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by PragmaticPulp 1807 days ago
We already knew that the mortality rate and hospitalization rate of children was low. Low isn't zero, of course, but it's lower than that of adults and the elderly.

The real question in my mind is the prevalence of Long COVID and other longer lasting changes. Having seen the debilitating effects of post-viral fatigue syndrome (non-COVID, but still very similar) I would caution everyone to do as much as possible to avoid getting illnesses that are known to trigger extended disability like this.

A COVID infection isn't a binary outcome of live or die. There's a lot of potential for lasting damage that isn't fully studied yet, so we need to stop treating the statistics as a simple matter of life or death.

It's also misleading to consider the statistics for children in isolation because children obviously don't live alone in isolation. If kids get a contagious illness, the parents are highly likely to get it. This is especially true for younger children, as any parent will tell you.

8 comments

The tough question is: how do the long-term, hard-to-pin-down, variable physical health effects of post-viral syndrome compare to the long-term, hard-to-pin-down, variable mental health effects of lockdown, social isolation, job insecurity, and disruption?
There's a wide spectrum between full lockdown and zero precautions taken. We were never choosing between one or the other, and very few places actually went into full lockdown.

Even some of the cities with the strictest regulations still felt like business as normal, albeit with masks, after about April or May of last year.

Let's not kid ourselves, there was never a proper lockdown. Barely anything changed besides working from home and kids having remote school for a few months. Nearly everything remained open with only half measures taken and most people ignored social isolation as well.
The impact on the virus was certainly minimal but I would not underestimate the impact on kids’ mental health and education, especially those kids with bad situations at home. My kids were fine because I bought them an outdoor playset and a thousand dollars of LEGOs, and taught them math and science three grades above their level. Other kids were stuck at home with abusive parents trying to do Zoom school with learning disabilities.
For a good analisys of related questions i recommend:

https://astralcodexten.substack.com/p/lockdown-effectiveness...

That's a false dichotomy, especially in countries which are planning to open up in spite of the science.

Aside from Long Covid, there's also a danger of adult's not being able to work, as people either self-isolate or are too ill to do their jobs.

Remote won't necessarily fix this - partly because if you're ill at home you're still ill, but also because there are many jobs which need people on-site.

If you get a huge peak at the same time, not only are hospitals overwhelmed - already happening in the UK - but other critical services are also endangered.

About zero for children.

Long-term symptoms after SARS-CoV-2 infection in school children: population-based cohort with 6-months follow-up (Preprint)

https://www.medrxiv.org/content/10.1101/2021.05.16.21257255v...

Reddit discussion: https://www.reddit.com/r/COVID19/comments/obm0wy/longterm_sy...

> About zero for children.

That's not what the study says. They found that the seropositive group of 6 to 16 year olds was more likely to report a symptom beyond 12 weeks than the seronegative group. 4% of the seropositive students versus only 2% for the control group.

The study authors conclude that the prevalence is low, but they do not conclude that it's about zero.

For comparison, Polio is estimated to be asymptomatic or extremely mild in 90% or 95% of cases. Polio only moves to the central nervous system in about 0.5% of cases, and only about 2-5% of children with CNS infection die (15-30% of adults with CNS involvement). That's a relatively small percentage, but at scale it's a devastating number of people impacted. At epidemic scales, you can't simply waive away small percentages in the 2% range as inconsequential when it translates to millions of people impacted.

"9% versus 10% reported at least one symptom beyond 4 weeks, and 4% versus 2% at least one symptom beyond 12 weeks"

That's not low for a virus which is infectious as Delta, and it's certainly not "about zero".

So 9% of seropositive and 10% of seronegative reported at least one symptom beyond 4 weeks. I.e. the background level is around 10% and the seronegative had "more" long covid than the ones who actually had covid in that group. Although this is pure randomness with such close measurements.
4% versus 2% in the longer term study.

> Although this is pure randomness with such close measurements.

That's not how this works at scale. We need larger studies, yes, but you can't simply dismiss a doubling of long-term symptom reports.

At population scale, even a 1-2% incidence means millions of people.

It is pretty weak though. There were only 109 seropositive kids in the follow-up according to the table, so you're talking about 2 more kids reporting a cough or headache as the entire basis of your concern.
There is no doubling here – only random noise.
It's also a preprint and other studies contradict it.
> the prevalence of Long COVID and other longer lasting changes.

That, and it will also be interesting to discover how different it is from the ordinary flu. I remember the last time I had a proper flu (well before COVID) it was months before I felt like I'd gotten over it even though the visible symptoms cleared up in a week or so.

The background rate of life-altering disease always seemed rather high to me. Life is far messier than what a "healthy/sick" binary can capture.

Also given the fast evolution of the virus (with the newest variants way more infectious and deadly than the original), it's not a given that the low effects in children will continue. Especially if children remain the only vulnerable population - it's conceivable that a variant that is way worse for children will arise.
> The real question in my mind is the prevalence of Long COVID and other longer lasting changes.

Are there any numbers on long covid in children? I would assume that those numbers are probably pretty low, also.

I agree with you that covid outcomes are not binary. The same as for other viruses, especially those that affect internal organs.

Another related question is whether “long COVID” (which feels imprecise to me), is something that should require everyone to lose their individual rights to decide what risks they undertake? In my opinion, if people are worried about it then they should just restrict themselves, rather than blocking everyone else from [going to school, opening their business, collecting rent, etc]. One reason I feel that way is that studies have shown that lingering issues like ARDS (which is now seemingly lumped into “long COVID”) are linked to obesity or vitamin D deficiency. It seems to me that limiting one individual’s freedom to accommodate the poor lifestyle choices of another individual is morally wrong.

Lastly I think your closing comment that parents are highly likely to get infections from children is misleading. Numerous studies show children are less likely to transmit COVID (example: https://www.sciencedaily.com/releases/2020/07/200710100934.h...).

I would be interested to know if there has been any attempt to correlate Long COVID in children with them having prior allergic responses.
No doubt that post-viral fatigue is a thing, but I wonder how much of Long COVID is the collective COVID anxiety and fear that continues to be fomented by all information sources (news, media, socials, etc). At this point we need to go back to pre-COVID in terms of how much attention it receives. We have vaccines, time to move on, the pandemic is over. Basically COVID needs to take a similar mental profile as the flu, which is that we annoyed everyone about vaccines yearly but other than that it was not nightly news and discussion, with warnings plastered everywhere like it's the Cold War. Even worse you have leaders branding this fear+anxiety-laced behavior as the "new normal"

I think behaving as-if the pandemic is over will do collectively far more for the well-being + psyche of fatigued citizens who have likely felt some measure of hope disappear over the past year. It does no benefit to keep circulating disproportionate levels of information about an uncertain and vague threat when we have the solution in vaccines. At this point "the only thing we have to fear is fear itself" as the saying goes.

That's not a position the huge majority of doctors and scientists agree with.

Why should anyone believe you instead of them?

This straight appeal to authority is particularly weak given the last year or so.

- lab leak hypothesis

- “masks don’t work”

- “not transmissible via the air”

- “it’s not a pandemic, don’t panic”

The authority has shown its capacity to be wrong here repeatedly and in obvious ways. This isn’t direct support of what OP said, but appeal to authority does little for me. The specifics matter.

The appeal to scientific authority is only weak if you are looking for a way to downplay the virus. How many scientific authorities were saying "It's not a pandemic, don't panic"?
I think the "not a pandemic" was a reference to the WHO's month-plus delay in declaring a pandemic.

There was definitely a mindset of potential panic being worse than the disease itself early on. Perhaps not downplaying per se, so much as resisting making any major pronouncements of danger until the evidence was overwhelming.

I’m not looking to downplay the virus - the initial downplay came from Vox and the NYT (journalists, not scientists - but often pretending they’re delivering scientific consensus): https://medium.com/@balajis/citations-for-the-recode-handsha...

They also framed virus fears at the time as racism and complained about border closures.

The “masks don’t work” arguments came from scientific authority though.

Same with “not transmitted via the air” and dismissing the lab leak hypothesis.

I’m not arguing with a partisan position - partisanship is what lead to a lot of dumb positions from scientific authority (and politicians too obviously).

You are citing points whereby there was confusion about the scientific consensus, but what has been the overarching consensus this whole time? It hasn't been masks don't work, it hasn't been social distancing doesn't work and it hasn't been "not transmitted via the air".
Are we saying vaccines are not the solution?
The majority of the world is not vaccinated. Hell, in some US states the majority is not vaccinated.
I think you’re talking past each other. Is the virus still with us (your point)? Yes. Do we have a potent and effective vaccine which, for vaccinated persons means the virus is no longer a threat (the other person’s point)? Yes.
Do we have enough supplies of those vaccines yet, worldwide? Have we vaccinated sufficient people yet, worldwide?

Sadly, no and no.

Even in many US states it's also not enough yet.

And many countries must be looking at their situation regarding vaccine production in general, particularly dependency on other countries, and finding that to be something that they want to secure for themselves.

> for vaccinated persons means the virus is no longer a threat

I would call it a much diminished threat, which would be further diminished by vaccinating more other people, rather than "no threat".

Still not enough vaccinated for herd immunity. And considering the effectiveness of the vaccine drops from ~95% to ~65% 6 months after (around more for a majority of people) then it's looking further from all clear.
Outside the northeast, US states are barely above 50%.

https://www.beckershospitalreview.com/public-health/states-r...

(link says march-15, page is updated through July 8)

You can probably add another 15%-20% from recovered immunity.
> the pandemic is over

This is surprising to read, guess it depends on where you live? Different countries are still at different stages of the pandemic, and it is most certainly not over for a lot of them, especially with the delta variant causing a third/fourth wave.

Yeah - I’m guessing American.

The pandemic is over in America (for now), definitely not true for all of the rest of the world though.

I do suspect while there are long term complications from particularly bad covid cases (lung damage, etc.) - the OP is probably right that the more generic “long covid” symptoms (fatigue, brain fog, heart rate) sound a lot like physical symptoms of anxiety - I’d expect probably those numbers to go down.

Australian here, in Sydney, we just entered our harshest lockdown days ago. We have achieved more or less zero COVID cases until Delta came.

Fully vaccinated rate: 6%

Ability for under 40s to get a vaccine: Only if you lie.

https://www.health.gov.au/sites/default/files/documents/2021... is a good summary of Australia's vaccine rollout.
What these statistics don't show you: even if you are an eligible <39 year old, the earliest booking you can make now is in october.
Oz probably has the means to produce vaccine and speed up roll out if the situation gets worse there.
especially when talking about UK, it's far from over (no matter what Boris Johnson is telling his people). With 30.000 cases per day and more opening up planned (and the Euro finals tomorrow), more and more people will get covid. Even if the death rate will be low compared to last year, people will get long covid. Probably hundreds of thousands of people. There are already 400k people in UK who suffer for more than 1 year from long covid. [1]https://www.telegraph.co.uk/news/2021/07/01/almost-400000-ha...
> pandemic is over

This is but true in a sense that pandemic never started.