Cognitive deficits in people who have recovered from Covid-19
thelancet.com
thelancet.com
People complaining of fatigue or having difficulty concentrating or having brain fog are in some studies already counted as suffering from long covid. No causual relationship required.
A friend of mine is a doctor and we were chatting about long covid 2 days ago, his description of it seemed pretty cut and dried to me - e.g. a swimmer here in Glasgow with hopes of getting to the 2024 olympics is currently unable to train due to breathing issues post-covid. They’re supposed to be fully immersed in training right now but can’t since covid in December 2020.
It's just not consistent with the "It's all in their minds theory," or "it's the same as stress from isolation" theory.
There's clearly something neurological going on, and we don't understand it yet.
Was a nightmare getting those under control but my symptoms eased up. Then I got covid and it all started up again. Took months to get back to a baseline, but symptoms were identical, aside from loss of smell.
Ofcourse long covid is real. I am just a bit skeptical about the diagnosis criteria.
I really don't understand what point you tried to make.
The whole point of scientific papers is to gather and document findings in a way to be subjected to critical analysis and serve as food for thought.
From your own example, which unfortunately is completely unsubstantiated, documenting symptoms reported by patients is a good starting point to form hypothesis to be verified or rejected.
I spent years being dismissed as depressed Or having anxiety. When I finally was diagnosed and started treating condition with medications I could handle my cognitive problems and depression lifted.
Support groups for autoimmune conditions are full of people who routinely are dismissed by doctors.
I don't know how we teach general practitioners, but we are doing something horribly wrong. A lot of long covid people must be finding this out too, and it is just super sad.
One of my biggest lessons early in life was that not all doctors are the same (by a long shot). This is why it’s so important to see specialists related to your condition. And ultimately you’re going to be most responsible for getting proper care as often only you know what you’re experiencing.
Medicine and pathology are far to wide of subjects for generalists to operate efficiently across every field and niche. Which is why specialization is so important and connecting the patients to the right specialists.
There’s a lot of analogies to technology, where people tend to expect the experts to do and know everything and completely defer to them. I think we all have experienced this with our parents or people who didn’t grow up with computers. When ultimately the individual is always going to be a huge part of the puzzle and must accept that fact.
We send them to a school which emphasizes cramming vast amounts of established knowledge into their heads, at the expense of critical thinking skills, social skills, and for that matter sleep. In a world where doctors use Google and WebMD the same as everyone else (because of course they do, no one retains an encyclopaedic knowledge of every medical condition), it's basically a hazing ritual.
What disease was it? What kind of medications have helped you?
I'm suffering from some kind of autoimmune-like disease with similar symptoms and trying to figure out what's wrong with me.
Plaqunial helped a lot, but I can’t tolerate it. Shame, it works well. Steroids are good for ending a flare but it’s hard to get prescribed, also side effects.
What really worked for me me was * blood thinners for cognitive defects * Avoid triggers, direct sun, sugar, caffeine, spice * autoimmune protocol diet * magnesium, vit d, e, b complex, fish oil
Get blood work done for each kind. ANA test as a starting point.
For me Early Sjo test confined diagnosis.
Make a list of ALL symptoms and take it with you to all doctors. A Neuro-ophthalmologist was the first to say Sjogrens based only off my sheet.
An elimination diet is probably the best place to start. I ate nothing but sweet potatoes for a month, my symptoms all cleared up. Stated coming back when I introduced random foods.
That’s how I started following AIP diet
Note this is a not-yet-peer-reviewed preprint.
https://www.medrxiv.org/content/10.1101/2021.06.11.21258690v...
IMO, while I'm not inclined to take either study at face value immediately, I think a serious person should be equally reluctant to join the "it's just a flu" camp either.
Your second remark is also peculiar: the "obvious sampling problem" to which you allude is either (1) a subtler-than-expected-point about the UK Biobank's program (designed to be a mass participation program to observe longitudinal effects in previous healthy or as yet undiagnosed people) or (2) evidence you are just making stuff up.
The long-term effects of flu are not studied that well, by the way. On the basis we're used to it from before such studies were possible.
None of those symptoms we hear about, getting our breath, unable to smell, brain fog etc., none of them are new. And they imply internal damage that lasts.
https://i.ibb.co/5YcxJHH/EDB20654-900-A-427-C-8063-B5-FA667-...
Figure 2 is the one you want https://els-jbs-prod-cdn.jbs.elsevierhealth.com/cms/attachme...
Which does show effect increasing with severity of the case. I've seen plots like that before in similar articles.
See also table 2.
"Nearly half the case participants had more gray matter after getting COVID" - as did the controls. It's almost like there's variability in the readings. If only someone would invent a subspeciality of mathematics about how to interpret noisy data and attempt to draw conclusions about the results.
I'm not totally sold on this study either, mind you. I'm just amazed at how many people are rushing to judgement in the other direction - the whole "just a flu" conclusion is wildly premature.
Yes, I mention the high variance. And indeed there are standard ways to interpret the effect size magnitude, given noisy data. The authors chose not to report Cohen's d. They do provide an r value (.16), which we can use to compute the the coefficient of determination. Since you are an advocate for reliance on traditional statistical interpretations, you should appreciate the meaning of r^2=.025
Furthermore the authors report a P=.01. They bootstrap this P, presumably because alpha significance level after multiple comparison adjustment renders cutoff well below .01. They also claim no a priori hypothesis wrt. gray matter increase or decrease. A 2-tailed alpha is typically shifted from p<.05 to p<.01 which their measured P value does not surpass. Nevertheless they claim statistical significance. Finally, after normalization, there is roughly an equal chance any given person will have more or less gray matter after getting covid - this doesn't require one to glean the importance of each ounce of gray matter to understand the effect size is small. I contend there is good reason this study has not yet passed peer review, if it ever will.
I don't know the appropriate way to extrapolate out but we're well past 200M globally.
0: https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...
1: https://graphics.reuters.com/world-coronavirus-tracker-and-m...
There's also not a globally accepted definition of the syndrome yet, so it won't show up in stats.
If you go by "still experiencing at least one symptom after 3 months", it's closer to 10-20% than 1% : https://twitter.com/Dr2NisreenAlwan/status/13775492575703162...
Another study found that around a third of these 10-20% consider it debilitating (significantly affects their daily lives)
Or are you making some other point I'm missing?
Getting estimates from the same people will provide a much lower variance estimaion of any potential effect.
Also, adding hospital records to this study would potentially provide a better estimation.
All studies have flaws, but this one does look pretty reasonable (the principal components method used should have been better described, for instance, and confidence bounds on the effect sizes would have been super useful).
Basically this is junk science. The only proper way to do such a study would be to compare the same subjects before and after infection. With so many cases such a study should be feasible.
I get the objection, but I'm getting annoyed at comments that state what's invalid with the study where we don't have the data available for that claim. What's wrong with "we don't know if the study is valid since we don't have details on X"?
Overall the majority of COVID-19 clinical research has been rushed and very low quality.
Is this not a randomised control trial? As I understand it, RCT is usually referred to as the “gold standard” - why would the gold standard be a flaw in this case?
What you describe sounds to me, a layman, as an improvement over and above but if RCT is good enough normally, why discount it entirely in this case because there’s some other improvement could be made?
No. I am not quite sure how one might even think the words apply here.
If it were, participants would be randomly assigned to the the "control" group where they do not get Covid, but would be told they had Covid (to control for the negative placebo of being told they are now afflicted with a horrible long term malady) and the "treatment" group which would actually be given a Covid infection. Assuming such a study were doable, one can then use a "within participant" comparison which is much more powerful than comparing statistics across groups.
>> We sought to confirm whether there was an association between cross-sectional cognitive performance data from 81,337 participants who between January and December 2020 undertook a clinically validated web-optimized assessment as part of the Great British Intelligence Test, and questionnaire items capturing self-report of suspected and confirmed COVID-19 infection and respiratory symptoms.
There is no randomized assignment here. Susceptibility to report a Covid infection without positive proof is a confounding variable. I suspect that susceptibility is correlated with other cognitive issues.
A "within participant" comparison as the GP brought up would avoid these kinds of issues.
That’s what’s require for the gold standard.
However, they did determine those individuals who contracted COVID were not different in their premorbid test performance from those who did not later contract COVID. This is a big part of what a "complete" longitudinal design would get you.
Let's say you did get that test data on follow-up. If post-COVID people who were infected were different cognitively, and not different premorbidly, that would suggest COVID was involved. If they weren't different cognitively, you'd have to explain why the first wave of individuals were different based on COVID history but not the later wave. Still important to show but maybe a different set of explanatory challenges.
That seems to add credibility here to a causal mechanism as opposed to a background correlation of risk of infection they are missing.
"A common challenge in studies of COVID-19 is that differences between people who have vs. have not been ill could relate to premorbid differences. To address this issue, a linear model was trained on the broader independent GBIT dataset (N = 269,264) to predict general cognitive performance based on age (to the third order), sex, handedness, ethnicity, first language, country of residence, occupational status and earnings. "
"We controlled for various things in the original regression, but hey, there still could be unmeasured confounders that make people who got COVID score less on IQ tests, even before they got COVID! (Like coming from a poorer background, other health vulnerabilities etc. etc. etc.) Unfortunately, we don't have a measure of IQ from before they got COVID. So, we estimated one using a set of variables that we do have measures for!"
Erm... if those extra variables predict IQ, then why not just add them as controls? And of course, if you do so, then you'll still hit the problem that there are plenty of potential unmeasured confounders out there. This is just a silly way to pretend you've controlled for something, when in fact you can't.
The quality of statistics in medicine is so bad. Disgracefully bad. In particular, the Lancet seems to be a serial offender.
The UK brain imaging study is a (small, not-yet-peer-reviewed) data point in that direction also:
https://www.medrxiv.org/content/10.1101/2021.06.11.21258690v...
There seems to be somewhat of suggestion that COVID may have serious long-term neurological effects. Given the massive numbers that it has affected already (and how many it would affect if it becomes endemic), even relatively small risk factors (i.e. single digit percentages) for things like Lewy body dementia and Parkinsons could have huge effect on public health.
It's worth reminding ourselves that we don't have any data on the mid-to-long term effects of COVID beyond about a 2 year window.
But unless you want to live like a recluse in a bunker, what are your options?
The way I see it, you're bound to catch it no matter how many precautions you take. Case in point: I know a guy with paranoid level of precautions that still got it and while he was confined with his family none of them caught it (this was before we had any vaccines in my country).
I could see some places where someone’s entire childhood memory is being under lockdown.
COVID-19 has only existed as a problem for less than twenty months - what childhood is that short? And even if that statement had some relation to reality, anyone would take a childhood lockdown vs a lifetime of impairment (&, yes I get that lockdown itself can have some long-term effects, but these are much more easily counteracted vs biological deficits).
That said, having kids that age, I would say my kids handled this pandemic way better than most adults. They adapt quicker and don’t have the emotional baggage (“masks are an evil plot to control the population” for example) to get through.
We have been lucky that they were able to attend school in person though - very strict COVID protocols plus a small population ensured that we never had an outbreak. Things would have been different if we didn’t have that ability.
And even new variants and vaccine delays cause us to get to years of lockdown that actually constitutes significant portions of full childhoods, are you arguing that childhoods full of funerals and an adulthood full of diminished mental capacity [1] and COVID sequalae are better?
The 'modern' world is not a stable reality, it is a priveliged bubble. In general, and throughout most of history, it is a harsh place with most things trying to kill us. Having to simply take protective measures is as old as humanity, from standing guard through the night watching for other apex predators, to avoiding invaders and plagues, it is a part of what it is to be human (and not even to mention how much easier it is then for other creatures). To view any alteration to our modern routines due to actual biological reality as some injustice is provileged and myopic. Better to turn it into a teaching moment and illustrate how it is a part of history, and in this case, a very mild version of what was previously endured.
[1] https://www.thelancet.com/journals/eclinm/article/PIIS2589-5...
I would imagine that a combination of mass vaccination (which seems to reduce transmission, although not by as much as was hoped) - and continued reasonable measures (mask wearing in crowded indoor places, better ventilation) we could achieve eventual elimination.
Alternately, on route to this less-than-comfortable-outcome, we could make strides in treating the long-term illness, improve short-term treatments and improve vaccines.
The other option is that maybe we'll work our way through the entire Greek alphabet of variations (and beyond; perhaps the Omega variation is followed by double-Alpha) with a large pool of sick people and vaccine escape whack-a-mole because people decided there was no options between "live in a bunker" and "free for all".
According to the latest data out of the UK, Delta is approximately as contagious as Alpha:
https://assets.publishing.service.gov.uk/government/uploads/...
There is simply no basis for these claims of dramatically increased contagion. It’s a meme that was based on early speculation, and repeated mindlessly by the press.
Are you talking about page 34, which compares secondary attack rate week by week? Can you explain how you read that chart?
On a social level: use the Aus model. Actually lockdown, get case numbers down to the 10s per million. The UK, US etc model is the opposite, it relies on having as many people as possible infected and not really engaging in any full lockdowns. So far that's meant more and longer lockdowns. It's also meant more variants. And it means the maximum number of people with long term effects. It's the worst of all worlds, even the economic one.
I am fully vaccinated, if you offer me a booster I will take it. If you offer me whatever, I will take it.
At that point I have done all I can do. If someone wants to stay in a bunker because things are beyond their risk preference then they should not be forced out of the bunker.
Forcing me back in a bunker though being fully vaccinated is absolute bullshit if anyone can get vaccinated.
It depends on work and family circumstances. But, stuff that works:
* Be outdoors, and socialize outdoors
* If in indoor unventilated spaces, wear a mask. Ideally N95 if lots of people and they aren’t mask
* Exercise more caution during local waves
* If socializing with others indoors, open a window. This can be done even during heat waves or winter: the greater the temp differential the more the air circulation for a given amount of window opening. Doesn’t raise costs too much, yet people treat it as impossible
* Buy a hepa filter for your home. Humidifiers can also help in winter
* Avoid indoor restaurants and bars and unmasked venues
* In risky venues, choose glasses over contacts. Eye protection is another layer
* Don’t hang out with symptomatic or unvaccinated people
* Get vaccinated
Whether you should choose to do this is another thing, but that’s what to do if you don’t want to catch a respiratory virus.
This above is consistent with: seeing friends, small indoor gatherings, travel (wear n95 + glasses!), etc. It certainly isn’t living in a bunker.
It does present problems during winter though, and it is also quite inconvenient in places with frequent large waves. Small ventilated indoor gatherings with vaccinated friends should be ok in low prevalence, but are risky in a big wave, for example.
It’s what I based the above on. Both pandemic summers Canada has had collapsing cases even while there were surged in parts of the world with winter or that use AC more than us.
Go to any restaurant with a patio and you’ll hardly see anyone inside. Everyone goes to the patios in summertime. And people tend to open windows rather than use AC on anything but the hottest days. Backyard dinners or rooftop drinks are one of the main ways people socialize privately.
What I wrote is less social than the average (one hopes) but more social than a lot of people lived the past year!
But if you’d rather live less restricted and are vaccinated, go nuts. The vaccines protect quite well against severe disease and it doesn’t strike me as a bad choice to not worry about it.
I'd rather keep our pre-Covid level of human interaction than limiting it forever.
But to each their own, one thing is that we must remove all restrictions so that each can choose their own way freely.
This last part is what politicians have a hard time to realize, but it's a necessity.
We can:
• Try not to get infected
• If inevitable: Get as little of it as we can
• Help the body clear the illness and after-effects
• Contract the illness as late as possible, as medicine advances faster than mutations
• Seek to support the science of figuring this thing out
• Do this together
• Seek to reduce the amount of contagious people in our local and global environment
Practically, we can:
• Wear masks. Better masks are better
• Use air conditioning, advocate for air conditioning and fresh air
• Exercise. Eat well. Go outside.
• Get vaccinated
• Read papers
• Discuss the science
• Participate in studies
• Fund science
• Explain to people what the scientific process is and how we know what we know
• Should we arrive at the opinion that certain substances, drugs, or supplements may have a protective effect, we might take those
• We can be the living scientific process: When we choose to experiment, seek to carefully note down the results and publish them
• Help others
• Fund healthcare for those who are less well off than we are
• Establish robust social immunity by discussing the options we do have to reduce infection
It's "funny" because a few months ago, I read that it was definitely an airborne virus, so hands contagion was absolutely not a concern.
Then yesterday I read the complete opposite.
In both case, they were reputable scientists.
Thanks for the advises anyway.
The amount of noise, publicity, and politicization of scientific research makes it very difficult to wisely set public policy at both the national and local levels.
Ah, and, it didn’t occur to me to make the distinction, but I was thinking of personal and direct funding of science. As something each of us might arguably do. It’s interesting to consider it because we arrive at the same question: What to fund?
We're a year and a half into it. We have the data. Aside from vaccination and some degree of proper ventilation, you need to:
1. Not be old. 2. Not be fat.
We talk a lot about #1, but #2 is taboo. We, as a society, prefers that you die unnecessarily young from COVID than feel a little bit of shame. Not to mention #2 was already murdering nearly half a million Americans annually on its own prior to COVID.
This needs to be fixed. Sugar/corn industry lobbyists and fast food advertisers should have been publicly hanged decades ago. Now we have even more incentive to address the issue, but I suppose slowly dying at the age of 37, gasping for breath, is a small price to pay to avoid feeling slightly negative about being 300lbs or impact the dividends of the Coca Cola Corporation.
where?
Number 2 is hard to fix as lobbyists and fast food companies have a lot of influence.
But it is concerning that of US women from age 20 and up, 60% or more are considered overweight.
A woman 50 years old has an average weight of 80 kg, using the Miller ideal weight formula and a height of 170 cm, the weight should be 62.5 kg.
https://www.healthline.com/health/womens-health/average-weig...
There should be some kind of reward or benefit for those that can keep to the ideal weight for a longer period of say 1 year.
Most people in the world have not contracted COVID-19. Personal precautions are well understood and vaccine distribution is well underway.
I’m sorry that your friend contracted it. In contrast I would characterize my family’s precautions as normal, and none of us have contracted it. Two of us are now vaccinated as well.
You mean like social distancing, wear respiratory masks in closed spaces, revise public spaces to improve air filtering and forced congregations, improve public transportation to avoid high concentration of passengers, and don't force returns to office in industries that do not require them?
You're talking about bunkers and recluses as if you are totally unaware that a) working from home means neither and b) people overwhelmingly prefer it.
Since we tend to mock such studies when done by antivax, we should also reserve all judgement here. Let’s keep the bar high for good science, the last year has been a flourish of unverified correlated statistics.
> Given massive numbers it has affected already
I don’t think people optimize for normal life either. For example, lockdowns do provoke effects which are at least as dangerous: We spend billions a year telling people to move more to fight obesity, so we are 100% sure that lockdowns have a negative effect on obesity and cardiovascular diseases, but also families breaking up, unemployment, loneliness, lack of sports (maybe close to weight gains of a 5-10 pounds in average, I’d be curious), and all those factors multiply further in the future and increase the risk of asthma, cancer, suicide, mental breakdowns (including knife attacks), we haven’t see the real delayed effects.
So, overreaction already killed more than even the (reasonable) estimated worst case scenario.
Let’s not focus just on Covid, and let’s look at everything else we don’t generally care about. My rule is, since they don’t care for my suicide, which is about 2 orders of magnitude higher than my Covid risk, I won’t vaccinate.
How did you come to this conclusion?
>My rule is, since they don’t care for my suicide, which is about 2 orders of magnitude higher than my Covid risk, I won’t vaccinate.
Not sure if I'm reading this correctly but basically not vaccinating out of spite?
I find it bizarre that all the stuff about depression, unemployment, etc is always neatly pigeonholed into "lockdown did it". Yeah, like if we were all just going about our business having Brazil-levels of disease and death , we'd all be really cheerful and gainfully employed.
Anti-lockdown people somehow interpret the world entirely through this narrow lens - perhaps some people are depressed/suicidal thanks to dread of the disease or personal losses of friends/family members to the disease. There's an amazing rush to judgement to assume that all the risks are due to lockdown, especially in countries that have high rates - as yet I don't think we know what suicide and unemployment rates are for people with Long COVID.
It's something of a right-wing bit of unpleasantry to say this, but "facts don't care about your feelings" (ugh). If there is a looming risk of - say - 2% of long COVID suffers getting Lewy Body Dementia or Parkinson's as a result of "mild COVID", that's a lot of new horrible cases - potentially with years of suffering involved.
If these ill effects are in fact looming, they will ensure that 'bad lockdown' stuff is lost in the noise.
I'm not advocating 'lock everyone down hard forever'; I just think this is a counterpoint to the whole "freedom day" nonsense where it's assumed that once we have a goodly portion of people vaccinated we can just let the virus rage through the population unchecked.
This virus is not going to be eliminated, and it’s well past time to move on from that discussion.
But what if they're never over?
The US and Western Europe have, by now, enough high-quality vaccine for everyone, and we're all stuck at, what, 60% of the population vaccinated?
A bunch of people died, a bunch of people went broke, but during this pandemic the rich have mostly gotten a whole lot richer. Even the rich who don't think of themselves as rich: own a house in Silicon Valley, have a dozen years of 401K and some stock -- these people have done very well.
We have to fight the virus; but we also have to fight the anti-vaxxers and the apathetic, and we have to do it in a world where the people with real power are actually gonna be just fine if everything locks down for four months out of every year.
I've started trying to imagine life in that kind of future. Say two lockdowns every year, in a good year it's a month each time, in a bad year maybe you're locked in your apartment half the time, and that's for people who get their booster shot every year.
Maybe forever. What does society look like in that scenario?
They’re over. The only people clinging to them are either playing political games, or are completely uninformed about the scientific evidence (and yes, I include the CDC and LA county’s public health authorities in those groups).
Masks were maybe slightly better than nothing when we didn’t have vaccines. They are utterly pointless now. There is zero evidence that they have any marginal benefit in a vaccinated population. This stuff has risen to the level of superstition, and like any superstition, there will be adherents who refuse to let go. That’s fine, but they’re not reflecting science or rational thinking. They are marginal.
Those who are scared of the virus should get vaccinated. Those who are not can do whatever they like, but their choices do not affect me, and they don’t affect you.
We have the technology to completely eradicate the 2019 novel coronavirus if we have the collective will to use it.
Other coronaviruses will evolve to infect humans, yes. We’ll never eradicate infectious disease in general. But we’re talking about one specific distinctive virus here. One for which we already have multiple effective vaccines.
Smallpox has exactly one host (us), had an amazingly effective vaccine, the virus doesn’t mutate quickly or spread as readily, and it still took almost 200 years to eradicate it.
Polio is NOT eradicated, it spreads only through contact with fecal matter, and the remaining areas where it is endemic make a great illustration of exactly why this virus isn’t going anywhere either: Afghanistan and Pakistan.
That you would suggest that either of these make an argument for eradication of a flu-like illness with multiple non-human hosts shows how detached from reality you have become.
And we have two vaccines against it with near 95% effectiveness, which compares with the estimated effectiveness of the smallpox vaccine.
If you want another point of comparison, look at measles. It’s not eradicated, but it’s not endemic either. In fact it is quite rare (far rarer than the flu) in counties with competent child vaccination programs.
"Based on prior expectations based on animal models and post mortem findings, we chose to focus a priori our primary analyses on a subset of 332 regions-of-interest (297 of which passed the reproducibility thresholding) from the available IDPs that anatomically corresponds to the telencephalic primary and secondary connections of the olfactory and gustatory cortex"
Full table:
Covid, no respiratory difficulty: 0.4 IQ point loss
Covid, respiratory difficulty, no home assistance: 1 IQ point loss
Covid, respiratory difficulty, with home assistance: 2 IQ point loss
Covid, hospitalized, without ventilation: 4 IQ point loss
Covid, hospitalized, with ventilation: 7 IQ point lossOn the other hand, 7 IQ point loss on ventilation does not surprise me as much. Being in a half-suffocated state for weeks must have some adverse effect on oxygen-hungry brain.
The black death came closest, but I feel it's safe to say COVID is nowhere near that.
Which is why one never ever trusts an article or paper with a bare number as claim. Confidence intervals, p-values, standard deviation, whatever it is, there are ways to tell whether it's significant or what the odds are that it's noise.
I haven't read the article btw so I don't know if it does, but since we're talking about a bare number, the answer to your question is that it indeed by itself doesn't tell us anything about measurability even if it had been five points.
Ignoring this, I think most other comments cover the fact that this study has the normal problem with this type of study. Poor stats which aren't statistically corrected for the subset the population who end up in hospital due to covid. (or again the subset with symptoms strong enough to be tested and diagnosed)
The "its just a flu" crowd have unfortunate points that many conditions sound like immunological effects brought on by a severe reaction to a virus in some way. Yes this is a different flu, but again we know this is not smallpocks or ebola and we should be taking advantage of this to determine the poorly understood impacts of covid virii on long term health of those who end up sick.
What subset do you mean?
If the was a subset of the population who are at risk due to covid. (other than the over 80s the sake of argument). Its difficult to know how much an impact on this subset the virus will be having. Its easiest to assess this by looking at those of the population on who did end up in hospital and trying to determine common effects by looking at those who contacted them and comparing the probabilities.
Ultimately the end goal is to infer how much of a risk impact this would/could have on the total population.
Failing to correct for the statistical population differences before making an inference is akin to saying A&E centers in the US or the EU are great for preventing tiger attacks. They don't treat it due to there not being so many tigers.
Again reporting on the worst case scenario for the virus impact on over 80s as being something that would/could impact 8yo people is obviously incorrect and potentially dishonest.
From the abstract: "Interpretation. These results accord with reports of ‘Long Covid’ cognitive symptoms that persist into the early-chronic phase. They should act as a clarion call for further research with longitudinal and neuroimaging cohorts..."
Yes, the impact and recovery will be different between those people. They didn't intend the paper to be a complete answer and with the method they used, it would be impossible to achieve. What you ask for is interesting and I hope other papers will be published digging deeper, but why not accept this result for what it is?
It's no different from a theorist publishing on arxiv "an analysis on the chances of the lhc destorying the solar system" vs "micro singularity formation cross sectional calculations for 7TeV".
The ultimate "further study needed" has become a comical tag line for poor stats and might as well be "chances of covid leading to me winning the lottery". Both are valid questions, but they have clear implications beyond enhancing scientific rigour.
I think we lost that long time ago when news started hyping up any study containing "cancer" and reporting their ideas as "researchers say".
The best we can do is discuss details as we do here, but without the hyperbole. There are claims made by the study and there are things not done in it. (whether missed or not possible to do from the data) Let's acknowledge them. But I think the "winning the lottery" is just going ad absurdum. If you'd like to see the split of impact for smaller groups, it will have to come from another paper. But it doesn't make this paper wrong or show "poor stats".
This is a virus from the covid family.
What reasonable assumption should lead us to suspect it behaves so strongly asymptomatically as to cause severe hitherto unheard of side effects compared to say "bird-flu"?
I am very much up for caution and as I say I very much welcome a renewed effort to say compare long term flu effects and things like cronif fatigue. But I think writing about evidence being inconclusive vs "there is no evidence to suggest" are strongly different lines for a journal which knows has the attention of a major global news source.
This is the difference between publishing this in nature and saying "more research needed" rather than "cautiously there is no strong evidence for".
In not invoking ad-abusurdism I'm highlighting mixing 2 statistically unlikely events can reveal unfortunate data points which incorrectly leads to the wrong result. If I caught the lottery after being diagnosed I could say I've strong evidence for when I don't. This is no different to getting cancer after being diagnosed and blaming cancer on covid from 1 case.
We are in vaccine autism territory again with long term covid studies and I just hope that the research community (not an individual researcher) and the media tred carefully. So far they have both been rather like a bull in a china shop with their subtleties.
Not remotely similar; whatever their flaws, the BBC is still internationally respected for impartiality and professionalism, and the UK is still a country that values the freedom of ideas and expression of them.
There are many areas where RT report really well and have been rewarded. I however wouldn't ever trust them as a reputable source of the status of the Russian vaccination program or Russian voting.
Frankly this is common sense, read the foreign reporting on any issue in a country to balance what is correct and what is being magnipulated regardless of who is reporting on it. This is how grown ups are supposed to use the Internet rather than falling into a bubble of trusting 3or4 sites as gospel.
The same way I would be weary of the BBC reporting on any topic remotely close to the political arena in the uk at the time.
The beeb are getting demonstrably concerningly biased their manipulation or changes to page ranking within their site. They regularly do publish quoting lancet pages without directly linking to them, the story then falls out of the ranking within 24hr and the external index engines struggle to find the static published content they still have. It's they're it's "just gone". This is not a result of reasonable reporting or sensible journalism. When the article is mistitled for clicks this is even worse.
I'm being nice to aunty beeb here. I want it to exist. But pretending it's currently an infallable entity and is unbiased is an insult to its heritage.
You: But pretending it's currently an infallable entity...
Completely not what I said.
Seriously, you should be more careful with your words: twice wide of the mark now - in just two comments.
They're an award winning news organisation with international respect and something worth being proud of certainly, but they're far from globally impartial or completely professional.
It may still hold some latent respect from the pre-david kelly days but it has fully transitioned to being an rt-like government mouthpiece.
A recent yougov poll found the british public considered them among the least trustworthy media outlets.
Hard to cover this truth up completely. Did you think the UK got 128,000 COVID deaths by doing everything right?
They're giving a platform to Dominic Cummings (I assume you're referring to this?). For better or worse his claims would come out sooner or later. It's more controllable if it comes out via the BBC. Propaganda management is not all about pushing good stories and hiding bad ones it's also about damage control on negative stories and ideally owning the ones you won't ever be able to suppress.
By owning the story they were better poised to claim that Cummings was just a liar who was bitter about being kicked out, for instance.
> All Cognitron tests were programmed in HTML5 with JavaScript by AH and WT. They were hosted on a custom server system (Cognitron) on the Amazon EC2 that can support diverse studies via custom websites. The server system was specifically developed to handle spikey acquisition profiles that are characteristic of main-stream media collaborative studies, fitting the number of server instances in an automated manner to rapid changes in demand. Here, maximum concurrent participants landing on the website information page was ~36,000, with this occurring at the point of the documentary airing on BBC2 in May.
Why wouldn't they also publish the source code? I took a couple of minutes to play with the test and I think I found some bugs. I would love to check myself. Isn't it quite important to audit the source code, given that it is the thing that collected the data?
(it is inexcusable in 2021 in my personal opinion, but in many ways science is still in the dark ages wrt some of the tools being used, just as the ML community is learning a lot about things like reproducability and falsafiability from scientists with experience here)
I just with the community would share code more to prevent common mistakes and repeated effort and so we can all learn.
Imagine a world with publically well documented code that helps people learn science rather than scientists having to teach coders what they want and codes having to teach scientists intracasies of languages and hardware choices.
News is pure entertainment. Its like a horror movie.
The only people worried about constitution at the moment are weirdos, extremists, and a very small number of people genuinly concerned about human rights in their own country.
I'm more and more seing this covid period as a perfect example on how this country could turn into a totalitarian regime as long as it's for the good cause(tm). It also another example on how china is definitely becoming a major cultural influence over the world.
The narrative being pushed to us is anyone who might have a different opinion to that of the authorities is a 'weirdo' or 'conspiracy theorist'. At any protest, the media will always show that 'anti-vax, bill gates conspiracy' guy holding up his sign and lumping everyone into that group. The majority of those protesting are rational people worried about their jobs, their businesses closing, their children's education and what the economic fallout will do to basic services like health, education, infrastructure.
Pointless lockdowns with arbitrary milestones that they are able to prescribe, daily zoom briefings where all eyes are on them as they explain “the science”.
For many, this is their 15 minutes of fame. Don’t expect them to give up that power and pseudo-celebrity easily. The attempts to scare and bully people will get more desperate as these people see their time in the spotlight coming to an end.
To meet these targets the majority of children must be vaccinated. Between the low risk posed to children and the governments (that's Australia btw) horrible mixed messaging regarding age groups and vaccination, a large portion of parents will be reluctant to vaccinate their children.
So whats the current approach to getting those vaccination numbers up? Just keep ramming home the fear of covid and restrictions while naming and shaming all who are ruining life for everybody. I wonder how that will go?
People are definitely taking the vaccination program seriously. The big question now is getting the final long tail vaccinated. While obviously there will be a subset which will always resist it.
The numbers coming out of the US show 99% of the deaths are unvaccinated people along with 97% of people hospitalized.
Vaccine administration data (about 31 million doses are currently being administered per day, and production continues to ramp).
Like, I'm not sure what you're looking for. No-one is going to publish a (credible) report saying "actually, covid is nice". The main avenue for hope is vaccination, and while that's not going perfectly, if you told someone in May 2020 that by July 2021 we'd have administered 3.8 billion vaccines, they would probably have been very sceptical, to say the least. It is the most rapid vaccine programme in history.
- positive study results validating stretched vaccine schedules
- more and easier vaccine availability locally
- infection rate in the region trending slightly downwards
- some new theories/results (didn't read the full article) regarding immunity in children
- some signs vaccine scepticism in some US states is decreasing
Bad news spreads easier than good. The news is mostly bad but some good news is what I mentioned above + high vaccine efficacy against severe disease.
How vaccines affect long covid type stuff is a big open question, but early doctor anecdotes suggest they lower it. That would be great news.
How can that be proven? This pandemic is less than two years old.
Since the vaccines are excellent at preventing serious outcomes, a fairly large share of the infected won't even go to a physician, and therefore getting a representative sample of infected people will be all of difficult, expensive and time-consuming.
Maybe there exists a set of people who ⓐ resembles the general population and ⓑ will be tested routinely and often for years to come, such that an accurate statistical picture can be found. But I can't think of any now.
I can deduce that "Patronymic" is "a name derived from the name of a father or ancestor", but I do not believe many native speakers I cross paths with can.
In any case, studies like this mention the total number of people who took the test (81,337 participants), but then, by definition, the effects come from small subgroups. E.g.,
> People who had been hospitalised showed substantial scaled global performance deficits dependent on whether they were (-0.47 standard deviations (SDs) N = 44) vs. were not (-0.26 SDs N = 148) put onto a ventilator. Those who remained at home (i.e., without inpatient support) showed small statistically significant global performance deficits (assisted at home for respiratory difficulty -0.13 SD N = 173; no medical assistance but respiratory difficulty -0.07 SDs N = 3,386; ill without respiratory difficulty -0.04 SDs N = 8,938).
The 44 people who were put on ventilators are different on other dimensions. It is hard to separate the effects of the news ("you have a horrible disease"), the medical treatment, and the psychological torment associated with being in a hospital during this time from the actual effects of the actual virus.
[1]: https://www.thelancet.com/action/showPdf?pii=S2589-5370%2821...
The evidence I've been reading the last decade+ suggests that disease is much more damaging than is generally acknowledged. But, as shown by the coronavirus, the costs of stopping (or, more realistically, delaying) them are huge. I'm wondering if, in my lifetime, we're going to see a plan for dealing with Herpes.
If we all wore $2 N95-equivalent masks, spread out 6 feet whenever convenient, did outside whatever can be done outside, and received a vaccine at (roughly) the same time, COVID19 would be gone.
The costs are huge because we made them huge.
We ignore COVID19 when case counts are low, giving it a chance to mutate and spread. We take extreme measures when hospitals start filling up, shutting down schools and businesses.
See Korea, China, Taiwan, etc. for examples of reasonable-cost ways to control COVID19.
You'll find that the systems that can force the unwilling to buy $2 masks, spread out 6 feet and get vaccinated are worse than the disease. If you recognise that the government can compel people to be healthy it opens up some terrifying cans of worms.
I'd like to see this implemented with roughly the same systems which make me wear a bicycle helmet, a seatbelt, or have turn signals, which I don't find so scary.
In these systems, you have a law. You have law enforcement. Law enforcement doesn't catch everyone, and doesn't have particularly aggressive police powers.
I'm fearful it will be implemented with the same systems which make us register guns and have background checks, track bank transfers over $10,000, check IDs when buying cold medicine, or track us as we travel.
In these systems, you have law enforcement. Enforcement is given tools to track and monitor what people do just in case someone might be a criminal.
There is a big difference between those and mandatory vaccinations. If you're going to vaccinate everyone then it isn't like people can choose to opt out. Plus the logistical issues of how to vaccinate foreigners.
In Australia, Sydney is currently in lockdown because it turns out that masks & social distancing can't be enforced enough to contain a COVID outbreak.
You pass a law:
- Requiring vaccinations, or a $800 fine
- Permitting private venues to verify vaccination status by looking at vaccine cards (e.g. employers, concerts, etc.)
- Make it a crime to forge vaccine cards
- International travel already has yellow vaccine books, and it's well-established to check vaccines upon entry to/from high-risk countries
You don't implement any infrastructure to track vaccinations. I show my vaccine card when I enter a concert, same as I do when ordering alcohol. No one records anything.
The bar for intentionally breaking laws is much higher than not getting a vaccine. I think most people will follow laws voluntarily. Most of the ones who don't follow the law won't get caught, but a few will.
If you think it is reasonable to force people to make medical decisions when it is for the greater good, do you have an argument against mandatory sterilisation? Because I don't see an easy way to be pro- forced vaccinations and anti- forced sterlisation.
The basic argument is if the government can do this with only 1-3 years debate (when previously vaccines takes 4+ years to evaluate) then it starts opening the door to some really scary stuff getting rushed through. I'm more interested now in what you think is holding the door shut.
> I show my vaccine card when I enter ... No one records anything.
The vaccine card is what people are talking about when the say 'record'.
"The scale of the observed deficit [of people who had covid] was not insubstantial; the 0.47 SD global composite score reduction for the hospitalized with ventilator sub-group was greater than the average 10-year decline in global performance between the ages of 20 to 70 within this dataset. It was larger than the mean deficit of 480 people who indicated they had previously suffered a stroke (−0.24SDs) and the 998 who reported learning disabilities (−0.38SDs). For comparison, in a classic intelligence test, 0.47 SDs equates to a 7-point difference in IQ." edit: well, on further thought, a stroke is not the same as a disease but still there's insight here.
I think most of these deficits are for the hospitalized. It will be interesting to see the why. Is it the virus itself? Is it the treatment? Combination? Or is it the extreme long term anxiety.
The IQ correlation in this study is: Covid, no respiratory difficulty: 0.4 IQ point loss Covid, respiratory difficulty, no home assistance: 1 IQ point loss Covid, respiratory difficulty, with home assistance: 2 IQ point loss Covid, hospitalized, without ventilation: 4 IQ point loss Covid, hospitalized, with ventilation: 7 IQ point loss
Let's ignore the respirator segment because lack of oxygen like that can surely cause problems and I don't think anyone is really arguing against it. Without a before test, the only thing this study can reasonably show (if you call 1IQ point showing anything) is that fat people or cashiers are ever so slightly less intelligent.
Honesty people, I was expecting on the order of 5-10 IQ points from the popularity and activity of this article. An average of 1IQ in a study with no control group and no pre-post test? Come on.
It’s interesting that this will likely contribute to further inequality as the rich had access to vaccines first and the uneducated are more likely to be skeptical of vaccines (note: everyone is skeptical, but the domain of skepticism is different for people depending on political leanings).
But really so few people of reproductive age die of the disease anyway it's unlikely to produce much effect.
I mean yes you can not RCT and yes a linear model should be the baseline, but then why not go ahead and do some synth control or double ML, or heck, take the survey twice and do some matched diff and diff?
Surely more can be done or not?
As another comment has mentioned, the best way to try to measure for this would be to have a pre-post, which could only be done on those who hadn't had it yet at the time of the first test but then later got at. Since vaccines are now a factor, and may correlate to intelligence, the study may not be possible in an ethical manner.
https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/as...
It just looked like a series of graphs and summary statistic tables.
Its definitly not the majority of viruses, and i'm not sure bacterial (benefit of the doubt here). Don't tell me you never exagerate a little :P
chickenpox.
:)
My mother ended up on anti-seizure tablets after the last flu outbreak having spent five days in intensive care.
The flu brought on a fit and hypo-natremia. It took months before she could walk properly again.
Our success against infectious diseases has left a generation or two with insufficient fear of them.
I’ve seen people catch a bad cold on Wednesday and be dead from pneumonia on Sunday.
The impact from Covid isn’t new. It’s just a rediscovery of why we spent the twentieth century on an all out war against infectious diseases and septicaemia.
https://en.wikipedia.org/wiki/Chronic_fatigue_syndrome#Viral...
The flu have this effect for sure.
The issue is that those cognitive disfunctions hit young people who were not hospitalized, or hospitalized only for safety (monitoring them with oxy at the ready). I know of one professionnal classical dancer, 26, who cannot coordinate following Covid, and was luckily already near the end of her career. But still, for some trade, this might be an issue, especially if Covid become as endemic as the flu
A number of diseases that were once globally endemic are now regionally endemic (eg polio, two countries), or eradicated (smallpox). Generally due to vaccination.
Any references or background to this?
It's weird because there are major media campaigns to encourage people to have a flu jab (UK) and "flu causes [irreversible] cognitive dysfunction" would be a major 'seller'.
I can also see that governments could have been reluctant to spread such information - if it's true - as it would change attitudes to schooling; schools being known to be a major vector for spreading flu.
Btw, i did not say "irreversible". I did lost a summer of training, probably because of the flu, and this is irreversible, but i'm pretty sure my balance is OK now (i had asthma 3 weeks ago, so the respiratory sytsem damage is not repaired however)
At both the micro and macro level there are perverse incentives beginning to form that will make this thing roll on longer than it has too
Or is this just the classic assumption that all people on the internet are American?
Funny how no other nation does that.