Just to flag I messed up the original calculation and underestimated everything by a factor of 2x, I’ve added an errata.
I’d also recommend Matt Bell’s recent analysis, who estimates 200 days of life lost. This is much higher than the analysis in my comment and the OP. I found the assumptions and sources somewhat pessimistic but ultimately plausible.
The main things driving the difference from my comment were:
Uses data from the UK’s Office of National Statistics that I’d missed, which has a very high number of 55% of people reporting symptoms after 5 weeks, with fairly slow rates of recovery all the way out to 120 days post-infection. Given this is significantly higher than most other studies I’ve seen, I think Matt is being pessimistic by only down-adjusting to 45%, but I should emphasize these numbers are credible and the ONS study is honestly better than most out there.
Long COVID making your life 20% worse is on the pessimistic end. I put most mild symptoms at 5% worse. Ultimately subjective and highly dependent on what symptoms you get.
I think the difference in hospitalized vs non-hospitalized risk is closer to 10x (based on Al-Aly figure) not Matt’s estimate of 2x, that means we should multiply by a factor of ~60% not ~97%.
I should probably argue with Matt directly, but my brief take is that this is just entirely incompatible with what we see on the ground. The friends of mine who got COVID aren’t reporting 45% chance of their life being 20% worse. That’s… an incredibly massive effect that we would definitely see. Would anyone realistically bet on that?
Bell mentions this paper in Nature Medicine that finds only 2.3% of people having symptoms after 12 weeks. (The UK ONS study that is Bell’s main sources estimates 13%). It seems better to take a mean of these estimates than to just drop one of them, as the studies are fairly similar in approach. (Both rely on self-report. The sample size for the Nature paper is >4000).
Note that the 13% figure in the ONS study drops to 1% if you restrict to subjects who had symptoms every week. (The study allows for people to go a week without any symptoms while still counting as a Long Covid case). I realize people report Long Covid as varying over time, but it’s clearly worse to have a condition that causes some fatigue or tiredness at least once a week rather at least once every two weeks.
(Do you mean the Lancet / British intelligence test paper when you say ONS? I embarrassingly don’t see a paper I cited with those letters in it.)
The current way I imagine citing this is to use as a corroboration of my rough estimate of <2% 30yos having Long COVID. I don’t see an easy way to integrate it with IQ loss estimates—since I wouldn’t expect tiny levels of IQ loss to show up on a survey about actual Long COVID symptoms, it seems relatively consistent for 2% symptoms after 12 weeks to still correspond to an average IQ loss of .15 points after 12 weeks (~10% lose 1 IQ point, 1% lose several IQ points). I do think it points downwards somewhat, though, maybe a factor of 2?
I added a link above. The ONS is the UK’s national statistics agency. This is not a peer-reviewed paper but a report they published. (I find these reports to be mixed in quality).
In the Nature paper, they get 2.3% with symptoms overall. But they estimate that 30 yos are less likely than older cohorts to have symptoms at 56 days and so you could adjust down a bit. (Women are also at higher risk according to this study).
Just to flag I messed up the original calculation and underestimated everything by a factor of 2x, I’ve added an errata.
I’d also recommend Matt Bell’s recent analysis, who estimates 200 days of life lost. This is much higher than the analysis in my comment and the OP. I found the assumptions and sources somewhat pessimistic but ultimately plausible.
The main things driving the difference from my comment were:
Uses data from the UK’s Office of National Statistics that I’d missed, which has a very high number of 55% of people reporting symptoms after 5 weeks, with fairly slow rates of recovery all the way out to 120 days post-infection. Given this is significantly higher than most other studies I’ve seen, I think Matt is being pessimistic by only down-adjusting to 45%, but I should emphasize these numbers are credible and the ONS study is honestly better than most out there.
Long COVID making your life 20% worse is on the pessimistic end. I put most mild symptoms at 5% worse. Ultimately subjective and highly dependent on what symptoms you get.
I think the difference in hospitalized vs non-hospitalized risk is closer to 10x (based on Al-Aly figure) not Matt’s estimate of 2x, that means we should multiply by a factor of ~60% not ~97%.
I should probably argue with Matt directly, but my brief take is that this is just entirely incompatible with what we see on the ground. The friends of mine who got COVID aren’t reporting 45% chance of their life being 20% worse. That’s… an incredibly massive effect that we would definitely see. Would anyone realistically bet on that?
Bell mentions this paper in Nature Medicine that finds only 2.3% of people having symptoms after 12 weeks. (The UK ONS study that is Bell’s main sources estimates 13%). It seems better to take a mean of these estimates than to just drop one of them, as the studies are fairly similar in approach. (Both rely on self-report. The sample size for the Nature paper is >4000).
Note that the 13% figure in the ONS study drops to 1% if you restrict to subjects who had symptoms every week. (The study allows for people to go a week without any symptoms while still counting as a Long Covid case). I realize people report Long Covid as varying over time, but it’s clearly worse to have a condition that causes some fatigue or tiredness at least once a week rather at least once every two weeks.
Great paper, thank you!
(Do you mean the Lancet / British intelligence test paper when you say ONS? I embarrassingly don’t see a paper I cited with those letters in it.)
The current way I imagine citing this is to use as a corroboration of my rough estimate of <2% 30yos having Long COVID. I don’t see an easy way to integrate it with IQ loss estimates—since I wouldn’t expect tiny levels of IQ loss to show up on a survey about actual Long COVID symptoms, it seems relatively consistent for 2% symptoms after 12 weeks to still correspond to an average IQ loss of .15 points after 12 weeks (~10% lose 1 IQ point, 1% lose several IQ points). I do think it points downwards somewhat, though, maybe a factor of 2?
I added a link above. The ONS is the UK’s national statistics agency. This is not a peer-reviewed paper but a report they published. (I find these reports to be mixed in quality).
In the Nature paper, they get 2.3% with symptoms overall. But they estimate that 30 yos are less likely than older cohorts to have symptoms at 56 days and so you could adjust down a bit. (Women are also at higher risk according to this study).
Oops, thought that was a top-level reply to me when I clicked on it, rather than a reply to Adam. Sorry. Makes more sense in context.