[dopylitty]

It’s worth noting that the bar for severe illness is set incredibly high. [1]

All of the major symptoms including high fever, cough, severe fatigue, loss of taste/smell, and shortness of breath still count as mild under their definition. This is very much a disease you don’t want to get, even the so called mild version that happens in vaccinated people.

1. https://www.covid19treatmentguidelines.nih.gov/overview/clin...

[version_five]

> Severe Illness: Individuals who have SpO2 <94% on room air at sea level, a ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (PaO2/FiO2) <300 mm Hg, respiratory frequency >30 breaths/min, or lung infiltrates >50%.

Isn't the point that levels below severe are not generally fatal and don't require hospitalization. Nobody thinks it's good to get sick, but it generally ceases to be a threat to public health with vaccination.

[gibba999]

The million dollar questions include:

- Long COVID post-vaccine. >10% of people have brain damage visible on MRIs, including mild cases.

- Future mutations. People have been overly optimistic for 15 months now, and believed bad things couldn't happen. They do. There's no reason to believe Delta or Gamma are the end, or anywhere close.

[inter_netuser]

brain damage after vaccine, or "mild" disease in vaccinated people?

can you point to that MRI imaging? curious to see.

[gibba999]

This is the major one:

https://www.medrxiv.org/content/10.1101/2021.06.11.21258690v...

This one scared me since it was a large, relatively unbiased sample, with before-and-after imaging. It also showed brain damage even in mild cases of COVID19 in >10% of cases.

There are a lot of supporting smaller-scale studies too, replicating the same general result. E.g.

https://www.khou.com/article/news/health/coronavirus/covid-1... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8066611/

If you Google, you'll find dozens of other small-scale studies.

[timr]

> This one scared me since it was a large, relatively unbiased sample, with before-and-after imaging. It also showed brain damage even in mild cases of COVID19 in >10% of cases.

It shows no such thing. It's an analysis of MRIs where the authors infer loss of gray matter in specific regions of the brain. This is in no way "brain damage", and representing it this way is leaping to wild conclusions.

Lest you not believe me, here is a randomized controlled trial, showing that "excessive online video gaming" reduces orbitofrontal gray matter:

https://pubmed.ncbi.nlm.nih.gov/29057579/

(...so your Mom was right: gaming is turning your brain to mush!)

Here is a review that shows that similar losses in gray matter are associated with anxiety and sleep loss (two problems that I'm sure didn't affect anyone in 2020):

https://pubmed.ncbi.nlm.nih.gov/29244642/

Similarly: "Profound and reproducible patterns of reduced regional gray matter characterize major depressive disorder"

https://pubmed.ncbi.nlm.nih.gov/31341158/

Just for fun: here's a paper that shows that "tooth loss was a causal factor for volume reduction in brain areas related to memory, learning and cognition"

https://pubmed.ncbi.nlm.nih.gov/29475808/

(bonus points: can you spot the missing correlate?)

The fact is, you can find research literature associating "loss of gray matter" with pretty much anything. And if a reliable trend does exist across this literature, it seems to be that gray matter changes are often seen in...wait for it: depressed people and the aged.

But I'm sure that Covid has done nothing to depress people or affect the aged, so we can probably safely ignore that little detail.

[gibba999]

I think a lot of this comes down to replication, effect size, and sample size.

Yes, there are studies which show virtually everything, but in this case, we have:

- >10% of mild cases reporting long COVID brain fog (without MRIs)

- Visible correlations on MRIs with large n (cited study)

- Lots of small-scale studies / looking at specific cases

- Some understanding of a relevant mechanism-of-action (see: olfactory loss)

Together, that's about as strong evidence as you'd expect after 15 months. We have effect, we have correlation, we have case studies, and we understand why it's plausible.

The big question is whether it strikes vaccinated mild / asymptomatic cases. We don't know. There are a lot of cases like this.

[ianlevesque]

Denial is quite a river these days. Where else are you going to get a brain imaging study with before and after data on thousands of people? If that's not persuasive and concerning to you I don't think anything will be.

[elcomet]

> bonus points: can you spot the missing correlate?)

Concussions ?

[eloff]

I couldn't find where it talks about vaccinated patients in the study you linked.

It's not surprising that covid19 can cause brain damage (and heart damage, and death) to unvaccinated people.

[gibba999]

That was listed under "The million dollar questions include"

I'm now realizing formatting / phrasing was unclear.

1. >10% of mild / asymptomatic cases have brain damage.

2. The million dollar question is whether this includes vaccinated cases. Vaccines reduce hospitalizations and deaths by far more than they do mild and asymptomatic cases.

[wesleywt]

The article says nothing about vaccinated people.

[peytn]

That first pre-print is wild. 8 pages of methods for 8 pages of results (incl. figures). Quite a "pipeline."

[Tepix]

Interesting!

[dopylitty]

That may be but it’s not a particularly useful definition on an individual level.

If I’m sick in bed for two weeks I can’t work or take care of my family so those mild symptoms very much would be a danger, not to mention the dangers from long COVID which hasn’t been ruled out in vaccinated folks and the dangers of exposing people who can’t be vaccinated.

[spoonjim]

It’s very useful on the individual level. All that sounds bad but not as bad as dying.

[ianai]

There could still be Lewy bodies (dementia) for all I know.

[lugged]

Sure if you don't think permanent social distancing and mask wearing is not a problem.

The severity of mild covid is still potentially long lasting and I'm willing to guess elderly aren't going to handle it well.

Letting covid become endemic could reduce our life expecty considerably.

[version_five]

> Sure if you don't think permanent social distancing and mask wearing is not a problem.

I'm confused by this comment. I do think they are a problem, that's why I am encouraged by a vaccine that reduces covid to something that is not life threatening and that we can stop freaking out about.

[throwawayboise]

It always was that for the vast majority of people.

[audiometry]

3mn Indian souls would disagree

[55555]

That's a terrible loss, practically a genocide, but to be fair the parent said "the vast majority of people" and there's 1.4 billion people in India. In India, 151,000 people die every year just from car accidents, and ~4 million die each year from heart disease.

[kadoban]

Isn't covid already endemic?

[lugged]

Some claim it can still be irradicated. But those people get banned on YouTube for saying bad words so you probably won't believe me.

[kadoban]

Do they say how? Doesn't seem like it even makes sense anymore. I'm going to guess based on your youtube wording that their answer is not vaccines?

[RalfWausE]

"Do they say how?"

I am relatively certain this is the reason they are banned from youtube... i have seen a (now removed) video from a crank on youtube who suggested saturation bombing of high incidence areas might be the solution...

[lugged]

Vaccines + ivermectin. The numbers seem to work but only if you accept the Mexico City study. Or the numbers coming out of India.

[bsdetector]

Bret Weinstein has been citing studies he claims show that ivermectin reduces spread such that even close family members are unlikely to be infected from a person with covid.

edit: curious how hn readers feel they will be able to correct misguided beliefs if they don't even know what those beliefs are.

[pas]

> permanent social distancing and mask wearing is not a problem.

It's a problem, but we can manage it better than overflowing morgues. Frequent tests, rapid antigen testing (let's say at the entrance of restaurants, clubs, festivals), encouraging people who feel ill to stay the fuck away from others, and so on.

[kumarvvr]

Whoa, I sometimes get SpO2 around 91 - 94 and I chalk it up to calibration error on cheap SpO2 devices (The ones that clip on to the hand, cost about 20 USD). Have been tested twice per employer requirements and was never positive though.

[rolleiflex]

The cheap SPO2 devices are calibrated on fair skin. If you have a darker complexion there is a known measurement error. If you are at 91% and feeling fine you are probably fine. Your body has a better SPO2 sensor than anything man-made.

[kumarvvr]

Damn, I am brown and I guess I have to take that as a 3 - 5% error?

[rolleiflex]

That is correct. See here: https://pubmed.ncbi.nlm.nih.gov/18048893/

[camillomiller]

I got it, and it was annoying, sure, but I had influenza A in the past and boy, was that REALLY bad. I would be totally fine if we get to a point where we consider Covid to be like an endemic seasonal flu for the vaccinated, because I can’t see many ways out otherwise

[foepys]

I think what a lot of people call the flu is actually "the sniffles" which desensitizes people to the danger. Influenza like you had is really, really bad. It takes weeks to recover and the first 1 or 2 weeks are hell.

[Pyramus]

Yes, that is correct. I believe the difference is that most of us were exposed to the flu when we were younger, building immunity to the strains that are seasonal.

This is not the case for new strains. There are reports from the 1918 influenza strain that it killed young people over night: Folks went to bed with fever and didn't wake up the next day.

If you had the flu or know somebody who had, it's no joke.

[blub]

A virus with the flu's potential for damage and the SARS-2 level of infectivity even after a vaccine would be terrible for those getting sick, but even worse for healthcare.

[MeinBlutIstBlau]

I had COVID before the lockdowns. It wasn't apparent to me until I started hearing about the symptoms. The fatigue was awful, but on top of that, the night my fever broke I was laying down on my bed during February with a window open and no sheets covering me. All while hyperventilating. I kinda thought this was a weird flu but fortunately I didn't have to worry up front about potential death while having it. Worst case scenario I just wouldn't have woken up.

[codr7]

Yeah, me too.

I traveled by bus all the way from Southern Italy to Sweden just before the virus hit the news, and fell sick with the same symptoms for about a week from the day I arrived.

The fever was nasty, but the one thing I remember most is lying there alone in the middle of the night feeling like I wasn't getting enough oxygen and wondering what the hell was going on.

[MeinBlutIstBlau]

I honestly was a little scared because it was so odd. I though it was just gonna be another flu. But of everything, the fatigue was the absolute worst. My spine, neck, and legs just felt like mush for a full week. Existing was effort. Could barely keep food down.

When my fever broke, I went about my life like normal. Still I'd hate to imagine what it would've been like in a not so vaccinated era like the early 1900s. I probably would've died.

[peter_retief]

I had the virus and it was slightly inconvenient, had a slight fever, cough and shortness of breath. Strangly my wife had different symptoms to me, no fever and vomiting. Lasted around 10 days with no lingering symptoms. I think the fever is important because my wife got reinfected but I did not.

[lambdaphagy]

Glad you're ok, but I'm surprised you describe SOB as a slight inconvenience. In general, SOB is a pretty bad sign-- you're having trouble getting the one thing you'll die fastest without. Sure, you can put up with temporary mild SOB if you know it's going to stay mild, but not everyone can know that :/

[peter_retief]

Thanks, I realize I was lucky, it is a wildly unpredictable virus and I am not trying to minimize the possible outcomes.

[peteretep]

> but I'm surprised you describe SOB as a slight inconvenience

Ever been to a high altitude city? I was short of breath for my first week in Mexico City, and my lungs hurt after exercise. It’s very disconcerting, but also just a slight inconvenience.

[lambdaphagy]

Yes, it's a minor inconvenience when it's expected and you have confidence in a good prognosis. It can be tortuous when you don't know whether it's about to get worse.

[JeremyNT]

i.e., it's like the common cold +/- a bit. Also keep in mind that many people are mostly asymptomatic entirely, even the unvaccinated.

Sure, try not to get sick. Understand that there is some risk of symptoms. But getting COVID once you've had the vaccine shouldn't really be a concern worthy of altering any behaviors to avoid for healthy people.