This is very interesting. I find this somewhat persuasive and am updating in the direction of being more afraid of getting covid. That being said, I think I’m still pretty far from your level of concern. I can think of three places where I think we may disagree.
I find your example in K very odd, in that it requires 100⁄900 people without covid to get illnesses that are as bad as long covid, but only 10⁄100 people who had covid to have similarly bad symptoms from long covid. It would be weird if we lived in a world where people without covid are so much more likely to get other illnesses that they’re more likely to have symptoms that could be confused for long covid then people who actually had covid (if this was the case for some reason, that would also make covid way less scary), and I think your assumption breaks down if the scenario was set up differently.
Judging by the effect size of vaccines on hospitalizations and deaths, my priors would be that they would be more than 50% effective against long covid (or at least the really bad long covid that seems most worrisome). The study in C makes me update a little towards 50% but not that much. One potential issue is that e.g. if 25% of the unvaccinated long covid were psychosomatic, and vaccination does not affect the probability of psychosomatic long covid, then an observed reduction of 50% from vaccination, would mean a 67% reduction of non-psychosomatic covid. I would guess Omicron is also less scary, given that it seems like it doesn’t infect the lungs nearly as much, but I’m less confident on that.
This is somewhat specific to me, but I suspect a lot of the people reading this also fit into the group of <40 yo, healthy, and not obese, so maybe it applies to others as well. Given how big the differences are between demographics for covid, I find anything that looks at the population-level to be potentially misleading for me. One thing that makes me feel less worried is looking at the results for professional athletes. There’s an obvious selection bias, there, but I think it’s better than having a non-obvious selection bias in basically any other study, and I suspect my risk factors are more similar to professional athletes than to the average American (given that risk scales superlinearly with age, weight, and medical history, it’s probably the case that a median American is closer to a professional athlete than to the mean American, and I’m younger and probably healthier than median). The other nice thing about professional athletes is that their health is tracked very closely (though unfortunately, I don’t see much work being done to compile and study it altogether). I feel like this is similar to the “How many people do I actually know that have been affected by this?” approach. From what I can tell, >50% of athletes in the four major US sports seems to have had covid already, and I can only find a few cases of long covid per sport. That seems approximately consistent with long covid risk being between 0.1%-1%, which isn’t far off from some of the estimates being quoted. Notably, though, I’m having trouble finding any cases that have come from after vaccinations were widely available. There could be all sorts of confounders here, the most obvious being that no one would yet be talking about a long covid cases from an Omicron infection they got a few weeks ago, but the fact that these leagues are not being devastated by long covid, despite having professionals who are very dependent on their lung function and energy levels makes me feel reasonably good about my own prognosis.
That being said this report that you referenced suggests the odds ratios between demographics are not as extreme for long covid as they are for hospitalizations or deaths, which would mean maybe I’m not that much safer than an average person. That could potentially also be explained by a fairly uniform distribution of psychosomatic cases, though.
This is very interesting. I find this somewhat persuasive and am updating in the direction of being more afraid of getting covid. That being said, I think I’m still pretty far from your level of concern. I can think of three places where I think we may disagree.
I find your example in K very odd, in that it requires 100⁄900 people without covid to get illnesses that are as bad as long covid, but only 10⁄100 people who had covid to have similarly bad symptoms from long covid. It would be weird if we lived in a world where people without covid are so much more likely to get other illnesses that they’re more likely to have symptoms that could be confused for long covid then people who actually had covid (if this was the case for some reason, that would also make covid way less scary), and I think your assumption breaks down if the scenario was set up differently.
Judging by the effect size of vaccines on hospitalizations and deaths, my priors would be that they would be more than 50% effective against long covid (or at least the really bad long covid that seems most worrisome). The study in C makes me update a little towards 50% but not that much. One potential issue is that e.g. if 25% of the unvaccinated long covid were psychosomatic, and vaccination does not affect the probability of psychosomatic long covid, then an observed reduction of 50% from vaccination, would mean a 67% reduction of non-psychosomatic covid. I would guess Omicron is also less scary, given that it seems like it doesn’t infect the lungs nearly as much, but I’m less confident on that.
This is somewhat specific to me, but I suspect a lot of the people reading this also fit into the group of <40 yo, healthy, and not obese, so maybe it applies to others as well. Given how big the differences are between demographics for covid, I find anything that looks at the population-level to be potentially misleading for me. One thing that makes me feel less worried is looking at the results for professional athletes. There’s an obvious selection bias, there, but I think it’s better than having a non-obvious selection bias in basically any other study, and I suspect my risk factors are more similar to professional athletes than to the average American (given that risk scales superlinearly with age, weight, and medical history, it’s probably the case that a median American is closer to a professional athlete than to the mean American, and I’m younger and probably healthier than median). The other nice thing about professional athletes is that their health is tracked very closely (though unfortunately, I don’t see much work being done to compile and study it altogether). I feel like this is similar to the “How many people do I actually know that have been affected by this?” approach. From what I can tell, >50% of athletes in the four major US sports seems to have had covid already, and I can only find a few cases of long covid per sport. That seems approximately consistent with long covid risk being between 0.1%-1%, which isn’t far off from some of the estimates being quoted. Notably, though, I’m having trouble finding any cases that have come from after vaccinations were widely available. There could be all sorts of confounders here, the most obvious being that no one would yet be talking about a long covid cases from an Omicron infection they got a few weeks ago, but the fact that these leagues are not being devastated by long covid, despite having professionals who are very dependent on their lung function and energy levels makes me feel reasonably good about my own prognosis.
That being said this report that you referenced suggests the odds ratios between demographics are not as extreme for long covid as they are for hospitalizations or deaths, which would mean maybe I’m not that much safer than an average person. That could potentially also be explained by a fairly uniform distribution of psychosomatic cases, though.