66% of adults had at least 1 symptom during the acute phase (first 2 months) of diagnosis of #COVID-19.
I’ve highlighted the symptoms experienced by at least 10%. Note that some of the less common symptoms are quite debilitating though (e.g., 9% w/lung pain).
2/12
If you had a #COVID symptom initially, what are the chances it persists beyond 2 months? See 2nd column, green highlights emphasize those enduring among >10%.
Many of the initial symptoms endure in about 20% of ppl. Russian-roulette like odds.
3/12
If you know someone with a new #COVID infection/reinfection who is experiencing symptoms, dive deep into that particular row.
For example, while memory loss is rare (4.3%), it’s the most enduring symptom beyond 2 months (40% persisting).
4/12
If you had an acute #COVID symptom, what were the chances it would resolve within 1 year?
See authors’ BLACK text.
I’ve also added a column with the chances a symptom persists (ORANGE text). Balanced framing. 🙂
5/12
Now, let’s manually combine the acute (<2 month), near-term (>2 month), and long-term (>1yr) #COVID data into one figure. Silly JAMA. 😊
Some symptoms present at 2 months largely fall off. Others persist in >25% (palp, art pain, att/conc, memory, sleep).
6/12
Overall, the number of #COVID-19 symptoms each person experiences diminishes over time.
Caveats: Initial infections were all pre-vax (call for hope), but also pre-omicron and before many reinfections (call for caution). Note, %s are among those who had an acute symptom.
7/12
Older adults, women, and ppl w/>5 acute symptoms were more likely to have persistent #COVID symptoms at 1 year.
Higher BMI = more persistent symptoms. Bad for the U.S.
8/12
An Appendix figure models the typical time to resolution of a #COVID symptom (crude estimate, varies by symptom & individual).
I added the blue line, which suggest about 5% would experience symptoms at 3 yrs. That's >16 million Americans. Very rough estimate. #recession
9/12
Model of time to COVID-19 symptom resolution by subgroup.
#COVID has persistent effects for those with a history of cancer or who had a bad acute case. Either we have a critical gender health disparity or men are trying to walk off heart palpitations. 🤔
An average of 10% of adults were experiencing long-term symptoms from #COVID-19.
The authors note that this is a critical public health problem b/c of the high incidence of infection. They are perhaps too optimistic. We have a high incidence of REinfections.
11/12
Limitations: The COVID-19 initial infections were all before the vaccine era, mostly before reinfections, and pre-omicron.
You cannot have long-term data AND up-to-date world events. Stay cautious until the long-term data are optimistic.
12/12
By the way, feel free to share any of this on other platforms (Mastodon, Discord, TikTok, Myspace, or even Facebook) and with family/friends. I tried to annotate the figures in a way that it would be relatable to a general audience. Where I failed, ask questions.
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You probably saw this week's NEJM article on #LongCOVID. We did a special section on it in this week's PMC COVID-19 Forecasting Report (pgs 6-8).
THREAD of tables. 🧵🔢
1/
Details:
Our model continues to provide estimates of Long COVID cases that will ultimately result from each day’s infections.
We provide a credible interval that 5-20% of infections will result in Long COVID.
This week, Al-Aly and colleagues reported in the New England Journal that in the more recent era of the pandemic, vaccinated individuals have a 3.5% chance of developing Long COVID from a particular infection.
They focused on medically documented new serious health conditions. We continue to view 5% as a useful lower bound for two reasons.
Long COVID chances were higher in unvaccinated individuals in their study, and there were no analyses based on time since last vaccination.
With many Americans still unvaccinated and many not vaccinated in the past year, the true estimate for a 2024 infection could well surpass 5% for a medically documented new serious health condition.
Moreover, Long COVID is a heterogeneous condition, and many cases are likely not medically documented, especially at the less debilitating end of the spectrum.
The following tables show the risk of ever developing Long COVID from an infection assuming 3.5%, 5.0%, and 20.0% rates.
These statistics document the seriousness of Long COVID with Americans getting infected nearly once a year (average of 12.5 months by our estimates).
However, it is also important to know that some effects are enduring, and others more likely to improve, so many with Long COVID will improve.
Many will also have repeated bouts of Long COVID, likely with different phenotypes.pmc19.com/data/
If you assume 3.5% of people get Long COVID per infection, the risk grows sizably with reinfections, which are happening nearly once per year. Avg of 9 infections/American the next decade.
In the previous Tweet, we note how 3.5% is an obvious underestimate.
2/
Based on that 3.5% estimate, a more realistic low-ball estimate of serious long COVID is 5-7%, given that not all serious new health conditions are documented in medical records & rates are higher among those unvaxxed or not recently vaxxed.
Transmission continues to decline. About 1 in 161 people in the U.S. are infectious, the lowest levels since July 1. Transmission levels are higher than during 27% of the pandemic, but a good time to catch up on delayed care. 1/4
I have some concerns about Biobot's real-time data quality at the moment. Their real-time data have over-reported levels the past 8 weeks (11% last week, previously 6%, 10%, 7%, 5%, 9%, 4%, 5%) relative to later corrections. Huge bias!
2/4
Qualitatively, the over-reporting in real-time data lead me to believe there's a 50-50 chance we see a May "wavelet" versus continued decline for a couple months. Some of the county-level Biobot data seem implausible (e.g., levels of "3" in Mason County, WA, but others too). 3/4
31 Reasons Why the New 1-Day COVID Isolation Policy is Wrong
#1
Experts in modeling and testing know that people are infectious with COVID for an average of 7 days, with substantial variability around that average.
#2
People use defense mechanisms to temporarily avoid the death anxiety evoked by thinking of COVID. The too-short 5-day iso was an example of this (see final example).
Such defenses provide temporary relief and are almost always harmful long-term.
PMC COVID-19 Forecast, Week of Feb 26, 2024
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Forecast for the next month
Over the next month, we should see transmission fall from 790,000 infections/day toward more like a range of 200,000-450,000 infections per day, depending on better or worse scenarios.
That's "good" news in the relative sense for those putting off medical appointments the past 6 months, though still extremely high transmission in any objective sense.
See the online report for details on the models.
Surge in Context
At this point in the surge, it is clear that the peak transmission day was around December 27 (1.92 million/day), and the midpoint of “surging” infections (>1 million/day) was around January 9.
We are estimated to have had 85 total days with >1 million infections per day (November 28 through February 20) during the surge, though these numbers may still fluctuate with corrections the next few weeks.
The low-point leading into the surge was October 18 at 547,000 infections/day. Infections have been at “wave” levels (>500,000 infections/day or higher) since the onset of the late summer wave surpassed that milestone on July 27. We are estimated to dip below 500,000 infections/day around March 6.
This is very unfortunate timing because the medical facilities that enacted universal masking may end policies on March 1. Many were hoping for a period of lower transmission before such policies ended. As of today, the estimated low point for transmission is March 27 (348,000 infections/day), but the level and date are subject to much uncertainty.
PMC COVID-19 Forecast, Week of Feb 26, 2024
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Current State of the Pandemic
🔹73 million infections in the U.S. in 2024 (so far)
🔹790,000 daily infections
🔹1.66% (1 in 60) actively infectious
🔹40,000+ resulting #LongCOVID cases/day
Deeper Dive
Transmission is finally starting to decline again, and expect major declines the next four week.
U.S. wastewater levels indicate that COVID transmission is higher than during 58.4% of the days of the pandemic (down from 85.9% a week ago). Transmission is lower than 41.6% of the pandemic.
As we noted the past two weeks, we believed the post-peak hill was itself peaking on around February 7th and that last week’s slightly higher values might get retroactively corrected downward. That was, in fact, the case (the peak was the 7th), and transmission has fallen further since.
We are still at very high “wave” levels, but no longer “surging” at over a million infections/day. The big picture remains very bad, but this is good news for people putting off medical appointments for months.
PMC COVID-19 Forecast, Week of Feb 26, 2024
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Risks in Group Settings
Although transmission is falling, it's easy to get distracted by the relative changes and ignore that the absolute risk remains high, especially in large groups with limited or no mitigation.
In a group of 10, there's a 15% at least one person is actively infectious. In a group of 30, it's a 40% chance, and so forth. Almost nobody would take those chances of a serious illness if informed and capable of grappling with the seriousness of that risk without becoming defensive. Unfortunately, a lot of institutions are pushing minimizer narratives if not directly forcing students and workers into more dangerous settings.
Dr. Moriarty & other modelers know people are infectious for an average of about 7 days, per high-quality studies. Many for much longer.
Dr. Mina's pinned Tweet lays out a sample timeline.
Sending kids to school on Day 2 positive will essentially maximize infections. 2/4
The consequence of the California 1-day isolation policy is that many parents and grandparents will develop serious health conditions and too often die prematurely.
Bad for families. Good for inspiring the next generation of bereavement workers.