Covid and the Heart: It Spares No One – Johns Hopkins | Hacker News Reader

Covid and the Heart: It Spares No One – Johns Hopkins

publichealth.jhu.edu

192 pointsalwillis153 comments

A more accurate headline would be "it spares 93%–97% of people," though the interview meticulously omitted almost all quantifiable information. The hazard ratios in the paper smitty1110 cited https://www.nature.com/articles/s41591-022-01689-3?s=08 are mostly 1.49–1.85, which as I understand it means that people with covid were 1½–2 times as likely to experience the condition, pericarditis or stroke or whatever, than thr control group. The exceptions are things that normally happen only once in a lifetime, like cardiac arrest (HR=2.45), so we're still talking about a tiny fraction of people.

This justifies the statement in the paper's abstract, "Our results provide evidence that the risk and 1-year burden of cardiovascular disease in survivors of acute COVID-19 are substantial," but (unless I'm misunderstanding the paper) shows that the interview headline is an irresponsible, sensationalist lie.

False.

> We went into it thinking that [the risk] was going to be most pronounced and evident in people who smoked a lot or had diabetes, heart disease, kidney disease, or some [other] risk factors. What we found is that even in people who did not have any heart problems start with, were athletic, did not have a high BMI, were not obese, did not smoke, did not have kidney disease or diabetes—even in people who were previously healthy and had no risk factors or problems with the heart—COVID-19 affected them in such a way that manifested the higher risk of heart problems than people who did not get COVID-19.

They found that even mild COVID damaged otherwise healthy people's hearts so badly that their risk for heart problems are now comparable to those of obese people.

In other words, it does damage your heart. That damage might result in a heart attack, reflected in the increased hazard ratio.

No, there's not enough data to be sure either way, but given that some/most people experience absolutely no lingering symptoms the simplest explanation is that even mild disease cases damage in some people.

EDIT: to be clear. We have no idea if the outcome-generating process is continuous or discontinuous. You seem to think it's continuous, analogous to risks from smoking or obesity, but others would assume not.

Lingering symptoms isn’t a useful diagnostic tool in this case. Hart damage is generally invisible up until people have a significant problem. This is why young marathon runners occasionally die of undiagnosed heart problems and the elderly get in depth testing before voluntary medical procedures.

Hypothetically, if 3/4 of population has the baseline risk and 1/4 the population has 8x the risk then you could say most people are at identical risks. But unless you can determine which population someone was in that’s irrelevant.

> They found that even mild COVID damaged otherwise healthy people's hearts so badly that their risk for heart problems are now comparable to those of obese people.

> In other words, it does damage your heart. That damage might result in a heart attack, reflected in the increased hazard ratio.

This seems an inaccurate reading of what's in the study. They did not find that all people who had COVID had heart damage, which would be the case if "it does damage your heart" were true. Instead it found that some previously healthy people now had some heart damage.

Well put, I think this should be considered the prevailing consensus for this discussion, frankly. There’s a lot of noise here…

How did they know they were previously healthy? Did they have pre-infection health screens?

Yes, they were all vets in the VA system so their pre-infection health had been documented.

Thanks for clarifying.

What percentage of previously healthy people had heart damage from covid? Did they break this down by age and vaccination status?

Just one person but i was an early case (family member went to Wuhan 1-2 times each month. During the firsr year of COVID, as early as march of 2020, i had serious issues with gut and hearth inflamation - repeated bouts that started as back pain, became chest pain, elevated heart-rate to 150 for ~3 days at a time, 24 hours a day. Gradyally the episodes became less frequent leading up to a stroke type event co current with a presumed second bout of covid. Was forced back to work about a week after the issue, and the only other coworker who was near me contracted covid about 10 days later.

Following the Stroke type event I lost virtually all of my talent at writing, And ultimately my job, which was very humbling. Ive spent the past year working gig jobs when i can, and fortunately all long covid symptoms have gone away. I feel like my brain is close to 100% but i lack the confidence in myself, my memory, and my writing and am constantly second guessing myself and assume im wrong if in a contested discussion. It really sucks, yet im probably one of the lucky ones

Condolences. That's terrible. I'm glad you're doing better than you were.

Finding this out would require doing mass exploratory surgery on asymptomatic people, which is obviously unethical, because it would kill a substantial number of them and damage all of their hearts.

>They found that even mild COVID damaged otherwise healthy people's hearts so badly that their risk for heart problems are now comparable to those of obese people.

False.

The study did NOT look for heart damage in the study population as a proximal cause for other cardiac events, it simply looked at incidence of cardiac events. Your interpretation is one possible explanation as to why this might be, but the study neither supports nor disproves this explanation.

False…

Increased incidents is in support of that conclusion, but does not provide direct evidence of it. An important but subtle difference.

Lack of evidence supports precisely nothing.

Increased incidence is evidence as is the known link between viral infections and heart problems.

Suppose your car doesn’t start. That supports the possibility of a dead battery, it also supports broken wire or anything else that’s a possible cause. What it doesn’t support is your car being in proper working order.

If your car doesn’t start and you haven’t used it in 2 months, well it could be something else but …

>Suppose your car doesn’t start. That supports the possibility of a dead battery, it also supports broken wire or anything else that’s a possible cause. What it doesn’t support is your car being in proper working order.

Yes, these are hypotheses. But they are not meaningful in a scientific sense until you design a study and set about to try to disprove them. OP's claim was in relation to precisely what a scientific paper did or did not prove. Therefore, the appropriate level of rigour we need to apply here is a scientific one.

It is the study’s author referring to damage, he wasn’t willing to say what kind.

“even in people who were previously healthy and had no risk factors or problems with the heart—COVID-19 affected them in such a way that manifested the higher risk of heart problems than people who did not get COVID-19.

It was really eye-opening that the risk was also evident in people who did not have severe COVID-19 that necessitated hospitalization or ICU care. People who got COVID-19 and were asymptomatic …

Why would SARS-CoV-2, the virus that causes COVID 19, which we all thought about as a respiratory virus, attack the heart up to a year down the road?”

I am sure the author would love to preform a more detailed study, but calling his conclusions unscientific seems to be overreaching.

I'm not calling the author's conclusions unscientific. At. All. He does not refer to damage, he does not draw conclusions about the mechanism which leads the cohort to have a higher risk of heart problems, and he certainly doesn't draw conclusions about individuals within the cohort, only the cohort as a whole.

Other people reading into the study things that aren't there is what I am calling out.

>He does not refer to damage

“Why would SARS-CoV-2, the virus that causes COVID 19, which we all thought about as a respiratory virus, attack the heart”

“Why would SARS-CoV-2, … attack the heart”

Are you suggesting attack the heart doesn’t mean to cause damage to it? I have trouble reading that as meaning anything else, how do you read it?

He's asking the same question I'm asking: "Why"? The scientist who conducted the study is saying his findings raises more questions, as any good study is likely to do. - I'm not sure why so many people want to read between the lines versus picking up the line of inquiry and doing further studies. There are any number of reasons why we could see heart issues from covid. Simply saying 'well, it must be direct damage to the heart, case closed' is completely reductive.

I agree he doesn’t know what specific method of action(s) or type of damage(s) is involved.

I suspect multiple different things result from getting COVID that directly or indirectly cause harm. The study only looks at the effects without digging into the proximate causes.

aw, cmon, you broke the "False" chain ...

True. ;)

Nevertheless, the sentence begins with "they found that", so the sentence is false.

"They found that" means their findings include it. Which is different from their findings being consistent with it.

He did say: What we found is that even in people who did not have any heart problems start with, … —COVID-19 affected them in such a way that manifested the higher risk of heart problems than people who did not get COVID-19.

That doesn’t imply that COVID caused damage directly, it could have done something else and that something else caused damage. But that still means COVID started a chain of events resulting in heart damage.

Why would SARS-CoV-2, the virus that causes COVID 19, which we all thought about as a respiratory virus, attack the heart up to a year down the road?

> In other words, it does damage your heart. That damage might result in a heart attack, reflected in the increased hazard ratio.

Or it only damages the heart in a small number of patients, and that damage always results in heart conditions. It is not possible to tell the difference between these two possibilities without actually taking a sample and looking for asymptomatic heart damage in the affected patients, which this study did not do.

These are the stats for heart conditions on mild covid patients from the paper. https://www.nature.com/articles/s41591-022-01689-3/figures/5 They don't look bad at all. Where is it stated that this effect is as bad as obesity?

First, the study does not even use the term "mild". They did look at three levels of severity: non-hospitalized, hospitalized, and admitted to ICU. The "non-hospitalized" group surely includes people who would describe their case as "worse than any flu", as well as those would describe theirs as "mild" (e.g. a few sniffles for a few days, like a number of my friends recently.)

Second, the hazard ratios differ widely between the three levels of severity. For example, for MACE (major adverse cardiac events) versus the contemporary control group, hazard ratios are:

    Non-hospitalized  1.26
    Hospitalized      2.41
    ICU               4.36

One would expect a similar gradation of risk by severity among the "non-hospitalized" group.

In the context of this and similar studies non-hospitalized means 'mild', even if it subjectively was 'real bad'

Hospitalized is severe

ICU is very severe / life threatening

Is "False." the new "Wrong."?

False.Incorrect.Wrong.

Are all easy ways to tell if someone is about to speak like Dwight Schrute from the Office.

The headline is badly phrased but I wouldn’t call it a “lie”. The intended interpretation is that significant long term risks were observed across the broad population, including otherwise healthy people. I perceive pretty widespread belief to the contrary right now, which could be dangerous for public health planning.

Future experimental vaccines could contain tracker chips and cause autism.

^--- also not a lie.

I'd expect John Hopkins to do better though.

I would add that for the non-hospitalised groups it is substantially lower again at more like HR of 1.3-1.4 - (see supplementary tables - https://static-content.springer.com/esm/art%3A10.1038%2Fs415...)

I would also add a few factors that likely mean that this is an upper bound: 1. As noted this is without vaccination 2. The mean age in the study is 60-65 (depending on the regression) 3. There is inherent bias in testing uptake (case ascertainment) over the period of the study early in the pandemic. This means the sample is inevitably skewed towards more severe cases (and will miss a very large fraction of asymptomatic cases) than either the population of Covid positive individuals or the sample of positive covid people today (as now testing is abundant).

This is not to say that the study is wrong that COVID increases one's risk of heart disease but for me the language used in the interview does seem inappropriate.

The increased risk affects everyone, even if the risk doesn't materialize for everyone.

"At increased risk for being at increased risk" is theoretically meaningful, but practically nonsensical unless you can tell which group someone falls into. If you can't, you may as well collapse all the probability into either being at increased risk or not.

You have no way of knowing if the increased risk materializes for you.

Saying that playing russian roulette doesn't affect you if you don't get the bullet is nonsensical.

No, see, that's not a good comparison. You're already doing exactly what I said, which is compressing to a single probability.

There's only one probability in russian roulette. The prior is that you pulled the trigger. The probability is whether you got a bullet.

There's two layers of probability in this instance. The prior is that you had COVID. The first layer is whether, due to your infection, you're at increased risk for the various heart diseases. The second layer is whether you actually get heart disease.

If you cannot determine which group an individual is in for the first layer, then insisting that it exists doesn't really help except for "well akshually". "You're at risk for increased risks of heart disease." Just collapse the probabilities to a single layer, "You're at increased risks of heart disease."

I now feel much less happy than I did. "Significant increase" could mean anything. A risk ratio of 1.49-1.85 is a huge increase. These conditions are rare but not that rare. Now I should be twice as worried about them? Oosh. Will someone at least tell me that Omicron's not so bad?

Life's too short to worry about everything and anything. What can you do about it anyway. Pretty much everyone will get COVID at some point and some people will develop heart conditions. You won't be able to prevent getting infected, so you might as well just accept it.

1.5 is a small increase, particularly when the baseline probabilities are small (as they are here).

For context, a "big" increase would be something like smoking, where the effect sizes are measured in HR multiples of ten.

I think it matters a lot whether we're talking about a relative hazard of 1.5 over a lifetime or, as in this case, over a year.

If, year after year, people who suffered covid in 02020 and 02021 continue to have 1½–2× the risk of developing pericarditis or stroke or congestive heart failure or all these other health problems, or if people keep getting covid every year, well, because of the high lifetime base rates of those problems, that would be a bigger health problem than anything since before AIDS, bigger than smoking, maybe bigger than anything since the Black Plague.

On the other hand, if, say, 1.8% of people develop ischemic heart disease in the year following covid, while 1.1% of people without covid do, and then in the following years they don't get covid again and the hazard rate declines to the base rate of 1.1% per year or whatever, that's still a significant public health problem, but it's not nearly as big as the people covid killed outright.

(Those numbers are from Supplementary Table 3 in https://static-content.springer.com/esm/art%3A10.1038%2Fs415...: "COVID-19 burden" of 18.47 cases of "Ischemic heart disease" at 12 months, and "Contemporary control burden" of 11.19. The other supplementary information is at https://static-content.springer.com/esm/art%3A10.1038%2Fs415... and https://github.com/yxie618/longCVD.)

Though I'm no virologist, I don't know of a plausible mechanism by which covid could cause people to get ischemic heart disease, pulmonary embolisms, etc., after 5 or 10 or 20 years of not having covid. More likely, what's happening is that people who haven't fully recovered from covid are getting blood clots, and that's damaging their organs and sometimes killing them, but after a few months they do fully recover and so these problems stop — unless they get covid again.

Given that we now have numerous effective vaccines and a few effective palliatives, it seems likely that even though covid has become endemic, people will be able to avoid suffering this level of damage year after year. But I have to admit it's an open question.

Yes, if you see the same thing for many years you gain more certainty over the signal, regardless of the strength of the signal. But a small signal is still small, regardless. And it's always incorrect to average together a high-risk group and a low-risk group and claim that everyone is at medium risk.

> More likely, what's happening is that people who haven't fully recovered from covid are getting blood clots, and that's damaging their organs and sometimes killing them, but after a few months they do fully recover and so these problems stop — unless they get covid again.

That's one hypothesis. Here's another: people (especially older people) deferred medical care throughout 2020 and 2021. They are seeking that medical care now. Undiagnosed heart problems are now being diagnosed. And oh yeah...they got a Covid test somewhere along the way. Often for (wait for it...) hospital admission.

I'm not in love with this hypothesis; it's just the first one I thought of. There are actually a ton of plausible reasons why you'd see slightly elevated rates of whatever in a group of older, less-healthy people. Claiming that the virus caused it through a mystery mechanism is a wild leap to conclusions.

It's baffling that a public health institution would discredit themselves so obviously in this way.

I don't understand the world that these people live in. It's like they don't understand the concept of trust _at all_, they're a few iterations of doubling down on just going into some sort of echochamber nonsense.

The headline isn't even true in the superlative sense (e.g. maybe it spares the odd person, but we make a reasonable allowance for that in colloquial speech.). It's in fact the case that it spares the vast majority - most of us have zero detectable symptoms, both during infection and after the fact.

> It's baffling that a public health institution would discredit themselves so obviously ...

Here's your proximate cause: The article's author is "director of public relations and marketing". This may go some way toward explaining why there's no link to the actual research document in the article.

It's worth saying that all of Al-Aly's papers so far have had the same basic structure, and the same basic problems: they take a population of older, sicker people (veteran's administration data), compare to some synthetic, non-randomized control group (this is where the "study of 15M" comes from), then extrapolate from that comparison to everyone. This is problematic for a few reasons:

* the older, sicker population is simply not representative of the population at large. No amount of normalization or adjustment can truly fix this.

* Moreover, the normalization process creates a "modeling problem" -- it's too easy for the researcher to find whatever outcome he's seeking by mucking with the weightings. With methods like this, you have to be very careful interpreting the results, because tiny details in the methods matter a lot.

* the signals in the data often are smaller in magnitude than the covariates in the study population (e.g. finding an X% difference in thing Y, when the population is more than X% sicker, overall)

* Use of ICD (medical billing) codes for a study like this is fraught. Choice of codes can create/remove a small signal in the data, and yet, it's not always clear that certain codes should be used (basic example: do you use the ICD code for a bypass graft as a "cardiac event" in a study like this? Almost certainly, a heart bypass surgery reflects a life-long problem, not an acute event due to Covid.) Again, methods matter a great deal here.

* Al-Aly is...less than transparent...about the size of the observed effect and its dependence on age and health. Often these details are buried in supplemental materials, and then he goes in the news media and makes bombastic claims about something "even happening in younger populations", based on a relatively weak effect size extrapolated in younger, healthy people.

* Relatively strong claims are made about small differences in outcome. For example, I just saw one last night from Al-Aly that turned a 13 per 1000 difference in outcome (1.3%), into a breathless claim of "over 40% increased risk". Mathematically true, perhaps, but utterly misleading (also, the difference was observed primarily in the oldest people, so the citing mean difference was simply wrong).

I could go on. Point is, please don't take this study as definitive. This is one paper, and Al-Aly has an agenda.

Don’t obsess over this. It’ll distract you and stress you out, which comes with its own health risks. None of us get out alive anyway. Go live as healthy a life as you can, find happiness, and help others when the opportunity presents.

You don't need to obsess over this, but you do need to remember that there has been, and continues to be a large pro-COVID faction that insists that getting everyone sick with it will be no big deal, because it only kills <0.X%> of people in <particular age range>.

They were, of course, speaking from a position of ignorance of long-term side effects, because the data wasn't yet in. It's been two years, and in many ways, the data is still not in yet.

We'll have another go-around[1] on the COVID rodeo next holiday season, if another dangerous variant emerges.

[1] Just because the news has forgotten about the virus, doesn't mean that the virus has forgotten about us. There are more daily worldwide cases right now, then there have been at any point prior to November 2021. That's a lot of opportunity for variants to mutate.

> It's been two years, and in many ways, the data is still not in yet.

But we hopefully aren’t expected to hide until the data are in?

You're expected to take simple, cheap precautions, proportionate to the expected consequences.

You're also expected to not take what you think is the best case scenario, and extrapolate that it's the scenario that we are actually in.

One cannot live in 2022 without catching covid, the level of precautions I would have to take to avoid it would be extreme and damage my quality of life and probably my mental health.

I've definitely had it once, likely twice, just doing basic things exposes me to it now, so what can I do?

Try wearing an N95 mask, for starters

That doesn’t really work if people around you do not. One less trip out of your house so you only leave 4 times a week instead of 5 is several orders of magnitude better than going out with an N95 the 5 times.

If you actually care about Covid the answer is to not leave the house. Putting an n95 on when the mandates are gone so nobody else is wearing one is just a religious act at this point.

Replace "N95" with "single layer cloth mask"

that's quite an exaggeration, and it hurts me personally to think that when I go out and im the only one wearing a mask, people are looking at me as though I'm engaged in a "religious act". For people who aren't immunocompromised, the N95 will grant a significant level of protection even if others aren't masked, especially if you're outdoors or in an otherwise well ventilated space, if you have short interactions from those who aren't masked and maintain distance, it all helps. obviously if I had my N95 and spent three hours in a crowded bar, that's a bit pointless, talking here about places that aren't tightly packed with non-masked people who are all talking 2 inches away from each other.

It is obviously not absolute protection and of course going nowhere at all is the best protection, but a properly worn N95 combined with up-to-date vaccination goes pretty far for someone who is fortunate enough to not be already immunocompromised and is fine avoiding places like concerts, clubs and bars.

> especially if you're outdoors or in an otherwise well ventilated space

Citation needed that it’s not being outdoors or a well-ventilated space that is doing all of the work and not the mask.

> but a properly worn N95 combined with up-to-date vaccination goes pretty far for someone who is fortunate enough to not be already immunocompromised and is fine avoiding places like concerts, clubs and bars.

You’re all over the place here. I’m talking specifically about avoiding all of those things as well but just skipping the mask. The risk profiles between those two are so negligible that skipping a single trip out to an enclosed space is orders of magnitude better than the difference between them.

That’s why what you’re doing is just a “religious act” at this point. There is no good medical reason for you to wear it if you’re already going out. 99.999% of the risk comes from the “going out” part if everyone else is unmasked, so wtf are you doing at a grocery store/restaurant/whatever if you are actually worried about getting COVID?

It’s no different than bringing a parachute on a commercial flight. The chance of you crashing on a flight are tiny and the probability of you being able to use a parachute if you are in one of those scenarios and surviving are less than 1% as well.

A life well-lived comes with inherent risks.

I'm not saying I want to go live recklessly, but I'd rather die slightly less old and happy, than old and miserable because I spent it worrying only to realize on my deathbed that I never lived.

> I'm not saying I want to go live recklessly, but I'd rather die slightly less old and happy, than old and miserable because I spent it worrying only to realize on my deathbed that I never lived.

So you're somewhere in the middle, like basically everyone else? Or are you saying that you're the reasonable one and anybody who takes precautions against COVID infection is living their life in a miserable state of worry?

Most are willing to live life to the fullest with negligible risks. Others who want to live life locked down and living in a plastic bubble, feel free to do so. If you think Covid can be eradicated with zero-covid policies, look at how China is faring [1]. Live and let live.

[1] https://www.reuters.com/world/china/refuse-quarantine-frustr...

The whole point of this sub-thread is that for the past two years, there has been no end of wishful-thinking arguments that tried their best to downplay and ignore the risks.

But your raise an excellent point - if only there were solutions that allowed you to live life to the fullest with negligible risks...

https://en.wikipedia.org/wiki/Vaccination

https://en.wikipedia.org/wiki/Hand_washing

https://en.wikipedia.org/wiki/Source_control_(respiratory_di...

> speaking from a position of ignorance of long-term side effects, because the data wasn't yet in.

That’s a two-way street (which I don’t think you’re denying). In 20 years it may turn out that the shot was worse than the disease.

We need to just all stay inside forever. Be safe my friend.

I had chest pains for the first time in my life in 2021 and I’m in late 20’s. Doctor couldn’t find anything. Felt much better after a month. But it came back after getting a booster.

I had COVID confirmed in 2020 with no such issues. For me, as far as i can tell, the chest pains are more correlated with the vaccinations. I’m rather grumpy at the idea of getting additional boosters.

Surprisingly I am having the same symptoms. Like I can feel chest pain during cycling and hours after I am done. This was not the case earlier.

I haven't got it checked yet. I am gonna do that soon.

It's possible they are related, or also possible just coincidence. When I was 31 or 32 I had a bout of crazy chest pains. Did all the tests, got all the EKGs... end result was Dr told me I was fine, lay off the stress. Has not come back, so I think it was just a reminder to take care of my flesh bag a big better.

I'm sorry you had that experience with vaccines. I know it won't make much difference to you personally, but the truth is that these sorts of chest pains and heart problems are far more common in immune-naive people who are infected with covid than in people who get vaccines.

Could you drop a link to some research for side effects of immune-naive infection versus vaccine? I've read the latest on the Pfizer side effects but have nothing to compare it to for immune-naive infection effects and rate of those kinds of symptoms.

Citation needed!

In fact, there is more and more data every day the EXACT opposite is true.

You demand citations from the parent, and then immediately make an opposing claim without providing any citations.

Lots of signals coming from the VAERS system [1]? And a few studies to take a look at below. I'd be curious what folks think about these studies.

In any case none of this compares to post-infection heart issue stats but it seems to me that there should be more research in this area.

"Myocarditis Cases Reported After mRNA-Based COVID-19 Vaccination in the US From December 2020 to August 2021" [2]

"Epidemiology of Acute Myocarditis/Pericarditis in Hong Kong Adolescents Following Comirnaty Vaccination" [3]

[1] https://openvaers.com/ [2] https://jamanetwork.com/journals/jama/fullarticle/2788346 [3] https://pubmed.ncbi.nlm.nih.gov/34849657/

Same for me (30), second dose gave me chest pains for 4/5 days. Doc did the standard checks and came back with nothing. First time I have ever experienced anything like this. I will not be ever injecting myself with another rna based "vaccine" again.

I've had a similar experience... Long before COVID 19 existed. Stress remains a risk factor with a much higher prevalence than COVID or vaccine induced myocarditis

Sorry about the chest pain, but I don't think a guess that vaccines caused chest pains - something that many people have experienced long before Coronavirus and vaccines - informs the conversation.

Did the guys who did the study control for vaccination status? Seems very relevant to the conversation. It’s a proven fact a small portion of recipients experience heart issues after getting one of the mRNA vaccines.

> Did the guys who did the study control for vaccination status?

Did they?

> It’s a proven fact a small portion of recipients experience heart issues after getting one of the mRNA vaccines.

How many? It's a proven fact that a small portion of people drown in their bathtubs, die of lightening strikes, and win the lottery.

I’m asking. If you don’t know the answer to my question you can say so.

Sometimes people experience very low probability events. Sometimes those events are random. Sometimes they’re not. It seems like vaccination status is a confounding variable that should have been controlled for.

You misspelled lightning, by the way.

There was a lot of information coming out of college athletics early on consistent with the research in this article. Young, healthy athletes that were asymptomatic showed signs of inflammation in the heart.

Since then there were follow up studies which were split in their findings. The early studies used MRI testing and suggested “high-risk” of heart damage/myocarditis in the athletes. Follow up studies tended not to use MRI, opting for testing for certain proteins associated with heart inflammation and ultra sounds and those studies found heart damage to be uncommon in the athletes.

If there's been such heart damage to athletes that caught it, how come they all are invariably coming back to the same exact performance they had previously? Is there such a thing as damage to the heart that has no effect on performance, particularly the incredibly demanding kinds of performances that sports like professional basketball require?

They haven't all. Look up Asia Durr if you want an anecdote. #2 draft pick for WBNA and hasn't played since her rookie season due to long haul covid effects.

I am not aware of any study on covid in athletes in particular, though.

Huh, you've got to reach to the WNBA to find someone. Kinda proves my point.

Edit: And to all the wonderful people who no doubt checked themselves to make sure they had expertise on the subject before they downvoted my question (!), here's some food for thought:

A 2021 study of 789 professional athletes found that only 5 (0.6%) had heart inflammation. https://jamanetwork.com/journals/jamacardiology/fullarticle/...

Another study found that COVID in athletes was rarely serious: "The severity of COVID-19 in elite athletes is predominantly mild and without complications. Athletes can return to sport after two symptom-free weeks and additional heart screening is usually not required." https://www.sciencedirect.com/science/article/pii/S144024402...

2021 review of 12 studies: "Athletes have an overall low risk of SARS-CoV-2 pericardial/myocardial involvement, arrhythmias and SCA/SCD." https://bmjopensem.bmj.com/content/7/4/e001164.abstract

2022 editorial review: "Most importantly, to date, there have been no acute adverse cardiac events reported as a direct consequence of COVID-19 infection in the athletes included in these large registries" and noted that the few smaller studies that deviated from these findings were badly designed. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8730531/

2022 study: "These data add to the growing body of the literature and agree with larger cohorts that the risk of cardiac involvement post-infection appears to be low among elite athletic and semi-professional athletic populations." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8791243/

2022 letter: "Several elite professional athletes tested positive for SARS-CoV-2. A few reports of persistent and residual symptoms of infections emerged. However, peak athletic performance in elite athletes did not seem to be affected, with some athletes recording historical performances both in the weeks following as well as several months after contracting the novel coronavirus.... These findings raise further awareness about the importance of performing regular physical activity and maintaining a favourable body composition and overall fitness, and emphasise the need for public health initiatives and actions to promote a healthy lifestyle on a population level." https://www.sciencedirect.com/science/article/abs/pii/S14402...

The idea - however appealing to Americans and apparently hackers - that everyone is on an equal playing field of risk is absolute nonsense.

> Edit: And to all the wonderful people who no doubt checked themselves to make sure they had expertise on the subject before they downvoted my question (!), here's some food for thought:

My original comment specifically highlights that the studies are split, but you are cherry-picking articles that support an argument you are trying to make that athletes aren’t suffering from heart inflammation.

Moreover, based on your initial question to my comment, you don’t even seem to be aware that heart inflammation isn’t necessarily going to effect performance, rather it presents potential longterm and acute risks of a negative outcome to the athletes, and you are specifically citing athlete performance as evidence athletes aren’t suffering from heart inflammation.

All things being equal it is probably better to be a young athlete with heart inflammation than to live a sedentary lifestyle and be obese with heart inflammation for purposes of health outcome, but I think you are confounding risk of having heart inflammation with risk of negative outcomes from heart inflammation. As research and studies continue it could very well be the risk of heart inflammation is in fact equal among the populace, while negative outcomes will be unequal, ultimately this is still going to drive up negative outcomes across the board.

How am I cherry-picking when I included several reviews? Find one review that concludes the opposite (or that such studies are "split" as you say) and perhaps you'll have an argument.

"based on your initial question to my comment, you are specifically citing athlete performance as evidence athletes aren’t suffering from heart inflammation"

How did I "cite" that in a question? That WAS my question, the answer to which I found myself.

To your second question, yes, heart inflammation doesn’t mean they can’t participate, participate at a high level, or that the athlete even notices any issue. It means they have heart inflammation which carries associated risks both long term and acute. If you are looking for anecdotal evidence, there are plenty of athletes that talk about post covid struggles that include a range of issues impacting performance (i.e. reduced cardio, more labored breathing, brain fog).

> how come they all are invariably coming back to the same exact performance they had previously?

What is that based on? It wouldn't be hard to study, given the statistics already available.

I think this post lacks an understanding of heart conditions. You can have an enlarged heart or other heart issues and still be a professional athlete. Ask Reggie Lewis. It took Jason Tatum many months to get back to some kind of playing condition after he contracted Covid, etc.

https://www.nbcsports.com/boston/celtics/celtics-star-jayson...

Yeah and he just won eastern conference player of the month. Article makes it sound like he's at risk of any game now dropping down with a heart attack, which on the face of it is ridiculous.

Exceptions do not contradict the rule - athletes in high demanding sports rarely have heart problems, and the idea that they are at equal risk than the gen pop is laughable.

But he only got back to being his pre-COVID self the last couple of months. Prior to that, he wasn't playing that well at all.

As a long time Celtics fan, there were games when he was close to normal and many other games where he just looked out of it.

Bottom line: he didn't just bounce back immediately after having Covid.

The article is about "one year later" - not "immediately after".

Some cyclists even survive cancer, and then come back to a higher level of performance than they had previously. Does that mean there is such a thing as a cancer that has a positive effect on athletic performance?

To keep on the topic of cyclists:

Tim DeClerq - out for months after being diagnosed with pericarditis after Covid infection.

Sonny Colbrelli - suffered cardiac arrest yesterday after his race, two months after Covid infection.

Again, the article is not about the immediate aftermath but one year later (i.e. long term effects). And Sonny Colbrelli was a freak incident - "All cardiac tests carried out last night showed no signs of concern or compromised functions." https://www.theguardian.com/sport/2022/mar/22/italian-cyclis...

My friend died 2 days ago. Heart attack at 31 years old. He had some unhealthy eating habits, but nothing out of the ordinary and he was at most slightly overweight. I wouldn't be surprised if him having covid a couple months ago was a major factor in his death.

Was the person vaccinated? This was done before people were vaccinated so it’s unclear if being vaccinated helped:

“THIS STUDY WAS DONE BEFORE VACCINATION WAS WIDELY AVAILABLE.”

The study, if I found the right one, has tables where they compare myocarditis in Covid patients to non-vaccinated by excluding data after vaccination, 62% of Covid patients and 56% of non-covid group excluded, to show that Covid itself caused damage.

I would hardly call half of data coming from vaccinated people "before widely available".

https://www.nature.com/articles/s41591-022-01689-3

Also an interesting bit, myocarditis hazard ratio for covid-infected by non-hospital / hospital / ICU vs:

Contemporary: 3.47 / 12.13 / 35.57

Historical: 5.67 / 19.82 / 58.11

The other outcomes were basically identical between contemporary and historical. I wonder what caused higher levels of mycarditis in half-vaccinated, uninfected contemporary group? That is a tough one.

He was vaccinated. Pfizer iirc. Not sure if he got a booster

Seems unlikely. Usually something as drastic as a heart attack at a young age like that is linked to genetics.

Very possible, there was a teen girl who was recovering from Covid around here a month ago that just hemorrhaged to death. Cardiovascular damage continues to be no joke.

I'm very sorry about your friend. That's incredible - 31 years old. How heart-breaking it must be.

Thank you. It's a shock to everyone. Been a weird week

Young people who are seemingly healthy do die of heart attacks from time to time. This happened before Covid. If we're picking random things preceding his death, why not some other thing he did in the last couple of months? Why Covid?

Why covid? Because covid causes cardiovascular damage. Travis was seemingly at least as healthy as the average American. He was physically active, going to the gym a couple times a week. Played softball in the summers. 31 is so young. My layman's assessment of my friend's death is that stress, covid, genetics are probably the things that came together to suddenly end his life.

Because covid causes heart damage and is ubiquitous in the community.

Unfortunately these things happen sometimes.

Unless you investigate though it's all pure speculation.

Here's a pro athlete that also died (at age 33) - riding his bike up a hill.

https://i.stuff.co.nz/sport/other-sports/76467759/kiwi-mount...

Dr. Al-Aly's paper is here: https://www.nature.com/articles/s41591-022-01689-3?s=08

Previous discussion: https://news.ycombinator.com/item?id=30249618

I'd be curious to know how the numbers compare other infections generally. This page [0] leads me to conclude that all types of infections, even the common cold, often affect the heart adversely. Are Covid's effects on the heart more severe than other studied viruses, or is this really just business as usual, the main difference being the comparatively widespread nature of the Covid virus?

[0] https://www.mayoclinic.org/diseases-conditions/myocarditis/s...

We should expect some heart damage because it happens after the flu too, but this study is flawed. If you had covid but weren't tested, you were put into the control group, meaning the conclusions they draw (ie. 5% increase in heart problems after a year) are going to be higher than in reality.

Looking at the title, I am sad to see the discourse in research sink to this level over the last few years (well, I think so – perhaps it was already at this level before?).

Honestly, it's hard to blame the author(s) for using such a clickbait title when Governments across the world have done precisely the same thing by trivializing the effects of a largely unknown disease, banning public health measures, or declaring the lifting of public health restrictions as a "Freedom Day".

I don't have a great solution for this – perhaps just that we should all tend towards discourse that is a bit more dry and phrased in terms of data; and steer it back to that phrasing when required.

The experiences of countries that didn't lock down proves that the "restrictions" were ineffective at best and more and more it looks like they caused and are continuing to cause more harm.

Lockdowns in cities was particularly dumb. Let's lock everyone indoor, in apartment buildings with shared air systems - yup, brilliant strategy for a highly contagious respiratory virus. If the weather is nice enough for people to be outside, the more that are outside the better!

The selective enforcement driven by non-medial reasoning was even more egregious. For example, forcing small businesses to close while allowing big box stores to remain open - either the virus is deadly enough to warrant the prohibition of ALL public contact or it isn't. Same with the ridiculous posturing during the "summer of love" as if the virus was smart enough to avoid spreading at BLM protests, but deadly everywhere else outdoors.

All the lockdowns did was foster the greatest transfer of wealth from the little guys to the big guys in all of human history :p

Even the definition of "emergency" is now hopelessly devalued. The best analogy to demonstrate this that I have heard: If someone asks to borrow your car for two weeks and after two years they still haven't brought it back, they are no longer borrowing your car.

How many people ended up in the hospital on a ventilator and potentially died needlessly while the government panned ivermectin and HCQ and the media/big tech demonized, banned and flat out declared war on anyone talking about anything other than complying with ridiculous mandates and vaccination as the only solution? Going on a ventilator was a 50/50 death sentence. ANYTHING that could have POSSIBLY prevented ANYONE from ever having to go into the hospital should have been thrown at anyone willing to try it. Ivermectin and HCQ are DECADES old, given to millions if not billions of people and even if they were 100% ineffective they certainly were not going to do harm to the VAST majority of people. But here we are. People still make fun of Ivermectin with the "horse dewormer" slur. It's very common for drugs to have human and animal uses and anyone who implies otherwise is either grossly ignorant or the most evil kind of person out there deliberately distorting actual science for political/tribal reasons.

I could go on, but the parameters of the disease were well known by the March after the December the virus really broke on our consciousness. The real problem is politics and money took over. Big pharma had a risk free gravy train as long as the "restrictions" and vaccine mandates were underway. Politicians got to boss people around and make themselves even more important. The government, media and big tech blatantly collaborated in flogging the messaging in ways never before seen in human history.

Trust in government, the media and big tech is at an all time low for very, very good reasons.

What's going to be really tragic - there may be a future biological incident where there are legitimate reasons for dramatic and long term restrictions; good luck getting everyone to cooperate after the ridiculous way COVID was handled. The more evidence that keeps coming out that much of the response and overreaction to it was utterly unwarranted, the more trust is going to be eroded. The most egregious that I am just dumbfounded that here is ongoing controversy over: it's beyond criminal that ANY kids are being forced to still wear face masks. It's flat out child abuse mainly to pleasure the teacher unions.

That you seem to be implying that governments didn't take COVID seriously enough when it's beyond obvious now that the opposite is true - the vast majority of governments dramatically overreacted and probably made things FAR worse with their policies shows just how big of a disconnect remains, unfortunately.

The lockdowns were not ineffective. They were only less effective because of people who cried "muh freedumbs". Masks have repeatedly shown to be effective, especially the N95/KN95 variety. Vaccines were shown to be very effective, if not 100% preventative. Big Tech is not a publisher and expects you to be skeptical of things you read that don't come from mainstream sources. Mainstream sources, other than Fox, tend to have some bias, but almost always contain facts they are based on. Fox however regularly breaks that trust between media and viewers/readers and has been called out over and over.

----

There are tens of thousands of stories that go out every day without errors. Pulling 8 or 10 stories out of those thousands upon thousands of stories that go out on legit news sources being incorrect or slipping in way too much does not bring into question the other 99.99% legit stories. You aren't making much sense to me here. Almost a million people have died above and beyond what normally would not have died in the USA due to Covid-19. I don't know about you, but that makes me extremely sad with the knowledge that 70-80% of those deaths could have been prevented with vaccines, masking, and observing proper protocols. It breaks my fucking heart to be honest, and I didn't even lose anyone close to me personally.

Your response is the perfect example why I no longer try to discuss this topic with any covid-response-enthusiasts. You're, obviously, entitled to your beliefs, and must consider them well-backed by your knowledge, life experiences and values. Just as six-days creationists are entitled to theirs. I do not judge either. But this response is so typical that I'll use it to point most problematic issues.

First, it contains a brisk, insulting, dismissive and unfalsifiable claim involving modern slur. This is in response to the GP post, where the author went to the pains of writing long-form in a very polite way.

Second, it professes the trust to mainstream media, which seems infallible to the poster. All while crapping en passe on "others" that they do not like. Sometimes it also contains accolades to bureaucrats and/or scientists. Cherry-picked ones, of course.

And concluded with another unfalsifiable claim that "70-80% of those deaths could have been prevented with vaccines, masking, and observing proper protocols.", again implying that all "measures" must have been followed precisely, and anyone disagreeing is nothing short of murderer. While all the available data increasingly pointing to the opposite, that all the "proper protocols" did bugger all and caused more harm then good. Heck, even the latest study from the beloved doom merchants of John Hopkins University declares that "lockdowns in Europe and the United States reduced only COVID-19 mortality by 0.2% on average." Note the order of magnitude. No, not completely ineffective, right?

It is sad, sad state of things, and the fallout will be felt for decades, I think. I absolutely agree with GP post, that when the real challenge comes the society mobilization will be impossible, because the trust is completely broken. I know mine is.

Your response is also why I do bother to comment sometimes. I don't want people to see the your side without seeing the other side. I'm a skeptic by nature, that's why I trust scientists and not internet "facts" that have almost nothing to back them up other than alt-right qanon sources. I automatically dismiss those sources as a default. Conservative media prints 100 to 1 (at least) unsupported to supported facts as opposed to more traditional liberal/moderate sources. I can go to fox or breitbart on any given day and find dozens of pieces of outright misinformation on display between their news reports and opinion shows. It's ludicrous. The only right wing mag that I can think of who regularly does a decent job is Reason magazine. If you want to deny basic physics and medical knowledge that masks block viruses and reduce viral load then go ahead. I wish you all the best and have a nice life.

Do we know whether Covid-19 is different wrt heart and other effects than other corona viruses or even flu viruses in general? For example, how is Covid-19/SARS-CoV-2 different from 2002-4's SARS-CoV-1 in this respect?

I ask because the reports of mental sluggishness for a couple of months after Covid-19 reminded me of how I felt after some previous flus.

New studies are suggesting links to nerve damage as a cause for long-covid symptoms https://www.nbcnews.com/health/health-news/long-covid-sympto...

My question is how different covid-19 is.

One of the things that has come out of Covid-19 is how little was actually known about flus, despite the fact that flus have been killing 30-70k Americans each year for decades. This ignorance is "interesting" because "we need to be ready for the next Spanish flu" has been at the core of the "give us more money for research" argument for decades.

For example, it looks like we still don't understand transmission in any useful sense. There was some reasonable research in the late 40s but we've learned more in the last two years than in the intervening 80 years.

Yes, some of the tools used in the last two years weren't available 20 years ago but they were available 10 years ago. That said, many of the tools have been available, albeit unused, for 80+ years.

I think going forward we are going to learn a lot more about these long term issues. Before COVID, getting chronic fatigue from flu was mostly ignored by the medical community. Now, with popularity of covid a lot more doctors are aware of some possible neurological issues.

There have been case studies, research and support groups for these things for many years. However, handful of physicians treating patients. I am now seeing more doctors seeing patients with odd symptoms at clinics all over the US, some even have ads targeting long covid.

I think we are going to make some major advancements in the next 10 years, and I'm happy many suffering quietly will be heard.

This chart from the actual paper contains much more useful information than the linked article. https://www.nature.com/articles/s41591-022-01689-3/figures/5

Basically, don't worry about this if you were not hospitalized with covid.

Whole paper: https://www.nature.com/articles/s41591-022-01689-3

It will be interesting to see the long term numbers for this on the vaxxed vs. unvaxxed.

So basically everyone who has had COVID (presumably even the "milder" Omicron variant family, although we seem to be permanently stuck on the name Omicron, so the association with "mildness" probably won't last forever) has heart damage, that could last for a year or more? Oh boy.

What’s the effect size? Didn’t see this anywhere in the article and seems pretty important to know.

What about those that took the vaccine?

> This study was done before vaccination was widely available. Is there any indication that, for example, breakthrough infections would have a different result long term?

> Yes. We are [studying] this, but I think the jury is still out. We're certainly very interested in addressing that publicly as soon as we can.

neat! that first quoted line has css text-transform:uppercase in the article, so firefox copies as original, lowercase text, but chromium copies as all caps!

> THIS STUDY WAS DONE BEFORE VACCINATION WAS WIDELY AVAILABLE. IS THERE ANY INDICATION THAT, FOR EXAMPLE, BREAKTHROUGH INFECTIONS WOULD HAVE A DIFFERENT RESULT LONG TERM?

> Yes. We are [studying] this, but I think the jury is still out. We're certainly very interested in addressing that publicly as soon as we can.

If you're referring to cases of myocarditis caused by vaccination itself, the cases are negligible: 2.3 per 100,000 [1]. Compare that with the apparent near-certainty of heart damage (and likely brain damage) if you contract COVID while being unvaccinated, and the decision to not get vaccinated is not just selfish but self-destructive.

[1] https://www.nejm.org/doi/full/10.1056/NEJMoa2110737

Heart damage from Covid is nothing like a "near-certainty". The vast majority don't experience it, upwards of 95% depending on the study. Framing this as "near-certainty" or "spares no one" is irresponsible fear-mongering.

The study is not saying that 95% of people who get COVID do not experience heart damage. It is only saying that 95% of people who get COVID did not have a heart-related acute event in the time period examined. That doesn't mean they had no heart damage at all. Their hearts were not directly examined.

The point of this study was to assess whether people who have had COVID are at increased risk for heart-related problems (and the conclusion was that yes, they are), not to assess what percentage of them had actual heart damage.

95% is not a "vast majority"; that's 5% of the population with quantifiable degradation in heart function. I fear for the catastrophe it will cause 20 years down the line in increased disease burden.

Near-certainty is literally the finding of the linked article. You're confusing your numbers. Heart damage != heart attacks.

This claim really requires a citation of some sort. In particular,

> don't experience it

is reckless, given that we know the vast majority of heart disease is undiagnosed until there are symptoms.

It's 1 in 10,000 according to NHS's vaccine factsheet.

> near-certainty of heart damage (and likely brain damage) if you contract COVID while being unvaccinated

This is the first I've seen it presented as a near-certainty. Where is this documented?

I think they are referring to the paper in the OP.

There is no indication that vaccination changes that. You still get it and and if i had to guess, lung antibodies will likely help as much for heart problems as they do for upper respiratory symptoms.

There's no indication either way because the reseach was done before widespread vaccination.

> if i had to guess

Your guesses are worthless (as are mine), unless you have some expertise. The last thing we need is more BS on the Internet about Coronavirus.

Even if it was that way, precautionary principle would still apply. Saying "nobody could have known" in a few years doesnt make your heart damage go away.

Couldn't you apply this logic to excuse doing any random thing? It might help so why not do it since we will potentially regret it in the future if we don't? I'm not necessarily disagreeing with you but by that logic we should certainly be giving everyone Ivermectin, it's been proven to be extremely safe and it might help so why not? You would certainly regret not taking it if it turns out it prevented heart damage.

Sorry I cant follow. I was arguing for quite the opposite, just assuming something will help wont make it so. We know there is heart damage as well as long covid even in low and asymptomatic cases. Sure you can bet that the vaccines will help there as well, but how confident are you in that? Because as far as i know nobody promised anything of the sorts. It is a leaky vaccine, you still get sick, you just get lung antibodies so you dont end up on intensive care.

Are you really willing to risk both on the grounds that it might or might not help? I would say if you dont know, you assume that its not a magic shield and adapt your behavior accordingly. Which means so you dont catch it.

Please knock it off with the "selfish" nonsense. Even if everyone got vaccinated, the virus would still get passed around. Then, when the next variant inevitably arises, and everyone's immunity wears off, we're back at square one. The anti-anti-vax crowd is just a walking meme at this point.

You have a valid point, but hospital beds are still a finite resource. So in that sense, yeah, it is selfish to not get vaccinated in the absence of other mitigating factors, since vaccination prevents hospitalization in a large majority of cases.

What's even more selfish is not treating COVID but just telling people to wait until it is bad enough to go into the hospital before doing anything, when we absolutely knew very early on that anyone going on a ventilator was essentially a 50/50 death sentence. Keeping everyone off of ventilators at all costs should have been the number one goal instead of futilely trying to stop the spread of a highly contagious arial virus that is in the same family as the common cold. I know few people who would think you were rational if you prescribed any of the COVID "solutions" to try to prevent cold viruses - yet somehow we were going to be effective with COVID?

What's beyond evil is demonizing any treatment other than vaccination - but that's still going on even today, as evidenced by posts like yours.

I got COVID and was (and still am) unvaccinated, yet I did not get anywhere near a hospital; and that is what happened to just about anyone who wasn't in one of the well known and well understood risk groups.

Treating everyone the same instead of focusing on those most at risk was and still is particularly dumb, but here we are with people like you still making completely baseless claims that are certainly not backed by any actual medical science.

Before baselessly judging everyone else as selfish you might want to spend more time looking in a mirror.

What I'm saying is that maybe some people who have been hospitalized due to covid wouldn't be in the hospital if they had gotten vaccinated.

Hospital beds are not an unlimited resource, and there are plenty of other conditions apart from covid that may also require hospitalization.

I genuinely fail to see what is unreasonable, selfish or factually wrong about any of the above statements.

Does that cover risky behavior that could lead to hospitalization as well? Lets be honest, we did collect quite a bit of data over the pandemic years and your risk of hospitalization from COVID is not some random chance but determined by your state of health.

Differently put, i am having a hard time calling healthy teenagers selfish if nobody thinks about calling anyone with a still obese BMI after 2 years the same. Because to be perfectly blunt, looking at the numbers the later is a lot bigger of a problem then the former.

edit: In case anyone is skeptical about the giant impact obesity has, here the CDC numbers from last year https://www.cdc.gov/pcd/issues/2021/pdf/21_0123.pdf Figure 1 has leading underlying medical conditions. Hypertension, Lipid metabolism (cholesterol), obesity itself, diabetes and coronary atherosclerosis being the first 5. Table 1 has the numbers of hospitalized. ~95% had two or more on the list.

Counterpoint: dude does not have a valid point.

> The anti-anti-vax crowd is just a walking meme at this point.

Not more than the actual anti-vax crowd.

> Even if everyone got vaccinated, the virus would still get passed around.

That's not necessarily true. The virus needs to spread faster than it dies (look up the R value). Vaccines have eliminated other diseases, such as small pox.

Thats not a realistic option for COVID and the vaccines we have for it. Its a leaky vaccine (meaning you still get sick and spread it just as much) and the reduced likelihood for infection is nowhere near enough to get R0 under 1. Especially with every mutation (delta, omicron ...) having higher R0

> Its a leaky vaccine (meaning you still get sick and spread it just as much)

No vaccine is perfect, but it greatly reduces your chances of becoming infected.

Relative to somebody not vaccinated with the same NPI. Just look at any of those studies, they are almost exclusively done on hospital staff which have among the strictest NPI. Once you drop those the difference doesnt mean much. Especially with the new mutations.

So again, herd immunity is not an option for the current vaccines and variants of covid. This is not a controversial statement.

Can you provide some expertise that says these things? Or are you an expert? Again, we don't need more people on the Internet speculating.

You are correct. We should use the terminology "insanely selfish." If everyone (not immunosuppressed etc) got vaccinated, fewer people would die. This is science, not religion. This is not hard to understand unless you're willfully committed to ignorance. The existing vaccines have so far still been effective against newer strains, just less so.

> The anti-anti-vax crowd is just a walking meme at this point.

This is a semantically null statement.

You cant just apply some general knowledge about vaccinations to COVID with some selfrighteousness sprinkled on top. Unfortunately its not that easy

>If everyone (not immunosuppressed etc) got vaccinated, fewer people would die.

People at risk of a severe case of covid fare better when vaccinated. Thats it. You vaccinating yourself doesnt save an obese elderly person from covid. Its not magic.

To be more precise, there wont be any herd immunity and that has been clear for well over a year. Its a leaky vaccine which means you still get it and spread it just as much as unvaccinated do. You are a bit less likely to catch it, but not to any meaningful degree. Especially not with the R0 of COVID mutations. Your behavior and non pharmaceutical interventions are still the driving factor.

Differently put, you are vaccinating yourself to protect yourself, not others. You have some implicit protection of others through not overloading the hospital system, but not to the degree some people think. Risk groups are a very real thing and if you are not in one, there are a lot of daily risks you take which are quite a lot riskier. Unless we categorize them as selfish too, i am calling hypocritical double standard.

I would also recommend some self reflection into whether you are using the fact that you are vaccinated as an letter of indulgence like far too many do. You do still spread it and covid isnt just solved once everyone is vaccinated. Not being honest with that could be described as willfully ignorant. Having identified a few especially stupid caricatures doesnt mean you are done thinking.

Has anyone found a quantification of the HR for vaccinated vs non-vaccinated patients in the study?

What was the methodology around asymptomatic covid cases and cardiac outcomes?

This seems like a sensationalist claim.

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