My question for Dr.Strauss is how much consideration he’s given to potential long term effects of COVID infections. A German study last year had noted permanent heart damage in 75% of people who’d had COVID, even mild cases. There was reporting of increased incidence of blood clots in younger people who’d had COVID. “Long COVID” appears to hit about 10% of cases. Anecdotally, my wife and her colleagues have noticed more cases of normally rare pediatric illnesses like septic hip over the past year. A lot of focus is put on reducing death rates in the short term, and managing ICU capacity. However, it seems like there’s a strong case to be made for use of measures like lockdowns to limit infections until we’ve deployed enough vaccines to approach herd immunity. The risk is that we have a generation of people afflicted by the COVID analogue of post-polio syndrome in a couple of decades.
I have given "long COVID' a lot of consideration. In general, it doesn't change my level of alarm too too much.
I think references to "long COVID" unfortunately tend to conflate a whole bunch of different things.
For instance, your wife anecdotally noticing more septic hip of late may have more to do with decreased children's health and fitness because of lockdown, not because of COVID.
If you'd like to link to the studies that concern you I'm happy to dissect them. By and large, when I have done so, I have not been impressed by their methodologies.
With 80% of the population NOT vaccinated, it would still grow exponentially. The USA at second-wave peak hit 300,000/day. We could easily hit 30,000.
Even if few were dying, pandemics enforce lockdowns, just because too few people can get in to work to keep things running; everybody's either home sick, or nursing a sick wife, child, or parent. We got that lecture about O1N1 when "dying" wasn't even being discussed.
The original Wuhan death rates were 1.9% for 60-70, 0.6% for 50-60, 0.16% for 40-60. All those should reportedly be doubled.
I really think you're still looking at an overall death rate close to 1%, once P1 and B117 are all there is, in three more weeks.
Also, the deaths would be far more pathetic and sympathy-raising. We're already getting news about one under-50 dying in Ontario ICU every 2.8 days. Were all of Canada to be at double Ontario's current infection rate, it would be ten forty-somethings dying every week, and a couple of 30-somethings.
Great article but not a license to defer 'circuit breaker' closures. I hope no one uses the headlines to go out and spread.
The new variants are seeing an increase in 20-50 year olds intubated in ICU.
Vaccines slowness is not a political issue it's a vaccine nationalism issue as one of the countries with no manufacturer and for distribution, with a very widely spread population, a real problem for vaccines with a short and cold shelf-life.
In addition, the comparison of ICU beds (and, I assume staff) numbers should be considered in the context of, for example, the US which spends 2.5 to 3 times per capita on their health care with the lowest life-expectancy in the G20, and, for example, the highest rate of maternal death in labour.
As a retired MD married to a doc FROM the US, we believe that the antiTaxxers who support privatization are dupes of the insurance industry. If we spent HALF what the US spends, we'd be in far better shape.
My non-doctor suggestion is that you should look at the actual numbers of 20-50 year olds intubated in ICU. There has been an increase of how many, exactly?
This is a trend, with exponential potential so the snapshot numbers are likely going to be falsely reassuring. The difference in ICU cohorts has is very different now from a few months ago. Further, as variants spread widely, new variants are evolving. The point is that to assume that, because of age, one is 'safe' is very dangerous.... to everyone.
The problem with this logic is twofold: Even though the variants are more risky for young people, they're still significantly less risky than just about everything young people do. As Strauss noted above, a young person who gets COVID tomorrow is still 3X more likely to die in a car crash than to die of COVID. That doesn't mean no young people will die of COVID, nor that no young people will die of a car crash. But even the variants are not equal-opportunity viruses; they overwhelmingly cause serious illness among the old. That remains the case.
The graph above is telling: Even as our case numbers rise exponentially, our ICU use is growing comparatively marginally (ie; thousands of cases to dozens of ICU patients.) This does not indicate that variants are mowing down young people -- quite the opposite.
The second problem with this logic is to conflate exponential growth with infinite growth. Eventually, the virus runs out of vulnerable bodies to infect, and growth plateaus. If COVID were to infect everybody simultaneously, there would be a hard cap on the number of patients who would require ICU care, and that cap is pre-determined by age and co-morbidity. ie; say 100 people get infected, 10 require hospitalization, 5 wind up in ICU, and 1 dies. The variants simply don't shift the math very much; perhaps 7 wind up in ICU instead of 5. This increase presents an issue for hospitals that cannot handle comparatively small increases in ICU need, but the potential growth still caps out once a critical mass of the vulnerable population is either infected or vaccinated.
It's wrong to compare Canada to the US Europe is a much better comparison a d as the article mentions Germany has 3 times the ICU capacity of Canada, as I can attests to, far shorter wait times foe surgery. From referal to knee replacement surgery was about 8 weeks, vs 2 plus years in Canada.
As it happens, I had my right knee replaced in Canada (small city near big one) in December. 1 month from referral to appointment. 28 days from appointment to surgery. But that's simply an example of how such 'showboat' stats are used to convince Americans that their profit-centred healthcare is the 'best in the world'... when it's close to the worst.
I've also worked in another Commonwealth/G20 country and came back realizing that we could BOTH learn from each other.
I agree with you that both Canada and the US spend too much time looking at just each other, but the fact remains that single-payer healthcare is by far the most efficient and its benefits, like good public education spread through the economy.
Canada, for example, would save the economy considerably, had we a NATIONAL pharmacare programme, and invest, as I said, half on our healthcare what the US does.
I'm not that familiar with the German system but Germany does have one of the highest population densities in Europe which is a huge advantage when it comes to medical evacuation and travel costs so we'd expect to spend more than they.... a small price to pay for our wonderful open spaces.
Our system has much to improve but privatization isn't the answer.
Those who advocate further lockdown don’t primarily use present numbers to determine policy – they rather use what analysis tells them will happen in the future if present practice continues to be followed. If one wants to make a successful case against further lockdown, I suggest that it is more legitimate to address the motivation for that policy head on rather than to build a case which tends to sidestep it. For what reason is the topic of projections avoided?
It is my view that abstracts of studies relate key findings. The Springer study which the article links to states the following: “These results indicate that COVID-19 is hazardous not only for the elderly but also for middle-aged adults, for whom the infection fatality rate is two orders of magnitude greater than the annualized risk of a fatal automobile accident and far more dangerous than seasonal influenza” in the abstract. In the conclusion, they write, “In summary, our analysis demonstrates that COVID-19 is not only dangerous for the elderly and infirm but also for healthy middle-aged adults.” It seems that a major finding of the study was that Covid-19 is something that should concern middle-age adults." It may be possible to show that the statement about a 35 year old is correct but a simple link to that study does not do so. And how a link to Canadian Mortality rates by age supports the claim about a 60 year old Canadian dying escapes me.
I also find the response to George Skinner troubling. In the linked article https://heavy.com/news/long-covid/ there are a number of links to studies that have been done. One which the article highlights is the one in Wuhan published in The Lancet. If one is aware of studies like this and finds them unconvincing because of their flaws, it would make sense to me that pointing out those flaws would be a more helpful strategy than tossing out a theoretical anecdotal example to illustrate that long haul effects are not worthy of serious consideration.
My question for Dr.Strauss is how much consideration he’s given to potential long term effects of COVID infections. A German study last year had noted permanent heart damage in 75% of people who’d had COVID, even mild cases. There was reporting of increased incidence of blood clots in younger people who’d had COVID. “Long COVID” appears to hit about 10% of cases. Anecdotally, my wife and her colleagues have noticed more cases of normally rare pediatric illnesses like septic hip over the past year. A lot of focus is put on reducing death rates in the short term, and managing ICU capacity. However, it seems like there’s a strong case to be made for use of measures like lockdowns to limit infections until we’ve deployed enough vaccines to approach herd immunity. The risk is that we have a generation of people afflicted by the COVID analogue of post-polio syndrome in a couple of decades.
I have given "long COVID' a lot of consideration. In general, it doesn't change my level of alarm too too much.
I think references to "long COVID" unfortunately tend to conflate a whole bunch of different things.
For instance, your wife anecdotally noticing more septic hip of late may have more to do with decreased children's health and fitness because of lockdown, not because of COVID.
If you'd like to link to the studies that concern you I'm happy to dissect them. By and large, when I have done so, I have not been impressed by their methodologies.
(Deleted then reposted with less typo)
With 80% of the population NOT vaccinated, it would still grow exponentially. The USA at second-wave peak hit 300,000/day. We could easily hit 30,000.
Even if few were dying, pandemics enforce lockdowns, just because too few people can get in to work to keep things running; everybody's either home sick, or nursing a sick wife, child, or parent. We got that lecture about O1N1 when "dying" wasn't even being discussed.
The original Wuhan death rates were 1.9% for 60-70, 0.6% for 50-60, 0.16% for 40-60. All those should reportedly be doubled.
I really think you're still looking at an overall death rate close to 1%, once P1 and B117 are all there is, in three more weeks.
Also, the deaths would be far more pathetic and sympathy-raising. We're already getting news about one under-50 dying in Ontario ICU every 2.8 days. Were all of Canada to be at double Ontario's current infection rate, it would be ten forty-somethings dying every week, and a couple of 30-somethings.
Great article but not a license to defer 'circuit breaker' closures. I hope no one uses the headlines to go out and spread.
The new variants are seeing an increase in 20-50 year olds intubated in ICU.
Vaccines slowness is not a political issue it's a vaccine nationalism issue as one of the countries with no manufacturer and for distribution, with a very widely spread population, a real problem for vaccines with a short and cold shelf-life.
In addition, the comparison of ICU beds (and, I assume staff) numbers should be considered in the context of, for example, the US which spends 2.5 to 3 times per capita on their health care with the lowest life-expectancy in the G20, and, for example, the highest rate of maternal death in labour.
As a retired MD married to a doc FROM the US, we believe that the antiTaxxers who support privatization are dupes of the insurance industry. If we spent HALF what the US spends, we'd be in far better shape.
My non-doctor suggestion is that you should look at the actual numbers of 20-50 year olds intubated in ICU. There has been an increase of how many, exactly?
This is a trend, with exponential potential so the snapshot numbers are likely going to be falsely reassuring. The difference in ICU cohorts has is very different now from a few months ago. Further, as variants spread widely, new variants are evolving. The point is that to assume that, because of age, one is 'safe' is very dangerous.... to everyone.
The problem with this logic is twofold: Even though the variants are more risky for young people, they're still significantly less risky than just about everything young people do. As Strauss noted above, a young person who gets COVID tomorrow is still 3X more likely to die in a car crash than to die of COVID. That doesn't mean no young people will die of COVID, nor that no young people will die of a car crash. But even the variants are not equal-opportunity viruses; they overwhelmingly cause serious illness among the old. That remains the case.
The graph above is telling: Even as our case numbers rise exponentially, our ICU use is growing comparatively marginally (ie; thousands of cases to dozens of ICU patients.) This does not indicate that variants are mowing down young people -- quite the opposite.
The second problem with this logic is to conflate exponential growth with infinite growth. Eventually, the virus runs out of vulnerable bodies to infect, and growth plateaus. If COVID were to infect everybody simultaneously, there would be a hard cap on the number of patients who would require ICU care, and that cap is pre-determined by age and co-morbidity. ie; say 100 people get infected, 10 require hospitalization, 5 wind up in ICU, and 1 dies. The variants simply don't shift the math very much; perhaps 7 wind up in ICU instead of 5. This increase presents an issue for hospitals that cannot handle comparatively small increases in ICU need, but the potential growth still caps out once a critical mass of the vulnerable population is either infected or vaccinated.
It's wrong to compare Canada to the US Europe is a much better comparison a d as the article mentions Germany has 3 times the ICU capacity of Canada, as I can attests to, far shorter wait times foe surgery. From referal to knee replacement surgery was about 8 weeks, vs 2 plus years in Canada.
As it happens, I had my right knee replaced in Canada (small city near big one) in December. 1 month from referral to appointment. 28 days from appointment to surgery. But that's simply an example of how such 'showboat' stats are used to convince Americans that their profit-centred healthcare is the 'best in the world'... when it's close to the worst.
I've also worked in another Commonwealth/G20 country and came back realizing that we could BOTH learn from each other.
I agree with you that both Canada and the US spend too much time looking at just each other, but the fact remains that single-payer healthcare is by far the most efficient and its benefits, like good public education spread through the economy.
Canada, for example, would save the economy considerably, had we a NATIONAL pharmacare programme, and invest, as I said, half on our healthcare what the US does.
I'm not that familiar with the German system but Germany does have one of the highest population densities in Europe which is a huge advantage when it comes to medical evacuation and travel costs so we'd expect to spend more than they.... a small price to pay for our wonderful open spaces.
Our system has much to improve but privatization isn't the answer.
Those who advocate further lockdown don’t primarily use present numbers to determine policy – they rather use what analysis tells them will happen in the future if present practice continues to be followed. If one wants to make a successful case against further lockdown, I suggest that it is more legitimate to address the motivation for that policy head on rather than to build a case which tends to sidestep it. For what reason is the topic of projections avoided?
It is my view that abstracts of studies relate key findings. The Springer study which the article links to states the following: “These results indicate that COVID-19 is hazardous not only for the elderly but also for middle-aged adults, for whom the infection fatality rate is two orders of magnitude greater than the annualized risk of a fatal automobile accident and far more dangerous than seasonal influenza” in the abstract. In the conclusion, they write, “In summary, our analysis demonstrates that COVID-19 is not only dangerous for the elderly and infirm but also for healthy middle-aged adults.” It seems that a major finding of the study was that Covid-19 is something that should concern middle-age adults." It may be possible to show that the statement about a 35 year old is correct but a simple link to that study does not do so. And how a link to Canadian Mortality rates by age supports the claim about a 60 year old Canadian dying escapes me.
I also find the response to George Skinner troubling. In the linked article https://heavy.com/news/long-covid/ there are a number of links to studies that have been done. One which the article highlights is the one in Wuhan published in The Lancet. If one is aware of studies like this and finds them unconvincing because of their flaws, it would make sense to me that pointing out those flaws would be a more helpful strategy than tossing out a theoretical anecdotal example to illustrate that long haul effects are not worthy of serious consideration.