Comment by JamisonM | Hacker News Reader

Comment by JamisonM | Hacker News Reader

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That article is really something, the first thing that jumps out:

"Second, covid is not some magical entity, it’s a coronavirus, and it behaves like other coronaviruses, and other respiratory viruses more generally. It would be strange for covid to cause symptoms that other respiratory viruses don’t. And since I’ve never heard of “long rhinovirus” or “long influenza”, I’m inherently doubtful of claims that there’s such a thing as “long covid”."

This is just getting caught up in silly semantics, people are experiencing longer term health effects, they are calling it "long covid" for lack of a better name not because it is an affirmative diagnosis.

"On MedRxiv, there is a pre-print awaiting peer review of a prospective cohort study that followed 4,182 people with positive PCR tests... if we assume that this study was reasonably accurate, then one in 50 people who get covid still have symptoms at the twelve week point..."

This is supposed to be an argument that inclines me to think that whatever "Long Covid" is I am not supposed to be worried about it? If 1 in 50 people that get a positive test are still feeling after effects of having what the author believes "behaves just like other coronaviruses" then I think we should be very concerned! Even if truly long term effects only develop in 1 in 500 COVID-19 cases.. that's a lot of people who are going to be sick for a really long time! It would be 400 Americans a day right now. Yikes! That's bad!

I'll take my chances with a vaccine!

(And I know the standard response to this is.. "well, those people are mostly old or sick with something else so you can't really count it that way" but a certain, maybe large, proportion of those people would probably never get a serious respiratory virus in the near or medium term in the absence of COVID-19. It is a really large number of extra sick people, and all at once.)

Also the 4 other coronaviruses circulating thing is silly, obviously the long term effects of the common cold viruses are not going to be comparable if the short term effects are clearly not comparable, it is reductionism of the worst kind.

Hmmm. I've read your comment twice now, and it seems like you have glossed over the entire observation and assertion that Rushworth (and Gupta, and Henneghan, and Kulldorff, and other reputable experts) are making with what amounts to a side note in your comment:

> Also the 4 other coronaviruses circulating thing is silly, obviously the long term effects of the common cold viruses are not going to be comparable if the short term effects are clearly not comparable, it is reductionism of the worst kind.

What you are saying is "obvious" is not at all obvious, and is not the assessment of the experts who have looked at the data and weighed in.

In terms of obviousness: why do you think that the long term effects are unlikely to be comparable (if not strikingly similar), since the long term (adverse) effects of each of these four (and also several of the influenza A) viruses seem to be clinically identical, despite each having distinguishable acute characteristics?

> This is just getting caught up in silly semantics, people are experiencing longer term health effects, they are calling it "long covid" for lack of a better name not because it is an affirmative diagnosis.

I agree that the terminology becomes tricky. But I think the question is better stated as: is "long COVID19" any different from other "long covid" (ie, the rare but well known post-viral syndrome that is observed with all coronaviruses).

> Even if truly long term effects only develop in 1 in 500 COVID-19 cases.. that's a lot of people who are going to be sick for a really long time! It would be 400 Americans a day right now.

...but a relatively small cohort in the bigger picture of post-viral syndrome, if indeed it occurs with approximately equal frequency with the other coronaviruses (and some influenza A viruses).

I think we need to be careful about measuring potential adverse outcomes against one another, and try our best to use numbers that reflect the likely lived experience of people (to wit, nearly everyone contracts the "garden variety" coronaviruses a few times in their life).

If the current slate of vaccines don't prevent this effect, then I'm having trouble putting any math together that suggests that it will generally reduce population-level instances of "long covid" (again, defined broadly as long effects from any covid, not just COVID19).

Inspired by your citation I went out and had a look on the Internets.. a direct quote from Sunetra Gupta in May: "the epidemic has largely come and is on its way out in [the UK]."

How is this a credible person to listen to? It boggles the mind, she is an epidemiologist! After making a professional error on that scale I would crawl in a hole and not come out for a year!

I guess I glossed over the claim that the author offered completely unsupported, yes. This is the fundamental problem here, you need to be completely absorbed into this information universe to just accept statements like "all coronaviruses are the same as this one" as fact. Rushworth is not an expert on viruses, Kulldorff is not an expert on viruses, Gupta is not an expert on viruses.. there is a difference between epidemiology and virology. If you want to make virology claims based on citing authorities, cite virologists.

Asserting that all coronaviruses are similar and must have very similar effects in the short and long term seems like a very bad assumption to make, before the original SARS outbreak the scientific consensus was that coronaviruses were not capable of causing sevre illness in humans - despite their long history of being known killers of animals! Asserting we absolutely know things about this virus based on things that we didn't think the whole category of viruses was capable of doing less than 20 years ago without citations is bad!

So asserting that the long term effects of this virus are likely to be similar to the long term effects of other coronaviruses is not credible given the available evidence, and saying that it is likely to be similar to influenza (an unrelated virus that is very different) is even less credible. (And if the hospitals were this overloaded with flu patients every year we'd be worried about the long term effects on the survivors, but they are not!)

"I think we need to be careful about measuring potential adverse outcomes against one another, and try our best to use numbers that reflect the likely lived experience of people (to wit, nearly everyone contracts the "garden variety" coronaviruses a few times in their life)."

I don't know what this is supposed to mean, but if is contingent on believing that "garden variety" coronaviruses are similar in their effect to SARS-COV2.. I mean we can see just by looking at the ICU tallies in nearly every jurisdiction in the world that this is not the case so I don't know what conclusions you expect anyone to draw.

At the end of the day that is what this always comes down to with these COVID-19 debates it seems, the jurisdictions that haven't taken the virus seriously have been absolutely devastated by it, there is no secret knowledge to uncover. One should draw from that the inference that assuming that there is some secret formula of logic that will arrive at the conclusion that we already know the long terms effects of this virus seems less than credible. It might turn out to be correct! But that still won't vindicate the flawed logic of drawing the conclusion now.

> Gupta is not an expert on viruses..

If having one's virus research repeatedly published in the world's top journals, and securing a patent for a novel influenza vaccine, does not make one an expert, I think maybe we're casting too narrow a net. Not only in Sunetra Gupta an expert on viruses in my book, but one of the world's best.

> Asserting that all coronaviruses are similar and must have very similar effects in the short and long term seems like a very bad assumption to make

But I didn't do that. This brings us back to my original question: is there evidence that "long COVID19" is different than other long covids? If I'm understanding you correctly, you seem wont to presume that the answer is "yes", simply because the acute affects are different. But, as I pointed out, viruses with a wide-range of acute effects all produce clinically similar "post-viral syndrome". To my knowledge, there is no convincing evidence that SARS-CoV-2 is an outlier in this specific respect. Or am I wrong?

You misunderstand the nature of Gupta's expertise and how it might relate to the issue at hand. She has also demonstrated her lack of qualifications in this matter with her public statements even in the areas where she would be legitimately qualified.

You're just goalpost moving here, the argument in the article you are citing clearly says the viruses are similar and presumes that their effects are similar on that basis. If YOU don't accept that then you don't accept your own cited authority, you're wasting your own time here on that basis.

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