Corona Virus: It's a Marathon, Not a Sprint

Smoove_B · Post by **Smoove_B** » Sun Oct 30, 2022 3:59 pm

As I've suspected for their policy choice, but this is the first type of "confirmation" I've seen:

A Chinese business consultant in a Ted-style talk justified zero-Covid policy by saying that in 10 years the West will be brought to its knees b/c long-Covid, which will decimate most of its labor force.

malchior · Post by **malchior** » Sun Oct 30, 2022 4:11 pm

It Is a logical conclusion. The Chinese presently tend to be much better at the long view. Our "leaders" don't think this way anymore consistently. Though it remains to be seen if they'll be right or whether it will remain realistic.

Smoove_B · Post by **Smoove_B** » Sun Oct 30, 2022 4:19 pm

Exactly. No one knows if they're right, but I can at least appreciate what they're thinking. Just seeing how the "Let it Rip" philosophy has affected us so far (politically, economically, health status, etc...) I don't necessarily think they're off base. To be clear, their Zero-COVID policy is also crazy but they seem to be in the driver's seat right now as we're collectively at the mercy of their production interruptions.

Zarathud · Post by **Zarathud** » Sun Oct 30, 2022 5:32 pm

COVID will definitely drive down U.S. productivity long term. I’ve been trying to watch the kids and work at home while my wife is isolating, and it’s been a 50% drain on my workflow.

Max Peck · Post by **Max Peck** » Mon Oct 31, 2022 4:28 pm

The happiest place in the world is... inside a Chinese COVID lockdown?

Shanghai Disney: Visitors unable to leave without negative Covid test as park shuts

Shanghai Disney has become the latest high-profile venue to shut its gates thanks to China's strict zero-Covid policy, trapping visitors inside.

People have been told they will not be allowed out of the theme park until they can show a negative test.

It comes after Shanghai reported 10 locally transmitted cases on Saturday.

China's controversial zero-Covid policy has already seen millions of people repeatedly locked down, sometimes in unusual locations.

The sudden nature lockdowns have seen people fleeing shops - including a Shanghai branch of Swedish furniture giant Ikea - and workplaces as they try to avoid being trapped inside.

However, those awaiting their freedom at Shanghai Disney can console themselves with one positive: rides are continuing to operate for those trapped inside The Happiest Place on Earth.

Isgrimnur · Post by **Isgrimnur** » Mon Oct 31, 2022 4:42 pm

I would be fleeing into IKEA.

Smoove_B · Post by **Smoove_B** » Mon Oct 31, 2022 4:49 pm

It's almost like 5 days isn't enough. But to consider anything else would cause financial problems, so get back to work.

Rochelle Walensky, director of the Centers for Disease Control and Prevention (CDC), has tested positive for COVID-19 again after completing a round of the coronavirus antiviral treatment Paxlovid.

Walensky tested positive for COVID-19 earlier this month, going into isolation and taking “appropriate action” for her health.

On Monday, the CDC said Walensky had experienced “mild symptoms” during her infection and eventually tested negative for the virus after completing a round of Paxlovid.

“On Sunday, Dr. Walensky began to develop mild symptoms and has again tested positive. Consistent with CDC guidelines, she is isolating at home and will participate in her planned meetings virtually,” the agency said.

This apparent case of Paxlovid rebound is not surprising. White House chief medical adviser Anthony Fauci and President Biden both tested positive for COVID-19 again following a round of Paxlovid.

Really, the take home message is that if you're wealthy and/or have a job with benefits, you can just work from home and not miss out on paycheck. I have a buddy that lives in VA that is on his second round of COVID-19 (he's current with vaccinations) but he can't afford the time off (he's an hourly heavy equipment operator) so his boss told him to wear a dust mask and just come in sick. Presumably a dust mask because that won't cause alarm on a construction site.

'merica.

gilraen · Post by **gilraen** » Mon Oct 31, 2022 4:54 pm

Is there anyone who didn't "rebound" after taking Paxlovid? Maybe that should be considered a feature and not a bug. I'm not arguing that it reduces risk of serious illness in older and immunocompromised people but since everyone appears to be taking it now even for mild symptoms, what's the point of even pretending that it will "cure" you in 5 days?

Smoove_B · Post by **Smoove_B** » Mon Oct 31, 2022 4:59 pm

Yeah it went from "this is a pretty rare event" to (anecdotally) quite common. But again, if we give someone medication and tell them in 5 days they're be super terrific and don't need to wear a mask - get back to work - the narrative falls apart when they get sick again ~7 days after getting better.

pr0ner · Post by **pr0ner** » Mon Oct 31, 2022 5:02 pm

gilraen wrote: ↑Mon Oct 31, 2022 4:54 pm Is there anyone who didn't "rebound" after taking Paxlovid? Maybe that should be considered a feature and not a bug. I'm not arguing that it reduces risk of serious illness in older and immunocompromised people but since everyone appears to be taking it now even for mild symptoms, what's the point of even pretending that it will "cure" you in 5 days?

I didn't rebound after taking Paxlovid.

Isgrimnur · Post by **Isgrimnur** » Mon Oct 31, 2022 5:07 pm

And that's why you're a horrible hockey center.

pr0ner · Post by **pr0ner** » Mon Oct 31, 2022 5:36 pm

Isgrimnur wrote: ↑Mon Oct 31, 2022 5:07 pm And that's why you're a horrible hockey center.

Good thing I don't play center!

LordMortis · Post by **LordMortis** » Mon Oct 31, 2022 6:03 pm

Smoove_B wrote: ↑Mon Oct 31, 2022 4:49 pm It's almost like 5 days isn't enough. But to consider anything else would cause financial problems, so get back to work.

Rochelle Walensky, director of the Centers for Disease Control and Prevention (CDC), has tested positive for COVID-19 again after completing a round of the coronavirus antiviral treatment Paxlovid.

Walensky tested positive for COVID-19 earlier this month, going into isolation and taking “appropriate action” for her health.

On Monday, the CDC said Walensky had experienced “mild symptoms” during her infection and eventually tested negative for the virus after completing a round of Paxlovid.

“On Sunday, Dr. Walensky began to develop mild symptoms and has again tested positive. Consistent with CDC guidelines, she is isolating at home and will participate in her planned meetings virtually,” the agency said.

This apparent case of Paxlovid rebound is not surprising. White House chief medical adviser Anthony Fauci and President Biden both tested positive for COVID-19 again following a round of Paxlovid.
Really, the take home message is that if you're wealthy and/or have a job with benefits, you can just work from home and not miss out on paycheck. I have a buddy that lives in VA that is on his second round of COVID-19 (he's current with vaccinations) but he can't afford the time off (he's an hourly heavy equipment operator) so his boss told him to wear a dust mask and just come in sick. Presumably a dust mask because that won't cause alarm on a construction site.

'merica.

Question. If resurfacing infection after Paxlovid is not all that uncommon doesn't that mean we are building an infection that is resistant to this form of treatment? If true, is that calculus in the prescribing method? As I mentioned earlier, my doctor has basically resigned to "we're all gonna get it so make sure you call if you think you have it, so we can treat it quickly (presumably with Pax, which every I know whose gone down, has taken.)

Also this make me nervous as I was just hanging out with someone who tested negative for days straight and Pax was part of his treatment.

Kraken · Post by **Kraken** » Mon Oct 31, 2022 6:19 pm

gilraen wrote: ↑Mon Oct 31, 2022 4:54 pm Is there anyone who didn't "rebound" after taking Paxlovid? Maybe that should be considered a feature and not a bug. I'm not arguing that it reduces risk of serious illness in older and immunocompromised people but since everyone appears to be taking it now even for mild symptoms, what's the point of even pretending that it will "cure" you in 5 days?

I didn't. Either time.

Isgrimnur · Post by **Isgrimnur** » Mon Oct 31, 2022 6:20 pm

It's not like antiviral resistance is a thing, right? What's that, CDC? Oh, it is? Well, shit.

And it's not like Covid is mutating faster than the influ ... fuck.

RunningMn9 · Post by **RunningMn9** » Mon Oct 31, 2022 6:40 pm

Isgrimnur wrote:It's not like antiviral resistance is a thing, right? What's that, CDC? Oh, it is? Well, shit.

And it's not like Covid is mutating faster than the influ ... fuck.

I don’t think anti-viral resistance is anything like anti-bacterial resistance though, is it?

Bacteria develop resistance because the antibiotic kills bacteria, but not all of them. The antibiotic specifically selects for resistance, no?

I know that’s not how vaccines and stuff work, but maybe anti-virals have a parallel mechanism that does the same thing?

Smoove_B · Post by **Smoove_B** » Mon Oct 31, 2022 8:02 pm

It comes down to the action of the anti-viral (what it's targeting) and how often (and how significantly) the virus is changing (genetically). Flu viruses don't typically change that much - they genetically "drift" every year so the current batch of flu antiviral work. For SARS-CoV-2, it's genetically going through variant-palooza right now and the non-stop uncontrolled spread we're encouraging will (theoretically) hit on a combination that will render our current treatments less effective or completely ineffective.

Blackhawk · Post by **Blackhawk** » Mon Oct 31, 2022 8:17 pm

It'll settle down somewhere around Zeta Lamba Sigma Q.94.7, I'm sure.

Smoove_B · Post by **Smoove_B** » Mon Oct 31, 2022 8:42 pm

Just seeing this interesting perspective:

Paxlovid has been taken by many without high risks of progressing to severe Covid-19, by people seeking to reduce their symptoms and shorten the duration of their illness. However, the evidence on symptom reduction and shortening the duration of illness is scant for Paxlovid. We also don’t know whether Paxlovid reduces Long Covid risk, has no effect, or increases the risk.

This is has led to debate as to whether Paxlovid is the right move for patients who are not actually in danger of bad Covid outcomes. Does Paxlovid shorten the duration of initial illnesses and the contagious windows in enough people to justify the risk of rebound—i.e., backfires on exactly these two outcomes? And even if it does backfire by those lights, does Paxlovid help enough people avoid hospitalization to be worth it on the population level? These remain unknowns.

There’s also a camp of people who think Paxlovid is not responsible for the rebound effects we are seeing, and that the rise in rebound reports reflect newer variants, existing immunity, or a combination of those.

Regardless, one thing is certain: either Paxlovid causes or increases the odds of Covid rebound, or the phenomenon is just being reported far more often than originally anticipated, either owing to the entity truly having become more common or, possibly, simply due to our enhanced ability to detect it using home rapid tests.

So what does this mean?

Either way, if we want to decrease the spread of Covid, rapid antigen testing needs to be continued for longer, possibly up to 20 days after a person initially gets sick. “Test to return”—the idea that ending isolation after getting Covid should be based on successive negative rapid antigen tests, rather than on some standard time period or symptom improvement, has always seemed like the strategy with the best chance to succeed. The more cases of rebound I hear about, the more convinced I am of that. Sadly, Dr. Walensky’s CDC has not been on the right side of this issue, frequently advising test-to-return and isolation strategies that are inadequate.

...

If and when I get Covid, I don’t think I’ll be taking Paxlovid, though I would advise at least some people in my family to do so, given their individual risks. But I will be testing myself daily for 2-3 weeks after, only ending isolation when I’m sure I am not contagious, and therefore not a risk others. I’m not trying to get other people infected.

Blackhawk · Post by **Blackhawk** » Mon Oct 31, 2022 8:47 pm

If the solution is to make things more restrictive, it's probably not happening.

Regardless, one thing is certain: either Paxlovid causes or increases the odds of Covid rebound, or the phenomenon is just being reported far more often than originally anticipated[...].

Don't forget the power of confirmation bias.

Kraken · Post by **Kraken** » Mon Oct 31, 2022 9:15 pm

Those who have long covid don't continue testing positive for covid, do they?

Smoove_B · Post by **Smoove_B** » Mon Oct 31, 2022 9:29 pm

Kraken wrote: ↑Mon Oct 31, 2022 9:15 pm Those who have long covid don't continue testing positive for covid, do they?

No. Long Covid by definition (the loose one we're using) happens after COVID illness is gone. Specifically, they stop testing positive for a live COVID infection but have a myriad of symptoms that persist for a wild range of time periods. The symptoms could be similar to what they were experiencing with COVID, though more commonly they seem to be different.

I'm still on the fringes of it all (reading as much as I can) but the leading theories all seem to point to the virus having longer term impacts on organs or systems, long after the initial fever/congestion/malaise passes, possibly related to where the virus ends up after it gets into your body and yet-to-be determined risk factors increase your chances of winning the unlucky lottery (most recent study is ~15% of adults that tested positive for COVID-19 develop long Covid), seemingly unmitigated by vaccinations or prior exposures. The rub is we're still not testing enough (STILL!) to really get a sense of how many people have/had COVID-19 vs those that are struggling with chronic issues - our sample is distorted.

Interestingly, in terms of risk, this is one of the first studies I'm seeing where they're starting to dial in:

This study suggests that long COVID is prevalent and associated with female gender and older age, while risk may be diminished by completion of primary vaccination series prior to infection.

I would expect this to continue over the next few years.

Kraken · Post by **Kraken** » Mon Oct 31, 2022 11:56 pm

Smoove_B wrote: ↑Mon Oct 31, 2022 9:29 pm
Kraken wrote: ↑Mon Oct 31, 2022 9:15 pm Those who have long covid don't continue testing positive for covid, do they?
No. Long Covid by definition (the loose one we're using) happens after COVID illness is gone. Specifically, they stop testing positive for a live COVID infection but have a myriad of symptoms that persist for a wild range of time periods. The symptoms could be similar to what they were experiencing with COVID, though more commonly they seem to be different.

Thanks, that's what I thought.

When I tested negative two weeks ago after a week of positive tests, my symptoms were unchanged. When I finished Paxlovid a few days later, my symptoms were still the same. Simultaneous with covid I think that I had one of the other respiratory viruses that're frolicking right now. Remember that Wife was sick at the same time, with the same symptoms, and never tested positive. This virus is still hanging on in both of us, although we're very slowly improving.

I could have long covid, since there's a whole constellation of symptoms and no test for it. But I think it's more likely long cold.

LawBeefaroni · Post by **LawBeefaroni** » Tue Nov 01, 2022 12:43 pm

malchior wrote: ↑Sun Oct 30, 2022 4:11 pm It Is a logical conclusion. The Chinese presently tend to be much better at the long view. Our "leaders" don't think this way anymore consistently. Though it remains to be seen if they'll be right or whether it will remain realistic.

It's more fuel for the "engineered bioweapon" conspiracies.

In other news, US productivity is the lowest since 1947.

Zaxxon · Post by **Zaxxon** » Tue Nov 08, 2022 11:23 am

Well, Colorado's COVID data has finally moved to updating only once/week. Guess the marathon has finally ended.

LawBeefaroni · Post by **LawBeefaroni** » Tue Nov 08, 2022 1:21 pm

DNF is definitely a kind of end.

Smoove_B · Post by **Smoove_B** » Tue Nov 08, 2022 1:26 pm

I wish I knew more about your state to understand what's happening (or what's happened). Namely, they're getting data every day so the decision to not publish it daily is coming from somewhere. Following national trends, I suppose. It'll be a "blip" to hear about once a week (probably dumped Friday night) and soon enough it'll be twice a month, then quarterly. And then just like every other communicable disease no one will hear about it or think about it anymore - that's the plan, at least.

Smoove_B · Post by **Smoove_B** » Thu Nov 10, 2022 7:44 pm

Not the news you want to read:

COVID-19 hospitalizations are rising among babies under 6 months old, and the US Centers for Disease Control and Prevention is urging mothers to get vaccinated to reduce the risk of infection in those not yet eligible for shots, Director Rochelle Walensky said.

“We’re seeing more and more of those younger babies getting hospitalized,” Walensky said in an exclusive interview at CDC’s headquarters in Atlanta. “That’s really where we’re trying to do some work now because we think we can prevent those by getting mom vaccinated.”

...

Average weekly hospitalization rates for babies younger than 6 months were similar to adults between the ages of 65 and 74, according to the study. But while the elderly and people with weak immune systems remain at highest risk of COVID hospitalization, they can get vaccinated, unlike the very youngest patients.

As predicted, the pandemic burden is now shifting to those that are least protected. It's laudable that they're pushing to vaccinate pregnant mothers (as they should) but as a group overall pregnant women are sometimes difficult to (1) reach and (2) convince - especially in marginalized populations.

Smoove_B · Post by **Smoove_B** » Thu Nov 10, 2022 11:19 pm

Additional news you don't want to read (but should be aware of):

The risk of death, hospitalization and serious health issues from COVID-19 jumps significantly with reinfection compared with a first bout with the virus, regardless of vaccination status, a study published on Thursday suggests.

"Reinfection with COVID-19 increases the risk of both acute outcomes and long COVID," said Dr. Ziyad Al-Aly of Washington University School of Medicine in St. Louis. "This was evident in unvaccinated, vaccinated and boosted people."

...

Reinfected patients had a more than doubled risk of death and a more than tripled risk of hospitalization compared with those who were infected with COVID just once. They also had elevated risks for problems with lungs, heart, blood, kidneys, diabetes, mental health, bones and muscles, and neurological disorders, according to a report published in Nature Medicine.

Important note - the study was conducted on individuals at VA health centers:

Experts not involved with the study said the VA population does not reflect the general population.

Patients at VA health facilities are generally older, sicker people and often men, a group that would typically have more than normal health complications, said John Moore, a professor of microbiology and immunology at Weill Cornell Medical College in New York.

Also of note:

However, Dr. Celine Gounder, an infectious disease epidemiologist and an editor-at-large at Kaiser Health News, said there seemed to be a "plateauing effect with multiple infections," with less of a jump in risk after the second infection.

So if you survive 2 infections, your 3+ likely won't leave you disabled. Which is nice.

Zaxxon · Post by **Zaxxon** » Thu Nov 10, 2022 11:45 pm

Smoove_B wrote: ↑Thu Nov 10, 2022 11:19 pm So if you survive 2 infections, your 3+ likely won't leave you disabled. Which is nice.

Snark aside, that's prob the buried lede there, since those of us middle-aged and younger are highly likely to contract it 3+ times since this nightmare is never-ending.

Smoove_B · Post by **Smoove_B** » Thu Nov 10, 2022 11:56 pm

Right, but those first two? Good luck.

Also note that this coupon doesn't necessarily cover new, future variants.

I'm getting ready for the holidays. Can you tell?

LawBeefaroni · Post by **LawBeefaroni** » Fri Nov 11, 2022 12:02 am

Smoove_B wrote: ↑Thu Nov 10, 2022 7:44 pm (2) convince - especially in marginalized populations.

I feel obligated to say, "Working as intended."

Max Peck · Post by **Max Peck** » Fri Nov 11, 2022 11:14 am

Smoove_B wrote: ↑Thu Nov 10, 2022 11:19 pm
However, Dr. Celine Gounder, an infectious disease epidemiologist and an editor-at-large at Kaiser Health News, said there seemed to be a "plateauing effect with multiple infections," with less of a jump in risk after the second infection.
So if you survive 2 infections, your 3+ likely won't leave you disabled. Which is nice.

Taking that statement at face value, I'm not sure that they're saying you're less likely to have a bad outcome after a second infection, just that the increase in risk is smaller. That doesn't imply a reduction in risk, just that the increase in risk from subsequent infections is lower (which does imply an incrementally increasing risk). You're still accelerating toward the cliff rather than decelerating.

Smoove_B · Post by **Smoove_B** » Fri Nov 11, 2022 12:01 pm

Right - the risk is never 0% as every exposure has the potential to cause Long COVID, but after your second infection the study suggests the first two are much more protective than just the first (in terms of reducing risk of Long COVID). The real story here is try not to get COVID. Good luck.

Smoove_B · Post by **Smoove_B** » Fri Nov 11, 2022 12:02 pm

Hey, remember when everyone was talking about going on cruises again? This sounds like a blast!

A cruise ship with an estimated 800 positive COVID-19 cases on board is set to dock in Sydney at 6am on Saturday.

About 3300 guests and 1300 crew members on the Majestic Princess cruise ship will disembark at Sydney Harbour following a 12-day cruise to New Zealand.

However, a Princess Cruises spokesperson said guests with COVID – who were all “mildly symptomatic or asymptomatic” – would isolate in their rooms on board the vessel before disembarking.

“Guests who have not been impacted are wearing masks and this will continue when they disembark,” the spokesperson said.

Guests will travel on to their chosen destinations via private transport arranged by the company.

Zaxxon · Post by **Zaxxon** » Fri Nov 11, 2022 12:05 pm

On a similar note--two work meetings today, two different people are 'a bit under the weather' but in the office. At school--a mom posts on Facebook last night about how her kiddos had expulsatory food exits yesterday, went to the doc, tested neg for flu but prob have it. This am, I see at least one of said kiddos heading into the school.

We can never, ever have nice things.

Smoove_B · Post by **Smoove_B** » Fri Nov 11, 2022 9:13 pm

Figured our friends up north would like this

Ontario will urge indoor masking as ‘three-headed monster’ strains hospital resources

Max Peck · Post by **Max Peck** » Fri Nov 11, 2022 9:49 pm

That's about as good as it's likely to get. Various doctors and public health officials have been asking people to mask up for a while now, but there is essentially no way the government will actually do anything until after the healthcare system is actively collapsing.

Fun fact: The current government would love to get out of the healthcare business, and ideologically it is to their advantage to let the system break so that they can then "fix" it through privatization.

Kraken · Post by **Kraken** » Fri Nov 11, 2022 9:56 pm

Ha. Hospitals here are dysfunctional and on the brink of collapse, especially in pediatrics and emergency medicine. Massachusetts hospitals have 19,000 open positions and more people are dropping out of the profession than going into it. Privatization doesn't work.

LordMortis · Post by **LordMortis** » Sat Nov 12, 2022 7:03 am

Smoove_B wrote: ↑Fri Nov 11, 2022 9:13 pm Figured our friends up north would like this

Ontario will urge indoor masking as ‘three-headed monster’ strains hospital resources

Isn't encourage above recommend. And it seems to have levels. Encourage, highly encourage, strongly encourage. We don't seem to be able to break the strongly encourage ceiling around here. But as stated before, the last time I was out was Tuesday to vote. And I was taken aback. There must have been more'n 20% of people wearing masks (maybe more'n25) in the plague village of that elementary school I had to vote in. I hadn't seen that level since 2020.