You may have seen today's announcement from San Francisco's Maskless Mayor Breed
I truly cannot comprehend peoples' aversion to wearing masks. It's an itty bitty piece of fabric. How is this even a big deal? These people react to being told "you have to wear a mask some times" as if they're being told they can never eat chocolate again.
My new favorite Twitter account:
Neoliberal John Snow: The father of epidemiology, but neoliberal. Addressing preventable disease through deregulation and individualism.
Cholera cases are declining in our community. Now's the time for everyone to resume drinking fecal contaminated water from the Broad Street pump! #FecalUrgencyOfNormal
According to our front door staff, we have been turning a lot of people away for not being boosted, so that's going great. Even though CA lowered the definition of "mega event" to 500 capacity, it seems that the other large local venues have all decided that they'd rather just cap their attendance at 500 than obey the "mega event" rules. Every venue in town that is not named "DNA Lounge" has decided that requiring boosters is a step too far, and they'd rather allow the infectiously under-vaccinated inside.
It is also driving me bonkers that so many people -- even friends -- have developed this attitude of "I'm tired of the pandemic, everyone's going to catch it anyway, so YOLO", and say things like "if you're boosted you're bulletproof".
I'm tired of it too. But you are not bulletproof.
Nobody seems to be taking the prospect of Long COVID seriously, or even considering that it is a thing that exists. To some degree it is hard to blame them, because the press on it is almost nonexistent.
All of the Long COVID articles open with a heart-wrenching profile of some mom who can't get out of bed because of 24/7 debilitating migraines, or some former triathelete who can no longer walk up stairs, but these are anecdotes, not numbers. Many of the articles say that somewhere between 10% and 30% of people who have even asymptomatic cases of COVID will have some Long COVID symptoms. But how severe and what are the odds of those severe outcomes? That's what nobody seems to be able to tell us.
For some people, the symptoms go away in a few months, but for some (how many??) they don't go away at all. Or COVID results in degenerative neurological conditions. There's some evidence that COVID can cause multiple sclerosis (!!) by re-activating and supercharging other viruses that you likely (90%) already have in your system.
COVID is more like polio than it is like the flu: a virus with a long-term impact.
What causes Long COVID?
Long Covid is a condition that arises after acute infection and often includes shortness of breath, fatigue, and "brain fog" but can also involve a wide range of debilitating problems in the heart, brain, lungs, gut, and other organs. According to the WHO's working definition, long Covid usually occurs three months after symptomatic Covid-19 begins and lasts for at least two months. Sometimes, the symptoms just never go away after the initial infection. Occasionally, they appear months after recovery or after an asymptomatic case. This means that if you've recovered from Covid-19, you're not necessarily in the clear.
Short-term and Long-term Rates of Postacute Sequelae of SARS-CoV-2 Infection
More than half of COVID-19 survivors experienced PASC 6 months after recovery. The most common PASC involved functional mobility impairments, pulmonary abnormalities, and mental health disorders. These long-term PASC effects occur on a scale that could overwhelm existing health care capacity.
We don't remember polio nowadays, only longpolio.
In 29.5%, it presents as diarrhea, GI distress. Only 0.5% of cases present with neurological symptoms. For the vast vast majority of people who got a disease which left hundreds of thousands disabled for the rest of their lives, polio was a few days of having the shits. If that.
There is absolutely no way the US would recognize polio as a problem nowadays, or do anything at all useful to try to stop it.
The First Epistemological Problem of Long Covid:
The question that everyone wants an answer to, "What are the chances that if I get COVID-19 I will also get Long Covid?" isn't one that has an answer. We are not going to get any sort of useful statistics about the prevalence rates of Long Covid, not for a long, long time, and maybe not ever. Because two years into this thing, we still don't have a working definition of Long Covid.
A few weeks ago a good friend said to me, "Eight week ago I caught COVID, boosted, and I still feel like shit" -- and then in the next sentence said, "So are you coming to my birthday party?"
If I believed that the worst thing that might happen to me, being boosted, was a few weeks of having to deal with the worst cold I'd had in my life, I'd have gone to my friend's party. But when I'm reading about possibly-double-digit percentage odds that I could end up with a condition that leads to having to drag an oxygen tank behind me for the rest of my life, or losing the use of my legs, I think I'll be staying home for a while longer.
In the US alone, we're having one 9/11 worth of deaths per day, and will be hitting one million deaths in just a few weeks. The first Omicron surge isn't even over yet and Omicron BA.2 is coming up fast and is 1.5 times more infectious and more able to re-infect.
But Maskless Mayor Breed says "YOLO" so here we are I guess.