tern Profile picture
Apr 22, 2024 25 tweets 6 min read Read on X
Wow.
Let's work through *all* the slides Yale School of Public Health shared...
🌎"What we know (and don't) know about Covid's effect on the immune system"
🧵
Image
(just the immune system, though, nothing here about cardio or lung or liver or nerve, or other stuff, OK?)
LASTING IMPACT.
"Growing research shows infection with SARS-CoV-2 can create lasting differences in some people's immune systems." Image
THIS LOOKS LIKE (1)
"Altered immune system cells

Severe cases of COVID-19 can change the parent stem cells that generate immune cells. These altered stem cells create cells that are more inflammatory." Image
THIS LOOKS LIKE (2)
"Viral reservoirs and fragments

Proteins and fragments that have been found in people with Long COVID can set off a continuing immune response and amplify inflammation." Image
THIS LOOKS LIKE (3)
"Immune dysregulation and chronic inflammation

Dysregulation = when some immune cells are working hard, and others are exhausted. How long it can last is unknown." Image
THIS LOOKS LIKE (4)
"Triggered autoimmune conditions, blood clots, and latent viruses

COVID-19 infections can trigger autoantibodies that lead to autoimmune disorders." Image
"5-20% of people develop lingering symptoms or new health conditions after infection, called Long COVID.

As of the CDC's latest count in March 2024, 30% of all American adults who've had COVID have experienced Long COVID."
👀🚨 Image
"The more COVID-19 vaccine doses you get, the lower the risk of Long COVID. The more reinfections you have, the higher the risk." Image
"172% INCREASED RISK

The risk of developing an autoimmune disease rose by up to 172% after infection, per a study following people from 2020 to 2022.

Up-to-date COVID-19 vaccination can reduce the likelihood of developing an autoimmune condition after infection." Image
"OTHER ILLNESSES

SARS-CoV-2 can also activate other viruses that have been lying dormant, like Epstein-Barr and herpes viruses.

Studies have found kids with prior COVID-19 infections had a greater risk of RSV infections." Image
Notice the little bit at the bottom?
"Always feel run-down? Practice harm reduction and learn how you can protect yourself from more damage."
Good idea. Image
"49% OF COVID INFECTIONS ARE ASYMPTOMATIC,

which means you may not know if you are actually sick. This is why it's important to take a multilayered approach (one or more of the following) to protect yourselves and others:" Image
"N95 and KN95 masks

Up-to-date vaccinations

HEPA air filtration

Rapid tests before gathering

Good ventilation (carbon dioxide <800 parts per million)

Attention to wastewater levels of COVID-19" Image
WHAT WE DON'T KNOW (1)
"The long-term impact on other illnesses

Outside of the influence on RSV and reactivated viruses, it's TBD whether altered immune systems predispose people to conditions like other infectious diseases, neurodegenerative diseases, or cancer." Image
WHAT WE DON'T KNOW (2)
"Why some people's conditions persist

We don't yet know why some people recover and their immune system restores, and why others continue to decline." Image
WHAT WE DON'T KNOW (3)
"What diagnostics and therapies can help restore the immune system

More identifiers like viral load tests and biomarker tests, plus treatments for Long COVID, are needed to help the millions living with the condition." Image
Wow.
And you might think that was an extensive deep dive into what Covid does to you...
BUT IT WAS ONLY ABOUT YOUR IMMUNE SYSTEM.
Covid does that to every bodily system.
That thread was only a glimpse of what we know about what Covid does.
Don't catch it.
Don't spread it.
But, of course, your immune system can then *also* affect every other bodily system, so the cycle continues.

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More from @1goodtern

Jan 17
A couple of very important studies out just in the last 24 hours confirming what we've been saying for years and years now: Covid infections affect your immune system *badly*.
Here's a few things you may have missed in them. Image
This is almost entirely post vaccination data
This is not an unprotected population.
Baseline immune measurements come from a period when vaccination coverage was already high, and the immune damage appears *after mass infection*.
So two things there:
The effect didn't appear until after infection.

Vaccination didn't stop it.
Read 86 tweets
Jan 15
You're not going to like the next tweet in this thread, so don't read it.
I don't think there's a difference between the set 'people who have had a covid infection' and 'people who have long term effects from a covid infection'.
I just think that the second set 'people who have long term effects from a covid infection' varies enormously in degree and condition.
Read 8 tweets
Jan 15
This may be obvious to everyone else already, but it occurred to me today that ICE just does not have the manpower to do everywhere what it's doing in Minnesota.

The surge there is not sustainable nationwide.
But the appearance of ICE being everywhere right now is heavily shaped by the unusually large and concentrated deployment in Minnesota, which is drawing outsized attention and resources.
They don't have capacity to mount similar surges everywhere simultaneously, especially given training and logistical limits.
Read 14 tweets
Jan 14
One of my dissertations was on the causes of the second world war.

I wrote it late, in a hurry, when I was young, naive, sleep deprived, and thought that it was ancient history.

But one aspect of what I wrote was what Germany looked like *from the outside*.
🧵
Here are six key views of Germany from other countries at the time that totally misread the situation.

Some of them might be relevant today.
They overlap a bit, but I've put a rough timeline along with them.
Read 61 tweets
Jan 10
Just imagine for a moment that you are infected with a virus that harms the lining of your arteries. The virus doesn't damage the artery walls in every part of your body to exactly the same degree. Some parts will be more damaged, some less.

At your next infection, will the parts of your artery wall that were more damaged first time round be more or less vulnerable to the virus?
It's an interesting question, isn't it.

Will those damaged parts be better equipped the next time round?
Sadly the answer is no

Those harder-hit patches do not reset to factory condition once the acute infection passes.
Read 9 tweets
Jan 10
I just want to do a very quick run through the latest up to date charts of rates of sickness absence in *young* doctors here.

Yeah. This is still *really* important, and I'll explain why in a moment.
There are some really really important points before I get on to the graphs.
First off - these are young doctors in their mid to late 20s.
'F1s' and 'F2s' and 'Core Training' doctors.

There may be a very tiny number of older F1s and F2s, but *they're rare*.
Read 77 tweets

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