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Comment by ceeplusplus | Hacker News Reader

The data showing the difference between percentage of college graduates and noncollege graduates who believe they have long COVID seems to point to a placebo effect. I don't see why college grads and non-college grads would have any reason to be affected differently by a virus.

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Far too quick. Of course, there isn't a direct causal connection between college degrees and severity of Covid, but there are huge average differences between more and less educated individuals, including lots of health related outcomes. https://www.economist.com/graphic-detail/2021/03/17/educated... (chosen basically at random, basically any relevant google search will get you many articles saying similar things).

It's also unbelievable that these groups don't differ in frequency of having Covid, vaccination rates, likelihood of having had Covid in 2020 vs. post vaccination, etc. Since we know vaccination has some protective effect against long-covid, that's another factor.

This doesn't mean these reports reflect underlying reality permanently (maybe a desk jockey reports disability differently than someone with a physically demanding job, maybe other factors make people less likely to report). But there are plenty of ways education can predict outcomes that aren't just reporting bias.

Probably because they were able to work remotely at a higher rate and thus fewer were actually infected. Being diagnosed with COVID was not a prerequisite for this study.

People with more (or later) education will often have better outcomes for things like Alzheimer’s Disease. It’s not unreasonable to think that education may have a protective role.

I agree. Research papers and books (can currently think of one[1]) mention that there is more nicotine users among less-educated.

It's not far-fetched to assume that this substance is not atypical and educated people make in general more health-conscious choices.

[1] https://moleculeofmore.com/

Nicotine itself is not particularly dangerous and smoking cigarettes with no nicotine would be just as bad for your lungs. The main with it is the addiction however there is bo clear link between long term use of nicotine itself and any significantly negative health outcomes.

I would argue that education enables a lifestyle that is protective, rather than education itself.

Education is also self selected, so it likely representative of other choices as well.

It just isn’t though. Opportunity is not doled out equally. Yes, everyone has the chance to be educated. But some schools are better, some families more supportive etc. And certainly there are exceptions that defy their environment but they are exceptions.

That doesn’t distract from the fact that many that have the opportunity chose not seek or continue higher education. This is especially true post collage.

One theory is that educated people compensate better for decline on cognitive tests, basically by “muscling through it”. I’ve heard it doesn’t change the overall course of the disease much but it does make the decline less noticeable in the early stages.

No, the data does not show placebo effect.

Reason: College grads are more likely to get vaccinated against COVID than non-grads. Leading to a reduction in symptom severity and perhaps long covid.

https://healthpolicy.usc.edu/evidence-base/education-is-now-...

But there could be other causes. You are operating under the default assumption long COVID must exist. But non-grads on average are poorer, work in different environments, and have different health (i.e. obesity and diabetes) than grads. There could be any number of underlying health conditions causing brain fog and other long COVID symptoms. Obesity and diabetes are known to impact brain function and are correlated with Alzheimer's. Sedentary lifestyles and poor diet can also lead to low energy.

The reason I say placebo is because any of these pre-existing conditions could be blamed on long COVID. Think about it: you don't know much about diseases, you see CNN/Fox News/MSNBC talking about long COVID. You think to yourself, hey I've got those symptoms! You blame long COVID, even though the underlying cause could have been obesity, diabetes, sedentary lifestyle, diet, etc.

We know obesity is harmful yet the fat acceptance movement exists. Do you think those people are going to blame their symptoms on their obesity?

Obesity among college graduates is relatively low in aggregate, and obesity is associated with LC.

College graduates may be less likely to be exposed to larger quantities of COVID molecules (e.g. driving via car, vs taking the subway, or any other number of possibilities), or perhaps they had better treatment of their COVID due to their financial capabilities.

There are strong selection criteria biases at work here; this does not indicate psychosomatic.

I think you are right, but I don't think placebo necessarily means psychosomatic. Does it?

If a placebo is effective it’s presumed to psychosomatic as there have been no underlying medical changes. In this case I presumed that the term ‘placebo’ was being used incorrectly and what was meant was psychosomatic.

That is certainly an explanation. But I'm large studies like this, it seems as likely it was just an uncontrolled variable. Right?

I’m unsure as to what you mean. There most certainly are lots of uncontrolled variables. I’d be highly surprised if this study wasn’t flawed in a number of material ways.

I'm just saying that we don't have to jump to psychosomatic to explain why a placebo may show identical results to a treatment. There are plenty of ways that can happen.

Education levels tracked the acceptance of masking and vaccination, and the political divide that has emerged from Trump.

I think highly educated people are often simply indoctrinated with facts and beliefs rather than trained to be intelligent and knowledgeable.

Education is about using intelligence not gaining it. That said, in practice knowledge can be more useful than intelligence if the circumstances presented fit the available knowledge well.

There is now fairly substantial evidence that COVID can cause your brain to physically shrink. Maybe some people experience a placebo effect, but long COVID is clearly a real, physical disease at this point.

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