People are just not going to be able to get their heads round the slow incubation period of hantavirus.

On reflection, thousands of people have probably already been exposed, and those thousands could expose tens, even hundreds, of thousands more. The sheer time scale is almost impossible to grasp when placed in the context of people engaged in the kind of fast international travel involved with a cruise ship.

I'm just going to say it again once, as simply as I can, for everyone who is slow to understand this:

Covid infection damages the vascular endothelium, the delicate lining inside your blood vessels.

Hantavirus *targets* the vascular endothelium. If you've had the first one, you're more likely to be susceptible to, and damaged by, the second.

I don't think Covid infections cause hantavirus infections, obviously. Who would?

But guess what:
Once you've had Covid, you're going to be more vulnerable to hantavirus, and then possibly increasingly with each extra infection.
Why?
Let me explain: Andes hantavirus is not really a 'disease of the lungs' disease in the simple sense people imagine. A huge part of the danger comes from what happens to the lining of the blood vessels, especially in the lungs.

Covid cases, positivity, hospitalisations, and wastewater here in the UK are all at their lowest point since surveillance started.

Here are the ten things I'm doing differently: 1
I'm still masking with an ffp3 mask everywhere indoors in public to avoid inhaling viral particles.

I've just written and deleted a few versions of a thread about how there are some health conditions that are socially acceptable.

The people who have them are somehow almost canonised just because they have those conditions... But there are also health conditions that are not socially acceptable.

Look:
There is no such thing as overdiagnosis.

There is just diagnosis (correct) or misdiagnosis (wrong).

If a diagnosis is correct, then you can't have too much of it. If there's any incorrect diagnosis, then it's a misdiagnosis.

Trigger warning.
It takes a while for this disgusting article to reach its point, but when it does, it does it with so much callousness and wanton cruelty.

"Long Covid – the disease that started as a hashtag"

No, you hideous ghouls, it starts as covid infection. On 2020:
"it’s inescapable that the period was a melting pot for psychosomatic conditions."

Yes, that would be what killed that quarter of a million people, and hospitalised one and a half million people. Psychosomatic conditions.

So it's now recognised that Long Covid is probably costing the world economy about a trillion a year in lost productivity.

You're reading that right.

So what should we do about it. 1) Reduce new infections by reducing transmission.

A) Clean the air in every public space now.

This is far easier than it sounds:

Here's a quick personal story.

Twenty something years ago, I picked up a mystery infection that hammered my system and left me with all sorts of health problems. I'll come back to some of those bits in a mo, but here's the point of the story:

After a while, I discovered that I'm ok with exercise as long as it's a very small increase of something that I'm used to.

I did an experiment two weeks ago.
I posted a request in two very similar fb groups, asking for advice in one on how to support 'someone with Long Covid', and in the other 'someone with a complicated post-viral condition'.

Four observations about the replies: Fewer people engaged with the long covid one.

When you have a chronic health condition, it can be hard to explain to people without a chronic health condition what it means. You say, "I have muscle pain", and they say, "oh yes, I did the London marathon and all my muscles hurt for two days".

Another quick dive into the NHS staff sickness absence data.

This gets nuts pretty fast... The NHS shares sickness absence data for different groups of staff.

Most of these staff groups include people of every age.

You may have thought that the chatter out of schools about kids having developmental problems was bad so far…

But this autumn, Reception will welcome kids born in late 2021… whose mothers caught Covid while pregnant… kids who have themselves caught Covid in every wave since. I work with three nurseries, and, let me tell you, schools and society are in for an even worse jolt than the ones they've had so far.

And did I post this one already for Core Training...

Covid infections cause a reduction in sets of your immune cells that fight infections... and when you keep catching covid that effect keeps getting worse, so you're increasingly prone to being off sick with cold cough flu. There are over 750 of these charts for the different categories... so I'm just going to pull out a very few of the serious ones for the different groups.

I'm in a lull on twitter without much visibility, so probably hardly anyone will see this, but here's an important thread on "why everyone's sick all the time".

No, you are not imagining it.
Sickness is increasing.
Sickness absence rates are increasing. Let's start with this graph.
The monthly sickness absence rates of staff at the NHS.

They have over a million employees, so this is a massive slice of the population of the country.

One of the subtle but serious problems in science and health communication at the moment is that people are treating Long Covid like a yes/no thing.

Do you have Long Covid? Yes
Do you have Long Covid? No It's just not that simple.

Five things about this study.

First, even mild Covid infection screws your immune system so you're 60% more likely to be hospitalised by EBV/mono/glandular fever for and the effect lasts ages.

Covid infection can screw up your immune system.

https://twitter.com/TeamPostX/status/2035592120887607735

Second, we're talking about *hospitalisation* by EBV after the covid infection, so it's not just getting extra 'mild' bugs afterwards.

I've seen this gotcha quite a few times now:
"If the Kent meningitis outbreak was caused by Covid, why is it just in Kent?"
Which completely misses the point of what people mean when they say that outbreaks like this are made more likely by the damage caused by covid infections. Wildfires aren't a perfect analogy for infection outbreaks - but they can help us understand certain aspects.

Think of a whole country made more prone to wildfires by a drought.

Enormously massively huge studies have shown that each wave of Covid infections causes damage to people's immune systems. The science is incontrovertible.

And yet you will not find a single media article about the current meningitis outbreak that mentions that. It's really simple.
It's been established science for decades that "a low CD4 count... has been shown to be associated with an increased risk of Invasive Meningococcal Disease"
Governments base policies on this established science.
pmc.ncbi.nlm.nih.gov/articles/PMC10…

Don't you get it?

If lots of people in your population have lower ability to fight infection, it doesn't just mean those people are more likely to *catch* infections.

It means they are more likely to *spread* them too.

Let me explain.
This is important. Jack has a metal lunchbox.
No ants can get into his lunchbox, so when he leaves the park, no ants fall out of his lunchbox.

Annie has a lunch bag made of wool.
Ants can climb into it, and they can also fall out easily too.
And that's what they do.

Ten things they'll be telling us about meningitis before the end of the week: 1
It's mild