COVID topic vol 2

[jacob]

https://www.nytimes.com/2020/12/30/heal ... sions.html

Article about long-haulers.

This outcome worries me significantly more than the small chance of death (for my age group). It could seriously derail FI under the current US health care regime. ERE would also be difficult. The renaissance strategy is not easy if one continuously suffers from brain fog or is left with a feeding tube out the nose that has to be hooked up to a nutrient bag for 20 hrs a day.

[Viktor K]

Currently rumor, since I haven’t been able to find any news coverage.

But my friend in Shenzhen told my girlfriend the other day of a new virus in Beijing.

So he’s ESL (but fluent), so of course we wanted to clarify... because sometimes his word choice... is it new outbreak, or the variant from UK... or like new virus?

And he’s sticking to new “virus”... so we’ll see.

[fiby41]

@Viktor K in Russian also new strains are being called as 'new virus.'

[Viktor K]

I’m still operating under that assumption as well (lost in translation). We’ve def-o had an entire conversation over different terms for different things, only realizing later....

20 mins later...

“I can’t believe XYZ!”

Friend: “Ya, but why are you so careful. It’s not so bad. It’s not like ABC”

Us: “ABC? You’ve been saying XYZ”

Friend: “It’s the same thing?

Us: “No! Not at all, ahhhhhhhh. Worked up over nothing.”

Friend: “oh hehe sorry”

[Redo]

"It could seriously derail FI under the current US health care regime. ERE would also be difficult. The renaissance strategy is not easy if one continuously suffers from brain fog or is left with a feeding tube out the nose that has to be hooked up to a nutrient bag for 20 hrs a day."

I think 1m will be the new ERE number. A lot of people will need long term care.

[theanimal]

I doubt it. If you look at the actual studies referenced in the article Jacob linked to almost all the readmissions were for those aged 65 and older. In the VA study (n=1775) the age range of 45-65 had 2% of patients readmitted to the hospital and under 45 had 0.5% of patients readmitted. I don't see how this is any different than the death statistics for specific age groups.

https://jamanetwork.com/journals/jama/f ... rt=article

The CDC study (n=126k) says more of the same. Age range 18-49 had roughly 5% readmittance for those who were hospitalized and 50-64 had roughly 7% with higher age ranges at or over 10%. They discuss how the severity and likelihood of readmission is accelerated by and is mainly a result of those with comorbidities.

https://www.cdc.gov/mmwr/volumes/69/wr/ ... tm#T1_down

ETA: I'm not that good at statistics but if 10% who contract the virus are hospitalized (I believe this is the common number thrown around here) and then at most ~10% of that group are readmitted after being hospitalized, that seems to end up being a very small number and skewed mainly to older people and those with pre existing conditions/comorbidities.

[A Life of FI]

I doubt it.

The CDC study (n=126k) says more of the same. Age range 18-49 had roughly 5% readmittance for those who were hospitalized and 50-64 had roughly 7% with higher age ranges at or over 10%. They discuss how the severity and likelihood of readmission is accelerated by and is mainly a result of those with comorbidities.

https://www.cdc.gov/mmwr/volumes/69/wr/ ... tm#T1_down

Yes and when considering that some readmissions would be for an ongoing case of the virus, rather than after effects of it, the situation looks even better for the healthy. That is people go to the hospital and are admitted but are at some point judged not serve enough for continued hospitalization however worsen afterwards and are readmitted. In the CDC study the average time to readmission for people not living in an assisted living situation was an average of 7 days with a range of 3-17 days, meaning a significant portion of the readmissions might be for the virus itself and not for the after effects of it.


And this 7 day average for readmission also coincides with the time to develop a severe case:

"A person may have mild symptoms for about one week, then worsen rapidly."

https://www.health.harvard.edu/diseases ... -19-basics

[jacob]

The calculus for so-called catastrophic risk is somewhat different than simple percentages and the resulting expectation values. Simplistic statistical concerns are valid for events that are minor OR reversible. It does not apply to catastrophic risk.

Lets say (making up numbers) that the odds of long-hauling for a 40 year old is 0.1% and that the cost of long-hauling is 1M. The expectation value for that is $1000000*0.001=$1000 and so traditional statistics would say that the cost of accepting the risk is $1000 and using standard economics in which everything is reversible (you can pay your way back to the previous state of thing minus relatively minor transaction costs) and substitutable (you can compare the cost of anything and everything in dollars) you should take the risk if the benefits otherwise lost exceeds $1000.

This calculation can and is made for the population level e.g. in terms of quality years lost, etc.

For small risk/high cost events on an individual basis, it works differently. Insofar the risk could literally end you as a going concern, you should not be comparing the $1000 risk cost to the $1000+ benefit you get from partying or traveling but to whether the adverse outcome is acceptable to you insofar you're the unlucky one.

Basically to summarize, expectation values only matter as a investment decision strategy insofar you can't go bankrupt. Once that becomes a possibility you need a different calculus like maximum drawdown.

Also see Earth killer asteroids. Same considerations but personal. Also see "I always thought accidents were something that happened to other people until one happened to me".

[Ego]

There are two elements to long-haul covid.

-Medically Unexplained Symptoms (MUS)
-Measurable Medically Explained Symptoms

Those who have a previous diagnosis of a psychological condition are more likely to later be diagnosed with Covid and visa-versa. The correlation runs in both directions. MUS.

https://www.thelancet.com/journals/lanp ... 4/fulltext

It is interesting that the characteristic long-haul symptoms are all MUS

Coughing
Ongoing, sometimes debilitating, fatigue
Body aches
Joint pain
Shortness of breath
Loss of taste and smell — even if this didn’t occur during the height of illness
Difficulty sleeping
Headaches
Brain fog
Dizziness

The measurable medically explained symptoms are very rare. The unexplained and unmeasurable symptoms have come to define the disorder.

When an increasing number of people are suffering depression, anxiety and obsessive-compulsive disorders they are more prone to these social contagions.

[Viktor K]

The calculus for so-called catastrophic risk is somewhat different than simple percentages and the resulting expectation values. Simplistic statistical concerns are valid for events that are minor OR reversible. It does not apply to catastrophic risk....

Weird to see this. Edited quote because built in quote button is unacceptable.

Mainly because I’ve always said, “Ya dying in a plane crash is very unlikely. Unless you’re on that plane, then the risk for you is 100%”

I’ve never had any logical way to explain this, it’s always just been a thought. Like my friend that drowned. Those moments underwater, it was a 100% for her. Doesn’t matter what the “risks” are.

Since I always knew it was not really based on anything but a thought... I think maybe this is the more logical thought process.

But ya it’s no consolation when they’re instigating you that “only 1% die and healthy people fine”. Girlfriend showed me 18 year old, no existing health conditions (and looked healthy from the photo as well, sometimes I see no existing health conditions and the person is obviously overweight), died of COVID.

[ZAFCorrection]

Maximum drawdown makes sense in the framework that there are a finite number of catastrophic but low probability events to worry about. I remember that guy who had the ends of all his limbs and nose chopped off because he got capnocytophaga from interacting with a dog. That was a one-in-a-bajillion event hanging out with the other infinite random things that can go wrong. There has got to be some probabilistic weighting.

[Ego]

Ivermectin once again.
https://youtu.be/BLWQtT7dHGE

From the Eastern Virginia Medical School Covid-19 Management Protocol

PDF: https://www.evms.edu/media/evms_public/ ... otocol.pdf

[shemp]

If maximum drawdown is the criterion, then vaccines and hospital treatment are both off the table (and not just for covid), because there's always the chance you'll die or be left paralyzed from the neck down due to some one in a billion allergic reaction or hospital acquired infection. Driving also off the table, but then so is walking. Can't shower either, because you might slip and crack your head in the bathtub and die of stroke. Even walking around your home has non-zero probability of falling and suffering a stroke such that you die or are left crippled. But staying in bed forever will guarantee you get sick from muscle wastage. So what to do?

Fact people are talking seriously about maximum drawdown as the criterion is clear proof that covid-19 is mostly a mental illness pandemic, hysterical overreaction to a legitimate disease that, like flu, kills mostly the weak and especially the elderly weak, but is maybe 3 times more deadly than a typical bad flu strain, such as the flu of winter 2017-2018. For example, https://www.euromomo.eu/graphs-and-maps shows excess deaths for much of western Europe. Cumulative charts definitely show excess deaths in 2020 compared to previous years, but only by factor of 3 compared to 2018: about 300K vs 100K. "Long haulers" probably another aspect of this pandemic of mental illness.

[7Wannabe5]

@shemp:

Putting aside the fact that most humans are terrible at calculating risk, your analysis is false because one-sided. You did not consider all the actions a rational actor in our society generally DOES avoid. For instance, driving without a seatbelt, driving drunk, sex with stranger met at bar while driving without a condom, investing all the money you have on stock tip from stranger with whom you had drunk, condom-less sex in a running car the previous evening, etc.

The frequency at which you take any given risk is also quite relevant, because the more frequently a risk is taken, the less risky it feels. Of course, the opposite does also apply, but neither of these irrational psychological states changes the underlying mechanics of the actual risk. For instance, driving risk increases with miles driven and whether or not a seatbelt was worn, and Covid risk increases with novel interactions and whether or not masks were worn. The risk of acquiring a deadly venereal disease from an affluent old man in my acquaintance even without use of condom is much less than the risk of acquiring Covid from an affluent old man, but I still “irrationally “ insisted on condom use even on occasions I chose to take the greater risk of riding in cars with the same affluent old men.

Maybe it’s due to the fact that I spent some of my teen years in late 70s/early 80s beach resort environment, but it boggles my mind that humans who routinely put on shoes, shirts, and condoms in appropriate settings become hysterical at the notion of wearing a mask when appropriate.

[ertyu]

I got into an argument today and I wonder if I have this wrong. It was my understanding that if you get covid, you can still contract it, get sick, and be contagious. What the vaccine does is reduce your chance of ending up on a ventilator. I believe we even discussed this here. My friend, an american from Ohio, instead says that 95% of people who would've contracted covid wouldn't contract it. Whereas it was my understanding that they would contract it and be less likely to develop symptoms / have lighter symptoms / just not end up on a ventilator. Sanity check please?

[2Birds1Stone]

Sanity check please?

My cousin is an MD in Europe. He sent me a selfie when he got the vaccine a few days ago. I asked him if he's worried about bringing the virus home from work to his wife and 2 young kids. He stated that the way it "should work" is that the virus will not easily replicate in the host who has been vaccinated, preventing it from reaching levels that would make one contagious.

I did not look into whether this was factual, but don't see why he wouldn't look into it and make sure to keep his family safer.

[ertyu]

Many thanks

[ducknald_don]

Every epidemiologist I've seen interviewed has said this is still an open question and won't really be known until we have rolled out the vaccine. It will be interesting to see what happens in Israel where they seem to be way ahead of everybody else in getting the population vaccinated.

[nomadscientist]

If maximum drawdown is the criterion, then vaccines and hospital treatment are both off the table (and not just for covid), because there's always the chance you'll die or be left paralyzed from the neck down due to some one in a billion allergic reaction or hospital acquired infection. Driving also off the table, but then so is walking. Can't shower either, because you might slip and crack your head in the bathtub and die of stroke. Even walking around your home has non-zero probability of falling and suffering a stroke such that you die or are left crippled. But staying in bed forever will guarantee you get sick from muscle wastage. So what to do?

Fact people are talking seriously about maximum drawdown as the criterion is clear proof that covid-19 is mostly a mental illness pandemic, hysterical overreaction to a legitimate disease that, like flu, kills mostly the weak and especially the elderly weak, but is maybe 3 times more deadly than a typical bad flu strain, such as the flu of winter 2017-2018. For example, https://www.euromomo.eu/graphs-and-maps shows excess deaths for much of western Europe. Cumulative charts definitely show excess deaths in 2020 compared to previous years, but only by factor of 3 compared to 2018: about 300K vs 100K. "Long haulers" probably another aspect of this pandemic of mental illness.

There's another explanation than mental illness: media manipulation of persons with limited attention span (all of us, ultimately, but impacting some worse than others).

The maximum drawdown analysis makes sense if you consider covid to be one of a very small set of maximum drawdown events, and ignore all the other maximum drawdown events. That doesn't require one be mentally ill in the conventional sense.

People are hard-wired to assume anything they personally hear about is at least 1% probable, and anything they hear about over and over for a few weeks is ~100% probable, which makes perfect sense given the Dunbar number. This is a subconscious belief that exists despite conscious knowledge otherwise, and people have varying ability to override the subconscious with the conscious.

People also round other risks down to ~0%, which also makes sense given we're evolved to produce maximum offspring number rather than to maximise life year sitting alone in a house. From a species level view, those risks usually aren't worth worrying about even if some individual specimens die as a result.

Modern propaganda is based almost exclusively on these two effects, using technology to break all the scale assumption of Dunbar socialisation and hack peoples' subconscious.

The BBC for example does not run age-stratified mortality stats for covid constantly, but does constantly run some anecdata one-in-a-million middle aged man who got his leg amputated, or a middle aged woman who developed "long covid" with symptoms that are not medically detectable, for example. Most people are defenceless against this manipulation.

[UK-with-kids]

It was my understanding that if you get covid, you can still contract it, get sick, and be contagious. What the vaccine does is reduce your chance of ending up on a ventilator..... Sanity check please?

In the early days of the AZN/Oxford vaccine development, I remember reading that none of the monkeys we're getting pneumonia in their lungs any more, but their noses were still full of the virus. That would imply that you would still get it (and spread it) but it wouldn't do so much damage.

This is actually what worries me once older people have been vaccinated and become less careful. For example if I go to visit my 70-something parents and they pass it onto us. I don't really want my partner and me to develop a serious illness while trying to look after our young children. It's hard enough just being in the house all day, without battling Covid symptoms at the same time.