SARS-CoV-2 infects human adipose tissue and elicits an inflammatory response
biorxiv.org
biorxiv.org
https://www.thelancet.com/journals/landia/article/PIIS2213-8...
That paper shows nearly 3x the hazard ratio for ICU admission and death for the most obese people which is terrifying!
I am by no means a Covid denier, but the bottom line is: Covid is more of a symptom (of broader health and healthcare issues) than it is a Black Plague-esque disease. Since the majoriry rules, and illness has been normalized there will be few in power willing to speak truth.
It's not logical that we (in the USA) continue to side step a serious discussion about the value of prevention (and how that relates to the level of unhealthines we are on average.)
Were you alive during the Black Death I imagine you'd be talking about how, though you're no denier, it's the fault of people using ships to trade.
> The Black Death was also carried by rats on merchant ships through the trade routes of Europe. It struck Europe in 1347, when 12 ships docked at the Sicilian port of Messina. Subsequently called “death ships”, those on board were either dead or sick
Parent is using an example of a case where we know trade by ships helped cause the plague to spread, so is similar to how obese people have worse covid outcomes. No one is really going to go on a platform and attack trade by ships, though, just like in modern times no one is allowed to discriminate against the obese.
Not even close to obesity. Maybe you are looking for "allowing home ovens to bake bread attracts rats."
Again, all that's being suggested is more transparency and honesty, and less hyperbole and statistical fueled manipulation. That is all.
Then, of course, there's how well Covid does against (often) preventable conditions.
We're on the same page. Context matters. Now let's human-up and table the details about Covid. Let's stop hiding behind fearmongering aggregated data, and abuse of the use of percentages and other intentionally manipulative tactics. Finally, let's not forget to ask why? Why the thumb on the scale approach?
Please don't be snarky. It's rude and it also makes it more difficult for others to follow your train of thought. I'm not part of the original thread and I don't understand what argument you're making here.
What is GGP's actual argument for why GGGP is wrong?
Pre-print might lead to it being rejected or outcomes changed or tweaked, and it clearly needs replication in a larger study to see if the findings hold up. But equally I think being healthy and reducing your weight is likely to increase your odds of not becoming severely ill.
These things, which are usually things like diabetes, blood sugar problems, high blood pressure, elevated cortisol and so on, do correlate with poorer COVID outcomes.
My understanding is that, even when you control for these factors, outcomes for obese patients are still below what we would expect to see. This means that there is still a contributing factor that we haven't considered yet, and the parent study hypothesizes one possible reason.
There's a good chance that whatever that is, isn't actually a thing, and that people unfairly find fat people repulsive for no reason except that they are fat,
https://podcasts.apple.com/us/podcast/is-being-fat-bad-for-y...
EDIT: Another post today titled "Causal Information Affects Decisions" seems relevant here:
Like, my confusion is that I didn't think we needed to go look for a new mechanism unique to Covid here.
Some people might argue that convincing people to not get fat is much lower hanging fruit than transforming every democracy into an authoritarian apartheid state for effects that are well below any statistical significance threshold.
Having spent a lot of time in academia before moving into biotech, I think this is a pilot study and they're fishing for more research funding. The way those funding mechanisms work, I tend to view manuscripts like this with a critical eye.
The mechanism also involves a way for SARS-CoV-2 to infect lymphocytes in fat tissue that doesn't involve ACE2, which the authors leave completely unexplained, which is whole lot of highly surprising results.
There's also simpler explanations for why the obese are at higher risk, because systemically they're in poorer shape to begin with (metabolic syndrome, etc), and mechanically they have more trouble breathing when they get sick.
The title explanation is so simplistically attractive while the biological mechanism is unexpected and unexplained, which I'd say adds up to requiring a large amount of skepticism, until it gets validated by real experts in the field (not just someone with an MD or PhD on twitter, but someone who is active in exactly this kind of research). It might be an emotionally satisfying result, but it smells like bad science to me.
Being totally open minded is actually not a virtue, you can be so open minded that you'll start to believe any sort of drivel you pour into your head because it sounds persuasive rather than being correct.
I will happily flip my impression of this paper on a dime if someone who is actually qualified to review the actual lab methods and procedures (and if adequate controls were used, etc) pops up to defend it and to explain how cells that don't express ACE2 could possibly be important in COVID-19 pathogenesis, but until then my default setting is to be critical since the paper "smells" bad. It is not a particularly "great" theory, its a very fishy smelling theory.
You seem to think that you're free to think very highly of this paper on zero experience because the headline is appealing, while someone critical of the paper needs to be an expert.
Listing important limitations of a study is not being negative. It is contributing to understanding the paper. The comment you are replying to is the most substantive comment in the thread.
One does not need to encourage authors with compliments, nor does one need to balance criticism with praise.
https://cardiologyres.org/index.php/Cardiologyres/article/vi...
It's disappointing that public health agencies haven't put much emphasis on telling people to reduce body fat. While the vaccines are fairly effective at preventing deaths, breakthrough infections are quite common and getting down to a healthy body fat level further reduces risk.
https://www.wfae.org/health/2021-09-30/novant-says-9-of-10-c...
Possibility of dying blind, without feet because of diabetes wasn't good enough reason to lose fat for many. COVID-19 won't be either.
Losing weight is very difficult for people to sustain. There are individual success stories but those don’t outweigh the fact that, statistically, people just isn’t lose weight and keep it off sustainably.
1 kg of fat is roughly 7500 Cal. Healthy deficit is 500 Cal a day, which means losing 2 kg of fat per month. 50 kg overweight means two years of suffering.
Most fat people probably don't like hearing wealthy skinny politicians with personal chefs and trainers telling them to lose weight. Doesn't score well with the focus group I guess.
Obesity is not a motivation problem.
I would believe that covid has provided all sorts of opportunities for changes in habit, though, which might help.
I’m not too familiar with the added risk from being over weight, but as I understand it, it is no where near that big of a step change.
Either way, telling people to change their lifestyles falls on deaf ears as a group. People know, for example, that being obese in your 50s and 60s puts you at a great deal of risk, yet most people who are obese at the beginning of their 50s are still obese at the end of their 60s, provided that they are still alive.
We've already normalized instituting authoritarian measures over this pandemic. Given the Rubicon we've already crossed, there's absolutely no moral reason we shouldn't be firing everyone who doesn't reduce their BMI below threshold X by Y date and confining them to their homes.
Vaccines and masks don't protect just you but also those around you. Its simple and effective measures. That's the justification for mandates.
Fat kills you and you alone. The reasons are often complex and it requires long-term changes in private lifestyle and behavior to make any change.
https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-si...
Nothing about losing weight, eating healthy, exercising. Nothing about vitamin D either.
Meanwhile we have very strong evidence from multiple controlled clinical studies that hypovitaminosis D is a critical risk factor.
E.g. HIV doesn't last long outside the body. By the time blood dries, almost all of the HIV is neutralized.
I think the research has said COVID is similar, and can really only live on a surface for minutes.
Hand washing is great for preventing disease generally. It's less effective against some diseases, but it also has virtually no downsides, so it's still a sane thing to do.
1. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precaut...
Wake me up when you find a US government with the guts to mandate cuts in the amount of high fructose corn syrup allowed in staple foods, put a tax on sugary drinks etc...
until then telling people to lose weight is a waste of time.
issues like these are very politicized, but it's likely that most of long covid is a combination of people who are having post-illness long-term sequelae and then also people with CFS-like symptoms, perhaps exacerbated by negative media coverage around covid and long covid.
as i've said, long-term sequelae certainly exist - and they are different for covid probably.
i also have had long-term loss of smell and modification of taste after getting a breakthrough delta case.
that said, demographically (as well as by diversity of symptoms reported), it does appear that there is also a "CFS-like" disease population being super-imposed on top of those that are experiencing long-term sequelae. much of the conversation around long covid is also being funded by ME/CFS lobbying/patient advocacy groups [0].
i think there are two distinct phenomena, and the fact that women are over-represented as long covid patients may be due to the CFS-like phenomena rather than the sequelae one.
[0]: https://www.wsj.com/articles/the-dubious-origins-of-long-cov...
The Journal has told us twice this year that “Herd Immunity is Near”
“Herd Immunity Is Near, Despite Fauci’s Denial”
https://www.wsj.com/amp/articles/herd-immunity-is-near-despi...
“Herd Immunity Is Near, Despite Fauci’s Denial”
It’s December 2021. What went wrong?
So, in March people should have said the opinion was reasonable and made corresponding policy decisions.
Include any facts that support a belief and omit all others.
Anyway, I’m simply saying the track record of the Journal leans more in one direction, and is frequently wrong.
Furthermore, no one ever follows up to correct all those incorrect opinions
Perhaps the steady diet of “coronavirus is no big deal” and “climate change “ opinions has skewed my opinion but to me the wsj seems to have an agenda.
“ Climate Change Calls for Adaptation, Not Panic”
https://www.wsj.com/amp/articles/climate-change-adaptation-p...
What a completely unrelated piece by Bjørn Lomborg has to do with covid is not easy to understand. Hopefully no one is surprised if Lomborg has a simplified view of any given environmental problem. He is a business school professor after all and pretty well known for these things.
If we would have reached herd immunity at 70-80% vaccinated (which is what was being said) then the argument was we would reach it sooner due to antibodies.
Given that delta evolved and rendered both of those stories bunk, I think it is silly to solely blame the WSJ for being wrong at predicting the future here.
And what do you mean by "politicized"? Where has long covid been politicized? I haven't seen anything like that.
Real illnesses that people are suffering from can be psychosomatic or affected by mental status. There is a ton of stigma around suggestions like these, hence the subtext of your comment that a "real illness" is independent from mental state.
> And what do you mean by "politicized"? Where has long covid been politicized? I haven't seen anything like that.
If you are a researcher and your research suggests that many cases of long covid or CFS have a psychological component or are psychosomatically driven, you will get death threats as well as condemned by advocacy organizations. [0] That is what I mean by politicized.
The underlying root of the issue is stigma around any sort of illness that has a psychological component.
[0]: https://www.nationalgeographic.com/science/article/chronic-f...
Just because the underlying biological mechanism isn't understood doesn't mean that there isn't one. To me CFS seems like a case of a disease neglected by medical science because it's dismissed as being psychosomatic.
> the most successful treatment programs tend to focus on careful regulating exercise and diet which again seems to be largely physical.
This is coming from the PACE study, I'm assuming. PACE is largely viewed as suggesting that CFS has a substantial psychological component. There is a bunch of other literature on this as well.
Exercise and diet changes are usually successful treatments for psychosomatic-like illnesses, so I disagree that this treatment means that it is a physical disease.
Many of the original researchers who provided evidence that the disease is non-physical in nature have since left the field after extensive death threats and harassment. [0]
> Reuters contacted a dozen professors, doctors and researchers with experience of analysing or testing potential treatments for chronic fatigue syndrome. All said they had been the target of online harassment because activists objected to their findings. Only two had definite plans to continue researching treatments.
[0]: https://www.reuters.com/investigates/special-report/science-...
The layman interpretation of this is that long COVID is possibly a mental health issue associated with the belief in having had a prior infection, except for the loss-of-taste symptom which is very specific to COVID (vs, say, persistent fatigue). Not to say "it's not real", but maybe "it's not always viral in origin".
2. Your point was that people with more severe covid would
> thinks they had COVID-19 and didn’t even bother getting tested
The problem with that theory is that the serology testing in this study was conducted on everybody so whether or not people chose to get tested when they had covid was irrelevant. The fact that perceived infection correlates higher with these symptoms means that these symptoms are more related to someone's self perception of infection than any physical change.
2. Psychological components of an illness are still an illness, and I'm not suggesting that long covid is a "fabrication." You need to get over your internalized stigma, psychological effects can be incredibly powerful.
People experiencing CFS get similarly outraged when people suggest there is a psychological component to the disease. This is due to stigma. Indeed, if anything, CFS is good evidence of the strong impact that even a (probably) psychologically derived illness can have on one's physical well-being.
3. Even saying that something is at least partially driven by the media does not mean it is not a "serious" problem. Media coverage of high profile suicides leads to a measurable increase in the number of suicides in the general population. Those people killing themselves is not a "fabrication" and is in fact a really serious problem. i would be surprised if we hadn't seen something like cfs for covid emerge given the level of scary (to be clear, not irrationally scary, justifiably scary) media coverage around covid.
AFAIK there is no strong consensus that (even covid-unrelated) CFS is probably psychosomatic in constrast to, say, immunologic.
Perhaps it doesn't matter that much at all, the treatment for either is the same. Indeed, if you tell people with CFS that they instead have post-viral sequelae, their outcomes are significantly better.
Basically, the current status is no mechanism has been identified to cause CFS, there is a huge diversity of symptoms and demographics of who gets CFS, and there is substantial circumstantial evidence suggesting large psychological components (differences in effectiveness based on what you call the disease, larger correlation between self-reported illness vs. serological results, etc.) that all come together to form a broader whole. PACE is largely accepted in the medical research community, it has only been "debunked" in the blogosphere and news articles.
I'm also not going to be drawing conclusions from "I know some people X" and "other people Y." Hopefully the scientists studying this don't do that either.
Long Covid _is_ CFS. Viruses and bacteria are always the trigger for CFS.
That is definitely not even close to the consensus opinion of the field. there have been a number of attempts to try to show viruses as causing cfs, they have been discredited, whereas the pace study has not. [0]
post-aids patient advocacy, in clinical practice it has become incredibly unwise and unpopular to say that something is psychological in nature. even researchers who don't do anything in the clinic will still get death threats for suggesting otherwise.
Whenever a doctor doesn’t know the answer, it’s always psychological. It’s the easy way out.
People like you piss me off to no end so I’m gonna stop replying.
this is exactly what i mean when i say this stuff is politicized.
i disagree fundamentally with the epistemic theory of "trust people to know what is causing their illness, not doctors or researchers."
e: for evidence of what this particular strain of "patient advocacy" looks like, just peruse through this person's previous comments (https://news.ycombinator.com/item?id=29398210), such as:
> Alzheimer isn’t a disease but a symptom of chronic viruses and bacteria. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6066504/
> People with Alzheimer have been cured after taking antibiotics.
https://pubmed.ncbi.nlm.nih.gov/3063394/
We don't know that viruses and bacteria are always the trigger for CFS. That's a reasonable hypothesis but remains unproven. There could be other root causes for some cases.
https://www.science.org/content/blog-post/androgen-receptors...
[0] https://www.cancerresearchuk.org/health-professional/cancer-...
US figures are here: https://www.niddk.nih.gov/health-information/health-statisti...
To make a toy example just to make the reasoning clear: if men’s BMI was distributed as 50% = 20, 50% = 35, and women’s BMI was distributed as 95% = 20, 5% = 35, the average body fat of all men would be higher than the average body fat of all women, even though the average body fat of women BMI=X would be higher than of men BMI=X for all X.
but it seems the real issue with fat is how much visceral fat there is vs. the total amount anyway. obese folks all tend to have much more visceral fat than relatively fit individuals. visceral fat interferes more with the workings of organs and the signaling mechanisms (hormones, neural pathways, lymph/blood compositions, etc.) that keep a body healthy.
Yeah, this is the Internet and I could do research to confirm or deny 1) and 2), but hey I'm just here because I'm distracting myself from work right now.
1. poor testing
2. much younger skewing population compared to any other continent.
I don't think that's accurate. Eye-balling this[0], northern African and South African women are more obese than most European and US countries, and although men seem less obese, when you look at it overall, over 50-60% of adult South Africans and northern Africans are overweight or obese, compated to 75% of Americans. Obviously cherry-picking a bit here and ignoring western and most of sub-Saharan Africa, but I don't think "not a lot of Africans are obese" stands up as an assumption.
I think a mostly vegan diet would probably be the best you can do as an individual to protect yourself from severe covid (aside from vaccination).
I know two vegans, who don't know each other as it happens, and both of them have what I'd call a shitty diet.
Sure, everything they eat is vegan but have you seen the contents of some vegan products? There are many things packed full of "filler". Especially stuff that comes in a box (although that's true of regular processed food too)
It's not like vegans just eat a steaming pile of broccoli each meal.
I'd say a diet that makes you healthier would be more appropriate: for some, that would be a high-animal-fat diet, others might be something else and so on.
Edit: I get your point: eating healthier is key but to say vegan is probably the wrong way of putting it.
It depends on you know. Until recently (the last couple of years), vegans did tend to have very healthy whole-food diets, for the simple reason that processed foods were rarely vegan. That is different now, but I can see why people associate such a diet with veganism.
That includes yellow bone marrow (which is adipose), red bone marrow (hence both the autoimmune/cytokine storm and immune deficiency/ADE effects), arteries and veins (hence blood clots, myocardia, stroke effects) and white fat (adipose, hence obesity as a pre-existing condition strongly associated with death from both virus and vaccine).
You only need to read the medical reports for people who die (including VAERS deaths) to see the obvious connections.
It could be more related to smoking in older people?
> Generally, men tend to use all tobacco products at higher rates than women. In 2015, 16.7 percent of adult males and 13.6 percent of adult females smoked cigarettes.
https://www.drugabuse.gov/publications/research-reports/toba...