Covid Disrupts Your Immune System
December 20, 2022 1:07 AM Subscribe
Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2 infection Would you change your behavior if you knew that COVID causes immunodeficiency that mirrors AIDS? Merck manual now lists COVID alongside AIDS as a cause of acquired Lymphocytopenia. “Patients with COVID-19 also frequently have lymphocytopenia (35 to 83% of patients).“ Recent papers show that SARS-CoV-2 infects the immune system, causes T cell exhaustion, B cell disregulation, immunosenescence, and is a lympho-manipulative pathogen.
ACE2-independent infection of T lymphocytes by SARS-CoV-2
“SARS-CoV-2 induced marked lymphopenia in severe patients with COVID-19. However, whether lymphocytes are targets of viral infection [had] yet to be determined, although SARS-CoV-2 RNA or antigen has been identified in T cells from patients. Here, we confirmed that SARS-CoV-2 viral antigen could be detected in patient peripheral blood cells (PBCs) or postmortem lung T cells, and the infectious virus could also be detected from viral antigen-positive PBCs.”
SARS-CoV-2 infection causes immunodeficiency in recovered patients by downregulating CD19 expression in B cells via enhancing B-cell metabolism
“In conclusion, we found that SARS-CoV-2 infection causes immunodeficiency in recovered patients by downregulating CD19 expression in B cells via enhancing B-cell metabolism, which may provide a new intervention target to cure COVID-19.”
Cytokine storm promoting T cell exhaustion in severe COVID-19 revealed by single cell sequencing data analysis
Immunosenescence and COVID-19
“Infection with SARS-CoV-2 is affecting the function of both innate and adaptive branches of the immune system, adding to the individual immunobiography. Summarizing, immunosenescence and inflammaging may aggravate, but also may be aggravated by SARS-CoV-2 infection.“
“These facets depict SARS-Cov-2 as a lympho-manipulative pathogen; it distorts T cell function, numbers, and death, and creates a dysfunctional immune response.”
ACE2-independent infection of T lymphocytes by SARS-CoV-2
“SARS-CoV-2 induced marked lymphopenia in severe patients with COVID-19. However, whether lymphocytes are targets of viral infection [had] yet to be determined, although SARS-CoV-2 RNA or antigen has been identified in T cells from patients. Here, we confirmed that SARS-CoV-2 viral antigen could be detected in patient peripheral blood cells (PBCs) or postmortem lung T cells, and the infectious virus could also be detected from viral antigen-positive PBCs.”
SARS-CoV-2 infection causes immunodeficiency in recovered patients by downregulating CD19 expression in B cells via enhancing B-cell metabolism
“In conclusion, we found that SARS-CoV-2 infection causes immunodeficiency in recovered patients by downregulating CD19 expression in B cells via enhancing B-cell metabolism, which may provide a new intervention target to cure COVID-19.”
Cytokine storm promoting T cell exhaustion in severe COVID-19 revealed by single cell sequencing data analysis
Immunosenescence and COVID-19
“Infection with SARS-CoV-2 is affecting the function of both innate and adaptive branches of the immune system, adding to the individual immunobiography. Summarizing, immunosenescence and inflammaging may aggravate, but also may be aggravated by SARS-CoV-2 infection.“
“These facets depict SARS-Cov-2 as a lympho-manipulative pathogen; it distorts T cell function, numbers, and death, and creates a dysfunctional immune response.”
Is this the sort of thing that would neatly explain the severity of RSV this winter?
posted by Mitheral at 1:34 AM on December 20, 2022 [23 favorites]
posted by Mitheral at 1:34 AM on December 20, 2022 [23 favorites]
I would imagine that if you are vaccinated, your risk of developing severe COVID is dramatically reduced, which makes it hard for an infection to damage your immune system. So it's not as if the majority of actual COVID infections is doing all these things being described in the papers.
For example, the first paper doesn't even discuss vaccines.
posted by polymodus at 3:13 AM on December 20, 2022 [6 favorites]
For example, the first paper doesn't even discuss vaccines.
posted by polymodus at 3:13 AM on December 20, 2022 [6 favorites]
Patients with COVID-19 also frequently have lymphocytopenia (35% to 83% of patients)Doubt. No primary source, so impossible to check context. But the context implied by the MSD article will be wrong.
35% of people infected[*] with SARS-CoV-2 in 2022[**] will not suffer lymphocytopenia as defined here[***]. Look at the next sentence:
Lower lymphocyte counts portend a poor prognosis and an increased likelihood of requiring ICU admission and of dying from the disease.[*] This will have come from a small sample (see wide confidence intervals) of patients who were sick enough to be admitted to hospital.
[**] It will not apply in 2022. The statistics from a novel pandemic differ v.s. a population which has been widely vaccinated. That was the point of doing it. Protection against severe disease is long-lasting. Hospital patients now have significantly different outcomes e.g. for ICU admission and death.
[***] Cumulative infection is essentially 100%, outside China. If 35% of the population "experience recurrent infections or develop infections with unusual organisms", in any way comparable with AIDS? We wouldn't be mentioning a mystery meat statistic with a confidence interval of 50 percentage points.
Severe covid is bad! Try not to get severe covid. Stay up to date with vaccines.
"initial mild-to-moderate SARS-CoV-2 infection" isn't going around and causing "immunodeficiency that mirrors AIDS" in the average Mefite. Nor has caused it in the average person who now has RSV, for that matter.
I expect the average Mefite is already concerned and sympathetic to the problem of Long Covid, at least some of which may be characterised by immune system markers. IMO putting it in an undifferentiated bag with severe Covid from 2020 and the 90% fatality of untreated HIV, is not a necessary or useful tactic for advocating here.
posted by sourcejedi at 3:23 AM on December 20, 2022 [66 favorites]
Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2 infection
....Huh.
I had a pretty mild case in July (symptoms never got beyond what I typically get with a cold). And then 2 months later, I got an ear infection for the first time in my life ever, one that was weirdly stubborn. It went away after a week of antibiotics, then came back a couple days later and finally went away after another week of antibiotics. And I was fine....until a week and a half ago, when the same kind of infection came back, and is following the same pattern (I just started the 2nd week of antibiotics yesterday).
I never even had ear infections as a child. I've been wondering why this suddenly happened now and now you've got me thinking this may have something to do with it.
posted by EmpressCallipygos at 3:46 AM on December 20, 2022 [17 favorites]
....Huh.
I had a pretty mild case in July (symptoms never got beyond what I typically get with a cold). And then 2 months later, I got an ear infection for the first time in my life ever, one that was weirdly stubborn. It went away after a week of antibiotics, then came back a couple days later and finally went away after another week of antibiotics. And I was fine....until a week and a half ago, when the same kind of infection came back, and is following the same pattern (I just started the 2nd week of antibiotics yesterday).
I never even had ear infections as a child. I've been wondering why this suddenly happened now and now you've got me thinking this may have something to do with it.
posted by EmpressCallipygos at 3:46 AM on December 20, 2022 [17 favorites]
The most robust information set we have about repeat infection shows NO difference between the vaccinated and unvaccinated cohorts in developing sequelae such as immune dysfunction.
Analyses of prespecified subgroups based on vaccination status before reinfection (no vaccination, one vaccination or two or more vaccinations) showed that reinfection (compared to no reinfection) was associated with a higher risk of all-cause mortality, hospitalization, at least one sequela and sequelae in the different organ systems (Fig. 2 and Supplementary Table 4) regardless of vaccination status.
So if vaccination prevents these outcomes the first time around that’s wonderful - although all the linked articles above do address mild to moderate covid, which is the goal of vaccination. That means you got a “freebie” and now you’re in the same boat as the unvaccinated in terms of sequelae.
The Merck Manual is considered a primary source for doctors and is consulted extensively. The figures it cites are actually in the papers linked above, and are pretty easy to find. Even if you take the low end of the percentages - that’s worse odds than Russian Roulette…
posted by Bottlecap at 3:51 AM on December 20, 2022 [21 favorites]
Analyses of prespecified subgroups based on vaccination status before reinfection (no vaccination, one vaccination or two or more vaccinations) showed that reinfection (compared to no reinfection) was associated with a higher risk of all-cause mortality, hospitalization, at least one sequela and sequelae in the different organ systems (Fig. 2 and Supplementary Table 4) regardless of vaccination status.
So if vaccination prevents these outcomes the first time around that’s wonderful - although all the linked articles above do address mild to moderate covid, which is the goal of vaccination. That means you got a “freebie” and now you’re in the same boat as the unvaccinated in terms of sequelae.
The Merck Manual is considered a primary source for doctors and is consulted extensively. The figures it cites are actually in the papers linked above, and are pretty easy to find. Even if you take the low end of the percentages - that’s worse odds than Russian Roulette…
posted by Bottlecap at 3:51 AM on December 20, 2022 [21 favorites]
Cumulative infection is essentially 100%, outside China.That's a source saying that, in the UK, about 50 to 70% of the population had at least one COVID-19 infection between early/mid 2020 and February 2022. For a more up-to-date study (albeit for a different region), a November preprint says: "Results: By November 10, 2022, 94% (95% CrI, 79%-99%) of the US population were estimated to have been infected by SARS-CoV-2 at least once."
The "Part 2: Casual Epidemiology" section of "Possible Post-COVID Immune Dysregulation & Its Epidemiological Consequences" by siderea says:
If Covid causes immune impairment – pretty much at all – then we should be seeing evidence of it in an up-tick in people getting sick with diseases they wouldn't normally get sick with. That is, if Covid causes any degree of immunocompromise, given the truly vast swaths of the human population it has infected, even if the percentage of Covid-immunocompromised people and extent of their immune disorder were small, there should be an observable increase in people getting sick with weird other diseases.and goes on to discuss STDs, mucormycosis, flu, monkeypox/mpox, Hepatitis of Unknown Cause/Adeno-associated virus 2 (AAV2), RSV, other childhood upper respiratory tract infections such as parainfluenza, rhinovirus, enterovirus, etc.
Which may be exactly what we're seeing.
posted by brainwane at 3:54 AM on December 20, 2022 [11 favorites]
Is lymphocytopenia an illness that stays with you once it gets into you? If yes, is there any treatment for it, to arrest it or, better, to get rid of it completely?
Seems that SARS-CoV-2 is a gift that just keeps on giving.
posted by dancestoblue at 4:02 AM on December 20, 2022 [2 favorites]
Seems that SARS-CoV-2 is a gift that just keeps on giving.
posted by dancestoblue at 4:02 AM on December 20, 2022 [2 favorites]
I would say that capitalism and its requirement for a near-destitute worker/consumer class is the gift that keeps on giving; a never-ending COVID pandemic is one of many things it's given us.
posted by seanmpuckett at 4:55 AM on December 20, 2022 [34 favorites]
posted by seanmpuckett at 4:55 AM on December 20, 2022 [34 favorites]
Pretty please, with sugar on top, wear a real mask.
posted by mhoye at 5:09 AM on December 20, 2022 [31 favorites]
posted by mhoye at 5:09 AM on December 20, 2022 [31 favorites]
The continued unpopularity of real masks confuses me. I go to the grocery store and of course very few people have masks on, but even among those who do, more than half are either hanging their noses out or wearing a single-layer fabric (essentially cosmetic) mask.
Nobody's making you wear the mask, so why go through the effort to do at all if you're going to do it wrong?
posted by The Monster at the End of this Thread at 5:37 AM on December 20, 2022 [28 favorites]
Nobody's making you wear the mask, so why go through the effort to do at all if you're going to do it wrong?
posted by The Monster at the End of this Thread at 5:37 AM on December 20, 2022 [28 favorites]
For example, the first paper doesn't even discuss vaccines.
The first paper is about the pathophysiology of Long COVID, not about the development of severe acute covid, or even about the development of long COVID. It's about what long COVID is and as such I wouldn't expect it to discuss vaccines.
posted by entropone at 5:52 AM on December 20, 2022 [8 favorites]
The first paper is about the pathophysiology of Long COVID, not about the development of severe acute covid, or even about the development of long COVID. It's about what long COVID is and as such I wouldn't expect it to discuss vaccines.
posted by entropone at 5:52 AM on December 20, 2022 [8 favorites]
I'm not sure if it's useful to conflate studies about the effects of cytokine storms with information about the long term effects of mild-to-moderate COVID. If you're experiencing a cytokine storm, by definition you're not experiencing mild anything.
Anyway, I've already had it, so I guess I just have to sit around and wait to develop airborne AIDS... shouldn't have clicked.
posted by kingdead at 5:57 AM on December 20, 2022 [3 favorites]
Anyway, I've already had it, so I guess I just have to sit around and wait to develop airborne AIDS... shouldn't have clicked.
posted by kingdead at 5:57 AM on December 20, 2022 [3 favorites]
The continued unpopularity of real masks confuses me.
It doesn't confuse me at all. There was a propaganda war, funded in very large part by rentier-capitalists who wanted people to come back to malls and office spaces so they could keep extracting rent. It was far better funded than our public health officials and the public lost.
posted by mhoye at 5:57 AM on December 20, 2022 [75 favorites]
It doesn't confuse me at all. There was a propaganda war, funded in very large part by rentier-capitalists who wanted people to come back to malls and office spaces so they could keep extracting rent. It was far better funded than our public health officials and the public lost.
posted by mhoye at 5:57 AM on December 20, 2022 [75 favorites]
For those of you who don't know anybody with long COVID (are there any of you here?) I hope y'all take this seriously, and I hope y'all know how much it means for there to be research that can hopefully pull people like me out of the hole we're in.
I'm 8 ish months after a fairly mild case. For months I had debilitating fatigue and brain fog. A walk around the block would exhaust me for days. Simple tasks confused me. I've had mild to moderate concussions before - this was worse. It was only after several months of extremely focused rest - basically fully time convalescence - that I started to see improvements. I'm finally at the point where I can do some light physical activity again, but it's so far away from what I was capable of. I am - was? - an athlete. I could pop off a 2-3 hour hard bike ride without feeling it the next day. Now, an easy 20 minutes sends me to bed early and makes me feel completely ragged the next day... So many of my favorite things have so sparse in my life: physical activity, music, sex, getting together with friends - with the big question hanging over me of whether I'll ever be able to get to anything resembling my previous levels.
I see a bunch of long COVID support groups with people waaaaay worse off than I am, and they are throwing all sorts of oxygen and money toward total snake oil stuff, vaccine skepticism, and other hallmarks of desperate people who just need a fucking lifeline and to be taken seriously. There but for the grace of god and all.
Anyway. Seeing research like this gives me hope. A bit for me. A lot more for everyone else like me, especially those worse off.
posted by entropone at 6:00 AM on December 20, 2022 [67 favorites]
I'm 8 ish months after a fairly mild case. For months I had debilitating fatigue and brain fog. A walk around the block would exhaust me for days. Simple tasks confused me. I've had mild to moderate concussions before - this was worse. It was only after several months of extremely focused rest - basically fully time convalescence - that I started to see improvements. I'm finally at the point where I can do some light physical activity again, but it's so far away from what I was capable of. I am - was? - an athlete. I could pop off a 2-3 hour hard bike ride without feeling it the next day. Now, an easy 20 minutes sends me to bed early and makes me feel completely ragged the next day... So many of my favorite things have so sparse in my life: physical activity, music, sex, getting together with friends - with the big question hanging over me of whether I'll ever be able to get to anything resembling my previous levels.
I see a bunch of long COVID support groups with people waaaaay worse off than I am, and they are throwing all sorts of oxygen and money toward total snake oil stuff, vaccine skepticism, and other hallmarks of desperate people who just need a fucking lifeline and to be taken seriously. There but for the grace of god and all.
Anyway. Seeing research like this gives me hope. A bit for me. A lot more for everyone else like me, especially those worse off.
posted by entropone at 6:00 AM on December 20, 2022 [67 favorites]
About masks: There's also the fact that good masks are still more expensive (which is an insane thing to be true, they should be subsidized). And I've met a lot of people who are convinced that the better ones, which they've never tried, must be harder to breathe through. (That's been the opposite of my experience, but I wonder if counterfeit masks are contributing to that impression.)
posted by trig at 6:03 AM on December 20, 2022 [8 favorites]
posted by trig at 6:03 AM on December 20, 2022 [8 favorites]
and they are throwing all sorts of oxygen and money toward total snake oil stuff
I now see cans of inhalable "oxygen" for sale at Lowes. I don't remember if this was a thing pre-pandemic, but it's kind of disturbing to see literal air for sale as an over-the-counter health treatment at a location where lots of vulnerable, under-insured people who've probably had multiple bouts of Covid probably spent a lot of time at.
posted by RonButNotStupid at 6:18 AM on December 20, 2022 [5 favorites]
I now see cans of inhalable "oxygen" for sale at Lowes. I don't remember if this was a thing pre-pandemic, but it's kind of disturbing to see literal air for sale as an over-the-counter health treatment at a location where lots of vulnerable, under-insured people who've probably had multiple bouts of Covid probably spent a lot of time at.
posted by RonButNotStupid at 6:18 AM on December 20, 2022 [5 favorites]
dancestoblue,
Lymphocytopenia isn’t a disease, it’s a symptom. The word basically means low immune cell/white blood cell count in the blood. You can low levels of immune cells for lots of different reasons, but the result is that your immune system is weakened. How long it lasts depends on what caused it — if it’s caused by malnutrition it will resolve when you get access to more and better food. If it’s caused by an active infection it will resolve when that infection clears. What’s being reported is that covid leaves your white blood cell count low for several months after infection. Presumably it goes back to normal eventually (AIDS is long term because the virus is never fully cleared from your body like covid is).
posted by antinomia at 6:21 AM on December 20, 2022 [9 favorites]
Lymphocytopenia isn’t a disease, it’s a symptom. The word basically means low immune cell/white blood cell count in the blood. You can low levels of immune cells for lots of different reasons, but the result is that your immune system is weakened. How long it lasts depends on what caused it — if it’s caused by malnutrition it will resolve when you get access to more and better food. If it’s caused by an active infection it will resolve when that infection clears. What’s being reported is that covid leaves your white blood cell count low for several months after infection. Presumably it goes back to normal eventually (AIDS is long term because the virus is never fully cleared from your body like covid is).
posted by antinomia at 6:21 AM on December 20, 2022 [9 favorites]
Yeah, this seems terrible. A small hit to the immune system across the population, year after year after year? Re-opening footholds for disease that we had previously tried to close off through all manner of public health measures, now opened more permanently?
RSV may (and I want to emphasize my lack of futuresight) be the weed you see growing out of the crack in the Jersey barrier. That's not the last thing we'll see growing there, it's just the first thing to reach that new space.
posted by Slackermagee at 6:25 AM on December 20, 2022 [6 favorites]
RSV may (and I want to emphasize my lack of futuresight) be the weed you see growing out of the crack in the Jersey barrier. That's not the last thing we'll see growing there, it's just the first thing to reach that new space.
posted by Slackermagee at 6:25 AM on December 20, 2022 [6 favorites]
I’ve been saying for a long time that while we know a lot about this disease, we don’t yet know enough to declare everything fine and dandy and back to normal. Bad enough that we’ve already thrown everyone with pre-existing conditions to the wolves.
posted by The Underpants Monster at 6:54 AM on December 20, 2022 [21 favorites]
posted by The Underpants Monster at 6:54 AM on December 20, 2022 [21 favorites]
Costco recently had a 960 pack of KN95s for $100. I snap up a 50 pack of KN 95s for $15 a few months earlier.
I Had a low level Covid infection that took weeks to clear this summer, and then had a common cold that also took weeks to clear this fall.
I am back on the masks at the grocery store wagon.
posted by CostcoCultist at 6:59 AM on December 20, 2022 [10 favorites]
I Had a low level Covid infection that took weeks to clear this summer, and then had a common cold that also took weeks to clear this fall.
I am back on the masks at the grocery store wagon.
posted by CostcoCultist at 6:59 AM on December 20, 2022 [10 favorites]
I think I have said this before in COVID threads on the Blue, but here goes: despite working in healthcare, I am one of the few in my clinic who hasn't gotten COVID, and I aim to keep it that way even if me wearing masks out and about in the world makes people uncomfortable. I feel I am relatively healthy enough to muddle through an initial COVID infection if I got it, but what really drives me in terms of personal safety is that I do not want long COVID. I do not want to risk the possibility of being unable to enjoy my life as it is now. If it means masking in public places forever, that's fine by me and I will do my best to be preventative. Again, things will always be out of my control but I can do what I can for my own personal safety.
posted by Kitteh at 7:01 AM on December 20, 2022 [51 favorites]
posted by Kitteh at 7:01 AM on December 20, 2022 [51 favorites]
... What’s being reported is that covid leaves your white blood cell count low for several months after infection.
Is that what it actually says? Or is that an example where lumping everything together has caused confusion?
Pronounced immune dysregulation with lymphopenia and increased expression of inflammatory mediators[3,4] have been described in the acute phase.
And the famous "Analyses of prespecified subgroups" paper is review of codes on electronic records. It's not going to be useful at picking out a more subtle long-term immune effect. I don't think it even has a category for immune disorders? So I'm guessing that paper isn't the main focus.
The link to siderea's blog sounds like a clearer explanation of the main point of interest, IIUC.
posted by sourcejedi at 7:08 AM on December 20, 2022 [2 favorites]
Is that what it actually says? Or is that an example where lumping everything together has caused confusion?
Pronounced immune dysregulation with lymphopenia and increased expression of inflammatory mediators[3,4] have been described in the acute phase.
And the famous "Analyses of prespecified subgroups" paper is review of codes on electronic records. It's not going to be useful at picking out a more subtle long-term immune effect. I don't think it even has a category for immune disorders? So I'm guessing that paper isn't the main focus.
The link to siderea's blog sounds like a clearer explanation of the main point of interest, IIUC.
posted by sourcejedi at 7:08 AM on December 20, 2022 [2 favorites]
Regardng the comment about 'cosmetic' masks: if you have a beard, like I do, a KN95 mask can easily lose up to 40 percent of its filtration capability because a skin-tight seal is crucial to its efficacy. In fact, even a poorly-fitted KN95 on a clean-shaven person can do a poor job of filtering.
My solution has been to double mask with a procedural and a cloth mask. It's not perfect, but neither is a KN95 (N95 is marginally 'better' if you have a short beard because of how the straps work, but it suffers in a similar fashion due to a lack of a skin-tight seal).
Perfect is the enemy of good when it comes to health measures, and I don't understand why someone would criticize someone for at least making the effort of wearing a mask of ANY kind by calling it 'cosmetic' or tagging procedural or cloth masks as not being 'real masks.' Most places I go here in Canada, I'm lucky if 15 percent of people are making any kind of masking effort at all. At my gym, that number drops to zero.
I've been wearing my 'cosmetic' double masks religiously in public for nearly 3 years now, and have yet to contract COVID.
posted by jordantwodelta at 7:20 AM on December 20, 2022 [18 favorites]
My solution has been to double mask with a procedural and a cloth mask. It's not perfect, but neither is a KN95 (N95 is marginally 'better' if you have a short beard because of how the straps work, but it suffers in a similar fashion due to a lack of a skin-tight seal).
Perfect is the enemy of good when it comes to health measures, and I don't understand why someone would criticize someone for at least making the effort of wearing a mask of ANY kind by calling it 'cosmetic' or tagging procedural or cloth masks as not being 'real masks.' Most places I go here in Canada, I'm lucky if 15 percent of people are making any kind of masking effort at all. At my gym, that number drops to zero.
I've been wearing my 'cosmetic' double masks religiously in public for nearly 3 years now, and have yet to contract COVID.
posted by jordantwodelta at 7:20 AM on December 20, 2022 [18 favorites]
The lede article is a study of long covid patients. Not the general population. You should really edit your title.
While immunodeficiency may well be an issue from covid, these articles don't add up to it, I'm afraid.
posted by Dashy at 7:20 AM on December 20, 2022 [3 favorites]
While immunodeficiency may well be an issue from covid, these articles don't add up to it, I'm afraid.
posted by Dashy at 7:20 AM on December 20, 2022 [3 favorites]
For those of you who don't know anybody with long COVID (are there any of you here?)
I don't personally know anyone among friends, family etc who developed long covid and pretty much 95% of everyone I know has gotten it by now. It's a thing that I see people discussing online and that's the extent of my experience with it. I think this is pretty common among most people who are generally not reading about it or hearing other people's experience online. I want to be really clear that this is not to say that I don't think there are real and serious post-viral risks that come with getting even a mild case of covid and certainly more so than something like the flu, making it a public health nightmare that needs to be taken seriously (speaking as someone who had some serious post-viral fatigue and exhaustion for many months after a bad flu case when I was younger). But I do think a majority of the population do not know, think about or see long covid or serious post-viral issues related to covid enough for it to really alter anyone's life choices with regards to masks etc.
I often think about my dad who is a huge sports nut turning on ESPN to hear about this or that player who is out this week because they caught covid, and then after they recover they're pretty much right back on the field or the court and seemingly doing fine. I suspect this is how the majority of people are experiencing covid and witnessing others getting covid, so when people mention Long covid I think they're just shrugging like "meh, haven't really seen that". And it leads them to believe it's rarer than they think. If people's favorite basketball players or actors or singers were dropping like flies and having to retire early - similarly to when there were a lot of really high-profile HIV/AIDS cases making the news - there'd definitely be a different mainstream conversation about it I'm sure.
posted by windbox at 7:26 AM on December 20, 2022 [14 favorites]
I don't personally know anyone among friends, family etc who developed long covid and pretty much 95% of everyone I know has gotten it by now. It's a thing that I see people discussing online and that's the extent of my experience with it. I think this is pretty common among most people who are generally not reading about it or hearing other people's experience online. I want to be really clear that this is not to say that I don't think there are real and serious post-viral risks that come with getting even a mild case of covid and certainly more so than something like the flu, making it a public health nightmare that needs to be taken seriously (speaking as someone who had some serious post-viral fatigue and exhaustion for many months after a bad flu case when I was younger). But I do think a majority of the population do not know, think about or see long covid or serious post-viral issues related to covid enough for it to really alter anyone's life choices with regards to masks etc.
I often think about my dad who is a huge sports nut turning on ESPN to hear about this or that player who is out this week because they caught covid, and then after they recover they're pretty much right back on the field or the court and seemingly doing fine. I suspect this is how the majority of people are experiencing covid and witnessing others getting covid, so when people mention Long covid I think they're just shrugging like "meh, haven't really seen that". And it leads them to believe it's rarer than they think. If people's favorite basketball players or actors or singers were dropping like flies and having to retire early - similarly to when there were a lot of really high-profile HIV/AIDS cases making the news - there'd definitely be a different mainstream conversation about it I'm sure.
posted by windbox at 7:26 AM on December 20, 2022 [14 favorites]
I'm currently in the middle of my 3rd go around with Covid. My mildest case yet, and hopefully the last. Fully vaxxed and boosted, but I work with the public. I try to mask up as much as possible, but it's often a physical job with some minor huffing and puffing involved. I'm mostly outdoors, but not always. Almost no one in public wears a mask except the elderly, and often they don't either. This is in a deep blue neighborhood in a blue, blue city.
No evidence of long Covid so far. Otherwise I've been very healthy. At this point I can only keep hoping for the best.
posted by SoberHighland at 7:32 AM on December 20, 2022 [4 favorites]
No evidence of long Covid so far. Otherwise I've been very healthy. At this point I can only keep hoping for the best.
posted by SoberHighland at 7:32 AM on December 20, 2022 [4 favorites]
Which may be exactly what we're seeing.
This seems sort of overdetermined. Everyone expected a nastier than average flu and cold season this winter for purely mechanical reasons- we suppressed the normal flu season two years in a row, people were always going to be more immune-naive to whichever strain was going to show up. Especially young kids who might not have seen any RSV at all for a large chunk of their lives! I am sure it might be possible to tease those apart but it's gonna be a hard one.
As for mpox, there was a smallish outbreak in Nigeria in 2017. It's not brand new, it's circulated periodically in humans before.
posted by BungaDunga at 7:36 AM on December 20, 2022 [7 favorites]
This seems sort of overdetermined. Everyone expected a nastier than average flu and cold season this winter for purely mechanical reasons- we suppressed the normal flu season two years in a row, people were always going to be more immune-naive to whichever strain was going to show up. Especially young kids who might not have seen any RSV at all for a large chunk of their lives! I am sure it might be possible to tease those apart but it's gonna be a hard one.
As for mpox, there was a smallish outbreak in Nigeria in 2017. It's not brand new, it's circulated periodically in humans before.
posted by BungaDunga at 7:36 AM on December 20, 2022 [7 favorites]
anyway I don't think it's fair to try and lump in long COVID (a real thing that deserves intense investigation and search for cures) and vague ideas that maybe we're all been immune-compromised and will stay that way.
As to why people who are fully aware of long COVID don't wear masks ? If the operating hypothesis is that long COVID will remain a threat for the rest of our lives, a lot of people are just going to respond fatalistically and take their chances. It's not an unnatural way to respond to a new risk, it happens all the time.
posted by BungaDunga at 7:52 AM on December 20, 2022 [6 favorites]
As to why people who are fully aware of long COVID don't wear masks ? If the operating hypothesis is that long COVID will remain a threat for the rest of our lives, a lot of people are just going to respond fatalistically and take their chances. It's not an unnatural way to respond to a new risk, it happens all the time.
posted by BungaDunga at 7:52 AM on December 20, 2022 [6 favorites]
I'm not sure why beard wins the choice between protection from deadly or debilitating disease and beard, but okay.
Either way, cloth masks were a stopgap measure when we didn't have better masks. We do, and they're pretty cheap now as noted above. I stand by what I said. If someone is taking their health seriously enough to be one of the rare people still masking now, why not do so in the most effective manner available, and definitely why poke your nose out? That's what people did when they had to wear masks somewhere but wanted to prove a point by wearing it incorrectly. There's no point to prove now, so just take it off.
posted by The Monster at the End of this Thread at 7:53 AM on December 20, 2022 [11 favorites]
Either way, cloth masks were a stopgap measure when we didn't have better masks. We do, and they're pretty cheap now as noted above. I stand by what I said. If someone is taking their health seriously enough to be one of the rare people still masking now, why not do so in the most effective manner available, and definitely why poke your nose out? That's what people did when they had to wear masks somewhere but wanted to prove a point by wearing it incorrectly. There's no point to prove now, so just take it off.
posted by The Monster at the End of this Thread at 7:53 AM on December 20, 2022 [11 favorites]
I don't personally know anyone among friends, family etc who developed long covid and pretty much 95% of everyone I know has gotten it by now. It's a thing that I see people discussing online and that's the extent of my experience with it.
All you wrote the same. I work around large numbers of people, including over 1000 kids between two schools, and 3000 in my office, plus another 200 world wide. If anyone has long COVID, they either keep it quiet or aren't aware.
posted by The_Vegetables at 8:12 AM on December 20, 2022 [2 favorites]
All you wrote the same. I work around large numbers of people, including over 1000 kids between two schools, and 3000 in my office, plus another 200 world wide. If anyone has long COVID, they either keep it quiet or aren't aware.
posted by The_Vegetables at 8:12 AM on December 20, 2022 [2 favorites]
The thing about long covid not being visible is that chronic illness often isn't visible. I kind of assume if I get long covid I'll just quietly disappear from people's minds. If I catch it at work and have to quit no one's going to be sat around thinking oh what a shame mosswinter had to quit because of long covid, they'll be bringing the same energy to it they bring to covid and mask wearing in general- it just disappears from their minds. Someone else has already filled my place. Also I fully assume a lot of newly disabled people are going to keep quiet about it because it's socially stigmatised. If you know people really well they might talk about how weird it is how tired they are lately. I really think there is going to be a social intensification of this kind of silence and long covid being stigmatised, being framed as overreaction in order to reduce the possibility of support. Hopefully I'm wrong and it's actually not a big deal.
posted by mosswinter at 8:29 AM on December 20, 2022 [38 favorites]
posted by mosswinter at 8:29 AM on December 20, 2022 [38 favorites]
Whenever COVID is mentioned in my running/cycling discords, many people are reporting that they're not back to normal after several months, sometimes more than six. It's not clear if this is caused by them trying to restart training efforts too early, or something else. But since everyone has a fitness watch and large swaths of heart rate / training data, their electronic gizmos are quite unanimous in saying: yeah, you're not back to normal.
These people know their 5K time down to the second, or their 20-minute critical power down to the watt. A sedentary office worker isn't going to know and test their limits on a regular basis.
posted by meowzilla at 8:29 AM on December 20, 2022 [31 favorites]
These people know their 5K time down to the second, or their 20-minute critical power down to the watt. A sedentary office worker isn't going to know and test their limits on a regular basis.
posted by meowzilla at 8:29 AM on December 20, 2022 [31 favorites]
If anyone has long COVID, they either keep it quiet...
Entirely possible. It can really feel invisibilizing.
Fwiw, among my ~40 close coworkers, 4 had some form of long covid. And easily a half dozen other friends have told me about their persistent issues.
In the sport I follow there are lots of names of riders who retired, skipped a year, or are a shadow of their former self due to LC.
posted by entropone at 8:29 AM on December 20, 2022 [10 favorites]
Entirely possible. It can really feel invisibilizing.
Fwiw, among my ~40 close coworkers, 4 had some form of long covid. And easily a half dozen other friends have told me about their persistent issues.
In the sport I follow there are lots of names of riders who retired, skipped a year, or are a shadow of their former self due to LC.
posted by entropone at 8:29 AM on December 20, 2022 [10 favorites]
There is a lot of stigma against Long COVID, as against all chronic illness. Also, you may not know anyone at work with Long COVID because many people with Long COVID are no longer able to work.
posted by hydropsyche at 8:30 AM on December 20, 2022 [34 favorites]
posted by hydropsyche at 8:30 AM on December 20, 2022 [34 favorites]
There can also be mild cases of long covid, and if you've been habitually tired, sore, or otherwise impaired to begin with, it can take time to realize there's something different than usual going on. (I have chronic fatigue and unlike a lot of people I have no idea when precisely it started - I'd been in bad shape for years for various reasons and there wasn't any unambiguous inflection point between the original, manageable fatigue and mild soreness and today's levels, which are often incapacitating.) And iirc (though I am not up to date on the research) you can get long covid even with mild or asymptomatic cases, so you might not realize that's what's going on, and that might not be what you get diagnosed with, if you ever do get diagnosed (and not just told you're dealing with something psychosomatic, or "everyone gets tired when they get older", or whatever).
posted by trig at 8:55 AM on December 20, 2022 [13 favorites]
posted by trig at 8:55 AM on December 20, 2022 [13 favorites]
I think the quiet part of long covid deserves some real attention. It's got to be a huge confound in any public health efforts to address it.
Like everyone, I know a lot of people who've had covid. I know a few who have persistent problems, but nowhere near the 5-10 (? really varies across reports) percent prevalence reported across research literature. I don't know of anyone close to me (excluding internet friends or figures) who have the fatigue/brain fog kind of long covid.
Behaviorally, it's very common for people to talk about, even exaggerate, acute (time-limited, not mild vs severe) illnesses (cf: "man flu"). We talk about longer illnesses, like cancer or MS, but less so. We barely talk about chronic illness; there's definitely a stigma attached to the idea that one might be less abled on a permanent basis.
posted by Dashy at 9:01 AM on December 20, 2022 [2 favorites]
Like everyone, I know a lot of people who've had covid. I know a few who have persistent problems, but nowhere near the 5-10 (? really varies across reports) percent prevalence reported across research literature. I don't know of anyone close to me (excluding internet friends or figures) who have the fatigue/brain fog kind of long covid.
Behaviorally, it's very common for people to talk about, even exaggerate, acute (time-limited, not mild vs severe) illnesses (cf: "man flu"). We talk about longer illnesses, like cancer or MS, but less so. We barely talk about chronic illness; there's definitely a stigma attached to the idea that one might be less abled on a permanent basis.
posted by Dashy at 9:01 AM on December 20, 2022 [2 favorites]
Right - I think the levels of visibility is playing a huge role in people's behavior with regards to masking, crowds, etc. I don't think people are fatalistically deciding to "take the risks" despite the "knowledge" they have about this, nor do I think they're "giving up" on protecting themselves or deliberately turning a blind eye to things.
It's not like when AIDS was constantly in the news in the 80s and 90s and people were seeing members of their community, or hearing about friends of friends, or hearing about famous public figures dying or testing HIV+. Covid seems very much the opposite - the majority of people who don't participate in or actively seek out online discourse about this sort of thing just don't personally know anyone who was fully vaccinated and then ended up permanently debilitated long covid. They're not seeing it happen to public figures who catch covid. They're seeing a little headline on ESPN's website like "Kelly Oubre is out this week because he tested positive for covid" and then he's playing again next week and that's pretty much it, and that's reflective of how they and many of their friends are experiencing covid. They're not seeing or hearing about long covid often enough to feel like it's anything beyond a rarity, therefore it doesn't enter into the calculus for how they're living their day to day life at all. Therefore covid is over and done with in their eyes. I suspect that's all there is to it.
posted by windbox at 9:02 AM on December 20, 2022 [10 favorites]
It's not like when AIDS was constantly in the news in the 80s and 90s and people were seeing members of their community, or hearing about friends of friends, or hearing about famous public figures dying or testing HIV+. Covid seems very much the opposite - the majority of people who don't participate in or actively seek out online discourse about this sort of thing just don't personally know anyone who was fully vaccinated and then ended up permanently debilitated long covid. They're not seeing it happen to public figures who catch covid. They're seeing a little headline on ESPN's website like "Kelly Oubre is out this week because he tested positive for covid" and then he's playing again next week and that's pretty much it, and that's reflective of how they and many of their friends are experiencing covid. They're not seeing or hearing about long covid often enough to feel like it's anything beyond a rarity, therefore it doesn't enter into the calculus for how they're living their day to day life at all. Therefore covid is over and done with in their eyes. I suspect that's all there is to it.
posted by windbox at 9:02 AM on December 20, 2022 [10 favorites]
I know of two people for sure who have long Covid, both roughly my age, in their 60s. One (a proud foodie) hasn't been able to taste anything for months, last I heard. The other who I just saw the other night, has (his words) "a comparatively mild case, thank God". He describes it as feeling like he's had a minor flu for more than six months now. Balance is off, particularly in the mornings, energy is down pretty much all the time ... but he can get some work done, he has been feeling a little better lately (knock on wood).
The other thing I'd add to all this is that, roughly eight months before Covid hit, I got nailed with a brutal flu. A solid week of thinking if it got any worse, I'd be checking into Emergency, and better part of a month before I was back to being what I'd call functional ... and many more months of weird aches and pains and recurring low energy phases before I was hundred percent. In fact, it was around the time that Covid hit that I realized I was finally back to "normal".
Call it long flu, I guess.
A few months back, I caught part of a Q+A with a highly regarded virus expert (forget his name and accreditation). He kept coming back to "My favourite three word answer. I Don't Know." And then to elaborate. "The phrasing of these questions tells me you want more certainty than I can offer. That's not how my field works."
posted by philip-random at 9:06 AM on December 20, 2022 [5 favorites]
The other thing I'd add to all this is that, roughly eight months before Covid hit, I got nailed with a brutal flu. A solid week of thinking if it got any worse, I'd be checking into Emergency, and better part of a month before I was back to being what I'd call functional ... and many more months of weird aches and pains and recurring low energy phases before I was hundred percent. In fact, it was around the time that Covid hit that I realized I was finally back to "normal".
Call it long flu, I guess.
A few months back, I caught part of a Q+A with a highly regarded virus expert (forget his name and accreditation). He kept coming back to "My favourite three word answer. I Don't Know." And then to elaborate. "The phrasing of these questions tells me you want more certainty than I can offer. That's not how my field works."
posted by philip-random at 9:06 AM on December 20, 2022 [5 favorites]
I'm not sure why beard wins the choice between protection from deadly or debilitating disease and beard, but okay.
I don't know if this is the case here, but there are religions which prohibit the cutting of body hair.
And...man. Do you drive or ride in a car for any nonessential trips? Have you been getting your flu shot every single year as an adult? This framing of COVID as the only or uniquely awful risk, one which could only be braved out of indifference or folly, is just so damn offputting. I stress that I say this as someone who has basically continued to mask in indoor public spaces throughout. Wilder and wilder claims and absolutist thinking like this won't make me stop masking, but it makes it hard for me to keep up on the latest news knowing that I'll have to wade through all the motivated reasoning to try to figure out what the science actually says, and with what degree of confidence it says it.
posted by praemunire at 9:18 AM on December 20, 2022 [25 favorites]
I don't know if this is the case here, but there are religions which prohibit the cutting of body hair.
And...man. Do you drive or ride in a car for any nonessential trips? Have you been getting your flu shot every single year as an adult? This framing of COVID as the only or uniquely awful risk, one which could only be braved out of indifference or folly, is just so damn offputting. I stress that I say this as someone who has basically continued to mask in indoor public spaces throughout. Wilder and wilder claims and absolutist thinking like this won't make me stop masking, but it makes it hard for me to keep up on the latest news knowing that I'll have to wade through all the motivated reasoning to try to figure out what the science actually says, and with what degree of confidence it says it.
posted by praemunire at 9:18 AM on December 20, 2022 [25 favorites]
I mean I guess this is useful for the what, three dozen people out there who have actually not had covid? (Setting aside all the folks who almost certainly DID have it but never tested and didn't have severe enough symptoms to do anything about it, which is almost everyone who claims never to have had COVID.)
posted by We put our faith in Blast Hardcheese at 9:29 AM on December 20, 2022 [1 favorite]
posted by We put our faith in Blast Hardcheese at 9:29 AM on December 20, 2022 [1 favorite]
Side discussion: Cumulative infection is essentially 100%, outside China.
Looking at the linked papers, it seems that estimates of cumulative infection are based on mathematical modeling not like, population sampling? I've been wondering about these numbers for a while. I can think of 10 people I'm close to (including me and my immediate family) who never tested positive and never had COVID symptoms. These folks have been more careful than most but that's a pretty big number of people I personally know. I am more than willing to believe that I had an asymptomatic case at some point, but the one time I had an antibody test it was negative (I know that doesn't prove I never had it). Anyhow, I wonder how this could ever be evaluated with precision? Certainly seems true that the majority has had at least one infection.
posted by latkes at 9:35 AM on December 20, 2022 [6 favorites]
Looking at the linked papers, it seems that estimates of cumulative infection are based on mathematical modeling not like, population sampling? I've been wondering about these numbers for a while. I can think of 10 people I'm close to (including me and my immediate family) who never tested positive and never had COVID symptoms. These folks have been more careful than most but that's a pretty big number of people I personally know. I am more than willing to believe that I had an asymptomatic case at some point, but the one time I had an antibody test it was negative (I know that doesn't prove I never had it). Anyhow, I wonder how this could ever be evaluated with precision? Certainly seems true that the majority has had at least one infection.
posted by latkes at 9:35 AM on December 20, 2022 [6 favorites]
One (a proud foodie) hasn't been able to taste anything for months, last I heard.
An online friend of mine caught COVID right in March 2020 and lost her taste/smell; nearly three years later, and a trip to a specialist (she's in the UK), she was told she will likely never get those senses back. She too was a rabid foodie and had a wonderful food blog at one point.
posted by Kitteh at 9:40 AM on December 20, 2022 [4 favorites]
An online friend of mine caught COVID right in March 2020 and lost her taste/smell; nearly three years later, and a trip to a specialist (she's in the UK), she was told she will likely never get those senses back. She too was a rabid foodie and had a wonderful food blog at one point.
posted by Kitteh at 9:40 AM on December 20, 2022 [4 favorites]
NY Times, Dec. 14th, 2022: "Who Are the ‘Never-Coviders’?"
While many people may have avoided infection through precaution or luck, “never Coviders,” scientists believe, are truly out there: People who are naturally immune and whose genetics could hold clues for treatment.....posted by brainwane at 9:44 AM on December 20, 2022 [3 favorites]
There are other viruses for which we know there are people who are naturally resistant. The most striking example I can think of is H.I.V., where there is a mutation that makes some people resistant to getting infected with the virus. That’s actually been the key to curing the very few people that have been cured of H.I.V.....
Some people have mutations in the innate immune system, which is like the first responder part of your immune system and is pretty generic....
We know now that people who have mutations in that first responder system tend to have very severe disease [when they catch COVID]. So the flip side is also likely to be true: Some people may have mutations that prevent them from getting infected [with COVID] at all.
If someone is taking their health seriously enough to be one of the rare people still masking now, why not do so in the most effective manner available
Because the biggest increase in protection comes from wearing a mask vs. not wearing one. The difference between a surgical mask and a KN95 is much less of a jump. I find KN95s horrendously uncomfortable and so I'm willing to take a bit of extra risk but still wear a mask.
The thing about long covid not being visible is that chronic illness often isn't visible
Disability applications to the social security administration have been decreasing or flat over the last three years, so it's not showing up there, either.
posted by Galvanic at 9:46 AM on December 20, 2022 [2 favorites]
Because the biggest increase in protection comes from wearing a mask vs. not wearing one. The difference between a surgical mask and a KN95 is much less of a jump. I find KN95s horrendously uncomfortable and so I'm willing to take a bit of extra risk but still wear a mask.
The thing about long covid not being visible is that chronic illness often isn't visible
Disability applications to the social security administration have been decreasing or flat over the last three years, so it's not showing up there, either.
posted by Galvanic at 9:46 AM on December 20, 2022 [2 favorites]
I haven't had covid (that I know of).
My own masking criteria has been to wait for public officials to give the OK to stop wearing masks, then wait a month to see if there's a covid spike. Which, lol.
posted by ryanrs at 9:47 AM on December 20, 2022 [14 favorites]
My own masking criteria has been to wait for public officials to give the OK to stop wearing masks, then wait a month to see if there's a covid spike. Which, lol.
posted by ryanrs at 9:47 AM on December 20, 2022 [14 favorites]
I've met a lot of people who are convinced that the better ones, which they've never tried, must be harder to breathe through. (That's been the opposite of my experience, but I wonder if counterfeit masks are contributing to that impression.)It’s possible that counterfeits are a factor but I would put far more weight on the multi year propaganda campaign saying masks make it hard to breathe. The right-wing and restaurant/bar owners have been screeching about that for ages and repetition works, especially since a lot of the chattering classes have been talking about it in terms of “getting back to normal”. The NYT gave David Leonhardt a ton of space to write about how we needed to drop safety measures so he could have brunch indoors without feeling guilty, and that thinking really covered a lot of elites.
posted by adamsc at 9:49 AM on December 20, 2022 [20 favorites]
Meanwhile, the organization I work for was just legally compelled to hire back most* of the people who were fired for not getting vaccinated. Things are going great!
* some retired before they could be fired, a few others got themselves into legal trouble for uttering threats and that sort of thing
posted by The Card Cheat at 9:52 AM on December 20, 2022 [2 favorites]
* some retired before they could be fired, a few others got themselves into legal trouble for uttering threats and that sort of thing
posted by The Card Cheat at 9:52 AM on December 20, 2022 [2 favorites]
If someone is taking their health seriously enough to be one of the rare people still masking now, why not do so in the most effective manner available
I haven't caught COVID. I am one of those assholes who is never sick. Between now and January, 2008, I have been sick precisely once.
I've received 4 doses of the original vaccines (2x Pfizer and 2x Moderna) and just recently got my bivalent booster.
I still wear a mask, it's just not a KN95. I am comfortable with my risk calculus.
posted by Dark Messiah at 9:54 AM on December 20, 2022 [5 favorites]
I haven't caught COVID. I am one of those assholes who is never sick. Between now and January, 2008, I have been sick precisely once.
I've received 4 doses of the original vaccines (2x Pfizer and 2x Moderna) and just recently got my bivalent booster.
I still wear a mask, it's just not a KN95. I am comfortable with my risk calculus.
posted by Dark Messiah at 9:54 AM on December 20, 2022 [5 favorites]
All of the people who are claiming they "never had covid" aren't in weekly testing regimes. They are saying "I never had symptoms" which is great, I'm glad you never had symptoms.
The mask thing: risk fatigue is real, the propoganda against masks has been successful, the education about comparative protection and when to upgrade has been ineffective/botched.
People absolutely choose beards, and fitting into the groups norms over their health and safety. Teenagers catch flack over it, but many adults are just older teenagers. Not an insult just an insight.
posted by anecdotal_grand_theory at 10:06 AM on December 20, 2022 [4 favorites]
The mask thing: risk fatigue is real, the propoganda against masks has been successful, the education about comparative protection and when to upgrade has been ineffective/botched.
People absolutely choose beards, and fitting into the groups norms over their health and safety. Teenagers catch flack over it, but many adults are just older teenagers. Not an insult just an insight.
posted by anecdotal_grand_theory at 10:06 AM on December 20, 2022 [4 favorites]
And yeah, no one can say with confidence they never had it. Asymptomatic things exist...my dad used to give my family strep over and over again when I was a kid and he never was sick. I hope we'll all know with time how many or if all of the population has had covid.
posted by tiny frying pan at 10:10 AM on December 20, 2022
posted by tiny frying pan at 10:10 AM on December 20, 2022
What is clear to me is that we failed this test. 5-15 million people are dead so far, (identified c19 deaths vs excess mortality) and the there are variations in how countries did. No country was able to solve this crisis in isolation to the rest, but many countries have much less death, disability, and spread rates.
Those are the places you should consider moving to, if they will have you.
posted by anecdotal_grand_theory at 10:11 AM on December 20, 2022 [7 favorites]
Those are the places you should consider moving to, if they will have you.
posted by anecdotal_grand_theory at 10:11 AM on December 20, 2022 [7 favorites]
More and more, things I see about COVID just make me professionally cranky.
I have in mind a question for Metatalktail Hour some day, some formulation like: What is your One Weird Trick, professionally? Like what is the leitmotif that the way you spend most of your time injects into every conversation you have in your personal life? Mine is selection bias. Every time I am in any conversation of substance I wonder, if this is part of the iceberg, where is the rest of it? Does it look the same as this part or does it look different in some important way?
My beliefs about COVID are (1) the iceberg of true prevalence is now barely visible and so the case-count piece of the CDC's community levels staging for COVID response is more or less useless; (2) the iceberg of transmission in any setting will always be underestimated in the absence of routine testing multiple times per week to catch asymptomatics; (3) the iceberg of what post-acute COVID is like should not be understood through ME/CFS, which I think we really would notice if it were as eye-wateringly high-prevalence as some of those estimates that make headlines, but instead through milder loss of function and new-onset chronic disease, which we probably would not notice because we don't go tell our neighbors and coworkers when our blood sugar is high, our mile time sucks, or we get lost every time we open the fridge; and (4) the iceberg of what most scientists believe about anything can't be properly understood through what gets the most sensational attention, and "airborne AIDS" is definitely sensational. Like siderea I have been watching this steady stream of infectious diseases and wondering the same thing. AFAIK, though, most virologists are not singing this tune. I wish we were all still cautious about masking (I continue to be, and I expect this to be a permanent lifestyle change) but I would also like us to be cautious when it comes to promoting ideas like this one that I think are still well outside the scientific mainstream.
posted by eirias at 10:12 AM on December 20, 2022 [19 favorites]
I have in mind a question for Metatalktail Hour some day, some formulation like: What is your One Weird Trick, professionally? Like what is the leitmotif that the way you spend most of your time injects into every conversation you have in your personal life? Mine is selection bias. Every time I am in any conversation of substance I wonder, if this is part of the iceberg, where is the rest of it? Does it look the same as this part or does it look different in some important way?
My beliefs about COVID are (1) the iceberg of true prevalence is now barely visible and so the case-count piece of the CDC's community levels staging for COVID response is more or less useless; (2) the iceberg of transmission in any setting will always be underestimated in the absence of routine testing multiple times per week to catch asymptomatics; (3) the iceberg of what post-acute COVID is like should not be understood through ME/CFS, which I think we really would notice if it were as eye-wateringly high-prevalence as some of those estimates that make headlines, but instead through milder loss of function and new-onset chronic disease, which we probably would not notice because we don't go tell our neighbors and coworkers when our blood sugar is high, our mile time sucks, or we get lost every time we open the fridge; and (4) the iceberg of what most scientists believe about anything can't be properly understood through what gets the most sensational attention, and "airborne AIDS" is definitely sensational. Like siderea I have been watching this steady stream of infectious diseases and wondering the same thing. AFAIK, though, most virologists are not singing this tune. I wish we were all still cautious about masking (I continue to be, and I expect this to be a permanent lifestyle change) but I would also like us to be cautious when it comes to promoting ideas like this one that I think are still well outside the scientific mainstream.
posted by eirias at 10:12 AM on December 20, 2022 [19 favorites]
I had a pretty mild case in July (symptoms never got beyond what I typically get with a cold). And then 2 months later, I got an ear infection for the first time in my life ever, one that was weirdly stubborn. It went away after a week of antibiotics, then came back a couple days later and finally went away after another week of antibiotics. And I was fine....until a week and a half ago, when the same kind of infection came back, and is following the same pattern (I just started the 2nd week of antibiotics yesterday).
I never even had ear infections as a child. I've been wondering why this suddenly happened now and now you've got me thinking this may have something to do with it.
Holy shit me too!
So I had COVID (for the first time I believe) in October. Pretty mild, like a bad cold. Then 2 weeks later I got strep--okay, I am prone to strep infections. But this one was bad. Like, 103.5 degree fever bad. Like, "should I go to the ER bad." (I did not go to the ER because my fever responded to Tylenol.)
Last week I get a cold. Not too bad. Then out of nowhere on Saturday afternoon my right ear starts hurting badly. I go to urgent care and I've got my first ear infection since I was a kid.
Something's off here.
posted by rhymedirective at 10:17 AM on December 20, 2022 [9 favorites]
I never even had ear infections as a child. I've been wondering why this suddenly happened now and now you've got me thinking this may have something to do with it.
Holy shit me too!
So I had COVID (for the first time I believe) in October. Pretty mild, like a bad cold. Then 2 weeks later I got strep--okay, I am prone to strep infections. But this one was bad. Like, 103.5 degree fever bad. Like, "should I go to the ER bad." (I did not go to the ER because my fever responded to Tylenol.)
Last week I get a cold. Not too bad. Then out of nowhere on Saturday afternoon my right ear starts hurting badly. I go to urgent care and I've got my first ear infection since I was a kid.
Something's off here.
posted by rhymedirective at 10:17 AM on December 20, 2022 [9 favorites]
Setting aside all the folks who almost certainly DID have it but never tested and didn't have severe enough symptoms to do anything about it, which is almost everyone who claims never to have had COVID
If I could get tested with the right test for free now, I would. No symptoms. I had the antibody test back mid-summer 2020 and PCRs at pretty regular intervals for several months once international travel was reopened (PCR can, though doesn't always, pick up infections months later), and rapid tests any time I've had even a bit of random congestion once they became available. So...definitely don't know I didn't have it, but...I'd say I have a fighting chance.
I definitely care about not getting it! Even with no sequelae, being incapacitated for a week sounds like no fun at all! But it's hard for me to calibrate my judgment with reference to people who are acting like it's still April 2020, when there were no known treatments, the course of the illness wasn't well understood, and there would have been huge benefits had we shut down transmission. The risks are substantially better understood, though certainly not fully yet; there are both treatments and vaccines (got all mine almost as soon as possible); the genie's out of the bottle on widespread transmission in the population. And I now have a couple years' data on how restricting my world affects both my physical and mental health, which means I know more about the costs of avoiding the risks.
posted by praemunire at 10:25 AM on December 20, 2022 [6 favorites]
If I could get tested with the right test for free now, I would. No symptoms. I had the antibody test back mid-summer 2020 and PCRs at pretty regular intervals for several months once international travel was reopened (PCR can, though doesn't always, pick up infections months later), and rapid tests any time I've had even a bit of random congestion once they became available. So...definitely don't know I didn't have it, but...I'd say I have a fighting chance.
I definitely care about not getting it! Even with no sequelae, being incapacitated for a week sounds like no fun at all! But it's hard for me to calibrate my judgment with reference to people who are acting like it's still April 2020, when there were no known treatments, the course of the illness wasn't well understood, and there would have been huge benefits had we shut down transmission. The risks are substantially better understood, though certainly not fully yet; there are both treatments and vaccines (got all mine almost as soon as possible); the genie's out of the bottle on widespread transmission in the population. And I now have a couple years' data on how restricting my world affects both my physical and mental health, which means I know more about the costs of avoiding the risks.
posted by praemunire at 10:25 AM on December 20, 2022 [6 favorites]
I'm just like, bitch, I had a very mild case, and since then I've had two likely bouts of angina and three visual auras, and a case of RSV that I'm still not sure I've kicked and if you're not wearing a mask at all times out of your house I am judging you, I am absolutely fucking judging you, as not caring enough about other people.
posted by seanmpuckett at 10:29 AM on December 20, 2022 [35 favorites]
posted by seanmpuckett at 10:29 AM on December 20, 2022 [35 favorites]
I really don't understand the thrust of the comments that imply that everyone has had COVID, as though people are just mistaken about never having had it, even if they've never had symptoms and never had a positive test. I mean...what? Is it difficult to believe that some people just haven't had it?
posted by mittens at 10:34 AM on December 20, 2022 [18 favorites]
posted by mittens at 10:34 AM on December 20, 2022 [18 favorites]
May I re-recommend the link I posted at the top of the thread? It’s from some Canadian doctors with relevant expertise, talks about the various theories to explain the larger and more severe RSV and flu seasons we’re seeing this year (explains what immunity debt is, and what it isn’t; also gives a useful similar phrase “immunity theft” for the thing that measles does and that the fpp links are trying to suss out about COVID-19), explains why the epidemiology points to immunity theft being likely (while acknowledging that we don’t have enough data yet to know for certain) despite the confounding issue of a double cohort of RSV and flu cases in infants and very young toddlers, and discusses what we know so far about how being up-to-date on vaccinations affects the whole picture (acknowledging that our data is also still incomplete in this area).
posted by eviemath at 10:36 AM on December 20, 2022 [8 favorites]
posted by eviemath at 10:36 AM on December 20, 2022 [8 favorites]
if you're not wearing a mask at all times out of your house I am judging you, I am absolutely fucking judging you, as not caring enough about other people
Cosign. I hate, hate, hate the way we branded this as "personal choice." I understand that this framing is in some sense deeply American, but that very fact has made me despise my own society -- another underaccounted cost of this disease, perhaps. My internal moral alignment used to come from a fairly individualistic place, and I cannot overstate how the pandemic has changed this.
posted by eirias at 10:40 AM on December 20, 2022 [33 favorites]
Cosign. I hate, hate, hate the way we branded this as "personal choice." I understand that this framing is in some sense deeply American, but that very fact has made me despise my own society -- another underaccounted cost of this disease, perhaps. My internal moral alignment used to come from a fairly individualistic place, and I cannot overstate how the pandemic has changed this.
posted by eirias at 10:40 AM on December 20, 2022 [33 favorites]
Is it difficult to believe that some people just haven't had it?
No, I believe some people haven't had it. But I don't believe self reporting on that point. Because people have been infected without realizing it, that's been documented.
posted by tiny frying pan at 10:42 AM on December 20, 2022 [8 favorites]
No, I believe some people haven't had it. But I don't believe self reporting on that point. Because people have been infected without realizing it, that's been documented.
posted by tiny frying pan at 10:42 AM on December 20, 2022 [8 favorites]
I've never knowingly had COVID. All four of my PCR tests and all of my FlowFlexes have been negative, even after known and repeated exposure to someone who had an active case (my wife). I can't prove a negative, and I don't know of a magic test that would clearly indicate that I had an active, asymptomatic case at some point (as compared to whatever immune-system markers two shots and three boosters have left in my system).
But I know that I don't want it. Whether for the first time or for the nth, whether I've previously displayed symptoms or not, I don't want any of it. My wife and I may be the only ones in N95s in many stores any more, we may get occasional stares, we may be passing up on social activities that we'd otherwise love to attend because they're likely to be bubbling viral cauldrons, but to me, it's worth it.
And with the rapid policy changes and uncertainty in China at the moment, the strong flu season and the lack of precautions taken by those around me, that's not changing any time soon.
posted by delfin at 10:58 AM on December 20, 2022 [13 favorites]
But I know that I don't want it. Whether for the first time or for the nth, whether I've previously displayed symptoms or not, I don't want any of it. My wife and I may be the only ones in N95s in many stores any more, we may get occasional stares, we may be passing up on social activities that we'd otherwise love to attend because they're likely to be bubbling viral cauldrons, but to me, it's worth it.
And with the rapid policy changes and uncertainty in China at the moment, the strong flu season and the lack of precautions taken by those around me, that's not changing any time soon.
posted by delfin at 10:58 AM on December 20, 2022 [13 favorites]
Thanks for the link, eviemath. I'm familiar with those people largely from Twitter and I have to say I eventually muted Gregory for bad behavior. I want to reiterate that I have also wondered about the exact idea they are promoting, but dermatology and emergency medicine aren't where I'd go to understand how probable this is. Evolutionary biology, maybe, depending on the specifics, but again I gotta take the stuff that particular guy says with a grain of salt.
I'm comparing this issue in my mind to the question of whether COVID is airborne, which was another important issue that flew in the face of conventional wisdom, and in that case the outliers were actually right and it was deeply damaging that we didn't listen to them sooner. The difference there, as far as I can tell, is that in that case there were hundreds of people with engineering / air quality expertise on the agitator side, and the problem was that conventional wisdom was ignoring these entire fields, so it was really a mainstream position within a minority that knew better. Here, I don't see hundreds of experts in relevant fields (immunology and virology, I'm guessing) coming out on the side of this hypothesis -- just a handful of people in other fields whose opinions all seem to come out at 90 dB anyway. In that context I really do not think we should be running around saying things like "airborne AIDS." If that changes I will certainly be glad I stayed conservative (although we're currently awaiting PCR results for Little e; there's only so far conservative can take you when you're a parent).
posted by eirias at 10:58 AM on December 20, 2022 [7 favorites]
I'm comparing this issue in my mind to the question of whether COVID is airborne, which was another important issue that flew in the face of conventional wisdom, and in that case the outliers were actually right and it was deeply damaging that we didn't listen to them sooner. The difference there, as far as I can tell, is that in that case there were hundreds of people with engineering / air quality expertise on the agitator side, and the problem was that conventional wisdom was ignoring these entire fields, so it was really a mainstream position within a minority that knew better. Here, I don't see hundreds of experts in relevant fields (immunology and virology, I'm guessing) coming out on the side of this hypothesis -- just a handful of people in other fields whose opinions all seem to come out at 90 dB anyway. In that context I really do not think we should be running around saying things like "airborne AIDS." If that changes I will certainly be glad I stayed conservative (although we're currently awaiting PCR results for Little e; there's only so far conservative can take you when you're a parent).
posted by eirias at 10:58 AM on December 20, 2022 [7 favorites]
I don't think the AIDS comparison is particularly helpful, even if technically true. Influenza is a known cause of acute lymphopenia, too, particularly in severe cases. COVID may be a more common and persistent cause. "COVID is generally worse than influenza (which is actually pretty bad) but not as bad as untreated HIV" has been a reasonable conclusion for a while now.
posted by atoxyl at 11:01 AM on December 20, 2022 [9 favorites]
posted by atoxyl at 11:01 AM on December 20, 2022 [9 favorites]
I don't know if this is the case here, but there are religions which prohibit the cutting of body hair.
I remember at the beginning of the pandemic, reading about Sikh doctors who decided that shaving their beards was the lesser of two evils.
posted by The Underpants Monster at 11:03 AM on December 20, 2022 [9 favorites]
I remember at the beginning of the pandemic, reading about Sikh doctors who decided that shaving their beards was the lesser of two evils.
posted by The Underpants Monster at 11:03 AM on December 20, 2022 [9 favorites]
Because people have been infected without realizing it, that's been documented.
Anecdotally, the university where I taught during the 2020-2021 year held in-person classes, but only provided monitoring testing for athletes. While no doubt the fact that almost 100% of my student-athletes got infected had to do with their practice routines, the fact that many of them were asymptomatic cases would seem to imply that the case count on campus was much higher than reported since the majority of the students were never testing. I'm willing to believe that there are people who have been vigilant this whole time and have never got it, but I'm skeptical of people who are basically back-to-normal who make similar claims.
posted by coffeecat at 11:08 AM on December 20, 2022 [3 favorites]
Anecdotally, the university where I taught during the 2020-2021 year held in-person classes, but only provided monitoring testing for athletes. While no doubt the fact that almost 100% of my student-athletes got infected had to do with their practice routines, the fact that many of them were asymptomatic cases would seem to imply that the case count on campus was much higher than reported since the majority of the students were never testing. I'm willing to believe that there are people who have been vigilant this whole time and have never got it, but I'm skeptical of people who are basically back-to-normal who make similar claims.
posted by coffeecat at 11:08 AM on December 20, 2022 [3 favorites]
Suggesting that people shave their beards to prove their commitment to public health is a pretty wild take, even for a COVID thread on Metafilter.
posted by cakelite at 11:10 AM on December 20, 2022 [19 favorites]
posted by cakelite at 11:10 AM on December 20, 2022 [19 favorites]
The most robust information set we have about repeat infection shows NO difference between the vaccinated and unvaccinated cohorts in developing sequelae such as immune dysfunction.
a couple thoughts about data like this:
a.) it's not really specifically accounting for boosters. I am little pessimistic about even the bivalent boosters keeping up with viral evolution right now but it's not especially controversial that an initial two-dose series 18 months ago hasn't.
b.) somebody who has been vaccinated and had three infections is sort of by definition a poor outcome as far as immune function
posted by atoxyl at 11:13 AM on December 20, 2022 [3 favorites]
a couple thoughts about data like this:
a.) it's not really specifically accounting for boosters. I am little pessimistic about even the bivalent boosters keeping up with viral evolution right now but it's not especially controversial that an initial two-dose series 18 months ago hasn't.
b.) somebody who has been vaccinated and had three infections is sort of by definition a poor outcome as far as immune function
posted by atoxyl at 11:13 AM on December 20, 2022 [3 favorites]
brainwane: That's a source saying that, in the UK, about 50 to 70% of the population had at least one COVID-19 infection between early/mid 2020 and February 2022.
Specifically "In England, an estimated 38.5 million people had coronavirus (COVID-19) between 27 April 2020 and 11 February 2022 [...] equating to 70.7% of the population (90% credible intervals: 66.0% to 75.6%)."
latkes: Looking at the linked papers, it seems that estimates of cumulative infection are based on mathematical modeling not like, population sampling?
The UK ONS survey is a population sample (regular PCR tests), with 100,000s of people. I trust them religiously at this point. It seems like they have the exact information to make this solid. OTOH, I don't get the methodology given for their cumulative infection model. I can't tell if "our established incidence methodology" is only needed to guess the *time* of infection in the pretty graphs, or whether it's adjusting the numbers and affecting the final result.
posted by sourcejedi at 11:23 AM on December 20, 2022 [1 favorite]
Specifically "In England, an estimated 38.5 million people had coronavirus (COVID-19) between 27 April 2020 and 11 February 2022 [...] equating to 70.7% of the population (90% credible intervals: 66.0% to 75.6%)."
latkes: Looking at the linked papers, it seems that estimates of cumulative infection are based on mathematical modeling not like, population sampling?
The UK ONS survey is a population sample (regular PCR tests), with 100,000s of people. I trust them religiously at this point. It seems like they have the exact information to make this solid. OTOH, I don't get the methodology given for their cumulative infection model. I can't tell if "our established incidence methodology" is only needed to guess the *time* of infection in the pretty graphs, or whether it's adjusting the numbers and affecting the final result.
posted by sourcejedi at 11:23 AM on December 20, 2022 [1 favorite]
I'll add to the anecdata: First time I had Covid was in the Fall after the vaccine was available (I was vaxxed). I had a cold with fever at night and stayed home from work for two days. Carefully took 2 home tests 2 days apart. Both negative. I stayed home another day (it was an off day for me) and went back to work, generally feeling OK. I started feeling really weird and winded that day even though my cold symptoms were mostly gone. Told my boss. He immediately sent me to a real testing facility my place of employment was associated with and sure enough—I had Covid. I stayed home for another 10 days.
My point? Home tests may not be accurate. I have Covid again right now, and my home test was positive. So who knows? There's so many variables in the mix here that it's head-spinning.
This is my THIRD time with Covid, and luckily all my cases were mild, but very unpleasant including low fever and shivering chills at night for a couple days (I'm a baby and I hate even having a minor cold). But nowhere near worthy of a trip to the ER, thankfully.
I'm fully vaxxed and boosted and have been since it was first available. Admittedly, I've been lrecently been lax with mask wearing except in crowds. But back to masks for me. Fuck Covid.
posted by SoberHighland at 11:24 AM on December 20, 2022 [5 favorites]
My point? Home tests may not be accurate. I have Covid again right now, and my home test was positive. So who knows? There's so many variables in the mix here that it's head-spinning.
This is my THIRD time with Covid, and luckily all my cases were mild, but very unpleasant including low fever and shivering chills at night for a couple days (I'm a baby and I hate even having a minor cold). But nowhere near worthy of a trip to the ER, thankfully.
I'm fully vaxxed and boosted and have been since it was first available. Admittedly, I've been lrecently been lax with mask wearing except in crowds. But back to masks for me. Fuck Covid.
posted by SoberHighland at 11:24 AM on December 20, 2022 [5 favorites]
Having no symptoms and no one becoming ill within any reasonable timeframe in which I had contact is sufficient for my definition of "never had it" -- we're in distinction without a difference territory. Truly proving a negative is futile if not impossible anyway.
posted by Dark Messiah at 11:34 AM on December 20, 2022 [4 favorites]
posted by Dark Messiah at 11:34 AM on December 20, 2022 [4 favorites]
It won't be a distinction worth much if it's true having it (even without knowing) can cause future health issues. I really hope that is not the case.
posted by tiny frying pan at 11:35 AM on December 20, 2022 [1 favorite]
posted by tiny frying pan at 11:35 AM on December 20, 2022 [1 favorite]
I haven't missed the headline. I think this headline is vague, scientifically, and thus irresponsible, socially.
I think the OP is misusing these papers. They replied to my comment by citing the VA study from November 10. One paper from a whole month ago. Guess what the virologist Racaniello said about the study? Anything as alarmist as this post? No. This is not how science discourse should be done.
posted by polymodus at 11:37 AM on December 20, 2022 [18 favorites]
I think the OP is misusing these papers. They replied to my comment by citing the VA study from November 10. One paper from a whole month ago. Guess what the virologist Racaniello said about the study? Anything as alarmist as this post? No. This is not how science discourse should be done.
posted by polymodus at 11:37 AM on December 20, 2022 [18 favorites]
My household (3 adults and 2 kids) has up to now been covid free to our knowledge. We mask and all but I've been having in-person meetings with clients the whole time and my spouse is a school teacher, my kids have been going to school in-person since September 2021, and my mother is retired but still has a reasonably active social life. We all still mask when we're out of the home and I figure it'll be our turn eventually but it hasn't happened yet.
posted by any portmanteau in a storm at 11:40 AM on December 20, 2022 [2 favorites]
posted by any portmanteau in a storm at 11:40 AM on December 20, 2022 [2 favorites]
I don't know of a magic test that would clearly indicate that I had an active, asymptomatic case at some point (as compared to whatever immune-system markers two shots and three boosters have left in my system)
I donate platelets and plasma at the local cancer center. A couple days after my donation I get a call or an email with the results of the blood test they do along with the donation, telling me I haven't had covid. I've asked, and they can indeed differentiate between having had covid and having had the shots (I've had all of them).
posted by Runes at 11:47 AM on December 20, 2022 [9 favorites]
I donate platelets and plasma at the local cancer center. A couple days after my donation I get a call or an email with the results of the blood test they do along with the donation, telling me I haven't had covid. I've asked, and they can indeed differentiate between having had covid and having had the shots (I've had all of them).
posted by Runes at 11:47 AM on December 20, 2022 [9 favorites]
'I'm not sure why beard wins the choice between protection from deadly or debilitating disease and beard, but okay.'
Maybe you should broaden your horizons regarding the religious practices of people outside your bubble. You might be surprised at the number of customs and practices that are different from your own.
posted by jordantwodelta at 11:47 AM on December 20, 2022 [1 favorite]
Maybe you should broaden your horizons regarding the religious practices of people outside your bubble. You might be surprised at the number of customs and practices that are different from your own.
posted by jordantwodelta at 11:47 AM on December 20, 2022 [1 favorite]
It won't be a distinction worth much if it's true having it (even without knowing) can cause future health issues.
The evidence presented for mild-to-moderate cases is not great, so I am not concerned (at this time) about any potential effects from asymptomatic infections. I will continue to take precautions but will not expend energy worrying about this possibility.
posted by Dark Messiah at 11:49 AM on December 20, 2022 [1 favorite]
The evidence presented for mild-to-moderate cases is not great, so I am not concerned (at this time) about any potential effects from asymptomatic infections. I will continue to take precautions but will not expend energy worrying about this possibility.
posted by Dark Messiah at 11:49 AM on December 20, 2022 [1 favorite]
A lot of people make up their minds before actually thinking about justifications for those decisions, really, most of the time.
posted by seanmpuckett at 12:12 PM on December 20, 2022 [2 favorites]
posted by seanmpuckett at 12:12 PM on December 20, 2022 [2 favorites]
Those of you who have found justifications that allow you to go maskless in public and feel good about it... fuck you. I hate every single maskless person I see at the grocery store; you're putting my life in danger, for no good reason.
I ride my bicycle to work most days and could probably think similar thoughts about most of the cars on the road. They directly put my life in danger multiple times a day and then there's the issues with respect to air pollution and carbon emissions that will shorten everyone's lives and render huge swaths of the planet uninhabitable soon enough. Why can't they all just ride their bikes too? (I'll consider ebikes and trikes to be bikes for the purposes of this wish)
posted by any portmanteau in a storm at 12:13 PM on December 20, 2022 [8 favorites]
I ride my bicycle to work most days and could probably think similar thoughts about most of the cars on the road. They directly put my life in danger multiple times a day and then there's the issues with respect to air pollution and carbon emissions that will shorten everyone's lives and render huge swaths of the planet uninhabitable soon enough. Why can't they all just ride their bikes too? (I'll consider ebikes and trikes to be bikes for the purposes of this wish)
posted by any portmanteau in a storm at 12:13 PM on December 20, 2022 [8 favorites]
windbox, I see your point, but it is in some sense self refuting as it casts this rage as a foolish choice made by individuals, which also doesn’t seem right. In the US at least, we are only offered individuals as the locus of intervention.
What recourse do we have, when something terrible happens to a commons? The commons in question here is the air. It’s come up in my mind over the last weeks also because of Twitter. Musk was able to take something of substantial value to many people and unilaterally do things to reduce that value. You could probably measure the loss monetarily for some people even. We don’t have a framework here for establishing that that was not okay to do, because formally it is not a collective resource. So he is the target of rage and humiliation because what else do we rage at?
posted by eirias at 12:14 PM on December 20, 2022 [2 favorites]
What recourse do we have, when something terrible happens to a commons? The commons in question here is the air. It’s come up in my mind over the last weeks also because of Twitter. Musk was able to take something of substantial value to many people and unilaterally do things to reduce that value. You could probably measure the loss monetarily for some people even. We don’t have a framework here for establishing that that was not okay to do, because formally it is not a collective resource. So he is the target of rage and humiliation because what else do we rage at?
posted by eirias at 12:14 PM on December 20, 2022 [2 favorites]
One of the things they have found is that the way you return to living your life after Covid plays a part in recovery.
The specific protocol mentioned has been written up by the WHO but isn't very well publicized (at least in this country).
posted by Runes at 12:19 PM on December 20, 2022 [13 favorites]
The specific protocol mentioned has been written up by the WHO but isn't very well publicized (at least in this country).
posted by Runes at 12:19 PM on December 20, 2022 [13 favorites]
The evidence presented for mild-to-moderate cases is not great, so I am not concerned (at this time) about any potential effects from asymptomatic infections. I will continue to take precautions but will not expend energy worrying about this possibility.
Ok? I'm not arguing you should?
posted by tiny frying pan at 12:25 PM on December 20, 2022
Ok? I'm not arguing you should?
posted by tiny frying pan at 12:25 PM on December 20, 2022
People (many) do not accept or internalize that asymptomatic spread is the main source of spread (either before symptoms occur, or symptoms never occur). Most cases of covid are asymptomatic, I believe that has been true since the start of the pandemic, this being the internet it would be cheating to provide a citation for it.
"It's invisible therefore it cant hurt me/does not exist" is a bias that germ theory science has struggled against (as well as "-my invisible thing exists without evidence and trumps your evidence "- another story).
People (some) can not accept any requirement that they take the consequences of their actions upon others into account, and that community mechanisms to do so, (governance) is illegitimate when they don't enjoy it.
Most people don't know the risks and rewards.. I certainly can't calculate the difference between wearing an N99 mask only when indoors vs wearing a Kn95 16hrs/day.
Even if we educated on risk-reward statistics on masks, indoor ventilation/filtration, physical distancing, 24hr wait times on surfaces etc. We have to get used to the fact that for a significant portion of the population, harming others is not a high ranking concern or even a plus (see 1/2 of republicans).
Research into long covid, immune defficiency from covid, other treatments for covid will all continue.
But what will also continue is people for whom admitting any mistake or inconvience is too much. They cause harm to their communities, they are a plague 5th column if you will. The harm they do is similar to wildy firing s gun in the air. Its careless and un-aimed, it most of the time doesn't kill someone, but it sometimes does and they will never get traced back to the people their negligence murdered.
They are basically germ polluters. And when we condemn them, we should remember thst we are them for other kinds of diffuse harm, like drunk driving, like fossil fuel use, like paying taxes to the war machines.
In sum: ethics a land of contrasts.
posted by anecdotal_grand_theory at 12:31 PM on December 20, 2022 [8 favorites]
"It's invisible therefore it cant hurt me/does not exist" is a bias that germ theory science has struggled against (as well as "-my invisible thing exists without evidence and trumps your evidence "- another story).
People (some) can not accept any requirement that they take the consequences of their actions upon others into account, and that community mechanisms to do so, (governance) is illegitimate when they don't enjoy it.
Most people don't know the risks and rewards.. I certainly can't calculate the difference between wearing an N99 mask only when indoors vs wearing a Kn95 16hrs/day.
Even if we educated on risk-reward statistics on masks, indoor ventilation/filtration, physical distancing, 24hr wait times on surfaces etc. We have to get used to the fact that for a significant portion of the population, harming others is not a high ranking concern or even a plus (see 1/2 of republicans).
Research into long covid, immune defficiency from covid, other treatments for covid will all continue.
But what will also continue is people for whom admitting any mistake or inconvience is too much. They cause harm to their communities, they are a plague 5th column if you will. The harm they do is similar to wildy firing s gun in the air. Its careless and un-aimed, it most of the time doesn't kill someone, but it sometimes does and they will never get traced back to the people their negligence murdered.
They are basically germ polluters. And when we condemn them, we should remember thst we are them for other kinds of diffuse harm, like drunk driving, like fossil fuel use, like paying taxes to the war machines.
In sum: ethics a land of contrasts.
posted by anecdotal_grand_theory at 12:31 PM on December 20, 2022 [8 favorites]
So the fact that a lot of people are so ignorant and selfish that they won't mask up in public is being used as an excuse for not masking up. Which means that if you don't mask up, you're not only risking the lives of everyone around you, you're also giving other people an excuse to not mask either.
posted by MrVisible at 12:39 PM on December 20, 2022 [5 favorites]
posted by MrVisible at 12:39 PM on December 20, 2022 [5 favorites]
All right, I get it. Metafilter and all. I'm absolutely incapable of caring about religious prohibitions against shaving when doing so puts one in a position to become a greater threat to the health of others who are not adherents of that religion.
I liked my beard before the pandemic. I shaved it so masks would fit. Since I still wear masks to doctor's appointments for my family I still don't get to grow it back. I'm happily free of religious complications though.
posted by The Monster at the End of this Thread at 12:40 PM on December 20, 2022 [5 favorites]
I liked my beard before the pandemic. I shaved it so masks would fit. Since I still wear masks to doctor's appointments for my family I still don't get to grow it back. I'm happily free of religious complications though.
posted by The Monster at the End of this Thread at 12:40 PM on December 20, 2022 [5 favorites]
But it's hard for me to calibrate my judgment with reference to people who are acting like it's still April 2020, when there were no known treatments, the course of the illness wasn't well understood, and there would have been huge benefits had we shut down transmission. The risks are substantially better understood, though certainly not fully yet; there are both treatments and vaccines (got all mine almost as soon as possible);
Yes, a common justification for lifting all societal protections and ignoring the risk for the immunocompromised was that we had available treatments. If you're not immunocompromised, you probably don't know that There aren’t any monoclonal antibody drugs that can treat the latest Covid-19 variants.
We still have Paxlovid. It has a lot of side effects and not everyone can take it. But we no longer have monoclonal antibody treatments, nor do we have Evusheld, the monoclonal antibody that could be administered prophylactically and was the only real preventative for organ transplant recipients and others who cannot make their own antibodies.
posted by hydropsyche at 12:41 PM on December 20, 2022 [16 favorites]
Yes, a common justification for lifting all societal protections and ignoring the risk for the immunocompromised was that we had available treatments. If you're not immunocompromised, you probably don't know that There aren’t any monoclonal antibody drugs that can treat the latest Covid-19 variants.
We still have Paxlovid. It has a lot of side effects and not everyone can take it. But we no longer have monoclonal antibody treatments, nor do we have Evusheld, the monoclonal antibody that could be administered prophylactically and was the only real preventative for organ transplant recipients and others who cannot make their own antibodies.
posted by hydropsyche at 12:41 PM on December 20, 2022 [16 favorites]
Sympathies to The Monster at the End of this Thread (cute username btw). Mr. eirias grew a wonderful beard at my request on our honeymoon and did not shave it for years and years. Then came omicron. I miss it.
posted by eirias at 12:48 PM on December 20, 2022
posted by eirias at 12:48 PM on December 20, 2022
Mod note: A comment and its replies deleted. While cursing is fine, cursing at someone else is not okay. I understand you have strong feelings about the subject but please keep it cool.
posted by loup (staff) at 12:49 PM on December 20, 2022 [2 favorites]
posted by loup (staff) at 12:49 PM on December 20, 2022 [2 favorites]
"All right, I get it. Metafilter and all. I'm absolutely incapable of caring about religious prohibitions against shaving when doing so puts one in a position to become a greater threat to the health of others who are not adherents of that religion."
It's absurd to me that you're positioning yourself as some kind of public health martyr here. I made a comment describing that I have a beard, and have been double-masking using surgical and cloth masks for years. I haven't been in a public space without a mask since March, 2020.
You interpret that as me being a "threat to the health of others." Ah yes. I'm definitely the problem when 85 percent of the "others" around me aren't masked whatsoever.
Truly a baffling/disgusting comment for you to make.
posted by jordantwodelta at 12:49 PM on December 20, 2022 [12 favorites]
It's absurd to me that you're positioning yourself as some kind of public health martyr here. I made a comment describing that I have a beard, and have been double-masking using surgical and cloth masks for years. I haven't been in a public space without a mask since March, 2020.
You interpret that as me being a "threat to the health of others." Ah yes. I'm definitely the problem when 85 percent of the "others" around me aren't masked whatsoever.
Truly a baffling/disgusting comment for you to make.
posted by jordantwodelta at 12:49 PM on December 20, 2022 [12 favorites]
if you're not wearing a mask at all times out of your house I am judging you, I am absolutely fucking judging you, as not caring enough about other people.
At all times?
posted by wondermouse at 12:50 PM on December 20, 2022 [8 favorites]
At all times?
posted by wondermouse at 12:50 PM on December 20, 2022 [8 favorites]
For all the folks talking about ear infections it’s worth noting that having two or more within a year is one of The Jeffrey Modell Foundations’ 10 warning signs of primary immune deficiency.
posted by joedan at 12:56 PM on December 20, 2022 [11 favorites]
posted by joedan at 12:56 PM on December 20, 2022 [11 favorites]
I don't know of a magic test that would clearly indicate that I had an active, asymptomatic case at some point (as compared to whatever immune-system markers two shots and three boosters have left in my system).
Odd to frame that as requiring magic - the vaccines only target one part of the virus so yes tests exist that distinguish antibodies resulting from infection. They aren’t something available at the average local pharmacy, though.
Most cases of covid are asymptomatic, I believe that has been true since the start of the pandemic, this being the internet it would be cheating to provide a citation for it.
Also no cite but I don’t think that’s true? Not sure it’s even statistically possible at this point. The bit about presymptomatic spreading being a big deal is true, though (as for a number of other viruses, I believe).
posted by atoxyl at 1:01 PM on December 20, 2022 [3 favorites]
Odd to frame that as requiring magic - the vaccines only target one part of the virus so yes tests exist that distinguish antibodies resulting from infection. They aren’t something available at the average local pharmacy, though.
Most cases of covid are asymptomatic, I believe that has been true since the start of the pandemic, this being the internet it would be cheating to provide a citation for it.
Also no cite but I don’t think that’s true? Not sure it’s even statistically possible at this point. The bit about presymptomatic spreading being a big deal is true, though (as for a number of other viruses, I believe).
posted by atoxyl at 1:01 PM on December 20, 2022 [3 favorites]
If you decide not to mask up while in a public space, you've decided that your personal comfort and convenience is more important than other peoples' lives. Your unmasked face is a declaration that you're too selfish to do even the minimum to protect others. You've declared that you don't care about the elderly, the chronically ill, or even infants.
You're proudly flying a flag that declares that you're an asshole.
And you're making it more acceptable for other people to do the same.
Whatever justifications you use to make it all better for yourself, know that there are people around you who view your petty, self-centered life choices with the deepest possible contempt.
posted by MrVisible at 1:10 PM on December 20, 2022 [20 favorites]
You're proudly flying a flag that declares that you're an asshole.
And you're making it more acceptable for other people to do the same.
Whatever justifications you use to make it all better for yourself, know that there are people around you who view your petty, self-centered life choices with the deepest possible contempt.
posted by MrVisible at 1:10 PM on December 20, 2022 [20 favorites]
Holding your fellow community members and human beings in constant withering contempt for failing to live up to your public health standards sounds really exhausting. I am genuinely curious if there are there are any cities or countries right now in December 2022 where masking in public spaces is still at a high level? And if so, what have they done right on public health communication or requirements?
posted by fancypants at 1:15 PM on December 20, 2022 [23 favorites]
posted by fancypants at 1:15 PM on December 20, 2022 [23 favorites]
So, the only possible defense is that everyone else is doing it?
That's a pretty weak justification for putting peoples' lives at risk.
Fortunately, being immunocompromised has given me an endless well of disappointment in humanity from which I draw my disdain.
posted by MrVisible at 1:25 PM on December 20, 2022 [8 favorites]
That's a pretty weak justification for putting peoples' lives at risk.
Fortunately, being immunocompromised has given me an endless well of disappointment in humanity from which I draw my disdain.
posted by MrVisible at 1:25 PM on December 20, 2022 [8 favorites]
I think it’s still the norm in Japan. Note the date on this article. I think what they did right, if you can call it that, was learning from a bad epidemic experience that predated COVID. I think what we learned collectively from this experience will mean that the next time a pandemic comes around, we will not respond at all.
posted by eirias at 1:25 PM on December 20, 2022 [5 favorites]
posted by eirias at 1:25 PM on December 20, 2022 [5 favorites]
If you're not living in Japan, can you really claim to care about public health at all?
posted by some loser at 1:28 PM on December 20, 2022 [9 favorites]
posted by some loser at 1:28 PM on December 20, 2022 [9 favorites]
For what it's worth, on the subject of beards, there is at least one effective technique for masking (this one was developed with religious restrictions in mind).
posted by trig at 1:36 PM on December 20, 2022 [6 favorites]
posted by trig at 1:36 PM on December 20, 2022 [6 favorites]
If you decide not to mask up while in a public space, you've decided that your personal comfort and convenience is more important than other peoples' lives. Your unmasked face is a declaration that you're too selfish to do even the minimum to protect others. You've declared that you don't care about the elderly, the chronically ill, or even infants.
Nope. I've simply decided that my masking in certain public spaces will not actually accomplish anything in terms of disease prevention, especially if I have no symptoms of anything. There are some public spaces where it seems quite unlikely that one would either catch or spread a respiratory illness from/to me regardless of masking, given the large size of the space, the ventilation of the space, and the lack of many people in the space.
I realize that some people are so immunocompromised that they do get sick very easily, but that has been true since long before COVID. The general public was never expected to wear masks all the time because of it. If you're going to go around judging people so harshly now for not doing it, you're just going to be miserable and hateful.
posted by wondermouse at 1:40 PM on December 20, 2022 [9 favorites]
Nope. I've simply decided that my masking in certain public spaces will not actually accomplish anything in terms of disease prevention, especially if I have no symptoms of anything. There are some public spaces where it seems quite unlikely that one would either catch or spread a respiratory illness from/to me regardless of masking, given the large size of the space, the ventilation of the space, and the lack of many people in the space.
I realize that some people are so immunocompromised that they do get sick very easily, but that has been true since long before COVID. The general public was never expected to wear masks all the time because of it. If you're going to go around judging people so harshly now for not doing it, you're just going to be miserable and hateful.
posted by wondermouse at 1:40 PM on December 20, 2022 [9 favorites]
I've simply decided that my masking in certain public spaces will not actually accomplish anything in terms of disease prevention.
Cite?
And do you mean disease prevention for you, or for others?
I mean, I assume that you're basing your public health decision on some sort of scientific evidence, right?
posted by MrVisible at 1:43 PM on December 20, 2022 [4 favorites]
Cite?
And do you mean disease prevention for you, or for others?
I mean, I assume that you're basing your public health decision on some sort of scientific evidence, right?
posted by MrVisible at 1:43 PM on December 20, 2022 [4 favorites]
I personally would love it if people would wear a mask when they're actually feeling sick. I see and hear you wet coughing, person in the pasta aisle! What are you doing!
It's like we as a society have learned nothing. A friend of mine came down with the flu a day after I hung out with him and he said "yeah I woke up feeling achy the day we hung out but I didn't wear a mask because reasons" and I was like............
IF YOU FEEL SICK, NEED MASK.
We can workshop the slogan.
posted by rhymedirective at 1:43 PM on December 20, 2022 [19 favorites]
It's like we as a society have learned nothing. A friend of mine came down with the flu a day after I hung out with him and he said "yeah I woke up feeling achy the day we hung out but I didn't wear a mask because reasons" and I was like............
IF YOU FEEL SICK, NEED MASK.
We can workshop the slogan.
posted by rhymedirective at 1:43 PM on December 20, 2022 [19 favorites]
If you decide not to mask up while in a public space, you've decided that your personal comfort and convenience is more important than other peoples' lives.
Man I always wonder if it were the 1980's AIDS epidemic dudes like this would be screaming about all of the disgusting and selfish individuals having unprotected sex. Like yeah ok no other systemic or structural factors at play here making this an epidemic, it's the billions of disparate individuals and their choices that are the problem. These are people who learned what Public Health was about 7 minutes ago and seem to think it means just scolding everyone around them into behaving (good person!) instead of misbehaving (selfish!). Bizarrely no mention or anger about how every federal, state, local government, leadership, the Biden administration, institutions public and private are not even gently encouraging people to mask up anymore. No free masks. No more free covid testing, no big free vaccine campaigns, no sick leave for people who test positive. Rail workers unions just had a deal rammed down their throat by the Biden administration because they don't want to give them sick leave. No harm reduction at all from the top level and strangely no anger over this.
No, just weird, sad hyper-individualistic analysis of everything where 90-something percent of the world's population are assholes who don't care and are "selfish". Just constant bizarre alienating toddler tantrum focused around masking and who is and who isn't and that's it. Strange and sad way to live.
posted by windbox at 1:49 PM on December 20, 2022 [30 favorites]
Man I always wonder if it were the 1980's AIDS epidemic dudes like this would be screaming about all of the disgusting and selfish individuals having unprotected sex. Like yeah ok no other systemic or structural factors at play here making this an epidemic, it's the billions of disparate individuals and their choices that are the problem. These are people who learned what Public Health was about 7 minutes ago and seem to think it means just scolding everyone around them into behaving (good person!) instead of misbehaving (selfish!). Bizarrely no mention or anger about how every federal, state, local government, leadership, the Biden administration, institutions public and private are not even gently encouraging people to mask up anymore. No free masks. No more free covid testing, no big free vaccine campaigns, no sick leave for people who test positive. Rail workers unions just had a deal rammed down their throat by the Biden administration because they don't want to give them sick leave. No harm reduction at all from the top level and strangely no anger over this.
No, just weird, sad hyper-individualistic analysis of everything where 90-something percent of the world's population are assholes who don't care and are "selfish". Just constant bizarre alienating toddler tantrum focused around masking and who is and who isn't and that's it. Strange and sad way to live.
posted by windbox at 1:49 PM on December 20, 2022 [30 favorites]
If you're going to go around judging people so harshly now for not doing it, you're just going to be miserable and hateful.
Strange and sad way to live.
It's so weird that people can't show the same degree of concern for my physical health as you do for my emotional wellbeing. Unless, of course, that was't an actual expression of concern, and was just meant as a passive-agressive jab.
posted by MrVisible at 1:57 PM on December 20, 2022 [8 favorites]
Strange and sad way to live.
It's so weird that people can't show the same degree of concern for my physical health as you do for my emotional wellbeing. Unless, of course, that was't an actual expression of concern, and was just meant as a passive-agressive jab.
posted by MrVisible at 1:57 PM on December 20, 2022 [8 favorites]
The terms of this mask argument seem a little weird. My framework has been:
- wearing a mask to the store/on public transit etc. is low cost and prosocial in a way that does make me think you’re kind of an asshole if you refuse to do it, but I understand that social norms determine people’s default behavior in these situations more than anything
- people who work in public places are kind of a special case because they have to do it all day every day, so the discomfort becomes more of a real issue and the protection may feel futile in the long run so I don’t judge them that much
- at indoor gatherings of friends, it’s kind of between you and everybody else there. Most people I know rarely wear masks in these situations at this point, except maybe when particularly vulnerable folks are present, because masking is a least a minor impediment to socialization, and people are going to be eating/drinking etc. I do still like to try to make things happen outdoors, but it’s winter.
- there are kinds of public spaces (i.e. bars and restaurants) that are just inherently a risk and where masks don’t really make sense. I still avoid these spaces but not everybody is going to.
In short, I feel like the reality is that there’s situational variation in a.) the legitimacy of reasons not to mask and b.) the risk that people are implicitly accepting by voluntarily being in that situation in the first place.
posted by atoxyl at 2:10 PM on December 20, 2022 [11 favorites]
- wearing a mask to the store/on public transit etc. is low cost and prosocial in a way that does make me think you’re kind of an asshole if you refuse to do it, but I understand that social norms determine people’s default behavior in these situations more than anything
- people who work in public places are kind of a special case because they have to do it all day every day, so the discomfort becomes more of a real issue and the protection may feel futile in the long run so I don’t judge them that much
- at indoor gatherings of friends, it’s kind of between you and everybody else there. Most people I know rarely wear masks in these situations at this point, except maybe when particularly vulnerable folks are present, because masking is a least a minor impediment to socialization, and people are going to be eating/drinking etc. I do still like to try to make things happen outdoors, but it’s winter.
- there are kinds of public spaces (i.e. bars and restaurants) that are just inherently a risk and where masks don’t really make sense. I still avoid these spaces but not everybody is going to.
In short, I feel like the reality is that there’s situational variation in a.) the legitimacy of reasons not to mask and b.) the risk that people are implicitly accepting by voluntarily being in that situation in the first place.
posted by atoxyl at 2:10 PM on December 20, 2022 [11 favorites]
Strange and sad way to live.
This is so close to "LOL, you're sad."
posted by paper chromatographologist at 2:15 PM on December 20, 2022 [1 favorite]
This is so close to "LOL, you're sad."
posted by paper chromatographologist at 2:15 PM on December 20, 2022 [1 favorite]
Especially since there was a LOL in a now-deleted comment.
posted by paper chromatographologist at 2:15 PM on December 20, 2022
posted by paper chromatographologist at 2:15 PM on December 20, 2022
I always wonder if it were the 1980's AIDS epidemic dudes like this would be screaming about all of the disgusting and selfish individuals having unprotected sex.
You don’t have to wonder. This was very much a real tension that occurred in the gay AIDS activist movement. This was real, painful history that you can learn about, not your fun thought experiment.
posted by Stacey at 2:21 PM on December 20, 2022 [28 favorites]
You don’t have to wonder. This was very much a real tension that occurred in the gay AIDS activist movement. This was real, painful history that you can learn about, not your fun thought experiment.
posted by Stacey at 2:21 PM on December 20, 2022 [28 favorites]
People can choose to not have sex if they want to (except if they get raped). Unfortunately, I can't choose to not breathe air.
Bizarrely no mention or anger about how every federal, state, local government, leadership, the Biden administration, institutions public and private are not even gently encouraging people to mask up anymore.
Oh, I am angry about that, but that war is so lost there's no point in discussing it any more. 99% of everyone has given up and gone back to normal, no matter what the consequences. All I can do is try to protect me.
posted by jenfullmoon at 2:26 PM on December 20, 2022 [8 favorites]
Bizarrely no mention or anger about how every federal, state, local government, leadership, the Biden administration, institutions public and private are not even gently encouraging people to mask up anymore.
Oh, I am angry about that, but that war is so lost there's no point in discussing it any more. 99% of everyone has given up and gone back to normal, no matter what the consequences. All I can do is try to protect me.
posted by jenfullmoon at 2:26 PM on December 20, 2022 [8 favorites]
I mean, I assume that you're basing your public health decision on some sort of scientific evidence, right?
So do you think that one's risk of either catching or spreading a respiratory illness is equally the same in a crowded restaurant with poor ventilation as it would be for people walking around a very sparsely populated Home Depot?
posted by wondermouse at 2:29 PM on December 20, 2022
So do you think that one's risk of either catching or spreading a respiratory illness is equally the same in a crowded restaurant with poor ventilation as it would be for people walking around a very sparsely populated Home Depot?
posted by wondermouse at 2:29 PM on December 20, 2022
I can't speak for anyone else, but I have been shopping at a pretty sparsely populated Home Depot when someone started hacking up a lung on the same aisle I was on, so...I dunno, I'm pretty glad I wear a mask everywhere!
I guess I'm a little surprised, reading this thread, that everyone isn't a simmering pot of anger over the pandemic, and over the fact that every single measure that might've gotten us out of it, has been refused. How are people not mad at, like, EVERYBODY? Government, individuals, people who are shopping for insulation at Home Depot at the same time you are, everyone? I don't think it's particularly hyper-individualistic to recognize that so few people care, and to feel a frustration (on up to raaaaage) about it? I was nodding right along to the sweary comments, figuring it was...like...how everybody felt at this point. Anger and exhaustion and a sort of fearful certainty of what'll happen at the next disaster? A sense that nobody--nobody at all--is looking out for the common good?
Not trying to emotion-police the people who aren't bundles of exposed nerves over it! Just, y'know, very surprised!
posted by mittens at 2:42 PM on December 20, 2022 [28 favorites]
I guess I'm a little surprised, reading this thread, that everyone isn't a simmering pot of anger over the pandemic, and over the fact that every single measure that might've gotten us out of it, has been refused. How are people not mad at, like, EVERYBODY? Government, individuals, people who are shopping for insulation at Home Depot at the same time you are, everyone? I don't think it's particularly hyper-individualistic to recognize that so few people care, and to feel a frustration (on up to raaaaage) about it? I was nodding right along to the sweary comments, figuring it was...like...how everybody felt at this point. Anger and exhaustion and a sort of fearful certainty of what'll happen at the next disaster? A sense that nobody--nobody at all--is looking out for the common good?
Not trying to emotion-police the people who aren't bundles of exposed nerves over it! Just, y'know, very surprised!
posted by mittens at 2:42 PM on December 20, 2022 [28 favorites]
So do you think that one's risk of either catching or spreading a respiratory illness is equally the same in a crowded restaurant with poor ventilation as it would be for people walking around a very sparsely populated Home Depot?
So, no evidence at all then? You're just doing what feels right and screw the consequences for anyone else?
posted by MrVisible at 2:44 PM on December 20, 2022
So, no evidence at all then? You're just doing what feels right and screw the consequences for anyone else?
posted by MrVisible at 2:44 PM on December 20, 2022
MrVisible, your insinuation that someone referencing the very well documented facts that transmission is impacted by quantity of the virus (i.e. crowds) and ventilation is guilty of "no evidence" strikes me as extremely bad faith. Personally, I wish the mods with close this thread - no useful dialogue is happening at this point.
posted by coffeecat at 2:51 PM on December 20, 2022 [16 favorites]
posted by coffeecat at 2:51 PM on December 20, 2022 [16 favorites]
Well, the lucky streak in our house is broken: Shepherd tested positive for COVID tonight. It's manifesting as a moderate cold for him. I feel fine but who knows tomorrow?
We were due to visit family for Christmas but we aren't doing that.
posted by Kitteh at 2:53 PM on December 20, 2022 [4 favorites]
We were due to visit family for Christmas but we aren't doing that.
posted by Kitteh at 2:53 PM on December 20, 2022 [4 favorites]
I just want to take a moment to stand up for myself here - this isn’t a collection of fringe articles. They’re from Nature, Immunology and other top journals in their fields. The author lists are quite robust, and they represent a range of data covering the acute and sequelae phases. I did not post any pre-prints, which means all of this information has passed rigorous review by the actual experts in the fields. I didn’t post any sensationalized reporting - of which there is A LOT - I posted the actual papers so people could read them and look at the tables and have accurate access to the unfiltered information from people who are dedicating their lives to the science. It is correct that most of these people aren’t virologists, but that’s because this is outside the expertise of virologists. It is the expertise area of immunologists and some clinicians and others who are trained in the fields addressed. Virologists can tell us about viral kinetics, viral genomes, viral sequences, and many important things about viruses! What they do not specialize in is all of the other things about how viruses impact the body. Because the body is hugely complex and that is why there are people who specialize in single body systems. And those are the people I trust to tell me about what’s happening in that body system.
The upshot is - it doesn’t really matter if you have had covid before? This is still damage that you can choose not to do to your system. And knowing that you have an acquired immune deficiency - that’s likely temporary if you allow yourself to heal - is very useful information when calculating your risks. Knowing that a covid infection can put you into the category of immunosuppressed individuals - the ones that keep being in the news for having the worst outcomes - is knowledge you can use to protect your own health.
I’ve given up on the idea that I will be able to return to public spaces, but I haven’t given up on you and caring about your health. I mean that with deep sincerity. My hidden agenda is “I think you should know that the top experts in immunology are seeing impacts in all phases of the disease and that you should probably be more careful with yourself following an infection, especially right now while other viruses are spreading rapidly and we’re also experiencing an antibiotic shortage, which would make another non-viral infection more serious than it would otherwise be. I care about your safety and health.”
posted by Bottlecap at 3:11 PM on December 20, 2022 [50 favorites]
The upshot is - it doesn’t really matter if you have had covid before? This is still damage that you can choose not to do to your system. And knowing that you have an acquired immune deficiency - that’s likely temporary if you allow yourself to heal - is very useful information when calculating your risks. Knowing that a covid infection can put you into the category of immunosuppressed individuals - the ones that keep being in the news for having the worst outcomes - is knowledge you can use to protect your own health.
I’ve given up on the idea that I will be able to return to public spaces, but I haven’t given up on you and caring about your health. I mean that with deep sincerity. My hidden agenda is “I think you should know that the top experts in immunology are seeing impacts in all phases of the disease and that you should probably be more careful with yourself following an infection, especially right now while other viruses are spreading rapidly and we’re also experiencing an antibiotic shortage, which would make another non-viral infection more serious than it would otherwise be. I care about your safety and health.”
posted by Bottlecap at 3:11 PM on December 20, 2022 [50 favorites]
My partner and I have been in a life-after-covid nightmare since September and it's really good to see research like this coming out.
We got Covid for the first time in mid-June of this year. Up until then, it was the only time in the 5+ years that I'd ever seen my partner be ill with anything. It was a mild case for him and he slept for a day and was mostly symptomless (on the other hand, I was absolutely down for the count for 10+ days).
Then starting in early September, he fell extremely ill with an acute liver injury. Took him to the hospital and he stayed there for six weeks. The doctors hadn't seen anything like it and nobody can explain it. We've ruled out absolutely everything.
He's still recovering, but very slowly. He's aiming to be able to work again in the new year, but his energy is basically nonexistent, still, after four months of this. He's lost over 40 lbs because when your liver fails, you can't absorb fat. He's so weak and the severe itchiness he experiences (because of the bilirubin flooding his system; not cleared out by the liver) means he constantly feels like his skin is on fire and he can't sleep. And of course he can't take anything for it.
It's heartbreaking and horrifying. And still a mystery.
Then there's of course all the small, stupid stuff that grinds us down. I won't go into all of that, but just imagine any everyday thing, but under those conditions.
It's so validating to see this research, plus more specifically about liver injury.
We were very mask compliant before, but it's taken on a whole new meaning now. I don't give a fk about the looks I get when I'm the only person in the shop with a mask on…after all we've been through already, the hell I'm bringing a cold back in the house. Or Covid again.
Somebody else we know experienced a similar thing, but with his heart. He's been recovering from it for over a year now. One thing he said really stuck with me, “Covid finds your weak spot and attacks it.”
posted by iamkimiam at 3:21 PM on December 20, 2022 [37 favorites]
We got Covid for the first time in mid-June of this year. Up until then, it was the only time in the 5+ years that I'd ever seen my partner be ill with anything. It was a mild case for him and he slept for a day and was mostly symptomless (on the other hand, I was absolutely down for the count for 10+ days).
Then starting in early September, he fell extremely ill with an acute liver injury. Took him to the hospital and he stayed there for six weeks. The doctors hadn't seen anything like it and nobody can explain it. We've ruled out absolutely everything.
He's still recovering, but very slowly. He's aiming to be able to work again in the new year, but his energy is basically nonexistent, still, after four months of this. He's lost over 40 lbs because when your liver fails, you can't absorb fat. He's so weak and the severe itchiness he experiences (because of the bilirubin flooding his system; not cleared out by the liver) means he constantly feels like his skin is on fire and he can't sleep. And of course he can't take anything for it.
It's heartbreaking and horrifying. And still a mystery.
Then there's of course all the small, stupid stuff that grinds us down. I won't go into all of that, but just imagine any everyday thing, but under those conditions.
It's so validating to see this research, plus more specifically about liver injury.
We were very mask compliant before, but it's taken on a whole new meaning now. I don't give a fk about the looks I get when I'm the only person in the shop with a mask on…after all we've been through already, the hell I'm bringing a cold back in the house. Or Covid again.
Somebody else we know experienced a similar thing, but with his heart. He's been recovering from it for over a year now. One thing he said really stuck with me, “Covid finds your weak spot and attacks it.”
posted by iamkimiam at 3:21 PM on December 20, 2022 [37 favorites]
I appreciate the articles, Bottlecap
I don't care for how the covid threads devolve into personal attacks and unadulterated venting, but new information is always welcome. Thanks.
posted by elkevelvet at 3:27 PM on December 20, 2022 [7 favorites]
I don't care for how the covid threads devolve into personal attacks and unadulterated venting, but new information is always welcome. Thanks.
posted by elkevelvet at 3:27 PM on December 20, 2022 [7 favorites]
Yes, to clarify my plea that this thread had gotten way off the rails was not to imply anything against the original post.
posted by coffeecat at 3:34 PM on December 20, 2022
posted by coffeecat at 3:34 PM on December 20, 2022
Every time one of these threads happen I hope that some of the anti-mask contingent, the no-shits-given-about-the-welfare-of-others contingent, the people advocating for endangering the lives of others contingent, has some sort of reasonable, rational justification for their selfish and immoral position.
But no. It's always just "everybody else is doing it, why can't I" again and again and again.
Shame. Shame on you. I hope someday you come face to face with the consequences of your decisions, and I hope you're not too dead inside by then to realize you're wrong, and develop some compassion.
posted by MrVisible at 3:35 PM on December 20, 2022 [10 favorites]
But no. It's always just "everybody else is doing it, why can't I" again and again and again.
Shame. Shame on you. I hope someday you come face to face with the consequences of your decisions, and I hope you're not too dead inside by then to realize you're wrong, and develop some compassion.
posted by MrVisible at 3:35 PM on December 20, 2022 [10 favorites]
If only there was a way to measure, compare and assess the risk of transmission, with replication of trials and peer review of results, and then having gathered that info, put it out to the public, so that public health rules and advice was clear and enforced and don't just come down to "i feel fine right now and the roof looks tall, guess I can do whatever I want. F you kids cripples and unfortunates and moral scolds." - a paraphrase.
Those systems failed, partly because of a disinformation campaign, partly because bureacracies soft-pedalled the threat and ignored the medical experience of east asians, because clearly what was happening to east asians was irrelevant to those from the west asian subcontinent and their settler colonies. I'll look for a link on asymptomatic transmission so that it can be ignored by the "chill out folks, its just the flu, nothing worth face diappering about."
posted by anecdotal_grand_theory at 3:35 PM on December 20, 2022 [2 favorites]
Those systems failed, partly because of a disinformation campaign, partly because bureacracies soft-pedalled the threat and ignored the medical experience of east asians, because clearly what was happening to east asians was irrelevant to those from the west asian subcontinent and their settler colonies. I'll look for a link on asymptomatic transmission so that it can be ignored by the "chill out folks, its just the flu, nothing worth face diappering about."
posted by anecdotal_grand_theory at 3:35 PM on December 20, 2022 [2 favorites]
People can choose to not have sex if they want to (except if they get raped). Unfortunately, I can't choose to not breathe air.
Oh boy.
posted by rhymedirective at 3:36 PM on December 20, 2022 [5 favorites]
Oh boy.
posted by rhymedirective at 3:36 PM on December 20, 2022 [5 favorites]
MrVisible, your insinuation that someone referencing the very well documented facts that transmission is impacted by quantity of the virus (i.e. crowds) and ventilation is guilty of "no evidence" strikes me as extremely bad faith.
I think it’s more that the way the poster said it comes off a little “I make up my own rules about what spaces are safe.” I doubt it would have drawn the same ire if it were framed specifically and conservatively in terms of indoors vs. outdoors or whatever.
I posted the actual papers so people could read them and look at the tables and have accurate access to the unfiltered information from people who are dedicating their lives to the science.
All respect but you have done some explicit and implicit editorializing in the post. That’s not a sin and I don’t know why you’d need to “stand up for yourself” about it but the other side of that is of course you’re going to get some arguments about the conclusions and comparisons.
posted by atoxyl at 3:37 PM on December 20, 2022
I think it’s more that the way the poster said it comes off a little “I make up my own rules about what spaces are safe.” I doubt it would have drawn the same ire if it were framed specifically and conservatively in terms of indoors vs. outdoors or whatever.
I posted the actual papers so people could read them and look at the tables and have accurate access to the unfiltered information from people who are dedicating their lives to the science.
All respect but you have done some explicit and implicit editorializing in the post. That’s not a sin and I don’t know why you’d need to “stand up for yourself” about it but the other side of that is of course you’re going to get some arguments about the conclusions and comparisons.
posted by atoxyl at 3:37 PM on December 20, 2022
eirias, I admit to not being personally familiar with the authors in my link. I found their argument convincing, however: that immunity gap was insufficient to explain the full scope and severity of this year’s respiratory illness season, pointing to immunity theft as a likely culprit. Their notes about the different policy responses that each situation would suggest were also on target. I’ve also been hearing a small but consistent thread of news from the earlier days of the pandemic of epidemiologists, doctors working in COVID wards, and immunologists about the potential for COVID to lead to immunity theft. The issue as I understand it has always been how frequent an outcome that is, and how the frequency is affected by age, vaccination status, and severity of infection; it has been known for over a year and a half if I recall correctly that COVID could lead to longer-term weakening of immune response in at least some cases, though.
Up here in Canada at least (and most other places as well, from what I read), few resources have gone toward the study of long term effects of COVID, so we’re really lacking in data (and especially good quality data), unfortunately. So instead, like for estimates of rates of infection, we have to rely on modelling and indirect measures (excess deaths and wastewater testing for rates of infection, expected rates and severity of RSV and flu cases in different age groups versus observed rates for testing the immunity theft hypothesis).
One thing I see with my own province’s data is also that vaccination categories aren’t super meaningful anymore. My province groups people into unvaccinated, 2 doses, or 3+ doses, and still defines 2 doses as “fully vaccinated”. But from what I read, vaccine efficacy drops off quickly enough so that someone whose last does was a year or so ago is at this point only marginally better protected than someone who has never been vaccinated? And while our initial vaccination rates were very good, only around 50% of people in my province have had 3+ doses, with the number having had the bivalent boosters this fall being unreported. So this means that when we look at our provincial numbers for deaths during the omicron wave (since Dec. 8 of last year), there’s a huge difference in mortality by age (people 70* being something like around 270 times more likely to die of COVID than people under 50), but people in the unvaccinated category are now only about three times more likely to die or be hospitalized from a COVID infection than people in the 3+ doses category, and that number has been dropping over time.
So not only has the funding for studying long term effects of COVID never really been there, but the funding for any study of COVID is drying up, and the government-collected data is getting less and less useful.
On top of that, while technically we have a provincial long COVID clinic, it doesn’t currently have a doctor to staff it.
It is for situations where public policy does have to be made despite this sort of degree of uncertainty that the precautionary principle was articulated. What would a precautionary response look like here? Ideally it would involve better ongoing funding to study COVID and similar diseases; as well as funding for better ventilation and air quality retrofits for existing buildings and better standards for new construction (bonus: also helps us in the next pandemic, which we know will be coming at some point), public health campaigns to promote mask-wearing (like, there’s a giant gap between new mask mandates and what most of our governments are currently doing, which is somewhere in the range of fuck-all to actively opposing building a culture of mask-wearing while sick), making medical grade masks more accessible to people at lower income levels, municipal mask recycling programs, and mandated paid sick days (in sufficient number to be useful for someone with COVID, where symptoms can last for two weeks and/or the best advice at avoiding sequelae is to rest for a bit longer after you start to feel better rather than getting back to full activity levels right away). Obviously some of those things, like building ventilation retrofits, are more expensive (though not more expensive than a number of other provincial or federal spending priorities that seem to benefit a much smaller number of people in private industry); but others (messaging via a public health camping that promotes mask wearing without a mandate, helping to coordinate mask availability for lower income folks alongside the still-available-here free rapid testing kits, or helping to coordinate making mask recycling programs that already exist in some health care setting available to the general public) are pretty low hanging fruit.
One of my points of reference is that the mathematician I know from grad school who was actively working on COVID modelling for the CDC seems to still be hiring people to work fully remotely.
posted by eviemath at 3:40 PM on December 20, 2022 [8 favorites]
Up here in Canada at least (and most other places as well, from what I read), few resources have gone toward the study of long term effects of COVID, so we’re really lacking in data (and especially good quality data), unfortunately. So instead, like for estimates of rates of infection, we have to rely on modelling and indirect measures (excess deaths and wastewater testing for rates of infection, expected rates and severity of RSV and flu cases in different age groups versus observed rates for testing the immunity theft hypothesis).
One thing I see with my own province’s data is also that vaccination categories aren’t super meaningful anymore. My province groups people into unvaccinated, 2 doses, or 3+ doses, and still defines 2 doses as “fully vaccinated”. But from what I read, vaccine efficacy drops off quickly enough so that someone whose last does was a year or so ago is at this point only marginally better protected than someone who has never been vaccinated? And while our initial vaccination rates were very good, only around 50% of people in my province have had 3+ doses, with the number having had the bivalent boosters this fall being unreported. So this means that when we look at our provincial numbers for deaths during the omicron wave (since Dec. 8 of last year), there’s a huge difference in mortality by age (people 70* being something like around 270 times more likely to die of COVID than people under 50), but people in the unvaccinated category are now only about three times more likely to die or be hospitalized from a COVID infection than people in the 3+ doses category, and that number has been dropping over time.
So not only has the funding for studying long term effects of COVID never really been there, but the funding for any study of COVID is drying up, and the government-collected data is getting less and less useful.
On top of that, while technically we have a provincial long COVID clinic, it doesn’t currently have a doctor to staff it.
It is for situations where public policy does have to be made despite this sort of degree of uncertainty that the precautionary principle was articulated. What would a precautionary response look like here? Ideally it would involve better ongoing funding to study COVID and similar diseases; as well as funding for better ventilation and air quality retrofits for existing buildings and better standards for new construction (bonus: also helps us in the next pandemic, which we know will be coming at some point), public health campaigns to promote mask-wearing (like, there’s a giant gap between new mask mandates and what most of our governments are currently doing, which is somewhere in the range of fuck-all to actively opposing building a culture of mask-wearing while sick), making medical grade masks more accessible to people at lower income levels, municipal mask recycling programs, and mandated paid sick days (in sufficient number to be useful for someone with COVID, where symptoms can last for two weeks and/or the best advice at avoiding sequelae is to rest for a bit longer after you start to feel better rather than getting back to full activity levels right away). Obviously some of those things, like building ventilation retrofits, are more expensive (though not more expensive than a number of other provincial or federal spending priorities that seem to benefit a much smaller number of people in private industry); but others (messaging via a public health camping that promotes mask wearing without a mandate, helping to coordinate mask availability for lower income folks alongside the still-available-here free rapid testing kits, or helping to coordinate making mask recycling programs that already exist in some health care setting available to the general public) are pretty low hanging fruit.
One of my points of reference is that the mathematician I know from grad school who was actively working on COVID modelling for the CDC seems to still be hiring people to work fully remotely.
posted by eviemath at 3:40 PM on December 20, 2022 [8 favorites]
I will retract my certainty that it is a majority, and submit this meta analysis that says at least 1/3. I think my broader point that behavior risking others is partly exacerbated by lots of asymptomatic people underappreciating their potential infectiousness.
Available data suggest that at least one third of SARS-CoV-2 infections are asymptomatic. Longitudinal studies suggest that nearly three quarters of persons who receive a positive PCR test result but have no symptoms at the time of testing will remain asymptomatic. Control strategies for COVID-19 should be altered, taking into account the prevalence and transmission risk of asymptomatic SARS-CoV-2 infection.
Primary funding source: National Institutes of Health.
https://pubmed.ncbi.nlm.nih.gov/33481642/ the link will follow.
posted by anecdotal_grand_theory at 3:41 PM on December 20, 2022 [2 favorites]
Available data suggest that at least one third of SARS-CoV-2 infections are asymptomatic. Longitudinal studies suggest that nearly three quarters of persons who receive a positive PCR test result but have no symptoms at the time of testing will remain asymptomatic. Control strategies for COVID-19 should be altered, taking into account the prevalence and transmission risk of asymptomatic SARS-CoV-2 infection.
Primary funding source: National Institutes of Health.
https://pubmed.ncbi.nlm.nih.gov/33481642/ the link will follow.
posted by anecdotal_grand_theory at 3:41 PM on December 20, 2022 [2 favorites]
re: things getting personal: In the US, at least, it's difficult for things to not get personal when the messaging we have at this point (and for most of the pandemic, quite frankly) is about "personal choice" and the government has abdicated any and all responsibility for keeping people safe.
If you know that wearing a mask helps protect other people, and you choose not to wear a mask, you're choosing not to protect people in that environment, or to help make that space safer for other people. At BEST you're choosing to not think about how your choice impacts others, because you don't have the capacity for that, but the rest of it is still true.
And also, most people are scraping by, and have to go to work to feed themselves/their families, and their bosses have never cared about their health and aren't going to start now, and they may feel inordinate pressures to not wear a mask -- including being fired.
It's a global airborne pandemic. It is not and cannot be about personal choice, it needs to be collective action.
The number of people I know who have gotten COVID from being at outdoor events is in the double-digits, and I don't know a lot of people. Every piece of "guidance" that comes out has the goal of getting you out spending money, and having your labor and life stolen by management.
It's not too late for a general strike, is what I'm saying.
(ps, this thread is pretty wild, and if you would like to see it less-so, please consider increasing your donation to MetaFilter so we can have some more mod hours. and don't forget to flag comments)
posted by curious nu at 3:42 PM on December 20, 2022 [22 favorites]
If you know that wearing a mask helps protect other people, and you choose not to wear a mask, you're choosing not to protect people in that environment, or to help make that space safer for other people. At BEST you're choosing to not think about how your choice impacts others, because you don't have the capacity for that, but the rest of it is still true.
And also, most people are scraping by, and have to go to work to feed themselves/their families, and their bosses have never cared about their health and aren't going to start now, and they may feel inordinate pressures to not wear a mask -- including being fired.
It's a global airborne pandemic. It is not and cannot be about personal choice, it needs to be collective action.
The number of people I know who have gotten COVID from being at outdoor events is in the double-digits, and I don't know a lot of people. Every piece of "guidance" that comes out has the goal of getting you out spending money, and having your labor and life stolen by management.
It's not too late for a general strike, is what I'm saying.
(ps, this thread is pretty wild, and if you would like to see it less-so, please consider increasing your donation to MetaFilter so we can have some more mod hours. and don't forget to flag comments)
posted by curious nu at 3:42 PM on December 20, 2022 [22 favorites]
US fatality rate from covid 1.1% (johns hopkins.
posted by anecdotal_grand_theory at 3:48 PM on December 20, 2022 [1 favorite]
posted by anecdotal_grand_theory at 3:48 PM on December 20, 2022 [1 favorite]
I'd like to challenge anyone in this thread to go to Home Depot, spend a half hour shopping, and not come within five feet of a person who's not wearing a mask.
Do this while trying to conceive of the fact that, if you lose this game, you lose internet points. If someone immunocompromised loses this game, they could die.
If you get to choose not to wear a mask, despite the danger you're inflicting on other people, I get to think you're an asshole.
posted by MrVisible at 3:49 PM on December 20, 2022 [7 favorites]
Do this while trying to conceive of the fact that, if you lose this game, you lose internet points. If someone immunocompromised loses this game, they could die.
If you get to choose not to wear a mask, despite the danger you're inflicting on other people, I get to think you're an asshole.
posted by MrVisible at 3:49 PM on December 20, 2022 [7 favorites]
I'm in Tokyo right now and masking isn't 100%, but indoors it's very close, and a lot of people also habitually mask outdoors. It's so lovely, honestly? My husband commented that he was surprised I was so comfortable to be out in crowds when I get so twitchy about it at home in the US and my reply was, "if the culture here is still so hardcore about masking, I fully believe people who don't feel well are actually staying home."
I really didn't feel ready to travel but I'm so glad that my first trip overseas since 2018 was to a place where people care for each other this way. Just nice to be reminded that it's not necessarily the natural condition of humanity to put the individual's preferences so far ahead of the group's needs.
posted by potrzebie at 3:53 PM on December 20, 2022 [19 favorites]
I really didn't feel ready to travel but I'm so glad that my first trip overseas since 2018 was to a place where people care for each other this way. Just nice to be reminded that it's not necessarily the natural condition of humanity to put the individual's preferences so far ahead of the group's needs.
posted by potrzebie at 3:53 PM on December 20, 2022 [19 favorites]
I think it’s more that the way the poster said it comes off a little “I make up my own rules about what spaces are safe.”
I mean, it was framed as "a crowded restaurant with poor ventilation" vs "a very sparsely populated Home Depot." I don't think it's a big reach to see this as trying to get the user to consider that some people have adjusted their risk analysis since 2020 based on what they've heard epidemiologists/politicians/public health officials say, and not simply because they're assholes. And for whatever it's worth, I say this as someone who is still masking.
posted by coffeecat at 3:54 PM on December 20, 2022 [4 favorites]
I mean, it was framed as "a crowded restaurant with poor ventilation" vs "a very sparsely populated Home Depot." I don't think it's a big reach to see this as trying to get the user to consider that some people have adjusted their risk analysis since 2020 based on what they've heard epidemiologists/politicians/public health officials say, and not simply because they're assholes. And for whatever it's worth, I say this as someone who is still masking.
posted by coffeecat at 3:54 PM on December 20, 2022 [4 favorites]
Bizarrely no mention or anger about how every federal, state, local government, leadership, the Biden administration, institutions public and private are not even gently encouraging people to mask up anymore. No free masks. No more free covid testing, no big free vaccine campaigns, no sick leave for people who test positive. Rail workers unions just had a deal rammed down their throat by the Biden administration because they don't want to give them sick leave. No harm reduction at all from the top level and strangely no anger over this.
I mean, that's kinda the trouble with societal atomization having bipartisan support, and "should you be able to expect government to do useful things for you" being a big-tent question on one side & actively worked against on the other. Even if you reject it, that it's worked so effectively in other spheres means that you're pushed into individual responses because if you could get people to group up & coordinate a response you wouldn't be where you're at.
Anger would be a good thing here. Anger is hope that things can improve.
What can I do? I can wear a mask. In spaces I control, I can require others wear a mask. (this effectively only counts 'my front door', but still) If I hear that someone I know has trouble sourcing good-quality masks, I can get them masks. I can keep up on my boosters.
I'd love to have a less individual response, but even local leftist groups seem to be by-and-large abandoning pandemic control requirements & reverting from virtual organization to in-person because it's what they're comfortable with.
It's a cold winter. Opportunity may thaw in the spring, but at the end of it each of us can only be as collectively minded as we have people around us to collect *with*.
posted by CrystalDave at 4:01 PM on December 20, 2022 [13 favorites]
I mean, that's kinda the trouble with societal atomization having bipartisan support, and "should you be able to expect government to do useful things for you" being a big-tent question on one side & actively worked against on the other. Even if you reject it, that it's worked so effectively in other spheres means that you're pushed into individual responses because if you could get people to group up & coordinate a response you wouldn't be where you're at.
Anger would be a good thing here. Anger is hope that things can improve.
What can I do? I can wear a mask. In spaces I control, I can require others wear a mask. (this effectively only counts 'my front door', but still) If I hear that someone I know has trouble sourcing good-quality masks, I can get them masks. I can keep up on my boosters.
I'd love to have a less individual response, but even local leftist groups seem to be by-and-large abandoning pandemic control requirements & reverting from virtual organization to in-person because it's what they're comfortable with.
It's a cold winter. Opportunity may thaw in the spring, but at the end of it each of us can only be as collectively minded as we have people around us to collect *with*.
posted by CrystalDave at 4:01 PM on December 20, 2022 [13 favorites]
For example, every single mask I have tried on the market, barring a pre pandemic, construction style shell N95, does not seal around my prominent nose.
Is there a reason not to wear a pre-pandemic, construction-style shell N95? I wear them quite often. They may not be stylish, but my own honker fits inside them nicely.
posted by delfin at 4:01 PM on December 20, 2022 [3 favorites]
Is there a reason not to wear a pre-pandemic, construction-style shell N95? I wear them quite often. They may not be stylish, but my own honker fits inside them nicely.
posted by delfin at 4:01 PM on December 20, 2022 [3 favorites]
So the original article is a warning of potential immune suppression post infection. Some people want to downplay that risk because (a) all the science is not settled and much more needs to be done to confirm this. (b) A unconfirmed believe that asympotmatic people and even mild covid infections are excempt from this risk or are at greatly reduced risk. (c) thst their own personal risk assesment excempts them from public health measures chosen to protect them, protect others and keep society functioning (and boy isnt that a can of worms).
We also know some people get lingering symptoms post infection that can be partially debilitating. We also know mortality rate from other causes post infection seems to be higher. For each of these we need to know: is the phenominon real, is the effect significant, does being asymptomatic ir mild covid impact that, and how should we adjust the risk-reward calculation of different public health measures.
Maybe asympotmatic people should Alfred E Neuman their ways through this like a reverse-precautionary principle whereby we don't ask people not to risk others until its very very obvious? Like, no CPR until they turn Blue? Don't stop for red-lights unless a car is coming. Don't pay your taxes unless you get audited. Don't plan an exit strategy for a land war in asia unless its more than a decade.....
All moot anyway. These dynamics of failure are worse for climate change and the ask is much larger. Won't be enough crops in a few decades, Covid will out live us in its animal resevoirs.
posted by anecdotal_grand_theory at 4:01 PM on December 20, 2022 [4 favorites]
We also know some people get lingering symptoms post infection that can be partially debilitating. We also know mortality rate from other causes post infection seems to be higher. For each of these we need to know: is the phenominon real, is the effect significant, does being asymptomatic ir mild covid impact that, and how should we adjust the risk-reward calculation of different public health measures.
Maybe asympotmatic people should Alfred E Neuman their ways through this like a reverse-precautionary principle whereby we don't ask people not to risk others until its very very obvious? Like, no CPR until they turn Blue? Don't stop for red-lights unless a car is coming. Don't pay your taxes unless you get audited. Don't plan an exit strategy for a land war in asia unless its more than a decade.....
All moot anyway. These dynamics of failure are worse for climate change and the ask is much larger. Won't be enough crops in a few decades, Covid will out live us in its animal resevoirs.
posted by anecdotal_grand_theory at 4:01 PM on December 20, 2022 [4 favorites]
Every piece of "guidance" that comes out has the goal of getting you out spending money
yeah but - people also want to do stuff!
like - you can check my history on this, I’ve been the furthest thing from a minimizer (also personally quite cautious and not to my knowledge infected, thus far). I’ve been consistent since the beginning that what should have happened was a true global lockdown effort with the aim of preventing the virus from becoming established, because the compounded costs of new virus forever are almost literally incalculable. This lack of conventional calculability is perhaps one reason this effort didn’t happen, but we could talk a lot about the reasons it didn’t happen, which are certainly also inclusive of “governments wanted people out spending money.”
Under the actually existing present circumstances, though, some of these comments seem curiously unable to acknowledge that a lot of shifts in behavior come down to the reality that actually people want to do stuff.
posted by atoxyl at 4:02 PM on December 20, 2022 [12 favorites]
yeah but - people also want to do stuff!
like - you can check my history on this, I’ve been the furthest thing from a minimizer (also personally quite cautious and not to my knowledge infected, thus far). I’ve been consistent since the beginning that what should have happened was a true global lockdown effort with the aim of preventing the virus from becoming established, because the compounded costs of new virus forever are almost literally incalculable. This lack of conventional calculability is perhaps one reason this effort didn’t happen, but we could talk a lot about the reasons it didn’t happen, which are certainly also inclusive of “governments wanted people out spending money.”
Under the actually existing present circumstances, though, some of these comments seem curiously unable to acknowledge that a lot of shifts in behavior come down to the reality that actually people want to do stuff.
posted by atoxyl at 4:02 PM on December 20, 2022 [12 favorites]
@MrVisible yes, you live in a society that even pre-Covid did not do its utmost to protect the most vulnerable. That same society is reacting similarly now.
So are you. Even wearing the best possible mask, you’re just reducing not eliminating the risk to others. The only way to do that is never go out at all…but then you’re asking others to do it for you.
posted by Galvanic at 4:06 PM on December 20, 2022 [1 favorite]
So are you. Even wearing the best possible mask, you’re just reducing not eliminating the risk to others. The only way to do that is never go out at all…but then you’re asking others to do it for you.
posted by Galvanic at 4:06 PM on December 20, 2022 [1 favorite]
I mean, it was framed as "a crowded restaurant with poor ventilation" vs "a very sparsely populated Home Depot." I don't think it's a big reach to see this as trying to get the user to consider that some people have adjusted their risk analysis since 2020 based on what they've heard epidemiologists/politicians/public health officials say, and not simply because they're assholes.
If, by 'adjusting their risk analysis', you mean 'decided not to wear a mask despite the ongoing danger this poses to others', then their risk analysis actually makes them assholes. I mean, the downside to wearing a mask is that you're mildly inconvenienced; the upside is that you're not an active threat to the people around you.
And now we're on to 'even with a mask you're not 100% safe'; well, who claimed you were? We're talking about taking minor precautions to lessen the risk of death to others, what kind of jackass doesn't do that?
posted by MrVisible at 4:10 PM on December 20, 2022 [4 favorites]
If, by 'adjusting their risk analysis', you mean 'decided not to wear a mask despite the ongoing danger this poses to others', then their risk analysis actually makes them assholes. I mean, the downside to wearing a mask is that you're mildly inconvenienced; the upside is that you're not an active threat to the people around you.
And now we're on to 'even with a mask you're not 100% safe'; well, who claimed you were? We're talking about taking minor precautions to lessen the risk of death to others, what kind of jackass doesn't do that?
posted by MrVisible at 4:10 PM on December 20, 2022 [4 favorites]
The number of people I know who have gotten COVID from being at outdoor events is in the double-digits, and I don't know a lot of people.
I keep wondering how many people are dead because of this one lazy journalist.
posted by joedan at 4:13 PM on December 20, 2022 [6 favorites]
I keep wondering how many people are dead because of this one lazy journalist.
posted by joedan at 4:13 PM on December 20, 2022 [6 favorites]
I mean, it was framed as "a crowded restaurant with poor ventilation" vs "a very sparsely populated Home Depot."
Realistically is there a difference in risk there? Sure, probably! Does this person bring their mask to Home Depot, estimate population per square meter and apply a research-backed formula to decide whether to put it on? Seems unlikely. I know I talked about these things being situational myself but the other side of my framework is “what are the mutually agreed shared risks, and what are the legitimate reasons not to do it?” In situations that are fundamentally “a bunch of strangers have to be in the same place for twenty minutes to get their daily business done” my instinct is that the simple, polite approach is just to put on the damn mask.
posted by atoxyl at 4:14 PM on December 20, 2022 [8 favorites]
Realistically is there a difference in risk there? Sure, probably! Does this person bring their mask to Home Depot, estimate population per square meter and apply a research-backed formula to decide whether to put it on? Seems unlikely. I know I talked about these things being situational myself but the other side of my framework is “what are the mutually agreed shared risks, and what are the legitimate reasons not to do it?” In situations that are fundamentally “a bunch of strangers have to be in the same place for twenty minutes to get their daily business done” my instinct is that the simple, polite approach is just to put on the damn mask.
posted by atoxyl at 4:14 PM on December 20, 2022 [8 favorites]
We're talking about taking minor precautions to lessen the risk of death to others, what kind of jackass doesn't do that?
Yeah, we are. What kind of jackass, indeed?
posted by Galvanic at 4:15 PM on December 20, 2022
Yeah, we are. What kind of jackass, indeed?
posted by Galvanic at 4:15 PM on December 20, 2022
US fatality rate from covid 1.1% (johns hopkins)
That's a Case Fatality Rate (CFR) which is understood to be inflated, because not all infections are "cases" (e.g. the health system doesn't record them) but pretty much all deaths are recorded.
Computing the Infection Fatality Rate (IFR) is more important, and now that "almost everyone" has had COVID, one can do quick calculations.
For example, USA population in 2022 is about 333 million, and covid deaths about 1.1 million, so the IFR is is probably closer to 0.3%. If you assume only 90% of people have had COVID, then it's a little higher, ~0.33%.
... so far
posted by soylent00FF00 at 4:19 PM on December 20, 2022
That's a Case Fatality Rate (CFR) which is understood to be inflated, because not all infections are "cases" (e.g. the health system doesn't record them) but pretty much all deaths are recorded.
Computing the Infection Fatality Rate (IFR) is more important, and now that "almost everyone" has had COVID, one can do quick calculations.
For example, USA population in 2022 is about 333 million, and covid deaths about 1.1 million, so the IFR is is probably closer to 0.3%. If you assume only 90% of people have had COVID, then it's a little higher, ~0.33%.
... so far
posted by soylent00FF00 at 4:19 PM on December 20, 2022
I would guess that the number of infections is actually higher than the population due to people having Covid multiple times.
posted by snofoam at 4:22 PM on December 20, 2022
posted by snofoam at 4:22 PM on December 20, 2022
This thread is interesting for what is (mostly) not being discussed:
Age.
From the start of the epidemic to today, the risk of serious illness or death from COVID is 100x higher (or more) in the oldest groups, and this is still true today for vaccinated groups.
How much of the arguments back & forth here are really about a proxy for age and perhaps ageism?
posted by soylent00FF00 at 4:27 PM on December 20, 2022 [6 favorites]
Age.
From the start of the epidemic to today, the risk of serious illness or death from COVID is 100x higher (or more) in the oldest groups, and this is still true today for vaccinated groups.
How much of the arguments back & forth here are really about a proxy for age and perhaps ageism?
posted by soylent00FF00 at 4:27 PM on December 20, 2022 [6 favorites]
I'll walk away from this.
If you drive drunk or fast or on a phone you might not kill someone but you raise the risk, and society has the right to inconveniece you with sobriety and safety measures while driving a car.
I wore masks for various jobs precovid I wear masks while working a physical job 8, 12 and sometimes 16 hr doubless and while cycling and hiking etc. Wearing a mask is not an imposition.
Mr. Visible is right. The anti maskers are assholes, and the "but no one wears them anymore" go-with-the-crowd people are either stuck in toxic work and social environments, cowards or assholes. And thats the world we are trapped in. Like Dark Helmet in SpaceBalls, surrounded by assholes.
Those of us who are taking covid precautions are most likely also those assholes in other domains. Drive recklessly, pollute etc. Its a failure mode of only partially eusocial species. We aren't bees or ants, we are apes. Apes together strong, assholes together dangerous.
so let's raise a toast to our sickly future. Covid is the leading cause of death until its famine, radiation, AI or whatever else comes. We failed at easy mode, we are not going to enjoy hard mode.
posted by anecdotal_grand_theory at 4:27 PM on December 20, 2022 [14 favorites]
If you drive drunk or fast or on a phone you might not kill someone but you raise the risk, and society has the right to inconveniece you with sobriety and safety measures while driving a car.
I wore masks for various jobs precovid I wear masks while working a physical job 8, 12 and sometimes 16 hr doubless and while cycling and hiking etc. Wearing a mask is not an imposition.
Mr. Visible is right. The anti maskers are assholes, and the "but no one wears them anymore" go-with-the-crowd people are either stuck in toxic work and social environments, cowards or assholes. And thats the world we are trapped in. Like Dark Helmet in SpaceBalls, surrounded by assholes.
Those of us who are taking covid precautions are most likely also those assholes in other domains. Drive recklessly, pollute etc. Its a failure mode of only partially eusocial species. We aren't bees or ants, we are apes. Apes together strong, assholes together dangerous.
so let's raise a toast to our sickly future. Covid is the leading cause of death until its famine, radiation, AI or whatever else comes. We failed at easy mode, we are not going to enjoy hard mode.
posted by anecdotal_grand_theory at 4:27 PM on December 20, 2022 [14 favorites]
Wearing a mask is not an imposition.
Thanks. I’ll let my asthmatic friends know. And the ones with COPD. They’ll be relieved.
posted by Galvanic at 4:32 PM on December 20, 2022 [1 favorite]
Thanks. I’ll let my asthmatic friends know. And the ones with COPD. They’ll be relieved.
posted by Galvanic at 4:32 PM on December 20, 2022 [1 favorite]
Personally, I want to downplay the risk suggested in the main post because the science is not just unsettled, but as best I can tell, coming from the fringe. I don’t want the push for caution to be weighed down by this. I think “extremely contagious virus that is still a leading cause of death, even after widespread exposure and vaccination, and has post acute effects that are not yet well understood” should be enough.
posted by eirias at 4:35 PM on December 20, 2022 [2 favorites]
posted by eirias at 4:35 PM on December 20, 2022 [2 favorites]
There is no evidence that wearing a face mask makes asthma worse. However, it is possible that some people with asthma may feel it is more difficult to get an adequate breath while wearing a face mask. While we support and advocate that people follow CDC recommendations, some people with asthma do not feel they can breathe adequately while wearing a mask. These individuals should avoid going to public places as much as possible. Being in public without a face mask may increase the chances of passing on the COVID-19 virus to others, even if symptoms are not present, or becoming infected with the COVID-19 virus.Want to try any of the other bullshit arguments that the anti-masking propaganda campaign spread?
Yes, people with asthma can wear face masks.
“For people with mild asthma or well-controlled asthma, it’s probably not going to be an issue,” said Dr. David Stukus, member of the Medical Scientific Council for the Asthma and Allergy Foundation of America (AAFA). “For people who have very severe disease and have frequent exacerbations, ER visits, hospitalizations, require lots of medications and frequent symptoms, it might cause more issues for those folks.”
It can be inconvenient, uncomfortable, and a hassle if you forget to bring it with you shopping — but one thing a face mask is not, is dangerous.
That’s what researchers found in the most recent study looking at how face masks do (or do not) affect the ability to breathe, even in people with lung disease.
If you have severe lung disease, such as COPD or asthma, we still recommend you wear a face covering. There has been information reported that masks do not allow you take in enough oxygen, or that they increase CO2 levels, but there is no medical evidence to support these claims.
posted by MrVisible at 4:40 PM on December 20, 2022 [17 favorites]
I think society itself ends up deciding what is acceptable. I may be the only one masking in a store, to protect people at home or that I will see later, but I don’t think me masking in a sea of unmasked people is protecting them to any significant degree.
I also don’t mask outside, and I rarely am inside in public spaces, which makes it a lot easier to pop on a mask to go into a store. I actually think that wearing a mask any time you are around people forever is a real imposition. I’m not saying people shouldn’t do it, but it’s not just discomfort or glasses falling off or whatever, it is also a barrier to a lot of social interaction. And abiding by it would mean never eating or having drinks with people. I feel like the more absolute one is about masking, the more it is actually not a trivial thing to do, but a huge change in how people live and interact.
I think there is also an argument that there are other airborne viruses that kill a significant number of people, often the same groups most at risk of severe consequences from Covid. I know Covid is different by degree, in a big way, but it is not fundamentally different in nature. By and large we don’t assume that everyone who didn’t mask during flu season for the last 100 years was a complete asshole.
Anyhow, I guess I think it is complicated and it would be great to work on solutions that don’t depend on voluntary masking, like air filtration and maybe easier, cheaper testing or whatever.
posted by snofoam at 4:50 PM on December 20, 2022 [7 favorites]
I also don’t mask outside, and I rarely am inside in public spaces, which makes it a lot easier to pop on a mask to go into a store. I actually think that wearing a mask any time you are around people forever is a real imposition. I’m not saying people shouldn’t do it, but it’s not just discomfort or glasses falling off or whatever, it is also a barrier to a lot of social interaction. And abiding by it would mean never eating or having drinks with people. I feel like the more absolute one is about masking, the more it is actually not a trivial thing to do, but a huge change in how people live and interact.
I think there is also an argument that there are other airborne viruses that kill a significant number of people, often the same groups most at risk of severe consequences from Covid. I know Covid is different by degree, in a big way, but it is not fundamentally different in nature. By and large we don’t assume that everyone who didn’t mask during flu season for the last 100 years was a complete asshole.
Anyhow, I guess I think it is complicated and it would be great to work on solutions that don’t depend on voluntary masking, like air filtration and maybe easier, cheaper testing or whatever.
posted by snofoam at 4:50 PM on December 20, 2022 [7 favorites]
I mean… my dad absolutely had a pass from me on masking because he was on like ten liters of oxygen and ain’t no N95 accommodates that. He also desperately needed not to get COVID. We kept him safe other ways — I tested daily, we masked, his caregivers masked, his nursing home ventilated so well my Aranet4 was practically putting on its sunglasses. He never got COVID. We should make precautions the norm because not everybody can do everything. Absolutism is very easily co-opted by those who would tear down precautions into an argument that because we can’t provide perfect protection, the efforts we can make don’t matter.
posted by eirias at 4:51 PM on December 20, 2022 [11 favorites]
posted by eirias at 4:51 PM on December 20, 2022 [11 favorites]
I think at this point the "if no mask then asshole"? discussion is very well covered and drifting from the original focus of the post.
posted by aniola at 4:58 PM on December 20, 2022 [5 favorites]
posted by aniola at 4:58 PM on December 20, 2022 [5 favorites]
I just want to take a moment to stand up for myself here - this isn’t a collection of fringe articles.
I'll take a moment too then. This is a collection of impressive looking articles that are decontextualized from their research process.
Long COVID research is slow and it will literally take years to figure out the science. Cherry picking these papers then drawing a conclusion that vaccines are now useless and/or past infections are useless... is both wrong, immunologically and virologically.
There's a thing that happens, due to ease of access today, when laypeople start citing Nature papers as if that tier is science dogma. That's not how real science works. It is very difficult, the work is ongoing and living knowledge. You can draw really inappropriate conclusions from a set of papers this way especially on such a topic that is a) rapidly evolving and b) everyone is trying to publish on it.
posted by polymodus at 5:06 PM on December 20, 2022 [25 favorites]
I'll take a moment too then. This is a collection of impressive looking articles that are decontextualized from their research process.
Long COVID research is slow and it will literally take years to figure out the science. Cherry picking these papers then drawing a conclusion that vaccines are now useless and/or past infections are useless... is both wrong, immunologically and virologically.
There's a thing that happens, due to ease of access today, when laypeople start citing Nature papers as if that tier is science dogma. That's not how real science works. It is very difficult, the work is ongoing and living knowledge. You can draw really inappropriate conclusions from a set of papers this way especially on such a topic that is a) rapidly evolving and b) everyone is trying to publish on it.
posted by polymodus at 5:06 PM on December 20, 2022 [25 favorites]
Shame. Shame on you.
Nope, it's shame on you. You are frankly being a real jerk in your comments and saying unpleasant things both to specific people here and about people in general. And, you are repeatedly and insistently ignoring the people who have taken the time and effort to reply in non-jerk ways. Sure, feel as mad as you want, but have the courtesy to dial down the jerkiness to your fellow travelers.
posted by Dip Flash at 5:23 PM on December 20, 2022 [23 favorites]
Nope, it's shame on you. You are frankly being a real jerk in your comments and saying unpleasant things both to specific people here and about people in general. And, you are repeatedly and insistently ignoring the people who have taken the time and effort to reply in non-jerk ways. Sure, feel as mad as you want, but have the courtesy to dial down the jerkiness to your fellow travelers.
posted by Dip Flash at 5:23 PM on December 20, 2022 [23 favorites]
. If people's favorite basketball players or actors or singers were dropping like flies and having to retire early - similarly to when there were a lot of really high-profile HIV/AIDS cases making the news - there'd definitely be a different mainstream conversation about it I'm sure.
posted by windbox at 7:26 A
Yes, the NBA is, in fact, in charge of public health policy in the USA, we all remember March 2020, when the NBA declared the national health emergency.
Sports media does seem like the only comms outlet that can compete with right wing media control
posted by eustatic at 5:24 PM on December 20, 2022 [2 favorites]
posted by windbox at 7:26 A
Yes, the NBA is, in fact, in charge of public health policy in the USA, we all remember March 2020, when the NBA declared the national health emergency.
Sports media does seem like the only comms outlet that can compete with right wing media control
posted by eustatic at 5:24 PM on December 20, 2022 [2 favorites]
Want to try any of the other bullshit argument
No, I’ll stay with the ones where I don’t try to explain to my asthmatic/COPD friends that the distress wearing masks they feel is illegitimate. Thanks!
posted by Galvanic at 5:26 PM on December 20, 2022
No, I’ll stay with the ones where I don’t try to explain to my asthmatic/COPD friends that the distress wearing masks they feel is illegitimate. Thanks!
posted by Galvanic at 5:26 PM on December 20, 2022
People who don't wear masks are not, in fact, my fellow anything. They're okay with risking my life because they can't be bothered to wear a cloth over their face-holes? Then they can deal with a tiny percentage of the rage that inspires in me.
posted by MrVisible at 5:27 PM on December 20, 2022 [1 favorite]
posted by MrVisible at 5:27 PM on December 20, 2022 [1 favorite]
I think you've expressed that rage extensively, and it feels like it's expanding to rage against people who aren't as angry as you are.
posted by sagc at 5:31 PM on December 20, 2022 [14 favorites]
posted by sagc at 5:31 PM on December 20, 2022 [14 favorites]
Heheheh. Most of them make Karl Marx look vaguely right wing and have as much time for science denial as Fauci does. But I appreciate your solicitude.
posted by Galvanic at 5:53 PM on December 20, 2022
posted by Galvanic at 5:53 PM on December 20, 2022
Mod note: MrVisible, it’s time to take a break from this thread
posted by travelingthyme (staff) at 5:53 PM on December 20, 2022 [17 favorites]
posted by travelingthyme (staff) at 5:53 PM on December 20, 2022 [17 favorites]
Arguing that the articles in the FPP may provide an incomplete picture because we don’t yet have sufficient evidence to draw scientifically/statistically valid conclusions (per polymodus) is one thing. If that’s all you’re saying, polymodus, I think that’s a reasonable discussion or debate to have. It’s also a bit separate from the question of what policy decisions should governments take in the absence (yet) of firm data. What is clear is that some percentage of people end up with immune theft past the end of their symptomatic infection with COVID. I would be interested in your take on the argument in the link I posted, which referenced what we should expect in terms of rates, severity, and age distribution of other respiratory illnesses this season versus what we are seeing, and the explanatory power of the immune gap versus immune theft hypotheses for that. So while we may not know the mechanism yet, that does increase the likelihood that COVID is having some wider scale effects on immune response post-infection. People will differ on their opinion of what threshold they think a precautionary approach in making policy decisions in the absence of clear evidence should kick in at. But that’s the discussion we should be having, if all you are saying is that our understanding of COVID’s effects on the immune system is still very preliminary and incomplete.
Arguing that the articles in the FPP represent a fringe opinion among relevant scientists (per eirias) is a very different thing. As I’ve noted and as poster Bottlecap has noted, that’s not a reasonable claim given the sourcing of the articles and given that this possibility has been raised since the early days of the pandemic, when doctors figured out that COVID was causing havoc with the immune systems of people with severe disease.
posted by eviemath at 5:56 PM on December 20, 2022 [13 favorites]
Arguing that the articles in the FPP represent a fringe opinion among relevant scientists (per eirias) is a very different thing. As I’ve noted and as poster Bottlecap has noted, that’s not a reasonable claim given the sourcing of the articles and given that this possibility has been raised since the early days of the pandemic, when doctors figured out that COVID was causing havoc with the immune systems of people with severe disease.
posted by eviemath at 5:56 PM on December 20, 2022 [13 favorites]
Disability applications to the social security administration have been decreasing or flat over the last three years, so it's not showing up there, either.
Well a disproportionate number of the the people who would be making those applications fell victim to a worldwide pandemic so more work than simple raw numbers of applications would be needed to tease out any meaning from applications.
Suggesting that people shave their beards to prove their commitment to public health is a pretty wild take, even for a COVID thread on Metafilter.
I no longer much care about the public health aspects because with less than 1% of the people I see in indoor public places masked it is blindingly obvious that ship has sailed. I am however still a little surprised more people aren't selfishly masking. I think not wearing a mask at a minimum indoors in public places is just individually foolish and excessively risky like impaired driving, not wearing a seatbelt, not getting vaccinated, riding a motorcycle without a helmet or base jumping. I choose not to engage in those activities and ya I'm going to think you are foolish if you do (I guess that makes me a bad person in those vanishingly small percentage of cases where one can't wear a mask for medical reasons).
I know lots of people get something out of religion but if it prevents you from wearing a mask I'm basically going to lump it in with those religions that prohibit blood transfusions or prioritize faith healing over healthcare as being a system that is shooting itself in the foot with a side helping of who wants to follow a higher being who is actively against its proponents looking after themselves.
At the moment I don't see myself ever not masking in public indoor spaces. I've found some cheap N95s that for the most part I forget I'm wearing and the health benefits verses not just Covid but also all other respiratory infections make continued masking attractive. Masking is just going to be one of those things I do in public like wearing shoes and covering my genitals.
posted by Mitheral at 6:11 PM on December 20, 2022 [11 favorites]
Well a disproportionate number of the the people who would be making those applications fell victim to a worldwide pandemic so more work than simple raw numbers of applications would be needed to tease out any meaning from applications.
Suggesting that people shave their beards to prove their commitment to public health is a pretty wild take, even for a COVID thread on Metafilter.
I no longer much care about the public health aspects because with less than 1% of the people I see in indoor public places masked it is blindingly obvious that ship has sailed. I am however still a little surprised more people aren't selfishly masking. I think not wearing a mask at a minimum indoors in public places is just individually foolish and excessively risky like impaired driving, not wearing a seatbelt, not getting vaccinated, riding a motorcycle without a helmet or base jumping. I choose not to engage in those activities and ya I'm going to think you are foolish if you do (I guess that makes me a bad person in those vanishingly small percentage of cases where one can't wear a mask for medical reasons).
I know lots of people get something out of religion but if it prevents you from wearing a mask I'm basically going to lump it in with those religions that prohibit blood transfusions or prioritize faith healing over healthcare as being a system that is shooting itself in the foot with a side helping of who wants to follow a higher being who is actively against its proponents looking after themselves.
At the moment I don't see myself ever not masking in public indoor spaces. I've found some cheap N95s that for the most part I forget I'm wearing and the health benefits verses not just Covid but also all other respiratory infections make continued masking attractive. Masking is just going to be one of those things I do in public like wearing shoes and covering my genitals.
posted by Mitheral at 6:11 PM on December 20, 2022 [11 favorites]
Re. quiet long Covid, I’m assuming long Covid is what I have, but since there’s no diagnostic criteria for it and it’s not really recognized where I live, I’m not saying much about it to anyone. The general vibe is also one of polite disbelief like with fibromyalgia or what have you. All I know is at the start of 2020 I was working out high-intensive strength and mobility training 4 times a week, and in the spring I started having trouble breathing, maintaining energy, excepting myself, which got worse until by winter I had put on 20 kilos, was falling asleep in the daytime and having back spasms that brought me to my knees. I ended up quitting my job and just trying to rest for the best part of a year. I am back at work but still can’t climb a flight of stairs or get my clothes on easily. I would say I hadn’t have Covid, but antibody testing says I did. The one time I thought I had a bit of a cold my PCR tests said negative. I’m not going around telling people though, what difference would it make?
posted by Iteki at 6:19 PM on December 20, 2022 [17 favorites]
posted by Iteki at 6:19 PM on December 20, 2022 [17 favorites]
so more work than simple raw numbers of applications would be needed to tease out any meaning from applications.
Sure, and the folks asserting the positive (that long Covid is a major issue) are the ones who need to undertake it.
posted by Galvanic at 6:20 PM on December 20, 2022
Sure, and the folks asserting the positive (that long Covid is a major issue) are the ones who need to undertake it.
posted by Galvanic at 6:20 PM on December 20, 2022
I’m tempted to believe that the reason long Covid isn’t “a thing” where I am (they literally shut down the one clinic they opened almost instantly) is because of what it might mean in terms of sick-leave and disability cases and costs.
posted by Iteki at 6:23 PM on December 20, 2022 [13 favorites]
posted by Iteki at 6:23 PM on December 20, 2022 [13 favorites]
I feel like on the plus side, there has been a lot of research on Covid, and it has turned up a lot of surprising stuff. I think we will be continuing to learn more for years. I think some of this will also help us better understand and recognize previously unnoticed impacts of other viruses.
posted by snofoam at 6:28 PM on December 20, 2022 [4 favorites]
posted by snofoam at 6:28 PM on December 20, 2022 [4 favorites]
Yes, the NBA is, in fact, in charge of public health policy in the USA, we all remember March 2020, when the NBA declared the national health emergency.
This comes close enough to an accurate description of events of March 2020 that it’s hard to tell how sarcastic you’re being.
posted by atoxyl at 6:40 PM on December 20, 2022 [14 favorites]
This comes close enough to an accurate description of events of March 2020 that it’s hard to tell how sarcastic you’re being.
posted by atoxyl at 6:40 PM on December 20, 2022 [14 favorites]
Not a research impact on other viruses, but I’ve started also getting an annual flu shot, as have more people I know in the 30-50 range. We all didn’t realize quite how bad annual flu was before. Which, I guess that’s one small silver lining to the people falsely claiming that COVID was just like the flu, is that then the annual flu death numbers became more publicized and folks like me were like, “OH. And a simple, free annual vaccine on my part can help lower that, even though I’m not yet in the higher risk age range, because all of us are potential transmission vectors? Sign me up!”
Somehow my province can use the pandemic situation and general public goodwill (if not necessarily good understanding) around COVID vaccination to clearly plan and communicate a public health campaign around flu vaccination, but not around mask wearing. Sigh. I mean, it’s not the worst of all worlds, but still frustrating. It’s like our politicians didn’t get the memo on the Swiss cheese model of infection prevention and the need for multiple layers of protection, and have just decided to throw all of our eggs into one basket.
posted by eviemath at 6:41 PM on December 20, 2022 [10 favorites]
Somehow my province can use the pandemic situation and general public goodwill (if not necessarily good understanding) around COVID vaccination to clearly plan and communicate a public health campaign around flu vaccination, but not around mask wearing. Sigh. I mean, it’s not the worst of all worlds, but still frustrating. It’s like our politicians didn’t get the memo on the Swiss cheese model of infection prevention and the need for multiple layers of protection, and have just decided to throw all of our eggs into one basket.
posted by eviemath at 6:41 PM on December 20, 2022 [10 favorites]
It’s possible “fringe” is too strong a position. I know my limits when reading science outside my field, and these papers exceed them. My subjective sense is that this is still very far from the center of gravity of people who do know how to read this work. I’ve seen some of those people say things like “there is no high quality evidence that mild COVID damages the immune system.” You can get a few papers in high impact journals that are nevertheless representing a position that is not widely shared. I think it’s been pointed out that if this type of effect were behind the multi-virus hospital crisis that’s happening now, it would not be expected to be a pediatric crisis. Sure, cumulative infection rates are probably higher in children, but not to this degree, and as has been mentioned elsewhere, older people are otherwise so much more vulnerable. And it would also not be expected that the IFR would have fallen as much as it has. Prior exposure to COVID does not seem to make you more susceptible to its worse manifestations, but less.
One thing I’m watching for is: do we have a repeat of this horror show next year?
posted by eirias at 6:50 PM on December 20, 2022 [2 favorites]
One thing I’m watching for is: do we have a repeat of this horror show next year?
posted by eirias at 6:50 PM on December 20, 2022 [2 favorites]
One thing I’m watching for is: do we have a repeat of this horror show next year?
Depends which specific horror show you're referring to, but my gut instinct says 'yes?'
Speaking for my fellow Americans in general, we will not care on a societal level (changing our behavior in any meaningful ways) unless we are literally forced to do so. Individuals may choose to protect themselves to various degrees, but the only thing that will bring back any kind of en-masse wariness will be a new variant that hits the genetic jackpot and couples high infectivity/evasion rates with significantly increased morbidity, and if THAT happens all bets are off.
So I don't know if things will get worse, but I see no path to things getting better on a macro level. We will stumble along with waves of infection, surges here and there, and a pink Somebody Else's Problem field surrounding the virus except for those of us who discover, abruptly, that they are Somebody Else.
posted by delfin at 7:40 PM on December 20, 2022 [4 favorites]
Depends which specific horror show you're referring to, but my gut instinct says 'yes?'
Speaking for my fellow Americans in general, we will not care on a societal level (changing our behavior in any meaningful ways) unless we are literally forced to do so. Individuals may choose to protect themselves to various degrees, but the only thing that will bring back any kind of en-masse wariness will be a new variant that hits the genetic jackpot and couples high infectivity/evasion rates with significantly increased morbidity, and if THAT happens all bets are off.
So I don't know if things will get worse, but I see no path to things getting better on a macro level. We will stumble along with waves of infection, surges here and there, and a pink Somebody Else's Problem field surrounding the virus except for those of us who discover, abruptly, that they are Somebody Else.
posted by delfin at 7:40 PM on December 20, 2022 [4 favorites]
Oh, I meant specifically the horror show of people being unusually susceptible to a wide variety of diseases. If next flu and RSV season are normal, that seems like it should provide some support for the immunity gap hypothesis. If they still exceed normal parameters for those diseases, we’ll need to look elsewhere for an explanation, I would think.
posted by eirias at 7:47 PM on December 20, 2022 [3 favorites]
posted by eirias at 7:47 PM on December 20, 2022 [3 favorites]
I had a pretty mild case in July (symptoms never got beyond what I typically get with a cold). And then 2 months later, I got an ear infection for the first time in my life ever, one that was weirdly stubborn.
Something similar happened to me. Avoided chicken pox my entire life but this year a few months after COVID it finally caught up to me. Could be a coincidence I suppose.
posted by xigxag at 7:50 PM on December 20, 2022 [1 favorite]
Something similar happened to me. Avoided chicken pox my entire life but this year a few months after COVID it finally caught up to me. Could be a coincidence I suppose.
posted by xigxag at 7:50 PM on December 20, 2022 [1 favorite]
There's a thing that happens, due to ease of access today, when laypeople start citing Nature papers as if that tier is science dogma. That's not how real science works.
Thanks polymodus for this perspective - I've certainly done the same in the past, shared what seems to be pretty good evidence for a thing, multiple studies, from reputable sources - later only to discover a few studies from those exact same sources claiming the exact opposite.
There have been a few studies, that have no obvious flaws, conducted pre-pandemic, that show mask-wearing is quite ineffective at reducing the spread of flu. And there have been regions of the world that required proper FFP2 respirators (same as N95) worn during the pandemic, to seemingly little effect. So sometimes it is quite easy to fall into the trap of 'aha, now I have found the answer!' without realizing that was the answer that you wanted, and then anchoring yourself to that answer.
posted by meowzilla at 8:30 PM on December 20, 2022 [3 favorites]
Thanks polymodus for this perspective - I've certainly done the same in the past, shared what seems to be pretty good evidence for a thing, multiple studies, from reputable sources - later only to discover a few studies from those exact same sources claiming the exact opposite.
There have been a few studies, that have no obvious flaws, conducted pre-pandemic, that show mask-wearing is quite ineffective at reducing the spread of flu. And there have been regions of the world that required proper FFP2 respirators (same as N95) worn during the pandemic, to seemingly little effect. So sometimes it is quite easy to fall into the trap of 'aha, now I have found the answer!' without realizing that was the answer that you wanted, and then anchoring yourself to that answer.
posted by meowzilla at 8:30 PM on December 20, 2022 [3 favorites]
Those are good questions, eirias. They do seem to be addressed in my link, though?
The immunity gap hypothesis has some surface plausibility. Under this view, since first infections are often the most severe, the surge in pediatric hospitalizations is simply a numbers game: more kids are ending up in hospital simply because there are far more susceptible kids infected after a period in which RSV and flu were absent. Indeed, while this does seem to be playing a role in the pediatric health-care crisis, it fails to account for several elements of the current situation. The premise, that first infection with RSV at any age is the most likely to result in a severe outcome, is simply not true.posted by eviemath at 9:00 PM on December 20, 2022 [4 favorites]
Infants aged 0-12 months are the highest risk group for severe outcomes from RSV and other respiratory viruses because of basic anatomy. They have the tiniest airways, meaning it takes less inflammation to obstruct their narrow little airways than it would for an older toddler. Delaying an infant’s first exposure to RSV until they are older than 12 months makes them much less likely to require hospitalization on first infection. In fact, this is exactly what can be seen in Denmark’s public RSV admissions data. Toddlers from the 2020-21 season, unexposed to RSV in their first year of life, and then subsequently exposed in later years, were LESS likely to be admitted to hospital than either pre-pandemic or late pandemic babies. It’s a great thing to not be exposed to RSV in the first year of life: these kids are less likely to experience severe outcomes.
Another issue inadequately addressed is that while RSV was absent in the winter of 2020-2021, last year still had a substantial RSV wave around the world. Since a significant portion of the gap was filled last season, one would expect the situation in our pediatric hospitals to be better this season. Instead, it is far worse. In the United States, infants not even conceived during the gap year are being hospitalized for RSV infections at seven times the rate seen before the pandemic.
This gap further fails to account for the increase in older children and adults that have been hospitalized for RSV this season. The vast majority of the population has had RSV by the age of two, so hospitalized patients aged three or more should have already built up some immunity … a one-year gap wouldn’t explain this year’s phenomenon.
Finally, while the immunity gap hypothesis is a valid consideration and a plausible contributing factor for the wildly transmissible RSV, it makes much less sense when applied to influenza. We have annual vaccination campaigns for the flu and even unvaccinated people only get ill from the flu once every 12 years or so. So if we don’t catch the flu most years and individuals at high risk, including infants and toddlers, are vaccinated each year at the start of the season, it’s hard to imagine how a gap year, or even two, would cause a significant increase in severe cases of this illness.
Agreed that the dynamics of next year’s flu and RSV season will provide significant evidence to support either the immunity gap or immunity theft hypothesis, depending. One might argue that such a wait and see approach would be very irresponsible public policy in the event that the immunity theft hypothesis turns out to be playing a significant role, however.
posted by eviemath at 9:03 PM on December 20, 2022 [2 favorites]
posted by eviemath at 9:03 PM on December 20, 2022 [2 favorites]
eviemath, I'm not seeing the connection between the stuff you quoted and the issue of why it isn't, say, older adults filling hospitals with RSV, if the root cause is some kind of COVID-mediated immune dysfunction -- since we know that older people are much more susceptible to COVID in other ways.
One might argue that such a wait and see approach would be very irresponsible public policy in the event that the immunity theft hypothesis turns out to be playing a significant role, however.
If I could pick the world where we were all still mitigating, I would absolutely do that. I think the approach we have taken as a society is imprudent and borne of selfish impulses we will probably pay for in ways we haven't fully reckoned yet, and I will never forgive Biden's administration for their considerable part in this. The reason I am pumping the brakes on accepting this particular narrative uncritically comes from a similar place: I have a conservative temperament and I worry that promoting science that is not widely accepted, in ways designed to trigger high emotion ("airborne AIDS"), will have negative consequences down the line. It's not like we're in a great place with public trust in science as it is.
posted by eirias at 9:22 PM on December 20, 2022
One might argue that such a wait and see approach would be very irresponsible public policy in the event that the immunity theft hypothesis turns out to be playing a significant role, however.
If I could pick the world where we were all still mitigating, I would absolutely do that. I think the approach we have taken as a society is imprudent and borne of selfish impulses we will probably pay for in ways we haven't fully reckoned yet, and I will never forgive Biden's administration for their considerable part in this. The reason I am pumping the brakes on accepting this particular narrative uncritically comes from a similar place: I have a conservative temperament and I worry that promoting science that is not widely accepted, in ways designed to trigger high emotion ("airborne AIDS"), will have negative consequences down the line. It's not like we're in a great place with public trust in science as it is.
posted by eirias at 9:22 PM on December 20, 2022
I did some poking around and voila:
That concern lies at the heart of a rolling, rancorous scientific debate, a lot of it conducted on Twitter. A person at the centre of the storm, sounding alarms about T cell “dysregulation” since the early days of the pandemic, has been a U.S. immunologist named Anthony Leonardi.
tyee article, "What If COVID Reinfections Wear Down Our Immunity?"
...
In January, sociologist and New York Times writer Zeynep Tufecki implied Leonardi was a solo outlier not to be trusted, tweeting:
“Reminder that not every crank is Galileo. Yes, experts can be wrong, even a field can be wrong — we saw with airborne — but challenges involve *groups* of actual working, publishing scientists.”
One of the barbs often tossed at Leonardi by critics is that he is not ensconced in a lab churning out results from experiments, so he doesn’t really belong to the club of researchers seriously trying to crack COVID. Leonardi is in fact a PhD accredited immunologist currently pursuing a master’s degree in public health.
So the context here is this OP is unknowingly passing on a very controversial topic (that overflowed from Twitter) divorced from that context. Some may find the hypothesis interesting on a theoretical level, but like otherwise, take it with a huge grain of salt.
Also, since I am a TWiV viewer it turns out people were already asking Racaniello about this as late as last week, and he has not seen strong evidence for that hypothesis: TWiV Q&A Dec. 7th.
posted by polymodus at 9:36 PM on December 20, 2022 [7 favorites]
That concern lies at the heart of a rolling, rancorous scientific debate, a lot of it conducted on Twitter. A person at the centre of the storm, sounding alarms about T cell “dysregulation” since the early days of the pandemic, has been a U.S. immunologist named Anthony Leonardi.
tyee article, "What If COVID Reinfections Wear Down Our Immunity?"
...
In January, sociologist and New York Times writer Zeynep Tufecki implied Leonardi was a solo outlier not to be trusted, tweeting:
“Reminder that not every crank is Galileo. Yes, experts can be wrong, even a field can be wrong — we saw with airborne — but challenges involve *groups* of actual working, publishing scientists.”
One of the barbs often tossed at Leonardi by critics is that he is not ensconced in a lab churning out results from experiments, so he doesn’t really belong to the club of researchers seriously trying to crack COVID. Leonardi is in fact a PhD accredited immunologist currently pursuing a master’s degree in public health.
So the context here is this OP is unknowingly passing on a very controversial topic (that overflowed from Twitter) divorced from that context. Some may find the hypothesis interesting on a theoretical level, but like otherwise, take it with a huge grain of salt.
Also, since I am a TWiV viewer it turns out people were already asking Racaniello about this as late as last week, and he has not seen strong evidence for that hypothesis: TWiV Q&A Dec. 7th.
posted by polymodus at 9:36 PM on December 20, 2022 [7 favorites]
Older people have worse accutr consequences for covid infection than young people. Do we have evidence that kids are less likely to get infected, instead of kids being less likey yo have symptoms, and if so severe ones. Plus vaccination came last to kids and boosters likewise. Maybe this immune gap rebound effect is the explanation and the apparent immune damage is either not to blame or not occuring. Lets hope more research is in the pipeline than just waiting til next year.
posted by anecdotal_grand_theory at 9:37 PM on December 20, 2022
posted by anecdotal_grand_theory at 9:37 PM on December 20, 2022
What’s being reported is that covid leaves your white blood cell count low for several months after infection
AFAICT this is absolutely not what is being reported. Though I admit I got frustrated after working through several of the links. But the whole framing is really horrible and (intentionally or not) quite misleading, and seems to have confused much of the commentary.
The first link is to a paper about long Covid (LC). It doesn't mention lymphopenia except in the intro, as an observation during the acute Covid infection. It then goes on to characterize pro-inflammatory markers, and some differences in types of immune cells1. It does not, for example, include lymphocytopenia in its findings.
Without even a paragraph break, the Merck manual report on lymphocytopenia is referenced. This refers to acute Covid infections, not LC, as above. If you've been primed from the write up to think that this is all about LC, I can get the confusion. But note even in the short write up the talk about lymphoctyopenia correlating with death--this makes no sense in the LC context (unless you think you get LC after you died of acute Covid?)
This is not a good opening. People got the idea that over 50% of people with Covid are walking around with low white blood cells 8 months later and that is not what either of these sources say!
Moving the through the rest, the papers linked to need to be read to see whether they are talking about acute Covid or LC. Spoiler: The scariest sounding stuff in all the papers I got through are from acute phase observations.
A lot of the LC stuff is describing biomarkers that change in the body after infection. They demonstrate some change, but the practical effect is not at all clear--I can guarantee you that if we could easily predict changes to humans from the way cells act in test tubes we'd have treatments for a lot more diseases right now.
I'm sorry, but this is a bad post and the discussion that follows has not redeemed it. The papers are poorly contextualized, and made it easy for commenters to misunderstand what is being said. Links between essentially unrelated events are implied. Alarmist language ("mirrors AIDS") is tossed out.
Basically what I see is some papers confirming that acute Covid is really bad and enumerating mechanisms by which it might kill you, and also some other groups are researching some avenues that allow further investigation into the the causes of LC (with no actual quantification of the impact LC has on human function.)
Since this comment is a bit combative, I feel like I should say I still wear a mask; in fact, I am often the only person in a room at work who is masked. The colleagues who go unmasked are frequently virologists, some I've worked with for decades. I wish they were masked, but thinking the papers here are some sort of compelling evidence in favor of masking is just not understanding the state of the science being presented.
1This is what sentences like "Naive T and B cells expressing low levels of CD127 and TIM-3 were detected in the MC and UHC groups but were absent in the LC group at months 3 and 8" mean. A lot of the paper seems to associating clusters of changes with Covid+ and Covid- people, which is opening up other avenues of study but is not remotely close to "oh, this mirrors AIDS."
posted by mark k at 9:37 PM on December 20, 2022 [36 favorites]
AFAICT this is absolutely not what is being reported. Though I admit I got frustrated after working through several of the links. But the whole framing is really horrible and (intentionally or not) quite misleading, and seems to have confused much of the commentary.
The first link is to a paper about long Covid (LC). It doesn't mention lymphopenia except in the intro, as an observation during the acute Covid infection. It then goes on to characterize pro-inflammatory markers, and some differences in types of immune cells1. It does not, for example, include lymphocytopenia in its findings.
Without even a paragraph break, the Merck manual report on lymphocytopenia is referenced. This refers to acute Covid infections, not LC, as above. If you've been primed from the write up to think that this is all about LC, I can get the confusion. But note even in the short write up the talk about lymphoctyopenia correlating with death--this makes no sense in the LC context (unless you think you get LC after you died of acute Covid?)
This is not a good opening. People got the idea that over 50% of people with Covid are walking around with low white blood cells 8 months later and that is not what either of these sources say!
Moving the through the rest, the papers linked to need to be read to see whether they are talking about acute Covid or LC. Spoiler: The scariest sounding stuff in all the papers I got through are from acute phase observations.
A lot of the LC stuff is describing biomarkers that change in the body after infection. They demonstrate some change, but the practical effect is not at all clear--I can guarantee you that if we could easily predict changes to humans from the way cells act in test tubes we'd have treatments for a lot more diseases right now.
I'm sorry, but this is a bad post and the discussion that follows has not redeemed it. The papers are poorly contextualized, and made it easy for commenters to misunderstand what is being said. Links between essentially unrelated events are implied. Alarmist language ("mirrors AIDS") is tossed out.
Basically what I see is some papers confirming that acute Covid is really bad and enumerating mechanisms by which it might kill you, and also some other groups are researching some avenues that allow further investigation into the the causes of LC (with no actual quantification of the impact LC has on human function.)
Since this comment is a bit combative, I feel like I should say I still wear a mask; in fact, I am often the only person in a room at work who is masked. The colleagues who go unmasked are frequently virologists, some I've worked with for decades. I wish they were masked, but thinking the papers here are some sort of compelling evidence in favor of masking is just not understanding the state of the science being presented.
1This is what sentences like "Naive T and B cells expressing low levels of CD127 and TIM-3 were detected in the MC and UHC groups but were absent in the LC group at months 3 and 8" mean. A lot of the paper seems to associating clusters of changes with Covid+ and Covid- people, which is opening up other avenues of study but is not remotely close to "oh, this mirrors AIDS."
posted by mark k at 9:37 PM on December 20, 2022 [36 favorites]
"No, COVID is not “airborne AIDS." But what it does to your immune system is still scary"
(Despite blunting the immune system, COVID is very unlike HIV. Experts say "airborne AIDS" is an irresponsible label)--Salon.com, Dec. 2. FTA:
Salon spoke with epidemiologists and immunologists about these theories about what COVID does to the immune system, and the "airborne AIDS" label. All of them said that calling SARS-2 "airborne AIDS" is deeply inaccurate, stigmatizing and just flat-out wrong. Yet they also cautioned that understanding what this virus actually does to the immune system is critical for developing protective therapies and keeping people safe as cases rise going into winter. And some researchers argue that not enough attention is being paid to how SARS-CoV-2 interacts with T cells.
Also note, the tyee.com article I linked above mentions the Merck documentation. Coincidence? So OP is knowingly or not, deriving their post of links uncritically from Twitterverse / social media news cycle. That's how misinformation propagates.
posted by polymodus at 10:28 PM on December 20, 2022 [11 favorites]
(Despite blunting the immune system, COVID is very unlike HIV. Experts say "airborne AIDS" is an irresponsible label)--Salon.com, Dec. 2. FTA:
Salon spoke with epidemiologists and immunologists about these theories about what COVID does to the immune system, and the "airborne AIDS" label. All of them said that calling SARS-2 "airborne AIDS" is deeply inaccurate, stigmatizing and just flat-out wrong. Yet they also cautioned that understanding what this virus actually does to the immune system is critical for developing protective therapies and keeping people safe as cases rise going into winter. And some researchers argue that not enough attention is being paid to how SARS-CoV-2 interacts with T cells.
Also note, the tyee.com article I linked above mentions the Merck documentation. Coincidence? So OP is knowingly or not, deriving their post of links uncritically from Twitterverse / social media news cycle. That's how misinformation propagates.
posted by polymodus at 10:28 PM on December 20, 2022 [11 favorites]
For example, every single mask I have tried on the market, barring a pre pandemic, construction style shell N95, does not seal around my prominent nose. I am simply unable to wear glasses with my masks,
Yeah, I have pretty much given up wearing my glasses when I have a mask on unless I absolutely have to, and go around nearsighted now. I canNOT seal around my nose (and it's a normal sized female nose) no matter how much I shove on the wires and it's a breathing balancing act if I'm wearing glasses at the theater or god help me, while driving. Nothing works on that problem to this day.
But...well, that is what it is. I'll never get a perfect fit or seal on a mask because noses don't do that, apparently. I do the best I can.
posted by jenfullmoon at 11:17 PM on December 20, 2022 [1 favorite]
Yeah, I have pretty much given up wearing my glasses when I have a mask on unless I absolutely have to, and go around nearsighted now. I canNOT seal around my nose (and it's a normal sized female nose) no matter how much I shove on the wires and it's a breathing balancing act if I'm wearing glasses at the theater or god help me, while driving. Nothing works on that problem to this day.
But...well, that is what it is. I'll never get a perfect fit or seal on a mask because noses don't do that, apparently. I do the best I can.
posted by jenfullmoon at 11:17 PM on December 20, 2022 [1 favorite]
Disability applications to the social security administration have been decreasing or flat over the last three years, so it's not showing up there, either.
I keep thinking about this point, because it's kind of weird that disability applications went down so drastically in the past couple of years. In 2020-2021, there were only about 85% as many applications as there were the previous five years. (Generally speaking the number of applications peaked a few years after the 2008 crash and has been declining ever since, but not typically by this much in this short a period of time.)
The SSA was going through some severe understaffing during that period, and were even more impossible to contact than usual (and usually they're pretty bad). It makes me wonder if the drop in applications has far more to do with office closures and a general lack of responsiveness. The SSI numbers also showed a drop in applications but an enormous rise in Pending Final Decision cases--again, signaling more of a processing problem than, say, the idea that fewer people were becoming disabled. I'm just not sure these numbers could be used as part of a discussion on how many people might have to leave the workforce due to long COVID.
posted by mittens at 5:05 AM on December 21, 2022 [6 favorites]
I keep thinking about this point, because it's kind of weird that disability applications went down so drastically in the past couple of years. In 2020-2021, there were only about 85% as many applications as there were the previous five years. (Generally speaking the number of applications peaked a few years after the 2008 crash and has been declining ever since, but not typically by this much in this short a period of time.)
The SSA was going through some severe understaffing during that period, and were even more impossible to contact than usual (and usually they're pretty bad). It makes me wonder if the drop in applications has far more to do with office closures and a general lack of responsiveness. The SSI numbers also showed a drop in applications but an enormous rise in Pending Final Decision cases--again, signaling more of a processing problem than, say, the idea that fewer people were becoming disabled. I'm just not sure these numbers could be used as part of a discussion on how many people might have to leave the workforce due to long COVID.
posted by mittens at 5:05 AM on December 21, 2022 [6 favorites]
I’m surprised this kind of misinformation about covid is allowed to stay on the blue. Covid does not “mirror AIDS.” And using AIDS as a scare tactic has obvious homophobic overtones.
posted by haptic_avenger at 5:48 AM on December 21, 2022 [7 favorites]
posted by haptic_avenger at 5:48 AM on December 21, 2022 [7 favorites]
keep thinking about this point, because it's kind of weird that disability applications went down so drastically in the past couple of years. In 2020-2021, there were only about 85% as many applications as there were the previous five years.
Disability claims have been going down since 2010 and the recent drop fits in with that pattern. Not to say the the understaffing didn't exist, but the drop during the pandemic was consistent with the pre-Covid pattern, and shows no sign of a massive long Covid created burst.
There's always a substantial number of pending cases in the latest year and the number in the current year is higher but not massively so than the 2018 number was in the 2019 report. In 2022, there were 331K pending cases left from 2021. In 2019, there were 245K pending cases left from 2018. Jumping back, in the 2014 report, there were 296K pending claims from 2013. So most of it is just the slowness of the system, not a pandemic created situation.
Again, it's hard to prove a negative, but the disabled claim numbers do nothing to show the positive -- that a large number of Americans are severely affected by long-COVID.
posted by Galvanic at 6:05 AM on December 21, 2022 [2 favorites]
Disability claims have been going down since 2010 and the recent drop fits in with that pattern. Not to say the the understaffing didn't exist, but the drop during the pandemic was consistent with the pre-Covid pattern, and shows no sign of a massive long Covid created burst.
There's always a substantial number of pending cases in the latest year and the number in the current year is higher but not massively so than the 2018 number was in the 2019 report. In 2022, there were 331K pending cases left from 2021. In 2019, there were 245K pending cases left from 2018. Jumping back, in the 2014 report, there were 296K pending claims from 2013. So most of it is just the slowness of the system, not a pandemic created situation.
Again, it's hard to prove a negative, but the disabled claim numbers do nothing to show the positive -- that a large number of Americans are severely affected by long-COVID.
posted by Galvanic at 6:05 AM on December 21, 2022 [2 favorites]
Ah, I completely skimmed over the mirroring AIDS part of the post when I read it because up here in Canada I have read a number of opinion pieces from a variety of doctors over the past two years saying they were worried about the possibility of COVID causing some mild immune theft (measles being the more common comparison I’ve read, AIDS being brought up just because people are generally much more familiar with it since the research on measles’ effects on kids immune systems for a couple years after infection is fairly new, but the articles I’ve read have all stressed that the effects of COVID are not in the same category as AIDS if they do bring it up), asking for more research in the area, and asking for a more cautious policy approach in the absence of confirmation that this wasn’t going to be a concern. In other words, what polymodus’ most recent link says. I can see where folks who haven’t had this on their radar before this week (or who spend way more time on Twitter than me, apparently?) are reacting more to the alarmist framing and confusing juxtaposition of the particular articles linked in the fpp.
As usual on Metafilter, we have a range of viewpoints expressed in the thread and it’s helpful not to conflate everything to one side of your viewpoint with the most extreme end of the scale.
(Also, maybe don’t get your pandemic news from Twitter? It seems to be bad for the blood pressure.)
posted by eviemath at 6:23 AM on December 21, 2022 [2 favorites]
As usual on Metafilter, we have a range of viewpoints expressed in the thread and it’s helpful not to conflate everything to one side of your viewpoint with the most extreme end of the scale.
(Also, maybe don’t get your pandemic news from Twitter? It seems to be bad for the blood pressure.)
posted by eviemath at 6:23 AM on December 21, 2022 [2 favorites]
I now see cans of inhalable "oxygen" for sale at Lowes. I don't remember if this was a thing pre-pandemic,
jfc this was actually a one-off gag in Spaceballs.
posted by mhoye at 7:16 AM on December 21, 2022 [3 favorites]
jfc this was actually a one-off gag in Spaceballs.
posted by mhoye at 7:16 AM on December 21, 2022 [3 favorites]
eirias, from what I’ve read, RSV is typically only a major risk for infants, not for older people. So any immune theft effects we’re seeing from COVID wouldn’t cause more RSV in the over 70 crowd than in the 6-69 population. Also, not to be too morbid, but a lot of folks in the over 70 population who might have been filling up hospitals with other respiratory infections this year have already succumbed to COVID. Eg. my province’s vaccine-adjusted data that people over 70 are around 270 times more likely to die of COVID than people under 50.
Everything I’ve read also says that it’s not immune gap versus immune theft as exclusively one of the other - that we know that there is an immune gap for infants 2 and under which is contributing to high RSV caseloads this year, but that the magnitude and severity of cases, between RSV and flu, is not sufficiently explained only by immune gap, and thus immune theft may also be contributing. (It may be some other weird population dynamics thing! But the magnitude of effect and increased rate of severe flu cases among age cohorts not affected by immune gap issues don’t seem to be solely attributable to immune gap.) But now that I better understand some of you all’s objections, I will clearly include the caveat that this isn’t saying that everyone’s immune system will be weakened from having COVID, just that it may be happening at some rate that is having the population level effects we’re seeing, and that we don’t have sufficient alternative hypotheses nor data to rule out some immune theft effect.
Perhaps where the sense of urgency that folks are picking up on is coming from is that our children’s hospitals up here in Canada are now at something like 1.5 times capacity. Our health care systems overall are stressed beyond capacity. And that’s before we even mention current medication shortages. The Canadian provincial systems are mostly set up to have family doctors as the first point of contact, but a significant percentage of Canadians are now without a family doctor. That leaves other options for non-emergency health care inaccessible in some cases - for example, in my health district, there are no walk-in, non-emergency clinics. There are only a handful in my entire province, which operate only at certain times, and have regularly been having to turn away the majority of people who show up to wait in line before they open for a chance at getting seen that day. The clinics that are available outside of the handful of walk-in clinics require that you call in the morning to get an appointment in the evening, and there’s no phone queue, so if you get a busy line you have to hang up and re-dial. In my experience, this generally means a rapid-fire call, hang up, redial process where I end up calling over 100 times over the better part of an hour before finally reaching someone and then having a 50-50 chance of having randomly been picked up on in time to actually get an appointment. There’s an online option which has similarly low rates of actually being able to access care for each attempt. And there have been a few recent news reports about adult patients seeking care but dying in over-crowded emergency room wait rooms in some provinces because of this overall system stress, as well.
I grew up in the US, without health insurance more often than not and without a family doctor, so medical care was sometimes inaccessible in different ways. And I’ve regularly read reports my whole life about people being turned away from hospital emergency rooms in the US due to inability to pay (eg. getting sent by taxi to LA’s skid row instead, in one memorable report from a decade or so ago). But that’s very much not the societal expectation in Canada - in fact, it quite horrifies people up here. And there is also something particularly frustrating about being prevented from accessing medical care by logistics even though technically one is allowed or due access, versus knowing ahead of time/in general that I’m not going to be able to have access because the US doesn’t think (as a country-wide policy decision) that lower income families deserve medical care.
So: there’s a significant systemic problem this year. The people who have always been at higher risk from medical things in general are also at risk from this problem, and the people who have always been at lower risk are still only minimally affected. The cause might be an immunity theft effect from COVID on top of the immunity gap issue that is affecting infants and toddlers - the effects we’re seeing would be consistent with this hypothesis, and some preliminary evidence from how COVID can potentially affect the body indicates that there may be some possible mechanisms, but we don’t have sufficient evidence yet to either rule it out or know for certain that it is part of the problem. It’s definitely not directly affecting the majority of people, but something is happening at a sufficiently increased rate that it is having severe effects on our health care systems overall, which is then also causing secondary harms to the majority of people through decreased access to health care overall. Thus the sense of urgency in discussions around the COVID immunity theft hypothesis. I do wish that we, as a culture in general, could distinguish between individual and systemic threats better, while also keeping a sense of urgency for systemic threats.
posted by eviemath at 7:29 AM on December 21, 2022 [7 favorites]
Everything I’ve read also says that it’s not immune gap versus immune theft as exclusively one of the other - that we know that there is an immune gap for infants 2 and under which is contributing to high RSV caseloads this year, but that the magnitude and severity of cases, between RSV and flu, is not sufficiently explained only by immune gap, and thus immune theft may also be contributing. (It may be some other weird population dynamics thing! But the magnitude of effect and increased rate of severe flu cases among age cohorts not affected by immune gap issues don’t seem to be solely attributable to immune gap.) But now that I better understand some of you all’s objections, I will clearly include the caveat that this isn’t saying that everyone’s immune system will be weakened from having COVID, just that it may be happening at some rate that is having the population level effects we’re seeing, and that we don’t have sufficient alternative hypotheses nor data to rule out some immune theft effect.
Perhaps where the sense of urgency that folks are picking up on is coming from is that our children’s hospitals up here in Canada are now at something like 1.5 times capacity. Our health care systems overall are stressed beyond capacity. And that’s before we even mention current medication shortages. The Canadian provincial systems are mostly set up to have family doctors as the first point of contact, but a significant percentage of Canadians are now without a family doctor. That leaves other options for non-emergency health care inaccessible in some cases - for example, in my health district, there are no walk-in, non-emergency clinics. There are only a handful in my entire province, which operate only at certain times, and have regularly been having to turn away the majority of people who show up to wait in line before they open for a chance at getting seen that day. The clinics that are available outside of the handful of walk-in clinics require that you call in the morning to get an appointment in the evening, and there’s no phone queue, so if you get a busy line you have to hang up and re-dial. In my experience, this generally means a rapid-fire call, hang up, redial process where I end up calling over 100 times over the better part of an hour before finally reaching someone and then having a 50-50 chance of having randomly been picked up on in time to actually get an appointment. There’s an online option which has similarly low rates of actually being able to access care for each attempt. And there have been a few recent news reports about adult patients seeking care but dying in over-crowded emergency room wait rooms in some provinces because of this overall system stress, as well.
I grew up in the US, without health insurance more often than not and without a family doctor, so medical care was sometimes inaccessible in different ways. And I’ve regularly read reports my whole life about people being turned away from hospital emergency rooms in the US due to inability to pay (eg. getting sent by taxi to LA’s skid row instead, in one memorable report from a decade or so ago). But that’s very much not the societal expectation in Canada - in fact, it quite horrifies people up here. And there is also something particularly frustrating about being prevented from accessing medical care by logistics even though technically one is allowed or due access, versus knowing ahead of time/in general that I’m not going to be able to have access because the US doesn’t think (as a country-wide policy decision) that lower income families deserve medical care.
So: there’s a significant systemic problem this year. The people who have always been at higher risk from medical things in general are also at risk from this problem, and the people who have always been at lower risk are still only minimally affected. The cause might be an immunity theft effect from COVID on top of the immunity gap issue that is affecting infants and toddlers - the effects we’re seeing would be consistent with this hypothesis, and some preliminary evidence from how COVID can potentially affect the body indicates that there may be some possible mechanisms, but we don’t have sufficient evidence yet to either rule it out or know for certain that it is part of the problem. It’s definitely not directly affecting the majority of people, but something is happening at a sufficiently increased rate that it is having severe effects on our health care systems overall, which is then also causing secondary harms to the majority of people through decreased access to health care overall. Thus the sense of urgency in discussions around the COVID immunity theft hypothesis. I do wish that we, as a culture in general, could distinguish between individual and systemic threats better, while also keeping a sense of urgency for systemic threats.
posted by eviemath at 7:29 AM on December 21, 2022 [7 favorites]
eviemath: RSV hospitalization rates for seniors 10 times higher than usual at this point in the respiratory illness season.
posted by cooker girl at 7:34 AM on December 21, 2022 [8 favorites]
posted by cooker girl at 7:34 AM on December 21, 2022 [8 favorites]
eviemath, I think it is absolutely critical for scientists to shut down alarmist framings of things. It isn’t that this question wasn’t on my radar, I have been wondering about this for months. It’s that I don’t trust either the people who wrote the editorial you cited or the framing in the post itself. Those are both reasonable things to push back on.
But the stuff in your most recent comment — I agree with much of that. The US is having a pediatric hospital crisis too and I think it’s been going on for months. I am watchful, and worried about ways in which our choices may have precipitated this; and my bias is that allowing mass sickness in perpetuity has to be worse than preventing it. But many things I wonder about or worry about turn out not to be true.
posted by eirias at 7:36 AM on December 21, 2022 [1 favorite]
But the stuff in your most recent comment — I agree with much of that. The US is having a pediatric hospital crisis too and I think it’s been going on for months. I am watchful, and worried about ways in which our choices may have precipitated this; and my bias is that allowing mass sickness in perpetuity has to be worse than preventing it. But many things I wonder about or worry about turn out not to be true.
posted by eirias at 7:36 AM on December 21, 2022 [1 favorite]
(Thanks for the link, cooler girl. I recalled reading that RSV was also more prevalent in all age ranges this year. But I don’t know if the 10x number applies across the board or if that is higher than for other non-infant/toddler age groups - I’ll try to find something to either confirm or refute that. But it would seem to make sense that seniors would also be more affected by RSV than 18-50 year olds.)
posted by eviemath at 7:45 AM on December 21, 2022
posted by eviemath at 7:45 AM on December 21, 2022
Er, cooker, not cooler. Missed the edit window; apologies.
posted by eviemath at 7:58 AM on December 21, 2022 [1 favorite]
posted by eviemath at 7:58 AM on December 21, 2022 [1 favorite]
The pediatric hosptial bed shortage is due to deliberate efforts by hospital systems to increase profits that well predates the RSV surge. Anyone who thinks the “crisis” in hospitals is due to people not masking has fallen for a line that I’m sure hospital administrators just love.
posted by haptic_avenger at 8:31 AM on December 21, 2022 [9 favorites]
posted by haptic_avenger at 8:31 AM on December 21, 2022 [9 favorites]
to be fair, from everything I see and from anyone I know working in hospitals, the crisis is not due to a single factor (Canadian context)
we are certainly seeing mismanagement, but higher-than-normal intakes due to e.g. RSV (esp. pediatric care) on top of the intense pressures on frontline staff over the past 3 years, have taken a toll
posted by elkevelvet at 8:58 AM on December 21, 2022 [2 favorites]
we are certainly seeing mismanagement, but higher-than-normal intakes due to e.g. RSV (esp. pediatric care) on top of the intense pressures on frontline staff over the past 3 years, have taken a toll
posted by elkevelvet at 8:58 AM on December 21, 2022 [2 favorites]
I think it is absolutely critical for scientists to shut down alarmist framings of things.
An instinct that has worked out just splendidly in other contexts, e.g., climate change.
posted by joedan at 9:55 AM on December 21, 2022 [1 favorite]
An instinct that has worked out just splendidly in other contexts, e.g., climate change.
posted by joedan at 9:55 AM on December 21, 2022 [1 favorite]
There's a sort of "didn't think of that, did ya?" contrarianism that I see a lot of online but especially on MetaFilter. Anyone not wearing a mask could have asthma. Anyone not shaving their beard for a better mask fit does so because they are a devout Sikh.
It's like being told the BMW that cut you off on the freeway going 20 over the limit and no turn signal could be a doctor rushing to the hospital to delivery a baby, therefore you shouldn't be annoyed at them. As long as some possibility doesn't violate the laws of physics, someone treats it as likely.
I've commented on this tendency before, using the comparison of anti-vaxxers who say "getting the covid shot doesn't keep you from getting covid" and, after a sigh, knowing you'll have to "yes, but" and point out the obvious but probably not be listened to anyway.
Thank you, bottlecap, for assembling this informative post and to many-things for the https://cantlivewithcovid.com link.
posted by AlSweigart at 1:26 PM on December 21, 2022 [8 favorites]
It's like being told the BMW that cut you off on the freeway going 20 over the limit and no turn signal could be a doctor rushing to the hospital to delivery a baby, therefore you shouldn't be annoyed at them. As long as some possibility doesn't violate the laws of physics, someone treats it as likely.
I've commented on this tendency before, using the comparison of anti-vaxxers who say "getting the covid shot doesn't keep you from getting covid" and, after a sigh, knowing you'll have to "yes, but" and point out the obvious but probably not be listened to anyway.
Thank you, bottlecap, for assembling this informative post and to many-things for the https://cantlivewithcovid.com link.
posted by AlSweigart at 1:26 PM on December 21, 2022 [8 favorites]
It's like being told the BMW that cut you off on the freeway going 20 over the limit and no turn signal could be a doctor rushing to the hospital to delivery a baby
They just didn't pay the additional charge to have their turn signals turned on. I hear it's quite expensive which is why most BMW drivers don't pay for it.
posted by any portmanteau in a storm at 1:41 PM on December 21, 2022 [1 favorite]
They just didn't pay the additional charge to have their turn signals turned on. I hear it's quite expensive which is why most BMW drivers don't pay for it.
posted by any portmanteau in a storm at 1:41 PM on December 21, 2022 [1 favorite]
There's a sort of "didn't think of that, did ya?" contrarianism that I see a lot of online but especially on MetaFilter.
It’s not contrarianism or edge cases. The vast majority of people don’t assess the risk of covid as worth masking or avoiding crowds. I live in an extremely left, well-educated and covid-cautious place, and basically nobody masks themselves or their kids. It’s an important fact to consider. It seems hard to conclude that everyone severely misunderstands the costs and benefits, or is severely morally deficient.
posted by haptic_avenger at 1:43 PM on December 21, 2022 [4 favorites]
It’s not contrarianism or edge cases. The vast majority of people don’t assess the risk of covid as worth masking or avoiding crowds. I live in an extremely left, well-educated and covid-cautious place, and basically nobody masks themselves or their kids. It’s an important fact to consider. It seems hard to conclude that everyone severely misunderstands the costs and benefits, or is severely morally deficient.
posted by haptic_avenger at 1:43 PM on December 21, 2022 [4 favorites]
There's a sort of "didn't think of that, did ya?" contrarianism
I've noticed that as well: "it can't be that case counts are actually down, it's just that they're undercounts." " I don't care about those stats on fatalities, what about long-COVID?" "That person you walked by outside without a mask on is definitely immunocompromised, you heartless jerk."
posted by Galvanic at 1:49 PM on December 21, 2022 [4 favorites]
I've noticed that as well: "it can't be that case counts are actually down, it's just that they're undercounts." " I don't care about those stats on fatalities, what about long-COVID?" "That person you walked by outside without a mask on is definitely immunocompromised, you heartless jerk."
posted by Galvanic at 1:49 PM on December 21, 2022 [4 favorites]
The vast majority of people don’t assess the risk of covid as worth masking or avoiding crowds.
The vast majority of people have either had it by now or been around many others who have, and are basing their opinions of it on what it was like in the short term. "I didn't end up in the hospital last time, I didn't get horrible long COVID symptoms from it, I wasn't disabled by it, and therefore I'm not one of the people who will be capable of being disabled by it next time."
And if they're vaccinated, which most people are, there's some truth to that. They are carrying some protection with them. They are likely to avoid the worst potential complications.
And so fatigue sets in. If I didn't get it bad when I took precautions, I won't get it bad when I go without them just this one time, right? Or just at these certain stores? Or just around these sets of people in these circumstances?
The vast majority of people are also not very good at interpreting "low probability" as "low" and not "no probability." Most of them will avoid finding that out the hard way. But the AD&D players among us understand how no matter how talented you are with the dice, a natural 1 is always lurking out there, waiting to be rolled.
posted by delfin at 2:11 PM on December 21, 2022 [8 favorites]
The vast majority of people have either had it by now or been around many others who have, and are basing their opinions of it on what it was like in the short term. "I didn't end up in the hospital last time, I didn't get horrible long COVID symptoms from it, I wasn't disabled by it, and therefore I'm not one of the people who will be capable of being disabled by it next time."
And if they're vaccinated, which most people are, there's some truth to that. They are carrying some protection with them. They are likely to avoid the worst potential complications.
And so fatigue sets in. If I didn't get it bad when I took precautions, I won't get it bad when I go without them just this one time, right? Or just at these certain stores? Or just around these sets of people in these circumstances?
The vast majority of people are also not very good at interpreting "low probability" as "low" and not "no probability." Most of them will avoid finding that out the hard way. But the AD&D players among us understand how no matter how talented you are with the dice, a natural 1 is always lurking out there, waiting to be rolled.
posted by delfin at 2:11 PM on December 21, 2022 [8 favorites]
Judging from my circles, in a part of Canada that had very good vaccine uptake and compliance with mask mandates when that was a thing, the vast majority of people don’t pay all that much attention to COVID news and just do what the news tells them that the government tells them they need to do. Which is currently basically nothing, including not even getting their COVID boosters this fall for half the population, because the public health campaigns for boosters and for voluntary masking have been relatively abysmal. And an awful lot of people I’ve heard discuss our emergency room issues currently believe the scientifically inaccurate misunderstanding of immunity debt and think that that’s what’s causing the current RSV and flu situation. They also significantly underestimate the current prevalence of COVID, according to wastewater sampling and what our actual public health officials who have access to all of the data are saying is our current prevalence of COVID. And people in general are not great at untrained, intuitive reasoning about complex systems where everyone’s small local actions add up to a global effect, so often fail miserably at prisoner’s dilemma style situations (no judgement on that - the human brain is very good at making direct inferences and direct pattern-finding, but lots of things are called paradoxes in probabilistic reasoning or emergent reasoning because that’s simply not what our brains are adapted for). Based on observed outcomes so far, people in my circles aren’t so far off in their estimates of likelihood of severe outcomes from getting COVID on a personal level, and they notice that the systemic issues are negatively impacting themselves or people they know and care about, but connecting the two is the missing component.
posted by eviemath at 6:38 PM on December 21, 2022 [7 favorites]
posted by eviemath at 6:38 PM on December 21, 2022 [7 favorites]
Whatever is going on with social media is beyond the scope of why I think this matters. I have been pretty deeply involved in HIV and AIDS research for years, and it’s the number of HIV researchers who are raising alarm bells that has me on alert. My hope is for people to recognize the danger and use harm mitigation strategies - in the same way we asked people to start wearing condoms, it makes sense to wear masks and create clean indoor air. Harm reduction has *always* been controversial in the United States and many parts of the world. It doesn’t surprise me that the same kind of black and white thinking is applied here. Especially because a central tenant of harm reduction is recognizing a communal responsibility, yes even for ~those people~, which is anathema to people on all sides of the political spectrum.
In Cleveland and beyond researchers begin to unravel the mystery of long COVID-19
In Cleveland and beyond researchers begin to unravel the mystery of long COVID-19
McComsey, who has spent the last two decades studying HIV, said that the data they have found so far paints a picture that is eerily familiar.posted by Bottlecap at 9:25 PM on December 21, 2022 [11 favorites]
“Now I just look at it, and I’m like gosh, it’s like a déjà vu,” McComsey said.
If the idea that the behavior of the SARS-CoV-2 virus might have any similarities to HIV is news to you, you aren’t alone. But McComsey said that for the HIV researchers who have made the crossover to studying this new coronavirus, the similarities that emerged were unmistakable.
To be clear, McComsey isn’t suggesting that the viruses themselves are similar. Coronaviruses are not retroviruses like HIV, nor are they sexually transmitted like HIV. But it’s the way they make the people they infect sick that caught her attention. It hides in the body and continues to wreak havoc in the various organ system by driving inflammation and disrupting the immune response.
“HIV patients don’t die from the virus itself. They die from immune activation – from the high levels of inflammation that causes cancer, heart disease, liver and kidney disease,” she said.
“The only reason we cannot cure HIV is because the virus hides where the HIV drugs can’t go in. So it continues to fuel this high inflammation. That’s why somebody like me who has been studying HIV for the last 20 years found that COVID is extremely similar to HIV. It’s a virus that produces a lot of inflammation. We see a lot of conditions that are known to stem from inflammation, and now we have some evidence that it persists in different organs.”
McComsey is referring to various published research papers that suggest the SARS-Cov-2 may linger in various organ tissues long after nasal swabs and blood tests come back negative.
An early pre-print autopsy study from the NIH has found the virus throughout the body – in a wide range of tissues including muscle, fat, gut, and brain tissue of patients who died with COVID, and in some cases in those who were asymptomatic, or had mild infections and died many months later. This proving, the authors say, that SARS-Cov-2 is capable of persisting in the body for many months after infection.
Another study further suggests that the SARS-Cov2 virus may have stolen yet another page from the HIV playbook, hijacking ancient and normally dormant human DNA sequences to reverse engineer its viral RNA and insert itself into the genomes of our cells.
Although the paper was originally met with a firestorm of criticism, some scientists do not find their theory so implausible, McComsey among them.
“It is a big possibility,” she said. “I would say it is very possible, even likely.”
This has resulted in fearmongering about the possibility that RNA-based COVID sequences in vaccines might somehow integrate themselves into our DNA via the same mechanism. Due to the fact that vaccines only contain a small portion of the complete viral sequence, the authors, and most scientists agree this is unlikely.
Immune systems seriously weakened by COVID — Evolving research says COVID leaves many people at heightened risk for other infections
The only other virus that attacks and kills T-cells is HIV, which causes AIDS, said Katzenback.posted by joedan at 11:38 PM on December 21, 2022 [8 favorites]
To be clear, nobody is equating COVID’s impact on T-cells to what HIV did to immune systems before effective retroviral treatments were developed. But COVID-19 does eliminate a significant number of T-cells, enough to make large numbers of sick people overwhelm emergency wards with RSV (respiratory syncytial virus), pneumonia, strep infections and other ailments.
“With the loss of these T-cells, we are now more vulnerable to all of these other infections, other viruses, other bacteria,” said Katzenback.
“They are getting in and causing disease — and often more severe disease than what we might have seen previously,” said Katzenback.
She said COVID-19 sparks what is called “programmed cell death” among T-cells.
Cells in the human body do this naturally as they age, but COVID-19 causes healthy T-cells to die that would otherwise be available to fight off infections.
“The fallout from all of this is more secondary infections, more extreme infections and mortality, or people dying because of these infections,” said Katzenback.
Thanks Bottlecap — McComsey is the kind of voice I’m most interested in hearing here, with a long history of relevant publications.
posted by eirias at 2:39 AM on December 22, 2022 [3 favorites]
posted by eirias at 2:39 AM on December 22, 2022 [3 favorites]
I think this thread by Dr. Ben Mazer puts some good perspective on this issue. This is clearly an area of active research, and as with most medical research, it is rare that an issue is fully resolved with a few papers, and in research done with small sample sizes it is pretty challenging to distinguish whether you have a real signal. We're a long way from consensus on this one.
posted by ch1x0r at 8:29 AM on December 22, 2022 [5 favorites]
posted by ch1x0r at 8:29 AM on December 22, 2022 [5 favorites]
“I’ve removed all of the labeling data that you would use to determine if a graph is showing you something statistically significant. See if you can tell if there is a statistically significant difference.” is certainly … an approach to public science communication.
posted by eviemath at 8:50 AM on December 22, 2022
posted by eviemath at 8:50 AM on December 22, 2022
Like, it would be helpful in the first post on that Mazer Twitter thread if he at least told his audience whether they were supposed to be looking for differences or lack thereof between left, middle, and right columns on each graph, or if they were supposed to be comparing the same column across the multiple graphs shown, at the very least, given that lots of folks on Twitter aren’t going to recognize the shorthand axis labels. Statistics is not my area of expertise within the mathematical sciences, but I do teach a course that involves basic data visualization and descriptive statistics, and I can tell you that many folks won’t even look at the axis labeling or know/think to compare scales, and that’s assuming that the scale in each graph measures the same thing/is commensurate in each case (folks have an even harder time interpreting graphs where the scales are measuring different things). So his audience could draw opposite conclusions depending on which comparison each person was making.
posted by eviemath at 9:00 AM on December 22, 2022
posted by eviemath at 9:00 AM on December 22, 2022
The graphs in the second post give slightly more useful labelling, so we at least can tell that we’re supposed to compare the three columns against each other in each graph. But a lot more context is needed to understand the consequences of the different distributions shown. Eg. if for most people, COVID-19 infection does my change the immune markers studied, but there is a tail of outliers that is not present without COVID-19 infection, that could be hidden or not considered statistically significant if you look at some measures of the data, yet also still represent enough people to be causing our systemic issues on the scale of country populations. That’s a really interesting point to make, and the graphs could potentially be very useful in helping the general public understand the situation if so!
One could also get into the difference between a median and a mean, and how you might use each in personal decision-making: medians are less influenced by outlying data points, so eg. median chance of getting mad cow disease at the height of the last outbreak was still vanishingly small; but we tend to intuitively make rough expected value calculations when assessing risk, weighting the probabilities with the severity of outcome, and the severity of outcome for getting mad cow - incurable brain-eating disease with rapid decline - is pretty severe, so most folks would worry more about it than about other equally unlikely risks with less severe outcomes, and depending on how one numeritized things (eg. if we’re looking at expected lifespan versus a binary getting/not getting infected), that could end up reflected in a mean calculation.
Not knowing the number of data points (yes, there are dots, but is each dot one individual? 10? 100? more?) also is one of the details that make it impossible to just read off from a minimally labelled graph whether a difference is statistically significant or not, but which his audience may not know to wonder about. (Funny story: I read a student paper once that did full descriptive statistics for data sets including one to three data points. Yep. That was an undergrad honours thesis paper, and the student’s supervisor in their non-math/stats but still in the sciences field of study didn’t flag that as problematic. Guarantee you it’s not on the radar of your average Twitter reader.)
posted by eviemath at 9:20 AM on December 22, 2022
One could also get into the difference between a median and a mean, and how you might use each in personal decision-making: medians are less influenced by outlying data points, so eg. median chance of getting mad cow disease at the height of the last outbreak was still vanishingly small; but we tend to intuitively make rough expected value calculations when assessing risk, weighting the probabilities with the severity of outcome, and the severity of outcome for getting mad cow - incurable brain-eating disease with rapid decline - is pretty severe, so most folks would worry more about it than about other equally unlikely risks with less severe outcomes, and depending on how one numeritized things (eg. if we’re looking at expected lifespan versus a binary getting/not getting infected), that could end up reflected in a mean calculation.
Not knowing the number of data points (yes, there are dots, but is each dot one individual? 10? 100? more?) also is one of the details that make it impossible to just read off from a minimally labelled graph whether a difference is statistically significant or not, but which his audience may not know to wonder about. (Funny story: I read a student paper once that did full descriptive statistics for data sets including one to three data points. Yep. That was an undergrad honours thesis paper, and the student’s supervisor in their non-math/stats but still in the sciences field of study didn’t flag that as problematic. Guarantee you it’s not on the radar of your average Twitter reader.)
posted by eviemath at 9:20 AM on December 22, 2022
(And now I’ve probably derailed the thread in the direction of complaining about lack of statistics understanding among researchers and the general public… sorry, I’ll stop here!)
posted by eviemath at 9:21 AM on December 22, 2022
posted by eviemath at 9:21 AM on December 22, 2022
A TV show recently filmed in a huge, huge building near me that is open to the public (for working, eating, markets). It is more open air than a Home Depot.
I worked from that space one day this month as they were getting ready to film (there was also a holiday market going on). You could tell who the TV production people were vs. the general public because they were all masked. I've seen/read about other productions that very masked, include very active/regular COVID testing.
My takeaway is that TV production is much more concerned about COVID protocols than local goverment, society, etc.
(I'm a big masker, if we ever get out of this I will still mask on planes because WOW I do not get sick from planes anymore and WOW listening to everyone cough/sniffle on a plane is gross)
posted by armacy at 11:14 AM on December 22, 2022 [12 favorites]
I worked from that space one day this month as they were getting ready to film (there was also a holiday market going on). You could tell who the TV production people were vs. the general public because they were all masked. I've seen/read about other productions that very masked, include very active/regular COVID testing.
My takeaway is that TV production is much more concerned about COVID protocols than local goverment, society, etc.
(I'm a big masker, if we ever get out of this I will still mask on planes because WOW I do not get sick from planes anymore and WOW listening to everyone cough/sniffle on a plane is gross)
posted by armacy at 11:14 AM on December 22, 2022 [12 favorites]
Thanks for sharing those plots, ch1x0r. When I talk about the whole iceberg, plots like those are part of what I want to see. For those who want more details (like actual labels; I agree that removing them was a little gimmicky) the full article they come from is linked here.
More iceberg questions -- how representative are these patients of the full spectrum of COVID? My guess is not very (this is common but complicates inference). And this paper relates biomarkers to one clinical variable having to do with COVID status, but I want to know about a different clinical variable, how these markers relate to a person's propensity to catch other infectious diseases e.g. over the next year. (This isn't a flaw in the paper: its aim was to characterize long COVID.) I'd be curious if anyone has done that. Maybe this is not a novel question, though (this is one of the dangers of reading outside one's field).
In terms of the iceberg of the scientific record and the main aims of this paper, which sorta came up with bupkis, I will say there have been other papers that, IIRC, did find what looked like plausible biomarkers for long COVID -- here is one (caveat: preprint). Another reminder that one study never says it all.
posted by eirias at 2:53 PM on December 22, 2022
More iceberg questions -- how representative are these patients of the full spectrum of COVID? My guess is not very (this is common but complicates inference). And this paper relates biomarkers to one clinical variable having to do with COVID status, but I want to know about a different clinical variable, how these markers relate to a person's propensity to catch other infectious diseases e.g. over the next year. (This isn't a flaw in the paper: its aim was to characterize long COVID.) I'd be curious if anyone has done that. Maybe this is not a novel question, though (this is one of the dangers of reading outside one's field).
In terms of the iceberg of the scientific record and the main aims of this paper, which sorta came up with bupkis, I will say there have been other papers that, IIRC, did find what looked like plausible biomarkers for long COVID -- here is one (caveat: preprint). Another reminder that one study never says it all.
posted by eirias at 2:53 PM on December 22, 2022
It seems hard to conclude that everyone severely misunderstands the costs and benefits, or is severely morally deficient.
Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2 infection, and yet most people refuse to wear a mask. Everyone severely misunderstanding the costs and benefits of masking is not only easy to conclude, but obvious.
(This "everyone" doesn't apply to Japan, where the overwhelming majority of people have no problem wearing a mask in public still.)
posted by AlSweigart at 10:17 PM on December 22, 2022 [3 favorites]
Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2 infection, and yet most people refuse to wear a mask. Everyone severely misunderstanding the costs and benefits of masking is not only easy to conclude, but obvious.
(This "everyone" doesn't apply to Japan, where the overwhelming majority of people have no problem wearing a mask in public still.)
posted by AlSweigart at 10:17 PM on December 22, 2022 [3 favorites]
Although the paper was originally met with a firestorm of criticism, some scientists do not find their theory so implausible, McComsey among them.
“It is a big possibility,” she said. “I would say it is very possible, even likely.”
Again, that's the kind of irresponsible media rhetoric I'm talking about. It's purposefully vague, devoid of nuance and context, and evidence-free (e.g., "likely"? then calculate a probability, please).
The precautionary principle itself has to be based on sound science. Not based on whatever subgroup of scientists' current hypothesis is. To base it on speculation would damage both science and social policy.
posted by polymodus at 1:38 AM on December 23, 2022 [2 favorites]
“It is a big possibility,” she said. “I would say it is very possible, even likely.”
Again, that's the kind of irresponsible media rhetoric I'm talking about. It's purposefully vague, devoid of nuance and context, and evidence-free (e.g., "likely"? then calculate a probability, please).
The precautionary principle itself has to be based on sound science. Not based on whatever subgroup of scientists' current hypothesis is. To base it on speculation would damage both science and social policy.
posted by polymodus at 1:38 AM on December 23, 2022 [2 favorites]
Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2 infection, and yet most people refuse to wear a mask. Everyone severely misunderstanding the costs and benefits of masking is not only easy to conclude, but obvious.
What you’re ignoring is the costs of masking and avoiding indoor crowds. And I just don’t think you’re correct that the impact of covid is “severe” on the vast majority. Everyone I know went through covid just fine with no “immunological dysfunction.” I don’t see the evidence of severity; nor do I see the evidence for masks.
I guess what I’m trying to say is, if your aim is to influence behavior to obtain a public health goal, you need to be much more realistic and honest about the costs and benefits. And, you need to accept that other people (reasonable, good people!) have a different risk tolerance than you, and assess risk/benefit differently.
Right now, the action that makes the most sense is continued work on vaccines and therepeutics, and public health campaigns to boost the most vulnerable. Being fixated on masks or fear-based metaphors “airborne HIV!!” seems more about a need to position yourself as a Cassandra than anything else.
posted by haptic_avenger at 5:15 AM on December 23, 2022 [5 favorites]
What you’re ignoring is the costs of masking and avoiding indoor crowds. And I just don’t think you’re correct that the impact of covid is “severe” on the vast majority. Everyone I know went through covid just fine with no “immunological dysfunction.” I don’t see the evidence of severity; nor do I see the evidence for masks.
I guess what I’m trying to say is, if your aim is to influence behavior to obtain a public health goal, you need to be much more realistic and honest about the costs and benefits. And, you need to accept that other people (reasonable, good people!) have a different risk tolerance than you, and assess risk/benefit differently.
Right now, the action that makes the most sense is continued work on vaccines and therepeutics, and public health campaigns to boost the most vulnerable. Being fixated on masks or fear-based metaphors “airborne HIV!!” seems more about a need to position yourself as a Cassandra than anything else.
posted by haptic_avenger at 5:15 AM on December 23, 2022 [5 favorites]
And, you need to accept that other people (reasonable, good people!) have a different risk tolerance than you, and assess risk/benefit differently.
I mean this as a general comment, not pointing at anyone specific here and certainly not asking anyone to justify themselves. But every time I read the kinds of ultra-strict and sometimes moralistic comments focused on covid risks that pop up in these threads, I wonder if that person ever engaged in sex that wasn't risk free, rode in a car with a driver who had drank a few beers, took a party drug of unknown purity, or anything else like that. In other words, is that person genuinely committed to practicing risk reduction in every facet of their life, or is it the novelty and uncertainty of covid that they are focused on?
posted by Dip Flash at 6:37 AM on December 23, 2022 [5 favorites]
I mean this as a general comment, not pointing at anyone specific here and certainly not asking anyone to justify themselves. But every time I read the kinds of ultra-strict and sometimes moralistic comments focused on covid risks that pop up in these threads, I wonder if that person ever engaged in sex that wasn't risk free, rode in a car with a driver who had drank a few beers, took a party drug of unknown purity, or anything else like that. In other words, is that person genuinely committed to practicing risk reduction in every facet of their life, or is it the novelty and uncertainty of covid that they are focused on?
posted by Dip Flash at 6:37 AM on December 23, 2022 [5 favorites]
I guess that's kind of like saying "do they never wear clothes on their body, or helmets, pads, or other gear to protect it? Are they so committed to a covering-free existence in every facet, or is it the novelty and discomfort of masks they are focused on?" Which would be about as simplistic. Because in the end there is something different about wearing - or being expected to wear - masks all the time when you never did before, and there is something different about being exposed - and having to be exposed - to other people's breath than there was before, and the details of those differences are both complex and consequential and affect people in lots of individual ways that have been discussed so thoroughly so many times here.
(Also, while there's no question life involves constant risks, I think maybe "rode in a car with a driver who had drank a few beers, took a party drug of unknown purity" are not as universal choices as you think they are, and how good would it be if you knew the odds were high that the new person you were having sex with was conscientious about protection and testing...)
posted by trig at 7:53 AM on December 23, 2022 [3 favorites]
(Also, while there's no question life involves constant risks, I think maybe "rode in a car with a driver who had drank a few beers, took a party drug of unknown purity" are not as universal choices as you think they are, and how good would it be if you knew the odds were high that the new person you were having sex with was conscientious about protection and testing...)
posted by trig at 7:53 AM on December 23, 2022 [3 favorites]
If every time I had to leave the house, my only form of transportation was my drunk friend, then yeah, I'd probably start doing some heightened risk assessments.
posted by mittens at 8:08 AM on December 23, 2022 [6 favorites]
posted by mittens at 8:08 AM on December 23, 2022 [6 favorites]
I’m certainly glad that all of your friends are fine, but “I don’t see the evidence of severity” in a thread where we’re talking about the potential that COVID may be an important component of the extra severe flu and RSV season that has produced severely over-crowded emergency rooms this season seems a rather narrow and short-sighted take.
People in the middle of the last century also didn’t see the evidence of severity of the effects of lead in fuel and paint. People are notoriously susceptible to baseline shifts in their expected normal, on top of the fact that some phenomena are more evident at different scales, so sometimes you need to look at - and do the research and statistics analysis on - what’s happening on the population-wide scale.
Absolutely it’s true that individual effects not being obvious (due to unequal distribution of negative outcomes in combination with the relatively high degree of socioeconomic, racial, and dis/ability-based segregation in US society, or people having adjusted to a shifted baseline expectation, or whatever other factors) will impact individual behavioural decisions. That is part of why we have public health campaigns and other public policies designed to influence people’s behavior for the better in areas where the effects are more problematic at the wider scale. What makes for effective messaging depends on whether people feel something as harmful in their own, small scale, individual lives or not, as well, so that’s an important detail to note. But poor reasoning to base policy around.
Putting all of our eggs in the single basket of vaccines and related therapeutics also flies in the face of public health knowledge and standards, not to mention current data showing that age is about two orders of magnitude more significant than vaccination status for risk of death or other severe outcome from COVID-19, and social determinants of health have an equally large impact as vaccination status. Vaccines are indeed quite helpful and a key component of the Swiss cheese model of disease prevention and response. But other factors, including those same social determinants mentioned above, also affect vaccine uptake rates as well as the degree of effectiveness of vaccines for individuals. Focusing solely on vaccination and related therapeutics (most of which are much less effective against omicron variants, as was mentioned above, and all of which are somewhat restricted in availability for most of us) is counterproductive and contraindicated by current available evidence.
posted by eviemath at 8:29 AM on December 23, 2022 [6 favorites]
People in the middle of the last century also didn’t see the evidence of severity of the effects of lead in fuel and paint. People are notoriously susceptible to baseline shifts in their expected normal, on top of the fact that some phenomena are more evident at different scales, so sometimes you need to look at - and do the research and statistics analysis on - what’s happening on the population-wide scale.
Absolutely it’s true that individual effects not being obvious (due to unequal distribution of negative outcomes in combination with the relatively high degree of socioeconomic, racial, and dis/ability-based segregation in US society, or people having adjusted to a shifted baseline expectation, or whatever other factors) will impact individual behavioural decisions. That is part of why we have public health campaigns and other public policies designed to influence people’s behavior for the better in areas where the effects are more problematic at the wider scale. What makes for effective messaging depends on whether people feel something as harmful in their own, small scale, individual lives or not, as well, so that’s an important detail to note. But poor reasoning to base policy around.
Putting all of our eggs in the single basket of vaccines and related therapeutics also flies in the face of public health knowledge and standards, not to mention current data showing that age is about two orders of magnitude more significant than vaccination status for risk of death or other severe outcome from COVID-19, and social determinants of health have an equally large impact as vaccination status. Vaccines are indeed quite helpful and a key component of the Swiss cheese model of disease prevention and response. But other factors, including those same social determinants mentioned above, also affect vaccine uptake rates as well as the degree of effectiveness of vaccines for individuals. Focusing solely on vaccination and related therapeutics (most of which are much less effective against omicron variants, as was mentioned above, and all of which are somewhat restricted in availability for most of us) is counterproductive and contraindicated by current available evidence.
posted by eviemath at 8:29 AM on December 23, 2022 [6 favorites]
I still meet people my parents' age who don't think there's any good reason to wear seatbelts in a car or refrain from smoking in a hospital.
posted by The Underpants Monster at 9:06 AM on December 23, 2022 [5 favorites]
posted by The Underpants Monster at 9:06 AM on December 23, 2022 [5 favorites]
People in the middle of the last century also didn’t see the evidence of severity of the effects of lead in fuel and paint. People are notoriously susceptible to baseline shifts in their expected normal, on top of the fact that some phenomena are more evident at different scales, so sometimes you need to look at - and do the research and statistics analysis on - what’s happening on the population-wide scale.
Reminds me of someone I know who moved to the US, to a colonial-era city with lots of old buildings, as an adult with a baby and was all "Americans are obsessed with lead, it's ridiculous!" Since in the country she was coming from there wasn't (and still isn't) pretty much any awareness about it, so that was her normal.
posted by trig at 9:26 AM on December 23, 2022 [5 favorites]
Reminds me of someone I know who moved to the US, to a colonial-era city with lots of old buildings, as an adult with a baby and was all "Americans are obsessed with lead, it's ridiculous!" Since in the country she was coming from there wasn't (and still isn't) pretty much any awareness about it, so that was her normal.
posted by trig at 9:26 AM on December 23, 2022 [5 favorites]
when I was a child (the 1960s) the only place you couldn't smoke a cigarette was part of the airplane. Jump ahead twenty-five years or so and suddenly, they were trying to ban them from bars and restaurants. As a non-smoker, I recall feeling somewhat ambivalent about it all. Obviously, I'd prefer a smoke free environment. Yet some of my best (and most fun) friends were smokers. I didn't want to see them suddenly banished from my world.
But the changes came regardless, the laws came down, and somehow the culture survived. The bizarre part to me now, is that we're roughly sixty years into cigarettes officially causing lung cancer and we've still got legal enterprises known as cigarette companies and an overall refusal on a cultural-political level to truly recognize nicotine addiction for the horrific affliction it is (ie: branded cigarettes are still legal pretty much everywhere, profits are allowed to be made on their sale, shareholders are still benefiting from slow, horrible deaths).
What's my point here?
I don't know exactly. I guess it's a kickback at the delusion that this culture (western, North American in particular) was ever going to wholeheartedly buy into long term adaptation of the severe health protocols that Covid-19 seemed to require (assuming maximum harm reduction to the point of overall eradication was the goal). That's just not who we are. We're not that homogenized. We're not that organized. There's a looseness to how we communicate (on every level -- one-on-one to mass and everything in between) that was always going to guarantee there would be gaps in our armour (he said, pretty sure he had his metaphors mixed up).
Anyway, I wear a mask because, for me, it's not that big a deal, and I'm sixty-three, I'm kind of in the danger zone and I definitely have contemporaries who are. But I don't HATE-REJECT-WANT-TO-TEAR-THE-FACES-OFF those who don't. It's not that I don't get the frustration and anger in this regard, I just know that it's not how we get to that place where we can communicate with each other in such a way that we can build the levels of trust, and yes love, that will allow us to collectively manoeuvre our way out of this mess ... and on to the next one. Because there will be a next one of some sort. I suppose the hope is that we handle it better having learned something about our selves, our communities, our nations, our culture, our lines of communication ... from this one.
posted by philip-random at 10:01 AM on December 23, 2022 [6 favorites]
But the changes came regardless, the laws came down, and somehow the culture survived. The bizarre part to me now, is that we're roughly sixty years into cigarettes officially causing lung cancer and we've still got legal enterprises known as cigarette companies and an overall refusal on a cultural-political level to truly recognize nicotine addiction for the horrific affliction it is (ie: branded cigarettes are still legal pretty much everywhere, profits are allowed to be made on their sale, shareholders are still benefiting from slow, horrible deaths).
What's my point here?
I don't know exactly. I guess it's a kickback at the delusion that this culture (western, North American in particular) was ever going to wholeheartedly buy into long term adaptation of the severe health protocols that Covid-19 seemed to require (assuming maximum harm reduction to the point of overall eradication was the goal). That's just not who we are. We're not that homogenized. We're not that organized. There's a looseness to how we communicate (on every level -- one-on-one to mass and everything in between) that was always going to guarantee there would be gaps in our armour (he said, pretty sure he had his metaphors mixed up).
Anyway, I wear a mask because, for me, it's not that big a deal, and I'm sixty-three, I'm kind of in the danger zone and I definitely have contemporaries who are. But I don't HATE-REJECT-WANT-TO-TEAR-THE-FACES-OFF those who don't. It's not that I don't get the frustration and anger in this regard, I just know that it's not how we get to that place where we can communicate with each other in such a way that we can build the levels of trust, and yes love, that will allow us to collectively manoeuvre our way out of this mess ... and on to the next one. Because there will be a next one of some sort. I suppose the hope is that we handle it better having learned something about our selves, our communities, our nations, our culture, our lines of communication ... from this one.
posted by philip-random at 10:01 AM on December 23, 2022 [6 favorites]
Because there will be a next one of some sort.
Technically there already is - multiple current and urgent ones, like climate change as one very prominent example - which I guess is part of why failure to actually change, and the furious outrage at the idea of sacrificing a bit in for the good of abstract others, leave me both angry and depressed. But you're right that telling people that they're asses is, alas, not usually an effective approach.
posted by trig at 10:48 AM on December 23, 2022 [6 favorites]
Technically there already is - multiple current and urgent ones, like climate change as one very prominent example - which I guess is part of why failure to actually change, and the furious outrage at the idea of sacrificing a bit in for the good of abstract others, leave me both angry and depressed. But you're right that telling people that they're asses is, alas, not usually an effective approach.
posted by trig at 10:48 AM on December 23, 2022 [6 favorites]
We're not that organized.
But we are. That's the infuriating part. Forget all the "that's not who we are" stuff, because "who we are" is a world that actually has done significant and effective planning around pandemics. We knew it was coming! Freaking George W. Bush had a plan for it! Obama continued the planning. And then it was dismantled, not because we're not organized or whatever, not because of some inherent North-Americanness that is adverse to planning, but because an unelected fraudster and his administration swept away all that planning, all the work, and the structure we'd built up to protect ourselves.
So much of the pent-up frustration around COVID is that we just didn't have to be here. We didn't have to be in this moronic situation where someone else's mask-exhaustion or whatever could lead to us getting sick. So yeah, there will be a next one, and we have to make sure that all those plans are reconstructed, revised in light of what we've learned from COVID, because literally no one around us will care enough to help on an individual level. It has to come from above.
posted by mittens at 12:30 PM on December 23, 2022 [12 favorites]
But we are. That's the infuriating part. Forget all the "that's not who we are" stuff, because "who we are" is a world that actually has done significant and effective planning around pandemics. We knew it was coming! Freaking George W. Bush had a plan for it! Obama continued the planning. And then it was dismantled, not because we're not organized or whatever, not because of some inherent North-Americanness that is adverse to planning, but because an unelected fraudster and his administration swept away all that planning, all the work, and the structure we'd built up to protect ourselves.
So much of the pent-up frustration around COVID is that we just didn't have to be here. We didn't have to be in this moronic situation where someone else's mask-exhaustion or whatever could lead to us getting sick. So yeah, there will be a next one, and we have to make sure that all those plans are reconstructed, revised in light of what we've learned from COVID, because literally no one around us will care enough to help on an individual level. It has to come from above.
posted by mittens at 12:30 PM on December 23, 2022 [12 favorites]
I’m sorry, it’s just not realistic to expect that people will mask and avoid crowds indefinitely to delay getting covid. (Delay, not avoid. Everyone is going to get it.) Zero covid didn’t work anywhere.
posted by haptic_avenger at 1:08 PM on December 23, 2022 [2 favorites]
posted by haptic_avenger at 1:08 PM on December 23, 2022 [2 favorites]
It'd probably have had a better chance if people weren't so hellbent on making that prophecy come true. "Government can't work. Now elect me so I can make sure it happens!"
It'd be one thing if it was a mapped-out plan of "Ok, we bought some time/lives with the vaccines, but variants are coming and we can't rely on one line of defense; so let's use this to change building code & commercial operation requirements to build out better HVAC systems & invest in Far-UV & isolated-UV systems so we have additional lines of defense ready when the time comes".
But you've consistently advocated in thread after thread that it's not reasonable to expect better things, and that the current state is the only way it could be. You say we need to be "much more realistic and honest about the costs and benefits.", and I agree. But being honest about the cost & benefits means avoiding unaccounted-for externalities, and making sure costs get accrued properly. Lots of people benefit from "Throw the gates open, don't worry about masks, you do you"; but they aren't paying the costs of that policy. And instead, other people are paying those costs. Let's talk about fixing *that*.
posted by CrystalDave at 1:18 PM on December 23, 2022 [15 favorites]
It'd be one thing if it was a mapped-out plan of "Ok, we bought some time/lives with the vaccines, but variants are coming and we can't rely on one line of defense; so let's use this to change building code & commercial operation requirements to build out better HVAC systems & invest in Far-UV & isolated-UV systems so we have additional lines of defense ready when the time comes".
But you've consistently advocated in thread after thread that it's not reasonable to expect better things, and that the current state is the only way it could be. You say we need to be "much more realistic and honest about the costs and benefits.", and I agree. But being honest about the cost & benefits means avoiding unaccounted-for externalities, and making sure costs get accrued properly. Lots of people benefit from "Throw the gates open, don't worry about masks, you do you"; but they aren't paying the costs of that policy. And instead, other people are paying those costs. Let's talk about fixing *that*.
posted by CrystalDave at 1:18 PM on December 23, 2022 [15 favorites]
I’m sorry, it’s just not realistic to expect that people will mask and avoid crowds indefinitely to delay getting covid. (Delay, not avoid. Everyone is going to get it.) Zero covid didn’t work anywhere.
To try to read this as charitably as possible, I would just point out that there is an enormous distance between the two mythical poles of "everyone is going to get it" and "nobody will ever get it." And it is a matter of public health, to try to nudge things to that latter pole. And some of that nudge does, in fact, come from delay. If we can keep masses of people from getting it all at once, then we put less pressure on an already-strained healthcare system. If you were bound to get COVID, if there was just no way you'd escape it, it'd still be better if you could put it off a few months, when the ERs weren't packed with flu and RSV.
Yet there is a certain public sentiment that leads to a cultural embrace of COVID--I won't go so far as call it a death-wish. We have heard impassioned arguments against every single intervention. We can't mandate masks, we can't mandate social distancing, we certainly cannot mandate vaccines. In a world where everything we do is constrained and informed by law and regulation, for some reason our hands are absolutely tied when it comes to COVID.
posted by mittens at 1:27 PM on December 23, 2022 [16 favorites]
To try to read this as charitably as possible, I would just point out that there is an enormous distance between the two mythical poles of "everyone is going to get it" and "nobody will ever get it." And it is a matter of public health, to try to nudge things to that latter pole. And some of that nudge does, in fact, come from delay. If we can keep masses of people from getting it all at once, then we put less pressure on an already-strained healthcare system. If you were bound to get COVID, if there was just no way you'd escape it, it'd still be better if you could put it off a few months, when the ERs weren't packed with flu and RSV.
Yet there is a certain public sentiment that leads to a cultural embrace of COVID--I won't go so far as call it a death-wish. We have heard impassioned arguments against every single intervention. We can't mandate masks, we can't mandate social distancing, we certainly cannot mandate vaccines. In a world where everything we do is constrained and informed by law and regulation, for some reason our hands are absolutely tied when it comes to COVID.
posted by mittens at 1:27 PM on December 23, 2022 [16 favorites]
for some reason our hands are absolutely tied when it comes to COVID.
Government hands were never tied. Schools were closed for 1.5 years. The National Guard threatened to arrest me for sitting under a tree in a park. Mask mandates for a long time. A complete revolution in telework. And most important, the government-sponsored creation & distribution of vaccines and therepeutics.
posted by haptic_avenger at 1:49 PM on December 23, 2022 [5 favorites]
Government hands were never tied. Schools were closed for 1.5 years. The National Guard threatened to arrest me for sitting under a tree in a park. Mask mandates for a long time. A complete revolution in telework. And most important, the government-sponsored creation & distribution of vaccines and therepeutics.
posted by haptic_avenger at 1:49 PM on December 23, 2022 [5 favorites]
So much of the pent-up frustration around COVID is that we just didn't have to be here. We didn't have to be in this moronic situation where someone else's mask-exhaustion or whatever could lead to us getting sick.
YES! COVID did not have to go down this way. I’ll bet the average American has no idea what a bullet we dodged with swine flu in the Obama years—a dodge we were only able to make through public infrastructure that had been painstakingly built up for years. Infrastructure that did its job so well that it became invisible to most, and ”wasteful spending” to the GOP. The Trump admin killed it, and now here we are.
posted by joedan at 2:28 PM on December 23, 2022 [8 favorites]
YES! COVID did not have to go down this way. I’ll bet the average American has no idea what a bullet we dodged with swine flu in the Obama years—a dodge we were only able to make through public infrastructure that had been painstakingly built up for years. Infrastructure that did its job so well that it became invisible to most, and ”wasteful spending” to the GOP. The Trump admin killed it, and now here we are.
posted by joedan at 2:28 PM on December 23, 2022 [8 favorites]
To try to read this as charitably as possible
Yeah, see the public health absolutism is a serious problem as well. That there are measures to be taken that would absolutely be the best for overall public health is absolutely true, but much of the discussion here refuses to acknowledge that those measures have serious side effects that may make them counterproductive. It might be best -- from a public health perspective -- to stay with remote schooling for the foreseeable future. It would also destroy entire generations of children. Should we not consider that? Masking everywhere might well be the best possible public health solution but it also has massive effects on a society already shaped by atomization and polarization. How do we balance that?
Well, I don't know, but the "you're an asshole if you don't immediately prioritize the immunocompromised/vulnerable populations above everything else" does not encourage much of a discussion.
(And no, per this thread, an early set of studies suggesting that COVID might have immune consequences is not convincing enough to lock society down again).
posted by Galvanic at 2:30 PM on December 23, 2022 [4 favorites]
Yeah, see the public health absolutism is a serious problem as well. That there are measures to be taken that would absolutely be the best for overall public health is absolutely true, but much of the discussion here refuses to acknowledge that those measures have serious side effects that may make them counterproductive. It might be best -- from a public health perspective -- to stay with remote schooling for the foreseeable future. It would also destroy entire generations of children. Should we not consider that? Masking everywhere might well be the best possible public health solution but it also has massive effects on a society already shaped by atomization and polarization. How do we balance that?
Well, I don't know, but the "you're an asshole if you don't immediately prioritize the immunocompromised/vulnerable populations above everything else" does not encourage much of a discussion.
(And no, per this thread, an early set of studies suggesting that COVID might have immune consequences is not convincing enough to lock society down again).
posted by Galvanic at 2:30 PM on December 23, 2022 [4 favorites]
Well, of course everyone is going to get it if we decide we can't be arsed to prevent that.
posted by The Underpants Monster at 3:37 PM on December 23, 2022 [3 favorites]
posted by The Underpants Monster at 3:37 PM on December 23, 2022 [3 favorites]
I don't think very many people want stay-at-home orders to resume; I certainly don't. Better to me would be a return to masking in public spaces, transparent progress toward improving ventilation and filtration, and social permission to require testing as a gate to unmasked indoor events. That isn't a lockdown any more than condoms or car insurance are a lockdown. It's an architecture of trust. The message that was sent when the bits of this architecture that already existed were deliberately dismantled in the spring was that if I had any complications in my life that made infection more than an annoyance, which I did, I was completely alone in managing them. My complications were temporary, but I fear the resultant anomie is permanent. Many other people's complications aren't temporary. The callousness that our manner of reopening has entailed simply takes my breath away. I fully believe philip-random is right about the role of love -- but I cannot love this any more readily than one can love one's rapist. We are at an impasse.
I can't see a way to what I want that isn't honest though. The title quoted above (which I think comes from the article itself) is, I think, dishonest, in that it makes it seem like eight months of immune dysfunction is a typical post-COVID course and I don't think the article says any such thing. I think it was eviemath above that made the point that we need to distinguish between what is typical and what is atypical but possible, but/and the second thing can still create big problems on a societal scale if it is some combination of bad enough and frequent enough. Adverse events don't have to affect more than half of patients for a drug to be pulled. Cribs don't have to kill more than half of infants to be recalled. The trust in strangers that these norms enable has value for the social fabric. I wish this were easier to convey.
Chances are I won't get what I want, which honestly makes me wonder why the anti-mask crowd keeps engaging. If the alarmism in this set of articles is more warranted than I think, if we don't rebound to more normalcy next year, if the one HIV researcher making analogies turns into a deluge, maybe we'll reassess our choices in a year or two and find some compromise that everyone can live with. If it isn't, maybe I'll give up and join the crowd. It's just hard to want to, now.
posted by eirias at 5:00 PM on December 23, 2022 [7 favorites]
I can't see a way to what I want that isn't honest though. The title quoted above (which I think comes from the article itself) is, I think, dishonest, in that it makes it seem like eight months of immune dysfunction is a typical post-COVID course and I don't think the article says any such thing. I think it was eviemath above that made the point that we need to distinguish between what is typical and what is atypical but possible, but/and the second thing can still create big problems on a societal scale if it is some combination of bad enough and frequent enough. Adverse events don't have to affect more than half of patients for a drug to be pulled. Cribs don't have to kill more than half of infants to be recalled. The trust in strangers that these norms enable has value for the social fabric. I wish this were easier to convey.
Chances are I won't get what I want, which honestly makes me wonder why the anti-mask crowd keeps engaging. If the alarmism in this set of articles is more warranted than I think, if we don't rebound to more normalcy next year, if the one HIV researcher making analogies turns into a deluge, maybe we'll reassess our choices in a year or two and find some compromise that everyone can live with. If it isn't, maybe I'll give up and join the crowd. It's just hard to want to, now.
posted by eirias at 5:00 PM on December 23, 2022 [7 favorites]
I appreciate your comment, eirias! One of the things that keeps me coming back to Metafilter is that we can end up eventually understanding each other better through discussions here. That feels particularly good and hopeful to me when it happens in discussion threads that have been more heated or contentious - usually because those are the topics that are really important to each of us.
I don’t follow any pandemic news or fights on Twitter, but our fellow Mefites in this thread who have been more vehement about mask-wearing, or have expressed more serious concerns about the potential immune theft effects possible from COVID-19 infection have also mentioned being immune compromised or otherwise at higher risk themselves. I worry that both-sidesing how bad divergence from what we perceive as the reasonable and scientifically accurate interpretations(*) of current research is can lead to some unethical-to-me tone policing of folks in a significantly structurally disadvantaged group relative to this issue. If someone’s personal risk is high, of course they are also going to be experiencing some significant grief and/or anger about how our societal responses to the pandemic have ended up going!
I can also see where for other folks at higher risk, feeling in control of how stuff is communicated to those around them who they need to pay more attention and be more careful, and having such communication follow guidelines that hopefully could make it optimally effective, would instead better control their own anxieties. This would clearly lead to the perception that other folks are doing a bad job with the science communication being quite stressful.
These sorts of tensions come up between folks with different responses or strategies that they are comfortable with in any group experiencing oppression or some sort of structural disempowerment and threat. We’re probably not used to thinking about more vulnerable people’s responses to changing societal pandemic response in this framework - tone policing comes up more often in relation to responses to racism or sexism than to ableism - but I would imagine it could help being a little more compassion and understanding to these pandemic threads?
In parallel, there is some research (though, if I understand correctly, also not fully settled) about best practices in communicating science and public health messages. It seems to me that the best approach for those of us who do care about taking care of all members of our communities or who have loved ones at higher risk, but aren’t directly at greater risk ourselves, would be to just be very proactive in communicating using those best practices, taking that on ourselves as our particular responsibility, but avoiding being too confrontational with other folks who are “doing it wrong”. Sometimes just offering a parallel channel or approach is the best method.
(* Collective policy or individual behavioural decisions are as much about values as about evidence and facts, however. Like, the precautionary principle isn’t a scientific law, it’s an ethical judgement (albeit informed by a sort of heuristic expected value model, if one is using the term as originally described or intended). Different folks will make different judgements based on the same set of facts. So the discussion around what our collective or individual actions should be given current knowledge of how, how much, and how often COVID-19 can lead to immunity theft post-infection will ideally be informed by the best current evidence, but isn’t only an issue of science communication. We also have to take into consideration best practices for communicating ethical norms and convincing others to act more in alignment with our preferred set of values. Also not my area of expertise, but there seems to be some differences between what works best for science and public health communication versus what works best for negotiating sometimes competing value judgements.)
posted by eviemath at 10:14 PM on December 23, 2022 [3 favorites]
I don’t follow any pandemic news or fights on Twitter, but our fellow Mefites in this thread who have been more vehement about mask-wearing, or have expressed more serious concerns about the potential immune theft effects possible from COVID-19 infection have also mentioned being immune compromised or otherwise at higher risk themselves. I worry that both-sidesing how bad divergence from what we perceive as the reasonable and scientifically accurate interpretations(*) of current research is can lead to some unethical-to-me tone policing of folks in a significantly structurally disadvantaged group relative to this issue. If someone’s personal risk is high, of course they are also going to be experiencing some significant grief and/or anger about how our societal responses to the pandemic have ended up going!
I can also see where for other folks at higher risk, feeling in control of how stuff is communicated to those around them who they need to pay more attention and be more careful, and having such communication follow guidelines that hopefully could make it optimally effective, would instead better control their own anxieties. This would clearly lead to the perception that other folks are doing a bad job with the science communication being quite stressful.
These sorts of tensions come up between folks with different responses or strategies that they are comfortable with in any group experiencing oppression or some sort of structural disempowerment and threat. We’re probably not used to thinking about more vulnerable people’s responses to changing societal pandemic response in this framework - tone policing comes up more often in relation to responses to racism or sexism than to ableism - but I would imagine it could help being a little more compassion and understanding to these pandemic threads?
In parallel, there is some research (though, if I understand correctly, also not fully settled) about best practices in communicating science and public health messages. It seems to me that the best approach for those of us who do care about taking care of all members of our communities or who have loved ones at higher risk, but aren’t directly at greater risk ourselves, would be to just be very proactive in communicating using those best practices, taking that on ourselves as our particular responsibility, but avoiding being too confrontational with other folks who are “doing it wrong”. Sometimes just offering a parallel channel or approach is the best method.
(* Collective policy or individual behavioural decisions are as much about values as about evidence and facts, however. Like, the precautionary principle isn’t a scientific law, it’s an ethical judgement (albeit informed by a sort of heuristic expected value model, if one is using the term as originally described or intended). Different folks will make different judgements based on the same set of facts. So the discussion around what our collective or individual actions should be given current knowledge of how, how much, and how often COVID-19 can lead to immunity theft post-infection will ideally be informed by the best current evidence, but isn’t only an issue of science communication. We also have to take into consideration best practices for communicating ethical norms and convincing others to act more in alignment with our preferred set of values. Also not my area of expertise, but there seems to be some differences between what works best for science and public health communication versus what works best for negotiating sometimes competing value judgements.)
posted by eviemath at 10:14 PM on December 23, 2022 [3 favorites]
tone policing of folks in a significantly structurally disadvantaged group relative to this issue.
Does my kid with autism who severely regressed due to school closures and masking count as “structurally disadvantaged”? How about all the kids who will never make up the learning loss?
posted by haptic_avenger at 6:31 AM on December 24, 2022 [1 favorite]
Does my kid with autism who severely regressed due to school closures and masking count as “structurally disadvantaged”? How about all the kids who will never make up the learning loss?
posted by haptic_avenger at 6:31 AM on December 24, 2022 [1 favorite]
No, I don’t feel bad about ensuring that the covid narrative takes kids into account. Nobody took the kids’ structural social welfare into account for the whole year + we decided their needs fell absolute last. And I think he would have been much better off in one of the countries that kept kids in school.
posted by haptic_avenger at 7:34 AM on December 24, 2022 [1 favorite]
posted by haptic_avenger at 7:34 AM on December 24, 2022 [1 favorite]
Your “nobody” is very far from universal. Do you not see the connection between finding one group expendable versus finding another group expendable, though? You only care when it happens to be your kid in the expendable group?
As an educator, I also find your belief that permanent learning loss has been widespread quite concerning. There are certainly some situations where early childhood interventions are critical for long term outcomes, but for most students, no learning gap is ever irrecoverable. Our mindsets as educators or parents in how we talk about those gaps makes a significant difference in whether students have the confidence and trust in themselves to continue learning, however.
posted by eviemath at 7:38 AM on December 24, 2022 [4 favorites]
As an educator, I also find your belief that permanent learning loss has been widespread quite concerning. There are certainly some situations where early childhood interventions are critical for long term outcomes, but for most students, no learning gap is ever irrecoverable. Our mindsets as educators or parents in how we talk about those gaps makes a significant difference in whether students have the confidence and trust in themselves to continue learning, however.
posted by eviemath at 7:38 AM on December 24, 2022 [4 favorites]
Do you find that it has helped your child for you to pick fights online rather than contribute to mutual understanding and compassion?
For someone who just recently advocated against tone-policing and for listening to people who are in particularly precarious positions, you're doing an impressive job here of both tone-policing and not listening.
posted by Galvanic at 7:43 AM on December 24, 2022 [1 favorite]
For someone who just recently advocated against tone-policing and for listening to people who are in particularly precarious positions, you're doing an impressive job here of both tone-policing and not listening.
posted by Galvanic at 7:43 AM on December 24, 2022 [1 favorite]
I also advocated for those of us who are at one remove from being directly affected being much more careful and strategic about our words and messsaging. That seems to be the group that haptic_avenger is in, along with myself.
posted by eviemath at 7:47 AM on December 24, 2022
posted by eviemath at 7:47 AM on December 24, 2022
I also advocated for those of us who are at one remove from being directly affected being much more careful and strategic about our words and messsaging. That seems to be the group that haptic_avenger is in, along with myself.
I don't think that haptic_avenger would agree that they are at "one remove" from being directly affected. I certainly don't -- and that your motivation is that they're not suffering in the right way sounds a lot like a covid version of the oppression olympics.
posted by Galvanic at 7:59 AM on December 24, 2022 [4 favorites]
I don't think that haptic_avenger would agree that they are at "one remove" from being directly affected. I certainly don't -- and that your motivation is that they're not suffering in the right way sounds a lot like a covid version of the oppression olympics.
posted by Galvanic at 7:59 AM on December 24, 2022 [4 favorites]
Ok. Please give me the same consideration then? Like, the consideration of reading my whole comment rather than cherry picking an out of context line to disagree with?
posted by eviemath at 9:00 AM on December 24, 2022
posted by eviemath at 9:00 AM on December 24, 2022
sounds a lot like a covid version of the oppression olympics.
Perhaps a useful place to start is acknowledging that Covid has affected EVERYONE. For many in the so-called western world (who have thus far been spared a war, a major natural disaster etc), it may well be the first time in their lives that History and/or nature collided (continues to collide) with their plans in an irrefutable way.
One particular moment comes to mind, maybe a year ago. A day on Facebook when two good friends who agreed on pretty much everything politically, socially, philosophically before Covid (ie: progressives), got into it with each other on the topic of schools being open. Both had kids roughly the same age. One was a therapist (a damned good one, I hear), the other the husband of a doctor. You can guess which side each took. I felt they both made compelling, impassioned arguments.
Both great people but I can't help but feel that if they happened upon each other in a dark alley on that particular day, they would've torn each others throats out.
posted by philip-random at 9:05 AM on December 24, 2022 [5 favorites]
Perhaps a useful place to start is acknowledging that Covid has affected EVERYONE. For many in the so-called western world (who have thus far been spared a war, a major natural disaster etc), it may well be the first time in their lives that History and/or nature collided (continues to collide) with their plans in an irrefutable way.
One particular moment comes to mind, maybe a year ago. A day on Facebook when two good friends who agreed on pretty much everything politically, socially, philosophically before Covid (ie: progressives), got into it with each other on the topic of schools being open. Both had kids roughly the same age. One was a therapist (a damned good one, I hear), the other the husband of a doctor. You can guess which side each took. I felt they both made compelling, impassioned arguments.
Both great people but I can't help but feel that if they happened upon each other in a dark alley on that particular day, they would've torn each others throats out.
posted by philip-random at 9:05 AM on December 24, 2022 [5 favorites]
Please give me the same consideration then? Like, the consideration of reading my whole comment rather than cherry picking an out of context line to disagree with?
My response was based on reading the whole thing, and I quoted the first line as an example of an attitude I thought went through the entire post.
posted by Galvanic at 9:17 AM on December 24, 2022
My response was based on reading the whole thing, and I quoted the first line as an example of an attitude I thought went through the entire post.
posted by Galvanic at 9:17 AM on December 24, 2022
And yet, nowhere was I disagreeing with haptic_averger’s (or your) tone, nor saying that my worries in that respect are or necessarily should be universal. I do disagree with what I understand based on both of your comments to be your values - that you each seem to be coming from a very individualistic perspective, only worried about the disadvantaged groups that you personally find yourselves in rather than trying to work with others on structural solutions that could meet everyone’s needs or better balance when there is an irreconcilable conflict. But hey, someone flagged the comment where I explained that in more detail and it got deleted, so this is probably an unproductive argument to continue.
posted by eviemath at 9:32 AM on December 24, 2022
posted by eviemath at 9:32 AM on December 24, 2022
Surely it wouldn't have been impossible to implement a system in which nobody's needs fell "absolute last?" In which one group's life and health weren't sacrificed for another group's social and mental development or vice versa? Nobody HAD to be thrown under the bus here.
posted by The Underpants Monster at 11:26 AM on December 24, 2022 [5 favorites]
posted by The Underpants Monster at 11:26 AM on December 24, 2022 [5 favorites]
It's quite easy and accessible for almost everyone to wear some form of mask when out in public. Masks are an effective way to reduce the spread of covid, a very serious and contagious disease.
These are not inaccurate statements to make. I know they sound simple, but that's because they are simple.
posted by AlSweigart at 2:16 PM on December 24, 2022 [6 favorites]
These are not inaccurate statements to make. I know they sound simple, but that's because they are simple.
posted by AlSweigart at 2:16 PM on December 24, 2022 [6 favorites]
Surely it wouldn't have been impossible to implement a system in which nobody's needs fell "absolute last?" In which one group's life and health weren't sacrificed for another group's social and mental development or vice versa?
The one advantage we have is that we understand some things we didn't before. We know that more disease transmits through the aerosol route than conventional wisdom had suggested. We also now understand that masking helps a great deal. And we certainly also understand that our jury-rigged replacements for school, for most children and families, did not work well, and left an enormous segment of society traumatized and mistrustful and angry.
We could spend the medium term upgrading ventilation and filtration in our buildings, focusing on schools first because it is clear that if they fall apart, a lot of other things do too. We could also invest money in companies who want to develop high-filtration masks that fit kids and ones that are less cumbersome for the wearer. The goal of this preparatory work would be: next time this happens, and I do expect to see a next time in my life because of climate change, next time don't close schools, or don't close them for long. Because now we know what to do instead.
We can't get there as long as we're all still mistrustful and angry. I don't have a path because I feel those things too. But that's the good endpoint we should be aiming for.
posted by eirias at 2:43 PM on December 24, 2022 [5 favorites]
The one advantage we have is that we understand some things we didn't before. We know that more disease transmits through the aerosol route than conventional wisdom had suggested. We also now understand that masking helps a great deal. And we certainly also understand that our jury-rigged replacements for school, for most children and families, did not work well, and left an enormous segment of society traumatized and mistrustful and angry.
We could spend the medium term upgrading ventilation and filtration in our buildings, focusing on schools first because it is clear that if they fall apart, a lot of other things do too. We could also invest money in companies who want to develop high-filtration masks that fit kids and ones that are less cumbersome for the wearer. The goal of this preparatory work would be: next time this happens, and I do expect to see a next time in my life because of climate change, next time don't close schools, or don't close them for long. Because now we know what to do instead.
We can't get there as long as we're all still mistrustful and angry. I don't have a path because I feel those things too. But that's the good endpoint we should be aiming for.
posted by eirias at 2:43 PM on December 24, 2022 [5 favorites]
It's quite easy and accessible for almost everyone to wear some form of mask when out in public. Masks are an effective way to reduce the spread of covid, a very serious and contagious disease.
These are not inaccurate statements to make. I know they sound simple, but that's because they are simple.
Simple, yes, but also kind of simplistic. I certainly don't disagree that masks reduce risk, but at the same time, the reality is that outside of a handful of countries like Japan where it was already fairly common, nowhere in the world has taken on mask wearing as a long-term solution. I understand the frustration being expressed, but it is also kind of strange for people to keep pushing daily-wear masks in public spaces as a solution when that has been resoundingly rejected by most societies, including ones that did much, much better than the US at protecting vulnerable people during the worst of the pandemic. It's sort of the pandemic equivalent of the simplistic tech-bro "solutions" that ignore all the human complexities.
As to schools, if I had to guess, I would bet that the judgment of history will be that closing schools for so long caused much greater harm than it benefited, but I don't think this is a settled question yet by any means.
posted by Dip Flash at 4:41 PM on December 24, 2022 [4 favorites]
These are not inaccurate statements to make. I know they sound simple, but that's because they are simple.
Simple, yes, but also kind of simplistic. I certainly don't disagree that masks reduce risk, but at the same time, the reality is that outside of a handful of countries like Japan where it was already fairly common, nowhere in the world has taken on mask wearing as a long-term solution. I understand the frustration being expressed, but it is also kind of strange for people to keep pushing daily-wear masks in public spaces as a solution when that has been resoundingly rejected by most societies, including ones that did much, much better than the US at protecting vulnerable people during the worst of the pandemic. It's sort of the pandemic equivalent of the simplistic tech-bro "solutions" that ignore all the human complexities.
As to schools, if I had to guess, I would bet that the judgment of history will be that closing schools for so long caused much greater harm than it benefited, but I don't think this is a settled question yet by any means.
posted by Dip Flash at 4:41 PM on December 24, 2022 [4 favorites]
the reality is that outside of a handful of countries like Japan where it was already fairly common, nowhere in the world has taken on mask wearing as a long-term solution.
The reality is that history is chock full of things that people didn't do until they started doing them.
posted by The Underpants Monster at 5:05 PM on December 24, 2022 [6 favorites]
The reality is that history is chock full of things that people didn't do until they started doing them.
posted by The Underpants Monster at 5:05 PM on December 24, 2022 [6 favorites]
I'm immunosuppressed and I don't think parents of kids who are worried about the effects of school closures are assholes. Who I think are a bunch of assholes are the politicians who did nothing to improve school HVAC (we could have had a WPA construction fest for this stuff) and didn't get out testing and masks when they could have because it was expensive. And the people who didn't want to pay taxes for the public good of public health. And the general anti-maskers, which I get being not crazy about them because they fog up my glasses, but it beats getting COVID and risking death/long COVID.
Autistic kids, even if they don't fall into the "disabled" camp, are like disabled folks in that they're expendable in the rat race of late stage capitalism. They don't have a lot of productivity to offer so society devalues them. How I feel about them with respect to COVID is mostly solidarity and a hope that they and their loved ones can work with folks like me to improve society's public health responses for all of us instead of assuming what we have is the best we can get and fighting for the scraps.
posted by gentlyepigrams at 7:57 AM on December 25, 2022 [13 favorites]
Autistic kids, even if they don't fall into the "disabled" camp, are like disabled folks in that they're expendable in the rat race of late stage capitalism. They don't have a lot of productivity to offer so society devalues them. How I feel about them with respect to COVID is mostly solidarity and a hope that they and their loved ones can work with folks like me to improve society's public health responses for all of us instead of assuming what we have is the best we can get and fighting for the scraps.
posted by gentlyepigrams at 7:57 AM on December 25, 2022 [13 favorites]
and fighting for the scraps
Thank you - I think that really encapsulates the situation.
posted by trig at 1:40 PM on December 25, 2022
Thank you - I think that really encapsulates the situation.
posted by trig at 1:40 PM on December 25, 2022
The reality is that history is chock full of things that people didn't do until they started doing them
History is also chock full of things that people didn't do and then continued not doing.
posted by Galvanic at 1:43 PM on December 25, 2022 [1 favorite]
History is also chock full of things that people didn't do and then continued not doing.
posted by Galvanic at 1:43 PM on December 25, 2022 [1 favorite]
in conclusion, history is full
posted by philip-random at 2:26 PM on December 25, 2022 [6 favorites]
posted by philip-random at 2:26 PM on December 25, 2022 [6 favorites]
of
posted by iamkimiam at 2:48 PM on December 25, 2022 [5 favorites]
posted by iamkimiam at 2:48 PM on December 25, 2022 [5 favorites]
things
posted by philip-random at 3:17 PM on December 25, 2022 [3 favorites]
posted by philip-random at 3:17 PM on December 25, 2022 [3 favorites]
you each seem to be coming from a very individualistic perspective
In this thread, I've suggest that public health recommendations take into consideration their larger social side effects and that asthmatics, people with COPD, and autistic children not be relegated to the second rank when harm is considered. I don't think either of those recommendations is particularly individualistic.
posted by Galvanic at 4:33 PM on December 25, 2022 [1 favorite]
In this thread, I've suggest that public health recommendations take into consideration their larger social side effects and that asthmatics, people with COPD, and autistic children not be relegated to the second rank when harm is considered. I don't think either of those recommendations is particularly individualistic.
posted by Galvanic at 4:33 PM on December 25, 2022 [1 favorite]
asthmatics
Just as a data point, asthma is numbered among my laundry list of chronic medical issues, and I am still masking in public with no ill effects. It's actually been pretty good at preventing exposure to common triggers.
posted by The Underpants Monster at 4:38 PM on December 25, 2022 [6 favorites]
Just as a data point, asthma is numbered among my laundry list of chronic medical issues, and I am still masking in public with no ill effects. It's actually been pretty good at preventing exposure to common triggers.
posted by The Underpants Monster at 4:38 PM on December 25, 2022 [6 favorites]
ust as a data point, asthma is numbered among my laundry list of chronic medical issues, and I am still masking in public with no ill effects. It's actually been pretty good at preventing exposure to common triggers.
Which is awesome and I'm extremely glad that's the case for you. What I'm pointing out is that your voice -- and the voice of asthmatics who are not having similar good luck -- should not be silenced.
posted by Galvanic at 4:47 PM on December 25, 2022
Which is awesome and I'm extremely glad that's the case for you. What I'm pointing out is that your voice -- and the voice of asthmatics who are not having similar good luck -- should not be silenced.
posted by Galvanic at 4:47 PM on December 25, 2022
People with COPD and asthma are among the people at higher risk for more serious outcomes from COVID-19. Public health campaigns that encourage more voluntary masking, improved building ventilation, sufficient paid sick days and government initiatives to discourage employers from forcing employees to come to work sick, and programs to address social determinants of health and fix health inequities in general would all certainly help such folks - and would help even if COVID weren’t a thing!
I don’t see how it helps folks with asthma, COPD, or autism to argue that COVID-19 isn’t serious for some people, with some potential risks that we still haven’t nailed down the degree of and need to do more research on rather than just ignore; or that folks at high risk should become shut-ins; or that our society just is what it is and we can’t ask for better; or that it’s somehow unjust to ask the majority of people who can mask without any health impacts to themselves to do so in order ensure that folks at higher risk from any of the tripledemic respiratory infections we’re dealing with this season or who can’t wear masks for sensory or trauma issues don’t have to choose between different risks, or have their needs be put in conflict with the needs of folks who are immune compromised or have COPD or asthma or are elderly but who can wear a medical mask safely. I also don’t see how it helps folks with asthma, COPD, or autism to completely ignore the systemic pressures on our health care systems from the current tripledemic of COVID-19, flu, and RSV, and only engage in a conversation about COVID risks by arguing against masking or arguing from an assumption that COVID safety needs and other needs are in irreconcilable conflict (they aren’t).
I know that the lack of access to health care overall - caused by the combination of long-term under-funding and the stresses the current extreme respiratory illness tripledemic have put on the health care system - in my region has had statistically negative overall outcomes for all folks who need to interact with the health care system regularly, which certainly includes folks with asthma, COPD, and to some extent or in some cases autism (though they tend to interact with a different part of the health care system which is mostly just secondarily affected by staff being out sick or under extra stress themselves due to the primary health care system issues, but otherwise operating at its usual inadequately resources levels).
posted by eviemath at 7:13 PM on December 25, 2022 [7 favorites]
I don’t see how it helps folks with asthma, COPD, or autism to argue that COVID-19 isn’t serious for some people, with some potential risks that we still haven’t nailed down the degree of and need to do more research on rather than just ignore; or that folks at high risk should become shut-ins; or that our society just is what it is and we can’t ask for better; or that it’s somehow unjust to ask the majority of people who can mask without any health impacts to themselves to do so in order ensure that folks at higher risk from any of the tripledemic respiratory infections we’re dealing with this season or who can’t wear masks for sensory or trauma issues don’t have to choose between different risks, or have their needs be put in conflict with the needs of folks who are immune compromised or have COPD or asthma or are elderly but who can wear a medical mask safely. I also don’t see how it helps folks with asthma, COPD, or autism to completely ignore the systemic pressures on our health care systems from the current tripledemic of COVID-19, flu, and RSV, and only engage in a conversation about COVID risks by arguing against masking or arguing from an assumption that COVID safety needs and other needs are in irreconcilable conflict (they aren’t).
I know that the lack of access to health care overall - caused by the combination of long-term under-funding and the stresses the current extreme respiratory illness tripledemic have put on the health care system - in my region has had statistically negative overall outcomes for all folks who need to interact with the health care system regularly, which certainly includes folks with asthma, COPD, and to some extent or in some cases autism (though they tend to interact with a different part of the health care system which is mostly just secondarily affected by staff being out sick or under extra stress themselves due to the primary health care system issues, but otherwise operating at its usual inadequately resources levels).
posted by eviemath at 7:13 PM on December 25, 2022 [7 favorites]
I don’t see how it helps folks with asthma, COPD, or autism to argue that COVID-19 isn’t serious for some people,
I agree with you, which is why I haven't made that argument.
posted by Galvanic at 8:16 AM on December 26, 2022
I agree with you, which is why I haven't made that argument.
posted by Galvanic at 8:16 AM on December 26, 2022
Then we have a communication breakdown, because, in your choices of both what to comment and what not to comment about, it has certainly come across as if either you don’t believe in the seriousness of COVID-19 for some individuals and overall to our health care systems, or that you don’t care about the individuals and don’t see or believe in the systemic stresses.
posted by eviemath at 11:18 AM on December 26, 2022 [6 favorites]
posted by eviemath at 11:18 AM on December 26, 2022 [6 favorites]
Mod note: A few comments deleted. Galvanic and eviemath, please drop this one-on-one back and forth on masking, or if you need to continue, take it to email. I'm sorry folks, COVID is a shitty thing with shitty consequences for a whole lot of people in a whole lot of different ways, and no amount of sparring with individual commenters here is going to change that. Nobody is going to solve the pro-masking versus anti-masking issues here because there is no simplistic black and white solution, and that is not what the article is about. Please resume discussion on the topic of the posted link, or take a break from this thread. Thanks.
posted by taz (staff) at 10:51 PM on December 26, 2022 [3 favorites]
posted by taz (staff) at 10:51 PM on December 26, 2022 [3 favorites]
Further discussion (Tweetthread pointing to nature.com post with back-and-forth in plainer English) as to how COVID may be rewiring immune systems, and how.
posted by delfin at 1:08 PM on January 1, 2023
posted by delfin at 1:08 PM on January 1, 2023
In addition to the conflating of acute phase and long Covid, there's a real danger of interpreting results like the ones the OP circularly.
Assuming you are not big on woo, any disease that has any impact will result in biological changes. Given sufficiently good tools (and we now have very good tools), time, and opportunity, we should be able to measure them. But the important thing in a public health setting is what the impact is, in terms of frequency and severity. And usually the best way of learning about that is by looking at actual patients. (I'm reminded of when genetic sequencing got really easy and people could find that we bearded men all had fecal bacteria in our beards, which sounded scary or at least unsanitary but it's just a fact we've learned about how bacteria get around.)
So we already know long Covid is a real thing, because people get it. In terms of impact, the LC papers in the link above are mostly just another way of saying that people get long Covid. They do not automatically mean that LC is worse or different than we thought--it's more a matter of saying "when we see these population effects, these are the molecular changes that are happening." It's very is to imagine "we see these changes, so things must be bad!" but they rarely tell us anything about severity; the severity gives meaning to the biomarkers.
There are exceptions, of course. In late stage AIDS someone can have CD4 counts going below 200 and it's we understand what that means enough to be more scared by that count than by the chest cold that made you get tested. But these are pretty rare. As I said in my other post on this thread, from the perspective of people trying to cure disease it's been really frustrating how unpredictable the relationship between various molecular, in vivo, and ex vitro measurements and actual disease really is.
These papers are scary to me, but mostly because I'm already scared of LC. If I saw a paper about dangerous sounding biomarkers in people who exercise a lot or smoke pot--and those people do get changes associated with harm too--it wouldn't seem especially frightening. It certainly could be the case that if I knew a lot about related research I'd be more scared, but I also might be less scared.
And keep in mind that when scientists interpret these for lay people, they are also drawing on their own pre-existing estimate of the dangers. Doubly so if you've previously selected for science interpreters who seem trustworthy because they think Covid is more dangerous than many of their colleagues beleive.
Further discussion (Tweetthread pointing to nature.com post with back-and-forth in plainer English) as to how COVID may be rewiring immune systems, and how.
The linked paper is another study of acute stage Covid. Indeed, it is specifically a study into the mechanisms of severe acute stage Covid, and trying to understand why it's severe in some people. The authors themselves speculate that what they are seeing might well happen in other respiratory diseases but it just hasn't been studied.
At a quick read, I don't see them putting forth a claim this has any long term impact. ("Reprogramming" sounds scary, but monocytes live a couple days, so it's not automatically a huge deal if that's the level it's happening on.)
The Twitterer is indeed speaking plain English when they say it's "much worse" than HIV, I just don't see any particular basis for it.
posted by mark k at 4:52 PM on January 1, 2023 [5 favorites]
Assuming you are not big on woo, any disease that has any impact will result in biological changes. Given sufficiently good tools (and we now have very good tools), time, and opportunity, we should be able to measure them. But the important thing in a public health setting is what the impact is, in terms of frequency and severity. And usually the best way of learning about that is by looking at actual patients. (I'm reminded of when genetic sequencing got really easy and people could find that we bearded men all had fecal bacteria in our beards, which sounded scary or at least unsanitary but it's just a fact we've learned about how bacteria get around.)
So we already know long Covid is a real thing, because people get it. In terms of impact, the LC papers in the link above are mostly just another way of saying that people get long Covid. They do not automatically mean that LC is worse or different than we thought--it's more a matter of saying "when we see these population effects, these are the molecular changes that are happening." It's very is to imagine "we see these changes, so things must be bad!" but they rarely tell us anything about severity; the severity gives meaning to the biomarkers.
There are exceptions, of course. In late stage AIDS someone can have CD4 counts going below 200 and it's we understand what that means enough to be more scared by that count than by the chest cold that made you get tested. But these are pretty rare. As I said in my other post on this thread, from the perspective of people trying to cure disease it's been really frustrating how unpredictable the relationship between various molecular, in vivo, and ex vitro measurements and actual disease really is.
These papers are scary to me, but mostly because I'm already scared of LC. If I saw a paper about dangerous sounding biomarkers in people who exercise a lot or smoke pot--and those people do get changes associated with harm too--it wouldn't seem especially frightening. It certainly could be the case that if I knew a lot about related research I'd be more scared, but I also might be less scared.
And keep in mind that when scientists interpret these for lay people, they are also drawing on their own pre-existing estimate of the dangers. Doubly so if you've previously selected for science interpreters who seem trustworthy because they think Covid is more dangerous than many of their colleagues beleive.
Further discussion (Tweetthread pointing to nature.com post with back-and-forth in plainer English) as to how COVID may be rewiring immune systems, and how.
The linked paper is another study of acute stage Covid. Indeed, it is specifically a study into the mechanisms of severe acute stage Covid, and trying to understand why it's severe in some people. The authors themselves speculate that what they are seeing might well happen in other respiratory diseases but it just hasn't been studied.
At a quick read, I don't see them putting forth a claim this has any long term impact. ("Reprogramming" sounds scary, but monocytes live a couple days, so it's not automatically a huge deal if that's the level it's happening on.)
The Twitterer is indeed speaking plain English when they say it's "much worse" than HIV, I just don't see any particular basis for it.
posted by mark k at 4:52 PM on January 1, 2023 [5 favorites]
Long-term perturbation of the peripheral immune system months after SARS-CoV-2 infection
posted by Bottlecap at 6:51 PM on January 15, 2023 [1 favorite]
posted by Bottlecap at 6:51 PM on January 15, 2023 [1 favorite]
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posted by many-things at 1:21 AM on December 20, 2022 [4 favorites]