My impression is that we’re much less likely to catch other infectious diseases that are nearly as severe in the long term (except maybe Lyme?), and unless your probability of catching COVID is very low, your risks from COVID seem worse than driving. This is based on a few people’s separate BOTECs for long COVID and my own (vague and personal, not well-researched) impression of how common and bad other infectious diseases are.
Note that a lot of other infectious diseases have become rarer under lockdowns, too, and that’s something to account for. If someone has had an infectious disease in the past month, I’d guess it’s reasonably likely to be COVID, given its high transmissibility. If someone who’s been fully vaccinated for > 1 month has had an infectious disease in the past month, I’m not sure, I’d have to do the math. Going forward, COVID seems likely to be one of the most common infectious diseases going around.
What (similarly addressable or more easily addressable) risks do you think add up to being worse? Or, do you have an overall risk estimate to compare?
What (similarly addressable or more easily addressable) risks do you think add up to being worse? Or, do you have an overall risk estimate to compare?
This question feels like a type error to me. My claim isn’t “we precisely measured a bunch of risks and covid didn’t make the top 5”, it’s “our measures of damage are not sufficiently precise to measure the danger of breakthrough covid against the accumulated risks we take elsewhere”. Additionally, which risks are worth lowering depends heavily on the individual, both what risks they were already taking and how much joy those risks bring them.
That said, I personally am focusing my energy on exercise, air quality, fixing the vaccine-induced chest congestion, and diet.
Sorry, I was responding to this, but forgot to quote it:
My tentative conclusion is that the risks to me of cognitive, mood, or fatigue side effects lasting >12 weeks from long covid are small relative to risks I was already taking, including the risk of similar long term issues from other common infectious diseases.
(emphasis mine)
My expectation is that compared to other infectious diseases, (long) COVID is
Much much worse, but less common (e.g. cold), or
Much worse and about as common (e.g. flu), or
Not as bad, but much much more common.
And these together make it seem reasonably likely to me that (long) COVID risk is not small relative to (long) risks from other common infectious diseases together.
10-20% chance of “failure to treat” acute Lyme, given Lyme
30-80% chance of post-ICU syndrome, given admission to ICU (but that’s not tracking the counterfactual). There are ~4 million ICU admissions in the US per year, although those have a heavy long tail.
Lifetime chance of 30% for shingles (which is a manifestation of dormant chicken pox), although that should be trending down with the chickenpox vaccine. 10%-18% of people who develop shingles will develop postherpetic neuralgia (another source has lifetime chance of postherpetic neuralgia at 20%).
500 traumatic brain injuries per 100,000 person-years (albeit concentrated amoung children) of which 26-30 will create a long term disability and 17 will cause death.
Ok, ya, some of these seem roughly within an order of magnitude of long COVID (higher or lower, since there’s a lot of uncertainty).
I think it’s worth mentioning that some of the risks here are more concentrated in older people, but can still be within an order of magnitude of COVID risk for people around my age (28). I would guess only Lyme and CFS would be concerning for a healthy person in their early 20s who doesn’t take excessive risks of physical injury (low brain injury and post-ICU syndrome risk). I do wonder about recreational drug use, especially binge drinking (I never drank, so this was never a risk for me) and bike riding.
I’m not sure what I can do about CFS, fribromyalgia and shingles other than maintain a healthy lifestyle (diet, sleep and exercise), which I already am trying to do (but I suppose could be doing more), and I recognize is part of the point of your article. Maybe there’s some link between CFS and viral infections (Epstein-Barr, herpes), so I could try to avoid those. I’ve already had chickenpox, so I’m not sure what else I can do about shingles.
95% of healthy people have been infected with Epstein-Barr, it just doesn’t have acute symptoms in many people
Both Epstein-Barr and chickenpox are herpes viruses, all of which establish residence in your cells forever. “Postherpetic” doesn’t necessarily mean HSV1/2, it includes multiple viruses that are (EB, cytomegalovirus) or were (chickenpox, pre-vaccine) nearly impossible to avoid without living in a bubble.
Thanks for writing this!
My impression is that we’re much less likely to catch other infectious diseases that are nearly as severe in the long term (except maybe Lyme?), and unless your probability of catching COVID is very low, your risks from COVID seem worse than driving. This is based on a few people’s separate BOTECs for long COVID and my own (vague and personal, not well-researched) impression of how common and bad other infectious diseases are.
Note that a lot of other infectious diseases have become rarer under lockdowns, too, and that’s something to account for. If someone has had an infectious disease in the past month, I’d guess it’s reasonably likely to be COVID, given its high transmissibility. If someone who’s been fully vaccinated for > 1 month has had an infectious disease in the past month, I’m not sure, I’d have to do the math. Going forward, COVID seems likely to be one of the most common infectious diseases going around.
What (similarly addressable or more easily addressable) risks do you think add up to being worse? Or, do you have an overall risk estimate to compare?
This question feels like a type error to me. My claim isn’t “we precisely measured a bunch of risks and covid didn’t make the top 5”, it’s “our measures of damage are not sufficiently precise to measure the danger of breakthrough covid against the accumulated risks we take elsewhere”. Additionally, which risks are worth lowering depends heavily on the individual, both what risks they were already taking and how much joy those risks bring them.
That said, I personally am focusing my energy on exercise, air quality, fixing the vaccine-induced chest congestion, and diet.
Sorry, I was responding to this, but forgot to quote it:
(emphasis mine)
My expectation is that compared to other infectious diseases, (long) COVID is
Much much worse, but less common (e.g. cold), or
Much worse and about as common (e.g. flu), or
Not as bad, but much much more common.
And these together make it seem reasonably likely to me that (long) COVID risk is not small relative to (long) risks from other common infectious diseases together.
Some very quick numbers (populations may overlap):
13.15 CFS diagnoses per 100,000 person-years (13.58 if you include idiopathic fatigue)
430 fibromyalgia diagnoses per 100,000 person-years
10-20% chance of “failure to treat” acute Lyme, given Lyme
30-80% chance of post-ICU syndrome, given admission to ICU (but that’s not tracking the counterfactual). There are ~4 million ICU admissions in the US per year, although those have a heavy long tail.
Lifetime chance of 30% for shingles (which is a manifestation of dormant chicken pox), although that should be trending down with the chickenpox vaccine. 10%-18% of people who develop shingles will develop postherpetic neuralgia (another source has lifetime chance of postherpetic neuralgia at 20%).
500 traumatic brain injuries per 100,000 person-years (albeit concentrated amoung children) of which 26-30 will create a long term disability and 17 will cause death.
Ok, ya, some of these seem roughly within an order of magnitude of long COVID (higher or lower, since there’s a lot of uncertainty).
I think it’s worth mentioning that some of the risks here are more concentrated in older people, but can still be within an order of magnitude of COVID risk for people around my age (28). I would guess only Lyme and CFS would be concerning for a healthy person in their early 20s who doesn’t take excessive risks of physical injury (low brain injury and post-ICU syndrome risk). I do wonder about recreational drug use, especially binge drinking (I never drank, so this was never a risk for me) and bike riding.
I’m not sure what I can do about CFS, fribromyalgia and shingles other than maintain a healthy lifestyle (diet, sleep and exercise), which I already am trying to do (but I suppose could be doing more), and I recognize is part of the point of your article. Maybe there’s some link between CFS and viral infections (Epstein-Barr, herpes), so I could try to avoid those. I’ve already had chickenpox, so I’m not sure what else I can do about shingles.
This isn’t cruxy for me, but:
95% of healthy people have been infected with Epstein-Barr, it just doesn’t have acute symptoms in many people
Both Epstein-Barr and chickenpox are herpes viruses, all of which establish residence in your cells forever. “Postherpetic” doesn’t necessarily mean HSV1/2, it includes multiple viruses that are (EB, cytomegalovirus) or were (chickenpox, pre-vaccine) nearly impossible to avoid without living in a bubble.