Almost third of UK Covid hospital patients readmitted within four months
theguardian.com
theguardian.com
From the study:
> At baseline, individuals with covid-19 had a mean age of 64.5 (standard deviation 19.2) and 54.9% were men. Compared with the general population, individuals in hospital with covid-19 were more likely to be: male, aged 50 or more, living in a deprived area, a former smoker, and overweight or obese (table 1). Individuals with covid-19 were also more likely to be comorbid than the general population, with a higher prevalence of previous admission to hospital and of all measured pre-existing conditions (most notably hypertension, major adverse cardiovascular event, respiratory disease, and diabetes).
> Individuals discharged from hospital after acute covid-19 had increased rates of multiorgan dysfunction (particularly respiratory and cardiometabolic) compared with a matched control group from the general population
> The rate ratio of multiorgan dysfunction (comparing individuals with covid-19 and matched controls) after discharge was greater in those aged less than 70 than in those aged 70 or more, and in ethnic minority groups than in the white population
> Our findings suggest that the diagnosis, treatment, and prevention of post-covid syndrome requires integrated rather than organ or disease specific approaches
> A total of 5960 patients were included in the studies identified. The current smoking prevalence ranged from 1.4% (95% CI 0.0–3.4%) to 12.6% (95% CI 10.6–14.6%). An unusually low prevalence of current smoking was observed from the pooled analysis (6.5%, 95% CI 4.9–8.2%) as compared to population smoking prevalence in China. The secondary analysis, classifying former smokers as current smokers, found a pooled estimate of 7.3% (95% CI 5.7–8.9%). In conclusion, an unexpectedly low prevalence of current smoking was observed among patients with COVID-19 in China, which was approximately 1/4th the population smoking prevalence. Although the generalized advice to quit smoking as a measure to reduce health risk remains valid, the findings, together with the well-established immunomodulatory effects of nicotine, suggest that pharmaceutical nicotine should be considered as a potential treatment option in COVID-19.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210099/
> Based on the early observations of the lower than expected smoking prevalence in hospitalised COVID-19 patients, Changeux and colleagues suggested a role for nicotinic acetylcholine receptors (nAChRs) in the pathophysiology of COVID-19 via a direct interaction between these receptors and the viral spike (S) glycoprotein.11 This suggestion was based in the fact that the S protein from SARS-CoV-2 contains a sequence motif similar to known nAChR antagonists11 (Figure S1), such as α-bungarotoxin from Bungarus multicinctus and glycoprotein from Rabies lyssavirus (formerly Rabies virus). Changeux et al. also proposed that COVID-19 might be controlled or mitigated by the use of nicotine, if the latter can sterically or allosterically compete with the virus for binding to these receptors.9,11
But temporary -- and not all that long compared to the hell we've all had to endure for more than a year now -- except in extremely rare cases. Evidence to the contrary is welcome, after more than a year there should be some.
https://www.health.harvard.edu/blog/the-tragedy-of-the-post-...
Search for the term "covid long haulers" to get more information.
> Search for the term "covid long haulers" to get more information.
No. https://thelogicofscience.com/2016/09/27/dont-tell-people-to...
You understand the burden of proof is on the person who's making a claim, not on people who disagree with the claim?
I've too suffered being stuck at home for more than a year, but in my book this is still better than me or somebody else getting sick with god-only-knows what long term complications, which we don't have data for one way or another, and won't for some time still.
Interesting idea, but false in this case unless you are arguing that lockdowns are and will be, in perpetuity, the status quo.
> this is still better than me or somebody else getting sick with god-only-knows what long term complications, which we don't have data for one way or another
Are you arguing your presence in society is outweighed by the mere possibility of you having a negative effect on it?
I am not arguing either way, what I am saying is shouting "here's what I think, prove me wrong" is not how it works. "Here's what I think, and here is the evidence" is how it works.
Lack of data can't support any claim. If we don't have good data on whether lockdowns are effective, it doesn't mean they aren't. It means we don't know. In which case we do a risk analysis, taking our uncertainty and potential benefits/drawbacks into account.
> Are you arguing your presence in society is outweighed by the mere possibility of you having a negative effect on it?
I don't consider myself absent from society. I am talking to you now, am I not? And yes, I consider my temporary suffering to be outweighed by potentially permanent suffering of myself or someone else.
> which we don't have data for one way or another, and won't for some time still.
Exactly. There is no evidence for "long Covid" as a frequent phenomenon. The pandemic has been going on for 15 months. Yet those who believe in long Covid still only provide evidence that people aren't always fully recovered after timespans like 3 months.
If Covid frequently caused permanent damage, there would be a lot of people who were infected, say, a year ago, who haven't recovered and show no sign of doing so (their condition has plateaued). There would be studies showing that, there isn't exactly a shortage of scientists researching the topic. And, obviously, people would provide that evidence as it would support their point better. Yet they don't.
So what you are saying is, despite "the experts" saying exactly the opposite... by slowing the spread of covid we'd somehow be out of this sooner?
Do you guys realize how insane this logic sounds? The goal of these lockdowns was to intentionally slow down the spread. Not stop or eradicate covid. Harder lockdowns mean this goes on much longer.
How can people genuinely think otherwise? It's like basic math.
There is a minimum number of deaths that we should accept as a society just like we accept other causes of death.
Speak for yourself!
My life was largely unchanged by covid beyond wearing a facial covering in public which I actually prefer. What a joy to not only walk into banks dressed like a bandit without getting arrested, but to be asked to do it and thanked for cooperating!
This certainly hasn't been any sort of hell for me, but catching covid let alone "long covid" seems likely to be quite awful and potentially life-changing for anyone.
Living in US, NJ FWIW
Not a doctor. Could be wrong. Just sound like anxiety symptoms from my experience.
I still haven’t gotten fully back on my feet.
I've had similar symptoms, and more, for the past 8 months. Heart palpitations, feeling of heaviness in the chest, strange exhaustion... I admit this does sound like anxiety. However, after suffering from anxiety for two decades, I've learned what my anxiety feels like. This is different. It's like comparing grits and runny oatmeal--I can understand why many descriptions are insufficient to distinguish between them, and even how one might be able to masquerade as the other, but having had both, it's clear they are not the same.
So maybe I'm wrong and I haven't been experiencing anxiety when I have these symptoms. I agree it's a bit different than having a panic attack in my experience.
No symptoms at that point. 2 days later, I started feeling more tired than usual. The next day I had a mild fever and was sweating more than usual when exercising. This lasted 3 days, after which I only felt the fatigue for another 5 days.
No lasting effects that I can name.
I'm 31, male.
I had a cold around 5th-10th of February. I take levothyroxine every day, multivitamin everyday, Gabapentin every day, Vitamin C 500mg twice a week. Light exercise everyday, a more thorough workout twice a week. I drink alcohol and smoke tobacco regularly, and everyday between 24th of February - 15th of March.
I mention all that because some research said the cold and CV viruses are competitive, plus having the immune system "battle ready" after a simple cold could've helped. Levothyroxine increases metabolism, vitamins and exercise probably help. Smoking has been linked to lesser symptoms, too. I wonder what the effects would've been without all that.
Anxiety over Covid (I scared myself reading reports on Reddit) and losing my job (unrelated, but bad timing) was by far a bigger problem than the virus itself.
Which is not to say that others do not have lingering symptoms -- but if we're going to emphasize scary anecdotes, it seems like we should spend proportional time reporting the vastly larger number of anecdotes that are not scary, as well?
Most people (I read it's around 86%) having such mild symptoms that they don't even realize it's Covid must've contributed a lot to its rapid spread.
The more vulnerable people get the same virus and suffer much more. Perhaps vulnerable people should've been subjected to stricter lockdown measures, not sure what else could help reduce the deaths.
I haven't backed up my personal data in years and nothing nasty has happened, despite all those catastrophic data-loss stories you read online. I'm all for proportional reporting time, but strangely, no one reports on stories like mine - it's mostly in the vein of "Company shutters after accidental db deletion". I wonder why.
There's a reason we pay attention to tail risks, where the low-probability negative consequences are far worse than the high-probability costs of averting them. The vast majority of people are not going to die in car crashes, or of SIDS, or of COVID, or from untreated kidney infections. They are lucky. But the consequences of death are so much worse than the costs of wearing a mask, or not seeing your friends in person, or dealing with anxiety, that it's worth taking some precautions even if the chance that you'll die from COVID is low.
I still hear people worrying about safety despite the fact that half the UK, a large part of the US and countless others have been jabbed. That's after the original trials. I can understand some people's reluctance wrt vaccination. Many countries have had examples of problematic vacc campaigns. In the UK the MMR jab had a major set back due to Andrew Wakefield's false article in the Lancet [1].
From what I gather the thrombosis risk from the Oxford/Astrazeneca jab is somewhat swamped by error bars and open to interpretation. However the risk from the pandemic is very real and demonstrably so. I had my jab last Tues and it was O/AZ but I wont ask anyone to extrapolate much from that!
No, by definition, they're the norm. They're not lucky, they're just normal. The expected outcome. The people who encounter the tail risks are unlucky.
Not too long ago, a part of a jet fell off over suburban Denver. I would be dismayed if someone -- engineers and investigators -- didn't obsess over this event. But if my brother wants to know if it's safe to get on an airplane, or live in suburban Denver, then my answer is not going to change.
I would also discourage anyone else from reading HN posts with obscure technical documents from Boeing and the FAA, and speculating about what it means for aviation in general. Or reading other peoples' posts on these topics, and sharing anecdotes about how "someone they knew" died in some ghastly aviation accident. And so on.
It is in our nature to exaggerate the importance of rare events. They are still rare.
> But the consequences of death are so much worse than the costs of wearing a mask, or not seeing your friends in person, or dealing with anxiety, that it's worth taking some precautions even if the chance that you'll die from COVID is low.
How did masks get swirled up into this? I swear...people will find any way to turn these things into a political debate. Can we agree that by this point, the debate about masks is fully baked, and no amount of discussion of Covid outcomes is going to change someone's mind?
You can find anecdotes on the internet to support literally any fear that you care to indulge. The point is, most of the time, these fears are not worth indulging, and what you read on the internet exaggerates the actual threat.
Unless I'm misunderstanding what you're saying I quite disagree with you that death is so much worse than anything else. Why is death so bad? It's the only certainty you actually have in life. There's an average age of death but you're quite unlikely to die at that specific one. It's gonna come either expectedly (like a cancer diagnosis giving you X months to live) or unexpectedly (an accident). Just accept it and stop trying to fight it by trying to minimize the risk since it'll happen anyways. Instead think about whether there are things you want to prepare for those left behind when you do go. And then stop worrying and enjoy the ride while it lasts. It's just a dice roll anyways, try to have fun! Don't hold back. Challenge yourself, face your fears, jump into the unknown. Don't try to follow the recipe for a perfect harm-free life to the book. That sounds like an insanely boring life to me but I suppose YMMV.
It also talks about how poorer people, and those from non-white backgrounds are disproportionately likely to have worse outcomes.
Just because you don't see it happening in your circles, doesn't mean it's not happening in other ones.
The authors write in the BMJ: “The increase in risk was not confined to the elderly and was not uniform across ethnicities."
Having an office of national statistics does not mean that this particular paper is being reported correctly by the mass media, it doesn't mean that the paper itself supports the discussion of "long covid" amongst otherwise healthy people, and it certainly doesn't mean that other people on this thread reporting personal stories are representative of the actual risk. That last bit is what I'm emphasizing here. Literally any scary anecdote is amplified, and the (many more) pedestrian anecdotes go undiscussed.
As other comments on this page have noted, there are a number of legitimate criticisms of this paper that should be considered carefully, and even if you don't agree with those, the paper is self-admittedly discussing a predominantly elderly, sick population who were hospitalized for the virus. It doesn't generalize to discussion of anecdotes of "long covid" from much healthier people.
> It also talks about how poorer people, and those from non-white backgrounds are disproportionately likely to have worse outcomes. Just because you don't see it happening in your circles, doesn't mean it's not happening in other ones.
You're making assumptions.
https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...
To me, they seem to be trying to make it as accessible and clear as possible with most news articles taking the salient points directly from the ONS's own summary.
As you can see from figure 2, their data is not focused on old people as you erroneously claim, it does seem to show that more deprived = more symptoms, and that non-white are more likely to have symptoms.
But the weird long-COVID cases are problematic - they're real, they affect a certain slice of the demographics, and can be pretty serious and long-term.
They are definitely real, and can be serious and long term, but they likely aren't novel; I suspect ME/CFS, "long lyme" and a variety of other conditions often dismissed as psychosomatic by practitioners who can't find a test for them - are post viral/post infectious syndromes, and they will be joined by "long covid".
Perhaps some good will come of this - those "long sequelae" diseases will get more and proper attention.
But none of the data I've seen so far about "long covid" puts it out of line with what we've known about post-viral sequalae for ages.
The hard part is unless you have diabetes or similar, it seems random to me. And I don’t see good accounting of long term symptoms.
The political bullshit is such that we won’t really know what’s up for a few years.
I am interested in reading about others' experiences, it's just that everything I could find (mostly on Reddit) depicted a much worse picture.
And yet statistics say that the vast majority of people have it easy like me.
I mentioned I would love a database like Erowid, with input from everyone who has had a confirmed infection. I'd read through all of it and make my own conclusions.
I was told to self quarantine and call an ambulance if I felt worse. The hospitals here are overwhelmed just like many other cities/countries.
A small minority of people having serious difficulties with the virus can turn into a large medical issue when the denominator is 1/3 to 1/2 of the country getting infected.
You may already be aware of this but there's an organ there called the thymus which is a core part of the immune system (especially in younger people)
Seems to be a symptom with relatively little discussion even in medical journals but can confirm I also had it for months after a relatively mild case, tending to reemerge due to tiredness or exercise.
The thymus (the favourite organ of a friend of mine) is quite unusual, being replaced by regular boring fatty tissue after childhood.
[0]: https://valerieeliotsmith.com/2021/02/19/a-short-post-on-lon...
But taking that perspective requires correcting for the systematic underweighting of the testimonial evidence of patients of chronic illnesses.
Less trendiness, more empathy, please.
Fortunately I'm on the mild end of the spectrum and flairs are infrequent but it'd be nice if we had something better to treat auto-immune disorders.
To control my chrohns I changed my diet by removing foods, keeping track of general well being for a few weeks then gradually introducing them to see what happened til I found a routine that worked, it's bland most of the time but I'll take the win - basically a Mediterranean diet which is fine.
There is however a bunch of things in the pipeline including things like targetted biologics to selectively target the immune system that are exciting.
I'd lost a lot of weight worryingly fast - mostly because of massive reflux problems (barrets oesophagus), was having frequent bouts of vomiting and diarrhoea and was generally in a shit state all around - as for diet it's really hard to recommend anything to anyone else since it varies so much - what worked for me was keeping a detailed journal of what I ate, how I felt, how I slept, toilet habits, times etc then I cut out basically everything from my diet I could for a few weeks (think porridge, cottage cheese and mashed potato/oven cooked chicken breasts) and very gradually added things back still keeping the journal until I had actual data I could look at - for me there isn't really any one food or group that acts as a trigger red meat/processed meat comes the closest, it's large high fat/high carb (think Pizza) that do it - if I eat fresh foods/veggies/fish/cheese (hard not soft) and limited amounts of fruit I have it mostly under control but what works for me might wreck you.
I am not a medical professional, but I know these people and how their bodies functioned beforehand. The way they are now is certainly not a hard-to-diagnose chronic syndrome that is unreleated to them catching the damn thing.
But, also, you'll find people with long COVID who are finally paying attention to other symptoms and ascribing them to the C-19 infection.
But if you screened any population of lower health you'd find a fair number of instances of these... and historical baselines are probably not valid because we've had a weird year. So-- the exact incidence of some of the milder end of long COVID is hard to pin down.
Certainly some people have these symptoms and they are very very likely to be from the COVID infection itself.
But other people have more minor symptoms and these are included in many estimates of post-COVID syndrome, and discerning whether they were related at all to COVID and caused by COVID itself is more complicated, because if you were to screen a normal population with these criteria you'd find a fair incidence of these symptoms.
I was down for about two additional months after that, in which I caught another flu twice, and could barely get out of bed for a while. And then I proceeded to have complications from colds and flus that evolved to bronchitis or pneumonia every single flu season for the next 8 years.
It took nearly a decade to really recover from that. I see no reason to think any sufficiently bad respiratory infection with high enough viral load wouldn't do the same thing, especially to people much less healthy than 20 year-old me, a two-time state champion cross country runner in high school.
post-infection complications are not uncommon, although specifics certainly vary. i'd also had a long tail of recovery from a flu->bronchitis->pneumonia cascade a few years ago (on the order of many months, not years).
Salt has a way of pulling infections out of tissues.
'"When fine salt particles are inhaled, they will fall on the airway linings and draw water into the airway, thinning the mucus and making it easier to raise, thus making people feel better," said Dr. Edelman.'
https://www.lung.org/blog/promising-placebo-salt-halotherapy...
There is salt in the air at the beach, so I'd stay away from the ocean if you think inhaling salt is a bad idea.
The political/social powder-keg of denying a covid related insurance claim is not one that a health insurance corporation would probably be willing to take, at least for another year or 2.
The "pushbacks" you see on social media are essentially the output of a random sentence generator. Covid is not real, covid escaped from a lab, covid is a conspiracy, etc. etc.
Be careful with that stuff. You are what you read (and believe).
There's varying severities. The 1/8 figure applies only to people who developed long-COVID after being hospitalized for acute COVID (i.e. most likely on a ventilator).
Minor COVID cases can still develop several long-COVID symptoms (the symptoms you pointed out) that aren't life-threatening. This is the long-COVID you generally hear about because surviving a minor or asymptomatic case of COVID isn't the end of your worries, and is why it is beyond idiotic to play fast and loose with the virus.
The "hospitalised for Covid" part of the sample group is introducing a lot of bias. Fit, young and healthy people are much less likely to end up in hospital. So it makes sense from the first that the group is suffering more problems than a general population control group.
Over a mean follow-up of 140 days, nearly a third of individuals who were discharged from hospital after acute covid-19 were readmitted (14 060 of 47 780) and more than 1 in 10 (5875) died after discharge, with these events occurring at rates four and eight times greater, respectively, than in the matched control group. Rates of respiratory disease (P<0.001), diabetes (P<0.001), and cardiovascular disease (P<0.001) were also significantly raised in patients with covid-19, with 770 (95% confidence interval 758 to 783), 127 (122 to 132), and 126 (121 to 131) diagnoses per 1000 person years, respectively. Rate ratios were greater for individuals aged less than 70 than for those aged 70 or older, and in ethnic minority groups compared with the white population, with the largest differences seen for respiratory disease (10.5 (95% confidence interval 9.7 to 11.4) for age less than 70 years v 4.6 (4.3 to 4.8) for age ≥70, and 11.4 (9.8 to 13.3) for non-white v 5.2 (5.0 to 5.5) for white individuals).
According to the paper, this control group was picked because, essentially, that’s what the authors wanted to choose:
> We selected controls from the general population rather than matching to non-covid hospital admissions to determine the increased risk after hospital admission for covid-19 versus no hospital admission for covid-19 (that is, compared with the expected risk for people with similar personal and clinical characteristics in the general population).
> Individuals were included if they had a hospital episode from 1 January to 31 August 2020 with a primary diagnosis of covid-19
(from the full paper)
People who present once for one thing are probably more likely to present a second time: either because they have a lower threshold for seeking help, they have overall poorer health and so present more often, or because they have a referring primary doctor who is biased towards admitting over treating outpatient.
However, I don't think it can explain the far higher death rate.
Isn't that a clear indication that there's something besides "general trends in old people" going on here?
Looking at the tables, you might get the idea that COVID hospitalization causes a lot of diabetes. The way they arrive at that is to count the diabetes diagnoses made after COVID admission.
However to me it seems far more likely that a diabetic without a diagnosis (which is common) gets hospitalized with COVID, then gets their diabetes diagnosis in the ensuing medical surveillance. Having an undiagnosed liver or heart issue is also common.
(There are other good questions to ask too, of course.)
Why deviate?
They do justify their choice in the actual paper (e.g. see the end of the "Study population" section).
(It's also interesting to compare COVID hospitalizations to other ones, say from a heart attack or allergic reaction, but those are different questions. For example, maybe a COVID hospitalization is less bad than one due to a heart attack, or worse than an allergy. Or maybe any hospital visit is just bad period. But given many people got hospitalized by COVID this year - something that never happened in the past - we need to know what that event cost them, that's the point of this study.)
How do you then control for those with a chronic condition that is undiagnosed? If somebody is hospitalized, they'll perform all sorts of tests on them, that's how many people get their diabetes diagnosis in the first place.
Looking at the charts, you might get the idea that there's a staggering increase in new-onset diabetes following COVID infection, which doesn't seem plausible to me. Yet, right next to that, you see damage in heart, liver and kidneys, and this gets picked up uncritically as an outcome of COVID. The hypothesis that COVID causes organ damage is already well-established, so this just confirms what we expect. What we don't expect, we just ignore, even though it might point to a flaw in our methodology.
But we know that COVID admittances caused a big increase in the total number of people hospitalized - to the point of overwhelming some health care systems. That strongly suggests that underlying conditions would not have sent as many people to the hospital anyhow if COVID had never appeared and infected them.
It is possible you explain the mechanism, though. Perhaps there are lots of people with undiagnosed underlying conditions, and getting a serious case of COVID is enough to worsen those conditions into life-threatening ones. (Perhaps this only hastens the inevitable for some of them.) If this is the mechanism then both you and the article's hypotheses would be correct.
> Rate ratios comparing patients with covid-19 and matched controls were greater in individuals aged less than 70 than those aged 70 or more for all outcomes
> An alternative approach might have involved comparing outcomes after covid-19 and other hospital admissions; such research has recently been conducted with similar data sources to those in our own study (although with a smaller covid-19 cohort), and comparable rates of organ dysfunction were found between patients with covid-19 and patients with pneumonia who were discharged from hospital in 2019.36 We believe that our study design, where comparisons were made with the expected risk in the general population, was more relevant to public health policy, and complementary to the study that used non-covid hospital admissions as the comparison group. Also, the use of non-covid hospital admissions as the comparison group does not allow estimation of excess morbidity because non-covid admission does not necessarily represent an appropriate counterfactual situation to admission to hospital for covid-19, and the size and direction of the inferences will depend on the choice of control admissions.
I wouldn’t call it the most useful one.
If those who were admitted to a hospital with COVID already were less healthy than those who weren’t before they got COVID (and that’s a given. Higher lung capacity can keep you out of the hospital, for example), I don’t think it is a surprise they still aren’t as healthy when they leave the hospital.
I could imagine COVID being causally implicated in respiratory disease or cardiovascular disease, but diabetes? That sounds to me like the control group wasn't representative.
https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precaut...
https://www.thelancet.com/journals/landia/article/PIIS2213-8...
No, because that is in literally the objective: "To quantify rates of organ specific dysfunction in individuals with covid-19 after discharge from hospital compared with a matched control group from the general population."
I wouldn't even rule out that COVID causes diabetes, but at the same time diabetes is commonly underdiagnosed, as is heart or liver disease.
https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports
Page 29 has a chart for spread of age. Most people (88%) live without any assistance in day to day activity.
> 47,780 patients with covid-19 (4,745 admitted to the intensive care unit and 43,035 not requiring admission to the intensive care unit) were included in the analysis
It's always possible they missed a factor, that's always a risk in such research, but they worked hard to address that possibility.
> We selected controls from the general population rather than matching to non-covid hospital admissions to determine the increased risk after hospital admission for covid-19 versus no hospital admission for covid-19 (that is, compared with the expected risk for people with similar personal and clinical characteristics in the general population).
It's all confounded. If you compare to other hospital admits, you're finding an even-less-healthy population (because they had a reason to show up to the hospital -without- COVID). If you compare to the general populace, you risk inadequately controlling the comparison.
But if you want to know the increased risk people have subsequent to COVID hospitalization, perhaps the latter makes the most sense to measure.
[1]: https://en.m.wikipedia.org/wiki/Strengthening_the_reporting_...
Maybe a better question to ask would have been: typically do 1 in eight people who have been discharged from the hospital after non-covid issues and have the same co-morbidities as the group in the study die within 4 months?
Person A: 'We should open up' Person B: 'Have you not heard most people have serious health problems after covid?'
When we talk about proportional reporting I think of the book 'Thinking fast and slow'.
Also, last year some newspapers irresponsibly allowed some people to share their claims that they were dealing with tough long-term COVID symptoms even when they had never even tested positive for the disease in the first place. It was no different than giving a megaphone to the people who, before COVID, experienced some distress and, without any actual medical verification, were sure they were cases of "chronic Lyme disease".
Health officials in several countries have plainly fudged the truth or left out details when speaking to the public, for what they see as the greater good of maintaining restrictions for long enough to reach their public-health goals. One naturally suspects that they found the panic about long COVID useful for this.
Are their unusual or particular symptoms compared to other people with long term issues after viral infections?
I full believe "long covid" is a thing. But so much of covid news has been shitty "studies" that get a lot of press despite shedding very little light and go on to be rapidly disproven but still repeated (Vit D, Chloroquinine etc).
https://news.harvard.edu/gazette/story/2017/02/study-confirm...
Folks needing hospitalization are pretty sick. If they're older, this seems a normal result. I'd have to see some statistics to call it remarkable.
Our vaccination numbers are terrible: at the rate we are vaccinating all Danes will have started their first vaccination round by July 21st, 2022. [1]
We've had the Moderna vaccine since January 13th [2] of the previous year. This is not people failing, these are our leaders failing.
I was so gung ho about us coming together to make the sacrifices and beat this thing but now a year and a half later I'm done with the colossal failures of our leadership and the promulgation of fear everywhere.
[1] https://hvorlangtervi.dk/english
[2] https://nymag.com/intelligencer/2020/12/moderna-covid-19-vac...
I don't think humans anywhere are able to "pull in the same direction" to the extent that such a lockdown is possible without an authoritarian government. Italy imposed pretty draconian rules for at least six weeks, and has still had to deal with a second wave and additional lockdowns.
Personally, I think that the principles of personal freedom (that such an authoritarian government is largely incompatible with) are much more valuable in the long run. Working through the disease has been messier in the last year, but the economic system largely based on these principles was also able to produce novel vaccines. While the last year has been rough, I'm much happier overall that I don't live in a place where an authoritarian lockdown is even possible.
The chance of stopping it early increases exponentially, if there are fewer ways into your country from countries that are themselves exploding with the virus.
In Europe, all countries broke down eventually and all these cases are ultimately imported from crisis areas. Many were never caught.
Keeping borders open - in the EU sadly not something that could have been realistically changed, if ever - is the reason.
Look at the facts: NZ caught all cases early. Full stop. So did Germany - at the beginning. It worked in either case. But NZ also kept cases low by limiting travel. Germany did not do this - least of all because the EU literally sued Germany when it started (very recently) to lock borders.
Australia not only can limit travel easily, but is also huge and barely populated. When there was a significant outbreak, it was physically possible to cordon off the state in question.
In Europe, once the spread began, it was already present in every locality - since Europe is tiny and entire countries have higher population densities than Sidney or Melbourne! And, this is also important, there is significantly more travel of people and goods, and it is far less concentrated on a few areas. Many people in Europe go to work in a different country from where they live, every day. There are literally no borders where you could test people. It is being tried. It does very little. Look at the spread in areas bordering high incidence regions. The borders are as closed as EU laws allows. It simply does nothing.
This is it. If you closed borders, then you made it. If you did not, then nothing much helps except trying to reduce incidence rate such that hospitals do not collapse.
We all dreamed of containing non-regionalized outbreak clusters by contact tracing. In reality all health services, even the very best ones in the world, eventually got rolled. Some sooner, some later. Sometimes contact tracing worked up until the mutation showed up. But it never worked consistently, except with closed borders.
Which countries contained the spread while having a high density and without being an island? Vietnam. However, cross border traffic between Laos and China is either strictly controlled or not economically significant - in either case, Vietnam is also an example of a country that managed to lock down borders - even tourism - almost entirely.
Conclusion: Covid has to be geographically contained with maximum force. If that is not realistic, for example if your country has the density of a city, then you need to stop it from getting in in the first place.
And unsurprisingly, being an Island and not 100% dependent and interconnected with daily border-less traffic helps a lot. Being a huge country with less population density or other ways to cordon off locally also helps.
In Europe, several countries were doing fine. They had lockdowns, contained local spreads and did contact tracing. They did not do less than NZ or Australia - except they were still surrounded by dozens of other highly populated areas with entirely different policies, all with different timings. The result was the same everywhere - eventually.
So, theoretically the EU could have been saved, if border would have been closed off immediately after the first cases appeared in Italy. Despite the fact that people believed contact tracing was viable - an option that does not shatter the political and economic fabric of the region.
This post is already too long, but you can read up on the discussions at the time and the political, geographical, economical and demographic situation in the EU to convince yourself that the chance of early border closings was close to zero.
The average for island nations like New Zealand was 0.
https://www.cbp.gov/newsroom/stats/southwest-land-border-enc...
How is this a fair comparison?
> This would have entailed no one working at grocery stores, no deliveries, no travel, no global trade. I just don't buy that this was ever plausible for however long people suggest: 3 weeks, 6 weeks whatever.
The experiences of (at least) New Zealand and Australia are clear evidence it is absolutely possible, without the absurd extremes you are talking about.
If I had to guess, I would guess that COVID can be transmitted by fomites, especially if kept cold, but that it’s extremely rare. In a place like the US or Europe, this is insignificant: your chance of getting seriously sick due to touching something is negligible, and the rate of additional cases due to this effect is inconsequential for public health. But in AU or NZ, where the background rate is essentially zero, a single reintroduction is a big deal.
Right, so why would the US - with much more porous borders - somehow do better?
But, beyond the fact that the US has large land borders, the US has a genuine problem. We are economically dependent on legal and illegal cross-border seasonal migration. I personally think that, with actual political will, the borders could be made a lot less porous, but this would involve attacking the supply and demand sides. Neither party is interested.
I don't like the previous administration one bit, but this was a really hard problem. By the time covid was taken seriously I think it is confirmed it was a least spreading in Seattle and Bay Area.
This reads like Covid arrived in the US through uncontrolled land crossings from Canada or Mexico? I'm pretty sure like Australia and NZ, it came by land and sea mainly.
> Also US has different states with different rules, but no ability to restrict travel between the states
Also Australia never had seen states close borders before. Yet somehow each of the 6 states and 2 territories managed to get legislation passed to do this, get police mobilised, and just got community buy-in that was going to work.
Any strategy which depends on complete cooperation of a large number of humans for success, well, I would short that stock.
The pandemic will pass soon, but countries walling themselves off could have consequences that even our grandchildren might have to deal with.
This idea that if we locked down harder or people "behaved" we'd be done with covid is a complete lie. That was never the intent of these restrictions. Ever.
I find it very curious how even after massive stockpiles of unused ventilators were donated and countless field hospitals were closed up after never seeing a single patient governors extended their stay-at-home orders. Despite it being shown that covid was never a true threat to healthcare, despite the sky-high IFR predictions being shown wrong (thankfully!), we let the goalpost shift to.... well... I still don't know what the goal is. We got very lucky having a vaccine delivered so quickly because without it, we'd have been drifting along aimlessly and things would have got very dark and ugly.
> Americans absolutely refuse to work together
Curious how many of the nations in Europe that "did it right" wound up getting major outbreaks regardless. Also curious how the curves of all regions basically mirror each other regardless of restrictions or "how serious they took it". Maybe, just maybe, humans aren't as in control of a widespread respiratory virus as they'd like to believe.
I believe it is peak human arrogance to think we could somehow control a respiratory virus in this manner. In my opinion history will look upon all this the same way we look at our ancestors performing rain dances and goat sacrifices. They are all examples of meaningless rituals humans perform in order to fool themselves into believing they have more control over mother nature than they actually do.
We detached this subthread from https://news.ycombinator.com/item?id=26673398.
Edit: your account has been breaking the HN guidelines a ton lately. If you keep doing that we will have to ban you. Please review https://news.ycombinator.com/newsguidelines.html and fix this.
Last week of January reported 55 vs 23,972 on average any other season.
Indeed there's a suspicious drop in influenza-type cases, likely caused by all the social distancing and perhaps by SarS-COV-2 simply out-competing influenza-types in knocking people out.
https://www.health.govt.nz/our-work/diseases-and-conditions/...
Shouldn't the vaccine have helped, though? I don't know.
Exactly the same about the lack of congestion. That's something I've never had in my life, cold symptoms without congestion. That's the reason why I think it was covid. Plus a little fatigue and muscle soreness.
Overall it was light, medium at most. But def something.
Here's an interesting explanation of how Vitamin D helps the immune system.
https://www.youtube.com/watch?v=cT1CaTv5-e4
Vitamin D improves your uptake of calcium. Vitamin K2 makes sure calcium goes where it's supposed to go. You want your BONES calcified, not your arteries.
> one in eight of patients dies in the same period
"Eight of them" is grammatically unremarkable. "Eight of the patients" and "eight patients" are also unremarkable, although slightly different in meaning.
"Eight of patients" is jarring. It sounds like "four of clubs."