Social distancing could worsen population level outcomes from Covid-19

[Yew]

You are of course entitled to your opinion. But you cannot deny that some recovered patients, who were previously in perfect health, now have permanent organ damage. As it is a "novel" coronavirus we don't yet know as much as we would like so it is true to say that detailed and reliable statistics about long-term impacts are not yet available. But it is undeniable that such impacts are occurring.

Have you any Journal papers which support this?

 

[MikeWM]

I browsed the paper but couldn't really work out the methodology.

Here's a twitter thread which gives an example of how this could work. It is less rigorous but easier to follow

https://twitter.com/BallouxFrancois/status/1307381101929926656

...
In this hypothetical toy example, country B is likely in a better situation not only because it experienced fewer deaths but also because a far larger proportion of the population has been immunised (50% vs. 10%).

 

[Bletchleyite]

A thought I had on this was that if there is natural immunity for say 3 months, the "least worst" way would seem to be to facilitate it "burning through" within 3 months to ensure it then "trips up" on herd immunity and wanes, rather than dragging it out over longer and getting many reinfections?

It would be really useful to know that.

 

[Yew]

A thought I had on this was that if there is natural immunity for say 3 months, the "least worst" way would seem to be to facilitate it "burning through" within 3 months to ensure it then "trips up" on herd immunity and wanes, rather than dragging it out over longer and getting many reinfections?

It would be really useful to know that.

An interesting thought, but I feel that most of the current research points to immunity being "robust and long lasting" which is not too surprising given that SARS patients still have T-cells to this day.

 

[Shaw S Hunter]

Have you any Journal papers which support this?

Plenty of press reports unless you don't trust the media to tell anything other than lies. One that I specifically became aware of was Boston Red Sox pitcher Eduardo Rodriguez (age 27) who having recovered from Covid-19 now has myocarditis and though it is hoped he will recover he certainly won't be throwing a baseball for many months. And he is a professional athlete and should have been Boston's pitching ace this year.

If it's a serious study you want then try https://www.sciencedirect.com/science/article/pii/S1547527120304227

Naturally there are qualifying comments in the paper but as I said we still have much to learn. But the suggestion that Covid-19 will either kill us or allow us to recover and resume our previous way of life is not a universally accurate statement. Accordingly I believe that a certain amount of trepidation at the prospect of otherwise apparently non-vulnerable people catching it is justified.

 

[takno]

Plenty of press reports unless you don't trust the media to tell anything other than lies. One that I specifically became aware of was Boston Red Sox pitcher Eduardo Rodriguez (age 27) who having recovered from Covid-19 now has myocarditis and though it is hoped he will recover he certainly won't be throwing a baseball for many months. And he is a professional athlete and should have been Boston's pitching ace this year.

If it's a serious study you want then try https://www.sciencedirect.com/science/article/pii/S1547527120304227

Naturally there are qualifying comments in the paper but as I said we still have much to learn. But the suggestion that Covid-19 will either kill us or allow us to recover and resume our previous way of life is not a universally accurate statement. Accordingly I believe that a certain amount of trepidation at the prospect of otherwise apparently non-vulnerable people catching it is justified.

A certain amount of trepidation is fine, but if you review the actual stats, this is still rare, mostly restricted to people who had it seriously enough to end up in hospital, and isn't enormously out if range of what happens with other viruses - even some with very low fatality rates can cause a couple of months of crushing fatigue.

The story of what happened to an individual baseball player is beyond anecdotal, since not only is it a single datapoint, but it's a story of somebody whose occupation means that they will be unusually badly impacted by any long term effects at all.

Also worth bearing in mind that where we are talking about statistically rare and completely unexpected complications, you could also just see somebody with bad luck or a compromised immune system getting two unrelated diseases in quick succession. It's worth of further investigation, but that doesn't make it worth staying in for the results

 

[big_rig]

A good article on the baseball player:

While Rodriguez is expected to make a full recovery, the news of an athlete developing a heart condition due to COVID-19 was unsettling for many. Still, Columbia University cardiologist Dr. Jennifer Haythe points out that these types of complications have been seen before even in patients that get the flu.

“We know that for the most part the people who get very sick from COVID are older people. Obviously, that doesn’t mean that younger people can’t get very sick from COVID as we’re seeing and I saw with my own eyes. But, it’s less common and the flu can do the same thing,” said Dr. Haythe in an interview with CBS Local’s DJ Sixsmith. “I’ve seen young people need heart transplants from getting the flu. It’s not something we’ve never seen before. The stories are obviously frightening but I think we need to keep in perspective that in general, younger people without a lot of co-morbidities do okay and it’s generally our older relatives and family that we need to keep protected.”

Rodriguez’s case, and other’s like it, are a reminder of just how little we know of the effects that follow having COVID-19. Dr. Haythe says that she’s not recommending her patients stayed locked inside for the next two years but that people should use “common sense and caution” when trying to protect themselves and others from COVID-19.

'It's Not Something We've Never Seen Before': Columbia University Cardiologist On Red Sox Pitcher Eduardo Rodriguez's Developing Heart Condition Due To COVID-19

The Columbia University cardiologist discusses what she's seen in terms of the effects of COVID-19 on the heart, like the case of Red Sox pitcher Eduardo Rodriguez.

boston.cbslocal.com

 

[Yew]

Plenty of press reports unless you don't trust the media to tell anything other than lies. One that I specifically became aware of was Boston Red Sox pitcher Eduardo Rodriguez (age 27) who having recovered from Covid-19 now has myocarditis and though it is hoped he will recover he certainly won't be throwing a baseball for many months. And he is a professional athlete and should have been Boston's pitching ace this year.

If it's a serious study you want then try https://www.sciencedirect.com/science/article/pii/S1547527120304227

Naturally there are qualifying comments in the paper but as I said we still have much to learn. But the suggestion that Covid-19 will either kill us or allow us to recover and resume our previous way of life is not a universally accurate statement. Accordingly I believe that a certain amount of trepidation at the prospect of otherwise apparently non-vulnerable people catching it is justified.

My understanding that myocarditis is a common side effect of many virus, including cold sores, other coronaviruses and influenza.

 

[Bletchleyite]

My understanding that myocarditis is a common side effect of many virus, including cold sores, other coronaviruses and influenza.

Post-viral asthma is another one - happened to me off the back of some sort of unidentified presumably viral chest infection a few years ago.

 

[Bantamzen]

Thanks to asymptomatic transmission random infection is exactly what can happen, hence the need for masks and social distancing, though those precautions are not the be all and end all.

We still don't know for sure if asymptomatic cases are a major source of transmission, but they certainly have attracted a large proportion of blame amongst the public. Very possibly many of those asymptomatic cases may simply be people whose immune systems have reacted swiftly, and those that test positive may actually be only displaying the protein fragments following T-cell intervention in shutting down infected cells.

It is also notable that one of the key policies amongst many governments is to limit household visits, which suggests very strongly that this is where they are being told transmission is highest, which is not random at all.

As to freedoms ISTM that younger people are saying that they should not be expected to give up any of their freedoms, even temporarily, but older people should have to give up most of theirs instead. It may be that older people statistically have most to lose but younger people are not immune to serious illness from the virus and even though recovery is much more likely it can be protracted and there is a risk of significant long-term damage to vital organs. This should not be dismissed lightly.

Unfortunately the young cannot be expected to shut down their lives pending a solution, or partial solution that may not be forthcoming for many months or even years. Many of the most vulnerable are deep into their retirement days and as such at least have some level of financial security. Indeed many need younger people in work to keep taxes flowing to pay for pensions, care & health services. There is not a bottomless pit of money the Treasury can just dip into, sooner or later with any full or partial lockdown scenarios the money will start to run out.

And at the end of the day, as we get older & more fragile we do become more vulnerable. Its a basic fact of life, we are not immortal. We don't however have to lock these people away, we simply need to adapt to ensure that we offer them as much support & information on how to mitigate for their own risks, and have systems in place for regular checks, tests and where necessary treatment. If there is anything the younger generations can do it is to feed the economy to allow more money to be directed where it is needed most.

Unfortunately we have become so conditioned to binary solutions that few people seem interested in striking a reasonable balance. In short some temporary loss of freedom is inevitable if we are to avoid collapsing the NHS but OTOH we continue to develop a better understanding of the virus meaning it may not be too long before we can find a way to live with the virus, even without a vaccine, while also restoring life close to the previous normality. But we are not there yet.

You might want to speak to the Chancellor of the Exchequer about that. Rumours are that he nearly needed the services of the NHS when the full cost of furlough & lost tax revenue was calculated. And add to that the millions of cancelled NHS treatments as a result of the partial shutdown on non-essential and even some essential services, the NHS could be facing an even bigger crisis in the coming months. By kicking these patient's treatments down the road, we now risk a really severe test that we might not be able to afford having blown more than 3 times the NHS budget elsewhere in just 6 months. So we may soon not have a choice but to get on and deal with it.