1. A consequence of 'normalising' Covid-19 (which, let's face it, is actually in many cases a concerted effort to *erase* discussion about the disease), is that it tacitly creates a false binary between living healthily and avoiding infection.
2. I've seen a few examples of this false binary lately, and generally they take the form of an earnest (and sincere) concentration on living and aging as healthily as possible without mentioning that SARS-CoV-2 infection is a risk factor for new-onset chronic illnesses.
3. There is a tacit and toxic assumption that underlies this false binary, which is as follows: that it is impossible to live and age healthily AND try to avoid SARS-CoV-2 infection. This notion is both incorrect and insidious.
4. The key determinants of living and aging healthily are in no way incompatible with trying to avoid Covid. Some adaptation may be required regarding social connections - specifically with people who are not trying to avoid infection - but it's not insurmountable by any means.
5. It is, of course, very easy to see the other unspoken assumption in this discourse, which is that people who are actively trying to avoid SARS-CoV-2 are, by definition, engaged in an *unhealthy* lifestyle.
Nothing could be further from the truth.
6. That isn't to say, of course, that people trying to avoid infection automatically have healthy lifestyles - rather, that the former is independent of the latter. Avoiding SARS-CoV-2 is not unhealthy in and of itself; it is the opposite. It's mind-boggling this has to be said.
7. In short, trying to avoid infection with a virus that can cause significant sequelae is a healthy lifestyle choice, because it reduces the risk of developing chronic ill health. It requires discipline to do so, as many healthy lifestyle choices do - fitness, diet, weight etc.
8. What is, in fact, unhealthy, is the widespread propagation of this false binary: if you tell the general population that Covid is nothing to worry about, and, as such, shouldn't even factor into living and aging healthily, you're actively promoting an unhealthy lifestyle. /end
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1. The reason the pandemic is uniquely dangerous is because of its pace. That is to say, the changes it is causing in society (highly stressed healthcare systems, workforce issues etc) and the long-term effects of infection are accumulating slowly enough to be normalised.
2. This phenomenon - familiar to climate scientists - is effectively the tale of the boiling frog. It is both insidious and pernicious.
3. We see this in the data on the prevalence of Long Covid and other sequelae of infection. We see it in the data on the increasing risks of re-infections. Many of us see anecdata in our own lives - a level of illness in our social circles that wasn't normal pre-pandemic.
1. I place tremendous value on my health - physical, mental, and cognitive. Since getting sober, over 16 years ago now, I have taken a fierce joy in both hard, challenging exercise, and tackling complex analysis at speed.
I am very aware how easily I could lose all of this.
2. I am 52 years old, and can run a half-marathon with essentially no warm-up and no recovery time. I can hike over rough terrain all day with a heavy rucksack moving at a steady three miles per hour pace. This level of fitness places me squarely in the top 5% of my age group.
3. The majority of my friends in Ireland are ten years younger than me. None of them have this level of cardiovascular fitness. I fully intend to get even more physically fitter and to tackle more and more mentally demanding tasks as I continue to age.
1. 'However, additional provisional data indicate that cases of tuberculosis (TB) in England rose by *10.7%* in 2023 compared to 2022 (4,850 compared to 4,380). The rise signals a rebound of TB cases to above the pre-COVID-19-pandemic numbers...
2. ...While England remains a low incidence country for TB, the current trajectory takes the UK further from the pathway to meet WHO 2035 elimination targets. **UKHSA is working with partners to investigate the reasons behind the increase in TB**'
** my emphasis.
3. I sincerely hope that one of the reasons @UKHSA is investigating regarding this increase in TB is the documented potential for SARS-CoV-2 infection to re-activate latent TB.
3. Addressing the hypothesis that a lack of effective vaccines would have inevitably led to the widespread introduction of indoor air filtration, well, it's possible, but, it's also possible that the dogma of 'immunity via infection' would have taken hold even more strongly.
A mantra in my analysis work is this: *risk mitigation can create new risks*.
A non-Covid related example: in general, soldiers only wear armour on their head and torso (helmet and Kevlar vest). Why aren't they equipped with leg / arm armour?
2. The answer is fundamentally this: extra armour on arms and legs would offer marginal extra protection at the expense of mobility and speed (body armour is heavy). As such, the effect of extra protection would actually be *negative*: moving very slow makes you an easy target.
3. As such, increased mitigation against one specific risk (in this example, protection from shrapnel injuries on the arms and legs) actually *creates* a much larger risk - the vastly reduced speed of the soldier makes injury / death much more likely on the battlefield.
1. This is both an excellent and difficult question, but I'll attempt to answer it. When I'm asked to forecast by corporate clients, I usually give three scenarios: base-case, best-case, worst-case.
2. Base-case: deployment of 2nd generation vaccines (higher efficacy, not sterilising) by first quarter of 2025, low uptake. As such, continual waves of acute infection and attendant sequelae. Those who can avail of 2nd gen vaccines will have ⬆️ protection from infection.
3. Increased use and availability of therapeutics, and protocols for ⬇️ risk of Long Covid and other sequelae. Some adoption of indoor air cleaning, thus ⬇️ transmission in those areas.