Wednesday, July 22, 2020
Chronic Effects of CoVid
I have mentioned a few times that we focus on deaths, but long-term effects of the illness seem to be present and deserve consideration. I have seen few articles, but this one came up on a site Grim led me to for another essay. CoVid 19's long-term effects. Please understand that I have not read any counterargument or refutation and cannot vouch for this. It does seem to hold together at first reading and thus seems worth your time.
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7 comments:
What are the long-term effects of other common diseases, like influenza or chickenpox? I'm not suggesting they are equivalent, but if he's going to bring up after-effects, the comparison should be part of the argument.
My digestion was never the same after a bout with some disease in my 30's.
Some of those symptoms could be a result of the treatments, not the disease. I realize that's nitpicking if the treatments resulted in living instead of dying, but they should be separate.
It’s a little early to talk about long term effects, isn’t it? To James’ point, I do know that t-cells cause lingering lung damage in the course of fighting off several diseases; it’s a side effect of their defensive activity. But these don’t last forever. If t-cells are doing a lot of the work in COVID defense, we might expect...
Yes, I know, that sounds like ‘it stands to reason...’. But it hasn’t been long enough for hard data.
I have only had one patient return for a different cause after having had corona. The radiologist noted on his new x-ray "unchanged from prior". That is, a month later the patient's lungs looked no better than they had while actively infected.
Hope that is not a trend. Some of the research I have seen suggests permanent lung damage is going to be fairly common. The blood clots in the lungs will end up as scar tissue and the lung capacity will be permanently reduced.
Fortunately we started preventive treatment against clotting fairly early on, so maybe this will be less of an issue than I fear. All of our corona patients are now getting Lovenox (low molecular weight heparin) unless there is a strong reason not to give it such as a recent history of bleeds.
I am actually pretty hopeful right now. Texas for example is about where Illinois was in May in terms of raw numbers at its peak. But its peak is much lower than the Illinois peak was, and the death rate has been far lower. TX looks to be topping out and hopefully in a month will be at a trickle. More worried about this fall, with corona and flu hitting hard at the same time.
My advice? Get your flu shot, please.
I'm not sure how he is using the term 'cases', does it refer to total infections (as determined by tests) or does it refer to patients with symptoms who actually present at a doctor or hospital? It matters...the question is the extent to which *mild* cases, which would be off the radar completely absent extended testing, are likely to get the long-term effects as opposed to the more serious questions.
Here are a whole bunch of links on possible long-term effects which were posted by a friend of a friend at FB:
https://www.thelancet.com/action/showPdf?pii=S1474-4422%2820%2930221-0
https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913%2820%2930121-1/fulltext
https://basictranslational.onlinejacc.org/content/5/5/518
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7228737/
https://jamanetwork.com/journals/jamaneurology/fullarticle/2766766
https://www.cureus.com/articles/32076-a-review-of-neurological-complications-of-covid-19
Regarding Male infertility: there is a working hypothesis regarding such, at this time the full extent of complications are unknown:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7171435/
https://journals.physiology.org/doi/full/10.1152/ajpendo.00183.2020
There is a practice in the British Military (and some others) that officers write what are called "Appreciations" that summarize the key elements of the strategic/tactical situation they face. Some of the more famous Appreciations are quite good even to a civilian. If I do this for COVID-19 it looks something like this
1. COVID-19 is a serious new virus but from a group that are pretty well understood and studied. This enhances medical responses like drugs and vaccines.
2. New Drugs and Vaccines are proceeding at remarkable speed. Multiple tracks of development prevent overreliance on one drug or vaccine. This is not widely understood.
3. Medical Treatment has evolved rapidly as the disease is better studied. Work by individuals worldwide is is broadly disseminated.
4. The epidemiology community has erred in publicizing projections with huge uncertainty bands. Rather than acknowledge a poor knowledge of key inputs, more time was spent on websites for public consumption. This did little but spread fear.
5. There is a significant racial (presumably genetic) factor in the severity of illness. This is seen worldwide.
6. Infection hotspots are highly localized even with a few miles of other areas of similar population density. This looks to be a combination of racial and prevalence of high in-group mixing. T
7. The infection is now increasingly understood as being very wide spread. IMHE just calculated about 3.5M infections in New York since March.
8. The high asymptomatic case levels suggest strongly the presence of significant pre-existing immune response.
9. The lockdown/shutdowns were largely ineffective. All were extremely porous as a big fraction of the population was still working in essential services. The early shutdowns were too late to be effective (New York City, CT, NJ, MA) while other shutdowns were too early as the virus had not yet progressed in many areas. The economic losses were at the expense of funding better targeted shutdown/quarantine programs.
10. The over-politicization of COVID-19 response was very detrimental. It sapped public confidence in official responses which will persist for a very long time.
On the whole things are promising. Remember the British war poster "Keep Calm and Carry On" was never used in WWII. It was intended for use if the Germans used poison gas from bombers. The message needs to be pushed in the USA extensively right now.
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