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Thanks for posting this! I'd vaguely planned to try it after seeing David's tweet, but never got around to it.
I see Healthline says there is little evidence on long-term effects - any thoughts on how long to take it?
Maybe ask on EA forum in addition? I donate to Amnesty International and I seem to recall my googling suggesting they are not totally useless, but no ideal what is optimal.
Dwarkesh Patel seems to have a full transcript on his blog https://www.dwarkeshpatel.com/p/carl-shulman#details
Any concerns about long term side effects?
FWIW, I haven't consulted the literature on this, but if you're interested, I noted my personal experience with some of these treatments here.
Judging from my PCP's positive reaction to my sharing I was using these approaches and my subjective experience with them, they are safe and effective. (My PCP also suggested phenylephrine, which is the more readily available but weaker variant of Sudafed, to alleviate nasal congestion, but after the steaming I didn't feel a need for it.)
You cite studies indicating that iodine spray (of which Betadine is one brand) can make you test negative "at least temporarily," and say, "Some people do test negative after applying the iodine, but this doesn’t seem that relevant to whether you get better sooner."
Any thoughts on whether this poses the risk that the spray could temporarily suppress the virus but leave you still infectious a few hours later? (I'm worried about this in the context of testing myself to see if I'm ready to exit isolation.)
I do seem to recall that Roche Pilot rapid antigen tests caution to avoid testing for at least half an hour after using any nasal spray, whereas Flowflex tests have no such guidance and in fact indicate no interactions with iodine. I don't know what to make of this.
Interesting, hadn't heard of that! Thanks for sharing. Looks like the video lists all of its sources in the notes below.
Has anyone experimented with keeping consistent wakeup time on weekends at the expense of more sleep, and have anecdotes to share on the impact it made for them?
Your Local Epidemiologist looked at a recent meta analysis and concluded the following
"the risk of debilitating long Covid is double the risk of permanent impairment from driving. Risk of debilitating long Covid is much higher than getting injured during a house fire and about the same as getting a serious dog bite"
(Source: https://yourlocalepidemiologist.substack.com/p/long-covid-an-update-and-gauging)
But the objections here need to be addressed, and suggest the risk could be significantly higher: https://yourlocalepidemiologist.substack.com/p/long-covid-an-update-and-gauging/comment/11173302 (read through the back and forth under that comment... Jetelina has not responded to his last one) -- if anyone better at reading studies than I am has insight, I would be very grateful!
Based on this, and the fact that anecdotally in my peer group, the incidence of significant long COVID is trivial, I have moved to taking significant COVID risk where I get appreciable value from doing so (e.g. I will go to an indoor house party without a mask, or eat or drink indoors in a bar/restaurant on a date if my date wants to. But I still wear masks in grocery stores or on transit, err towards outdoor public dining when it's comfortable, etc because there's little benefit to not doing so, and I still think the likelihood of non-debilitating but significant long term health effects from COVID is non-trivial, and the risk of debilitating long COVID is more than vanishingly unlikely.)
You should put this in your main post - it greatly increased my interest in actually trying to learn.
I find exercise super helpful as well. I'd amend the suggestion to note that you should also avoid pushing yourself so far that you're drained or exhausted.
Next on my list is 30-60 sec of cold shower at the end of a hot shower.
And then meditation.
More generally, I find making a schedule the night before and the pomodoro technique helpful.
Got it. It's actually possible this is true for me as well -- I have minor knee problems and always assumed that it's the knee braces I wear while jogging that keep my knees feeling ok, but I haven't really tested this systematically, so perhaps I have more leeway to run short distances than I think!
I seem to recall your saying at some point (on a post about biking?) that you have knee problems. How do you handle that with this approach?
I live in the Bay Area and I don't check the news in detail daily. I knew we have more rain coming but found this post helpful in increasing the salience of the storm and the precautions I might want to take.
Given the range of incredibly niche and personal things people post on LW, I think posting this here is perfectly fine.
I eat a slice of Dave's killer bread with almond butter and some honey and cinnamon drizzled on top, microwaved for 30 sec, along with half a glass of vegan milk. I don't track my blood glucose, but am sensitive to simple carbs, and I feel quite good after this breakfast.
I used to simply eat a couple scoops of nut butter for breakfast, but then I grew soft or something.
Thank you for writing this! I was wondering whether Kat's babysitting test would lead to false negatives, and was thinking of writing a post polling LW on the subject. To add more anecdata, I asked a friend who's been a dad for... 8 years, I believe, and he thought that he just cares about / likes / finds it easier to tolerate his own kids in a way that's not true with others' kids, and he expects this would generalize to other parents as well.
(I - a man in my mid 30s without much experience actually spending time with kids - have had a clear felt sense of wanting a kid for several years now, but value my time and energy fairly highly, so Kat's post really gave me pause. I still feel an emotional pull to having a kid that I don't think would be satisfied by the alternatives in her post, even though I think it will have lots of costs/difficulties.)
FYI, Alyssa Vance provided additional disability statistics https://www.lesswrong.com/posts/4z3FBfmEHmqnz3NEY/long-covid-risk-how-to-maintain-an-up-to-date-risk?commentId=GKmqE9PKXfRSKb5PC which suggest "serious, long-term illness from COVID is pretty unlikely."
Siebe, I would be interested to hear your take on that, since you seem to have a substantially more pessimistic view of this.
Thanks!
Thanks! I have not, but defer to Elizabeth's comment below on this.
Thanks very much for looking into this, and sharing all those details about the conclusion you came to!
I have the PM-type skills for this, but if the consensus of smart people far more numerate than I is that the risk of debilitating long COVID is low enough that it's comparable to other risks normal people routinely tolerate, it doesn't seem worth it.
Some follow-up questions for you:
1) Is this still your assessment (i.e. how your assessment evolved since the post you wrote 8 months ago, if at all)?
- My assessment that, post-vaccination, covid was in the range of other health concerns, and most people had lower hanging fruit to pick on their health.
2) How likely do you think it is that this would change with further variants? Do you think it is likely enough that this is worth keeping tabs on? (My guess is that this is covered in your overall comment above, but thought I'd check, in case your overall conclusion was about updating risk assessment to reflect new studies, rather than new variants).
https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/selfreportedlongcovidafterinfectionwiththeomicronvariant/6may2022 which a couple other commenters shared seems to indicate that Omicron certainly hasn't been more likely to cause long COVID than Delta (based on a quick read of the summary at the beginning)
Thanks for this!
Question: It seems possible that long COVID prevalence / impact falls short of the level that would qualify a significant proportion of the American workforce for disability, but would still be very concerning for folks with cognitively intensive professions (i.e., the majority of LW readers). How likely do you think this is?
[I removed the other question I'd included here earlier, quoting the insurer Unum from the last article you cited, because I only saw the part where "it has approved “hundreds of thousands” of additional disability claims since the beginning of the pandemic, with an increase from pre-pandemic levels of 35 percent" but missed the part where they said "In general, disability and leave claims connected to covid-19 have been primarily short-term events with the majority of claimants recovering before completing the normal qualification period for long term disability insurance." Incidentally, per https://caveylaw.com/practice-areas/long-term-disability-erisa-lawyer/medical-conditions/ it seems like the threshold for LTD is to be out of work for more than 3-6 months.]
Other comments:
The stats you cited regarding disability claims seem compelling in assessing this question. (I wonder if there are countervailing (non COVID-related) forces that would drive down the aggregate rates of disability claims, but the stats on COVID-related disability specifically would seem to avoid that concern.)
I tend to be wary of arguments which say "the press is just lying" (perhaps because it's really hard for me to assess that, and seems like a convenient way to dismiss evidence that doesn't fit your favored model), but I could believe that the press's assertions are driven by the desire for a dramatic headline, and full of sloppy thinking (and subject to the same sorts of issues that you and Zvi have noted). Regardless, if you have stats on disability claims, and the press does not have better stats, then that seems to settle the issue.
Thanks! I'm curious what you think of his argument that if debilitating long COVID were common, that would be obvious anecdotally and in aggregate statistics:
Every week someone comes in and says things like 30% chance of brain fog, but think about that for a second. Half the country has had Covid. So this is saying 15% or more of the population is suffering from crippling brain fog? Wouldn't we know? I mean come on.
Thanks! I find that compelling.
Thanks - I find that ("Half the country has had Covid. So this is saying 15% or more of the population is suffering from crippling brain fog? Wouldn't we know?") compelling, and it usefully cuts through the new claims / studies that continue to pop up without needing to examine every one.
Thanks for chiming in! If I'm interpreting your response correctly, it seems you've stopped closely analyzing evidence on long COVID not because you necessarily think your original analysis is highly likely to be robust against further findings; rather, you think that the cost of avoiding COVID is high enough that even a significantly higher risk of long COVID wouldn't change your behavior.
This suggests to me that for folks who weigh the cost of avoiding COVID differently, it would be worthwhile continuing to assess the risk of long COVID. (Not saying you should be the one assessing it further, given your relative priorities - just that this is useful information for other interested parties who may be thinking, "well, Zvi doesn't think any of the new stuff refutes his analysis, so must be fine.")
As tslarm's comment suggests, I think there are a bunch of personal options that significantly COVID risk without having to "never live your life and hide in your apartment forever." (For me personally, that looks like avoiding public indoor dining, bars, and large events, and avoiding even smaller indoor events when transmission risk is very high). That wouldn't be ideal, but if the alternative is, say, a 30% chance of years of fatigue / brain fog, for me it would be very much be a price worth paying. (For the many reasons you articulate, I think the alternative is much less dire -- just illustrating that at a certain risk of debilitating long-term symptoms, the cost-benefit analysis weighs towards avoiding COVID, so "live your life or never live your life and hide in your apartment forever" doesn't seem like the right frame to analyze this from.).There are also a ton of societal investments that could be made to shift that cost-benefit analysis (e.g. broad deployment of better ventilation/filtration, UV light, continuing investment in vaccines, treatments, etc), some of which you cover in your posts.)
It would be helpful to hear more specific thoughts on whether / why this data is "garbage".
An initial thought on that (since I don't have time to dive deeper on this today) is that the first source linked in this post says most of the studies did not use a control group:
For the assessment of the quality of the included studies, we used the Newcastle-Ottawa Scale for observational studies.(22) Not every item from this scale was relevant for the included studies as most included studies did not use a control group. Therefore, we used two items from Selection (representativeness and ascertainment of outcome) and the three items from Outcome (assessment of outcome, follow-up long enough, adequacy of follow-up; see Supplementary Material).
Thanks for this. Prompted by this and other recent posts, I'm trying to mobilize more of a systematic effort to maintain an updated assessment of Long COVID risk -- if you're interested, please chime in here! https://www.lesswrong.com/posts/4z3FBfmEHmqnz3NEY/long-covid-risk-how-to-maintain-an-up-to-date-risk
Thanks for this. Prompted by this and other recent posts, I'm trying to mobilize more of a systematic effort to maintain an updated assessment of Long COVID risk -- if you're interested, please chime in here! https://www.lesswrong.com/posts/4z3FBfmEHmqnz3NEY/long-covid-risk-how-to-maintain-an-up-to-date-risk
I meant time in bed... My Fitbit does claim I get about an hour less than that in terms of actual sleep, despite not feeling like I have problems sleeping.
Ah interesting point. That is helpful, maybe I'll play with that.
I do find the effects I observed despite drinking tea until and even past 4pm.
Interesting! So when you did this, did you find that you were able to avoid the afternoon crash?
Yeah there is definitely a lot of variation in how good / crappy decaf tastes!
I don't remember, unfortunately, since it's now been a few months. But less than a week, probably a few days.
Have you read anything lately on whether throat swabs are a reliable procedure for antigen tests that aren't officially indicated for throat swabs? Back when I looked into this in December it seemed like there were concerns about false positives (though the only study I found from a quick search was one which literally used drinks - soda, if I recall correctly - as buffer - https://www.sciencedirect.com/science/article/pii/S1201971221006548), and public health authorities / experts are still not officially recommending that (for whatever that is worth...).
And...sorry to hear you might (probably?) have COVID!
A friend raised concerns that as people are increasingly using at-home tests instead of PCR, the data sources for microCOVID are underreporting risk.
Detailed her concerns further here:
Would be curious to hear thoughts from you all who have been thinking about the related issues Jeff raised earlier (albeit with the trend in the opposite direction).
Glad to hear you've been able to bring back events! As a fusion dancer in SF, I know how amazing it has been to have partner dance in my life again.
Couple thoughts:
- why not have the sign-in form (and email collection) be on a spreadsheet on a tablet or something, to avoid the burden of having to transcribe?
- check out this group for how other organizers are navigating questions around masking and others https://www.facebook.com/groups/158671312715141/?ref=share. It's led by a COVID researcher/MD who is also a dance organizer
Thanks for sharing this! It is worrying, but the magnitude does not seem like it would change Zvi's overall conclusion. Some reasons why:
- Not enormous increase in absolute terms. Per the article
- Increase in stroke: 0.4% pts
- Increase in HF: 1.2% pts
- Most participants likely were not vaccinated (looking at the study itself)
- 162,690 participants who had a positive COVID-19 test between 1 March 2020 and 15 January 2021 were selected into the COVID-19 group
- Increase in any cardiovascular outcome for non-hospitalized individuals was 2.85% points (difference of 28.5 cases out of 1000) (Supplementary Table 8 in the study itself)
- Stroke is 1.85 / 1000 (0.2% pts), heart failure is 6.05 / 1000 (0.6% pts)
- I assume they highlighted stroke and HF because those are particularly severe issues, but eyeballing the table for other scary things (as someone who is not a medical expert): myocardial infarction 0.39, cardiac arrest -0.04, MACE (any major adverse cardiac events) 11.29 (all out of 1000)
- Limitation with controls (though I dunno if this is likely to make a significant difference)
- Ardehali cautions that the study’s observational nature comes with some limitations. For example, people in the contemporary control group weren’t tested for COVID-19, so it’s possible that some of them actually had mild infections. And because the authors considered only VA patients — a group that’s predominantly white and male — their results might not translate to all populations.
Thanks!
FYI, prevalence updater now seems to be fixed https://github.com/microCOVID/microCOVID/issues/1358
I'm a little confused by your methodology here - if the last day they have is 2/18, and today is 2/22 (or was 2/21 when you posted it), why are you extrapolating out by 10 days (29.7 - 21 ~ 9k)?
More generally, does the following seem like a valid way to input data manually into microCOVID?
- Take the last reported daily cases/100K from covidactnow.org. Reduce by extrapolating to what you'd expect for today
- Multiply by 7 and input into "Reported cases in past week"
- Enter "100000" into Total Population
- Leave "Percent increase in cases from last week to this week" at 0%, since you can't set it to negative
- Take the latest "percent of tests that come back positive" as-is from the latest number available at covidactnow
- Take the "2+ or J&J" number and enter it into "Percent of population fully vaccinated" (looking at the default number in there before I typed mine in, it looks like that's what microCOVID is using, not % boosted)
Thanks!
Thanks for this!
What had you conclude that microCOVID fails to model the impact of vaccinations? I haven't looked closely at their methodology, but just toggling "Their vaccine" from "Yes" to "No" to "I don't know" does change the risk estimate.
So sorry to hear you're suffering through this, and thank you for sharing your experience!
This was very sweet and reinforced my desire to have a child (a topic I'm chewing on at the moment).
I'm still worried about the risk of long COVID. See e.g., Katja Grace's recent post, though I am still trying to incorporate the comments on that post into my mental model. I also saw some really concerning Twitter threads on long COVID, but I don't know how good the posters' epistemics are, and don't know how they interface with say, Zvi/Scott/Elizabeth's earlier analyses of earlier studies on long COVID which treat it as a minor concern.
Both, I guess, though my primary strategy for protecting others is to not get COVID myself, so protecting myself is paramount.
Thank you!
I've found it really hard to find a respirator that seals (judging from the fact my glasses fog), and per microcovid.org that still leaves me with a fair amount of exposure. I imagine many others are in the same boat.
Good point, agreed! Here is my (not very good) current attempt to adjust manually: https://www.lesswrong.com/posts/YtWqgzLDqxSvJDkCi/how-should-we-adjust-microcovid-estimates-for-omicron
Most urgently, I'd like the bugs around missing vaccination data for SF and NYC (and possibly other locales) to be fixed. https://github.com/microCOVID/microCOVID/issues/1280
I hope the team is not holding off on fixing critical functionality that is obviously broken / missing (e.g. this bug, adjustment for omicron) while they wait for data in response to this post.
If the team is resource constrained in some way (money, people with particular skillsets), would love to know how the community can help!