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My advice for the general public?

DO NOT WORRY ABOUT HEART DAMAGE FROM COVID.

"If you as a member of the public are searching the internet for scientific data on heart damage, you are doing it wrong."

Uncle Darrel
J Condescending but True Facts
The reason why I recommend the general public not to worry about such things is that there is nothing useful you can do about the worry, other than just worry.

The whole point of having scientists to do science and doctors to explain it to you, is so that it is done well.
Scientists spend a lifetime learning how to examine experimental designs, results, and claims from the results; how to check track records of researchers; and how to integrate this into a useful view of the universe.

It is not easy and it is not quick.
Meanwhile doctors spend a lifetime learning to give useful, actionable advice, rather than hitting you with a list of a million things that you could worry about.

That too is not easy to learn and is not quick.
"The man who is his own lawyer,
has a fool for his client"

Source: books.google.co.uk/books?id=oLUEA…
Yes, anyone can of course search for anything.

But in general it is not a good idea for members of the public to do so, in my opinion (only).

Again, an illustration of how easy it is to terrify yourself with (perfectly correct) information.
That mortality rate is EXACTLY what I would estimate. So we are starting from the same facts.

But this is my thinking process.

This virus is ferociously infectious.

0.5-1% of the population of the world is an enormous figure.

So we don't want to let it run its natural course.
Therefore I do my personal bit not to let myself be the conduit between an existing virus carrier, and the hundreds of future deaths that could arise from me passing it on (even if I was only mildly asymptomatic or asymptomatic).

Hand washing, distance, masks etc.
If I and the other non fatally affected people in my downstream chain, can thereby not get it, we will all be saved from all long term consequences, known and unknown.
Yes there maybe long term consequences of Covid.

Every infectious disease has long term consequences in survivors.

They vary in intensity and frequency.

How do we (scientists) learn the answer for a new virus?
When will this information be available?
Normally I try to find out things by myself, using rational methods.

When I can't, due to lack of time or lack of skill, I preferentially rely on the opinions of others WHO SHOW A TRACK RECORD of being as meticulous as I would ideally aim to be.

Not random people.
Yes it is intellectual elitism but that is a part of science.

Not all opinions are of equal value.

A scientific reputation is built over decades and destroyed in a day.

That is why scientists are so careful in their speculation and so quick to correct errors.
What is the possible range of proportion of Covid survivors with organ effects in organ X?
It could be anything. 100% entirely possible.

For example,

Chickenpox leaves 100% of people scars on their skin.

Covid MIGHT leave 100% with people with fatal heart failure.
Let's see if stupid people retweet that as "Covid denier Francis flip flops and admits end of world is nigh".
Literally anything is possible.

Scientists know that.

But we also have a good grip on what is plausible, and the types of things that we as a civilization can do about them.

In fact it is scientists that provide those things.
Just because the probability of something is unknown, does not mean that it will definitely happen.

It is weird to have to say that, but this fact is apparently novel to some people.
What would a good scientist be SAYING about the number of people worldwide who will get long term heart failure from Covid?
Exactly.

The job of a scientist is to recognise when a thing is unknown and to develop an experiment to find out.

If someone is today telling you what that proportion is, what do you know about them?
THIS is how scientists think!

They start off any unknown with a range of POSSIBLE that is wide, and then progressively narrow it as more information comes in.

I've never met Jacob and don't know what he does for a living, but this looks like perfect scientific reasoning.
Is there a Loch Ness type monster in the Thames?
I would accept "No" or "don't know" as correct.

Don't know - for strict purists.

No - for people applying the Jacob Guidol principle, of "if there was, with the number of tourists and camera phones, SURELY it would have been photographed many times by now!"
That's where I am for Covid heart devastation in the *majority* of Covid survivors.

Strictly speaking, "Don't know".
But bearing in mind what we know from:

...

Scientific data on other very ill people who get better.

Effects of other viruses.

Lack of onslaught of new heart failure admissions dwarfing the Covid admissions.

Screeching tone of Covid HF advocates.
I would go for a "No", and be confident about it.

If I am wrong, what are the consequences?

It will happen, and most of us will go onto ACEi BB Spiro and perhaps even empafligznzonglif.

There are bigger, actionable, things to worry about at present.

Enjoy your weekend!
Another person desperate to become upset at all costs.

Let's trace the story.

Ironically, the source was Eric Topol, this time on the side of the angels though.
This is proper science.
Think about the people with virus in their lungs.

How do the virus particles eventually get got ridden of?

Do they die of boredom?

Is it a millennial virus, i.e. dying of lack of convenient wifi access?

Or is it destroyed by the body?

What eliminates the billions of virions?
And what is this body response made of?
And what happens when these T cells and other stuff that I long ago forgot about from medical school, all show up in the lung, and start grinding up the virus particles?
And what does it mean when the inflammation shows up on the CT scan?
So if the inflammation manages to screw the virus WITHOUT you even noticing, what is that?
Eric Topol is quite right in the story.

He says it means that social distancing should not be for only symptomatic people, but ideally everyone, since we can easily have a major fight going on in our lungs without any symptoms.

That is what our immune system is for.
Right got to have a socially distanced samosa ... errrrr ... visit with my parents.
Omg I have been disproven.

Somebody has made an intelligent and well explained case.

Proves that maybe everyone's opinion is equal.
Or maybe not.
Yes you are right Mary, if you are skillful in analysing data and can prevent yourself panicking, the best approach is to evaluate the info for yourself.
However for the average person in the street without the good fortune of a PhD, this is difficult and they are more likely to traumatise themselves than help themselves.

And, more importantly, they may spread an epidemic of bad information to others.
It takes a lot of confidence (some people call it arrogance) to laugh off news stories etc.
In a world where people seriously believe in ghosts, astrology, alien abduction, 9-11 conspiracy, flat earth, faked moon landings, creationism, etc, there are risks to encouraging formation of opinions, without prior formation of skills to form those opinions wisely.
Another angry person
One of the problems I was trying to illustrate in my thread is that careless, busy, or unintelligent people may be unable to distinguish between

Covid deniers (who are a public health scourge)

and

people who are teaching how to make rational inferences from data.
The tweet illustrates the inability to distinguish,

"Avoid spreading Covid. Hygiene, distancing, masks. It kills people now. Don't waste your time worrying about what else it might do. Death is reason enough."

From

"Please get Covid and die while I hide in my house."
This is a far more sophisticated and intelligent challenge to my line of reasoning.
Many times the settled science has been overturned.

But by striking experiments, such as the Michelson Morley, which made the aether evaporate.

Or still-hard-to-believe double slit photon interference thing, which dynamited the concept of "things".

Not by random hysteria.
The whole point of being a scientist is to try and learn to distinguish a world overturning / expert-shaming / avenue-opening / awe-inspiring inexplicable experimental result from
A. Mistake in experimental design
B. Miscalculation
C. Misinterpretation
Or even
D. Mismotivation.
Important subtle point here.

I have a different view.
I think scientists do validly say:

"We do not know, but here is my inference based on the available data, and here is my reasoning."

It is a subtle point, that non-scientists often do not understand.
In the absence of proof either way, scientists DO form opinions.

And I listen to those opinions.
But I am choosy about whose opinions I give weight to.

I look for a logical approach and careful reasoning, and a recognition of the uncertainty.
I don't KNOW that there is no Loch-Thames monster, but when people say "We don't know, so the probability is 50%", they go to the bottom of my list of plausible people to borrow opinions from.

8-)
That is disappointing. The advice was most certainly not for you.
It was for people who read a news article about 50% of people who get covid getting "permanent heart damage" and get scared.

And then pass it on to their friends and relatives.

(Either the covid or the false inference!)
My advice for general members of the public remains, "Unless you are ready to become unnecessarily upset and distressed, do not read news stories or scientific papers about dangerous other effects of a disease that we ALREADY know is fatal and we should be trying to prevent."
Very nice thread Peter.

And I note that you recognise that Amateur Epidemiology can get it wrong.

How much more wrong could it be, if one doesn't even do Amateur Epidemiology, but rather copy and paste the shreikingest news story that one can find?
Certainly help people get up to speed in Professional Epidemiology.

On the Cardiology side here's an excellent story by Anish Koka.

Your professional epi tutoring + Anish's professional cardio info would be a great place for the Worried Well to start.

medscape.com/viewarticle/93…
Well here is another example of incorrect inference.
I would argue the opposite.

Most radical skeptics turn out to be wrong, which is why scientists tend to disregard people whose only demonstrable skill is radical skepticism.

livescience.com/24310-flat-ear…
The fact that radical skeptics can construct a detailed interpretation, doesn't automatically mean we should believe them.

Note the care with which the 32-mile wide Sun/Moon are given a generous 100 mile clearance from the stars.

Meticulous,
Fervently believed,
but still wrong.
Missing some Tweet in this thread? You can try to force a refresh.

Keep Current with Prof Darrel Francis ☺ Mk CardioFellows Great Again

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