Seconding the sentiment here. Quibbling about "causal" being used in the title aside, we're building more observational evidence that there's negative cognitive effects associated with covid and long covid.
Zhao et al '24 [0] comes immediately to mind; operating on a radically different set of people and data sets from Al-Aly and the gang, they find substantial differences in simple reaction time between covid and no-covid groups.
It seems we're in a phase of the pandemic where denying long tail effects is going to become more prominent as concerning evidence continues to pile up. The name of the game is still to reduce your infection count as much as possible. Stay safe out there, share aerosols unprotected at your own peril.
(threading along for a minor nitpick on above post)
Ya, correct enough.
> > Higher mushroom consumption was associated with lower risk of total cancer (pooled RR for the highest compared with the lowest consumption groups: 0.66; 95% CI: 0.55, 0.78; n = 17)
> Specifically the “0.66; 95% CI: 0.55, 0.78; n = 17” line?
For a given study with a cohort of A entities, and a count of events A_event, and a cohort of B entities, with count of events B_event; the A_risk will be A_event/A, B_risk will be B_event/B; and the risk ratio (RR) between the cohorts will be RR = A_risk/B_risk. [wiki gives a cursory math explainer: https://en.wikipedia.org/wiki/Relative_risk#Numerical_exampl...] If the RR here is lower than 1, whatever distinguishes cohort A from B is interpreted as reducing the risk.
The linked study does a systematic review of the literature. From that review, they ultimately find 17 studies which are suitably comparable under their criteria. Each of these 17 studies are observational studies over different sizes of cohorts (table 1 in linked paper characterizes the n for each study) that report their own risk ratios (figure 3 in the paper plots each of those RR), then they pooled those risk ratios with a random effects model to synthesize each of the different risk ratios between those studies into the single pooled RR within some confidence interval quoted above. ("pooled" because it's pooling the results from multiple studies.)
>sample size n = only 17 after all
The nitpick is that n=17 is referring to the number of papers pooled, not the population sampled in the underlying observational studies. (that number is higher than 17; lee et al in table 1/ fig 3 is n=112,991).
> The COVID devastation is also about long COVID, and even people who had COVID but either recovered “fully” or never displayed symptoms. None of this is over, and we are so, so fucked
You're right by way of the literature available to evaluate this claim. (Even jobs numbers are starting to note that some amount of the worker shortage is likely related to long COVID) Most of the "oh i got it [a few times] and i'm fine" posts are ignoring the long tail risks here.
Unfortunately, it will take 5-20 years for many of the worst long tail consequences of mass spread of sars-cov-2 to become imminently clear. (Enjoy access to your medical specialists while you can! There's not enough slack in the system for doubled-or-worse hazard ratios for most serious conditions, lol!) Decision makers broadly prioritized public dining over prudence. For this choice, we get at least an entire generation picking up sars-cov-2, likely yearly, and our reward will be a horrifying number of early deaths and disability.
This tragedy is so senseless and so avoidable. Zero COVID was and still is the rational strategy; "Let-er-rip" (and the GBD by extension) is anything but rational.
Poz rates in NY state have been sitting near 60ish percent, don't forget your well fitted respirator, usps is doing another round of free test distribution (RATs but better than nothing), and good luck out there. solidarity.
> Zero COVID was and still is the rational strategy
How? The vaccines are mediocre at best and are nowhere near good enough to get R < 1 (except maybe in a population where most people already had COVID, and that’s a big maybe). Masks might be effective enough if everyone wears a good one correctly, but good luck — even if you convinced people, people like eating indoors. And seeing each other’s faces, etc. And the antigen tests are not terrible sensitive.
>This tragedy is so senseless and so avoidable. Zero COVID was and still is the rational strategy
That statement is beyond ridiculous. Zero COVID was a pipe dream (as in: flat out impossible to achieve by any realistically implementable policy) by the time Omicron appeared, which really means: by the time it was spreading in Africa and India.
To be sort of nitpicky: the underlying study [0] does not argue a direct causal connection. This is one of many current observational studies reporting on population level trends and measuring associated incidence ratios/risk ratios/hazard ratios.
That said, dismissing the COVID correlation entirely out of hand also feels wrong here; in part because there are meta analysis in the literature [1] that show risk ratios very comparable to increases here.
To compare from the quote in the article:
> Rates of type 2 diabetes were 62% higher (IRR, 1.62) in 2020 to 2021 than in 2016 to 2019. The incidence of type 2 diabetes rose from 14.8 to 24.7 per 100,000 person-years over that time.
To this in Ssentongo et al:
> Of the 8 studies that characterized the risk of incident diabetes among survivors of COVID-19, the pooled point estimates was 1.66 (95% CI 1.38; 2.00, Fig. 2), implying a 66% higher risk of diabetes.
covid-19 is a complex disease that is correlated to problems with almost every major system in the body (See any of the cites implied by my handle), to suggest it's not a factor at all is very likely incorrect.
> To be sort of nitpicky: the underlying study [0] does not argue ...
To be sort of nitpicky at the time I made that comment there were only four (IIRC) other comments here all of which were making direct causal connections.
It was less the article I was addressing and more those commenters that felt the need to jump straight into "COVID ate my homework" stories.
I can see that both yourself and I appear to agree that covid-19 is a complex disease with a great many correlations and it certainly factors into to at least some kind of indirect connection.
Of interest, perhaps, is this quote from the link I provided above:
After adjusting for differences in the age structure of the population, the proportion of people living with type 2 diabetes almost doubled between 2000 and 2013, and has remained relatively stable in the last decade.
There was no covid in the post 2000 decade, something in that time period caused type-2 diabetes to double (rise by 100%) all the same.
I hope you and I both share a similar degree of wariness towards the conclusions of meta-analysis reviews.
> However, I understand that not everyone can afford to keep buying good masks
As a tip for fellow price-constrained folks out there: upgrading to an elastomeric respirator can help substantially with costs. Dentec's marketing copy suggests about a 90% reduction in costs compared to using disposable respirators [0]; given a pack of 50 duckbills on projectn95 [1] is roughly the same price as a new elastomeric w/ filters [2], seems to check out.
As an added benefit, going in on an elastomeric can help a bit with both mask fit and comfort.
Long COVID/PASC is absolutely a ticking time bomb for the return to office crowd. A previous story on here discussed the "echo chamber of CEO feelings" around the decision to force RTO (https://news.ycombinator.com/item?id=37408985), prominently missing from that article was any grappling with the tradeoff for RTO during substantial community covid spread (disabling anywhere from 16-30% of your employees sharing aerosols.)
Do people in the US still wear masks? Here in Spain it's 1 in 200 now, in public transport, offices etc.
The strange things is those people tend to wear them even outdoors where the risk of infection was always low anyway.
Personally I think the quality of life loss of wearing masks is heavier than that of getting COVID. So I don't either. But every person can make that determination for themselves.
I've thrown away my stockpile of masks too, I had a lot of them because I was always looking for some that met the minimum requirements but we're nevertheless easy to breathe and soft to wear. That was hard to find.
It seems like everyone thinks that wearing masks is only to protect themselves from other people, and completely forgot (or never learned in the first place) that it's actually arguably even more important to wear a mask to protect others from your own cold, whether it's COVID or not.
This is something I really love about Japan and Korea. People are very considerate about not spreading their germs around in public places, by wearing a mask when they're sick.
It really feels like the rest of the world missed that part of the memo, even though we all wore masks for an entire pandemic. It actually boggles my mind.
It was indeed to protect others in the days that covid was not abundant in the air.
Now it's everywhere and there isn't really any point to limit the spread. Sooner or later everyone is getting it anyway. There are no peaks overloading the system anymore.
If I'm sick I'll just stay home instead, whether it's covid or something else.
I'm really glad we don't have a formal society like Japan though.
The way people are so regimental. People are very formal, you can see it in everything. The way they queue even, how they are so traditional and don't like people deviating from the norm. It's a very strict society.
It would not work for me as I really embrace individuality and casual norms.
No mask wearing isnt really a thing in the US anymore. Last year was different. In big cities today, you mostly only see masks on elderly, people who are sick, or other special situations. There is a tiny percentage of healthy, low risk neurotic people who wear them all the time, but they're rare.
> Personally I think the quality of life loss of wearing masks is heavier than that of getting COVID.
You will lose way more DALYs catching COVID (especially multiple times) than you will wearing a mask. We are already seeing the emerging auto-immune effects at a population level as well (rising fungal infections, etc) :\
But that's exactly my point. I don't care about the number of life years. I care about the ones I have being fun and interesting.
Shying away behind a mask and avoiding to busy night clubs etc defeats that purpose. That I will die a few years early when I'm old doesn't really bother me because that time will be less valuable anyway.
One way or another I will catch diseases and I could die at any time. Might as well make the journey interesting and without too much worries.
If I cared so much I wouldn't be obese either :)
But like I said this is a tradeoff for each of us to make, I'm surprised though that the US is still like this, here the masks are really over and done with and everyone is trying to forget those horrible years as much as possible.
I appreciate that these conversations have the same futility as trying to push for condom use during the aids/hiv crisis. The next 5-20 years hold a lot of unneeded suffering that will be difficult to witness and experience. :( It doesn't have to be this way, and we can make far better choices.
The rational, self-interested strategy right now is to minimize viral load, minimize exposure, and minimize infection count. well fitted, high quality masks and respirators are a component of that strategy. if empirical appeals to the literature do not motivate adopting that strategy, nor do emotional appeals to those currently suffering with long covid; that's fine. at some level i'd hoped the detailed vlogs about physics girl's suffering with pasc would have helped people stay safe, this has obviously not happened. it's perhaps Tragic, but it's certainly A Choice One Can Make.
As for myself, i'm not looking to rawdog with people i'm not fluid bonded with. I'm certainly not looking to swap aerosols unprotected with people i don't know. The costs are far too high for a payoff that is far too low. solidarity and may the odds remain ever in your favor.
Well yeah, the kind of night clubs I visit are the kind where aerosols are really the least of the risk, and physical contact is ubiquitous. It's not for everyone. But of course that factors into my risk analysis.
And also that nobody else uses masks there, so there is little point. But condoms are something I do always use and are commonplace in the community I frequent. HIV is a totally different matter than COVID though. It was a terminal disease for decades (and even now it's extremely difficult to deal with)
But HIV has a major difference to COVID: The effectiveness of condoms in preventing it is almost absolute, and is only really negated by unfortunate accidents. They also don't really have serious downsides like masks do (the lower sensitivity is something I in fact like). Compared to the masks which only delay infection, they are by no means a prevention method on a personal scale.
But if the lockdowns have taught me anything it's that a life without human contact is no life, and I've been making up for lost time.
I could care less if people wear masks to protect themselves, but I do wish that people who are in public spaces coughing extremely aggressively and loudly, would think about the others around them and wear a mask. It comes across as extremely inconsiderate to me now whenever I witness this.
At this point everyone is going to get it anyway. And when someone coughs it may not even be covid. Personally it's only ever given me the sniffles rather than coughing (I mistook it for hayfever once).
But even if you're vulnerable, you're gong to get it sooner or later. This is why the vaccines are still being offered to vulnerable people. As healthy individuals can't even get it anymore here even if they want it.
If catching covid multiple times breaks the human immune system, then humanity is screwed. Anyone who lives a non hermitic existence is inevitably getting it multiple times.
I know you think masks are no big deal, and they're not if used temporarily, but long term they're a huge deal for huge swaths of people. I'm an introvert and I'd be delighted to never socialize in person ever again, but I understand most aren't built that way.
The primary thing I don't understand about lab leak and bioweapon theories surrounding SARS-Cov-2 (And if you're an advocate of ideas in this vicinity I'd love a deeper explanation) is this:
If this disease has human origins, accidental or otherwise, why allow it to spread unrestrained?
We know the disease spreads through aerosol transmission. We know that it presents serious long term risks for people who catch it, even those who only have a mild asymptomatic case. Hazard ratios for most "scary" health impacts (strokes, heart attack, diabetes, etc) sit anywhere from 1.75 to near 3, even in broader meta analyses. We know that reinfection can magnify the risk profile of the disease. Estimates for pasc/long covid sit any where between 10 and 30% of all cases for at least 6 months after infection.
Community transmission, as measured by waste water numbers, has been at or above the levels observed during the delta wave for more than half of the months since the omicron wave. We've abandoned masking, destroyed testing infrastructure, indoor air quality is still not substantially better than it was pre 2019, and we have done nothing to bring ANY interventions back.
Isn't all of this just a failure? Or at least a contradiction? If you believe that this disease originated in a lab, why does it make sense to welcome it into your body without any protective measures? Every person on this subcomittee is talking about this lab leak while making sure that they take no visible measures to protect themselves from it, at a time when there's still nonzero community transmission. And now, of course, wastewater numbers are increasing and we are on the precipice of another period of delta-wave-level community transmission.
If this was some nefarious bioweapons play, isn't the response to let it spread and to give up on the disease a confirmation that that such bioweapons are a viable strategy? Why aren't rational actors that believe in these theories of covid's origins doing everything to ensure that they do not get the disease and in turn everything to bring transmission of the disease down to 0?
Zhao et al '24 [0] comes immediately to mind; operating on a radically different set of people and data sets from Al-Aly and the gang, they find substantial differences in simple reaction time between covid and no-covid groups.
It seems we're in a phase of the pandemic where denying long tail effects is going to become more prominent as concerning evidence continues to pile up. The name of the game is still to reduce your infection count as much as possible. Stay safe out there, share aerosols unprotected at your own peril.
[0] https://www.thelancet.com/journals/eclinm/article/PIIS2589-5... "Long COVID is associated with severe cognitive slowing: a multicentre cross-sectional study"