in anybody. With severe COVID-19 - the kind that almost kills people - you might have a few months of non-permanent lung abnormalities.

SARS-2 is not the scary virus it’s made out to be. It’s just not. It’s a poor killer and a great spreader. Exactly the type of virus we in the general population need to let pass through us.

You sound authoritative, so I'll ask you to respond to something that seems on the face of it to be scary,

"Hundreds of health-care workers lost their lives battling the coronavirus"

https://www.washingtonpost.com/graphics/2020/health/healthca...

"The nation’s largest nurses union, National Nurses United, puts the total much higher: 939 fatalities among health-care workers, based on reports from its chapters around the country, social media and obituaries."

Isn't that a lot?

https://www.washingtonpost.com/investigations/2020/05/02/exc...

"Excess U.S. deaths hit estimated 37,100 in pandemic’s early days, far more than previously known"

Isn't the fact that you can visibly SEE excess deaths, greater than previous years' trends, concerning?

> It’s a poor killer and a great spreader.

It's such a great spreader, that even though it's a poor killer, it's killed 140,000 in the US.

Isn't that, you know, a lot?

No, 140,000 is not particularly a lot for a semi-novel virus, especially when you look at the populations dying from it (at least half of these deaths are people at death's door. That doesn't mean their lives don't matter, but it does mean that, it's not necessarily something unique about COVID-19 that killed them)

You should know that the way we classify deaths is highly suspect, but my argument doesn't hinge on that so assume all the deaths are legit.

> Isn't the fact that you can visibly SEE excess deaths, greater than previous years' trends, concerning?

As for excess deaths, assuming those are COVID-19 deaths is foolish. More people die every year from cardiac events than have died thus far from COVID-19 (and likely that will still hold by the end of this year for an apples-to-apples comparison); it stands to reason that many of those deaths are from cardiovascular disease, amplified by the unprecedented suspension of elective surgeries and preventative care, not to mention how afraid of going to the hospital people are.

BTW, go look at 2019 all-cause mortality compared to 2020 all-cause mortality. They're almost identical. So no, statistically this is not something super crazy.

^ Seriously, go actually look at that data. You will probably be shocked. I was.

Likewise, hundreds of health-care workers losing their lives isn't very surprising. Although in general I don't like to 'rebut' news articles because they don't give much that's actually rebuttable.

---

BTW, I've said this elsewhere but probably not on this thread yet:

Given COVID-19 kills the very old and spares the very young, once it has passed through the population, deaths in subsequent years will be nearly non-existent. Why? Because the set of COVID-19-naive individuals (of those who can actually get infected, since many cannot due to cross reactivity) becomes dominated by new entrants to the world, e.g. babies/toddlers. The same individuals who are virtually incapable of dying from COVID-19. Therefore unlike Flu, which apart from its ability to mutate is responsible for significant recurring death, COVID-19 will not have significant recurring death. Thus amortized over many years, the numbers look even better than they do now. And I know this sounds hard to believe, but the numbers to me look really good.

I believe our policy of lockdown has certainly increased all-cause mortality - I consider that inarguable - but furthermore, I think it is very likely that our policies have put our bodies into a state where we suffer worse outcomes from COVID-19. This is due to people staying inside and therefore not getting sun exposure, with vitamin d and to a much lesser extent nitric oxide playing INCREDIBLE roles in the outcomes of respiratory diseases (the magnitude of effect size shocked me w/ vitamin D), lack of exercise due to gym closures etc, social isolation which has been shown to increase death apart from the feeling of emotional loneliness (i.e. even if you take away peoples' emotional loneliness they still die more), lack of sleep and general life disruption attributable to unemployment and the "new normal", etc. I could go on, but really I should step away now before I spend hours in this thread...

> Likewise, hundreds of health-care workers losing their lives isn't very surprising.

Sorry, this seems to be completely wrong.

"5,250 workers died on the job in 2018." If 939 health-care workers died from Covid-19... That's a really big percentage.

> You should know that the way we classify deaths is highly suspect,

That's why looking at excess deaths makes a ton of sense to me.

> it stands to reason that many of those deaths are from cardiovascular disease

Sorry, that seems like an extraordinary claim.

It sounds like you're standing on your head to not blame the novel disease. And intentionally standing on your head to say that when the conclusion of the cause of death is Coronavirus, it's wrong. Both at the same time.

Wouldn't we see autopsies saying "the cause of death is a cardiac event" close to 140,000 cases more than normal, for your claim to be remotely true? We're not seeing that.

> BTW, go look at 2019 all-cause mortality compared to 2020 all-cause mortality.

Can you provide the references that you found? It's not clear to me how to find this exact data.

How many people who would have lived from a cardiac event are having trouble finding an ICU bed?

We hear 50+ hospitals in Florida have their ICUs completely full?

According the the CDC [1] the all-cause mortality in 2020 is currently 155,446 higher than the equivalent date range in 2019. This despite the fact that recent weeks for 2020 are definitely undercounts as it takes time for all the data to come in.

[1]:https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm

> BTW, go look at 2019 all-cause mortality compared to 2020 all-cause mortality. They're almost identical. So no, statistically this is not something super crazy.

This is just a flat-out lie.

[1]:https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm

Absence of evidence is not evidence of absence.

Too lazy to google, but has anyone done any research on how the recovered are doing, say in Wuhan 6 months after they got infected?

Long term effects: https://www.bbc.com/news/stories-53368768

This meme just won't die. It's a pandemic. It doesn't matter whether any given individual is at risk directly, becuase everyone can get this. Everyone sick, whether they live or die, means more people sick.

This conflation between individual risk and aggregate risk is just pathological at this point. It won't stop.

What about the overwhelming body of evidence showing that specifically children rarely if ever infect adults with COVID-19?

I expected children to be virtually incapable of dying from it, but learning the truth about spread was quite surprising to me.

> What about the overwhelming body of evidence showing that specifically children rarely if ever infect adults with COVID-19?

I don't know what you're citing. There are a few papers out there showing effects like this, there's certainly no "overwhelming" evidence of anything in a pandemic that's barely seven months old, be real.

> but learning the truth about spread was quite surprising to me

That phrasing freaks me out a bit. What, exactly, are you reading? This is science, that kind of certainty is a design smell.

s/truth/the current reality which is well-supported by the literature/ if it makes you happy. Don't read too much into the wording.

As far as the overwhelming body of evidence, let's start with some weaker but still reasonable evidence:

https://www.folkhalsomyndigheten.se/contentassets/c1b78bffbf...

> In conclusion, closure or not of schools had no measurable direct impact on the number of laboratory confirmed cases in school-aged children in Finland orSweden. The negative effects of closing schools must be weighed against the positive indirect effects it might have on the mitigation of the covid-19 pandemic.

https://www.eurosurveillance.org/content/10.2807/1560-7917.E...

Title: No evidence of secondary transmission of COVID-19 from children attending school in Ireland, 2020 separator commenting unavailable

> Children are thought to be vectors for transmission of many respiratory diseases including influenza [2]. It was assumed that this would be true for COVID-19 also. To date however, evidence of widespread paediatric transmission has failed to emerge

> Among 1,001 child contacts of these six cases there were no confirmed cases of COVID-19. In the school setting, among 924 child contacts and 101 adult contacts identified, there were no confirmed cases of COVID-19.

> In summary, examination of all Irish paediatric cases of COVID-19 attending school during the pre-symptomatic and symptomatic periods of infection (n = 3) identified no cases of onward transmission to other children or adults within the school and a variety of other settings. These included music lessons (woodwind instruments) and choir practice, both of which are high-risk activities for transmission. Furthermore, no onward transmission from the three identified adult cases to children was identified.

> The only documented transmission that occurred from this cohort was between adults in a working environment outside school. Among 1,025 child and adult contacts of these six cases in the school setting there were no confirmed cases of COVID-19 during the follow-up period. Follow-up period was at least one incubation period (14 days) from last contact with a case.

https://wwwnc.cdc.gov/eid/article/26/10/20-2403_article

> Children are underrepresented in coronavirus disease (COVID-19) case numbers (1,2). Severity in most children is limited, and children do not seem to be major drivers of transmission (3,4). However, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects children of all ages (1,3). Despite the high proportion of mild or asymptomatic infections (5), they should be considered as transmitters unless proven otherwise.

^ Note I included the "they should be considered as transmitters until included otherwise" to ward off accusations of cherry-picking

---

Now, even if children did spread normally, I would still be against school closures, indeed I am against the policy of containment entirely because I view it as an infantile and ineffective policy that just leads to worsened all-cause mortality and likely worsened COVID-19 mortality over the medium-term.

There is one last study that I am having trouble finding which was much stronger/more conclusive than the ones I linked above, but I'm having trouble finding it. Really need to organize these studies better. (I have a master list of studies w/ relevant tidbits but haven't done that for the children studies since it doesn't interest me as much, given we already know that children don't personally die from COVID-19 in any real numbers)

None of that is the kind of evidence that you'd use to justify the kind of hyperbole you used above. Kids definitely don't seem to get sick from this disease with the frequency we'd expect. And this should absolutely inform policy on the margins. You'd open a school before a senior's choir for sure, etc...

But you don't play games here. This age dependency is just barely measured, not understood well AT ALL (it actually runs counter to the way almost all other respiratory viruses work!), and based on measurements that at best are a few months old. Most of the papers in this space are preprints, peer review is just now catching up.

Just stop. A few links doesn't make for proof in this space. People will die if we get it wrong.

Yes, people will die if we get it wrong by engaging in a destructive policy of lockdown.

That's your problem. You and everyone in your camp acts as if all the uncertainty exists in the "herd immunity" side. It doesn't. The risks of SARS-2 infection are much better bounded than the risks of unprecedented lockdown and economic destabilization. Full stop.

What do you want to imply by that?

"Only" is quite cruel btw considering that those kids will never grow up to have a life and how many other people sick kids infect and probably kill.

>What do you want to imply by that?

That the death rate for children is incredibly low.

This is not what he/she wanted to imply. This is what was written there.

Reply on news.ycombinator.com