[HN Gopher] Almost third of UK Covid hospital patients readmitte...
___________________________________________________________________
Almost third of UK Covid hospital patients readmitted within four
months
Author : curmudgeon22
Score : 210 points
Date : 2021-04-02 14:37 UTC (8 hours ago)
(HTM) web link (www.theguardian.com)
(TXT) w3m dump (www.theguardian.com)
| JoeAltmaier wrote:
| What is the control? Folks admitted for (any other disease)? What
| was their readmission rate?
|
| Folks needing hospitalization are pretty sick. If they're older,
| this seems a normal result. I'd have to see some statistics to
| call it remarkable.
| Tarsul wrote:
| what I find to be even more astonishing: "and about one in eight
| had died", so 1/8 of those who were in hospital for covid AND
| discharged afterwards, died within 4 months. We also had another
| article in the guardian that said that 1 million of people in the
| UK suffer from long covid ("Symptoms vary but include fatigue,
| muscle pain and difficulty concentrating."):
| https://www.theguardian.com/society/2021/apr/01/long-covid-s...
| gxqoz wrote:
| I've seen some pushback that a lot of hard-to-diagnose chronic
| syndromes are now being deemed "long covid." My assumption is
| that at least some of this is happening as it's the trendiest
| disease of the moment. Not to say there aren't a lot of people
| with clear-cut long covid syndromes.
| Florin_Andrei wrote:
| > _I 've seen some pushback that a lot of hard-to-diagnose
| chronic syndromes are now being deemed "long covid." My
| assumption is that at least some of this is happening as it's
| the trendiest disease of the moment._
|
| The "pushbacks" you see on social media are essentially the
| output of a random sentence generator. Covid is not real,
| covid escaped from a lab, covid is a conspiracy, etc. etc.
|
| Be careful with that stuff. You are what you read (and
| believe).
| [deleted]
| JulianMorrison wrote:
| It looks like there's an overlap with post-viral syndromes
| and chronic fatigue syndrome, pointing to a common etiology
| under the hood.
| sprkwd wrote:
| It would be nice if this helped research in to chronic
| fatigue conditions.
| JulianMorrison wrote:
| I strongly suspect it will.
| gnabgib wrote:
| There is some overlap and some similarities.. if long covid
| doesn't end perhaps it'll even be considered M.E[0].
| Myalgic Encephalomyelitis sufferers have been ignored by
| mainstream medicine, maybe this will bring change.
|
| [0]: https://valerieeliotsmith.com/2021/02/19/a-short-post-
| on-lon...
| howinteresting wrote:
| Or maybe, people have been dealing with post-viral syndromes
| for a long time, our society is completely unequipped to
| understand and deal with them, and they see post-COVID
| syndrome as _finally_ a chance to address this.
|
| But taking that perspective requires correcting for the
| systematic underweighting of the testimonial evidence of
| patients of chronic illnesses.
|
| Less trendiness, more empathy, please.
| galangalalgol wrote:
| A lot of post viral stuff seems to be autoimmune, and we
| don't treat autoimmune well. Chronic fatigue and
| fibromyalgia weren't even recognized as real things not
| that long ago. Others like RA or Hashi's we suppress the
| immune system and/or rely entirely on simple tests to
| determine medication levels instead of relying on patient
| testamony and testing instead for over medication symptoms.
| These feedback loops are amazingly complex and looking at a
| few numbers doesn't cut it. In addition we know diet and
| environmental triggers are a thing from many studies, but
| doctors don't say "eat more greens" anymore, they say lets
| do a test now take this pill.
| noir_lord wrote:
| I have chrohn's and the treatment for that is high dose
| steroids or chopping sections out.
|
| Fortunately I'm on the mild end of the spectrum and
| flairs are infrequent but it'd be nice if we had
| something better to treat auto-immune disorders.
|
| To control my chrohns I changed my diet by removing
| foods, keeping track of general well being for a few
| weeks then gradually introducing them to see what
| happened til I found a routine that worked, it's bland
| most of the time but I'll take the win - basically a
| Mediterranean diet which is fine.
|
| There is however a bunch of things in the pipeline
| including things like targetted biologics to selectively
| target the immune system that are exciting.
| galangalalgol wrote:
| Do you have any good wisdom on how you got diagnosed and
| what diets? I've always had GI issues and I have found
| some triggers like mushrooms, blackberries and
| cauliflower which poimt towards SIBO but my GI doc says
| there is no SIBO treatment or diet, and sometimes I have
| problems even on fodmaps. I did AIP diet with my wife who
| has Hashi's and I think that might have helped a little
| but not sure. Everything my GI prescribes just makes it
| worse. I can't eat sweet potatoes anymore after he put me
| on a round of fluconozole.
| noir_lord wrote:
| In my case my diagnosis was because they didn't know what
| was going on and the gastro doc ordered a camera both
| ends to rule things out - it showed up on the colonoscopy
| and the biopsies up til then I had no idea.
|
| I'd lost a lot of weight worryingly fast - mostly because
| of massive reflux problems (barrets oesophagus), was
| having frequent bouts of vomiting and diarrhoea and was
| generally in a shit state all around - as for diet it's
| really hard to recommend anything to anyone else since it
| varies so much - what worked for me was keeping a
| detailed journal of what I ate, how I felt, how I slept,
| toilet habits, times etc then I cut out basically
| everything from my diet I could for a few weeks (think
| porridge, cottage cheese and mashed potato/oven cooked
| chicken breasts) and very gradually added things back
| still keeping the journal until I had actual data I could
| look at - for me there isn't really any one food or group
| that acts as a trigger red meat/processed meat comes the
| closest, it's large high fat/high carb (think Pizza) that
| do it - if I eat fresh foods/veggies/fish/cheese (hard
| not soft) and limited amounts of fruit I have it mostly
| under control but what works for me might wreck you.
| galangalalgol wrote:
| Thanks! I don't loose weight easily, and everyone
| mentions that, so I don't think that is my problem. My
| gut does well on a western processed food diet, but that
| would kill me eventually. Greens and roots lean poultry
| and fish don't cause me discomfort, but diarrhea is
| common. I keep hoping I'll just adapt to it, but I think
| maybe I'm not built for that much fiber.
| splithalf wrote:
| One unexpected long covid symptom: writing buggy code.
| https://arstechnica.com/gadgets/2021/03/buffer-overruns-
| lice...
| brundolf wrote:
| The virus has hopped from humans to computers
| djmips wrote:
| Interesting article, the whole landlord part was out of
| place but it does seem like he was unmotivated because
| those faults are not even tricky.
| genericone wrote:
| Someone please correct me if I'm wrong... but I don't think
| it's just trendy, its also profitable. Insurance claims with
| "covid" noted are, in my rational opinion, processed a lot
| more liberally, quickly, and without deeply looking at the
| details of the claim. The claimant could probably even charge
| insurance more for the same service if covid is noted in the
| claim notes.
|
| The political/social powder-keg of denying a covid related
| insurance claim is not one that a health insurance
| corporation would probably be willing to take, at least for
| another year or 2.
| atoav wrote:
| I know anecdotes are not evidence, but I knwo two personally.
| Both had covid and no troubles breathing before they had it.
| Afterwards not so much.
|
| I am not a medical professional, but I know these people and
| how their bodies functioned beforehand. The way they are now
| is certainly not a _hard-to-diagnose chronic syndrome_ that
| is unreleated to them catching the damn thing.
| mlyle wrote:
| He said: "Not to say there aren't a lot of people with
| clear-cut long covid syndromes."
|
| But, also, you'll find people with long COVID who are
| finally paying attention to other symptoms and ascribing
| them to the C-19 infection.
| watwut wrote:
| The long haulers I know have long symptoms that would be
| impossible to ignore previously too. The doctors won't
| care about tiny symptoms either.
| mlyle wrote:
| Some of the things that cause concern are studies finding
| depression, fatigue, brain fog, etc.
|
| But if you screened any population of lower health you'd
| find a fair number of instances of these... and
| historical baselines are probably not valid because we've
| had a weird year. So-- the exact incidence of some of the
| milder end of long COVID is hard to pin down.
| nonameiguess wrote:
| Just to add to the post-viral syndrome chorus, this happened
| to me when I was 20. I caught what seemed like a pretty
| normal flu, but it eventually morphed into bronchitis and
| then pneumonia because I was an idiot who thought he was
| immortal and continued going out clubbing and staying out
| late with friends and it was four months before I finally saw
| a doctor and took the advice to rest and get blasted with
| high dose antibiotics.
|
| I was down for about two additional months after that, in
| which I caught another flu twice, and could barely get out of
| bed for a while. And then I proceeded to have complications
| from colds and flus that evolved to bronchitis or pneumonia
| every single flu season for the next 8 years.
|
| It took nearly a decade to really recover from that. I see no
| reason to think any sufficiently bad respiratory infection
| with high enough viral load wouldn't do the same thing,
| especially to people much less healthy than 20 year-old me, a
| two-time state champion cross country runner in high school.
| stretchwithme wrote:
| I had persistent lung congestion for weeks. I did some
| research online and found this thing called a salt inhaler.
| That cleared it up in a couple of days.
|
| Salt has a way of pulling infections out of tissues.
| sithadmin wrote:
| I'm not a physician, but intentionally inhaling salt
| particles into the respiratory tract to 'pull infections
| out of tissues' strikes me as an extremely bad idea.
| kian wrote:
| Saline solutions dissolve mucous.
| sp332 wrote:
| The description of the mechanism is probably wrong, but
| the Asthma and Allergy Foundation of America says it's
| probably safe.
| clairity wrote:
| yes, what we're seeing is the frenzy around covid latching
| onto any and all related phenomena and pulling them into
| it's orbit. it's reasonable to study those phenomena for
| their relationship to a particular infection, but not to
| conclude that relationship based on merely studying it, as
| is happening here.
|
| post-infection complications are not uncommon, although
| specifics certainly vary. i'd also had a long tail of
| recovery from a flu->bronchitis->pneumonia cascade a few
| years ago (on the order of many months, not years).
| base698 wrote:
| With the median death being > 80 is this surprising?
| tim333 wrote:
| One in 8 died is pretty bad for average age 65.
| zamalek wrote:
| > the guardian that said that 1 million of people in the UK
| suffer from long covid
|
| There's varying severities. The 1/8 figure applies only to
| people who developed long-COVID after being hospitalized for
| acute COVID (i.e. most likely on a ventilator).
|
| Minor COVID cases can still develop several long-COVID symptoms
| (the symptoms you pointed out) that aren't life-threatening.
| This is the long-COVID you generally hear about because
| surviving a minor or asymptomatic case of COVID isn't the end
| of your worries, and is why it is beyond idiotic to play fast
| and loose with the virus.
| jaybrendansmith wrote:
| Long Covid is real. I had a mild case back in August, but it took
| around 5 months to feel 'normal' again. Lots of inexplicable
| things: Minor heart palpitations, feeling of 'heaviness' behind
| my breastbone. When I exercised, even moderately like running a
| half mile, I would feel strangely exhausted for many hours later.
| All of this has gone away now, but I can easily see how someone
| who is hospitalized could have a relapse, either by overdoing it
| because they think they should be fully recovered, or through
| some other mysterious after-effect. Personally I believe it is
| caused by an immune system that is on 'high alert' after being
| attacked in every organ for multiple weeks (this is how Covid
| feels). It is logical to me that it might take multiple months
| for an immune system to gain back its equilibrium. Just guesses,
| I am not a doctor.
| bserge wrote:
| I'll just add my own experience. I had almost no symptoms, no
| cough, no taste loss, not even sniffles. Likely infection date
| 15th of February. PCR test on the 24th of February.
|
| No symptoms at that point. 2 days later, I started feeling more
| tired than usual. The next day I had a mild fever and was
| sweating more than usual when exercising. This lasted 3 days,
| after which I only felt the fatigue for another 5 days.
|
| No lasting effects that I can name.
|
| I'm 31, male.
|
| I had a cold around 5th-10th of February. I take levothyroxine
| every day, multivitamin everyday, Gabapentin every day, Vitamin
| C 500mg twice a week. Light exercise everyday, a more thorough
| workout twice a week. I drink alcohol and smoke tobacco
| regularly, and everyday between 24th of February - 15th of
| March.
|
| I mention all that because some research said the cold and CV
| viruses are competitive, plus having the immune system "battle
| ready" after a simple cold could've helped. Levothyroxine
| increases metabolism, vitamins and exercise probably help.
| Smoking has been linked to lesser symptoms, too. I wonder what
| the effects would've been without all that.
|
| Anxiety over Covid (I scared myself reading reports on Reddit)
| and losing my job (unrelated, but bad timing) was by far a
| bigger problem than the virus itself.
| klyrs wrote:
| So... you weren't hospitalized, and also weren't readmitted
| to the hospital? What's the purpose of this anecdote?
| jhayward wrote:
| They are engaging in the currently obvious right-wing
| syndrome: if it didn't happen to me it's not important.
| Once it happens to me, it's of primary importance.
| bserge wrote:
| No purpose, I guess. Just took the opportunity to share my
| experience.
|
| I am interested in reading about others' experiences, it's
| just that everything I could find (mostly on Reddit)
| depicted a much worse picture.
|
| And yet statistics say that the vast majority of people
| have it easy like me.
|
| I mentioned I would love a database like Erowid, with input
| from everyone who has had a confirmed infection. I'd read
| through all of it and make my own conclusions.
|
| I was told to self quarantine and call an ambulance if I
| felt worse. The hospitals here are overwhelmed just like
| many other cities/countries.
| lamontcg wrote:
| 95% of people (which is a "vast majority") could have
| normal mild to moderate post-viral symptoms which go away
| entirely in 12 months. If 5% have long term disabilities
| then with something like ~100M people in the USA having
| been infected that would be ~5M with long term
| disabilities. That would be 20 times more people than
| were affected by Gulf War Syndrome. That amounts to a
| 1.5% chunk taken out of the civilian labor force
| participation rate.
|
| A small minority of people having serious difficulties
| with the virus can turn into a large medical issue when
| the denominator is 1/3 to 1/2 of the country getting
| infected.
| pcthrowaway wrote:
| You're right that the experience reports skew in favour
| of the more extreme. However, I have enjoyed perusing
| reddit.com/r/covid19positive nonetheless (with that
| understanding)
| timr wrote:
| I now personally know over a dozen people (ranging from
| mid-20s up through upper 40s) who have had Covid-19. All had
| minor illness and are now fine.
|
| Which is not to say that others do not have lingering
| symptoms -- but if we're going to emphasize scary anecdotes,
| it seems like we should spend proportional time reporting the
| vastly larger number of anecdotes that are _not_ scary, as
| well?
| sangnoir wrote:
| > but we're going to emphasize scary anecdotes, it seems
| like we should spend proportional time reporting the vastly
| larger number of anecdotes that are not scary, as well?
|
| I haven't backed up my personal data in _years_ and nothing
| nasty has happened, despite all those catastrophic data-
| loss stories you read online. I 'm all for proportional
| reporting time, but strangely, no one reports on stories
| like mine - it's mostly in the vein of "Company shutters
| after accidental db deletion". I wonder why.
| nostrademons wrote:
| Similarly, I've been wearing my seatbelt my whole life
| and have never gotten into an accident while driving. My
| kid was placed on his back in the crib without any
| pillows or blankets, even though he hated it, but never
| once stopped breathing. I have health insurance but ...
| shit, there was that one time in high school where a
| kidney infection put me in the hospital and would've
| killed me had I not gone, was billed at a hundred grand
| or so, but insurance covered the whole thing.
|
| There's a reason we pay attention to tail risks, where
| the low-probability negative consequences are far worse
| than the high-probability costs of averting them. The
| vast majority of people are not going to die in car
| crashes, or of SIDS, or of COVID, or from untreated
| kidney infections. They are lucky. But the consequences
| of _death_ are so much worse than the costs of wearing a
| mask, or not seeing your friends in person, or dealing
| with anxiety, that it 's worth taking some precautions
| even if the chance that you'll die from COVID is low.
| gerdesj wrote:
| Quite. Anecdata does have its place but only for the
| sample population (1).
|
| I still hear people worrying about safety despite the
| fact that half the UK, a large part of the US and
| countless others have been jabbed. That's after the
| original trials. I can understand some people's
| reluctance wrt vaccination. Many countries have had
| examples of problematic vacc campaigns. In the UK the MMR
| jab had a major set back due to Andrew Wakefield's false
| article in the Lancet [1].
|
| From what I gather the thrombosis risk from the
| Oxford/Astrazeneca jab is somewhat swamped by error bars
| and open to interpretation. However the risk from the
| pandemic is very real and demonstrably so. I had my jab
| last Tues and it was O/AZ but I wont ask anyone to
| extrapolate much from that!
|
| [1] https://en.wikipedia.org/wiki/MMR_vaccine_and_autism
| timr wrote:
| > There's a reason we pay attention to tail risks, where
| the low-probability negative consequences are far worse
| than the high-probability costs of averting them. The
| vast majority of people are not going to die in car
| crashes, or of SIDS, or of COVID, or from untreated
| kidney infections. They are lucky.
|
| No, by _definition_ , they're the norm. They're not
| _lucky_ , they're just normal. The expected outcome. The
| people who encounter the tail risks are _unlucky_.
|
| Not too long ago, a part of a jet fell off over suburban
| Denver. I would be dismayed if someone -- engineers and
| investigators -- _didn 't_ obsess over this event. But if
| my brother wants to know if it's safe to get on an
| airplane, or live in suburban Denver, then my answer is
| not going to change.
|
| I would also discourage anyone else from reading HN posts
| with obscure technical documents from Boeing and the FAA,
| and speculating about what it means for aviation in
| general. Or reading other peoples' posts on these topics,
| and sharing anecdotes about how "someone they knew" died
| in some ghastly aviation accident. And so on.
|
| It is in our nature to exaggerate the importance of rare
| events. They are still rare.
|
| > But the consequences of death are so much worse than
| the costs of wearing a mask, or not seeing your friends
| in person, or dealing with anxiety, that it's worth
| taking some precautions even if the chance that you'll
| die from COVID is low.
|
| How did _masks_ get swirled up into this? I
| swear...people will find any way to turn these things
| into a political debate.
|
| You can find anecdotes on the internet to support
| literally any fear that you care to indulge. The point
| is, _most of the time_ , these fears are not worth
| indulging, and what you read on the internet exaggerates
| the actual threat.
| mattmanser wrote:
| Ok, but the UK has a large, integrated, health care system,
| with an office of national statistics that is following the
| disease and published this data.
|
| It also talks about how poorer people, and those from non-
| white backgrounds are disproportionately likely to have
| worse outcomes.
|
| Just because you don't see it happening in your circles,
| doesn't mean it's not happening in other ones.
|
| _The authors write in the BMJ: "The increase in risk was
| not confined to the elderly and was not uniform across
| ethnicities. "_
| timr wrote:
| > Ok, but the UK has a large, integrated, health care
| system, with an office of national statistics that is
| following the disease and published this data.
|
| Having an office of national statistics does not mean
| that this particular paper is being reported correctly by
| the mass media, it doesn't mean that the paper itself
| supports the discussion of "long covid" amongst otherwise
| healthy people, and it certainly doesn't mean that _other
| people on this thread reporting personal stories_ are
| representative of the actual risk. That last bit is what
| I 'm emphasizing here. Literally any scary anecdote is
| amplified, and the (many more) pedestrian anecdotes go
| undiscussed.
|
| As other comments on this page have noted, there are a
| number of legitimate criticisms of this paper that should
| be considered carefully, and even if you don't agree with
| those, the paper is _self-admittedly_ discussing a
| predominantly elderly, sick population who were
| _hospitalized for the virus_. It doesn 't generalize to
| discussion of anecdotes of "long covid" from much
| healthier people.
|
| > It also talks about how poorer people, and those from
| non-white backgrounds are disproportionately likely to
| have worse outcomes. Just because you don't see it
| happening in your circles, doesn't mean it's not
| happening in other ones.
|
| You're making assumptions.
| Spooky23 wrote:
| I have had a lot of exposed colleagues and friends. (~100
| total) It's a bell curve ranging from nothing to death.
|
| The hard part is unless you have diabetes or similar, it
| seems random to me. And I don't see good accounting of long
| term symptoms.
|
| The political bullshit is such that we won't really know
| what's up for a few years.
| LeCow wrote:
| I had it based of an anti-bodies test. 0 symptoms
| absolutely fine...like 99% of everyone.
| mikevm wrote:
| What about this? https://www.instagram.com/p/CMwwVxZMiBb/
| Florin_Andrei wrote:
| We know that a majority of cases are asymptomatic or have
| minor symptoms. That's not news.
|
| But the weird long-COVID cases are problematic - they're
| real, they affect a certain slice of the demographics, and
| can be pretty serious and long-term.
| bserge wrote:
| It would be great to have such a database of reports from
| anyone with a _confirmed_ Covid infection. Like Erowid for
| Covid.
|
| Most people (I read it's around 86%) having such mild
| symptoms that they don't even realize it's Covid must've
| contributed a lot to its rapid spread.
|
| The more vulnerable people get the same virus and suffer
| much more. Perhaps vulnerable people should've been
| subjected to stricter lockdown measures, not sure what else
| could help reduce the deaths.
| azeirah wrote:
| You could start by datamining /r/covid19positive
| timelines. There should be over 100 personal experiences
| there, with symptoms per date
| rriepe wrote:
| Maybe get your iron checked out? I have iron issues (overload)
| and noticed the spike after Covid was really intense. If your
| 'heaviness' is on the right side it could be liver swelling.
| All cold/flu will give you a spike like this because your body
| absorbs all the iron from the cells that died. It throws off
| your balance of circulating/stored iron for a while. Normal
| people won't notice it but if you have iron issues you will.
| But this is just a guess too, I am also not a doctor.
| a_brawling_boo wrote:
| Thanks for this. I had a mild case in January and have been
| feeling 'off' in multiple ways including the above. Glad to
| know there is light at the end of the tunnel.
| notahacker wrote:
| > feeling of 'heaviness' behind my breastbone.
|
| You may already be aware of this but there's an organ there
| called the thymus which is a core part of the immune system
| (especially in younger people)
|
| Seems to be a symptom with relatively little discussion even in
| medical journals but can confirm I also had it for months after
| a relatively mild case, tending to reemerge due to tiredness or
| exercise.
| jjeaff wrote:
| I think it could also be due to damaged heart tissue as there
| have been reports of covid having that affect on people.
| [deleted]
| guscost wrote:
| This may be unpopular to say, but anxiety could have caused
| some or all of these symptoms.
| oger wrote:
| You don't die from anxiety.
| Wohlf wrote:
| You don't die from obesity either, you die from the effects
| it has on the body.
| guscost wrote:
| Anxiety is one of the _worst possible_ influences on
| cardiovascular health:
|
| https://pubmed.ncbi.nlm.nih.gov/26027689/
| [deleted]
| ckosidows wrote:
| Sounded like anxiety to me. I experience a number of those
| things on and off again and as far as I can tell they've
| always been because of anxiety. They can feel serious but
| it's often just your mind telling you something is wrong when
| it's not.
|
| Not a doctor. Could be wrong. Just sound like anxiety
| symptoms from my experience.
| Twounwhe wrote:
| (I'm not the person you were replying to.).
|
| I've had similar symptoms, and more, for the past 8 months.
| Heart palpitations, feeling of heaviness in the chest,
| strange exhaustion... I admit this does sound like anxiety.
| However, after suffering from anxiety for two decades, I've
| learned what my anxiety feels like. This is different. It's
| like comparing grits and runny oatmeal--I can understand
| why many descriptions are insufficient to distinguish
| between them, and even how one might be able to masquerade
| as the other, but having had both, it's clear they are not
| the same.
| kayodelycaon wrote:
| I have anxiety and asthma that are well-controlled and I've
| never been afraid or worried about COVID-19. I got sick
| last March for four months with severe symptoms that were
| described above. I was having many anxiety and asthma
| attacks with no obvious cause.
|
| I still haven't gotten fully back on my feet.
| anoncake wrote:
| > Long Covid is real.
|
| But temporary -- and not all that long compared to the hell
| we've _all_ had to endure for more than a year now -- except in
| extremely rare cases. Evidence to the contrary is welcome,
| after more than a year there _should_ be some.
| raarts wrote:
| I fully agree with you. And considering the fact that a virus
| cannot be eradicated and will continue to mutate we will have
| to live with covid just like we do with the flu.
|
| There _is_ a minimum number of deaths that we should accept
| as a society just like we accept other causes of death.
| itake wrote:
| > surveys conducted by patient groups indicate that 50% to
| 80% of patients continue to have bothersome symptoms three
| months after the onset of COVID-19 -- even after tests no
| longer detect virus in their body.
|
| https://www.health.harvard.edu/blog/the-tragedy-of-the-
| post-...
|
| Search for the term "covid long haulers" to get more
| information.
| mvid wrote:
| Death isn't temporary.
| b3kart wrote:
| > Evidence to the contrary is welcome
|
| You understand the burden of proof is on the person who's
| making a claim, not on people who disagree with the claim?
|
| I've too suffered being stuck at home for more than a year,
| but in my book this is still better than me or somebody else
| getting sick with god-only-knows what long term
| complications, which we don't have data for one way or
| another, and won't for some time still.
| krona wrote:
| _> You understand the burden of proof is on the person who
| 's making a claim, not on people who disagree with the
| claim?_
|
| Interesting idea, but false in this case unless you are
| arguing that lockdowns are and will be, in perpetuity, the
| status quo.
|
| _> this is still better than me or somebody else getting
| sick with god-only-knows what long term complications,
| which we don 't have data for one way or another_
|
| Are you arguing your presence in society is outweighed by
| the mere possibility of you having a negative effect on it?
| b3kart wrote:
| > unless you are arguing that lockdowns are and will be,
| in perpetuity, the status quo
|
| I am not arguing either way, what I am saying is shouting
| "here's what I think, prove me wrong" is not how it
| works. "Here's what I think, and here is the evidence" is
| how it works.
|
| Lack of data can't support any claim. If we don't have
| good data on whether lockdowns are effective, it doesn't
| mean they aren't. It means we don't know. In which case
| we do a risk analysis, taking our uncertainty and
| potential benefits/drawbacks into account.
|
| > Are you arguing your presence in society is outweighed
| by the mere possibility of you having a negative effect
| on it?
|
| I don't consider myself absent from society. I am talking
| to you now, am I not? And yes, I consider my temporary
| suffering to be outweighed by potentially permanent
| suffering of myself or someone else.
| pengaru wrote:
| > compared to the hell we've all had to endure for more than
| a year now
|
| Speak for yourself!
|
| My life was largely unchanged by covid beyond wearing a
| facial covering in public which I actually prefer. What a joy
| to not only walk into banks dressed like a bandit without
| getting arrested, but to be _asked_ to do it and thanked for
| cooperating!
|
| This certainly hasn't been any sort of hell for me, but
| catching covid let alone "long covid" seems likely to be
| quite awful and potentially life-changing for _anyone_.
| twox2 wrote:
| Funny, my life even changed for the better in many ways...
| work from home is wonderful.
| pengaru wrote:
| Yeah, I ended up getting a shitload of projects done on
| my property instead of the usual summer vacation. It was
| probably the better path since I had been procrastinating
| many of those things for too long already.
| moate wrote:
| Legitimately, my finances are in such better shape than
| the were in March 2020, and I've been laid off twice and
| on unemployment for extended periods.
|
| Living in US, NJ FWIW
| castis wrote:
| I wish to point out that the hell you're describing is also
| temporary, and would have possibly been much shorter if
| everyone had just gone along with it from the start.
| spookthesunset wrote:
| > would have possibly been much shorter if everyone had
| just gone along with it from the start.
|
| So what you are saying is, despite "the experts" saying
| exactly the opposite... by slowing the spread of covid we'd
| somehow be out of this sooner?
|
| Do you guys realize how insane this logic sounds? The goal
| of these lockdowns was to intentionally slow down the
| spread. Not stop or eradicate covid. Harder lockdowns _mean
| this goes on much longer_.
|
| How can people genuinely think otherwise? It's like basic
| math.
| mdoms wrote:
| The only reason you've had to endure this for over a year is
| because you never once tried to do it properly. 6 weeks of
| hard (proper) lockdown followed by sensible plans to manage
| outbreaks and boom you'd have been done. But no, Americans
| absolutely refuse to work together, to pull in the same
| direction, to achieve something.
| nickpp wrote:
| Hey, you know, if you ever get a bad disease, like an
| infection, here is your solution: just shut down your whole
| body for a while, completely stopping the blood supply
| carrying food and oxygen to your bacteria.
|
| Then when all the infecting bacteria are dead, just restart
| your body again. Easy, no?
| s1artibartfast wrote:
| Try to get 350, million different people to pull in the
| direction of anything and you'll have the same reaction.
| at_a_remove wrote:
| Similarly, we could defund the police if everyone would
| just stop doing crime. And think of what we could do with
| the defense budget if we made some agreements about war!
|
| Any strategy which depends on complete cooperation of a
| large number of humans for success, well, I would short
| that stock.
| rorykoehler wrote:
| Europeans were no different. It's changed my perspective on
| who we are and not in a good way.
| spookthesunset wrote:
| If your plan requires 100% compliance to succeed, it
| failed before you even started. Good plans operate within
| the realities of human nature and respect people's
| inalienable human rights.
| emptysongglass wrote:
| I'm not sure this is true. We did it right in Denmark and
| we're still in what is starting to feel like one long
| lockdown with no end in sight.
|
| Our vaccination numbers are terrible: at the rate we are
| vaccinating all Danes will have _started_ their first
| vaccination round by July 21st, _2022_. [1]
|
| We've had the Moderna vaccine since January 13th [2] of the
| previous year. This is not people failing, these are our
| leaders failing.
|
| I was so gung ho about us coming together to make the
| sacrifices and beat this thing but now a year and a half
| later I'm done with the colossal failures of our leadership
| and the promulgation of fear everywhere.
|
| [1] https://hvorlangtervi.dk/english
|
| [2] https://nymag.com/intelligencer/2020/12/moderna-
| covid-19-vac...
| amscanne wrote:
| Are you saying that an Wuhan-style lockdown would have been
| a better or even feasible approach?
|
| I don't think humans anywhere are able to "pull in the same
| direction" to the extent that such a lockdown is possible
| without an authoritarian government. Italy imposed pretty
| draconian rules for at least six weeks, and has still had
| to deal with a second wave and additional lockdowns.
|
| Personally, I think that the principles of personal freedom
| (that such an authoritarian government is largely
| incompatible with) are much more valuable in the long run.
| Working through the disease has been messier in the last
| year, but the economic system largely based on these
| principles was also able to produce novel vaccines. While
| the last year has been rough, I'm much happier overall that
| I don't live in a place where an authoritarian lockdown is
| even possible.
| mdoms wrote:
| We did it in New Zealand.
| ahepp wrote:
| What's up with people from NZ constantly spamming every
| post about covid with an "I DoNt uNdErStAnD wHy YoU dIdNt
| jUsT lOcK dOwN"
|
| Absolutely infuriating, look at a map dude
|
| inb4 vietnam
|
| Yeah, it's landlocked. Great job Vietnam, we should learn
| from how they did it. Doesn't change the fact that it's a
| major outlier.
| castis wrote:
| > we should learn from how they did it
|
| Lockdowns and people immediately willing be a part of the
| contract tracing part.
|
| https://www.businessinsider.com/vietnam-coronavirus-
| measures...
| trickstra wrote:
| Hello from Vietnam.
|
| Lockdowns are not about islands. It helps, kinda, but not
| completely. Vietnam completely sacrificed the tourist
| industry, unlike US or Europe. Quarantine is at a
| designated facility, not at home, unchecked, like in US
| or Europe. And dissent is suppressed.
|
| The last part is a bit unfortunate, but the former ones
| are really just a matter of decision. And it works.
| ahepp wrote:
| Sincere congratulations, living in the US I think it's
| inspiring to see all the countries with incredible (and
| relatively equally distributed) health outcomes at costs
| that society can bear.
|
| That said, I want people from island countries to stop
| saying "being an island country has nothing to do with
| it", when all evidence and logic says being an island
| country has _a lot_ to do with it.
|
| I'll happily take criticism from Vietnam, even if I think
| it's of questionable utility to say "you just did it
| wrong" when the overwhelming majority of countries seem
| to have "done it wrong"
| dnautics wrote:
| you're also an island. there's a strong multiscalar
| correlation between being an island and having good covid
| outcomes. NZ, Taiwan, South Korea (not technically an
| island, but might as well be), Australia, Japan. And at
| subnational levels too: The best us state is Hawaii. The
| best city in the bay area is Alameda.
| mdoms wrote:
| The lockdown worked, though... We had the virus, then we
| locked down, then we didn't have the virus. Why didn't
| you lock down?
| dnautics wrote:
| you can't say it would have worked. There are places that
| locked down harder than the US and still fared worse.
| I'll remind you that the EU had 1.5x the population
| adjusted mortality of the US, _before_ their immunization
| shenanigans; and that 's despite the US having an
| irresponsible science-denier president.
| mdoms wrote:
| Half a million dead Americans. Fair to say what you're
| doing didn't work.
| snapetom wrote:
| "the population adjusted mortality." I don't know why
| this is so hard to understand, and I'd expect a HN
| audience to understand how proportions work instead of
| just parroting hyperbole.
| spookthesunset wrote:
| > Half a million dead Americans.
|
| One of the hardest challenges of leadership is resisting
| the urge to DO SOMETHING when crisis happens.
|
| > Fair to say what you're doing didn't work.
|
| And yet western nations keep trying the same failed
| policies over and over again and getting the same
| results.
| dnautics wrote:
| Nobody is arguing that what the US did "worked". I am
| saying we don't know that what you are proposing would
| have "worked".
| s1artibartfast wrote:
| It worked as well as Europe and and better than most
| countries, Once you adjust per population size.
|
| https://91-divoc.com/pages/covid-visualization/countries-
| nor...
| lifeformed wrote:
| How does being an island help? Are America's covid
| problems primarily caused by infected Mexicans crossing
| the border? Do the islands you listed not have much air
| travel?
| Mediterraneo10 wrote:
| Being an island that gets all its goods through cargo
| ships or planes allows a lockdown as strict as NZ's. That
| cargo influx involves a small number of personnel.
| However, that isn't the case in e.g. Europe, where
| countries have not been self-sufficient in foodstuffs
| etc. for long decades, and many people live on one side
| of a border and work on the other side. That means there
| is a steady flow of trucks across the continent, as well
| as commuting of at least workers judged essential.
| s1artibartfast wrote:
| The average land traffic crossing US boarders in 2020
| was: 681,750 incoming land travelers and 273,338 incoming
| privately owned vehicles.
|
| The average for island nations like New Zealand was 0.
|
| https://www.cbp.gov/newsroom/stats/typical-day-fy2019
| s1artibartfast wrote:
| The main difference is islands are smaller. New Zealand
| has about 1% of the population of the US
| dnautics wrote:
| Alameda is just enough of a pain in the ass to get to
| that nobody really goes there unless they need to. That's
| what helps. People WANT to go to hawaii, but it's pretty
| easy to cut off (and they did). Note if you are
| unfamiliar with the geography and look up "Alameda"
| numbers, you'll probably get Alameda County, which more
| than just Alameda the island. Alameda County is,
| interestingly, the worst county in the bay area.
| zwaps wrote:
| You can only stop it if you catch it early.
|
| The chance of stopping it early increases exponentially,
| if there are fewer ways into your country from countries
| that are themselves exploding with the virus.
|
| In Europe, all countries broke down eventually and all
| these cases are ultimately imported from crisis areas.
| Many were never caught.
|
| Keeping borders open - in the EU sadly not something that
| could have been realistically changed, if ever - is the
| reason.
|
| Look at the facts: NZ caught all cases early. Full stop.
| So did Germany - at the beginning. It worked in either
| case. But NZ also kept cases low by limiting travel.
| Germany did not do this - least of all because the EU
| literally sued Germany when it started (very recently) to
| lock borders.
|
| Australia not only can limit travel easily, but is also
| huge and barely populated. When there was a significant
| outbreak, it was physically possible to cordon off the
| state in question.
|
| In Europe, once the spread began, it was already present
| in every locality - since Europe is tiny and entire
| countries have higher population densities than Sidney or
| Melbourne! And, this is also important, there is
| significantly more travel of people and goods, and it is
| far less concentrated on a few areas. Many people in
| Europe go to work in a different country from where they
| live, every day. There are literally no borders where you
| could test people. It is being tried. It does very
| little. Look at the spread in areas bordering high
| incidence regions. The borders are as closed as EU laws
| allows. It simply does nothing.
|
| This is it. If you closed borders, then you made it. If
| you did not, then nothing much helps except trying to
| reduce incidence rate such that hospitals do not
| collapse.
|
| We all dreamed of containing non-regionalized outbreak
| clusters by contact tracing. In reality all health
| services, even the very best ones in the world,
| eventually got rolled. Some sooner, some later. Sometimes
| contact tracing worked up until the mutation showed up.
| But it never worked consistently, except with closed
| borders.
|
| Which countries contained the spread while having a high
| density and without being an island? Vietnam. However,
| cross border traffic between Laos and China is either
| strictly controlled or not economically significant - in
| either case, Vietnam is also an example of a country that
| managed to lock down borders - even tourism - almost
| entirely.
|
| Conclusion: Covid has to be geographically contained with
| maximum force. If that is not realistic, for example if
| your country has the density of a city, then you need to
| stop it from getting in in the first place.
|
| And unsurprisingly, being an Island and not 100%
| dependent and interconnected with daily border-less
| traffic helps a lot. Being a huge country with less
| population density or other ways to cordon off locally
| also helps.
|
| In Europe, several countries were doing fine. They had
| lockdowns, contained local spreads and did contact
| tracing. They did not do less than NZ or Australia -
| except they were still surrounded by dozens of other
| highly populated areas with entirely different policies,
| all with different timings. The result was the same
| everywhere - eventually.
|
| So, theoretically the EU could have been saved, if border
| would have been closed off immediately after the first
| cases appeared in Italy. Despite the fact that people
| believed contact tracing was viable - an option that does
| not shatter the political and economic fabric of the
| region.
|
| This post is already too long, but you can read up on the
| discussions at the time and the political, geographical,
| economical and demographic situation in the EU to
| convince yourself that the chance of early border
| closings was close to zero.
| JimDabell wrote:
| I don't really understand this argument in relation to
| the USA. A country like Germany, where they are in the
| Schengen Area, surrounded on all sides by multiple
| countries, with no hard border? Sure, I can see that
| being a factor. But the USA has only two land borders,
| both of them hard. If the USA had locked down properly,
| it would have resembled New Zealand a lot more closely
| than Germany.
| Bellyache5 wrote:
| Based on the tens of thousands if illegal aliens flooding
| into the US across the southern border, I'm not sure it
| can be considered a "hard" border.
|
| https://www.cbp.gov/newsroom/stats/southwest-land-border-
| enc...
| dnautics wrote:
| it's more like between the states, not between the US and
| other countries. One should think of the US analogous to
| the EU and the state analgous to the countries within the
| EU, with schengen. The virus need only make a beachhead
| early on (which it did) and then it was inside of an
| unsealable domain that is wide enough to basically keep
| things going in perpetuity.
| systemvoltage wrote:
| NZ population is 4.9 million people. That's half the size
| of SF Bay Area.
|
| How is this a fair comparison?
| skipwalker wrote:
| I'm sorry but I think this is hogwash. The idea that
| America could function for 6 weeks in a lockdown to the
| level described to actually stop the transmission, by the
| time transmission started, is not plausible to me, and I
| imagine many others. This would have entailed no one
| working at grocery stores, no deliveries, no travel, no
| global trade. I just don't buy that this was ever plausible
| for however long people suggest: 3 weeks, 6 weeks whatever.
| And to what end. When do we open up to the rest of the
| world. I think your sentiment is hindsight wishful
| thinking/blame assignment. Now, criticizing the fact that
| we did not try what I would term more effective measures to
| stop transmission are fair points. Wide-spread cheap
| testing, ramping up massive manufacturing of real N95
| respirators for the entire country, I think these are more
| plausibly effective techniques we did not do that are
| worthy of criticism.
| abraae wrote:
| I don't like the xenophobic tone of the parent, but you
| are incorrect.
|
| > This would have entailed no one working at grocery
| stores, no deliveries, no travel, no global trade. I just
| don't buy that this was ever plausible for however long
| people suggest: 3 weeks, 6 weeks whatever.
|
| The experiences of (at least) New Zealand and Australia
| are clear evidence it is absolutely possible, without the
| absurd extremes you are talking about.
| Izkata wrote:
| Both of which still have lockdowns. So no, they couldn't
| manage it either.
| amluto wrote:
| They periodically reimport it.
|
| If I had to guess, I would guess that COVID can be
| transmitted by fomites, especially if kept cold, but that
| it's extremely rare. In a place like the US or Europe,
| this is insignificant: your chance of getting seriously
| sick due to touching something is negligible, and the
| rate of additional cases due to this effect is
| inconsequential for public health. But in AU or NZ, where
| the background rate is essentially zero, a single
| reintroduction is a big deal.
| kmonsen wrote:
| Although I largely agree with you, they found a case in
| Norway where the most likely explanation was contact
| spreading from a person who had worked in that area 2
| days prior. I feel there must be another explanation, but
| they do probably know the facts a lot better than me.
| kmonsen wrote:
| They are islands though, even if large ones. I don't
| think there are any large connected landmass that has
| managed to successfully take a New Zealand/Taiwan. Also
| US has different states with different rules, but no
| ability to restrict travel between the states. And lots
| of rural areas that potentially had small covid pocket
| before it got diagnosed.
|
| I don't like the previous administration one bit, but
| this was a really hard problem. By the time covid was
| taken seriously I think it is confirmed it was a least
| spreading in Seattle and Bay Area.
| martyvis wrote:
| >They are islands though
|
| This reads like Covid arrived in the US through
| uncontrolled land crossings from Canada or Mexico? I'm
| pretty sure like Australia and NZ, it came by land and
| sea mainly.
|
| > Also US has different states with different rules, but
| no ability to restrict travel between the states
|
| Also Australia never had seen states close borders
| before. Yet somehow each of the 6 states and 2
| territories managed to get legislation passed to do this,
| get police mobilised, and just got community buy-in that
| was going to work.
| AshWolfy wrote:
| We love to say something isnt possible, while other
| countries do what we just said isnt possible.
| systemvoltage wrote:
| USA is 330 million people. New Zealand is 1/2 the
| population of SF Bay Area.
|
| Just because NZ can demonstrate good COVID control, it
| cannot just apply at a massive nation. China has done it
| with authoritarian enforcement. There is no solution to
| this for USA, EU or large countries. Asian nations such
| as Japan and Korea are culturally different than the
| west. It's impossible to change the culture of 330
| million overnight.
| Marsymars wrote:
| Trying to explain away every incidence of successful
| covid-squashing as not applicable isn't very convincing
| given that there aren't _any_ examples of jurisdictions
| that failed at a real attempt at covid squashing - _every
| one of them succeeded_. And this list is quite varied -
| it includes jurisdictions that are islands, that have
| long land borders, that are countries, that are sub-
| country-level, that are in the Anglosphere, that are
| outside of the Anglosphere, that have small populations,
| that have large populations, that are on three different
| continents, etc.
| goddess33 wrote:
| nationalistic flamebait is not welcome on HN, dang will
| likely remove this.
| spookthesunset wrote:
| That is patently false. The whole idea of lockdowns was to
| "flatten the curve" in order to prevent healthcare from
| collapsing. It was never, ever to stop outbreaks or stop
| covid. It was made quite explicit by "the experts" that
| everybody who was gonna get covid would do so and everybody
| who would die would do so. The area under the "death curve"
| was going to be exactly the same so long as healthcare
| didn't collapse. The goal was to literally _slow_ the
| spread not stop it. Make it roll out _slower_ to keep
| healthcare in check.
|
| This idea that if we locked down harder or people "behaved"
| we'd be done with covid is a complete lie. That was never
| the intent of these restrictions. Ever.
|
| I find it very curious how even after massive stockpiles of
| unused ventilators were donated and countless field
| hospitals were closed up after never seeing a single
| patient governors extended their stay-at-home orders.
| Despite it being shown that covid was never a true threat
| to healthcare, despite the sky-high IFR predictions being
| shown wrong (thankfully!), we let the goalpost shift to....
| well... I still don't know what the goal is. We got very
| lucky having a vaccine delivered so quickly because without
| it, we'd have been drifting along aimlessly and things
| would have got very dark and ugly.
|
| > Americans absolutely refuse to work together
|
| Curious how many of the nations in Europe that "did it
| right" wound up getting major outbreaks regardless. Also
| curious how the curves of all regions basically mirror each
| other regardless of restrictions or "how serious they took
| it". Maybe, just maybe, humans aren't as in control of a
| widespread respiratory virus as they'd like to believe.
|
| I believe it is peak human arrogance to think we could
| somehow control a respiratory virus in this manner. In my
| opinion history will look upon all this the same way we
| look at our ancestors performing rain dances and goat
| sacrifices. They are all examples of meaningless rituals
| humans perform in order to fool themselves into believing
| they have more control over mother nature than they
| actually do.
| Mediterraneo10 wrote:
| When people claim that a country should have "done it
| properly", they usually mean closed borders, that end up
| having to stay closed for the long haul to prevent COVID
| from re-entering the country. Personally, I find the long-
| term risks of closed borders in terms of rekindling
| nationalist sentiment and eroding international solidarity,
| to be far more of a threat than COVID.
|
| The pandemic will pass soon, but countries walling
| themselves off could have consequences that even our
| grandchildren might have to deal with.
| dukeofdoom wrote:
| I once had pneumonia, early 30s. It took months to feel 100%
| again. Its just your lungs get damaged, and takes time to heal.
| But if you have other health problems, its a spiral. One bad
| thing leads to the next. Hence, I feel that life is like a bumpy
| pothole filled road. For the most part, if you get past one, you
| will keep rolling down. The key is to avoid the big potholes.
| Some people in terrible physical shape get lucky, and missed a
| few. When reality is anyone of those previous ones could have
| taken them out. I learned this on a road from the airport to a
| hotel in Dominican Republic.
| mjfl wrote:
| There needs to be some kind of analysis to determine whether they
| have causality flipped- do they have these long term health
| problems because of severe COVID or did they get severe COVID due
| to these long term health problems?
| benjaminwootton wrote:
| Or are they both getting seriously ill with Covid and long term
| health problems because they are typically aged 70+ with
| comorbidities
| stretchwithme wrote:
| All the more reason to make sure you're getting enough Vitamins D
| and K2.
|
| Here's an interesting explanation of how Vitamin D helps the
| immune system.
|
| https://www.youtube.com/watch?v=cT1CaTv5-e4
|
| Vitamin D improves your uptake of calcium. Vitamin K2 makes sure
| calcium goes where it's supposed to go. You want your BONES
| calcified, not your arteries.
| randomopining wrote:
| I had both vaccines shots and prob got covid last week. Had no
| nasal congestion, 100F low fever coming and going, little
| fatigue, night sweats. After I felt more normal, developed a
| little cough that I still have.
| incrudible wrote:
| Those symptoms are consistent with the dozens of common cold
| viruses that haven't diseappeared. Consider that many people
| get COVID tests because they are _symptomatic_ , yet most of
| them are negative.
| randomopining wrote:
| I've never had a cold _without_ some level of nasal
| congestion. That 's the only reason that I think it was most
| likely covid.
| alacombe wrote:
| According to https://www.canada.ca/en/public-
| health/services/diseases/flu..., there has been pretty much
| no flu season this year compared to ~any other year (which in
| itself is highly suspect).
|
| Last week of January reported 55 vs 23,972 on _average_ any
| other season.
| lostlogin wrote:
| I'm missing your angle - why is it suspect that there are
| so few cases?
| DanBC wrote:
| You might want to check how they count flu in normal years.
| incrudible wrote:
| Influenza is not the same as the common cold, which is also
| sometimes referred to as "the flu". Besides influenza-
| types, there are a couple of viruses that cause the common
| cold, among them the aptly named rhinoviruses but also
| other coronaviruses.
|
| Indeed there's a suspicious drop in influenza-type cases,
| likely caused by all the social distancing and perhaps by
| SarS-COV-2 simply out-competing influenza-types in knocking
| people out.
| bserge wrote:
| Sounds close to my symptoms. Different than a cold because I
| had no nasal congestion, pain in my throat/neck, cough or the
| usual weird effects on my ears (sometimes one or the other
| feels "covered", an imbalance in hearing, when I have a cold).
|
| Shouldn't the vaccine have helped, though? I don't know.
| lostlogin wrote:
| How soon after the immunisation did you get those symptoms? If
| it was just a day or two, it might be that.
|
| https://www.health.govt.nz/our-work/diseases-and-conditions/...
| godmode2019 wrote:
| In my opinion the 'long covid' was a line thrust into the
| spotlight from the media to justify continued restrictions.
|
| Person A: 'We should open up' Person B: 'Have you not heard most
| people have serious health problems after covid?'
|
| When we talk about proportional reporting I think of the book
| 'Thinking fast and slow'.
| Mediterraneo10 wrote:
| You are not wrong. Yes, scientific studies speak of some subset
| of patients experiencing symptoms weeks or months (but not
| necessarily longer) after COVID. However, the actual studies
| emphasize that severity of long-term symptoms strongly
| correlates with severity of illness. That means that young
| people are at very low risk (not zero, of course, but as low as
| with many other common illnesses). When the media has taken
| these research findings up, however, they typically leave out
| all the nuance, because that way it sounds like more dramatic,
| attention-catching news.
|
| Also, last year some newspapers irresponsibly allowed some
| people to share their claims that they were dealing with tough
| long-term COVID symptoms even when they had never even tested
| positive for the disease in the first place. It was no
| different than giving a megaphone to the people who, before
| COVID, experienced some distress and, without any actual
| medical verification, were sure they were cases of "chronic
| Lyme disease".
|
| Health officials in several countries have plainly fudged the
| truth or left out details when speaking to the public, for what
| they see as the greater good of maintaining restrictions for
| long enough to reach their public-health goals. One naturally
| suspects that they found the panic about long COVID useful for
| this.
| roenxi wrote:
| The article doesn't give us quite enough information - what
| percentage of hospitalised Covid patients are over 70? 70 year
| olds are getting to the point where they spend a lot of time in
| hospital.
|
| The "hospitalised for Covid" part of the sample group is
| introducing a lot of bias. Fit, young and healthy people are much
| less likely to end up in hospital. So it makes sense from the
| first that the group is suffering more problems than a general
| population control group.
| [deleted]
| morsch wrote:
| Four times more often than the control group.
|
| _Over a mean follow-up of 140 days, nearly a third of
| individuals who were discharged from hospital after acute
| covid-19 were readmitted (14 060 of 47 780) and more than 1 in
| 10 (5875) died after discharge, with these events occurring at
| rates four and eight times greater, respectively, than in the
| matched control group. Rates of respiratory disease (P <0.001),
| diabetes (P<0.001), and cardiovascular disease (P<0.001) were
| also significantly raised in patients with covid-19, with 770
| (95% confidence interval 758 to 783), 127 (122 to 132), and 126
| (121 to 131) diagnoses per 1000 person years, respectively.
| Rate ratios were greater for individuals aged less than 70 than
| for those aged 70 or older, and in ethnic minority groups
| compared with the white population, with the largest
| differences seen for respiratory disease (10.5 (95% confidence
| interval 9.7 to 11.4) for age less than 70 years v 4.6 (4.3 to
| 4.8) for age >=70, and 11.4 (9.8 to 13.3) for non-white v 5.2
| (5.0 to 5.5) for white individuals)._
| incrudible wrote:
| _" Rates of respiratory disease (P<0.001), diabetes
| (P<0.001), and cardiovascular disease (P<0.001) were also
| significantly raised in patients with covid-19, with 770 (95%
| confidence interval 758 to 783), 127 (122 to 132), and 126
| (121 to 131) diagnoses per 1000 person years, respectively."_
|
| I could imagine COVID being causally implicated in
| respiratory disease or cardiovascular disease, but diabetes?
| That sounds to me like the control group wasn't
| representative.
| morsch wrote:
| Maybe I'm understanding you wrong, but diabetes is a well-
| known risk factor for COVID-19.
|
| https://www.cdc.gov/coronavirus/2019-ncov/need-extra-
| precaut...
|
| https://www.thelancet.com/journals/landia/article/PIIS2213-
| 8...
| incrudible wrote:
| It is, my point is that the study presents it as an
| _outcome_ of COVID-19, next to outcomes like "death" and
| "re-hospitalizations".
| morsch wrote:
| I can see how you could read it that way, but I think
| they're just confirming the increased rates of covid with
| the three named pre-existing conditions. It never occured
| to me to understand it otherwise when I read it first.
| peytn wrote:
| Worth mentioning that the control group wasn't matched for
| hospital admission status, while the study group was solely
| people who ended up in the hospital. I'm guessing that the
| authors likely could have acquired the data to match a
| control group of people who had been admitted to the
| hospital, so I'd be curious to see what the results would've
| been there.
|
| According to the paper, this control group was picked
| because, essentially, that's what the authors wanted to
| choose:
|
| > We selected controls from the general population rather
| than matching to non-covid hospital admissions to determine
| the increased risk after hospital admission for covid-19
| versus no hospital admission for covid-19 (that is, compared
| with the expected risk for people with similar personal and
| clinical characteristics in the general population).
| azakai wrote:
| Yes, but that seems like a very relevant type of control
| group. If a person got COVID and ended up in the hospital,
| and that person wants to know what possible long-term harm
| that could cause them (that is, compared to had they not
| gotten COVID and not been hospitalized), then the article
| focused on exactly that.
| makomk wrote:
| Not really. The UK has been testing pretty much
| _everyone_ who 's admitted to hospital for COVID since
| the start of the outbreak regardless of why they were
| admitted, which means there's going to be quite a few
| people in the COVID and in hospital group who were
| actually admitted due to other, unrelated conditions.
| Particularly if they were being admitted to hospital
| regularly...
| iso1210 wrote:
| And throughout their stay. My father was vaccinated in
| January, went into hospital after a siezure (not unknown)
| a in mid febuary, he was tested on arrival, and was
| negative. Continued to be tested, and by early march (2
| weeks after admittance) he tested positive.
| azakai wrote:
| Good question to ask, but no, they didn't look at people
| who tested positive but were admitted for something else:
|
| > Individuals were included if they had a hospital
| episode from 1 January to 31 August 2020 with a primary
| diagnosis of covid-19
|
| (from the full paper)
| sokoloff wrote:
| That's what they attempt to focus on, but inadvertently
| introduce bias in terms of people's proclivity to show up
| at the hospital for any given severity of issue.
|
| People who present once for one thing are probably more
| likely to present a second time: either because they have
| a lower threshold for seeking help, they have overall
| poorer health and so present more often, or because they
| have a referring primary doctor who is biased towards
| admitting over treating outpatient.
| azakai wrote:
| That's a fair point. That could inflate the later
| admission numbers.
|
| However, I don't think it can explain the far higher
| death rate.
| sokoloff wrote:
| The poorer general health one it seems would have a bias
| towards all-cause mortality rate, though perhaps not to
| the full magnitude as observed.
| azakai wrote:
| Possibly. But poorer general health is something they
| explicitly tried to account for with the control group,
| at least.
| surfpel wrote:
| The most useful result here is to isolate the impact of
| covid hospital admission status on the probability of
| mortality, not the difference between covid and other
| hospitalizations.
| peytn wrote:
| Anyone who's even dipped a toe in this policy area can
| tell you that when old people and hospitals meet, gaudy
| statistics follow. It's common knowledge in the field. To
| not include that context or any points of comparison
| seems irresponsible to me given the publicity.
| nightpool wrote:
| The excerpt from the study quoted above says "Rate ratios
| were greater for individuals aged less than 70 ... with
| the largest differences seen for respiratory disease
| (10.5 (95% confidence interval 9.7 to 11.4) for age less
| than 70 years v 4.6 (4.3 to 4.8) for age >=70)"
|
| Isn't that a clear indication that there's something
| besides "general trends in old people" going on here?
| incrudible wrote:
| Age isn't the only factor, you need to control for
| underlying health conditions, which apparently they chose
| not to. Suppose you have COPD at age 50, for one you are
| less likely to _live to 70_ , but also you are at a far
| greater risk with COVID. It would not be unexpected if
| such a person were readmitted to the hospital or die
| months later.
| azakai wrote:
| They did account for underlying health conditions. The
| control group was matched for relevant clinincal
| diagnoses, as well as general health factors like BMI and
| smoking (see "matching variables" section in the paper).
| incrudible wrote:
| I see that they were matched now, still the control group
| wasn't _hospitalized_ , which must skew the result.
|
| Looking at the tables, you might get the idea that COVID
| hospitalization causes a lot of diabetes. The way they
| arrive at that is to count the diabetes diagnoses made
| after COVID admission.
|
| However to me it seems far more likely that a diabetic
| _without a diagnosis_ (which is common) gets hospitalized
| with COVID, then gets their diabetes diagnosis in the
| ensuing medical surveillance. Having an undiagnosed liver
| or heart issue is also common.
| azakai wrote:
| See the discussion above - it's very intentional that the
| control group wasn't hospitalized. It's the right
| approach for the question they are trying to answer, "how
| bad off is a person that got COVID and got hospitalized
| as a result of that".
|
| (There are other good questions to ask too, of course.)
| peytn wrote:
| Given the discussion generated here and probably
| elsewhere, why do you believe the authors chose not to
| present a matched hospitalization control group alongside
| their control group? It's pretty standard: that's why
| they included a sentence saying they chose not to (albeit
| without any justification).
|
| Why deviate?
| surfpel wrote:
| > The increase in risk was not confined to the elderly
| and was not uniform across ethnicities
|
| > Rate ratios comparing patients with covid-19 and
| matched controls were greater in individuals aged less
| than 70 than those aged 70 or more for all outcomes
|
| > An alternative approach might have involved comparing
| outcomes after covid-19 and other hospital admissions;
| such research has recently been conducted with similar
| data sources to those in our own study (although with a
| smaller covid-19 cohort), and comparable rates of organ
| dysfunction were found between patients with covid-19 and
| patients with pneumonia who were discharged from hospital
| in 2019.36 We believe that our study design, where
| comparisons were made with the expected risk in the
| general population, was more relevant to public health
| policy, and complementary to the study that used non-
| covid hospital admissions as the comparison group. Also,
| the use of non-covid hospital admissions as the
| comparison group does not allow estimation of excess
| morbidity because non-covid admission does not
| necessarily represent an appropriate counterfactual
| situation to admission to hospital for covid-19, and the
| size and direction of the inferences will depend on the
| choice of control admissions.
| Someone wrote:
| That's the number this study went for, but it also is a
| number that doesn't tell us anything about whether the
| increased chance of hospitalization and increased death
| rate are due to COVID, due to the first hospitalization,
| or due to those being hospitalized in the first place
| already being weaker than the general population.
|
| I wouldn't call it the most useful one.
|
| If those who were admitted to a hospital with COVID
| already were less healthy than those who weren't before
| they got COVID (and that's a given. Higher lung capacity
| can keep you out of the hospital, for example), I don't
| think it is a surprise they still aren't as healthy when
| they leave the hospital.
| DanBC wrote:
| The ICNARC reports give more information. It's only for ICU.
|
| https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports
|
| Page 29 has a chart for spread of age. Most people (88%) live
| without any assistance in day to day activity.
| azakai wrote:
| The full article says it is _not_ only for the ICU, and most
| were not in the ICU:
|
| > 47,780 patients with covid-19 (4,745 admitted to the
| intensive care unit and 43,035 not requiring admission to the
| intensive care unit) were included in the analysis
|
| https://www.bmj.com/content/372/bmj.n693
| LatteLazy wrote:
| What's the usually figure for (1) patients of flu admitted to
| hospital, (2) patients of flu with this sort of age breakdown?
|
| Are their unusual or particular symptoms compared to other people
| with long term issues after viral infections?
|
| I full believe "long covid" is a thing. But so much of covid news
| has been shitty "studies" that get a lot of press despite
| shedding very little light and go on to be rapidly disproven but
| still repeated (Vit D, Chloroquinine etc).
| incrudible wrote:
| Vitamin D supplementation has been "disproven" as an emergency
| treatment, not for prevention. I still think it's worthwhile,
| with or without COVID.
|
| https://news.harvard.edu/gazette/story/2017/02/study-confirm...
| rdkbo wrote:
| https://www.rdkbo.id/
| surfpel wrote:
| Link to the study: https://www.bmj.com/content/372/bmj.n693
|
| From the study:
|
| > At baseline, individuals with covid-19 had a mean age of 64.5
| (standard deviation 19.2) and 54.9% were men. Compared with the
| general population, individuals in hospital with covid-19 were
| more likely to be: male, aged 50 or more, living in a deprived
| area, a former smoker, and overweight or obese (table 1).
| Individuals with covid-19 were also more likely to be comorbid
| than the general population, with a higher prevalence of previous
| admission to hospital and of all measured pre-existing conditions
| (most notably hypertension, major adverse cardiovascular event,
| respiratory disease, and diabetes).
|
| > Individuals discharged from hospital after acute covid-19 had
| increased rates of multiorgan dysfunction (particularly
| respiratory and cardiometabolic) compared with a matched control
| group from the general population
|
| > The rate ratio of multiorgan dysfunction (comparing individuals
| with covid-19 and matched controls) after discharge was greater
| in those aged less than 70 than in those aged 70 or more, and in
| ethnic minority groups than in the white population
|
| > Our findings suggest that the diagnosis, treatment, and
| prevention of post-covid syndrome requires integrated rather than
| organ or disease specific approaches
| noodlenotes wrote:
| I remember at the beginning of the pandemic, it seemed as
| though few current smokers were getting seriously ill, although
| former smokers were at high risk. Did anything come of that?
| [deleted]
| bedhead wrote:
| There is a ton of selection bias here, these are already
| generally speaking very unhealthy people.
| azakai wrote:
| That's why the study looked at a control group, to try to
| account for that bias (as the abstract says, the control group
| was chosen to match "personal and clinical characteristics").
|
| It's always possible they missed a factor, that's always a risk
| in such research, but they worked hard to address that
| possibility.
| arbitrage wrote:
| > It's always possible they missed a factor
|
| in public health medical science? you don't say.
| peytn wrote:
| Not matching for hospital admission status is a pretty big
| factor given the bold, highly publicized top-line numbers:
|
| > We selected controls from the general population rather
| than matching to non-covid hospital admissions to determine
| the increased risk after hospital admission for covid-19
| versus no hospital admission for covid-19 (that is, compared
| with the expected risk for people with similar personal and
| clinical characteristics in the general population).
| azakai wrote:
| (I disagree, see discussion above:
| https://news.ycombinator.com/item?id=26672461 )
| peytn wrote:
| Essentially any contact with a hospital in that
| population produces eye-popping statistics. Having worked
| in this area, I'm of the opinion that the presentation of
| this work is misleading.
| mlyle wrote:
| But the opposite would be misleading, too, in that the
| hospital contact was induced by COVID.
|
| It's all confounded. If you compare to other hospital
| admits, you're finding an even-less-healthy population
| (because they had a reason to show up to the hospital
| -without- COVID). If you compare to the general populace,
| you risk inadequately controlling the comparison.
|
| But if you want to know the increased risk people have
| subsequent to COVID hospitalization, perhaps the latter
| makes the most sense to measure.
| peytn wrote:
| My beef isn't with the measurement, but with the
| presentation thereof. This problem you have recognized is
| so common that a framework was developed [1]. I don't
| feel the work addresses all element of that framework
| satisfactorily. Others may disagree, and that's okay.
|
| [1]: https://en.m.wikipedia.org/wiki/Strengthening_the_re
| porting_...
| legerdemain wrote:
| > one in eight of patients dies in the same period
|
| Another nuanced and striking peculiarity of the English language
| that writers for this international paper may not have mastered
| yet!
|
| "Eight of them" is grammatically unremarkable. "Eight of the
| patients" and "eight patients" are also unremarkable, although
| slightly different in meaning.
|
| "Eight of patients" is jarring. It sounds like "four of clubs."
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(page generated 2021-04-02 23:01 UTC)