(2022-05-26) ZviM Covid 5/26/22 I Guess I Should Respond To This Weeks Long Covid Study
Zvi Mowshowitz: Covid-19 5/26/22: I Guess I Should Respond To This Week’s Long Covid Study. Covering Covid means that the subject matter is always, at its core, a combination of people dying and a portrait of civilizational collapse. The whole situation is usually rather dismaying. It is likely to remain rather dismaying permanently.
I’m hoping to pivot away from short term developments and towards more longer term, less speed premium explorations of how the world works, in places that can lead to more generally useful insight and more delight, although still with a lot of silent screaming about the ways in which things are terrible
One key is that I like to think of finding out things are terrible, whenever I can, as good news and a source of delight. As long as we know roughly how bad things are already, identifying the sources and finding them to be crazy unnecessary idiocy is often good news. It means things can more easily be fixed
Executive Summary
Covid-19 still exists and BA.4/5 have substantial immune escape.
Thus I keep doing these posts every week.
Ideally they keep slowly getting shorter.
The Numbers
The Never-Ending Pandemic
Here we go again with slight variations edition: A prediction that Covid will not only stick around, but ‘infect most people several times a year.’
doesn’t render a steady state of 2 million per day impossible exactly if the virus continues to mutate at lightning speed, but it does not seem like where one would set the betting line.
The next question is whether or not something like a soft version of this scenario should bother us.
If one has the model that each infection is an additional independent chance for bad things to happen, then it is very bad. If you think those bad things prominently include a big risk for Long Covid, it’s even worse.
I would once again (to repeat the argument) strongly urge almost everyone... not to go into permanent midnight mode
Even more than now, most cases will be fully asymptomatic and most other cases annoying. Yes, there will be ‘another flu’ running around of some average severity, and that will make life permanently worse. But the default will not feel like getting infected multiple times a year, certainly not with anything serious.
My model of Long Covid continues to think that if you get a reinfection that doesn’t produce symptoms, the chance of this causing Long Covid is miniscule – if getting infected more often means total severity goes down, then total Long Covid would likely decline as well.
what could we do about it? Barring further technological and scientific developments, nothing. None of our options for making this not happen are worth their costs. With proper pandemic funding for new development, we can change that.
FDA Delenda Est vs. Vaccines
The FDA wants to change the formulations of the vaccines because they are worried not doing so would ‘befuddle’ people. I happen to think the exact opposite. Different people like different things. Making this seem more like a choice seems likely to be actively good. I would not, however, be so bold as to change the formulations of the vaccines to try and play mind games with the public.
I don’t see a way the CDC could have issued better guidelines.
Long Covid Yet Again, Sigh
this Washington Post article about the new Nature paper claiming that vaccination was not protective against Long Covid
Paper did not move me substantially from what I said in The Long Long Covid Post. Explaining why would mostly be a rehash of that post.
Study pre-dates Omicron
Vaccination did reduce risk for all death
One interpretation of this is that Long Covid is real, it is everywhere, it is not much reduced by vaccination, and thus it also must not care much about severity of the infection.
Another interpretation of this is that those who say they suffer from Long Covid are mostly not suffering from Long Covid.
Here’s the bullet point version.
Instead, this would be a mix of:
A: Those who get Covid being less healthy, those whose Covid is detected being less healthy, and controls not fully handling this.
And B: Those whose Covid is detected being more likely to report things that they believe are wrong with them both because it is in their nature and because they are more likely to associate the issues with Covid and thus report them.
I have intentionally been avoiding discussing news on Long Covid that didn’t adjust my priors
I don’t know any way to describe this except you can’t do that, you can’t do any of that, you people are cheating, you know you are cheating and you’re doing it anyway.
What the CDC did in the claim in question is deeply, deeply alarmist and irresponsible. Also, when one reads the report: Matched controls? What are matched controls?
I mean, here’s what they say among other things about ‘limitations
The nature of the problem makes the question extremely hard to study if you’re interested in getting the real answer.
Going forward, my policy will continue to be:
If something involving Long Covid changes my model I’ll discuss it.
If something doesn’t change my model much, I’ll do my best to skip it.
BA 1 2 3 4 5
BA.4 and BA.5 indeed have meaningful additional escape properties (link to paper), but the escape is not total, and the escape from BA.1-breakthrough-elicited antibodies is not as bad
Prevention and Prevention Prevention Prevention
An estimate that good ventilation reduces Covid transmission by ~80%.
In Other News
Think of the Children (non-Covid Edition)
Tragedy struck this week in the form of a school shooting in Texas.
What we need to avoid doing is compounding the tragedy of school shootings by doing serious damage to all of the children in school in the whole country. Having children constantly walk through metal detectors, or removing doors from buildings, or having teachers carrying guns, or treating any child who does anything weird or makes their fingers into a fake weapon as a potential serial killer, or most importantly doing traumatic live shooter drills, are profoundly terrible policies that impose huge costs on our children’s lived experiences (mash shooting)
All of that really is incredibly bad. It bears keeping in mind the magnitude of the problem: less than 10 deaths and less than 50 injuries per year for the entire country, out of roughly 50 million students.
Would preventing that be worth a decade of going through metal detectors and periodically being traumatized by pretending you were being hunted by a killer and teach them to view the world through the lens of firearms even if it fully worked? I know if I was choosing for my own children I would answer an emphatic no.
There’s even reason to suspect that creating a culture in which children are taught that school shootings are far more common than they are, that they are expected behavior, could be a large contributor to why we have so many such shootings. The idea to do it has to come from somewhere.
It’s another thing to have people with guns hanging around your kids who when the time comes if anything actively prevent people from stopping the one in a million risk. Those who buy a little temporary security often do not get what they paid for.
It all also echoes, of course, Covid-19, both what we did as adults but especially what we did to kids.
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