General concerns which push me towards being much less cautious re: Long Covid than you, without getting into the specific details of studies:
We have studied COVID far more than other diseases, so we may be finding stuff that either isn’t real or more likely, occurs with other pathogens (we just hadn’t bothered to look that closely before.)
Upshot: worry less about Long Covid
In general, a strong bias against preclinical/in-vitro work because I think that kind of lit is not very predictive of real-world issues.
Upshot: worry less about Long Covid
I’m more pessimistic than you about almost everyone getting Covid. Even with theoretical new vaccines for Omnicron or next-strain that approximate the original vaccine efficacy against the Wuhan strain, which was maybe 95% against severe outcomes and ~ 70-90% against infection in general, it seems difficult to achieve the herd immunity required for the more contagious strains. It is hard to find exact values but this article implies an R value of 4 or 5. That would require herd immunity threshold of 75-80%, which might be achieved with full next-gen vaccine uptake in the whole population, but that won’t happen in the US because mandates are not going to happen on a large scale.
But you could probably achieve herd immunity in a conscientious network of people, so perhaps this doesn’t matter to you if you mostly socialize with those types of people.
Nobody who I know personally who had a mild (defined as not hospitalized) case of COVID (at least 30 people I know well) has had any long-term (more than 3 months) issues, and I have asked in detail. One person I know was in the ICU and does have long-term issues but that’s expected for any ICU case from a respiratory disease. One person with a moderate case had a cough for 2 months after. From my limited interactions with LW/EA/rationalist types, I would guess my network is significantly less neurotic than what I’m guessing is your network and so they are less likely to experience psychosomatic symptoms .
Upshot: worry less about Long Covid from personal experience
To balance that critique out, something that makes me think long-term issues from Covid are not so fanciful: a decent number of pathogens can cause weird long-term issues: EBV, measles, polio, Encephalitis lethargica, H. Pylori-->cancer. So COVID causing issues is not unprecedented.
Still, the idea of Covid causing accelerated aging in mild cases seems unlikely to me. I can’t justify this intuition in-depth but my understanding is that when pathogens do cause long-term issues, it is relatively specific to a tissue or organ type, so I’m skeptical of broadly dysregulated issues from a mild infection.
To balance that critique out, something that makes me think long-term issues from Covid are not so fanciful: a decent number of pathogens can cause weird long-term issues: EBV, measles, polio, Encephalitis lethargica, H. Pylori-->cancer. So COVID causing issues is not unprecedented.
Quite crucially, we know that SARS did often cause long-term issues.
Still, the idea of Covid causing accelerated aging in mild cases seems unlikely to me. I can’t justify this intuition in-depth but my understanding is that when pathogens do cause long-term issues, it is relatively specific to a tissue or organ type, so I’m skeptical of broadly dysregulated issues from a mild infection.
In the beginning of the pandemic there was a study that did heart scans that suggested that COVID infection generally cause lasting heart inflamation. It seems to me that there wasn’t a lot of research to validate to what extend that’s true and I see no reason to rule out that thesis.
>>In the beginning of the pandemic there was a study that did heart scans that suggested that COVID infection generally cause lasting heart inflamation. It seems to me that there wasn’t a lot of research to validate to what extend that’s true and I see no reason to rule out that thesis.
My understanding is that similar findings occur in other diseases, especially in patients who are hospitalized, so I’m not sure that’s novel to Covid.
Bad long term consequences aren’t about whether there’s something novel to COVID but whether COVID is similar to SARS which had very bad long term effects or whether it’s not similar to SARS.
The studies that I remember saw such findings also in patients that were not hospitalized.
General concerns which push me towards being much less cautious re: Long Covid than you, without getting into the specific details of studies:
We have studied COVID far more than other diseases, so we may be finding stuff that either isn’t real or more likely, occurs with other pathogens (we just hadn’t bothered to look that closely before.)
Upshot: worry less about Long Covid
In general, a strong bias against preclinical/in-vitro work because I think that kind of lit is not very predictive of real-world issues.
Upshot: worry less about Long Covid
I’m more pessimistic than you about almost everyone getting Covid. Even with theoretical new vaccines for Omnicron or next-strain that approximate the original vaccine efficacy against the Wuhan strain, which was maybe 95% against severe outcomes and ~ 70-90% against infection in general, it seems difficult to achieve the herd immunity required for the more contagious strains. It is hard to find exact values but this article implies an R value of 4 or 5. That would require herd immunity threshold of 75-80%, which might be achieved with full next-gen vaccine uptake in the whole population, but that won’t happen in the US because mandates are not going to happen on a large scale.
But you could probably achieve herd immunity in a conscientious network of people, so perhaps this doesn’t matter to you if you mostly socialize with those types of people.
Upshot: avoiding COVID forever seems quite challenging
Nobody who I know personally who had a mild (defined as not hospitalized) case of COVID (at least 30 people I know well) has had any long-term (more than 3 months) issues, and I have asked in detail. One person I know was in the ICU and does have long-term issues but that’s expected for any ICU case from a respiratory disease. One person with a moderate case had a cough for 2 months after. From my limited interactions with LW/EA/rationalist types, I would guess my network is significantly less neurotic than what I’m guessing is your network and so they are less likely to experience psychosomatic symptoms .
Upshot: worry less about Long Covid from personal experience
To balance that critique out, something that makes me think long-term issues from Covid are not so fanciful: a decent number of pathogens can cause weird long-term issues: EBV, measles, polio, Encephalitis lethargica, H. Pylori-->cancer. So COVID causing issues is not unprecedented.
Still, the idea of Covid causing accelerated aging in mild cases seems unlikely to me. I can’t justify this intuition in-depth but my understanding is that when pathogens do cause long-term issues, it is relatively specific to a tissue or organ type, so I’m skeptical of broadly dysregulated issues from a mild infection.
Quite crucially, we know that SARS did often cause long-term issues.
In the beginning of the pandemic there was a study that did heart scans that suggested that COVID infection generally cause lasting heart inflamation. It seems to me that there wasn’t a lot of research to validate to what extend that’s true and I see no reason to rule out that thesis.
>>In the beginning of the pandemic there was a study that did heart scans that suggested that COVID infection generally cause lasting heart inflamation. It seems to me that there wasn’t a lot of research to validate to what extend that’s true and I see no reason to rule out that thesis.
My understanding is that similar findings occur in other diseases, especially in patients who are hospitalized, so I’m not sure that’s novel to Covid.
Bad long term consequences aren’t about whether there’s something novel to COVID but whether COVID is similar to SARS which had very bad long term effects or whether it’s not similar to SARS.
The studies that I remember saw such findings also in patients that were not hospitalized.