Long Covid & other SARS-COV-2 sequelae are underreported in the US.

1. ~55% of Americans believe they've had covid

2. IMHE estimates 98% of Americans have actually had covid

People who don't believe they've had covid won't attribute new health conditions to it. /1 🧵
About 5% of ALL US adults have activity limitations from their long COVID. This is obviously only counting people in the 55% who believe that they have had COVID. That means the real number will certainly be more. /2
We have a crisis of unawareness of covid due to multiple factors. There is also some level of disbelief and an unwillingness to distinguish it from other viruses. We need updated easy to access tests, and we need to encourage testing. /3
In the US there is politicization of health and beliefs about the body and self. We saw this earlier in the pandemic when people going on ventilators in ICU for covid would refuse to believe they had it. Some of that politicization is relevant here, if a secondary explanation. /4
We need more scientific research into people who don't believe they have ever had covid but who have had new onset health conditions since the pandemic began. It's absolutely crucial to show all the ways covid is doing harm, and discover the extent of it. /5
If we can't show the true toll of COVID with science many of its sequelae will be ignored & lumped into other categories that ultimately will result in a failure to address the underlying cause. This is what is happening to people with Long Covid and other sequelae every day. /6
Sources:

CDC Pulse Survey:
cdc.gov/nchs/covid19/p…

Institute for Health Metrics and Evaluation:
healthdata.org/sites/default/…

/7
This is a correction thread because I erroneously misinterpreted the CDC survey's info on the original thread after misreading another post about it. I apologize for that and corrected my error within an hour.

The message here remains extremely important.

/8
Many seem fixated on the 98% number I used. Sure, maybe that estimate is inaccurate, but certainly not by more than 20%, meaning we still have a large problem with health condition attribution. I actually would find it unsurprising if only 6.5 million the US haven't had covid. /9

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More from @BlakeMMurdoch

Mar 23
1. 55% of Americans believe they've NEVER had covid (up from 40%)

2. IMHE estimates 98% of Americans have had covid

Long Covid & other SARS-COV-2 sequelae are underreported in the US.

People who don't believe they've had covid won't attribute new health conditions to it. 🧵 /1 ImageImage
About 5% of ALL US adults have activity limitations from their long COVID. This is obviously only including people from the 45% who believe that they have had COVID. That means the real number could easily be double or more, or less than double. But it will certainly be more. /2 Image
We have a growing crisis of unawareness of covid due to lack of testing & some level of delusion about covid. Unless statistical problems with CDC's surveys explain the variance, since summer 15% of Americans went from believing they had COVID to claiming they never had it. /3
Read 7 tweets
Mar 16
@jljcolorado is correct, and this is a huge deal.
Shifting evidentiary standards for NPI's to cumbersome, confounder-ridden evidence-based medicine standards can be intentional.

That's because it is incredibly easy to manipulate data to manufacture and merchant doubt with EBM.🧵
Some EBM experts still don't accept that masks work. This is because they have fallen into the trap of believing their area of expertise is the only true lens of knowing.

Engineers modelled & tested masks, just like they modelled spaceships before sending people into orbit.
Masks (specifically fitted respirators) work, this is not a question. What are the upper bounds of compliance with a continuous masking policy in a given context? We can study that. But when we are studying mask mandates with respirators we are primarily just studying compliance.
Read 4 tweets
Mar 14
"High prevalence of breakthrough infections are evidence of us failing in our war of attrition against the virus... increased caseload, hospitalisations... lost days from work, chronic disability symptoms, & an inability to simply return to normal life."🧵 thelancet.com/journals/lanin…
Essay from @Daltmann10 & @BoytonRosemary.

"If we now appreciate that even hybrid immunity to SARS-CoV-2 infection is (differentially, depending on previous immune experience) poorly durable and annual debates on booster strategy are required, how should we move forward?"
"In terms of sequence and epitope expression, the XBB omicron subvariant is now as distant from wild-type SARS-CoV-2 as SARS-CoV-2 is from SARS-CoV, such that XBB should probably be called SARS-CoV-3."
Read 6 tweets
Mar 7
There have been many reports of people going out knowing they are positive for COVID, denying a known infection is COVID, etc. This is a very interesting essay on some possible mechanisms by which SARS-COV-2 may manipulate infected people's behaviour. /1🧵link.springer.com/article/10.100…
These are potential mechanisms and are not proven to my knowledge (paper is 2021). Some of them are based on known potential effects of specific biological interactions. Social factors are likely more powerful than biological ones for explaining behaviour that transmits COVID. /2
Definitely the most important one is that COVID has several possibly mechanisms by which it can make infected people feel fine. I recall at the beginning of the pandemic, people would feel fine but have incredibly low oxygenation, meaning they were about to crash and die. /3
Read 13 tweets
Feb 26
Francois Balloux criticized me today for pointing out problems with the Cochrane masking review.

He said that Cochrane reviewers shouldn’t contact authors of the studies they are reviewing. The problem: that’s exactly the opposite of what the official Cochrane guide says.
My tweet thread here, which he was attempting to discredit, showed the Cochrane reviewers didn’t seem to be aware of the existence of the publicly available raw data from a key COVID-era masking trial, and didn’t contact the authors to ask for it.
Indeed, if you look at the 2022 Cochrane review training guide, it recommends the exact opposite of what Balloux says.
training.cochrane.org/handbook/curre…
Read 4 tweets
Feb 25
An anonymous parrot on Twitter somehow knows more about research ethics than many dominant medical voices. There is no equipoise to respirator RCTs.

Engineers do not run experiments where people are sent into chemical-laden vessels with & without respirators to see what happens.
Nor do they compare fit-tested P100 elastomeric respirators to surgical-style masks with far worse lab filtration rates & giant gaps in the fitment. There is NO NEED. It is unethical and pointless. We know respirators work. See also: international industrial safety standards.
I sit on a data safety monitoring board that oversees medical research. We have to assess over time whether there is still clinical equipoise. I.e. if we assess that one arm of the trial is proving strongly superior, we must halt the research as it would be unethical to continue.
Read 5 tweets

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