Thread by @NjbBari3

This is a very carefully considered, thought through thread, and yet I am expecting the opposite.

https://twitter.com/gidmk/status/1551749537810681857

First assumption.

Long COVID is a single entity.

It probably isn’t.

If it was, you could expect the whole thing to behave in a certain way, and respond to prevention similarly.

It probably won’t.

There will be some factors that are reversible. Those will respond well to prevention, such as timely, effective boosters.

There will be some things that are either irreversible, or so slowly reversible that it doesn’t make much difference. The deterioration of these will be slowed by effective boosters, but not stopped, and they will accumulate.

Finally, it is probable that some of the problems may be progressive. In particular I am thinking about the neuro inflammation that appears to be ongoing for months and therefore inflicting ongoing damage.

It’s possible that any further insult may accelerate these.

Second assumption.

That we will indeed be able to access timely boosters for all age groups as well as early antivirals.

Hmmm…

Third assumption. That the boosters will be timed well with infections.

If you are unlucky and always manage to get your infection 6 months after your last booster… it may not be so good for you if the waning pattern we are seeing is the same in the future.

Then there are grey rhino events. (Sudden worse strain, sudden vaccine escape, sudden failure of immune system to respond for any reason from another intercurrent illness or injury, sudden failure of health systems (war, poverty etc)).

Long COVID will eventually be broken down into systems and lots of diagnoses. Pathological mechanisms. Then hopefully treatments.

Each diagnosis will have its own prognosis etc.

For me, I think the best way to be certain to prevent disease accumulation due to COVID is to try to avoid (re)infections.

#VaccinesPlus
#COVIDisAirborne

Should also point out that severity of COVID is associated with one group of complications, often caused by fulminant organ damage, but there is a different thing that happens after mild or even asymptomatic COVID-19.