[HN Gopher] Cognitive deficits in people who have recovered from...
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       Cognitive deficits in people who have recovered from Covid-19
        
       Author : erentz
       Score  : 228 points
       Date   : 2021-07-24 09:33 UTC (13 hours ago)
        
 (HTM) web link (www.thelancet.com)
 (TXT) w3m dump (www.thelancet.com)
        
       | rob_c wrote:
       | FYI: the lancet has unfortunately become a rather alarmist
       | journal of late. There are several articles citing "bbc.co.uk" as
       | fact which is similar to a Russian source citing "rt.com". Those
       | articles in turn getting cited by the beeb in the uk to publish
       | daily mail style FUD headlines which are quickly buried on the
       | site.
       | 
       | Ignoring this, I think most other comments cover the fact that
       | this study has the normal problem with this type of study. Poor
       | stats which aren't statistically corrected for the subset the
       | population who end up in hospital due to covid. (or again the
       | subset with symptoms strong enough to be tested and diagnosed)
       | 
       | The "its just a flu" crowd have unfortunate points that many
       | conditions sound like immunological effects brought on by a
       | severe reaction to a virus in some way. Yes this is a different
       | flu, but again we know this is not smallpocks or ebola and we
       | should be taking advantage of this to determine the poorly
       | understood impacts of covid virii on long term health of those
       | who end up sick.
        
         | viraptor wrote:
         | > which aren't statistically corrected for the subset the
         | population who end up in hospital due to covid
         | 
         | What subset do you mean?
        
           | rob_c wrote:
           | Not everyone in the pre-vaccine world would have ended up on
           | a ventilator due to covid.
           | 
           | If the was a subset of the population who are at risk due to
           | covid. (other than the over 80s the sake of argument). Its
           | difficult to know how much an impact on this subset the virus
           | will be having. Its easiest to assess this by looking at
           | those of the population on who did end up in hospital and
           | trying to determine common effects by looking at those who
           | contacted them and comparing the probabilities.
           | 
           | Ultimately the end goal is to infer how much of a risk impact
           | this would/could have on the total population.
           | 
           | Failing to correct for the statistical population differences
           | before making an inference is akin to saying A&E centers in
           | the US or the EU are great for preventing tiger attacks. They
           | don't treat it due to there not being so many tigers.
           | 
           | Again reporting on the worst case scenario for the virus
           | impact on over 80s as being something that would/could impact
           | 8yo people is obviously incorrect and potentially dishonest.
        
             | viraptor wrote:
             | I think you expect more from the study than it explicitly
             | says.
             | 
             | From the abstract: "Interpretation. These results accord
             | with reports of 'Long Covid' cognitive symptoms that
             | persist into the early-chronic phase. They should act as a
             | clarion call for further research with longitudinal and
             | neuroimaging cohorts..."
             | 
             | Yes, the impact and recovery will be different between
             | those people. They didn't intend the paper to be a complete
             | answer and with the method they used, it would be
             | impossible to achieve. What you ask for is interesting and
             | I hope other papers will be published digging deeper, but
             | why not accept this result for what it is?
        
               | rob_c wrote:
               | Again, hence my warning about the quality of the lancet
               | and how the published result will be interpreted.
               | 
               | It's no different from a theorist publishing on arxiv "an
               | analysis on the chances of the lhc destorying the solar
               | system" vs "micro singularity formation cross sectional
               | calculations for 7TeV".
               | 
               | The ultimate "further study needed" has become a comical
               | tag line for poor stats and might as well be "chances of
               | covid leading to me winning the lottery". Both are valid
               | questions, but they have clear implications beyond
               | enhancing scientific rigour.
        
               | viraptor wrote:
               | > and how the published result will be interpreted.
               | 
               | I think we lost that long time ago when news started
               | hyping up any study containing "cancer" and reporting
               | their ideas as "researchers say".
               | 
               | The best we can do is discuss details as we do here, but
               | without the hyperbole. There are claims made by the study
               | and there are things not done in it. (whether missed or
               | not possible to do from the data) Let's acknowledge them.
               | But I think the "winning the lottery" is just going ad
               | absurdum. If you'd like to see the split of impact for
               | smaller groups, it will have to come from another paper.
               | But it doesn't make this paper wrong or show "poor
               | stats".
        
               | rob_c wrote:
               | I'm sorry, but I strongly, firmly, believe with evidence
               | based research to back my concerns that this is a large
               | amount of alarmist research which at best is to cash in
               | on readily available covid money. I unfortunately believe
               | this to be shortsighted and ultimately unethical.
               | 
               | This is a virus from the covid family.
               | 
               | What reasonable assumption should lead us to suspect it
               | behaves so strongly asymptomatically as to cause severe
               | hitherto unheard of side effects compared to say "bird-
               | flu"?
               | 
               | I am very much up for caution and as I say I very much
               | welcome a renewed effort to say compare long term flu
               | effects and things like cronif fatigue. But I think
               | writing about evidence being inconclusive vs "there is no
               | evidence to suggest" are strongly different lines for a
               | journal which knows has the attention of a major global
               | news source.
               | 
               | This is the difference between publishing this in nature
               | and saying "more research needed" rather than "cautiously
               | there is no strong evidence for".
               | 
               | In not invoking ad-abusurdism I'm highlighting mixing 2
               | statistically unlikely events can reveal unfortunate data
               | points which incorrectly leads to the wrong result. If I
               | caught the lottery after being diagnosed I could say I've
               | strong evidence for when I don't. This is no different to
               | getting cancer after being diagnosed and blaming cancer
               | on covid from 1 case.
               | 
               | We are in vaccine autism territory again with long term
               | covid studies and I just hope that the research community
               | (not an individual researcher) and the media tred
               | carefully. So far they have both been rather like a bull
               | in a china shop with their subtleties.
        
         | mellosouls wrote:
         | _There are several articles citing "bbc.co.uk" as fact which is
         | similar to a Russian source citing "rt.com"._
         | 
         | Not remotely similar; whatever their flaws, the BBC is still
         | internationally respected for impartiality and professionalism,
         | and the UK is still a country that values the freedom of ideas
         | and expression of them.
        
           | pydry wrote:
           | >BBC is still internationally respected for impartiality and
           | professionalism
           | 
           | It may still hold some latent respect from the pre-david
           | kelly days but it has fully transitioned to being an rt-like
           | government mouthpiece.
           | 
           | A recent yougov poll found the british public considered them
           | among the least trustworthy media outlets.
        
           | rob_c wrote:
           | I'm sorry but frankly no. You are so demonstrably incorrect
           | on this assertion.
           | 
           | There are many areas where RT report really well and have
           | been rewarded. I however wouldn't ever trust them as a
           | reputable source of the status of the Russian vaccination
           | program or Russian voting.
           | 
           | Frankly this is common sense, read the foreign reporting on
           | any issue in a country to balance what is correct and what is
           | being magnipulated regardless of who is reporting on it. This
           | is how grown ups are supposed to use the Internet rather than
           | falling into a bubble of trusting 3or4 sites as gospel.
           | 
           | The same way I would be weary of the BBC reporting on any
           | topic remotely close to the political arena in the uk at the
           | time.
           | 
           | The beeb are getting demonstrably concerningly biased their
           | manipulation or changes to page ranking within their site.
           | They regularly do publish quoting lancet pages without
           | directly linking to them, the story then falls out of the
           | ranking within 24hr and the external index engines struggle
           | to find the static published content they still have. It's
           | they're it's "just gone". This is not a result of reasonable
           | reporting or sensible journalism. When the article is
           | mistitled for clicks this is even worse.
           | 
           | I'm being nice to aunty beeb here. I want it to exist. But
           | pretending it's currently an infallable entity and is
           | unbiased is an insult to its heritage.
        
             | mellosouls wrote:
             | Me: _whatever their flaws..._
             | 
             | You: _But pretending it 's currently an infallable
             | entity..._
             | 
             | Completely not what I said.
             | 
             | Seriously, you should be more careful with your words:
             | twice wide of the mark now - in just two comments.
        
               | rob_c wrote:
               | Impartiality and professionalism with a global context is
               | a bit of an absolutist statement.
               | 
               | They're an award winning news organisation with
               | international respect and something worth being proud of
               | certainly, but they're far from globally impartial or
               | completely professional.
        
       | 100011 wrote:
       | They did not have the bravery to control for race. You might as
       | well throw it in the trash, it is already politically colored
       | junk.
        
         | viraptor wrote:
         | Are you implying that covid infections depend on the race? If
         | not then controlling for socio-economic attributes should
         | fulfill the role that you'd often see approximated via race.
         | And if yes - could you link a relevant paper?
        
           | murgindrag wrote:
           | They did control for race.
           | 
           | And no, controlling for socio-economic attributes does not
           | fulfill the role "approximated via race."
           | 
           | Statistically, racial differences tend to include:
           | 
           | - Cultural differences, including preferences for field-of-
           | work, family structure, socialization patterns, etc., all of
           | which affects R0
           | 
           | - Economic differences (e.g. Does one need to take a Tylenol
           | and show up to work even when sick?)
           | 
           | - In some cases, medical differences (e.g. vitamin D, which
           | appears to play a major role in COVID19)
           | 
           | - Geographic differences (communities tend to segregate by
           | race, and outbreaks are geographic in nature)
           | 
           | - Trust of institutions (which impacts vaccination, testing,
           | and treatment rates)
           | 
           | ... and so on.
           | 
           | This is about group-level statistics, and isn't helpful with
           | individuals.
           | 
           | But if you're doing a population study, yes, this is an
           | important control.
        
             | tpxl wrote:
             | > In some cases, medical differences
             | 
             | Sickle cell disease is an example of this, as it mostly
             | appears in black people ("Sub-saharan descent").
             | 
             | https://en.wikipedia.org/wiki/Sickle_cell_disease
        
               | murgindrag wrote:
               | I like vitamin D since we have a clear mechanism-of-
               | action specifically for COVID19:
               | 
               | - We adapt skin color based on latitude to maintain
               | vitamin D levels and prevent sunburns at different levels
               | of sun exposure.
               | 
               | - At this point, we have incredible strong correlations
               | between vitamin D and COVID19 outcomes.
        
         | maweki wrote:
         | They tried to control for uneven sociodemographic distribution
         | of virus prevalence. Why would explicitly controlling for race
         | be any more useful than that?
        
           | 100011 wrote:
           | The question was about COVID's effects on IQ. For example,
           | there's a consistent one standard deviation IQ difference
           | between Whites and Africa-Americans. Feel like it should be
           | an important factor to get the better signal rather than a
           | proxy (education) out there when talking about effects on IQ.
        
             | [deleted]
        
         | mrob wrote:
         | The controlled for "racial-ethnic group". How does this differ?
        
       | mushufasa wrote:
       | I didn't see a regression table in the paper. Did I miss
       | something?
       | 
       | It just looked like a series of graphs and summary statistic
       | tables.
        
       | stjo wrote:
       | The paper has a paragraph or two dedicated to the software used:
       | 
       | > All Cognitron tests were programmed in HTML5 with JavaScript by
       | AH and WT. They were hosted on a custom server system (Cognitron)
       | on the Amazon EC2 that can support diverse studies via custom
       | websites. The server system was specifically developed to handle
       | spikey acquisition profiles that are characteristic of main-
       | stream media collaborative studies, fitting the number of server
       | instances in an automated manner to rapid changes in demand.
       | Here, maximum concurrent participants landing on the website
       | information page was ~36,000, with this occurring at the point of
       | the documentary airing on BBC2 in May.
       | 
       | Why wouldn't they also publish the source code? I took a couple
       | of minutes to play with the test and I think I found some bugs. I
       | would love to check myself. Isn't it quite important to audit the
       | source code, given that it is the thing that collected the data?
        
         | xyst wrote:
         | When a person(s) says they programmed it in HTLM5, you know
         | they fucked up.
        
         | chriswalz wrote:
         | If they don't share it we can safely assume it's shitty
        
           | rob_c wrote:
           | It almost certainly is. And that's not entirely awful its a
           | tool used by scientists to do work.
           | 
           | (it is inexcusable in 2021 in my personal opinion, but in
           | many ways science is still in the dark ages wrt some of the
           | tools being used, just as the ML community is learning a lot
           | about things like reproducability and falsafiability from
           | scientists with experience here)
           | 
           | I just with the community would share code more to prevent
           | common mistakes and repeated effort and so we can all learn.
           | 
           | Imagine a world with publically well documented code that
           | helps people learn science rather than scientists having to
           | teach coders what they want and codes having to teach
           | scientists intracasies of languages and hardware choices.
        
       | mensetmanusman wrote:
       | Since COVID will become endemic like HIV, I wonder if the average
       | IQ around the works will experience a measurable downwards blip.
       | 
       | It's interesting that this will likely contribute to further
       | inequality as the rich had access to vaccines first and the
       | uneducated are more likely to be skeptical of vaccines (note:
       | everyone is skeptical, but the domain of skepticism is different
       | for people depending on political leanings).
        
         | guerrilla wrote:
         | Could also do the opposite as anti-medicine people are killed
         | off. We'll see.
        
           | ryandrake wrote:
           | You're getting downvoted for snark, and it's a morbid
           | thought, but it might be true. In places where the vaccine is
           | readily available and statistically only the unvaccinated are
           | dying, you'd expect the population's average intelligence to
           | increase as people die of the disease.
        
             | [deleted]
        
           | mythrwy wrote:
           | Assuming they are wrong about their reasons for refusing the
           | vax. Otherwise the reverse.
           | 
           | But really so few people of reproductive age die of the
           | disease anyway it's unlikely to produce much effect.
        
       | [deleted]
        
       | irrational wrote:
       | Has anyone heard of weight related COVID issues? I know of 2
       | people who's weight ballooned immediately post COVID despite not
       | changing eating or exercise habits and despite a year passing
       | they haven't been able to lose any weight and doctors haven't
       | been able to figure out why.
        
         | blindmute wrote:
         | I would hazard a guess that it's because their calories
         | consumed is exceeding their calories used. I would recommend
         | for them to eat fewer calories
        
           | Aachen wrote:
           | _That 's_ the secret that GP says doctors haven't been able
           | to figure out..?
        
       | calsy wrote:
       | Are there ever any hopeful reports published about Covid-19. It's
       | just one constant miserable study after another in the news. Yeah
       | we get it we need to be hiding under our beds in fear of the
       | invisible entity that could strike. It is relentless, obviously
       | people just cant get enough of it cause it has been front page
       | news for 1 1/2 years now.
        
         | LatteLazy wrote:
         | In the UK were almost 70% vaccinated (adults, 2 jabs). So it's
         | getting back to BAU here.
        
           | dmix wrote:
           | Canada had 47 million vaccinations (so ~23M if we're assume 2
           | doses) with a total population of 37M. Google says "at least
           | one dose" is 70% while "2 doses" is 54.4% of the population.
           | 
           | People are definitely taking the vaccination program
           | seriously. The big question now is getting the final long
           | tail vaccinated. While obviously there will be a subset which
           | will always resist it.
           | 
           | The numbers coming out of the US show 99% of the deaths are
           | unvaccinated people along with 97% of people hospitalized.
        
             | makomk wrote:
             | The numbers coming out of the US are not representative of
             | what other countries have been seeing. Apparently it's more
             | like 60% of people who're hospitalized that are
             | unvaccinated in the UK, for example, and that's pretty in
             | line with other countries with reasonably successful
             | vaccination campaigns.
        
           | calsy wrote:
           | In Australia I believe its around 13.6% vaccinated at this
           | stage. If we were able to match the UK vaccination numbers at
           | this moment, we would be a shining example of managing CovID.
           | But we screwed up, we dropped the ball on vaccinations and
           | pretended we could continue to keep Covid at bay
           | indefinitely, and failed.
        
         | blindmute wrote:
         | This study is honestly quite hopeful. For the last year we've
         | been bombarded with propaganda that long covid is going to
         | cause brain damage and turn you into a fogged up idiot. This
         | study which is not even controlled or pre-post tested at all,
         | and which is primed to show worse effects than the truth due to
         | placebo effects, shows less than 1 IQ point loss for people who
         | don't need hospitalization. Compared to what doomers want us to
         | believe, this is great news.
        
         | [deleted]
        
         | gccs wrote:
         | Hahahaa. The media sells you fear because they know it will
         | keep you tuned in. It doesn't matter what thr current 'issue'
         | is. They will always sell whatever will most likely keep you
         | coming back.
         | 
         | News is pure entertainment. Its like a horror movie.
        
           | jmnicolas wrote:
           | It's more than the media. The politicians (at least in my
           | country, France) are using it to take much more power than a
           | democracy should ever allow.
        
             | bsaul wrote:
             | the most alarming thing in france is that almost everyone
             | in the middle/upper social groups is completely convinced
             | the government is right and that it's worth it (aka : it'll
             | get us rid of covid).
             | 
             | The only people worried about constitution at the moment
             | are weirdos, extremists, and a very small number of people
             | genuinly concerned about human rights in their own country.
             | 
             | I'm more and more seing this covid period as a perfect
             | example on how this country could turn into a totalitarian
             | regime as long as it's for the good cause(tm). It also
             | another example on how china is definitely becoming a major
             | cultural influence over the world.
        
               | Method-X wrote:
               | Same for Canada.
        
               | calsy wrote:
               | I believe it is much larger number of people who have
               | reasoned concerns about the governments approach.
               | 
               | The narrative being pushed to us is anyone who might have
               | a different opinion to that of the authorities is a
               | 'weirdo' or 'conspiracy theorist'. At any protest, the
               | media will always show that 'anti-vax, bill gates
               | conspiracy' guy holding up his sign and lumping everyone
               | into that group. The majority of those protesting are
               | rational people worried about their jobs, their
               | businesses closing, their children's education and what
               | the economic fallout will do to basic services like
               | health, education, infrastructure.
        
               | [deleted]
        
             | bequanna wrote:
             | In the US we have seen unelected people in previously
             | ignored roles relish the new found attention and power they
             | have received.
             | 
             | Pointless lockdowns with arbitrary milestones that they are
             | able to prescribe, daily zoom briefings where all eyes are
             | on them as they explain "the science".
             | 
             | For many, this is their 15 minutes of fame. Don't expect
             | them to give up that power and pseudo-celebrity easily. The
             | attempts to scare and bully people will get more desperate
             | as these people see their time in the spotlight coming to
             | an end.
        
         | TazeTSchnitzel wrote:
         | Yes, there are regular hopeful reports published about
         | vaccination and other measures reducing deaths and illness.
        
           | calsy wrote:
           | The majority of reports regarding vaccination are those
           | chastising anyone who hasn't dared got their shot yet along
           | with continued threats of restrictions to our lives until an
           | almost impossible target is met in the near future. Those
           | 'other measures' that include lockdowns, limited social
           | interaction and financial hardship are not positive at all.
        
             | SamoyedFurFluff wrote:
             | Why is the target impossible? We have had successful
             | nationwide vaccine programs in the past. Polio is a distant
             | memory because of this.
        
               | calsy wrote:
               | How long did it take for polio vaccinations to reach the
               | target set for the Covid thresholds and are we willing to
               | accept the threat of restrictions to our lives until
               | then?
               | 
               | To meet these targets the majority of children must be
               | vaccinated. Between the low risk posed to children and
               | the governments (that's Australia btw) horrible mixed
               | messaging regarding age groups and vaccination, a large
               | portion of parents will be reluctant to vaccinate their
               | children.
               | 
               | So whats the current approach to getting those
               | vaccination numbers up? Just keep ramming home the fear
               | of covid and restrictions while naming and shaming all
               | who are ruining life for everybody. I wonder how that
               | will go?
        
               | SamoyedFurFluff wrote:
               | I only asked why the target is impossible.
        
               | calsy wrote:
               | Never said the target was impossible, I said it was
               | impossible 'in the near future'.
        
         | rob_c wrote:
         | Yes but the magical news stats from "experts" say I could die
         | if I crossed the road without looking so I'll stay at home and
         | order off amazon... </wishingiwasjoking>
        
         | rsynnott wrote:
         | > Are there ever any hopeful reports published about Covid-19
         | 
         | Vaccine administration data (about 31 million doses are
         | currently being administered per day, and production continues
         | to ramp).
         | 
         | Like, I'm not sure what you're looking for. No-one is going to
         | publish a (credible) report saying "actually, covid is nice".
         | The main avenue for hope is vaccination, and while that's not
         | going perfectly, if you told someone in May 2020 that by July
         | 2021 we'd have administered 3.8 billion vaccines, they would
         | probably have been very sceptical, to say the least. It is the
         | most rapid vaccine programme in history.
        
         | detaro wrote:
         | Just what I've seen _today_ in the news:
         | 
         | - positive study results validating stretched vaccine schedules
         | 
         | - more and easier vaccine availability locally
         | 
         | - infection rate in the region trending slightly downwards
         | 
         | - some new theories/results (didn't read the full article)
         | regarding immunity in children
         | 
         | - some signs vaccine scepticism in some US states is decreasing
        
         | graeme wrote:
         | Certainly. There was a study on low long term impacts on
         | children for example.
         | 
         | Bad news spreads easier than good. The news is mostly bad but
         | some good news is what I mentioned above + high vaccine
         | efficacy against severe disease.
         | 
         | How vaccines affect long covid type stuff is a big open
         | question, but early doctor anecdotes suggest they lower it.
         | That would be great news.
        
       | zug_zug wrote:
       | I want to believe this, however, as far as I can tell, the design
       | finds a correlation between severity of covid and IQ. One other
       | possible explanation is that healthy immune system correlates
       | both with lesser covid symptoms and higher IQ (less
       | inflammation/whatever).
       | 
       | As another comment has mentioned, the best way to try to measure
       | for this would be to have a pre-post, which could only be done on
       | those who hadn't had it yet at the time of the first test but
       | then later got at. Since vaccines are now a factor, and may
       | correlate to intelligence, the study may not be possible in an
       | ethical manner.
        
       | roenxi wrote:
       | The question I'm interested in: What are the general cognitive
       | deficits in the population caused by disease?
       | 
       | The evidence I've been reading the last decade+ suggests that
       | disease is much more damaging than is generally acknowledged.
       | But, as shown by the coronavirus, the costs of stopping (or, more
       | realistically, delaying) them are huge. I'm wondering if, in my
       | lifetime, we're going to see a plan for dealing with Herpes.
        
         | murgindrag wrote:
         | > But, as shown by the coronavirus, the costs of stopping (or,
         | more realistically, delaying) them are huge
         | 
         | If we all wore $2 N95-equivalent masks, spread out 6 feet
         | whenever convenient, did outside whatever can be done outside,
         | and received a vaccine at (roughly) the same time, COVID19
         | would be gone.
         | 
         | The costs are huge because we made them huge.
         | 
         | We ignore COVID19 when case counts are low, giving it a chance
         | to mutate and spread. We take extreme measures when hospitals
         | start filling up, shutting down schools and businesses.
         | 
         | See Korea, China, Taiwan, etc. for examples of reasonable-cost
         | ways to control COVID19.
        
           | roenxi wrote:
           | Well, yeah. Pretty much all problems humans face are caused
           | by humans. And death, which is still forced on us by the laws
           | of entropy.
           | 
           | You'll find that the systems that can force the unwilling to
           | buy $2 masks, spread out 6 feet and get vaccinated are worse
           | than the disease. If you recognise that the government can
           | compel people to be healthy it opens up some terrifying cans
           | of worms.
        
             | sudosysgen wrote:
             | It's not about compelling others to be healthy, it's about
             | preventing you from infecting others.
        
             | murgindrag wrote:
             | I think it depends on how it's done.
             | 
             | I'd like to see this implemented with roughly the same
             | systems which make me wear a bicycle helmet, a seatbelt, or
             | have turn signals, which I don't find so scary.
             | 
             | In these systems, you have a law. You have law enforcement.
             | Law enforcement doesn't catch everyone, and doesn't have
             | particularly aggressive police powers.
             | 
             | I'm fearful it will be implemented with the same systems
             | which make us register guns and have background checks,
             | track bank transfers over $10,000, check IDs when buying
             | cold medicine, or track us as we travel.
             | 
             | In these systems, you have law enforcement. Enforcement is
             | given tools to track and monitor what people do just in
             | case someone might be a criminal.
        
               | roenxi wrote:
               | > I'd like to see this implemented with roughly the same
               | systems which make me wear a bicycle helmet, a seatbelt,
               | or have turn signals, which I don't find so scary.
               | 
               | There is a big difference between those and mandatory
               | vaccinations. If you're going to vaccinate everyone then
               | it isn't like people can choose to opt out. Plus the
               | logistical issues of how to vaccinate foreigners.
               | 
               | In Australia, Sydney is currently in lockdown because it
               | turns out that masks & social distancing can't be
               | enforced enough to contain a COVID outbreak.
        
               | murgindrag wrote:
               | I'm not quite sure I see the difference.
               | 
               | You pass a law:
               | 
               | - Requiring vaccinations, or a $800 fine
               | 
               | - Permitting private venues to verify vaccination status
               | by looking at vaccine cards (e.g. employers, concerts,
               | etc.)
               | 
               | - Make it a crime to forge vaccine cards
               | 
               | - International travel already has yellow vaccine books,
               | and it's well-established to check vaccines upon entry
               | to/from high-risk countries
               | 
               | You don't implement any infrastructure to track
               | vaccinations. I show my vaccine card when I enter a
               | concert, same as I do when ordering alcohol. No one
               | records anything.
               | 
               | The bar for intentionally breaking laws is much higher
               | than not getting a vaccine. I think most people will
               | follow laws voluntarily. Most of the ones who don't
               | follow the law won't get caught, but a few will.
        
         | Tarsul wrote:
         | the results hint at your question:
         | 
         | "The scale of the observed deficit [of people who had covid]
         | was not insubstantial; the 0.47 SD global composite score
         | reduction for the hospitalized with ventilator sub-group was
         | greater than the average 10-year decline in global performance
         | between the ages of 20 to 70 within this dataset. _It was
         | larger than the mean deficit of 480 people who indicated they
         | had previously suffered a stroke (-0.24SDs)_ and the 998 who
         | reported learning disabilities (-0.38SDs). For comparison, in a
         | classic intelligence test, 0.47 SDs equates to a 7-point
         | difference in IQ. " edit: well, on further thought, a stroke is
         | not the same as a disease but still there's insight here.
        
           | zaroth wrote:
           | It's not 7 points reduction for anyone who had COVID, I think
           | that's specific to cases which had to be on a ventilator.
        
       | etherio wrote:
       | Another selfish question: do we know if this cognitive deficit is
       | also found in teenagers who contracted the virus?
        
         | murgindrag wrote:
         | Preliminary evidence: Yes.
         | 
         | https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/as...
        
       | slickrick216 wrote:
       | Regrettably cynical view but I've seen first hand 3 people use
       | long covid symptoms to extend pandemic related benefits which are
       | paying at a rate approximate to their past/current jobs.
       | 
       | At both the micro and macro level there are perverse incentives
       | beginning to form that will make this thing roll on longer than
       | it has too
        
         | OliverM wrote:
         | Incidental bad actors don't invalidate the entire approach of
         | safeguarding people's livelihoods. The 3 people you describe
         | would likely try to exploit any system unfairly. The perfect is
         | the enemy of the good here as in most other places.
        
           | slickrick216 wrote:
           | Yeah agreed they would and do. I'm not saying it invalidates
           | anything but what this may indicate is inflated numbers which
           | in the current situation causes overreaction.
        
         | resoluteteeth wrote:
         | None of the pandemic benefits in the US required people to
         | claim to have long covid symptoms.
        
           | slickrick216 wrote:
           | Not everyone using HN lives in the US.
        
           | breakfastduck wrote:
           | Where did anyone mention the US?
           | 
           | Or is this just the classic assumption that all people on the
           | internet are American?
           | 
           | Funny how no other nation does that.
        
       | isaacremuant wrote:
       | There's growing concern from the pro lockdown lancet that people
       | will try and move past them.
       | 
       | There's never concern about consequences from lockdowns,
       | virtually mandatory vaccines on trial until 2023 (through
       | coercion and segregation), delays in any other health ailment,
       | etc.
       | 
       | In many places around Europe we no longer have freedom nor the
       | constitutions matter. We're looking at this type of hygiene
       | theater for years to come and people keep bringing up the likes
       | of the Lancet and Sage to keep the fear mongering and pretend a
       | zero covid at any cost is possible while increasing dystopian
       | measures.
       | 
       | Compare the hailed Australia/Israel/New Zealand dystopian futures
       | with many states in the US (like Florida/Texas) that didn't
       | succumb to the dystopia through fearmongering.
       | 
       | 2 weeks passed many times. It's now time to stop the damage
       | that's being done in the name of "protecting people". It's not
       | that different from the security theater after 9/11. Just because
       | you DO something doesn't mean it's a good thing.
       | 
       | Edit: I know this will get downvoted as it's par for the course
       | of anything in HN that doesn't toe the line of more LDs and
       | hygiene theater (and US based partisanship) but this is for those
       | who are disenfranchised and are not interested in petty
       | left/right divisions and more to stand up against increasing
       | authoritarianism and apartheid. Specially in some European
       | countries.
        
         | wesleywt wrote:
         | I never understood why the right decided to be against logical
         | public health measures and decided to tie their ideaology to
         | it. It never use to be like this. Care to explain?
        
           | orangecat wrote:
           | Lockdowns are massive restrictions of individual freedom,
           | which is something the right claims to care about and
           | sometimes actually does.
        
           | isaacremuant wrote:
           | Actually, the aligned with "US democrats" (not the left,
           | necessarily) made the whole thing political by going against
           | anything Trump did (like banning travel From China being
           | racist or the ties with the lab leak theory).
           | 
           | It used to be the left would stand against authoritarianism.
           | Skepticism. Now it's seen as a duty to support corporate
           | interestes, gov excuses, not question anything (or you'll
           | help the right).
           | 
           | There's nothing logical about Lockdowns. It was never done
           | before and has done nothing in terms of excess deaths while
           | There's ample examples of the damage and inequality
           | 
           | But again, HN types from the laptop class are fine at home,
           | advancing in life, not caring that much about others but
           | pretending they do with the approved virtue signalling. It's
           | disgusting.
        
             | SamoyedFurFluff wrote:
             | Banning travel from China was a nonsense response because
             | US got exposed via Europe. Similarly, prioritizing
             | investigating the lab leak theory without real evidence at
             | the same time as tons of people were dying seemed messed
             | up.
        
         | jhgb wrote:
         | > There's never concern about consequences from lockdowns,
         | virtually mandatory vaccines on trial until 2023 (through
         | coercion and segregation), delays in any other health ailment,
         | etc.
         | 
         | Is this some kind of a "who can build the biggest straw man"
         | competition?
        
           | isaacremuant wrote:
           | No. It's a "enough is enough" comment.
           | 
           | I know that hackernews types who have largely not been
           | affected that much, specially US based, will be fine
           | downvoting and promoting more propaganda, segregation and
           | fearmongering but those that do are morally corrupt to the
           | core and I'm tired at pretending otherwise.
        
             | 100011 wrote:
             | HN is populated by the very liberal types. This study had
             | access to racial data (see Q5) yet it chose to not control
             | for it. The result might have shown that contracting the
             | disease acts as an IQ test itself. But Lancet was behind
             | other trash releases too earlier.
        
               | selimthegrim wrote:
               | So all the anti-maskers are what race now? You might want
               | to bring body armor when you tell them the verdict, if
               | you're going South.
        
               | wesleywt wrote:
               | Why are you so convinced that there is a link between
               | race and intelligence? There is a link between biased
               | measure of intelligence such as IQ tests and race. But no
               | actual link has been proven.
        
               | jhgb wrote:
               | > biased measure of intelligence such as IQ tests
               | 
               | Where's the evidence that IQ tests are biased? They're
               | supposed to estimate the g-factor. I'm sure that if they
               | were biased estimates of the g-factor they'd be
               | recalibrated ASAP to estimate it in an unbiased way.
        
               | blindmute wrote:
               | Every possible test of intelligence, and everything that
               | correlates with intelligence, all points toward the same
               | conclusion that there is a link between race and
               | intelligence.
               | 
               | IQ, income, education, crime rate, school achievement,
               | quite literally every possible measure that you would
               | expect to correlate with intelligence also correlates
               | with race. This occurs even when you control for factors
               | like income. The myth and the lie that there is no link
               | is often said and never shown. The evidence is
               | overwhelming and the burden of rejection is on the
               | deniers at this point.
        
               | 100011 wrote:
               | The Crowd only "Believes the Science" when it aligns with
               | their political goals, simple as.
        
         | unlikelymordant wrote:
         | I disagree with you on most of this. Looking at the all cause
         | mortality graphs for the US is pretty sobering, and comparing
         | to the relatively much more flat all cause mortality graph for
         | australia is all the reason i need to be pro lockdown. It seems
         | pretty clear that lockdowns work, and also that governments
         | dont want to be locked down any longer than necessary- because
         | it _is_ bad for the economy. But hospitals being over capacity
         | like in the UK or india is also pretty bad, and i see
         | healthcare as being one of the pillars of civilisation.
         | 
         | I do see some 'cleanliness theatre', but the thing about r
         | values is that little things help a lot. Washing hands
         | regularly, wearing a mask. I havnt a cold in 18 months, which
         | is pretty unheard of for me, because everyone is taking a bit
         | more care. If only covid were 'only' as contagious as the cold,
         | we probably would have beaten it already.
        
           | isaacremuant wrote:
           | > I disagree with you on most of this. Looking at the all
           | cause mortality graphs for the US is pretty sobering, and
           | comparing to the relatively much more flat all cause
           | mortality graph for australia is all the reason i need to be
           | pro lockdown.
           | 
           | You're literally doing what I said. You're using the one
           | metric to justify never ending lockdowns. Because lockdowns
           | Haven't worked or we wouldn't be having them again in
           | Australia. Unless life needs to be continuously cycled
           | lockdowns. Which is preposterous and something many of us
           | warned against. There's no exit strategy out of hygiene
           | theater. Only the blame game.
           | 
           | As for your comment about govs having the best intentions.
           | That's clearly false. They've shown they care about
           | prolonging their political positions so that trumps anything.
           | Which is why protests that are politically convenient can go
           | ahead while those that go against lockdowns are attacked in
           | many ways.
           | 
           | Healthcare in Ireland, for example, has always been bad and
           | "over capacity". Every flu season. That hasn't changed. They
           | haven't invested in healthcare really. Your lockdown proposal
           | will only mean forever lockdowns and, now, a 2 tier society
           | where those who don't comply with every rule get blamed while
           | their businesses and lives get destroyed and politicians are
           | exempt from those rules.
           | 
           | Your anecdotes about colds are ridiculous. I haven't either
           | and I haven't been a germophobe like you seem to now. I've
           | travelled and I've exercised with people and met people
           | against the fascist regulations and will keep doing so. The
           | problem is that, even if I manage to "save myself by moving
           | around" from this insane apartheid and fascist state of
           | things, in the name of the greater good, millions will suffer
           | while the laptop hackernews socially awkward class stays at
           | home with their back yards and their online yoga.
           | 
           | You've had 16 months of screwing people out of choice to live
           | how they see fit. Now you'll attack anyone who doesn't yield
           | Every bit of the way including medical procedures. Now 100%
           | vaccination rate seems to be the goal as to why you can't
           | have freedoms back. It's insane. It's wrong. It's wrong in
           | 1930 levels of wrong. Enough is enough. /Rant
        
             | unlikelymordant wrote:
             | > Because lockdowns Haven't worked or we wouldn't be having
             | them again in Australia.
             | 
             | But australia has beat many flare ups by locking down,
             | right back to 0. The fact it keeps coming back from
             | countries that dont lock down is hardly proof lockdowns
             | never work.
             | 
             | The thing about r values is it doesnt need everybody to be
             | washing their hands, just enough to break the chain. If the
             | person who would have infected you never caught it, then
             | you wont get it, and so on.
             | 
             | >You're literally doing what I said. You're using the one
             | metric to justify never ending lockdowns
             | 
             | Total deaths? Yeah im using that metric. A lot of people
             | have died, australias response shows they died
             | unnecessarily.
        
           | murgindrag wrote:
           | > If only covid were 'only' as contagious as the cold, we
           | probably would have beaten it already
           | 
           | Nope. When numbers go down, we relax. When hospitals fill up,
           | we lock down. It doesn't matter how contagious COVID is. It
           | will remain at endemic levels forever, on the path we're on.
           | 
           | We've turned a billion dollar problem into a multi-trillion
           | dollar one in February 2020. Now, we're turning it into a
           | tens-of-trillions-of-dollars problem.
           | 
           | 100% N95-equivalent masks. 100% vaccination. 6 foot
           | distancing whenever possible. Outdoors whenever possible.
           | That would still get COVID today, but it might not in a year.
           | Delta and Gamma are concerning, and we'll only see more
           | mutations, and ones better able to jump our mitigation
           | measures.
        
             | unlikelymordant wrote:
             | We beat sars-1 just fine, and mers, mainly by quarantining
             | infected. Sars-1 literally no longer exists. This is very
             | strong proof that we would have beat covid too, if it were
             | less contagious.
        
               | murgindrag wrote:
               | I think it's a better example of random chance. We had a
               | series of diseases. We didn't heed that as a warning. One
               | eventually (and predictably) slipped out.
        
         | jpmoral wrote:
         | >Compare the hailed Australia/Israel/New Zealand dystopian
         | futures with many states in the US (like Florida/Texas) that
         | didn't succumb to the dystopia through fearmongering.
         | 
         | Texas (29M) and Florida (21M) have a somewhat comparable
         | population to Oz (25M). I think I'll take our (Oz) numbers over
         | theirs in a heartbeat. Whatever we're doing it's clearly not
         | theater.
        
       | bijant wrote:
       | This Study suffers from at least one significant methodological
       | flaw. They did not evaluate the same individuals pre- and post
       | Covid infection but instead evaluated people as a group who were
       | either previously infected or not. While they did try to correct
       | for some socio-economic factors such as age their data did not
       | allow them to factor in the socio-economic discrepancies in the
       | distribution of early Covid cases which overwhelmingly hit
       | service industry workers with direct customer exposure. People
       | with Graduate Degrees were much more frequently able to self
       | isolate and work from home than people without a high school
       | equivalent degree. What I find to be quite sad, is the fact that
       | these researchers were actually in a position to retest a subset
       | of the original test takers as more than 10% completed a follow
       | up survey in December 2020 which surfaced 275 individuals who had
       | contracted Covid after their first participation in the study.
       | Retesting those, as well as the >8000 individuals who had no
       | change in Covid status to control for increase in age, increase
       | in points due to getting better at the test with repeated
       | exposure etc, would have been a sufficiently large dataset to
       | actually confirm or rule out at least large effect sizes.
        
         | CraigJPerry wrote:
         | >> suffers from at least one significant methodological flaw
         | 
         | Is this not a randomised control trial? As I understand it, RCT
         | is usually referred to as the "gold standard" - why would the
         | gold standard be a flaw in this case?
         | 
         | What you describe sounds to me, a layman, as an improvement
         | over and above but if RCT is good enough normally, why discount
         | it entirely in this case because there's some other improvement
         | could be made?
        
           | nanis wrote:
           | > Is this not a randomised control trial?
           | 
           | No. I am not quite sure how one might even think the words
           | apply here.
           | 
           | If it were, participants would be randomly assigned to the
           | the "control" group where they do not get Covid, but would be
           | told they had Covid (to control for the negative placebo of
           | being told they are now afflicted with a horrible long term
           | malady) and the "treatment" group which would actually be
           | given a Covid infection. Assuming such a study were doable,
           | one can then use a "within participant" comparison which is
           | much more powerful than comparing statistics across groups.
           | 
           | >> We sought to confirm whether there was an association
           | between cross-sectional cognitive performance data from
           | 81,337 participants who between January and December 2020
           | undertook a clinically validated web-optimized assessment as
           | part of the Great British Intelligence Test, and
           | questionnaire items capturing self-report of suspected and
           | confirmed COVID-19 infection and respiratory symptoms.
           | 
           | There is no randomized assignment here. Susceptibility to
           | report a Covid infection without positive proof is a
           | confounding variable. I suspect that susceptibility is
           | correlated with other cognitive issues.
           | 
           | A "within participant" comparison as the GP brought up would
           | avoid these kinds of issues.
        
           | tinus_hn wrote:
           | How can it be a randomized controlled trial? Did they
           | randomize a group from the general population in advance and
           | then randomly and blindly, but in a controlled fashion,
           | infect part of the subjects and did they then consider the
           | effects without looking at whether they were the infected
           | people or the control group, until the conclusion of the
           | study?
           | 
           | That's what's require for the gold standard.
        
           | bdauvergne wrote:
           | RCT is not referred as "gold standard" by serious people, htt
           | ps://www.thelancet.com/journals/lancet/article/PIIS0140-6...
           | that's marketing.
        
         | agnosticmantis wrote:
         | If about 10% of participants followed up, wouldn't there be a
         | possibility of non-response/self-selection bias in the pre-post
         | study? If I suffered cognitive deficit, I'd be more/less (I'd
         | think less) likely to follow up.
        
         | usaar333 wrote:
         | They note though that the follow up population that had caught
         | covid after testing didn't differ significantly from those that
         | didn't.
         | 
         | That seems to add credibility here to a causal mechanism as
         | opposed to a background correlation of risk of infection they
         | are missing.
        
         | irthomasthomas wrote:
         | Also those symptoms look very similar to stress, anxiety and
         | depression. Which I think are to be expected after contracting
         | a pandemic level virus and being forced to isolate. I would
         | like to see results after treating or controlling for those
         | conditions.
        
           | treeman79 wrote:
           | I have an autoimmune decease and factor 5. Very similar
           | symptoms as long term covid. Lots of inflammation, brain fog,
           | cognitive defects.
           | 
           | I spent years being dismissed as depressed Or having anxiety.
           | When I finally was diagnosed and started treating condition
           | with medications I could handle my cognitive problems and
           | depression lifted.
           | 
           | Support groups for autoimmune conditions are full of people
           | who routinely are dismissed by doctors.
        
             | MikeLumos wrote:
             | Can you share a bit more about your autoimmune disease?
             | 
             | What disease was it? What kind of medications have helped
             | you?
             | 
             | I'm suffering from some kind of autoimmune-like disease
             | with similar symptoms and trying to figure out what's wrong
             | with me.
        
               | treeman79 wrote:
               | Sjogrens. Second most common after lupus. Lots of
               | neurological complications.
               | 
               | Plaqunial helped a lot, but I can't tolerate it. Shame,
               | it works well. Steroids are good for ending a flare but
               | it's hard to get prescribed, also side effects.
               | 
               | What really worked for me me was * blood thinners for
               | cognitive defects * Avoid triggers, direct sun, sugar,
               | caffeine, spice * autoimmune protocol diet * magnesium,
               | vit d, e, b complex, fish oil
               | 
               | Get blood work done for each kind. ANA test as a starting
               | point.
               | 
               | For me Early Sjo test confined diagnosis.
               | 
               | Make a list of ALL symptoms and take it with you to all
               | doctors. A Neuro-ophthalmologist was the first to say
               | Sjogrens based only off my sheet.
               | 
               | An elimination diet is probably the best place to start.
               | I ate nothing but sweet potatoes for a month, my symptoms
               | all cleared up. Stated coming back when I introduced
               | random foods.
               | 
               | That's how I started following AIP diet
        
             | ImaCake wrote:
             | A few years ago I suffered from an autoimmune issue for
             | about 3 months. It took most of that time just to convince
             | a doctor to give me meloxicam, which is just strong
             | panadol/aspirin really. Having a chronic fever for a few
             | months really made it hard to do anything more substantial
             | than play video games.
             | 
             | I don't know how we teach general practitioners, but we are
             | doing something horribly wrong. A lot of long covid people
             | must be finding this out too, and it is just super sad.
        
               | dTal wrote:
               | >I don't know how we teach general practitioners
               | 
               | We send them to a school which emphasizes cramming vast
               | amounts of established knowledge into their heads, at the
               | expense of critical thinking skills, social skills, and
               | for that matter sleep. In a world where doctors use
               | Google and WebMD the same as everyone else (because of
               | course they do, no one retains an encyclopaedic knowledge
               | of every medical condition), it's basically a hazing
               | ritual.
        
               | dmix wrote:
               | A big part is people are typically afraid, or don't have
               | the opportunity, to get a second opinion.
               | 
               | One of my biggest lessons early in life was that not all
               | doctors are the same (by a long shot). This is why it's
               | so important to see specialists related to your
               | condition. And ultimately you're going to be most
               | responsible for getting proper care as often only you
               | know what you're experiencing.
               | 
               | Medicine and pathology are far to wide of subjects for
               | generalists to operate efficiently across every field and
               | niche. Which is why specialization is so important and
               | connecting the patients to the right specialists.
               | 
               | There's a lot of analogies to technology, where people
               | tend to expect the experts to do and know everything and
               | completely defer to them. I think we all have experienced
               | this with our parents or people who didn't grow up with
               | computers. When ultimately the individual is always going
               | to be a huge part of the puzzle and must accept that
               | fact.
        
           | IfOnlyYouKnew wrote:
           | If COVID causes stress, anxiety, and depression, why wouldn't
           | that count as a legitimate effect of the disease?
        
           | adflux wrote:
           | I agree. I suspect many "long covid" cases are probably not
           | caused by covid, but by the lockdown and psychological impact
           | of this phenomenon.
           | 
           | People complaining of fatigue or having difficulty
           | concentrating or having brain fog are in some studies already
           | counted as suffering from long covid. No causual relationship
           | required.
        
             | CraigJPerry wrote:
             | That suspicion goes against what the people who are dealing
             | with this every day are saying. What makes you suspect
             | this?
             | 
             | A friend of mine is a doctor and we were chatting about
             | long covid 2 days ago, his description of it seemed pretty
             | cut and dried to me - e.g. a swimmer here in Glasgow with
             | hopes of getting to the 2024 olympics is currently unable
             | to train due to breathing issues post-covid. They're
             | supposed to be fully immersed in training right now but
             | can't since covid in December 2020.
        
               | murgindrag wrote:
               | One person I know is suffering from serious balance
               | problems post-COVID.
               | 
               | It's just not consistent with the "It's all in their
               | minds theory," or "it's the same as stress from
               | isolation" theory.
               | 
               | There's clearly something neurological going on, and we
               | don't understand it yet.
        
               | treeman79 wrote:
               | In my case it was a mix of information, increased cranial
               | pressure, and minor clots.
               | 
               | Was a nightmare getting those under control but my
               | symptoms eased up. Then I got covid and it all started up
               | again. Took months to get back to a baseline, but
               | symptoms were identical, aside from loss of smell.
        
               | adflux wrote:
               | Have you read the diagnosis criteria and studies
               | regarding long covid? I have read a few, and I see that
               | many are using the widest net possible to define long
               | covid, counting people who self diagnose symptoms such as
               | brain fog and having trouble concentrating.
               | 
               | Ofcourse long covid is real. I am just a bit skeptical
               | about the diagnosis criteria.
        
               | toss1 wrote:
               | That conclusion raises skepticism based on the appearance
               | of motivated reasoning and confirmation bias, but there's
               | insufficient data for a firm conclusion.
        
         | derbOac wrote:
         | I agree it's curious they didn't retest individuals at
         | followup, although it's much easier to ask if they contracted
         | COVID than to have them retest.
         | 
         | However, they did determine those individuals who contracted
         | COVID were not different in their premorbid test performance
         | from those who did not later contract COVID. This is a big part
         | of what a "complete" longitudinal design would get you.
         | 
         | Let's say you _did_ get that test data on follow-up. If post-
         | COVID people who were infected were different cognitively, and
         | not different premorbidly, that would suggest COVID was
         | involved. If they weren 't different cognitively, you'd have to
         | explain why the first wave of individuals were different based
         | on COVID history but not the later wave. Still important to
         | show but maybe a different set of explanatory challenges.
        
         | yosito wrote:
         | Not to mention that many people just aren't smart enough to
         | evaluate risk and understand how to protect themselves in a
         | pandemic. Just today I saw a guy on the metro wearing
         | disposable latex gloves but no mask on the metro. He was
         | obviously concerned about covid but had no concept of how it's
         | transmitted. Some of the other PPE mishaps I've seen would be
         | hilarious of they weren't so sad.
        
         | DominikPeters wrote:
         | I find it pretty concerning that they don't mention this issue
         | in their discussion section, which was also the first thing
         | that came to mind when reading the abstract: people who've
         | caught COVID may differ significantly from those who didn't.
         | Did none of the authors nor the reviewers think of this?
        
           | viraptor wrote:
           | Have you seen "2.4. Statistical methods" and "Table 1" which
           | discuss this? The whole paper is available below the
           | abstract.
        
             | DominikPeters wrote:
             | Yes, they control for various variables that they know
             | about. I'm not convinced this gets rid of the bias (e.g.
             | they don't control for working from home, many others). It
             | is not true that they discuss this obvious objection in
             | either 2.4 or Table 1. They only discuss methods they've
             | used that very partially mitigate the issue, without
             | mentioning the problem.
        
               | viraptor wrote:
               | How/why do you think working from home would affect the
               | results of the infected and not infected group? We can
               | throw lots of possible ways to divide the samples of
               | course, but I'd like to understand why you chose that
               | example. (and what's the threshold for "they should've
               | mentioned criteria X")
        
         | glangdale wrote:
         | There's a UK brain imaging study - small, due to the fact that
         | one required the "lucky" confluence of having participated in
         | the study before the COVID-19 epidemic, and having gotten COVID
         | - showing the kind of longitudinal effects you are asking for.
         | Alarmingly, it shows shrinkage of various brain structures even
         | among the mildly ill.
         | 
         | Note this is a not-yet-peer-reviewed preprint.
         | 
         | https://www.medrxiv.org/content/10.1101/2021.06.11.21258690v...
         | 
         | IMO, while I'm not inclined to take either study at face value
         | immediately, I think a serious person should be equally
         | reluctant to join the "it's just a flu" camp either.
        
           | saddlerustle wrote:
           | Apart from the effect size in that study being pretty low,
           | theres the obvious sampling problem in that sort of people
           | regularly having their brain imaged are not normal!
        
             | Aeolun wrote:
             | I dunno, I just have anxiety and the docs only feel safe
             | ruling certain stuff out after either a CT or MRI. If I
             | ever contract COVID I can look back through multiple years
             | of history.
        
             | glangdale wrote:
             | I'm not clear on what level of "pretty low" I'd have to see
             | before being reassured here. I guess it's HN, where I'm the
             | only dummy who doesn't know what acceptable changes in
             | everyday metrics like "Parahippocampal gyrus thickness" and
             | "Lateral orbitofrontal cortex volume" are.
             | 
             | Your second remark is also peculiar: the "obvious sampling
             | problem" to which you allude is either (1) a subtler-than-
             | expected-point about the UK Biobank's program (designed to
             | be a mass participation program to observe longitudinal
             | effects in previous healthy or as yet undiagnosed people)
             | or (2) evidence you are just making stuff up.
        
           | yourenotsmart wrote:
           | > I think a serious person should be equally reluctant to
           | join the "it's just a flu" camp either.
           | 
           | The long-term effects of flu are not studied that well, by
           | the way. On the basis we're used to it from before such
           | studies were possible.
           | 
           | None of those symptoms we hear about, getting our breath,
           | unable to smell, brain fog etc., none of them are new. And
           | they imply internal damage that lasts.
        
           | subroutine wrote:
           | Looking at the scatter plot from their most statistically
           | significant finding (parahippocampal gray matter change), the
           | effect size is tiny, and the variance is large. Nearly half
           | the case participants had _more_ gray matter after getting
           | COVID.
           | 
           | https://i.ibb.co/5YcxJHH/EDB20654-900-A-427-C-8063-B5-FA667-.
           | ..
        
             | glangdale wrote:
             | As I've stated elsewhere, apparently everyone on HN
             | understands what acceptable levels of "parahippocampal gray
             | matter change" might be, which is reassuring.
             | 
             | "Nearly half the case participants had more gray matter
             | after getting COVID" - as did the controls. It's almost
             | like there's variability in the readings. If only someone
             | would invent a subspeciality of mathematics about how to
             | interpret noisy data and attempt to draw conclusions about
             | the results.
             | 
             | I'm not totally sold on this study either, mind you. I'm
             | just amazed at how many people are rushing to judgement in
             | the other direction - the whole "just a flu" conclusion is
             | wildly premature.
        
               | subroutine wrote:
               | > It's almost like there's variability in the readings.
               | If only someone would invent a subspeciality of
               | mathematics about how to interpret noisy data and attempt
               | to draw conclusions about the results.
               | 
               | Yes, I mention the high variance. And indeed there are
               | standard ways to interpret the effect size magnitude,
               | given noisy data. The authors chose not to report Cohen's
               | d. They do provide an r value (.16), which we can use to
               | compute the the coefficient of determination. Since you
               | are an advocate for reliance on traditional statistical
               | interpretations, you should appreciate the meaning of
               | r^2=.025
               | 
               | Furthermore the authors report a P=.01. They bootstrap
               | this P, presumably because alpha significance level after
               | multiple comparison adjustment renders cutoff well below
               | .01. They also claim no a priori hypothesis wrt. gray
               | matter increase or decrease. A 2-tailed alpha is
               | typically shifted from p<.05 to p<.01 which their
               | measured P value does not surpass. Nevertheless they
               | claim statistical significance. Finally, after
               | normalization, there is roughly an equal chance any given
               | person will have more or less gray matter after getting
               | covid - this doesn't require one to glean the importance
               | of each ounce of gray matter to understand the effect
               | size is small. I contend there is good reason this study
               | has not yet passed peer review, if it ever will.
        
             | jvanderbot wrote:
             | That's not what I see in that plot. I see a distribution
             | shift, with zero linkage between before and after cases
             | that would suggest "Half had more gray matter"
             | 
             | Figure 2 is the one you want https://els-jbs-prod-
             | cdn.jbs.elsevierhealth.com/cms/attachme...
             | 
             | Which _does_ show effect increasing with severity of the
             | case. I 've seen plots like that before in similar
             | articles.
             | 
             | See also table 2.
        
           | NoblePublius wrote:
           | we are up to 2 billion+ covid infections globally, so if 1%
           | have Long Haul...where the hell are they?
        
             | mmmmmbop wrote:
             | Where did you read that number (2B+ Covid infections)?
        
             | renaudg wrote:
             | A large number of these infections are simply too recent
             | for "long haul" Covid to have settled in.
             | 
             | There's also not a globally accepted definition of the
             | syndrome yet, so it won't show up in stats.
             | 
             | If you go by "still experiencing at least one symptom after
             | 3 months", it's closer to 10-20% than 1% : https://twitter.
             | com/Dr2NisreenAlwan/status/13775492575703162...
             | 
             | Another study found that around a third of these 10-20%
             | consider it debilitating (significantly affects their daily
             | lives)
        
             | amcoastal wrote:
             | In most countries they are probably dead.
        
             | renonce wrote:
             | It's 200 million or 0.2 billion
        
               | caseysoftware wrote:
               | According to the CDC, the US has had an (estimated) 100M+
               | infections as of mid-April[0] and Europe had 50M+ as of
               | last week.[1]
               | 
               | I don't know the appropriate way to extrapolate out but
               | we're well past 200M globally.
               | 
               | 0: https://www.cdc.gov/coronavirus/2019-ncov/cases-
               | updates/burd...
               | 
               | 1: https://graphics.reuters.com/world-coronavirus-
               | tracker-and-m...
        
         | jvanderbot wrote:
         | Wait, what about this:
         | 
         | "A common challenge in studies of COVID-19 is that differences
         | between people who have vs. have not been ill could relate to
         | premorbid differences. To address this issue, a linear model
         | was trained on the broader independent GBIT dataset (N =
         | 269,264) to predict general cognitive performance based on age
         | (to the third order), sex, handedness, ethnicity, first
         | language, country of residence, occupational status and
         | earnings. "
        
           | dash2 wrote:
           | That's ridiculously bad. In effect their logic is:
           | 
           | "We controlled for various things in the original regression,
           | but hey, there still could be unmeasured confounders that
           | make people who got COVID score less on IQ tests, even before
           | they got COVID! (Like coming from a poorer background, other
           | health vulnerabilities etc. etc. etc.) Unfortunately, we
           | don't have a measure of IQ from before they got COVID. So, we
           | estimated one using a set of variables that we do have
           | measures for!"
           | 
           | Erm... if those extra variables predict IQ, then why not just
           | add them as controls? And of course, if you do so, then
           | you'll still hit the problem that there are plenty of
           | potential unmeasured confounders out there. This is just a
           | silly way to pretend you've controlled for something, when in
           | fact you can't.
           | 
           | The quality of statistics in medicine is so bad.
           | Disgracefully bad. In particular, the Lancet seems to be a
           | serial offender.
        
         | viraptor wrote:
         | Why do you think adjusting the model for: "Nuisance variables
         | were age, sex, racial-ethnicity, gender, handedness, first
         | language (English vs other), country of residence (UK vs
         | other), education level, vocational status and annual earning."
         | doesn't cover what you ask for here? (including graduate
         | degrees) With the described adjustments and enough data points,
         | the distribution of infection cases shouldn't matter.
         | 
         | Or are you making some other point I'm missing?
        
           | bijant wrote:
           | Correcting a model is always a somewhat subjective process
           | that can introduce bias, especially when it is done after the
           | study is completed pre-publication. I am not at all opposed
           | to such adjustments and I was actually involved in a research
           | project that improved on pure chance based randomized
           | selection of trial participants into different buckets
           | (substance/placebo) by weighing in the necessary adjustments
           | in the selection phase. That is why I'm intimately familiar
           | with the state of the art in academia. Novel approaches, such
           | as the one I worked on, are unpopular with reviewers which
           | makes them unpopular with researchers even though they would
           | allow, for faster trials, with smaller cohorts or
           | alternatively to find smaller effect sizes. My criticism of
           | the OP Study however is not the adjustments per se, which as
           | you point out seem reasonable (although we don't know what
           | alternative corrections they could have made with the
           | available data and what impact that would have had on their
           | findings)but the fact that they had what was needed to
           | conduct one of the rare properly executed longitudinal
           | studies on this question and wasted that opportunity.
        
           | disgruntledphd2 wrote:
           | Statistical adjustments at a population level will be much
           | less useful than the pre post design above.
           | 
           | Getting estimates from the same people will provide a much
           | lower variance estimaion of any potential effect.
           | 
           | Also, adding hospital records to this study would potentially
           | provide a better estimation.
           | 
           | All studies have flaws, but this one does look pretty
           | reasonable (the principal components method used should have
           | been better described, for instance, and confidence bounds on
           | the effect sizes would have been super useful).
        
             | yourenotsmart wrote:
             | The "pre post" is not much of a design, unless we've had a
             | long-term practice to force random healthy people into
             | scanning their brains, or we have a time machine.
        
               | disgruntledphd2 wrote:
               | Nonetheless, it would be a better design. Horribly
               | impractical, but really useful.
        
               | nradov wrote:
               | There are always medical studies running for other
               | purposes that involve doing brain scans on otherwise
               | healthy people. One of my relatives participated in such
               | a study. Presumably those same subjects could be enrolled
               | in a "pre post" study for COVID-19 effects.
        
           | nradov wrote:
           | With so many variables to adjust for the error bars should be
           | huge.
        
             | viraptor wrote:
             | The paper discusses how the variables were handled and
             | lists the error for estimates. Is your objection that they
             | calculated it wrong? Or that/how they used a linear model
             | for adjustments? What's the range for "huge"?
        
               | nradov wrote:
               | I'm saying that there's no reliable data to establish how
               | those variables impacted the final results. The
               | correction factors are mostly just guesswork. Signal to
               | noise ratio is low.
               | 
               | Basically this is junk science. The only proper way to do
               | such a study would be to compare the same subjects before
               | and after infection. With so many cases such a study
               | should be feasible.
        
               | viraptor wrote:
               | We don't know what the SNR is. It would be great if the
               | paper included the linear regression values and fit
               | analysis. It could be rubbish or not - but we don't have
               | the data to confirm or deny that.
               | 
               | I get the objection, but I'm getting annoyed at comments
               | that state what's invalid with the study where we don't
               | have the data available for that claim. What's wrong with
               | "we don't know if the study is valid since we don't have
               | details on X"?
        
               | nradov wrote:
               | That's not how real science works. The burden is on the
               | paper authors to prove they have adequately controlled.
               | From what I can see they haven't done so.
               | 
               | Overall the majority of COVID-19 clinical research has
               | been rushed and very low quality.
        
       | victor106 wrote:
       | > Cognitive problems in those who have required a lengthy
       | hospital stay or intubation are expected [[19]]. What is less
       | clear is whether milder cases who have not been hospitalized also
       | can suffer objectively measurable cognitive deficits. Measuring
       | such associations is challenging.
       | 
       | I think most of these deficits are for the hospitalized. It will
       | be interesting to see the why. Is it the virus itself? Is it the
       | treatment? Combination? Or is it the extreme long term anxiety.
        
         | mrcartmenez wrote:
         | Most likely the lack of oxygen to the brain
        
         | SamoyedFurFluff wrote:
         | Lengthy hospital stays, particularly intubation, is associated
         | with cognitive decline. https://pulmccm.org/critical-care-
         | review/cognitive-impairmen...
        
         | ekianjo wrote:
         | Not sure what is the current state of the research but I seem
         | to recall that some researchers mentioned that COVID19 could
         | break through the brain blood barrier and therefore could also
         | affect the brain in unknown ways:
         | 
         | https://www.nature.com/articles/s41593-020-00771-8
        
       | codesections wrote:
       | Results: The study shows ~1 IQ point decline for non-hospitalized
       | Covid patients.
       | 
       | Full table:                 Covid, no respiratory difficulty: 0.4
       | IQ point loss       Covid, respiratory difficulty, no home
       | assistance: 1 IQ point loss       Covid, respiratory difficulty,
       | with home assistance: 2 IQ point loss       Covid, hospitalized,
       | without ventilation: 4 IQ point loss       Covid, hospitalized,
       | with ventilation: 7 IQ point loss
        
         | mrfusion wrote:
         | Not so bad for the worst disease in history I guess?
        
           | ignoranceprior wrote:
           | COVID might be the worst infectious disease in recent memory,
           | but it is far from the worst disease in history.
        
         | redis_mlc wrote:
         | Note that ventilation for more than a week alone damages organs
         | - no corona needed.
        
         | inglor_cz wrote:
         | I wonder if you can even reliably measure a 0.4 IQ point loss.
         | Factors such as aging, changes in environment, perhaps even
         | work from home will act as confounding influences.
         | 
         | On the other hand, 7 IQ point loss on ventilation does not
         | surprise me as much. Being in a half-suffocated state for weeks
         | must have some adverse effect on oxygen-hungry brain.
        
           | Aachen wrote:
           | > I wonder if you can even reliably measure a 0.4 IQ point
           | loss.
           | 
           | Which is why one never ever trusts an article or paper with a
           | bare number as claim. Confidence intervals, p-values,
           | standard deviation, whatever it is, there are ways to tell
           | whether it's significant or what the odds are that it's
           | noise.
           | 
           | I haven't read the article btw so I don't know if it does,
           | but since we're talking about a bare number, the answer to
           | your question is that it indeed by itself doesn't tell us
           | anything about measurability even if it had been five points.
        
           | murgindrag wrote:
           | My follow-up question is how damage accumulates. We're on-
           | track for COVID19 becoming a thing, where we'll catch
           | mutations over and over and over.
        
             | Filligree wrote:
             | We'll know afterwards.
        
               | inglor_cz wrote:
               | Or, if the cumulative effects are bad enough, we won't
               | know.
        
         | blindmute wrote:
         | I'll take the 1IQ loss if it means society can stop this health
         | theater farce. I've probably lost more than that already from
         | the lockdowns.
        
           | vletal wrote:
           | Well, the important question is whether the number of deaths
           | and total number of IQ points lost in case of "stopping this
           | theater" would be better or worse compare to the points and
           | lives lost caused by the "theater".
        
       | guerrilla wrote:
       | Did the control for being an anti-vaxxer and anti-lockdown?
        
       | mrfusion wrote:
       | Would this have been published if they found no cognitive
       | deficit?
        
       | NoblePublius wrote:
       | They did not have a control group for "being locked inside for a
       | year" which I bet also has a pretty bog effect on cognition.
        
         | caddemon wrote:
         | Given that most people were locked inside for a year, and those
         | who didn't get COVID are even more likely to have followed
         | lockdown rules, any control group measured right now would be
         | reflecting the "locked inside" condition.
        
         | viraptor wrote:
         | What would be the goal? If the bog effect exists , the possible
         | extremes are "being locked inside makes infections more common"
         | which should not impact the result (adding people to both
         | pools), or "being locked inside prevents all infections" which
         | would make the deficit larger than reported. (but as noted,
         | it's a call for further study rather than a precise result)
        
       | nanis wrote:
       | Looking at Figure one in the PDF[1], I don't think I do well on
       | this test at all. I mean "lion is to feline as close is to
       | distant, true/false"? Or, "Emotional Discrimination"? What is the
       | "correct" answer there?
       | 
       | I can deduce that "Patronymic" is "a name derived from the name
       | of a father or ancestor", but I do not believe many native
       | speakers I cross paths with can.
       | 
       | In any case, studies like this mention the total number of people
       | who took the test (81,337 participants), but then, by definition,
       | the effects come from small subgroups. E.g.,
       | 
       | > People who had been hospitalised showed substantial scaled
       | global performance deficits dependent on whether they were (-0.47
       | standard deviations (SDs) N = 44) vs. were not (-0.26 SDs N =
       | 148) put onto a ventilator. Those who remained at home (i.e.,
       | without inpatient support) showed small statistically significant
       | global performance deficits (assisted at home for respiratory
       | difficulty -0.13 SD N = 173; no medical assistance but
       | respiratory difficulty -0.07 SDs N = 3,386; ill without
       | respiratory difficulty -0.04 SDs N = 8,938).
       | 
       | The 44 people who were put on ventilators are different on other
       | dimensions. It is hard to separate the effects of the news ("you
       | have a horrible disease"), the medical treatment, and the
       | psychological torment associated with being in a hospital during
       | this time from the actual effects of the actual virus.
       | 
       | [1]:
       | https://www.thelancet.com/action/showPdf?pii=S2589-5370%2821...
        
         | herendin2 wrote:
         | It's very hard to believe that you're able to make such a
         | complex and erudite argument as this, and yet you're utterly
         | unable to parse something as simple as "lion is to feline as
         | close is to distant, true/false". Both tasks require the same
         | basic skills.
        
       | blindmute wrote:
       | What's strange is that they didn't control for obesity or
       | occupation. It's known that being more obese leads to worse
       | symptoms. It's known that chance of infection is higher among
       | retail workers and such, who have lower IQs than people working
       | from home.
       | 
       | The IQ correlation in this study is: Covid, no respiratory
       | difficulty: 0.4 IQ point loss Covid, respiratory difficulty, no
       | home assistance: 1 IQ point loss Covid, respiratory difficulty,
       | with home assistance: 2 IQ point loss Covid, hospitalized,
       | without ventilation: 4 IQ point loss Covid, hospitalized, with
       | ventilation: 7 IQ point loss
       | 
       | Let's ignore the respirator segment because lack of oxygen like
       | that can surely cause problems and I don't think anyone is really
       | arguing against it. Without a before test, the only thing this
       | study can reasonably show (if you call 1IQ point showing
       | anything) is that fat people or cashiers are ever so slightly
       | less intelligent.
       | 
       | Honesty people, I was expecting on the order of 5-10 IQ points
       | from the popularity and activity of this article. An average of
       | 1IQ in a study with no control group and no pre-post test? Come
       | on.
        
       | BurningFrog wrote:
       | Is the obvious "smarter people are better at avoiding covid"
       | theory disproven?
        
       | bserge wrote:
       | Just like many other viral and bacterial infections, then. No
       | surprise here.
        
         | VortexDream wrote:
         | I'm not aware of similarities with other infections. Care to
         | cite sources?
        
           | guruz wrote:
           | Post Viral Fatigue Syndrome
           | 
           | https://en.wikipedia.org/wiki/Chronic_fatigue_syndrome#Viral.
           | ..
        
           | orwin wrote:
           | (Not OP) Viral infection can have this effect. The flu for
           | sure, but also the varicella virus (i think this is the
           | translation?) do too. West Nile virus also?
           | 
           | Its definitly not the majority of viruses, and i'm not sure
           | bacterial (benefit of the doubt here). Don't tell me you
           | never exagerate a little :P
        
             | _moof wrote:
             | > varicella virus (i think this is the translation?)
             | 
             | chickenpox.
             | 
             | :)
        
           | neilwilson wrote:
           | Influenza can trigger numerous issues.
           | 
           | My mother ended up on anti-seizure tablets after the last flu
           | outbreak having spent five days in intensive care.
           | 
           | The flu brought on a fit and hypo-natremia. It took months
           | before she could walk properly again.
           | 
           | Our success against infectious diseases has left a generation
           | or two with insufficient fear of them.
           | 
           | I've seen people catch a bad cold on Wednesday and be dead
           | from pneumonia on Sunday.
           | 
           | The impact from Covid isn't new. It's just a rediscovery of
           | why we spent the twentieth century on an all out war against
           | infectious diseases and septicaemia.
        
             | VortexDream wrote:
             | Maybe. However, the rates at which I'm seeing long Covid
             | seem entirely novel. Something like 30% of all cases in a
             | recent study show signs of it, including mild cases. I
             | admit there are overlaps in fatigue syndrome (and should've
             | phrased my original comment differently), but AFAIK we've
             | usually only seen that in severe infections with other
             | diseases while we're seeing abnormally high rates of (to
             | varying degrees) cognitive impairment even in mild or
             | asymptomatic Covid infections.
        
           | ekianjo wrote:
           | Many infections (viral or bacterial) can cause long term
           | inflammation, and inflammation can have such effects. Now
           | what would really need to be measured if the degree of change
           | is really different with COVID vs other infections.
        
         | orwin wrote:
         | You mean some, it is not the majority. And often viral, not
         | bacterial.
         | 
         | The flu have this effect for sure.
         | 
         | The issue is that those cognitive disfunctions hit young people
         | who were not hospitalized, or hospitalized only for safety
         | (monitoring them with oxy at the ready). I know of one
         | professionnal classical dancer, 26, who cannot coordinate
         | following Covid, and was luckily already near the end of her
         | career. But still, for some trade, this might be an issue,
         | especially if Covid become as endemic as the flu
        
           | pbhjpbhj wrote:
           | > The flu have this effect for sure.
           | 
           | Any references or background to this?
           | 
           | It's weird because there are major media campaigns to
           | encourage people to have a flu jab (UK) and "flu causes
           | [irreversible] cognitive dysfunction" would be a major
           | 'seller'.
           | 
           | I can also see that governments could have been reluctant to
           | spread such information - if it's true - as it would change
           | attitudes to schooling; schools being known to be a major
           | vector for spreading flu.
        
             | orwin wrote:
             | Well, sorry, i said "for sure" because i was hit by the flu
             | october 2019, and my recovery left me weaker to other
             | respiratory diseases (first time asthma) and caused me
             | balances issue for a year. But ancdata is not data, so i'm
             | sorry. Let's say chickenpox, West Nile?
             | 
             | Btw, i did not say "irreversible". I did lost a summer of
             | training, probably because of the flu, and this is
             | irreversible, but i'm pretty sure my balance is OK now (i
             | had asthma 3 weeks ago, so the respiratory sytsem damage is
             | not repaired however)
        
           | strangemonad wrote:
           | In what scenario does it bot become endemic?
        
             | unlikelymordant wrote:
             | If everyone develops immunity, either by vaccine or
             | infection, and it dies out on its own i assume would be the
             | only way
        
             | rsynnott wrote:
             | Full vaccination. A few countries (developed countries with
             | high levels of vaccine acceptance) will be able to
             | vaccinate virtually everyone over 16 within the next month
             | or so, maybe everyone over 12 (though there is likely to be
             | way more hesitancy there almost everywhere). At that point,
             | it's likely to be suppressed in those countries, and that
             | may reduce hesitancy elsewhere, and so on.
             | 
             | A number of diseases that were once globally endemic are
             | now regionally endemic (eg polio, two countries), or
             | eradicated (smallpox). Generally due to vaccination.
        
         | pjc50 wrote:
         | That's rather a surprise to me, given the lack of recognition
         | of post-viral fatigue!
        
           | trhway wrote:
           | there are studies connecting chronic fatigue syndrome to
           | increased B-cells numbers (like it happens after viral
           | infections like flu for example, and i'd guess after covid
           | too) https://www.discovermagazine.com/health/are-b-cells-to-
           | blame...
        
       | iloveyouocean wrote:
       | My first, selfish question: When will the article that examines
       | cognitive function in recovered people who were fully vaccinated
       | before contracting COVID arrive?
        
         | ypcx wrote:
         | That may depend (or be influenced by) on whether the results
         | are negative or positive versus unvaccinated and who advertises
         | in said journal.
        
         | Arnt wrote:
         | That'll take a long time.
         | 
         | Since the vaccines are excellent at preventing serious
         | outcomes, a fairly large share of the infected won't even go to
         | a physician, and therefore getting a representative sample of
         | infected people will be all of difficult, expensive and time-
         | consuming.
         | 
         | Maybe there exists a set of people who a resembles the general
         | population and b will be tested routinely and often for years
         | to come, such that an accurate statistical picture can be
         | found. But I can't think of any now.
        
           | Aachen wrote:
           | OT - how do you make those circled symbols? A tool or do you
           | have a nice keyboard combo for it? It makes this in-line
           | summing up of points much clearer, I like it at least at
           | first sight.
        
         | paulsutter wrote:
         | Reading the results, the less severe the case the less severe
         | the impact. Effects were severe for hospitalized patients, and
         | mild for mild cases. Hospitalization is rare among vaccinated
         | people.
        
       | tomp wrote:
       | I wonder what the discussion would be if the same study was
       | posted but "in people who were vaccinated against Covid-19".
        
       | zwaps wrote:
       | Does anyone know why these medicinal studies do not seem to use
       | more modern statistical methods of observational causal
       | inference?
       | 
       | I mean yes you can not RCT and yes a linear model should be the
       | baseline, but then why not go ahead and do some synth control or
       | double ML, or heck, take the survey twice and do some matched
       | diff and diff?
       | 
       | Surely more can be done or not?
        
       | notjes wrote:
       | The Cognitive deficits in people can be clearly see in most
       | health scientists.
        
       | glangdale wrote:
       | I think it's reasonable to be way more cautious about COVID than
       | the "just a flu" and "it'll become endemic" (for some value of
       | 'endemic') crowd seem to think.
       | 
       | The UK brain imaging study is a (small, not-yet-peer-reviewed)
       | data point in that direction also:
       | 
       | https://www.medrxiv.org/content/10.1101/2021.06.11.21258690v...
       | 
       | There seems to be somewhat of suggestion that COVID may have
       | serious long-term neurological effects. Given the massive numbers
       | that it has affected already (and how many it would affect if it
       | becomes endemic), even relatively small risk factors (i.e. single
       | digit percentages) for things like Lewy body dementia and
       | Parkinsons could have huge effect on public health.
       | 
       | It's worth reminding ourselves that we don't have any data on the
       | mid-to-long term effects of COVID beyond about a 2 year window.
        
         | [deleted]
        
         | irq11 wrote:
         | It _is_ endemic. What you think of that fact is irrelevant.
         | It's a contagious respiratory virus with multiple animal
         | reservoirs. Even if you could somehow vaccinate every person on
         | earth tomorrow, the virus would still be here.
         | 
         | This virus is not going to be eliminated, and it's well past
         | time to move on from that discussion.
        
           | biztos wrote:
           | I was just thinking about this today as I prepare for another
           | transatlantic flight: we seem to all be planning for a time
           | when mask mandates and lockdowns are over.
           | 
           | But what if they're never over?
           | 
           | The US and Western Europe have, by now, enough high-quality
           | vaccine for everyone, and we're all stuck at, what, 60% of
           | the population vaccinated?
           | 
           | A bunch of people died, a bunch of people went broke, but
           | during this pandemic the rich have mostly gotten a whole lot
           | richer. Even the rich who don't think of themselves as rich:
           | own a house in Silicon Valley, have a dozen years of 401K and
           | some stock -- these people have done very well.
           | 
           | We have to fight the virus; but we also have to fight the
           | anti-vaxxers and the apathetic, and we have to do it in a
           | world where the people with real power are actually gonna be
           | just fine if everything locks down for four months out of
           | every year.
           | 
           | I've started trying to imagine life in that kind of future.
           | Say two lockdowns every year, in a good year it's a month
           | each time, in a bad year maybe you're locked in your
           | apartment half the time, and that's for people who get their
           | booster shot every year.
           | 
           | Maybe forever. What does society look like in that scenario?
        
           | snowwrestler wrote:
           | Smallpox is gone and polio is almost gone.
           | 
           | We have the technology to completely eradicate the 2019 novel
           | coronavirus if we have the collective will to use it.
           | 
           | Other coronaviruses will evolve to infect humans, yes. We'll
           | never eradicate infectious disease in general. But we're
           | talking about one specific distinctive virus here. One for
           | which we already have multiple effective vaccines.
        
         | Jeema101 wrote:
         | That study is somewhat alarming, but I think they were only
         | looking specifically at parts of the brain related to smell and
         | taste, not the brain as a whole, as stated here:
         | 
         | "Based on prior expectations based on animal models and post
         | mortem findings, we chose to focus a priori our primary
         | analyses on a subset of 332 regions-of-interest (297 of which
         | passed the reproducibility thresholding) from the available
         | IDPs that anatomically corresponds to the telencephalic primary
         | and secondary connections of the olfactory and gustatory
         | cortex"
        
         | jmnicolas wrote:
         | > I think it's reasonable to be way more cautious about COVID
         | than the "just a flu" and "it'll become endemic" (for some
         | value of 'endemic') crowd seem to think.
         | 
         | But unless you want to live like a recluse in a bunker, what
         | are your options?
         | 
         | The way I see it, you're bound to catch it no matter how many
         | precautions you take. Case in point: I know a guy with paranoid
         | level of precautions that still got it and while he was
         | confined with his family none of them caught it (this was
         | before we had any vaccines in my country).
        
           | glangdale wrote:
           | Delta, so far, seems to infect whole households with ease in
           | a way that we didn't see. Sydney, Australia is on severe
           | lockdown at the moment thanks to a delta outbreak (it hasn't
           | helped that, like many countries that handled the
           | lockdown/test-and-trace methodology well, we fucked up the
           | vaccination program).
           | 
           | I would imagine that a combination of mass vaccination (which
           | seems to reduce transmission, although not by as much as was
           | hoped) - and continued reasonable measures (mask wearing in
           | crowded indoor places, better ventilation) we could achieve
           | eventual elimination.
           | 
           | Alternately, on route to this less-than-comfortable-outcome,
           | we could make strides in treating the long-term illness,
           | improve short-term treatments and improve vaccines.
           | 
           | The other option is that maybe we'll work our way through the
           | entire Greek alphabet of variations (and beyond; perhaps the
           | Omega variation is followed by double-Alpha) with a large
           | pool of sick people and vaccine escape whack-a-mole because
           | people decided there was no options between "live in a
           | bunker" and "free for all".
        
             | irq11 wrote:
             | > Delta, so far, seems to infect whole households with ease
             | in a way that we didn't see.
             | 
             | According to the latest data out of the UK, Delta is
             | approximately as contagious as Alpha:
             | 
             | https://assets.publishing.service.gov.uk/government/uploads
             | /...
             | 
             | There is simply no basis for these claims of dramatically
             | increased contagion. It's a meme that was based on early
             | speculation, and repeated mindlessly by the press.
        
               | mortehu wrote:
               | > According to the latest data out of the UK, Delta is
               | approximately as contagious as Alpha
               | 
               | Are you talking about page 34, which compares secondary
               | attack rate week by week? Can you explain how you read
               | that chart?
        
           | AnthonBerg wrote:
           | _> But unless you want to live like a recluse in a bunker,
           | what are your options?_
           | 
           | We can:
           | 
           | * _Try_ not to get infected
           | 
           | * If inevitable: Get as little of it as we can
           | 
           | * Help the body clear the illness and after-effects
           | 
           | * Contract the illness as late as possible, as medicine
           | advances faster than mutations
           | 
           | * Seek to support the science of figuring this thing out
           | 
           | * Do this together
           | 
           | * Seek to reduce the amount of contagious people in our local
           | and global environment
           | 
           | Practically, we can:
           | 
           | * Wear masks. Better masks are better
           | 
           | * Use air conditioning, advocate for air conditioning and
           | fresh air
           | 
           | * Exercise. Eat well. Go outside.
           | 
           | * Get vaccinated
           | 
           | * Read papers
           | 
           | * Discuss the science
           | 
           | * Participate in studies
           | 
           | * Fund science
           | 
           | * Explain to people what the scientific process is and how we
           | know what we know
           | 
           | * Should we arrive at the opinion that certain substances,
           | drugs, or supplements may have a protective effect, we might
           | take those
           | 
           | * We can be the living scientific process: When we choose to
           | experiment, seek to carefully note down the results and
           | publish them
           | 
           | * Help others
           | 
           | * Fund healthcare for those who are less well off than we are
           | 
           | * Establish robust social immunity by discussing the options
           | we do have to reduce infection
        
             | SquibblesRedux wrote:
             | I think we need to put considerably more effort into
             | discussing existing and new scientific endeavors before we
             | consider funding. I am not saying we should pause or reduce
             | funding, but rather the reach of our public coffers has
             | increasingly exceeded our understanding of what we are or
             | are not accomplishing with that funding.
             | 
             | The amount of noise, publicity, and politicization of
             | scientific research makes it very difficult to wisely set
             | public policy at both the national and local levels.
        
               | AnthonBerg wrote:
               | I would agree, although not _completely_ - but will I
               | also claim that this falls under discussing, studying,
               | funding, and doing more science %D
               | 
               | Ah, and, it didn't occur to me to make the distinction,
               | but I was thinking of _personal and direct_ funding of
               | science. As something each of us might arguably do. It's
               | interesting to consider it because we arrive at the same
               | question: What to fund?
        
             | jmnicolas wrote:
             | > Seek to support the science of figuring this thing out
             | 
             | It's "funny" because a few months ago, I read that it was
             | definitely an airborne virus, so hands contagion was
             | absolutely not a concern.
             | 
             | Then yesterday I read the complete opposite.
             | 
             | In both case, they were reputable scientists.
             | 
             | Thanks for the advises anyway.
        
               | AnthonBerg wrote:
               | Exactly! And which leads us to asking: How do we know???
        
             | [deleted]
        
           | machinehermiter wrote:
           | There are no options obviously.
           | 
           | I am fully vaccinated, if you offer me a booster I will take
           | it. If you offer me whatever, I will take it.
           | 
           | At that point I have done all I can do. If someone wants to
           | stay in a bunker because things are beyond their risk
           | preference then they should not be forced out of the bunker.
           | 
           | Forcing me back in a bunker though being fully vaccinated is
           | absolute bullshit if anyone can get vaccinated.
        
           | graeme wrote:
           | > But unless you want to live like a recluse in a bunker,
           | what are your options?
           | 
           | It depends on work and family circumstances. But, stuff that
           | works:
           | 
           | * Be outdoors, and socialize outdoors
           | 
           | * If in indoor unventilated spaces, wear a mask. Ideally N95
           | if lots of people and they aren't mask
           | 
           | * Exercise more caution during local waves
           | 
           | * If socializing with others indoors, open a window. This can
           | be done even during heat waves or winter: the greater the
           | temp differential the more the air circulation for a given
           | amount of window opening. Doesn't raise costs too much, yet
           | people treat it as impossible
           | 
           | * Buy a hepa filter for your home. Humidifiers can also help
           | in winter
           | 
           | * Avoid indoor restaurants and bars and unmasked venues
           | 
           | * In risky venues, choose glasses over contacts. Eye
           | protection is another layer
           | 
           | * Don't hang out with symptomatic or unvaccinated people
           | 
           | * Get vaccinated
           | 
           | Whether you _should_ choose to do this is another thing, but
           | that's what to do if you don't want to catch a respiratory
           | virus.
           | 
           | This above is consistent with: seeing friends, small indoor
           | gatherings, travel (wear n95 + glasses!), etc. It certainly
           | isn't living in a bunker.
           | 
           | It does present problems during winter though, and it is also
           | quite inconvenient in places with frequent large waves. Small
           | ventilated indoor gatherings with vaccinated friends should
           | be ok in low prevalence, but are risky in a big wave, for
           | example.
        
             | blindmute wrote:
             | I would quite literally rather contract covid than live
             | like that for any period of time.
        
               | graeme wrote:
               | I should add, of course, that I mainly wrote that for
               | those who 1. Really would like to avoid catching the
               | virus for now, but 2. Think it requires ungodly levels of
               | isolation to do
               | 
               | What I wrote is less social than the average (one hopes)
               | but more social than a lot of people lived the past year!
               | 
               | But if you'd rather live less restricted and are
               | vaccinated, go nuts. The vaccines protect quite well
               | against severe disease and it doesn't strike me as a bad
               | choice to not worry about it.
        
               | graeme wrote:
               | Apart from the masks, it's how much of Canada lives for
               | four months of the year (summer). We hardly do any
               | indoors socializing.
               | 
               | It's what I based the above on. Both pandemic summers
               | Canada has had collapsing cases even while there were
               | surged in parts of the world with winter or that use AC
               | more than us.
               | 
               | Go to any restaurant with a patio and you'll hardly see
               | anyone inside. Everyone goes to the patios in summertime.
               | And people tend to open windows rather than use AC on
               | anything but the hottest days. Backyard dinners or
               | rooftop drinks are one of the main ways people socialize
               | privately.
        
               | sharken wrote:
               | Difference being that Covid restrictions take away the
               | free choice of the individual, remove restrictions and
               | let each get on with their lives as they choose.
        
             | sharken wrote:
             | There is absolutely no way that we can implement the above,
             | WITHOUT losing a lot of what makes us humans in the
             | process.
             | 
             | I'd rather keep our pre-Covid level of human interaction
             | than limiting it forever.
             | 
             | But to each their own, one thing is that we must remove all
             | restrictions so that each can choose their own way freely.
             | 
             | This last part is what politicians have a hard time to
             | realize, but it's a necessity.
        
           | snowwrestler wrote:
           | There's no reason to believe catching COVID-19 is inevitable.
           | Consider that the best estimates about the Spanish flu of
           | 1918 are that about a third of the world caught it before
           | that pandemic ended. Today we have much better knowledge and
           | hygiene, and extremely effective vaccines.
           | 
           | Most people in the world have not contracted COVID-19.
           | Personal precautions are well understood and vaccine
           | distribution is well underway.
           | 
           | I'm sorry that your friend contracted it. In contrast I would
           | characterize my family's precautions as normal, and none of
           | us have contracted it. Two of us are now vaccinated as well.
        
             | nickthemagicman wrote:
             | The Spanish Flu never went away, it just became "The
             | Flu(tm)".
        
           | BoxOfRain wrote:
           | Exactly, at some point the cure will become worse than the
           | disease. The fact this makes people uncomfortable is no
           | reason to push it under the rug!
        
             | treeman79 wrote:
             | How many years of lockdown will people put up with?
             | 
             | I could see some places where someone's entire childhood
             | memory is being under lockdown.
        
               | toss1 wrote:
               | If an actual proper hard lockdown is done, it takes only
               | a matter of weeks.
               | 
               | COVID-19 has only existed as a problem for less than
               | twenty months - what childhood is that short? And even if
               | that statement had some relation to reality, anyone would
               | take a childhood lockdown vs a lifetime of impairment (&,
               | yes I get that lockdown itself can have some long-term
               | effects, but these are much more easily counteracted vs
               | biological deficits).
        
               | ipython wrote:
               | Yes, intellectually speaking, 20 months is not an entire
               | childhood. But from a relative perspective- let's take a
               | five year old- that's about 40% of his lifetime to date.
               | That feels very significant to him/her.
               | 
               | That said, having kids that age, I would say my kids
               | handled this pandemic way better than most adults. They
               | adapt quicker and don't have the emotional baggage
               | ("masks are an evil plot to control the population" for
               | example) to get through.
               | 
               | We have been lucky that they were able to attend school
               | in person though - very strict COVID protocols plus a
               | small population ensured that we never had an outbreak.
               | Things would have been different if we didn't have that
               | ability.
        
             | snowwrestler wrote:
             | It's hard to confidently assert that the cure is worse than
             | the disease if we don't know the long-term effects of the
             | disease yet. (Which is why we're discussing the Lancet
             | article.)
        
           | LatteLazy wrote:
           | On a personal level, get vaccinated. That seems to reduce
           | risks by a factor of at least 1000.
           | 
           | On a social level: use the Aus model. Actually lockdown, get
           | case numbers down to the 10s per million. The UK, US etc
           | model is the opposite, it relies on having as many people as
           | possible infected and not really engaging in any full
           | lockdowns. So far that's meant more and longer lockdowns.
           | It's also meant more variants. And it means the maximum
           | number of people with long term effects. It's the worst of
           | all worlds, even the economic one.
        
           | caeril wrote:
           | > what are your options?
           | 
           | We're a year and a half into it. We have the data. Aside from
           | vaccination and some degree of proper ventilation, you need
           | to:
           | 
           | 1. Not be old. 2. Not be fat.
           | 
           | We talk a lot about #1, but #2 is taboo. We, as a society,
           | prefers that you die unnecessarily young from COVID than feel
           | a little bit of shame. Not to mention #2 was already
           | murdering nearly half a million Americans annually _on its
           | own_ prior to COVID.
           | 
           | This needs to be fixed. Sugar/corn industry lobbyists and
           | fast food advertisers should have been publicly hanged
           | decades ago. Now we have even more incentive to address the
           | issue, but I suppose slowly dying at the age of 37, gasping
           | for breath, is a small price to pay to avoid feeling slightly
           | negative about being 300lbs or impact the dividends of the
           | Coca Cola Corporation.
        
             | sharken wrote:
             | You are absolutely right.
             | 
             | Number 2 is hard to fix as lobbyists and fast food
             | companies have a lot of influence.
             | 
             | But it is concerning that of US women from age 20 and up,
             | 60% or more are considered overweight.
             | 
             | A woman 50 years old has an average weight of 80 kg, using
             | the Miller ideal weight formula and a height of 170 cm, the
             | weight should be 62.5 kg.
             | 
             | https://www.healthline.com/health/womens-health/average-
             | weig...
             | 
             | There should be some kind of reward or benefit for those
             | that can keep to the ideal weight for a longer period of
             | say 1 year.
        
             | tester756 wrote:
             | >but #2 is taboo.
             | 
             | where?
        
         | laurent92 wrote:
         | > small, not-yet-peer-reviewed) datapoint in that direction
         | 
         | Since we tend to mock such studies when done by antivax, we
         | should also reserve all judgement here. Let's keep the bar high
         | for good science, the last year has been a flourish of
         | unverified correlated statistics.
         | 
         | > Given massive numbers it has affected already
         | 
         | I don't think people optimize for normal life either. For
         | example, lockdowns do provoke effects which are at least as
         | dangerous: We spend billions a year telling people to move more
         | to fight obesity, so we are 100% sure that lockdowns have a
         | negative effect on obesity and cardiovascular diseases, but
         | also families breaking up, unemployment, loneliness, lack of
         | sports (maybe close to weight gains of a 5-10 pounds in
         | average, I'd be curious), and all those factors multiply
         | further in the future and increase the risk of asthma, cancer,
         | suicide, mental breakdowns (including knife attacks), we
         | haven't see the real delayed effects.
         | 
         | So, overreaction already killed more than even the (reasonable)
         | estimated worst case scenario.
         | 
         | Let's not focus just on Covid, and let's look at everything
         | else we don't generally care about. My rule is, since they
         | don't care for my suicide, which is about 2 orders of magnitude
         | higher than my Covid risk, I won't vaccinate.
        
           | jpmoral wrote:
           | >So, overreaction already killed more than even the
           | (reasonable) estimated worst case scenario.
           | 
           | How did you come to this conclusion?
           | 
           | >My rule is, since they don't care for my suicide, which is
           | about 2 orders of magnitude higher than my Covid risk, I
           | won't vaccinate.
           | 
           | Not sure if I'm reading this correctly but basically not
           | vaccinating out of spite?
        
           | glangdale wrote:
           | I love how you pivot from "demanding peer review" and a "high
           | bar for science" to unleashing a great pile of anecdata about
           | overreaction. Much of the science on depression and social
           | ill effects of lockdowns is no more conclusive, but you're
           | already 100% convinced of it, even making up numbers for
           | average weight gain.
           | 
           | I find it bizarre that all the stuff about depression,
           | unemployment, etc is always neatly pigeonholed into "lockdown
           | did it". Yeah, like if we were all just going about our
           | business having Brazil-levels of disease and death , we'd all
           | be really cheerful and gainfully employed.
           | 
           | Anti-lockdown people somehow interpret the world entirely
           | through this narrow lens - perhaps some people are
           | depressed/suicidal thanks to dread of the disease or personal
           | losses of friends/family members to the disease. There's an
           | amazing rush to judgement to assume that all the risks are
           | due to lockdown, especially in countries that have high rates
           | - as yet I don't think we know what suicide and unemployment
           | rates are for people with Long COVID.
           | 
           | It's something of a right-wing bit of unpleasantry to say
           | this, but "facts don't care about your feelings" (ugh). If
           | there is a looming risk of - say - 2% of long COVID suffers
           | getting Lewy Body Dementia or Parkinson's as a result of
           | "mild COVID", that's a _lot_ of new horrible cases -
           | potentially with years of suffering involved.
           | 
           | If these ill effects are in fact looming, they will ensure
           | that 'bad lockdown' stuff is lost in the noise.
           | 
           | I'm not advocating 'lock everyone down hard forever'; I just
           | think this is a counterpoint to the whole "freedom day"
           | nonsense where it's assumed that once we have a goodly
           | portion of people vaccinated we can just let the virus rage
           | through the population unchecked.
        
           | SamoyedFurFluff wrote:
           | Since you also focus that you want to keep a high bar for
           | good science, where are you studies that claim that "
           | overreaction already killed more than even the (reasonable)
           | estimated worst case scenario"?
        
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