DNA Lounge: Wherein nobody's boosted, and nobody believes that Long COVID exists

You may have seen today's announcement from San Francisco's Maskless Mayor Breed (D-Coronavirus) that SF will be dropping all pretense of requiring masks, against the guidance of both the WHO and the CDC.

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.

pookleblinky:

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.

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COVID-19 takes serious toll on heart health - a full year after recovery

Researchers found the risk of 20 different heart and vessel maladies was substantially increased.

The risk rose with severity of initial disease and extended to every outcome the team examined, including heart attacks, arrhythmias, transient ischemic attacks, heart failure, inflammatory heart disease, cardiac arrest, pulmonary embolism, and deep vein thrombosis. Even people who never went to the hospital had more cardiovascular disease than those who were never infected.

The results are "stunning... worse than I expected, for sure," says Eric Topol, a cardiologist at Scripps Research. "All of these are very serious disorders. If anybody ever thought that COVID was like the flu this should be one of the most powerful data sets to point out it's not." [...]

"We found an increased risk of cardiovascular problems in old people and in young people, in people with diabetes and without diabetes, in people with obesity and people without obesity, in people who smoked and who never smoked." [...] The authors say their findings suggest millions of COVID-19 survivors could suffer long-term consequences, straining health systems for years to come. [...]

Al-Aly adds: "What really worries me is that some of these conditions are chronic conditions that will literally scar people for a lifetime. It's not like you wake up tomorrow and suddenly no longer have heart failure."

Previously, previously, previously.

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What Happened After the Chicken-Pox Vaccine?

In the COVID era, the success of the varicella vaccine in the nineties is staggering to contemplate.

A vaccine for varicella received full approval from the FDA in 1995, and within a decade forty states and DC added varicella as a required immunization for enrollment in public elementary schools. Today all fifty states enforce this mandate. Near-universal mandatory immunization against chicken pox virtually eliminated the disease in the space of a generation.

This past October, a coronavirus vaccine for children aged five to eleven received emergency-use authorization from the FDA; since then, a little more than 18% of eligible children in the U.S. have received the two shots required for vaccination [....] across large swaths of the U.S. -- including in states where COVID-vaccine mandates for state employees and health-care workers are banned -- any large-scale immunization effort is a nonstarter. It's also increasingly likely that existing vaccine mandates will collapse. [...]

Ted Cruz stated, "COVID policies should be based on science and common sense, not the hysterical demands of radical liberal activists and union bosses who have no interest in what's best for our children.") [...]

Having had chicken pox places you in a specific before-time, the way that the smallpox-vaccine scar on my father's upper arm does for him. Perhaps it's only natural to long, a little, for the before-time of chicken pox, when the question was whether we would be able to wipe out a disease and not, once we had the capability, whether we would choose to do it.

Previously, previously, previously.

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jwz mixtape 233

Please enjoy jwz mixtape 233.

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Current Music: as noted

Crosswalks

Mapping Crosswalk Coverage via Satellite Imagery in San Francisco.

I particularly commend the absolute grind of the data collection method:

The method was time-consuming, but simple. I manually reviewed satellite imagery at every single intersection citywide. I did this in order to maximize accuracy, and dig deeper than a binary crosswalk vs. no-crosswalk score.

Previously, previously, previously, previously.

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