Thread by @brownecfm

1. I've said exactly this for quite some time. Expanding on Adrian's point here, Covid-19 has three distinct characteristics as a disease that enables it to be denied at a societal level.

https://twitter.com/SillyPutty78/status/1954315595039887370

2. First, none of its symptoms trigger the human disgust mechanism. Adrian gives a great example of this. The two key symptoms that distinguish Covid-19 from other common diseases are cognitive dysfunction and anosmia, both of which are *invisible* to other people.

3. In simulations I took part in long before the Covid-19 pandemic, diseases with symptoms that triggered the human disgust mechanism - symptoms such as disfigurement, vomiting, incontinence, bleeding, and convulsive syncope - were most likely to cause people to avoid infection.

4. Second, unlike other common diseases, Covid-19 is not generalisable. That is to say, unlike the common cold, influenza, or norovirus, one person's experience of the disease cannot be relied upon to accurately predict another's.

5. For example, if you're unfortunate enough to get norovirus, and then a month later a friend of yours gets it, you can describe to your friend exactly what his or her disease course is going to be like with a high degree of accuracy, based on your own experience.

6. Likewise with flu or the common cold. This is absolutely not the case with Covid-19. The wide spectrum of symptoms and severity of the disease means it is not easily generalisable in this regard. Just because 'it's the sniffles' to you does not mean it will be for your friend.

7. This inability to generalise the experience of Covid-19 sets it apart from other common diseases, and also, more profoundly, from our shared sociological understanding of how diseases operate in society. Fundamentally, one person's experience of the disease is not predictive.

8. This sets the scene for the disconnect we see across society today; because we are so used to being able to predict another's experience of a disease on the basis of our own experience of it, there is a constant, flawed, and ever-present societal assumption that Covid is mild.

9. Third, in my own experience, people do not understand Long Covid. They have a fixed view of it that can be summed up as 'severe symptoms that do not resolve'. It is also seen as rare, which is why I know people with Long Covid who don't know they have Long Covid.

10. In addition, the vast majority of people are not accustomed to viewing acute diseases as risk factors. Most people don't grasp that a cardiovascular event could be triggered by a mild bout of Covid-19 they had three months previously, for example.

11. These three factors: lack of triggering the human disgust mechanism, inability to be generalised, and lack of widespread understanding of sequelae of infection all contribute to the societal denial of the dangers of Covid-19.

/end