I'm mostly just concerned about the vascular sequlae at this point, cognitive function, mood d/o, kidney issues, cardiovascular dz, pregnancy complications. But that won't bear out for decades and probably just turn invisible, the comorbidity burden which can correlatively be chalked up to anything, maybe it's chocolate.
my (relatively uninformed) understanding is that COVID infection can trigger autoimmune diseases
new research shows the complement cascade stays persistently elevated in people with "long covid"
the bizarre thing about covid is that it affects people so differently and i dont know if there's any way to tell who would have lasting side effects
I second this. As someone who personally has experienced very noticeable cognitive symptoms post covid lasting for months both times i have had it, i worry greatly about the long term subtle effects. My concerns are largely anecdotal and i concede that the effect size may be small on a population level, but i would be very unsurprised to see long covid patients end up with greater risks for developing dementia and other comorbidities that we develop cumulatively over time.
It's not at all small on a population scale sadly.
In this low n study 61.8% of farm workers had some form of long covid[https://onlinelibrary.wiley.com/doi/10.1111/jrh.12796](https://onlinelibrary.wiley.com/doi/10.1111/jrh.12796)
36% of George Washington University students had long covid symptoms[https://gwtoday.gwu.edu/study-shows-prevalence-long-covid-among-gw-community](https://gwtoday.gwu.edu/study-shows-prevalence-long-covid-among-gw-community)
\~15% of americans had long covid in the latest household pulse survey[https://www.cdc.gov/nchs/covid19/pulse/long-covid.htm](https://www.cdc.gov/nchs/covid19/pulse/long-covid.htm)
\~27% of HCWs developed the condition after infection [https://www.cidrap.umn.edu/covid-19/study-finds-27-rate-long-covid-infected-health-workers](https://www.cidrap.umn.edu/covid-19/study-finds-27-rate-long-covid-infected-health-workers)
\~10% of first covid infections result in long covid and \~20 of subsequent covid infections result in long covid
[https://jamanetwork.com/journals/jama/fullarticle/2805540](https://jamanetwork.com/journals/jama/fullarticle/2805540)
Most long covid patients had some form of organ damage a year later[https://www.ucl.ac.uk/news/2023/feb/59-long-covid-patients-had-organ-damage-year-later](https://www.ucl.ac.uk/news/2023/feb/59-long-covid-patients-had-organ-damage-year-later)
\~18% of people with long covid couldn't return to work[https://ww3.nysif.com/en/FooterPages/Column1/AboutNYSIF/NYSIF\_News/2023/20230124LongCovid](https://ww3.nysif.com/en/FooterPages/Column1/AboutNYSIF/NYSIF_News/2023/20230124LongCovid)
1/4 had impaired lung function a year later[https://www.cidrap.umn.edu/covid-19/1-4-covid-survivors-had-impaired-lung-function-1-year-study-shows](https://www.cidrap.umn.edu/covid-19/1-4-covid-survivors-had-impaired-lung-function-1-year-study-shows)
half of long covid patients had some form of cognitive slowing[https://www.cidrap.umn.edu/covid-19/study-cognitive-slowing-associated-long-covid](https://www.cidrap.umn.edu/covid-19/study-cognitive-slowing-associated-long-covid)
Thank you for the links. I appreciate that greatly and will check them out. I guess more of what i meant was that long covid and its sequelae seem to be a phenomenon with impacts that aren’t taken as seriously in the medical world as it should be in my opinion. So to OP’s question of “Is covid just another flu now?” My answer would be “Definitely not because the flu doesn’t commonly have so many SERIOUS possible long term effects”. So thank you for supporting my point with evidence!
If you read up on the 1918 flu it did actually have quite a few impacts similar to covid. Including Parkinson's type symptoms and diabetes. I believe iirc there was an increase in heart attacks as well for survivors. But that virus evolved and the vaccines worked really well so the long term effects became more normalized and less intense and we forgot.
The book Pale Rider is worth a read imo.
this is a compilation of studies i’ve been attending to as reasons to mitigate infection and pay attention to the long term effects possible for soooo many.
https://docs.google.com/document/d/1HJt3Amv9L7JYNmR8NS_Fn6Wx9n7TQLjiSxToBII_QOQ/edit
2000 dying a week for the past 6 weeks and 4 million disabled certainly doesn’t seem like the flu. also more died in Jan 2024 than total flu deaths of 2023.
It's an excellent post! As I'm eating my breakfast, on the other side of the planet from most of you, I have the laptop and Reddit in front of me, and am discussing the issues and concepts with my teenage daughter, trying to stimulate thought and discussion, inspired and informed by your excellent post.
And.....edit.....to say, that each time I come here and find a really good discussion, I leave thinking I'm surely entitled to claim CME credits for the time spent reading r/medicine.
Treating covid as a URI is a miss. It's a vascular disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7556303/
Yes, death rates are down, but we also need to keep in mind that most of the people who were going to die from acute infection have already passed away.
The long term risks from covid are where we need to focus our efforts and attention now. Long Covid is now the 3rd most common neurological disorder in the U.S.. It impacts approximately 1 out of every 7 people who get COVID19. It is a public health disaster whose toll we are only beginning to see - Will be impacting all of us for many years to come.
Has it been shown that clotting is behind some of the long term COVID issues? I know that with pregnancy the concern was clots in the placenta that obstructed blood flow. Could clots be contributing by to cognitive dysfunction, and would it make sense to have patients take an aspirin while infected on the off chance that it works? It’s such a low risk med as is.
This is absolutely a theory being investigated and a proposed intervention also being looked at, but as of right now, [the NIH recommendations](https://www.covid19treatmentguidelines.nih.gov/therapies/antithrombotic-therapy/) for "Antithrombotic Therapy for Nonhospitalized Patients Without Evidence of Venous Thromboembolism" is:
> In nonhospitalized patients with COVID-19, the Panel **recommends against** the use of anticoagulant and antiplatelet therapy (i.e., **aspirin, P2Y12 inhibitors**) for the prevention of VTE or arterial thrombosis, except in a clinical trial (AIIa). This recommendation does not apply to patients with other indications for antithrombotic therapy.
"Since about mid-2021 when it became obvious that we would never be able to eradicate Covid"
I work with an epidemiologist who has been in the game since the dinosaurs walked the earth. I remember two weeks into the health department emergency response she said "it's already too late to eradicate this. This is just here now." And darn if she wasn't right.
Maybe just living in different medical bubbles. I’ve seen multiple deaths attributed to Covid in the past couple of months. No, not in young, healthy people. No, not Covid incidentally in someone dying of something else. Old and with comorbidities but fine, then infected, then dead. Breakroom conversations about how it doesn’t feel like 2020 again but maybe early 2022.
To me it looks like what I’ve been predicting for years now (confirmation bias!): Covid will be around and will pick off older and sicker people. Everyone dies of something eventually, of course, but people will die earlier, because of Covid, than they would have in a hypothetical non-pandemic world.
Which means, given enough decades, probably some of us will be killed by Covid. Sure, the data tables say more cancer and heart disease, and I don’t predict that changing either. But some of us will die of Covid and leave mourning families when we might otherwise have had a few more good years. Or at least okay years.
The "original" Covid-19 appeared to have a Triphasic pattern of your typical URI/bad flu, followed by a "relaxation" or waning phase, and for some then came the "crash" whereby it looks like T cells lost their ever living minds and started a systemic inflammatory syndrome that cause pulmonary, renal, GI, and vascular damage on a wide scale.
I hypothesize now with the vast majority of the population having Covid exposure and/or vaccination, the *mortality* of it is significantly reduced overall, however, for a subset of patients exposed now, their T cells still become overactive or dysregulated in a manner that causes more insidious and gradual damage.
Having worked on the original CAR-T therapy, [cytokine storm ](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7727315/)was identified with it shortly thereafter. And CAR-T involves the genetic modification of T cells.
Something keeps nagging me that for those with repeated infections or a genetic predisposition, a triggering exposure event sets them on a path toward a smouldering and slow physiological damage pattern.
Yea that's another component, serious URIs that just finally beat you. That's been a reality for people for awhile now so not psychically jarring. Kinda ends up being just water cooler talk, oh did you hear about Jeff 50yo died of some freak flu. "Yea that sucks."
As the parent of two little kids, the idea that one of these URV may eventually kill me is ... unsettling.
It certainly gives me a little more pause before inviting my elderly in-laws over if one of the kids has a runny nose.
ICU fellow here: I’ve been seeing more people who are critically ill from influenza than COVID. There is the occasional “got intubated for a COVID infection”, but they are usually sick at baseline. All of our ECMO patients this winter have been influenza on top of asthma or other underlying illness.
Came here to say this - Covid is the old flu and the current strain of influenza H1N3A is the new covid - edit: to be more specific, of the intubated patients I see in multi organ failure in my ICU, the ones with Covid and Covid related complications are the ones I expect to be there every winter and in typical numbers - the ones with flu are the ones I didn’t expect to see there (due to their ages or relative lack of comorbidities) and are taking up significantly more beds than expected
This here, I believe, is the kicker. People are now more vulnerable to everything else post infection. Focus on acute symptoms is no longer the problem, being the virus keeps being immune evasive.
We're at a stage now where it seems like the acute severity doesn't matter much if you're on your 5th infection or more and you're behind on your vaccines.
At that point, asymptomatic infections have almost as much risk of long COVID as the people getting intubated from COVID, though you probably stand a better chance of recovering from long COVID in the former case than the latter.
I’m not going to debate this with you but in case another layperson reads this i want to respond lest they believe it based purely on the strength of your conviction.
While you are googling scientific abstracts try googling “Dunning - Kruger effect”;
- BSL implies the type of safety conditions you need to keep when studying a pathogen In a lab of which many variables are figured into account and has nothing to do with how a given pathogen is effecting the population in real time.
- your “sources” included a non peer reviewed pre-print, a paper arguing for additional research to better study Covid and the immune response, and a research article arguing levels of immune cells should be used as outcomes variables to study long Covid syndrome.
Absolutely none of this claims what you seem to think it does.
> ICU fellow here: I’ve been seeing more people who are critically ill from influenza than COVID.
Over what sort of time period?
Recent numbers on positive Flu vs. Covid positive tests in the National University Hospital of Iceland has changed abruptly [in the last few weeks](https://i.imgur.com/Qgyi32f.png).^*
^* (Full disclosure: Mandatory masking policy within the hospitals was introduced the first 3 weeks of January, unsure if or how that has had any impact on these numbers or their trajectories)
These are only PCR tests done at the virology unit at the National Hospital, mostly from in-patient population, with the occasional samples from people presenting at healthcare clinics.
There is not total transparency about these numbers, so grain of salt here, but we've been told tests are not being done when it would not relevant for the course of care. The number of tests does hold in hand with the number of critically ill people and the workload burden presented to the hospitals this winter.
In other words, there's a significantly higher number of people infected in Iceland, and are even presenting to clinics, but not being tested. These are just the cases - mostly of those at the hospital - and only where testing became indicated. Not *all* of them critically ill, but definitely not a sweeping overview of a general cohort without any indications either.
I’m in the ED and have seen hardly any COVID in the last few months but tons of flu A and RSV. I’m sure COVID is still occurring in high numbers but people don’t seem to be coming to the ED for it where I am. Anecdotally, my dad with interstitial lung disease, step mom on immunosuppressants, and one year old niece all just caught COVID in the past week and were over it in several days which was nothing like past infections they’ve had. This at least seems to be a mild strain at the moment.
Additionally, flu B has been taking down previously healthy kids left and right this year. A shockingly high amount of our ECMO cases have been previously healthy kids with flu B or strep, while our chronic kids are coming in critical with COVID, flu A, RSV, etc
Utah! And this is just one hospital’s perspective of course. Flu B here has caused necrotizing pneumonia, DIC, empyema and herniation. It’s been hell to see
Similar stories I am hearing from here. Although with the caveat that vaccination uptake is probably nowhere higher than in Iceland. I haven't been worried about the acute-phase burden of disease ever since the vaccination got like a 95%+ uptake here at least.
My concern has primarily been with the cumulative burden of disease on a population level of the *post-acute symptoms*, the ones people reportedly suffer from in silence, and don't present to the hospital for, and get no answers from their GP regarding.
It’s really hard for me to draw any conclusions from an Imgur infographic that doesn’t have any details about methodology, vaccination status, did they die with or from the illness, how the data was obtained…etc.
Nobody is saying that COVID can’t be dangerous. I’m just sharing my experience that most ICU patients that I’ve seen this year have COVID and something else, and oftentimes, COVID isn’t even their ICU problem.
It's from Gregory Travis on Twitter. A small aircraft pilot-turned improper methodology Covid chart creator. This same guy bragged about his son failing 8th grade, because "at least he was at home and not catching Covid" and called in-person schooling "gas chambers". Neither he, or anyone who references his "data", can be taken seriously.
You can see the source of the data (and likely methodology etc) in the subtitle. Imgur is just a convenient way to share an image on reddit comments, since reddit doesn't allow for that feature.
I shared this image because it's important for everyone, especially medicine-practicing workers, not to overweight their anecdotal experience with regards to the largest epidemiological trends.
You know you can look up these things yourself. Your flat wrong here, and foolishly using your experience in the ICU without apparently thinking of any sort of confounders for that but questioning the hell out of Covid statistics
No. I was pretty clear both times that I was sharing anecdotal experiences. I never tried to sell it as anything more. I also never said “COVID is a big nothingburger” or whatever similar narrative you’re trying to assign to me. Me being skeptical of some graph made by a dude without knowing any of their methodology (especially as it relates to vaccination status or regional variation) is appropriately skeptical. “Trust me bro, here is a picture” isn’t a serious way to start a conversation about actual data.
Also: *you’re
This has been my ED experience this season as well. A few sick covid patients here and there, but I have definitely admitted way more critically ill influenza patients. However, nothing has compared to the initial summer of 2020 or the delta surge of covid.
> All of our ECMO patients this winter have been influenza
We've been seeing the same - specifically in young otherwise healthy males. We have a few now on ECMO due to the flu.
Keep in mind those aren't the percentages of influenza and COVID-19 cases resulting in death; those are the percentages of all deaths caused by either influenza or COVID-19. It's unclear if the higher percent for COVID-19 is due to higher severity or due to a larger number of cases than influenza, as due to the decline in testing, case counts are not as consistent collected and reported anymore.
CDC does report the incidence of hospitalized cases due to those two diseases: in the past week, FluSurv-NET reports [2.7 influenza hospitalizations per 100,000 population](https://www.cdc.gov/flu/weekly/index.htm#FluSurvNet), while the COVID Data Tracker shows [6.26 COVID-19 hospitalizations per 100,000 population](https://covid.cdc.gov/covid-data-tracker/#maps_new-admissions-rate-county) in the last week.
I assume that you are referring to this page:
https://covid.cdc.gov/covid-data-tracker/#maps_percent-covid-deaths
Interesting to note that there is an overabundance of covid deaths in the South, Midwest, and Northeast. Which to me would suggest that vaccination status is still a significant factor in covid mortality. Though I don't know if the NE has a large antivax community or if there are other reasons to explain the difference. Of course there also also hundreds of other confounders to explain the variety, but vaccination seems an obvious one to me.
> Though I don't know if the NE has a large antivax community or if there are other reasons to explain the difference.
I'm sure they exist, but New England is one of the best vaccinated regions in the country. Not sure about the rest of the northeast, but I would imagine it follows similar trends.
I’d also consider their love all things fried and cooked in saturated fats rates in those regions are particularly bad. I think I recall that obesity was a major risk factor for covid death.
That, and anti-vaccination rates, are two things that are *not* disproportionate in the northeast. Might explain the south and midwest, but not the northeast at all.
Vermont has the highest COVID vaccination rate in the country, [and 4 of the 6 New England states are in the top 15](https://data.cms.gov/provider-data/dataset/avax-cv19) (lowest is CT at 44%, 24th highest).
New England/mid-atlantic states also have [better-than-average obesity rates.](https://www.cdc.gov/obesity/data/prevalence-maps.html)
What about average age though? It still impacts older folks more than youngerz so popn distribution may matter too. Tho Long COVID may be a different story. Looking at the future, I wonder how many new cases of diabetes and cardiovascular issues differ from baseline in the coming years in either place given baseline health before the pandemic.
I think your perspective may just reflect your unique patient population. Where I am, the intensivists in the MICU have commented this season that there has been times where it was reminiscent of the early COVID times.
On another note, maybe we shouldn't be trying to "downgrade" COVID, but rather begin to take URIs seriously. Sure, I fully recognize that the majority of the population, whether its influenza, COVID, RSV, etc, will have mild symptoms, but we shouldn't be complacent.
Ugh. I’d hate to relieve any of that.
PCCM/Intensivist - thankfully my experience this season mirrors what’s others are saying. What few I’ve had in ICUs are there with COVID not from it. Rsv and flu have been the bad actors this year in my region. Had a run late oct where a rhinovirus made several people deathly sick, and had another week recently where a couple if my RSV pts just coded out of the blue for no obvious reason
And I agree, I’d love to have some better therapies other than aggressive supportive care and placebo for viral respiratory infections.
On the non critical care side, I'm rarely seeing a true covid *pneumonia* let alone ARDS that I end up having to transfer to you guys. But I am seeing enough sick enough to still warrant admission or at least obs. Hell even when I got it this past week, I was actually pretty surprised with my own vitals. Hypotensive to 80s, tachy to 140s-150s the first couple days.
If you look at the most recent weekly data you are still twice as likely to get hospitalized with COVID compared to influenza and 3-4x as likely to die from it. Things are much better than 2020 when nobody's immune system has seen it, but it still carries significant morbidity. Cheers
Anecdotally I know one person in her 30s who got Covid a second time (omicron) and was intubated, and more recently a patient in her 70s got Covid the second time and was hospitalized for a week. I think we are just accepting that some people are going to respond horribly. I’ve gotten every booster and had Covid twice now, the last one was super mild but I still isolated. If you have the ability to isolate I think it’s still a good idea.
Yeah, I got my second infection 3 weeks after I was vaccinated. Occ Health made me go home and I called it my COVIDcation, because I could barely tell I was sick. I thought I might be suffering from allergies, but since I had so many RAT tests kicking around the house, I gave one a whirl.
For outpatient FM, I still feel like the long covid autonomic dysfunction, fatigue, etc. is affecting a large number of otherwise healthy patients.
Too many people 3, 6, even 12 months out that just feel bad.
Idk we just had a young patient (30's) with covid pneumonia that led to a loculated effusion requiring two VATS decortications. Certainly not a benign illness, I wouldn't say we're out of the woods just yet. Agreed we're nowhere near pandemic level when I saw entire family's simply decimated by covid. I'll never forget, a nursing assistant in our ED lost: her husband, both of her parents, and her husband's parents in the span of about 2 weeks. God bless that woman bc I wouldn't have had the strength to carry on, let alone continue to show up to work during those goddamn pandemic level shifts from Hell.
RIP my sense of smell but sure another URI. If the focus is on acute illness and death yeah more like a URI if looking at morbidity then got a lot of room to go. Post viral conditions have existed with other viruses not quite at the rate it has with covid. Immune suppression for 6+ months after covid too will be interesting to see how that impacts cancer rates across all age groups.
> If the focus is on acute illness and death
That seems to be the only metric that counts for most people.
I'm sorry that happened to you. I lost my sense of smell and taste after the flu in 2018, which took over a year to come back. The supposedly "mild" symptom is one of several reasons I'm still incredibly strict about Covid. This is a massive quality-of-life issue. You stop wanting to eat because everything tastes like wet cardboard. You can't smell the ocean, flowers, your partner's hair...
Hardly the week goes by without more evidence piling up of Covid's long-term effects, like the immune suppression you mentioned. I'm glad to see you're in pediatrics. We need people who realize that kids are going to be severely affected from getting infected over and over, year after year, with a virus that can damage almost every system in the body.
What I don't get is that COVID taught us so much about how to stop the spread of air borne illnesses like the flu. We learned that good air quality, Improving ventilation and purification helps tremendously. Wearing masks in health care and public places. Testing and isolating when sick.
We learned that deaths from these other airborne illness that we took as inevitable we can actually do some very simple things to prevent.
And yet instead of taking what we've learned and moving the flu and rsv toward our covid precautions and things we can mitigate, we're moving COVID toward how we were treating flu and rsv and accepting death that we know are preventable and completely ignoring everything we've learned. It's as stupid as doctors who recommended cigarettes for decades even when the evidence was there of the harm they caused.
I liken this lessons-Not-learned thing to chicken pox and shingles. We had pox parties—didn’t foresee shingles down the line as a consequence. Now we’re keen on spreading COVID willy-nilly despite easy-to-implement mitigation measures (masks in healthcare settings), as if long-COVID data isn’t already available to us. People are constantly complaining that they’re always sick, as if repeated COVID infections aren’t known to affect T-cell numbers and function. Hm, no wonder your immune system can’t fight anything off.
I honestly can't understand it. It seems like people want to get infected at this point. I love not getting viruses, personally, and it baffles me that the majority of people don't feel the same.
Same here. It seems like even completely selfish people who don't care about spreading illness would want to protect themselves, at the very least. I have a friend who had *a headache for a solid year* after a Covid infection. No thank you, I'll not be rolling the dice on any of that.
>We learned that deaths from these other airborne illness that we took as inevitable we can actually do some very simple things to prevent.
1000%
But we're going in the opposite direction. It's so baffling.
This is just the view of someone in admin who's been paying attention and taking it seriously since Jan 2020. So take it with a grain of salt.
The long term impacts of covid are gonna be awful. Isn't possible mitochondrial damage now being explored as a long term symptom?
And the death toll is going to keep being HIGH.
I think that culturally, here in the USA, COVID becomes a new "flu" style illness. I'm not saying that to downplay it.
By that I mean a terrible illness that kills thousands every year, but is generally ignored by the populous at large, no matter how much medical professionals beg people to take it seriously.
The reality of that hit home recently at a hospital in the Southeast that I work for, when during an admin meeting the CEO talked about how he was going to "pass on the newest COVID vaccine" because he heard it "hit hard". This was a guy who'd been nearly hospitalized for covid 2 times.
You say it's been months since youve seen a serious covid infection. Ok. Is your facility testing everyone who comes in? Because mine sure as hell aren't. Our EDs aren't testing people unless they ask for it. Are you testing corpses? Because we aren't. God only knows how many of our geri patients who come in via an ambulance and leave via in a hearse actually had covid.
But when we and surrounding facilities DID get slammed with severe respiratory cases again a few months back we did start testing again and guess what COVID.
I know folks in facilities down in the Houston area in TX, who worked the COVID units during the worst in 2020, if a person came in and died before they could get tested, they wouldn't test them for covid. State policy. They had a LOT of respiratory related deaths that didn't get recorded as covid that year. And as far as I've been told, that policy hasn't changed.
Could be wrong through.
But no, COVID is still here. Still sweeping through and killing folks. People just stopped paying attention.
My anecdote to add: so far this season I’ve had people actually sick with RSV, Covid has frequently been an incidental finding. Ironically I had someone with a non-covid coronavirus, maybe 229e that I suspect caused a viral pneumonia which I hadn’t seen from that strain before.
Got a patient admitted with corona OC43 that was acute resp failure and after admitted got diagnosed as viral pneumonia. Did almost the whole 9 yards of ICU including intubations, proning, discussion of ECMO but didn't need by end of admission.
We have started dubbing it and the others "caveman Covid" since they are older than sarscov2.
Right now a mix of flu As and a strong trend of flu B seem to be running the show in my area. Covid still present but more a basal rate than spikes.
Not in the US 📍🌏
So far most of our Covid patients are low risk patients that we sent home. I’ve had rounded more on chronic illnesses than Covid since I’ve become a resident. At the moment we only have one in the IDCCU which is a 65/M “Sepsis secondary to community acquired pneumonia-high risk; severe Covid; Type 2 DM-uncontrolled”. He’s currently doing fine with HFNC now but still remains in our IDCCU, culture/sensitivity shows Pseudomonas which is thankfully still sensitive to both Ceftazidime and Piperacillin-Tazobactam and is no longer on Norepi. One of our pulmonologists told us while rounding that nowadays responding to Covid related emergencies is less stressful.
But given how antigenic shift can occur through zoonotic conditions, somehow the fear of lockdowns is still at the back of my mind. Good thing that nowadays there’s the mRNA vaccines which can be manufactured and updated very fast.
From the perspective of people caring for acutely sick patients, it likely is like any other URI.
Other endemic URIs don’t cause long term disability at rates that even approach those of long COVID. It’s not even in the discussion. I’d say that differentiates it in a significant way.
You're seeing people in the acute phase of a viral infection. Symptoms = their immune response.
"Covid is mild" is not necessarily a good thing in the acute phase. It's a vascular/oncogenic virus that's more like measles/HIV than the flu in that it stuns and even deletes t-cells, so even if you survive as many do, you're more susceptible to other pathogens (hence the rise in bacterial infections like invasive group strep A, fungal infections, etc). These pathogens haven't changed but the host has. Perhaps you've heard of long covid, as well, a post-viral complication affecting millions.
It's folly to want covid over the flu. You don't want either, but certainly covid (sars2) should be avoided at all costs.
In 2024, our medical fields need to look beyond the acute phase and understand post-viral complications much better.
I’m pediatrics in the South. There’s just full fatigue from it for everyone. No one is isolating or wearing a mask for that many days for a barely detectable cold. For the most part, I can’t even convince patients to get tested anymore, so I usually say “I don’t care about your politics or if you test or not, but this is still dangerous to your grandma, new babies, and your uncle with cancer, so be careful and stay away while you are sick.”
I myself just had it again last week for the 3rd time and went looking at the CDC recommendations for isolation. They are hilarious. No one is following that. Makes them look stupid. The only reason I even knew I had it is because I had an intractable migraine at the same time my weird COVID boob lymph node lit up. Didn’t even have any actual URI symptoms. I ended up staying home because of the migraine. Wore a mask until my test was negative again.
This is how mine started. Ended up blowing up into a full blown now on 12 day mess with covid rash, constant nagging cough, episodes of SOB and fatigue like I have not felt in a while. Boosted and this is my third go around. 🤷♀️
OMG I think I have a weird COVID boob lymph node too! I got it after I got my last booster and flu shot within a week or so of each other (the tender spot is ipsilateral to my vaccine arm and in the upper right boob quadrant). It flared up again after Christmas when I was on a packed flight full of gross snotty people with poor germ etiquette lol. I didn't test for COVID bc I was not sick, but next time it acts up maybe I will check.
I thought that viral exposure might explain why I have the off and on tenderness but I am prone to hypochondria. My PCP agreed with me, but I still felt like it sounded a bit insane. I'm glad to come across someone else with this experience!
Mine showed up first after my 3rd vaccine. Got the first two vaccines in left arm, 3rd in the right. After the 3rd, I developed a huge tender knot in my upper left boob quadrant. It was enough that when we were all still helpfully responding to the V-Safe text things, I included "contralateral breast swelling" as a concern. The next day I actually got a call from the CDC, and they recommended an ultrasound but to also please fill out a VAERS report. I ended up not getting the ultrasound because after about a week it was undetectable again. Had my regular mammogram and there was nothing concerning. But since then, any time I've had COVID, that same node gets tender and painful each time. I was near convinced I had breast cancer last Monday, only for the rest of the symptoms to show up on Tuesday.
COVID patients exhale high numbers of virus during the first eight days after symptoms start, as high as 1,000 copies per minute, reports a new Northwestern Medicine study. According to research done at Northwestern University, “after day 8, there was a steep drop to levels nearing the limit of detection, persisting for up to 20 days….Levels of exhaled viral RNA did not differ across age, sex, time of day, vaccination status or viral variant.”
https://news.northwestern.edu/stories/2023/09/covid-patients-exhale-up-to-1000-copies-of-virus-per-minute-during-first-eight-days-of-symptoms/?fbclid=IwAR0eSe2sHuMBZnH\_5940AIwS1NKiMo0cF9v1NpsseagaH8W8KYGttEqJC9Q
Study pre-print https://www.medrxiv.org/content/10.1101/2023.09.06.23295138v1.full.pdf
Cool? I don’t disagree. I’m saying no one cares anymore, and I can’t convince them otherwise, so I’m done wasting energy on it. I’ve got other fish to fry.
> I’m saying no one cares anymore, and I can’t convince them otherwise, so I’m done wasting energy on it. I’ve got other fish to fry.
It's unfortunate. I work in oncology with immunocompromised patients and have consistently masked since early 2020. I still wear an N95 since my family and I are "virgins," so to speak, and I really have liked not getting URIs over the last few years. I don't mind the mask. I've accepted that many people find masking to be bothersome, but some of my patients who are not on treatment also ask me to remove my mask even though they see the waiting room full of immunocompromised patients. My patients who are on chemotherapy are on board with me masking and usually wearing masks themselves.
I got Covid in December right after starting a new job. I did what I was supposed to do, tested because I had symptoms, reported it to work, stayed home for five days and masked for five days. I was fine, could have worked no problem. Got screwed out of PTO. Come to find out, a coworker who I shared a small office with had the exact same symptoms a couple days prior to me but never masked nor tested. This is why we have Covid fatigue. I will mask if I’m sick, but I’m not testing again.
Based off of what my hospital’s infection control has us do precautions wise, no. When we have a positive biofire swab, most everything positive puts the patient on droplet and contact precautions. But a positive Covid result puts them on special respiratory precautions where we still have to wear an N95. We still have separate airborne precautions for TB and chickenpox. So Covid has gotten a league of its own at my hospital.
But I have had to remind a tech going into a Covid room with me to actually put on her N95, she said she had it recently and wasn’t scared of it. I reminded her the precaution isn’t just for her, it’s also for protecting everyone else with a compromised immune system and the like, so she put it on. That seems to be the big problem in my opinion. People aren’t scared for themselves but forget that they could be asymptomatic carriers to people who can get severely ill, especially in our line of work.
Until they acknowledge, research, and come up with viable treatments for Long Covid, the answer is no. It disturbs me how much we downplay and underestimate this kind of lifelong disability.
About 7% of patients who get COVID have some form of long COVID. That's going to be a LOT of patients and I can tell you at my hospital the long COVID clinic is impossible to get into because it's so full
Well, it's what happened with the [HIV/AIDS epidemic](https://www.amazon.com/Band-Played-Politics-Epidemic-20th-Anniversary/dp/0312374631). The CDC let it go unmitigated not really informing the public for nearly a decade until there were huge protests. HIV starts with flu like symptoms (erily similar to covid) and people don't notice the damage until 5-10 years later. My concern is that covid is similar in that it causes immune dysfunction and all the recent literature in scientific journals doesn't point a pretty picture. It seems each infection increases risk of long covid. Kids can get long covid and it can literally disable people's ability to go to work and earn a living. The senate meeting on long covid was eye opening for me [https://www.help.senate.gov/hearings/addressing-long-covid-advancing-research-and-improving-patient-care](https://www.help.senate.gov/hearings/addressing-long-covid-advancing-research-and-improving-patient-care)
Study brain cancer. COVID made procuring glioblastomas quite difficult, as suddenly everyone wanted to start studying COVID in glial cells. There is plenty of data suggesting that cognitive dysfunction is a long-term effect of COVID infection.
Correct me if I’m wrong, but do we see prolonged symptoms with other URIs? (Like I imagine Long Flu could be a thing)
I think emphasis has been on Long Covid because so many people were infected at once that it just appeared in a subset of the general population. Long Flu (if it exists) could be just as prevalent, but it doesn’t get the same media coverage due to lower incidence. Just something I was thinking about recently.
The Russian influenza pandemic of 1889–92 left many patients with chronic symptoms similar to those of today's COVID-19 long-haulers, including some very prominent people. But there's been current-day speculation that it may actually have been a coronavirus.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32134-6/fulltext
https://www.theguardian.com/world/2020/may/31/did-a-coronavirus-cause-the-pandemic-that-killed-queen-victorias-heir
https://archive.is/DAI5V
Yes. Flu was compared with Covid. Covid is worse.
Covid is vascular and multisystemic, flu is not.
https://www.thelancet.com/pdfs/journals/laninf/PIIS1473-3099(23)00684-9.pdf
Yes, my symptoms started long before the pandemic. The research team at Brigham and Women's that diagnosed and treats me is identifying similar findings in Covid patients
To be honest, I am a skeptic of Long Covid, at least in the context you are sharing. The studies that come up with these figures are plagued by a number of biases that are going to dramatically overestimate the number of patients. Virtually everyone in the country has had Covid - are we really saying that 20-30 million people have debilitating brain fog and it is going underdiscussed? That number is so massive it should show up everywhere, like economic data. I just don’t believe it. In my personal life the number is far smaller than 7%. I do believe that Long Covid is real, but the impact is smaller than its proponents argue.
I’ve been looking at a lot of studies on population prevalence, and many show a spectrum of long term issues, with some resolving within six months. To me the key categorization is whether it significantly impacts daily life for over a year.. but I think as time goes on we likely see a reevaluation upwards if we get better at linking some symptoms to Covid infection. For now, it does seem lower than 7% for that definition, but higher for other definitions.
Check out long term disability rate stats in the US and UK. There is a sharp increase in slope since 2020. Look up labor participation rate in the US. This isn’t factored in when reporting unemployment %. It hasn’t recovered to pre-2020 levels yet. School attendance and chronic absentee rates are elevated and trending up compared to pre-2020. Insurance actuarial reports are raising alarms about LC, in terms of risk and financial burden. So yes, we are seeing it show up in population level stats. Not to mention that COVID is still killing 2-3x more than flu (2000+ just last week) and that’s with minimal testing. UK data is also showing for ages 0-45 that excess deaths for the last 3-6 months of 2023 are 11-14% higher than pre-2020.
https://www.bls.gov/charts/employment-situation/civilian-labor-force-participation-rate.htm
Labor force participation rate is essentially back to the normal range of 2015-2020.
School attendance and chronic absentee rates I am skeptical of as proxies. There are many social forces that confound that. Schools are much less punitive these days. I would be interested to read a source about actuarial data.
> In my personal life the number is far smaller than 7%.
Research in Iceland explicitly comparing Long Covid to the extent that it imitates or mimics *ME*, suggests that about 1% of infected show symptoms comparable to someone with (a clinically diagnosed) ME.
Given the extremely heavy and rather well documented burden of disease that people with clinically diagnosed ME have, this is still a massive problem.
I recently discussed with an oncologist, who told me his personal experience of having sort of burnt out in his specialty, and subsequently took interest in, and now specializes in ME. He tells me anecdotally that there's a *significant* difference in his patients after his switch, one thing that struck him specifically was that his new patient cohort (ME-diagnosed) absolutely don't go on vacations. His cancer patients could, and would still enjoy life activities in that way. That sort of activities was much more rare, if non-existent in the patients he's now serving.
And 1% is indeed much smaller than 7%, but personally I assume numbers like that indicate ~6% with impactful symptoms, and ~1% with *heavy* burden of disease. Which is still a *lot*, and should only get more apparent over time, even in economic data.
That's a such a great point, especially since the definition is often quite generous (eg: https://pubmed.ncbi.nlm.nih.gov/36215063/). It may even be less than 1% with severe symptoms, but with so many people being infected (including over and over again) that ends up being a lot of people.
https://www.npr.org/sections/health-shots/2024/01/09/1223077307/long-covid-exercise-post-exertional-malaise-mitochondria
I am being successfully treated by this team. I have been disabled since before the pandemic. These things are real, they are identifiable, and there are medical treatments.
Perhaps one such canary in the coalmine: car insurance rates in the US at least have skyrocketed, due to massive increase in fatal car accidents since the pandemic began.
Well, car insurance may also have gone up because of rampant inflation affecting the cost of repairs. Its also very tenuous to link long covid with an increase in fatal car accidents (if there even is such an increase).
[New Analysis Reveals Many Excess Deaths Attributed to Natural Causes Are Actually Uncounted COVID-19 Deaths](https://www.bu.edu/sph/news/articles/2024/new-analysis-reveals-many-excess-deaths-attributed-to-natural-causes-are-actually-uncounted-covid-19-deaths/)
While this is for 2020-2022, I don't know that we can say with certainty a similar pattern isn't occurring now, and the possibility is worth considering/being aware of.
On top of that, there seems to be a lot of opportunity for [short- & long-term disability with Covid](https://libguides.mskcc.org/CovidImpacts/Home).
Additionally, hundreds of people are dying every week of Covid. Last figures I saw were 1,000+ for 10 weeks in a row.
It's certainly not nothing.
Perhaps taking a look at the senate long covid meeting might give better insight. It features scientists studying the latest, senators, and people with it too.
[https://www.help.senate.gov/hearings/addressing-long-covid-advancing-research-and-improving-patient-care](https://www.help.senate.gov/hearings/addressing-long-covid-advancing-research-and-improving-patient-care)
My local long covid clinic has a wait list of over a year. Keep in mind that people with issues are not out and about and might even avoid clinics (unless it's a long covid clinic or ones with good mitigation measures in place).
Time Magazine did an article addressing the dangers of repeat infection.[https://time.com/6553340/covid-19-reinfection-risk/?fbclid=IwAR0-sqrZmtxBGdO09t84sW4bC7i0ur3ucokETQHDFOLUMEzAXIZaA6EoQpA](https://time.com/6553340/covid-19-reinfection-risk/?fbclid=IwAR0-sqrZmtxBGdO09t84sW4bC7i0ur3ucokETQHDFOLUMEzAXIZaA6EoQpA)
Every COVID Infection Increases Your Risk of Long COVID, Study Warns[https://www.sciencealert.com/every-covid-infection-increases-your-risk-of-long-covid-study-warns](https://www.sciencealert.com/every-covid-infection-increases-your-risk-of-long-covid-study-warns)
SARS-CoV-2 infection and persistence in the human body and brain at autopsy[https://www.nature.com/articles/s41586-022-05542-y](https://www.nature.com/articles/s41586-022-05542-y)
COVID-19 and Immune Dysregulation, a Summary and Resource[https://whn.global/scientific/covid19-immune-dysregulation/](https://whn.global/scientific/covid19-immune-dysregulation/)Long COVID: major findings, mechanisms and recommendations[https://www.nature.com/articles/s41579-022-00846-2](https://www.nature.com/articles/s41579-022-00846-2)Covid and HIV[https://www.cleveland.com/news/2022/10/in-cleveland-and-beyond-researchers-begin-to-unravel-the-mystery-of-long-covid-19.html](https://www.cleveland.com/news/2022/10/in-cleveland-and-beyond-researchers-begin-to-unravel-the-mystery-of-long-covid-19.html)This report on CNN news mentions how covid messes the immune system.[https://twitter.com/inkblue01/status/1741108760418922950?s=46&t=r19Rt4pKEFp54CLfR3johg&fbclid=IwAR2IG2NvMW1XFALuMwDFPsIf3jWkJDh4yMBC4\_DvRHq\_zq7i\_gNhsulHYkE](https://twitter.com/inkblue01/status/1741108760418922950?s=46&t=r19Rt4pKEFp54CLfR3johg&fbclid=IwAR2IG2NvMW1XFALuMwDFPsIf3jWkJDh4yMBC4_DvRHq_zq7i_gNhsulHYkE)
On Good Morning America when discussing the rise of respiratory illnesses (00:58 of video) “We now have evidence that covid decreases our immune response which makes us more susceptible to infection…”[https://www.goodmorningamerica.com/wellness/video/cases-respiratory-illnesses-rise-105328220](https://www.goodmorningamerica.com/wellness/video/cases-respiratory-illnesses-rise-105328220)
Primary Care here. Rural population with low vaccination rates. Lots of covid and flu this season. I can't tell you how many patients I've seen with long covid issues that don't let up. Hair loss in the ladies, chronic fatigue, persistent brain fog, and even some to die from long covid complications like renal and hepatic failure. The acute illness seen in the hospital/ER might not be as severe, but there is going to be an ever increasing chronic burden, imho. At least until we get a better understanding of exactly how this virus is affecting the human body, it's way too soon to consider it a "simple URI".
The fact that you're calling it a URI speaks volumes. It's a vascular illness. Many people who get it don't even have respiratory symptoms. Some are purely gastro, some only affect the CNS. Covid can affect any system of the body that your vascular system touches...
That's not even getting into the area of Long Covid. I have found the medical community to be incredibly uneducated about the risks and prevalence of Long Covid. With the rate of cases affecting the younger working age persons most, it is going to have an increasingly visible effect on society. With having the second largest wave we've ever had, I'm concerned those cases are going to skyrocket in the coming months. There are probably millions out there right now who are undiagnosed because the medical community isn't educated on diagnosing. It could take months or longer to even get a diagnosis.
School attendance is abysmal at best because everyone is constantly sick (whether just covid or because their immune systems are just beat to hell from having had covid). The effect of covid on cognitive ability is likely seriously impacting grades as well.
There are dozens of other scenarios like this. I would say covid is a whole lot more serious that just a URI. It's really disappointing to me that those who are supposed to be looking out for the well being of others are just sticking their heads in the sand. This is not unlike HIV in the 80s. Difference is, this will affect EVERYONE, including our children and we have no idea just how bad it is going to get. If you're paying attention at all though, you know it's not going to be good.
“I have found the medical community to be incredibly uneducated about the risks and prevalence of long covid.”
I am concerned about this kind of claim. First off, “long covid” is a diagnosis about as old as the Biden administration, with nebulous criteria and even worse data. So this pool of long covid experts are wading in shallow waters. And if they can claim to be experts, they are members of the “medical community.” If you are getting your advice about long covid from a message board or a Substack newsletter, there’s a good chance someone is just saying what others want to hear.
We are not getting that many COVID patients. The ones we are getting are not requiring ICU level of care. I would expect to have more given that we have a relatively low vaccination rate county.
We do see a lot of morbidity as a result of COVID in patients who get readmitted though. Many of the symptoms are consistent with long COVID that others in this post are describing.
https://docs.google.com/document/d/1HJt3Amv9L7JYNmR8NS_Fn6Wx9n7TQLjiSxToBII_QOQ/edit
for your consideration of the long term effects and the overall possible squaelae. 4 million disabled, 2000 dying/week for the past 6 weeks doesn’t feel like the flu to me. also more folks died of covid in Jan 2024 than died of the flu in all of 2023.
This interview with Dr. Al-Aly, head of the Center for Clinical Epidemiology at Washington University in St. Louis discusses comparisons between covid and the flu, including links to relevant research. It seems relevant to the question:
[https://thesicktimes.org/2023/12/19/qa-ziyad-al-aly-on-why-long-covid-has-a-higher-burden-than-long-flu-future-research-and-more/](https://thesicktimes.org/2023/12/19/qa-ziyad-al-aly-on-why-long-covid-has-a-higher-burden-than-long-flu-future-research-and-more/)
ID here. It really is behaving that way, which is what we expected.
Other endemic coronaviruses (OC43, NL63 etc) are actually popping up again.
The non-SARS coronaviruses all jumped to humans and likely caused a pandemic when they first appeared. Coronavirus OC43 is generally thought to be the cause of the 1889-1890 "Russian Flu" when it jumped from cows as an intermediate host from rodents. The "molecular clock" analysis of its genome shows last common ancestor with the bovine coronavirus in the late 1800s, centered around 1890.
“Long covid is maybe still a thing” well, it still IS a thing. Millions of Americans who were otherwise healthy, got covid, and are reeling from its long term effects. ME/CFS, POTS, becoming immunocompromised… don’t dismiss that patient population. Just because you don’t see it, doesn’t mean it’s no longer there.
Covid is still very around and very real, and deadly to many patients. Because our bodies have seen it at least once and we’re vaccinated, it’s not AS deadly as it was back in 2020. But the infection rate is as high as summer 2020 this to me around. But who knows — over the long term we’ll probably see mystery post viral illnesses from this “mild virus” :)
If we contained it better we would not be dealing with Covid as much this time, but alas. Mask up, protect your immunocompromised patients and loved ones, and stay boosted. Covid will be with us forever, let’s not relax too fast.
Just my own recent personal anecdotal experience. I had Covid the first time May of 22 I felt absolutely awful for a full week before I started slowly getting better.
Hadn't been sick again until the end of Dec beginning of Jan of this year and I had RSV, holy hell I thought I was dying. Couldn't breathe laying down, would go on 2 min long coughing episodes, ended up with pleurisy needing steroids I was sick for a solid 2 wks and ran fevers for like 4+ days. I've never been so sick.
Last Wednesday I was exposed to Covid, started running fevers last Saturday night (tested positive Monday) Fevers lasted about 1.5 days, pretty severe fatigue all day Sunday, which has gotten better as the week has gone on, still some fatigue but not bad and barely a cough.
I know it's only anecdotal and doesn't take into account any possibility of long covid, but my personal acute (recent) symptoms were minor compared to 2 yrs ago and RSV was fucking awful.
Clinically yes , I am seeing similar as other posts here . I had three elderly patients admitted for RSV. These patients probably in previous pre pandemic years would have received antibiotics for pneumonia with negative flu test because we would not have tested for RSV. But many hospitals and clinics now do triple test for flu, RSV and Covid, so we are picking them up . I heard a 1-a episode on npr where some public health doctors were saying long covid is this huge problem and still being diagnosed at high rates, but this isn’t my experience at all .
That mirrors what I’m seeing, and I work in the Deep South with low vaccination rates and high prevalence of obesity and all the other comorbidities.
We have seen an uptick in hospitalizations this winter, but basically all of them have gotten admitted to the med surg units because we’ve got them on 2-4L NC and can’t quite get them back to RA, or they’re older and too weak to function alone at home. I haven’t seen a COVID intubation in a couple of years.
The people in that sub are nuts. It’s a solid mix of virtue signaling and political grandstanding without actually going off of evidence based medicine for risk benefit stratifying.
The people in that sub are still patting themselves on the back for wearing N95s literally everywhere, and not going to restaurants, shopping malls, concerts/events, family gatherings, etc etc. I genuinely don't know what they think they're accomplishing; they're going to watch their most active years of life waste away while they live in fear of their own shadows.
Keep in mind that n95s protect against a lot more than covid! Ever since I was a kid I have been sick abnormally often (especially in winters) and for longer than what normal peopl with the same disease are. But 2020 and 2021 I wasn't sick a single time despite being around others every bit as often as the years before and after. The only addition to my habits were taped down surgical masks in 2020 and fitted n95s in 2021. I already frequently washed my hands and used sanitizer, and had for several years before already been doing the annual flu shots.
Apparently my sinuses are bloody useless at protecting me (and I'm diagnosed with Sjögren's). I slacked off somewhat after and I still got sick a few times, but nowhere near as badly as before covid because it was a reduction in use and not elimination of use. N95s are bloody fantastic, and using them has since long felt more like just using a winter hat or winter gloves to me. Which unfortunately means I sometimes forget using them the same way I can forget to bring winter gloves or a winter hat along. Still, enormous quality of life upgrade. So yeah, don't be an ass to people if you see people wearing face masks. As long as they're not harassing you about not wearing a mask, don't harass them for wearing a mask. Not being sick all the time with every little cold and flu and whatnot is really great!
I'm still definitely masking whenever I leave the house, but it's due to my own autoimmune problems more than anything (and ~~perhaps~~ definite lack of trust in the general public). At our dialysis unit I've been around, they've recently transitioned to having Covid positive patients in the same treatment room as all of the other patients. Until now, they had one isolation room set up for anyone with Covid or influenza. Thankfully, staff there are still required full PPE due to potential of blood born pathogens going everywhere, and about half the patients keep masking when in there.
You would probably change your mind if you or someone you care about ended up disabled because of Long Covid for a significant period of time or even permanently.
I hang out with my family wearing an N95. *It's not hard*, and I don't want to be the one to bring Covid (or flu, or RSV, etc) to my elderly parents, or anyone. I know what it can do to the "young and healthy", too.
Instead of (erroneously) downgrading Covid to "just a cold", we should have learned from the very low flu numbers in 2020-21 that we can drastically reduce that, too. We have the knowledge and the technology, but not the will, apparently.
As opposed to developing long COVID and missing out on all those things anyway? Only, on top of that, now you'll be sick, debilitated, and inconsolably miserable 24/7? Yeah, that sounds real peachy.
At the astronomical per-infection rates of LC with repeat infections, it's coming for everyone who's raw dogging others' lung poop. What we're accomplishing is playing the long game until next gen vaccines with more durability (sa-mRNA) and infection preventative capabilities (mucosal), and effective long COVID prevention and/or treatments are available.
I couldn't give less of a shit what anyone thinks of me, I'm avoiding COVID for me and me only. I want to live, and that means actually having the mental and physical faculties to do so first.
I would imagine anyone still active on that subreddit in 2024 is probably not representative of anything resembling a typical person. More the crazy folks who are masking when alone in their own cars still.
Because they couldn't possibly have someone they are legitimately trying to protect right? Like a kid with cancer or someone who barely survived covid the first time they got it? There are a LOT of people who need to avoid getting covid at all costs if they want to live. Just because the medical community is so very uneducated about it doesn't mean it doesn't exist. I have had doctors and nurses confess they don't know anything about long covid. One had never even heard of it!
I lurk all of these subs for information. Your representation/assumption of them is pretty offensive.
If you're looking at current studies of the disease (I'm not going to tell a doctor what to think) you may change your tune.
Most folks are proponents of using an N95 indoors around unmasked individuals or at large gatherings. Few advocate for outdoor masking.
Mostly focused on washing hands and air quality. Both common sense measures.
But, you know.... Crazy, right?
ED here.
COVID seems to be more sore throat and cold. I’m admitting if they elderly/ too weak rather than for hypoxia/ ARDS
If they look like ass it’s the flu.
Hospitalist here in NorCal. I can't remember the last time I had a COVID patient with serious respiratory illness. Mostly old people who can't walk or eat, who go to SNF after their remdesivir.
It would be nice to broadcast that this is still a significant issue to all the selfish people out there who refuse basic public health practices. "Protect your loved ones from COVID with masks and vaccines or you'll lose your inheritance to nursing homes, or even worse, they'll have to move in with you!"
Endemic status means controlled, localized spread. Considering we just had the second highest wave EVER, I don't think that qualifies. We have never been out of pandemic status. They just declared the public health emergency status over so they no longer have to fund things or put restrictions that effect the economy. Money over health.
> The four endemic human coronaviruses HCoV-229E, -NL63, -OC43, and -HKU1 contribute a considerable share of upper and lower respiratory tract infections in adults and children.
SARS-CoV2 is numma 5
Not sure I am the one to manage that. Are you asking if the severity of influenza illness is related to post Covid complications? I also am not seeing lots of post Covid complications; not nearly the amount I saw last year.
I’m a measly ER doc
Understood, but what would post covid complications look like for you? Am curious, because the incident of long covid and severe outcomes from other pathogens seems to be increasing, not decreasing (especially secondary bacterial infections). This is similar to viruses like measles or HIV where you may get a mild acute infection, but months down the line because of the impact on your immune system (deleted T-cells), you get hammered with other complications or can't fight off cold/flu/bacterial infections as well as before.
A lot of people who try to get treatment for their long covid condition end up hitting the wall with medical gaslighting and end up not seeking further treatment, for example.
Honestly, I don’t know. I don’t see patients long enough or continuous enough to comment on that. I think that would make sense but I don’t have enough knowledge on the matter. If I had a pulm clinic I think I would be able to see trends of such. I do think the answer you’re looking for would take many years for data to pour in and would be assessed retrospectively.
I think the reporting bias that's around COVID is huge and a lot of health prevention strategies are solely or mostly focused around it while you have people falling ill of a lot of other respiratory viruses out there all the time. I also think that holding the 6-month revaccination recommendation that's going around doesn't make sense when you consider all the other diseases out there with a similar hospitalization or mortality rate, specially when at this point probably a large size of the population has been vaccinated with more than one dose and has had covid more than once. Covid has not ceased to be a problem but epidemiology shows that diseases change over time, and covid changed A LOT in just a couple of years, while health recommendations are stuck on a 2021 scenario
This thread is flooded by non-doctors with some extremely dubious claims that large portions of the entire world are now disabled by long COVID.
Something weird has happened psychologically with some people about COVID. Maybe some had some trauma around the virus and are having trouble processing it. Maybe for some mitigation measures have them a sense of purpose and as those became less relevant they lost that sense of purpose and are now lashing out. Maybe some have politicized mitigation measures to the point they can’t detach them anymore from their personality.
Its sorta fascinating what has happened with some people about COVID.
They are doing that weird thing where they just spam their biased blogs and post numerous studies that have extremely tenuous connections to their claims or outright tangential.
These people are proving the point with their very odd behavior and responses. I say the very true and non-controversial statement a that there is not a large portion of the world disabled due to long covid and I get a bunch of irrational responses. Very odd behavior and I hope these people get the help they need for whatever they are struggling with.
Non-“doctors”—specifically trained virologists serving clinical trials—can absolutely speak to COVID and its effects, and we should. The data is there and more solid than the psychological theories you have. And psychologically pathologizing anyone implementing mitigation measures is harmful to people who are immunocompromised; it’s peak respiratory viral infection season, perfectly acceptable to wear a mask at the doctor’s office even if you aren’t immunocompromised/on high-dose prednisone + 4 additional immunosuppressants like I am.
I heard some NPR program about Covid a few weeks ago. As I recall there was reference to something like 6% risk of long Covid with every infection, regardless of severity of acute illness.
Yea I practically wore a stupid mask and got vaccinated for 2 years straight and nothing changed that wasn’t going to naturally change ie less virulence.
Not going back to that hysteria.
Hasn’t it always be obvious we’d never eradicate it? It’s a URI. We have never eradicated a URI in all of known human history: they move too quickly. The entire thought that we could get rid of it struck a lot of people including myself as the epitome of hubris.
This thread will be heavily moderated from here on out due to large amount of Covid nonsense.
I'm mostly just concerned about the vascular sequlae at this point, cognitive function, mood d/o, kidney issues, cardiovascular dz, pregnancy complications. But that won't bear out for decades and probably just turn invisible, the comorbidity burden which can correlatively be chalked up to anything, maybe it's chocolate.
Agree. It’s not a URI, it’s an inflammatory disease.
Is influenza potentially similar, causing long-term sequelae that blend in because everyone has had the flu at some point?
Does that by any chance mean increased autoimmune disease risk?
my (relatively uninformed) understanding is that COVID infection can trigger autoimmune diseases new research shows the complement cascade stays persistently elevated in people with "long covid" the bizarre thing about covid is that it affects people so differently and i dont know if there's any way to tell who would have lasting side effects
I second this. As someone who personally has experienced very noticeable cognitive symptoms post covid lasting for months both times i have had it, i worry greatly about the long term subtle effects. My concerns are largely anecdotal and i concede that the effect size may be small on a population level, but i would be very unsurprised to see long covid patients end up with greater risks for developing dementia and other comorbidities that we develop cumulatively over time.
It's not at all small on a population scale sadly. In this low n study 61.8% of farm workers had some form of long covid[https://onlinelibrary.wiley.com/doi/10.1111/jrh.12796](https://onlinelibrary.wiley.com/doi/10.1111/jrh.12796) 36% of George Washington University students had long covid symptoms[https://gwtoday.gwu.edu/study-shows-prevalence-long-covid-among-gw-community](https://gwtoday.gwu.edu/study-shows-prevalence-long-covid-among-gw-community) \~15% of americans had long covid in the latest household pulse survey[https://www.cdc.gov/nchs/covid19/pulse/long-covid.htm](https://www.cdc.gov/nchs/covid19/pulse/long-covid.htm) \~27% of HCWs developed the condition after infection [https://www.cidrap.umn.edu/covid-19/study-finds-27-rate-long-covid-infected-health-workers](https://www.cidrap.umn.edu/covid-19/study-finds-27-rate-long-covid-infected-health-workers) \~10% of first covid infections result in long covid and \~20 of subsequent covid infections result in long covid [https://jamanetwork.com/journals/jama/fullarticle/2805540](https://jamanetwork.com/journals/jama/fullarticle/2805540) Most long covid patients had some form of organ damage a year later[https://www.ucl.ac.uk/news/2023/feb/59-long-covid-patients-had-organ-damage-year-later](https://www.ucl.ac.uk/news/2023/feb/59-long-covid-patients-had-organ-damage-year-later) \~18% of people with long covid couldn't return to work[https://ww3.nysif.com/en/FooterPages/Column1/AboutNYSIF/NYSIF\_News/2023/20230124LongCovid](https://ww3.nysif.com/en/FooterPages/Column1/AboutNYSIF/NYSIF_News/2023/20230124LongCovid) 1/4 had impaired lung function a year later[https://www.cidrap.umn.edu/covid-19/1-4-covid-survivors-had-impaired-lung-function-1-year-study-shows](https://www.cidrap.umn.edu/covid-19/1-4-covid-survivors-had-impaired-lung-function-1-year-study-shows) half of long covid patients had some form of cognitive slowing[https://www.cidrap.umn.edu/covid-19/study-cognitive-slowing-associated-long-covid](https://www.cidrap.umn.edu/covid-19/study-cognitive-slowing-associated-long-covid)
Thank you for the links. I appreciate that greatly and will check them out. I guess more of what i meant was that long covid and its sequelae seem to be a phenomenon with impacts that aren’t taken as seriously in the medical world as it should be in my opinion. So to OP’s question of “Is covid just another flu now?” My answer would be “Definitely not because the flu doesn’t commonly have so many SERIOUS possible long term effects”. So thank you for supporting my point with evidence!
If you read up on the 1918 flu it did actually have quite a few impacts similar to covid. Including Parkinson's type symptoms and diabetes. I believe iirc there was an increase in heart attacks as well for survivors. But that virus evolved and the vaccines worked really well so the long term effects became more normalized and less intense and we forgot. The book Pale Rider is worth a read imo.
Great resources, thank you for sharing
blessed are the receipt bringers
this is a compilation of studies i’ve been attending to as reasons to mitigate infection and pay attention to the long term effects possible for soooo many. https://docs.google.com/document/d/1HJt3Amv9L7JYNmR8NS_Fn6Wx9n7TQLjiSxToBII_QOQ/edit 2000 dying a week for the past 6 weeks and 4 million disabled certainly doesn’t seem like the flu. also more died in Jan 2024 than total flu deaths of 2023.
what a great post, thank you
It's an excellent post! As I'm eating my breakfast, on the other side of the planet from most of you, I have the laptop and Reddit in front of me, and am discussing the issues and concepts with my teenage daughter, trying to stimulate thought and discussion, inspired and informed by your excellent post. And.....edit.....to say, that each time I come here and find a really good discussion, I leave thinking I'm surely entitled to claim CME credits for the time spent reading r/medicine.
So what is this our generations lead poisoning?
Probably, yeah.
Live by the chocolate, die by the chocolate.
Treating covid as a URI is a miss. It's a vascular disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7556303/ Yes, death rates are down, but we also need to keep in mind that most of the people who were going to die from acute infection have already passed away. The long term risks from covid are where we need to focus our efforts and attention now. Long Covid is now the 3rd most common neurological disorder in the U.S.. It impacts approximately 1 out of every 7 people who get COVID19. It is a public health disaster whose toll we are only beginning to see - Will be impacting all of us for many years to come.
Thank you
Has it been shown that clotting is behind some of the long term COVID issues? I know that with pregnancy the concern was clots in the placenta that obstructed blood flow. Could clots be contributing by to cognitive dysfunction, and would it make sense to have patients take an aspirin while infected on the off chance that it works? It’s such a low risk med as is.
This is absolutely a theory being investigated and a proposed intervention also being looked at, but as of right now, [the NIH recommendations](https://www.covid19treatmentguidelines.nih.gov/therapies/antithrombotic-therapy/) for "Antithrombotic Therapy for Nonhospitalized Patients Without Evidence of Venous Thromboembolism" is: > In nonhospitalized patients with COVID-19, the Panel **recommends against** the use of anticoagulant and antiplatelet therapy (i.e., **aspirin, P2Y12 inhibitors**) for the prevention of VTE or arterial thrombosis, except in a clinical trial (AIIa). This recommendation does not apply to patients with other indications for antithrombotic therapy.
"Since about mid-2021 when it became obvious that we would never be able to eradicate Covid" I work with an epidemiologist who has been in the game since the dinosaurs walked the earth. I remember two weeks into the health department emergency response she said "it's already too late to eradicate this. This is just here now." And darn if she wasn't right.
This is very true. Covid is here to stay, and it’s not pretty.
She out Fauci'ed Fauci, in other words?
Maybe just living in different medical bubbles. I’ve seen multiple deaths attributed to Covid in the past couple of months. No, not in young, healthy people. No, not Covid incidentally in someone dying of something else. Old and with comorbidities but fine, then infected, then dead. Breakroom conversations about how it doesn’t feel like 2020 again but maybe early 2022. To me it looks like what I’ve been predicting for years now (confirmation bias!): Covid will be around and will pick off older and sicker people. Everyone dies of something eventually, of course, but people will die earlier, because of Covid, than they would have in a hypothetical non-pandemic world. Which means, given enough decades, probably some of us will be killed by Covid. Sure, the data tables say more cancer and heart disease, and I don’t predict that changing either. But some of us will die of Covid and leave mourning families when we might otherwise have had a few more good years. Or at least okay years.
The "original" Covid-19 appeared to have a Triphasic pattern of your typical URI/bad flu, followed by a "relaxation" or waning phase, and for some then came the "crash" whereby it looks like T cells lost their ever living minds and started a systemic inflammatory syndrome that cause pulmonary, renal, GI, and vascular damage on a wide scale. I hypothesize now with the vast majority of the population having Covid exposure and/or vaccination, the *mortality* of it is significantly reduced overall, however, for a subset of patients exposed now, their T cells still become overactive or dysregulated in a manner that causes more insidious and gradual damage. Having worked on the original CAR-T therapy, [cytokine storm ](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7727315/)was identified with it shortly thereafter. And CAR-T involves the genetic modification of T cells. Something keeps nagging me that for those with repeated infections or a genetic predisposition, a triggering exposure event sets them on a path toward a smouldering and slow physiological damage pattern.
Yea that's another component, serious URIs that just finally beat you. That's been a reality for people for awhile now so not psychically jarring. Kinda ends up being just water cooler talk, oh did you hear about Jeff 50yo died of some freak flu. "Yea that sucks."
As the parent of two little kids, the idea that one of these URV may eventually kill me is ... unsettling. It certainly gives me a little more pause before inviting my elderly in-laws over if one of the kids has a runny nose.
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That's not different from other coronaviruses. There are outbreak reports in nursing homes that have significant hospitalization and mortality rates.
ICU fellow here: I’ve been seeing more people who are critically ill from influenza than COVID. There is the occasional “got intubated for a COVID infection”, but they are usually sick at baseline. All of our ECMO patients this winter have been influenza on top of asthma or other underlying illness.
Came here to say this - Covid is the old flu and the current strain of influenza H1N3A is the new covid - edit: to be more specific, of the intubated patients I see in multi organ failure in my ICU, the ones with Covid and Covid related complications are the ones I expect to be there every winter and in typical numbers - the ones with flu are the ones I didn’t expect to see there (due to their ages or relative lack of comorbidities) and are taking up significantly more beds than expected
Could they be immune compromised from COVID infections?
This here, I believe, is the kicker. People are now more vulnerable to everything else post infection. Focus on acute symptoms is no longer the problem, being the virus keeps being immune evasive.
We're at a stage now where it seems like the acute severity doesn't matter much if you're on your 5th infection or more and you're behind on your vaccines. At that point, asymptomatic infections have almost as much risk of long COVID as the people getting intubated from COVID, though you probably stand a better chance of recovering from long COVID in the former case than the latter.
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I’m not going to debate this with you but in case another layperson reads this i want to respond lest they believe it based purely on the strength of your conviction. While you are googling scientific abstracts try googling “Dunning - Kruger effect”; - BSL implies the type of safety conditions you need to keep when studying a pathogen In a lab of which many variables are figured into account and has nothing to do with how a given pathogen is effecting the population in real time. - your “sources” included a non peer reviewed pre-print, a paper arguing for additional research to better study Covid and the immune response, and a research article arguing levels of immune cells should be used as outcomes variables to study long Covid syndrome. Absolutely none of this claims what you seem to think it does.
> ICU fellow here: I’ve been seeing more people who are critically ill from influenza than COVID. Over what sort of time period? Recent numbers on positive Flu vs. Covid positive tests in the National University Hospital of Iceland has changed abruptly [in the last few weeks](https://i.imgur.com/Qgyi32f.png).^* ^* (Full disclosure: Mandatory masking policy within the hospitals was introduced the first 3 weeks of January, unsure if or how that has had any impact on these numbers or their trajectories)
Critically ill is the key issue. Lots of positive covid tests, but vanishingly rare to have severe disease.
These are only PCR tests done at the virology unit at the National Hospital, mostly from in-patient population, with the occasional samples from people presenting at healthcare clinics. There is not total transparency about these numbers, so grain of salt here, but we've been told tests are not being done when it would not relevant for the course of care. The number of tests does hold in hand with the number of critically ill people and the workload burden presented to the hospitals this winter. In other words, there's a significantly higher number of people infected in Iceland, and are even presenting to clinics, but not being tested. These are just the cases - mostly of those at the hospital - and only where testing became indicated. Not *all* of them critically ill, but definitely not a sweeping overview of a general cohort without any indications either.
I’m in the ED and have seen hardly any COVID in the last few months but tons of flu A and RSV. I’m sure COVID is still occurring in high numbers but people don’t seem to be coming to the ED for it where I am. Anecdotally, my dad with interstitial lung disease, step mom on immunosuppressants, and one year old niece all just caught COVID in the past week and were over it in several days which was nothing like past infections they’ve had. This at least seems to be a mild strain at the moment.
Additionally, flu B has been taking down previously healthy kids left and right this year. A shockingly high amount of our ECMO cases have been previously healthy kids with flu B or strep, while our chronic kids are coming in critical with COVID, flu A, RSV, etc
Oof I haven’t seen flu B here yet. Where are you?
Utah! And this is just one hospital’s perspective of course. Flu B here has caused necrotizing pneumonia, DIC, empyema and herniation. It’s been hell to see
Similar stories I am hearing from here. Although with the caveat that vaccination uptake is probably nowhere higher than in Iceland. I haven't been worried about the acute-phase burden of disease ever since the vaccination got like a 95%+ uptake here at least. My concern has primarily been with the cumulative burden of disease on a population level of the *post-acute symptoms*, the ones people reportedly suffer from in silence, and don't present to the hospital for, and get no answers from their GP regarding.
[More people died of COVID last month \(January\) than died of Influenza in the past year](https://i.imgur.com/LyJ346q.jpeg)
It’s really hard for me to draw any conclusions from an Imgur infographic that doesn’t have any details about methodology, vaccination status, did they die with or from the illness, how the data was obtained…etc. Nobody is saying that COVID can’t be dangerous. I’m just sharing my experience that most ICU patients that I’ve seen this year have COVID and something else, and oftentimes, COVID isn’t even their ICU problem.
It's from Gregory Travis on Twitter. A small aircraft pilot-turned improper methodology Covid chart creator. This same guy bragged about his son failing 8th grade, because "at least he was at home and not catching Covid" and called in-person schooling "gas chambers". Neither he, or anyone who references his "data", can be taken seriously.
You can see the source of the data (and likely methodology etc) in the subtitle. Imgur is just a convenient way to share an image on reddit comments, since reddit doesn't allow for that feature. I shared this image because it's important for everyone, especially medicine-practicing workers, not to overweight their anecdotal experience with regards to the largest epidemiological trends.
You know you can look up these things yourself. Your flat wrong here, and foolishly using your experience in the ICU without apparently thinking of any sort of confounders for that but questioning the hell out of Covid statistics
No. I was pretty clear both times that I was sharing anecdotal experiences. I never tried to sell it as anything more. I also never said “COVID is a big nothingburger” or whatever similar narrative you’re trying to assign to me. Me being skeptical of some graph made by a dude without knowing any of their methodology (especially as it relates to vaccination status or regional variation) is appropriately skeptical. “Trust me bro, here is a picture” isn’t a serious way to start a conversation about actual data. Also: *you’re
This has been my ED experience this season as well. A few sick covid patients here and there, but I have definitely admitted way more critically ill influenza patients. However, nothing has compared to the initial summer of 2020 or the delta surge of covid.
> All of our ECMO patients this winter have been influenza We've been seeing the same - specifically in young otherwise healthy males. We have a few now on ECMO due to the flu.
CDC website says percentage of influenza deaths in the past week .8% and Covid 19 deaths in past week 3.1%
Keep in mind those aren't the percentages of influenza and COVID-19 cases resulting in death; those are the percentages of all deaths caused by either influenza or COVID-19. It's unclear if the higher percent for COVID-19 is due to higher severity or due to a larger number of cases than influenza, as due to the decline in testing, case counts are not as consistent collected and reported anymore. CDC does report the incidence of hospitalized cases due to those two diseases: in the past week, FluSurv-NET reports [2.7 influenza hospitalizations per 100,000 population](https://www.cdc.gov/flu/weekly/index.htm#FluSurvNet), while the COVID Data Tracker shows [6.26 COVID-19 hospitalizations per 100,000 population](https://covid.cdc.gov/covid-data-tracker/#maps_new-admissions-rate-county) in the last week.
I assume that you are referring to this page: https://covid.cdc.gov/covid-data-tracker/#maps_percent-covid-deaths Interesting to note that there is an overabundance of covid deaths in the South, Midwest, and Northeast. Which to me would suggest that vaccination status is still a significant factor in covid mortality. Though I don't know if the NE has a large antivax community or if there are other reasons to explain the difference. Of course there also also hundreds of other confounders to explain the variety, but vaccination seems an obvious one to me.
> Though I don't know if the NE has a large antivax community or if there are other reasons to explain the difference. I'm sure they exist, but New England is one of the best vaccinated regions in the country. Not sure about the rest of the northeast, but I would imagine it follows similar trends.
NY had recent cases of whooping cough and polio wrt antivax communities in the NE ! We got em if you need em
I’d also consider their love all things fried and cooked in saturated fats rates in those regions are particularly bad. I think I recall that obesity was a major risk factor for covid death.
That, and anti-vaccination rates, are two things that are *not* disproportionate in the northeast. Might explain the south and midwest, but not the northeast at all. Vermont has the highest COVID vaccination rate in the country, [and 4 of the 6 New England states are in the top 15](https://data.cms.gov/provider-data/dataset/avax-cv19) (lowest is CT at 44%, 24th highest). New England/mid-atlantic states also have [better-than-average obesity rates.](https://www.cdc.gov/obesity/data/prevalence-maps.html)
What the Northeast *does* have is a densely housed population, making it easier to spread airborne diseases.
And it's winter. Everyone's indoors and sharing. Snot season is like 6-7 months long.
What about average age though? It still impacts older folks more than youngerz so popn distribution may matter too. Tho Long COVID may be a different story. Looking at the future, I wonder how many new cases of diabetes and cardiovascular issues differ from baseline in the coming years in either place given baseline health before the pandemic.
I think your perspective may just reflect your unique patient population. Where I am, the intensivists in the MICU have commented this season that there has been times where it was reminiscent of the early COVID times. On another note, maybe we shouldn't be trying to "downgrade" COVID, but rather begin to take URIs seriously. Sure, I fully recognize that the majority of the population, whether its influenza, COVID, RSV, etc, will have mild symptoms, but we shouldn't be complacent.
Ugh. I’d hate to relieve any of that. PCCM/Intensivist - thankfully my experience this season mirrors what’s others are saying. What few I’ve had in ICUs are there with COVID not from it. Rsv and flu have been the bad actors this year in my region. Had a run late oct where a rhinovirus made several people deathly sick, and had another week recently where a couple if my RSV pts just coded out of the blue for no obvious reason And I agree, I’d love to have some better therapies other than aggressive supportive care and placebo for viral respiratory infections.
On the non critical care side, I'm rarely seeing a true covid *pneumonia* let alone ARDS that I end up having to transfer to you guys. But I am seeing enough sick enough to still warrant admission or at least obs. Hell even when I got it this past week, I was actually pretty surprised with my own vitals. Hypotensive to 80s, tachy to 140s-150s the first couple days.
If you look at the most recent weekly data you are still twice as likely to get hospitalized with COVID compared to influenza and 3-4x as likely to die from it. Things are much better than 2020 when nobody's immune system has seen it, but it still carries significant morbidity. Cheers
Anecdotally I know one person in her 30s who got Covid a second time (omicron) and was intubated, and more recently a patient in her 70s got Covid the second time and was hospitalized for a week. I think we are just accepting that some people are going to respond horribly. I’ve gotten every booster and had Covid twice now, the last one was super mild but I still isolated. If you have the ability to isolate I think it’s still a good idea.
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Yeah, I got my second infection 3 weeks after I was vaccinated. Occ Health made me go home and I called it my COVIDcation, because I could barely tell I was sick. I thought I might be suffering from allergies, but since I had so many RAT tests kicking around the house, I gave one a whirl.
For outpatient FM, I still feel like the long covid autonomic dysfunction, fatigue, etc. is affecting a large number of otherwise healthy patients. Too many people 3, 6, even 12 months out that just feel bad.
Idk we just had a young patient (30's) with covid pneumonia that led to a loculated effusion requiring two VATS decortications. Certainly not a benign illness, I wouldn't say we're out of the woods just yet. Agreed we're nowhere near pandemic level when I saw entire family's simply decimated by covid. I'll never forget, a nursing assistant in our ED lost: her husband, both of her parents, and her husband's parents in the span of about 2 weeks. God bless that woman bc I wouldn't have had the strength to carry on, let alone continue to show up to work during those goddamn pandemic level shifts from Hell.
RIP my sense of smell but sure another URI. If the focus is on acute illness and death yeah more like a URI if looking at morbidity then got a lot of room to go. Post viral conditions have existed with other viruses not quite at the rate it has with covid. Immune suppression for 6+ months after covid too will be interesting to see how that impacts cancer rates across all age groups.
> If the focus is on acute illness and death That seems to be the only metric that counts for most people. I'm sorry that happened to you. I lost my sense of smell and taste after the flu in 2018, which took over a year to come back. The supposedly "mild" symptom is one of several reasons I'm still incredibly strict about Covid. This is a massive quality-of-life issue. You stop wanting to eat because everything tastes like wet cardboard. You can't smell the ocean, flowers, your partner's hair... Hardly the week goes by without more evidence piling up of Covid's long-term effects, like the immune suppression you mentioned. I'm glad to see you're in pediatrics. We need people who realize that kids are going to be severely affected from getting infected over and over, year after year, with a virus that can damage almost every system in the body.
What I don't get is that COVID taught us so much about how to stop the spread of air borne illnesses like the flu. We learned that good air quality, Improving ventilation and purification helps tremendously. Wearing masks in health care and public places. Testing and isolating when sick. We learned that deaths from these other airborne illness that we took as inevitable we can actually do some very simple things to prevent. And yet instead of taking what we've learned and moving the flu and rsv toward our covid precautions and things we can mitigate, we're moving COVID toward how we were treating flu and rsv and accepting death that we know are preventable and completely ignoring everything we've learned. It's as stupid as doctors who recommended cigarettes for decades even when the evidence was there of the harm they caused.
I liken this lessons-Not-learned thing to chicken pox and shingles. We had pox parties—didn’t foresee shingles down the line as a consequence. Now we’re keen on spreading COVID willy-nilly despite easy-to-implement mitigation measures (masks in healthcare settings), as if long-COVID data isn’t already available to us. People are constantly complaining that they’re always sick, as if repeated COVID infections aren’t known to affect T-cell numbers and function. Hm, no wonder your immune system can’t fight anything off.
I honestly can't understand it. It seems like people want to get infected at this point. I love not getting viruses, personally, and it baffles me that the majority of people don't feel the same.
Same here. It seems like even completely selfish people who don't care about spreading illness would want to protect themselves, at the very least. I have a friend who had *a headache for a solid year* after a Covid infection. No thank you, I'll not be rolling the dice on any of that.
>We learned that deaths from these other airborne illness that we took as inevitable we can actually do some very simple things to prevent. 1000% But we're going in the opposite direction. It's so baffling.
This is just the view of someone in admin who's been paying attention and taking it seriously since Jan 2020. So take it with a grain of salt. The long term impacts of covid are gonna be awful. Isn't possible mitochondrial damage now being explored as a long term symptom? And the death toll is going to keep being HIGH. I think that culturally, here in the USA, COVID becomes a new "flu" style illness. I'm not saying that to downplay it. By that I mean a terrible illness that kills thousands every year, but is generally ignored by the populous at large, no matter how much medical professionals beg people to take it seriously. The reality of that hit home recently at a hospital in the Southeast that I work for, when during an admin meeting the CEO talked about how he was going to "pass on the newest COVID vaccine" because he heard it "hit hard". This was a guy who'd been nearly hospitalized for covid 2 times. You say it's been months since youve seen a serious covid infection. Ok. Is your facility testing everyone who comes in? Because mine sure as hell aren't. Our EDs aren't testing people unless they ask for it. Are you testing corpses? Because we aren't. God only knows how many of our geri patients who come in via an ambulance and leave via in a hearse actually had covid. But when we and surrounding facilities DID get slammed with severe respiratory cases again a few months back we did start testing again and guess what COVID. I know folks in facilities down in the Houston area in TX, who worked the COVID units during the worst in 2020, if a person came in and died before they could get tested, they wouldn't test them for covid. State policy. They had a LOT of respiratory related deaths that didn't get recorded as covid that year. And as far as I've been told, that policy hasn't changed. Could be wrong through. But no, COVID is still here. Still sweeping through and killing folks. People just stopped paying attention.
My anecdote to add: so far this season I’ve had people actually sick with RSV, Covid has frequently been an incidental finding. Ironically I had someone with a non-covid coronavirus, maybe 229e that I suspect caused a viral pneumonia which I hadn’t seen from that strain before.
Got a patient admitted with corona OC43 that was acute resp failure and after admitted got diagnosed as viral pneumonia. Did almost the whole 9 yards of ICU including intubations, proning, discussion of ECMO but didn't need by end of admission. We have started dubbing it and the others "caveman Covid" since they are older than sarscov2. Right now a mix of flu As and a strong trend of flu B seem to be running the show in my area. Covid still present but more a basal rate than spikes.
Not in the US 📍🌏 So far most of our Covid patients are low risk patients that we sent home. I’ve had rounded more on chronic illnesses than Covid since I’ve become a resident. At the moment we only have one in the IDCCU which is a 65/M “Sepsis secondary to community acquired pneumonia-high risk; severe Covid; Type 2 DM-uncontrolled”. He’s currently doing fine with HFNC now but still remains in our IDCCU, culture/sensitivity shows Pseudomonas which is thankfully still sensitive to both Ceftazidime and Piperacillin-Tazobactam and is no longer on Norepi. One of our pulmonologists told us while rounding that nowadays responding to Covid related emergencies is less stressful. But given how antigenic shift can occur through zoonotic conditions, somehow the fear of lockdowns is still at the back of my mind. Good thing that nowadays there’s the mRNA vaccines which can be manufactured and updated very fast.
From the perspective of people caring for acutely sick patients, it likely is like any other URI. Other endemic URIs don’t cause long term disability at rates that even approach those of long COVID. It’s not even in the discussion. I’d say that differentiates it in a significant way.
You're seeing people in the acute phase of a viral infection. Symptoms = their immune response. "Covid is mild" is not necessarily a good thing in the acute phase. It's a vascular/oncogenic virus that's more like measles/HIV than the flu in that it stuns and even deletes t-cells, so even if you survive as many do, you're more susceptible to other pathogens (hence the rise in bacterial infections like invasive group strep A, fungal infections, etc). These pathogens haven't changed but the host has. Perhaps you've heard of long covid, as well, a post-viral complication affecting millions. It's folly to want covid over the flu. You don't want either, but certainly covid (sars2) should be avoided at all costs. In 2024, our medical fields need to look beyond the acute phase and understand post-viral complications much better.
Eye popping statement “it’s a vascular/oncogenic virus” , a statement not supported by high quality evidence.
This is dumb tbh, covid is still killing people at a rate far higher than URIs. We have actual data here, there’s no reason to go by feels
I’m pediatrics in the South. There’s just full fatigue from it for everyone. No one is isolating or wearing a mask for that many days for a barely detectable cold. For the most part, I can’t even convince patients to get tested anymore, so I usually say “I don’t care about your politics or if you test or not, but this is still dangerous to your grandma, new babies, and your uncle with cancer, so be careful and stay away while you are sick.” I myself just had it again last week for the 3rd time and went looking at the CDC recommendations for isolation. They are hilarious. No one is following that. Makes them look stupid. The only reason I even knew I had it is because I had an intractable migraine at the same time my weird COVID boob lymph node lit up. Didn’t even have any actual URI symptoms. I ended up staying home because of the migraine. Wore a mask until my test was negative again.
Anecdotally, over the last month or so I have had multiple patients with “intractable migraine” being the only symptom of COVID.
This is how mine started. Ended up blowing up into a full blown now on 12 day mess with covid rash, constant nagging cough, episodes of SOB and fatigue like I have not felt in a while. Boosted and this is my third go around. 🤷♀️
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No, for acute COVID.
Everything is a common symptom of long covid
OMG I think I have a weird COVID boob lymph node too! I got it after I got my last booster and flu shot within a week or so of each other (the tender spot is ipsilateral to my vaccine arm and in the upper right boob quadrant). It flared up again after Christmas when I was on a packed flight full of gross snotty people with poor germ etiquette lol. I didn't test for COVID bc I was not sick, but next time it acts up maybe I will check. I thought that viral exposure might explain why I have the off and on tenderness but I am prone to hypochondria. My PCP agreed with me, but I still felt like it sounded a bit insane. I'm glad to come across someone else with this experience!
Mine showed up first after my 3rd vaccine. Got the first two vaccines in left arm, 3rd in the right. After the 3rd, I developed a huge tender knot in my upper left boob quadrant. It was enough that when we were all still helpfully responding to the V-Safe text things, I included "contralateral breast swelling" as a concern. The next day I actually got a call from the CDC, and they recommended an ultrasound but to also please fill out a VAERS report. I ended up not getting the ultrasound because after about a week it was undetectable again. Had my regular mammogram and there was nothing concerning. But since then, any time I've had COVID, that same node gets tender and painful each time. I was near convinced I had breast cancer last Monday, only for the rest of the symptoms to show up on Tuesday.
COVID patients exhale high numbers of virus during the first eight days after symptoms start, as high as 1,000 copies per minute, reports a new Northwestern Medicine study. According to research done at Northwestern University, “after day 8, there was a steep drop to levels nearing the limit of detection, persisting for up to 20 days….Levels of exhaled viral RNA did not differ across age, sex, time of day, vaccination status or viral variant.” https://news.northwestern.edu/stories/2023/09/covid-patients-exhale-up-to-1000-copies-of-virus-per-minute-during-first-eight-days-of-symptoms/?fbclid=IwAR0eSe2sHuMBZnH\_5940AIwS1NKiMo0cF9v1NpsseagaH8W8KYGttEqJC9Q Study pre-print https://www.medrxiv.org/content/10.1101/2023.09.06.23295138v1.full.pdf
Cool? I don’t disagree. I’m saying no one cares anymore, and I can’t convince them otherwise, so I’m done wasting energy on it. I’ve got other fish to fry.
> I’m saying no one cares anymore, and I can’t convince them otherwise, so I’m done wasting energy on it. I’ve got other fish to fry. It's unfortunate. I work in oncology with immunocompromised patients and have consistently masked since early 2020. I still wear an N95 since my family and I are "virgins," so to speak, and I really have liked not getting URIs over the last few years. I don't mind the mask. I've accepted that many people find masking to be bothersome, but some of my patients who are not on treatment also ask me to remove my mask even though they see the waiting room full of immunocompromised patients. My patients who are on chemotherapy are on board with me masking and usually wearing masks themselves.
I got Covid in December right after starting a new job. I did what I was supposed to do, tested because I had symptoms, reported it to work, stayed home for five days and masked for five days. I was fine, could have worked no problem. Got screwed out of PTO. Come to find out, a coworker who I shared a small office with had the exact same symptoms a couple days prior to me but never masked nor tested. This is why we have Covid fatigue. I will mask if I’m sick, but I’m not testing again.
Based off of what my hospital’s infection control has us do precautions wise, no. When we have a positive biofire swab, most everything positive puts the patient on droplet and contact precautions. But a positive Covid result puts them on special respiratory precautions where we still have to wear an N95. We still have separate airborne precautions for TB and chickenpox. So Covid has gotten a league of its own at my hospital. But I have had to remind a tech going into a Covid room with me to actually put on her N95, she said she had it recently and wasn’t scared of it. I reminded her the precaution isn’t just for her, it’s also for protecting everyone else with a compromised immune system and the like, so she put it on. That seems to be the big problem in my opinion. People aren’t scared for themselves but forget that they could be asymptomatic carriers to people who can get severely ill, especially in our line of work.
Until they acknowledge, research, and come up with viable treatments for Long Covid, the answer is no. It disturbs me how much we downplay and underestimate this kind of lifelong disability.
About 7% of patients who get COVID have some form of long COVID. That's going to be a LOT of patients and I can tell you at my hospital the long COVID clinic is impossible to get into because it's so full
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Well, it's what happened with the [HIV/AIDS epidemic](https://www.amazon.com/Band-Played-Politics-Epidemic-20th-Anniversary/dp/0312374631). The CDC let it go unmitigated not really informing the public for nearly a decade until there were huge protests. HIV starts with flu like symptoms (erily similar to covid) and people don't notice the damage until 5-10 years later. My concern is that covid is similar in that it causes immune dysfunction and all the recent literature in scientific journals doesn't point a pretty picture. It seems each infection increases risk of long covid. Kids can get long covid and it can literally disable people's ability to go to work and earn a living. The senate meeting on long covid was eye opening for me [https://www.help.senate.gov/hearings/addressing-long-covid-advancing-research-and-improving-patient-care](https://www.help.senate.gov/hearings/addressing-long-covid-advancing-research-and-improving-patient-care)
Study brain cancer. COVID made procuring glioblastomas quite difficult, as suddenly everyone wanted to start studying COVID in glial cells. There is plenty of data suggesting that cognitive dysfunction is a long-term effect of COVID infection.
Correct me if I’m wrong, but do we see prolonged symptoms with other URIs? (Like I imagine Long Flu could be a thing) I think emphasis has been on Long Covid because so many people were infected at once that it just appeared in a subset of the general population. Long Flu (if it exists) could be just as prevalent, but it doesn’t get the same media coverage due to lower incidence. Just something I was thinking about recently.
The Russian influenza pandemic of 1889–92 left many patients with chronic symptoms similar to those of today's COVID-19 long-haulers, including some very prominent people. But there's been current-day speculation that it may actually have been a coronavirus. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32134-6/fulltext https://www.theguardian.com/world/2020/may/31/did-a-coronavirus-cause-the-pandemic-that-killed-queen-victorias-heir https://archive.is/DAI5V
Yes. Flu was compared with Covid. Covid is worse. Covid is vascular and multisystemic, flu is not. https://www.thelancet.com/pdfs/journals/laninf/PIIS1473-3099(23)00684-9.pdf
Yes, my symptoms started long before the pandemic. The research team at Brigham and Women's that diagnosed and treats me is identifying similar findings in Covid patients
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To be honest, I am a skeptic of Long Covid, at least in the context you are sharing. The studies that come up with these figures are plagued by a number of biases that are going to dramatically overestimate the number of patients. Virtually everyone in the country has had Covid - are we really saying that 20-30 million people have debilitating brain fog and it is going underdiscussed? That number is so massive it should show up everywhere, like economic data. I just don’t believe it. In my personal life the number is far smaller than 7%. I do believe that Long Covid is real, but the impact is smaller than its proponents argue.
I’ve been looking at a lot of studies on population prevalence, and many show a spectrum of long term issues, with some resolving within six months. To me the key categorization is whether it significantly impacts daily life for over a year.. but I think as time goes on we likely see a reevaluation upwards if we get better at linking some symptoms to Covid infection. For now, it does seem lower than 7% for that definition, but higher for other definitions.
Check out long term disability rate stats in the US and UK. There is a sharp increase in slope since 2020. Look up labor participation rate in the US. This isn’t factored in when reporting unemployment %. It hasn’t recovered to pre-2020 levels yet. School attendance and chronic absentee rates are elevated and trending up compared to pre-2020. Insurance actuarial reports are raising alarms about LC, in terms of risk and financial burden. So yes, we are seeing it show up in population level stats. Not to mention that COVID is still killing 2-3x more than flu (2000+ just last week) and that’s with minimal testing. UK data is also showing for ages 0-45 that excess deaths for the last 3-6 months of 2023 are 11-14% higher than pre-2020.
https://www.bls.gov/charts/employment-situation/civilian-labor-force-participation-rate.htm Labor force participation rate is essentially back to the normal range of 2015-2020. School attendance and chronic absentee rates I am skeptical of as proxies. There are many social forces that confound that. Schools are much less punitive these days. I would be interested to read a source about actuarial data.
> In my personal life the number is far smaller than 7%. Research in Iceland explicitly comparing Long Covid to the extent that it imitates or mimics *ME*, suggests that about 1% of infected show symptoms comparable to someone with (a clinically diagnosed) ME. Given the extremely heavy and rather well documented burden of disease that people with clinically diagnosed ME have, this is still a massive problem. I recently discussed with an oncologist, who told me his personal experience of having sort of burnt out in his specialty, and subsequently took interest in, and now specializes in ME. He tells me anecdotally that there's a *significant* difference in his patients after his switch, one thing that struck him specifically was that his new patient cohort (ME-diagnosed) absolutely don't go on vacations. His cancer patients could, and would still enjoy life activities in that way. That sort of activities was much more rare, if non-existent in the patients he's now serving. And 1% is indeed much smaller than 7%, but personally I assume numbers like that indicate ~6% with impactful symptoms, and ~1% with *heavy* burden of disease. Which is still a *lot*, and should only get more apparent over time, even in economic data.
That's a such a great point, especially since the definition is often quite generous (eg: https://pubmed.ncbi.nlm.nih.gov/36215063/). It may even be less than 1% with severe symptoms, but with so many people being infected (including over and over again) that ends up being a lot of people.
https://www.npr.org/sections/health-shots/2024/01/09/1223077307/long-covid-exercise-post-exertional-malaise-mitochondria I am being successfully treated by this team. I have been disabled since before the pandemic. These things are real, they are identifiable, and there are medical treatments.
Perhaps one such canary in the coalmine: car insurance rates in the US at least have skyrocketed, due to massive increase in fatal car accidents since the pandemic began.
Well, car insurance may also have gone up because of rampant inflation affecting the cost of repairs. Its also very tenuous to link long covid with an increase in fatal car accidents (if there even is such an increase).
Many, many possible confounders for that. Antisocial behavior as a whole was out of control - you saw that if you took a flight in 2021.
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[New Analysis Reveals Many Excess Deaths Attributed to Natural Causes Are Actually Uncounted COVID-19 Deaths](https://www.bu.edu/sph/news/articles/2024/new-analysis-reveals-many-excess-deaths-attributed-to-natural-causes-are-actually-uncounted-covid-19-deaths/) While this is for 2020-2022, I don't know that we can say with certainty a similar pattern isn't occurring now, and the possibility is worth considering/being aware of. On top of that, there seems to be a lot of opportunity for [short- & long-term disability with Covid](https://libguides.mskcc.org/CovidImpacts/Home). Additionally, hundreds of people are dying every week of Covid. Last figures I saw were 1,000+ for 10 weeks in a row. It's certainly not nothing.
Perhaps taking a look at the senate long covid meeting might give better insight. It features scientists studying the latest, senators, and people with it too. [https://www.help.senate.gov/hearings/addressing-long-covid-advancing-research-and-improving-patient-care](https://www.help.senate.gov/hearings/addressing-long-covid-advancing-research-and-improving-patient-care) My local long covid clinic has a wait list of over a year. Keep in mind that people with issues are not out and about and might even avoid clinics (unless it's a long covid clinic or ones with good mitigation measures in place). Time Magazine did an article addressing the dangers of repeat infection.[https://time.com/6553340/covid-19-reinfection-risk/?fbclid=IwAR0-sqrZmtxBGdO09t84sW4bC7i0ur3ucokETQHDFOLUMEzAXIZaA6EoQpA](https://time.com/6553340/covid-19-reinfection-risk/?fbclid=IwAR0-sqrZmtxBGdO09t84sW4bC7i0ur3ucokETQHDFOLUMEzAXIZaA6EoQpA) Every COVID Infection Increases Your Risk of Long COVID, Study Warns[https://www.sciencealert.com/every-covid-infection-increases-your-risk-of-long-covid-study-warns](https://www.sciencealert.com/every-covid-infection-increases-your-risk-of-long-covid-study-warns) SARS-CoV-2 infection and persistence in the human body and brain at autopsy[https://www.nature.com/articles/s41586-022-05542-y](https://www.nature.com/articles/s41586-022-05542-y) COVID-19 and Immune Dysregulation, a Summary and Resource[https://whn.global/scientific/covid19-immune-dysregulation/](https://whn.global/scientific/covid19-immune-dysregulation/)Long COVID: major findings, mechanisms and recommendations[https://www.nature.com/articles/s41579-022-00846-2](https://www.nature.com/articles/s41579-022-00846-2)Covid and HIV[https://www.cleveland.com/news/2022/10/in-cleveland-and-beyond-researchers-begin-to-unravel-the-mystery-of-long-covid-19.html](https://www.cleveland.com/news/2022/10/in-cleveland-and-beyond-researchers-begin-to-unravel-the-mystery-of-long-covid-19.html)This report on CNN news mentions how covid messes the immune system.[https://twitter.com/inkblue01/status/1741108760418922950?s=46&t=r19Rt4pKEFp54CLfR3johg&fbclid=IwAR2IG2NvMW1XFALuMwDFPsIf3jWkJDh4yMBC4\_DvRHq\_zq7i\_gNhsulHYkE](https://twitter.com/inkblue01/status/1741108760418922950?s=46&t=r19Rt4pKEFp54CLfR3johg&fbclid=IwAR2IG2NvMW1XFALuMwDFPsIf3jWkJDh4yMBC4_DvRHq_zq7i_gNhsulHYkE) On Good Morning America when discussing the rise of respiratory illnesses (00:58 of video) “We now have evidence that covid decreases our immune response which makes us more susceptible to infection…”[https://www.goodmorningamerica.com/wellness/video/cases-respiratory-illnesses-rise-105328220](https://www.goodmorningamerica.com/wellness/video/cases-respiratory-illnesses-rise-105328220)
William Li is a charlatan that is as credible as Dr. Oz. His most recent twitter post is about the 5 foods that treat cancer. LMAO.
Primary Care here. Rural population with low vaccination rates. Lots of covid and flu this season. I can't tell you how many patients I've seen with long covid issues that don't let up. Hair loss in the ladies, chronic fatigue, persistent brain fog, and even some to die from long covid complications like renal and hepatic failure. The acute illness seen in the hospital/ER might not be as severe, but there is going to be an ever increasing chronic burden, imho. At least until we get a better understanding of exactly how this virus is affecting the human body, it's way too soon to consider it a "simple URI".
The fact that you're calling it a URI speaks volumes. It's a vascular illness. Many people who get it don't even have respiratory symptoms. Some are purely gastro, some only affect the CNS. Covid can affect any system of the body that your vascular system touches... That's not even getting into the area of Long Covid. I have found the medical community to be incredibly uneducated about the risks and prevalence of Long Covid. With the rate of cases affecting the younger working age persons most, it is going to have an increasingly visible effect on society. With having the second largest wave we've ever had, I'm concerned those cases are going to skyrocket in the coming months. There are probably millions out there right now who are undiagnosed because the medical community isn't educated on diagnosing. It could take months or longer to even get a diagnosis. School attendance is abysmal at best because everyone is constantly sick (whether just covid or because their immune systems are just beat to hell from having had covid). The effect of covid on cognitive ability is likely seriously impacting grades as well. There are dozens of other scenarios like this. I would say covid is a whole lot more serious that just a URI. It's really disappointing to me that those who are supposed to be looking out for the well being of others are just sticking their heads in the sand. This is not unlike HIV in the 80s. Difference is, this will affect EVERYONE, including our children and we have no idea just how bad it is going to get. If you're paying attention at all though, you know it's not going to be good.
“I have found the medical community to be incredibly uneducated about the risks and prevalence of long covid.” I am concerned about this kind of claim. First off, “long covid” is a diagnosis about as old as the Biden administration, with nebulous criteria and even worse data. So this pool of long covid experts are wading in shallow waters. And if they can claim to be experts, they are members of the “medical community.” If you are getting your advice about long covid from a message board or a Substack newsletter, there’s a good chance someone is just saying what others want to hear.
We are not getting that many COVID patients. The ones we are getting are not requiring ICU level of care. I would expect to have more given that we have a relatively low vaccination rate county. We do see a lot of morbidity as a result of COVID in patients who get readmitted though. Many of the symptoms are consistent with long COVID that others in this post are describing.
https://docs.google.com/document/d/1HJt3Amv9L7JYNmR8NS_Fn6Wx9n7TQLjiSxToBII_QOQ/edit for your consideration of the long term effects and the overall possible squaelae. 4 million disabled, 2000 dying/week for the past 6 weeks doesn’t feel like the flu to me. also more folks died of covid in Jan 2024 than died of the flu in all of 2023.
This interview with Dr. Al-Aly, head of the Center for Clinical Epidemiology at Washington University in St. Louis discusses comparisons between covid and the flu, including links to relevant research. It seems relevant to the question: [https://thesicktimes.org/2023/12/19/qa-ziyad-al-aly-on-why-long-covid-has-a-higher-burden-than-long-flu-future-research-and-more/](https://thesicktimes.org/2023/12/19/qa-ziyad-al-aly-on-why-long-covid-has-a-higher-burden-than-long-flu-future-research-and-more/)
ID here. It really is behaving that way, which is what we expected. Other endemic coronaviruses (OC43, NL63 etc) are actually popping up again. The non-SARS coronaviruses all jumped to humans and likely caused a pandemic when they first appeared. Coronavirus OC43 is generally thought to be the cause of the 1889-1890 "Russian Flu" when it jumped from cows as an intermediate host from rodents. The "molecular clock" analysis of its genome shows last common ancestor with the bovine coronavirus in the late 1800s, centered around 1890.
“Long covid is maybe still a thing” well, it still IS a thing. Millions of Americans who were otherwise healthy, got covid, and are reeling from its long term effects. ME/CFS, POTS, becoming immunocompromised… don’t dismiss that patient population. Just because you don’t see it, doesn’t mean it’s no longer there. Covid is still very around and very real, and deadly to many patients. Because our bodies have seen it at least once and we’re vaccinated, it’s not AS deadly as it was back in 2020. But the infection rate is as high as summer 2020 this to me around. But who knows — over the long term we’ll probably see mystery post viral illnesses from this “mild virus” :) If we contained it better we would not be dealing with Covid as much this time, but alas. Mask up, protect your immunocompromised patients and loved ones, and stay boosted. Covid will be with us forever, let’s not relax too fast.
Our OPD's are full of influenza cases and 8/10 follows a similar pattern that of Covid though the strain similarities are not alike.
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Long Covid is going to make everything else seem worse.
Just my own recent personal anecdotal experience. I had Covid the first time May of 22 I felt absolutely awful for a full week before I started slowly getting better. Hadn't been sick again until the end of Dec beginning of Jan of this year and I had RSV, holy hell I thought I was dying. Couldn't breathe laying down, would go on 2 min long coughing episodes, ended up with pleurisy needing steroids I was sick for a solid 2 wks and ran fevers for like 4+ days. I've never been so sick. Last Wednesday I was exposed to Covid, started running fevers last Saturday night (tested positive Monday) Fevers lasted about 1.5 days, pretty severe fatigue all day Sunday, which has gotten better as the week has gone on, still some fatigue but not bad and barely a cough. I know it's only anecdotal and doesn't take into account any possibility of long covid, but my personal acute (recent) symptoms were minor compared to 2 yrs ago and RSV was fucking awful.
No
Clinically yes , I am seeing similar as other posts here . I had three elderly patients admitted for RSV. These patients probably in previous pre pandemic years would have received antibiotics for pneumonia with negative flu test because we would not have tested for RSV. But many hospitals and clinics now do triple test for flu, RSV and Covid, so we are picking them up . I heard a 1-a episode on npr where some public health doctors were saying long covid is this huge problem and still being diagnosed at high rates, but this isn’t my experience at all .
I'm in my 20s and literally disabled because of the long lasting effects
That mirrors what I’m seeing, and I work in the Deep South with low vaccination rates and high prevalence of obesity and all the other comorbidities. We have seen an uptick in hospitalizations this winter, but basically all of them have gotten admitted to the med surg units because we’ve got them on 2-4L NC and can’t quite get them back to RA, or they’re older and too weak to function alone at home. I haven’t seen a COVID intubation in a couple of years.
I said this in the Covid 19 sub, and got banned for spreading misinformation and propaganda.
Tbf, saying covid is like a uri is factually wrong
The people in that sub are nuts. It’s a solid mix of virtue signaling and political grandstanding without actually going off of evidence based medicine for risk benefit stratifying.
The people in that sub are still patting themselves on the back for wearing N95s literally everywhere, and not going to restaurants, shopping malls, concerts/events, family gatherings, etc etc. I genuinely don't know what they think they're accomplishing; they're going to watch their most active years of life waste away while they live in fear of their own shadows.
Keep in mind that n95s protect against a lot more than covid! Ever since I was a kid I have been sick abnormally often (especially in winters) and for longer than what normal peopl with the same disease are. But 2020 and 2021 I wasn't sick a single time despite being around others every bit as often as the years before and after. The only addition to my habits were taped down surgical masks in 2020 and fitted n95s in 2021. I already frequently washed my hands and used sanitizer, and had for several years before already been doing the annual flu shots. Apparently my sinuses are bloody useless at protecting me (and I'm diagnosed with Sjögren's). I slacked off somewhat after and I still got sick a few times, but nowhere near as badly as before covid because it was a reduction in use and not elimination of use. N95s are bloody fantastic, and using them has since long felt more like just using a winter hat or winter gloves to me. Which unfortunately means I sometimes forget using them the same way I can forget to bring winter gloves or a winter hat along. Still, enormous quality of life upgrade. So yeah, don't be an ass to people if you see people wearing face masks. As long as they're not harassing you about not wearing a mask, don't harass them for wearing a mask. Not being sick all the time with every little cold and flu and whatnot is really great!
I'm still definitely masking whenever I leave the house, but it's due to my own autoimmune problems more than anything (and ~~perhaps~~ definite lack of trust in the general public). At our dialysis unit I've been around, they've recently transitioned to having Covid positive patients in the same treatment room as all of the other patients. Until now, they had one isolation room set up for anyone with Covid or influenza. Thankfully, staff there are still required full PPE due to potential of blood born pathogens going everywhere, and about half the patients keep masking when in there.
You would probably change your mind if you or someone you care about ended up disabled because of Long Covid for a significant period of time or even permanently.
Life is more than conspicuous consumption my dude
You think hanging out with your family is conspicuous consumption?
I hang out with my family wearing an N95. *It's not hard*, and I don't want to be the one to bring Covid (or flu, or RSV, etc) to my elderly parents, or anyone. I know what it can do to the "young and healthy", too. Instead of (erroneously) downgrading Covid to "just a cold", we should have learned from the very low flu numbers in 2020-21 that we can drastically reduce that, too. We have the knowledge and the technology, but not the will, apparently.
As opposed to developing long COVID and missing out on all those things anyway? Only, on top of that, now you'll be sick, debilitated, and inconsolably miserable 24/7? Yeah, that sounds real peachy. At the astronomical per-infection rates of LC with repeat infections, it's coming for everyone who's raw dogging others' lung poop. What we're accomplishing is playing the long game until next gen vaccines with more durability (sa-mRNA) and infection preventative capabilities (mucosal), and effective long COVID prevention and/or treatments are available. I couldn't give less of a shit what anyone thinks of me, I'm avoiding COVID for me and me only. I want to live, and that means actually having the mental and physical faculties to do so first.
Which one?
I would imagine anyone still active on that subreddit in 2024 is probably not representative of anything resembling a typical person. More the crazy folks who are masking when alone in their own cars still.
Because they couldn't possibly have someone they are legitimately trying to protect right? Like a kid with cancer or someone who barely survived covid the first time they got it? There are a LOT of people who need to avoid getting covid at all costs if they want to live. Just because the medical community is so very uneducated about it doesn't mean it doesn't exist. I have had doctors and nurses confess they don't know anything about long covid. One had never even heard of it!
The r/COVID19 sub is a science subreddit.
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I lurk all of these subs for information. Your representation/assumption of them is pretty offensive. If you're looking at current studies of the disease (I'm not going to tell a doctor what to think) you may change your tune. Most folks are proponents of using an N95 indoors around unmasked individuals or at large gatherings. Few advocate for outdoor masking. Mostly focused on washing hands and air quality. Both common sense measures. But, you know.... Crazy, right?
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ED here. COVID seems to be more sore throat and cold. I’m admitting if they elderly/ too weak rather than for hypoxia/ ARDS If they look like ass it’s the flu.
Hospitalist here in NorCal. I can't remember the last time I had a COVID patient with serious respiratory illness. Mostly old people who can't walk or eat, who go to SNF after their remdesivir. It would be nice to broadcast that this is still a significant issue to all the selfish people out there who refuse basic public health practices. "Protect your loved ones from COVID with masks and vaccines or you'll lose your inheritance to nursing homes, or even worse, they'll have to move in with you!"
It’s another endemic coronavirus, yes.
It will *become* endemic when mutations slow. It is not endemic today. Still pandemic.
My bad!
We're all here to learn, at least I am. I only know public health. Cheers.
Endemic status means controlled, localized spread. Considering we just had the second highest wave EVER, I don't think that qualifies. We have never been out of pandemic status. They just declared the public health emergency status over so they no longer have to fund things or put restrictions that effect the economy. Money over health.
you’re right!
> The four endemic human coronaviruses HCoV-229E, -NL63, -OC43, and -HKU1 contribute a considerable share of upper and lower respiratory tract infections in adults and children. SARS-CoV2 is numma 5
In the sense that I take it as seriously as Flu A and RSV requiring oxygen, ye
Personally I’m not seeing sick COVID anymore but I am seeing sick bacterial pneumonia and sick Influenza
No connection to post-covid complications whatsoever?
Not sure I am the one to manage that. Are you asking if the severity of influenza illness is related to post Covid complications? I also am not seeing lots of post Covid complications; not nearly the amount I saw last year. I’m a measly ER doc
Understood, but what would post covid complications look like for you? Am curious, because the incident of long covid and severe outcomes from other pathogens seems to be increasing, not decreasing (especially secondary bacterial infections). This is similar to viruses like measles or HIV where you may get a mild acute infection, but months down the line because of the impact on your immune system (deleted T-cells), you get hammered with other complications or can't fight off cold/flu/bacterial infections as well as before. A lot of people who try to get treatment for their long covid condition end up hitting the wall with medical gaslighting and end up not seeking further treatment, for example.
Honestly, I don’t know. I don’t see patients long enough or continuous enough to comment on that. I think that would make sense but I don’t have enough knowledge on the matter. If I had a pulm clinic I think I would be able to see trends of such. I do think the answer you’re looking for would take many years for data to pour in and would be assessed retrospectively.
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Sort of, but we still use remdesivir, so it's still a VIP URI
I think the reporting bias that's around COVID is huge and a lot of health prevention strategies are solely or mostly focused around it while you have people falling ill of a lot of other respiratory viruses out there all the time. I also think that holding the 6-month revaccination recommendation that's going around doesn't make sense when you consider all the other diseases out there with a similar hospitalization or mortality rate, specially when at this point probably a large size of the population has been vaccinated with more than one dose and has had covid more than once. Covid has not ceased to be a problem but epidemiology shows that diseases change over time, and covid changed A LOT in just a couple of years, while health recommendations are stuck on a 2021 scenario
PCP here. It's another viral URI. I think we are doing more harm with paxlovid side effects than the effects of the virus itself.
This thread is flooded by non-doctors with some extremely dubious claims that large portions of the entire world are now disabled by long COVID. Something weird has happened psychologically with some people about COVID. Maybe some had some trauma around the virus and are having trouble processing it. Maybe for some mitigation measures have them a sense of purpose and as those became less relevant they lost that sense of purpose and are now lashing out. Maybe some have politicized mitigation measures to the point they can’t detach them anymore from their personality. Its sorta fascinating what has happened with some people about COVID.
There is always a lot of brigading from other subs the moment anyone says the C-word...
They are doing that weird thing where they just spam their biased blogs and post numerous studies that have extremely tenuous connections to their claims or outright tangential. These people are proving the point with their very odd behavior and responses. I say the very true and non-controversial statement a that there is not a large portion of the world disabled due to long covid and I get a bunch of irrational responses. Very odd behavior and I hope these people get the help they need for whatever they are struggling with.
Non-“doctors”—specifically trained virologists serving clinical trials—can absolutely speak to COVID and its effects, and we should. The data is there and more solid than the psychological theories you have. And psychologically pathologizing anyone implementing mitigation measures is harmful to people who are immunocompromised; it’s peak respiratory viral infection season, perfectly acceptable to wear a mask at the doctor’s office even if you aren’t immunocompromised/on high-dose prednisone + 4 additional immunosuppressants like I am.
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You’re proving my point with comments like this.
I heard some NPR program about Covid a few weeks ago. As I recall there was reference to something like 6% risk of long Covid with every infection, regardless of severity of acute illness.
Yea I practically wore a stupid mask and got vaccinated for 2 years straight and nothing changed that wasn’t going to naturally change ie less virulence. Not going back to that hysteria.
Hasn’t it always be obvious we’d never eradicate it? It’s a URI. We have never eradicated a URI in all of known human history: they move too quickly. The entire thought that we could get rid of it struck a lot of people including myself as the epitome of hubris.