(2022-02-10) Zvi M The Long Long Covid Post

Zvi Mowshowitz: The Long Long Covid Post. First I deal with Katja Grace’s post, then Scott Alexander’s Long Covid: Much More Than You Wanted to Know.

My core model of Long Covid after writing this post... (see very end)

Katja’s Post

This may or may not be entirely fair, but I am going to use Katja Grace’s post on LessWrong as a steelman of the case for worrying about Long Covid

Katja assigns letters A-R to her points

C. Rates of ambiguously-maybe-quite-bad symptoms seem very high, even for people who only had mild Covid....This Norwegian study, n = 70k

Huge if true.

That’s among the unvaccinated – she estimates based on other studies that vaccination cuts this in half.

As I said when I first saw this study, these results would show up at the population level.

given the correlation between different symptoms is imperfect, and how often the polls I’ll get to shortly showed that these symptoms interfere with the ability to work, this is a very large set of claims, enough to materially decrease the size of the productive workforce

Does the anecdata above match several percent increases in a large number of distinct symptoms? No, it doesn’t.

As Katja notices, these numbers imply that a lot of people can’t work.

As an experiment, I did a poll while writing this

Of those that report having had Covid, 29% report symptoms. Of those that report not having had Covid, 27% report symptoms. That’s ‘not significant’ in both senses.

This is not a scientific study but it also really is not compatible with rates doubling or more.

D. It looks like a lot of people can no longer do their jobs

I list all the article’s anecdotes both to illustrate that the article is largely a long list of such anecdotes, and also to note the times of infection...

What stands out about March 2020 is that cases were on average more severe and we had both poor understanding of how to treat Covid and a lack of hospital capacity. If lots of our examples of Long Covid also come from that early, we should be skeptical that the risks are similar going forward.

It’s fair to care a non-zero amount about something that causes a 1.6% rise in chances of disability within the year, but this does not rise to the level of ‘distort my life for months or years to avoid this.’

As noted earlier, a lot of the studies in the meta-analysis seem to be small n, involving hospitalized people, without controls, and I don’t know what they did about this

As I’ve noted in the past when discussing many similar studies (some of which likely got into this analysis) proper controls are key. This includes controlling for perception

These are two results that don’t smell right to me at all.
No change in symptom rate over time.
No change in symptom rate based on severity or hospitalization.
Those make perfect sense if the symptoms are unrelated to Covid.

And always compare to the baseline, for example from Google: There are approximately 45 million Americans complaining of headaches each year. That works out to about one in every six people or 16.54% of the population. More than eight million Americans visit their doctor for complaints of headache each year.

K. Long covid probably isn’t psychosomatic

A French study found that long covid is barely associated with having had covid according to an antibody test, yet associated with believing one has had covid (which itself is unrelated to the antibody test results).

To me, the French study is very strong evidence that Long Covid isn’t the big deal it looks like elsewhere

I think Long Covid is rare, and also puts psychosomatic explanations more into play to the extent it matters

L. The general discussion of what is going on with people’s brains sounds terrible

the descriptions here are in hospitalized patients, which is very much not a representative sample of the young

Scott Alexander’s Post

I will also repost this, from a comment on a previous weekly post: Via an excellent comment, we have an important discovery about the Long Covid data. A major source for the previous pessimistic LC estimates, like Scott Alexanders (the UK’s giant ONS survey) published an update... This is a pretty dumb error, a very dumb way to get a lot of people very scared and destroy a lot of value. Many thanks to the team for correcting the error, whether or not it was intentional and whether or not they should never have made the mistake... To be blunt, they cheated (intentionally or otherwise), it was a massive effect, and we should have caught it, but to my knowledge none of us did. They have now fessed up.

The scary part about chronic fatigue is long-existing chronic fatigue studies in general, not Covid-related.

The claim I’m making earlier is not that people are ‘making all this up’ or anything, it’s that they are often attributing it to Covid when it’s there for other reasons. That doesn’t make their lives suck less. Nor would it being psychosomatic. Again, still makes life suck. I do think that the French study suggests that something like half and perhaps more of the Long Covid claims are being misattributed.

8. Your risk of a terrible long COVID outcome conditional on COVID is probably between a few tenths of a percent and a few percent

A 0.2% forward-looking chance for a boosted, essentially healthy person of 'some serious s**’ seems fully consistent with my observations.*

Here are Scott’s conclusions:...

Other Things Of Note

There’s a long and good analysis in the Long Covid section of this post from 07/29/21 (2021-07-29) ZviM Covid 7/29 You Play To Win The Game

Conclusion

here I’ll end with an even shorter practical summary.
Children are at minimal risk.
Risk from a given case is proportional to its severity.
One can act as if serious Long Covid will occur in ~0.2% of boosted Covid cases.
That’s not nothing, but it’s not enough that you shouldn’t live your life.