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We thought it was just a respiratory virus (ucsf.edu)
265 points by thereare5lights 17 days ago | hide | past | favorite | 150 comments



But the virus hadn’t wrecked Dowd’s lungs. In fact, she had only mild pneumonia. Instead, SARS-CoV-2 had ruptured her heart.

A lot of the early part of the article rehashes basics, like how viruses replicate. If you have basic knowledge of that sort, you can kind of skim until the mid point, where we find the above factoid.

I have been reading less about the virus of late, but this fits with everything I know. It causes blood clots. Ventilators aren't really fixing it. The lack of oxygen is probably more about what it does to the blood (than what it does to the lungs).

Later in the article, it talks about impacts on the feet suspected to be a side effect. Feet issues are commonly associated with blood/circulation issues. This is why diabetes can lead to feet being amputated.

The blood issues are well established and this has been known for some time. I'm somewhat aghast to see this article talking like we don't already know that detail.


This is the feature article in a special series of articles on combating the virus. As such it's presenting a summary of what we know about it so far, and references a lot of sources, some going back several months. Given that context I think that's exactly what I'd expect it to do.

Not everyone has done as much research as you, and the public perception and debate is still awash with "just a bad flu" disinformation, so its really important a clearer and more accurate picture is put out as widely as possible.


Thank you.

The stuff about blood clots began coming out about the time I concluded I probably had it and had been mostly asymptomatic and about that same time I ran into a researcher on HN who said something about the blood that I didn't follow and I asked questions and that went weird places and then they said something else about zinc.

And that led to an epiphany for me and I turned to my son and kind or recounted the exchange with the researcher and then I said "We've been eating a lot of zinc-rich foods. I am going to go get a cheese pizza because cheese has zinc." So I got a pizza and then he felt vastly better.

So the whole blood angle is cemented in my mind like "Clearly, this is a hard fact and everyone knows it." But it's probably just me in my little bubble and that's it.

I'm still aghast. But what you say makes sense.


It's worth remembering that just because you have a bubble of belief/knowledge it doesn't automatically make it scientific fact rather than anecdotally coinciding with some science.

For example, yes there is some research suggesting zinc (and related, vitamin D) may be very relevant with covid-19, but there isn't yet definitive understanding among experts yet alone us HN commenters.

Anecdotally: I often feel better after eating a pizza, dating back to before covid-19 existed, and despite my zinc levels being fine. I just really fucking love pizza.

All of us, whether we are trying to read every research paper released or not following anything except newspaper headlines, need to keep reminding ourselves that just as the experts will keep revising their beliefs to fit new findings, we need to keep checking if our own knowledge is correct, or if it might be either outdated and/or based on cognitive biases.

Personally I'm recommending friends/family to make sure that they are getting enough of various vitamins/minerals, while being very clear that my suggestion is a "can't do any harm to have the right levels of whatever" rather than "I'm sure this will help with covid".


It's worth remembering that just because you have a bubble of belief/knowledge it doesn't automatically make it scientific fact rather than anecdotally coinciding with some science.

I'm well aware of that. I'm just trying to say that it made an especially big impression on me because of my personal experience, not that my anecdote makes it scientific fact.

I'm still appalled that they know it causes blood issues and are not connecting the dots between that and the feet issues. The article doesn't explicitly say that feet issues of that sort are consistent with blood issues, though that is an extremely well-established scientific fact.

I paid accident claims for five years. As part of that job, I read medical records all day. I paid for foot amputations and we had to sometimes try to decide "Was this really an accident? Or was this really a complication of diabetes?"

So I'm not just talking out my ass here. I completed a Certified Life and Health Insurance Specialist certificate. I also just do a lot of reading of medical stuff because of my own health issues.

I'm pretty confident the blood issues are very well established at this point and have been for some time.


> I'm still appalled that they know it causes blood issues and are not connecting the dots between that and the feet issues.

I feel like you're jumping to conclusions prematurely. If you as health insurance specialist can connect these dots, you can be sure that researchers did, too. However, having a hunch is only the first step of a thorough scientific investigation, and those take time. Until we have collected and analyzed the evidence, this remains speculation, and scientists shouldn't go off spouting half-researched speculations. That leads to only more fake news. If you look through the Lancet or JAMA, you might find first articles on this connection (if there is one). But until there are peer reviewed papers about this, most researchers know that it's better not to speculate when talking to the press.

Source: am researcher


I feel like you're jumping to conclusions prematurely.

I honestly don't think I am. I am currently a freelance writer by trade. I sometimes write health articles. I'm familiar with protocols for how to carefully qualify things to keep them factual and avoid wild speculation and suggest confidence levels for various tidbits while being informative.

I am not super impressed with the quality of the medical information in the piece.

But given that thanking someone for their remark and saying "Oh, that makes sense to me" is getting me so much flak, it's probably best for me to bow out of this discussion at this point.


Completely fine to bow out, and if you don't reply to this comment I won't infer that it means you agree I'll assume you're still bowing out.

But if you sometimes write health articles, I feel it worth saying: health articles should be written having understood the proven science and convey it to people in an easy to understand way of what is or isn't proven, not by people who assume their connecting the dots is right before the research shows that.

I haven't read any of your articles, for all I know you're a fantastic writer on those subjects. But your HN comments specifically have not been written in the way that health articles should be, which is why people are giving you flak. And on that subject, sorry that you feel attacked here - it certainly wasn't my intention, nor I think the others', we just aren't in agreement.


I get your point, but I think Doreen is actually being reasonable here. Even if you just consider children, the link between covid-19 and Kawasaki Syndrome is well-established (https://www.cdc.gov/kawasaki/about.html).

But, it's not like there hasn't been additional coverage on covid-19 as a circulatory disease rather than a respiratory-first one.

https://news.weill.cornell.edu/news/2020/07/what-is-known-ab... and https://health.clevelandclinic.org/should-you-be-worried-abo... and https://www.the-scientist.com/news-opinion/autopsies-indicat... for consumer-oriented overviews.

A recent covid-19 study here: https://pubmed.ncbi.nlm.nih.gov/32291094/

And this from a post-SARS study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6178621/

There's plenty of primary and secondary research out there. The problem, I think, is that mainstream media headlines have been -- and continue to -- present covid-19 as a respiratory virus.

Perhaps like Doreen, my family have been tracking the circulatory effects more closely than most, given we have a toddler with a heart condition and family with diabetes.


I feel you are missing the point of my comments. I wasn't arguing anything about the disease itself, only about how to approach understanding and talking about it.

Additionally... the article submitted that we're all commenting in response to specifically makes the case that this virus is affecting more than the respiratory system.

I don't disagree with anything in your comment, but I also don't see how any of your comment disagrees with anything I said or with the original article.


I'm not disputing your claims.

Not because I specifically agree (or disagree) with them. Personally, I also consider myself in a pretty good position to judge this stuff, however I decided a while back that even when I think I'm sure I'm not going to tell it as a fact, especially online where other readers can't easily tell if corin_ or doreenmichele are making great points or deluded idiots. (A quick edit here: I didn't mean that to imply one or both of us are deluded or idiots. Just that neither of us are coming into this thread with "here are my qualifications and/or research to make me more than a random commenter".)

My reply wasn't that you were wrong in your beliefs, however this part in particular:

"And that led to an epiphany for me [...] So I got a pizza and then he felt vastly better. So the whole blood angle is cemented in my mind like "Clearly, this is a hard fact and..."

My point is that even if you are 100% correct about the blood issues and zinc, you have literally described a one day process of epiphany to pizza to fact proven. Whether you're right or wrong overall, that's not how people should be forming opinions on fighting covid.


My point is that even if you are 100% correct about the blood issues and zinc, you have literally described a one day process of epiphany to pizza to fact proven. Whether you're right or wrong overall, that's not how people should be forming opinions on fighting covid.

You are wildly misreading my comment.

A professional researcher stated their opinion that there was something blood related -- that I didn't understand so I asked for clarification -- and then said something about zinc. I then went over our consumption habits, realized that we were eating a lot of zinc-rich foods we don't normally eat in large quantities and felt it was worth betting on "It's the zinc, like the researcher said." And that bet paid off for us -- though me and my oldest son both have a genetic disorder, so I'm absolutely not inclined to generalize from that.

So I'm not recommending anything about how to fight covid. It's a personal anecdote about how this got cemented in my mind so clearly. That's it. Nothing more.


Apologies for misreading your comment, but you did describe a pizza cementing your view.

We all have cognitive biases, including the most intelligent, accomplished people anywhere.

Plenty of research shows that the placebo effect is a very real phenomenon (even when we are told we're being given a placebo pill it can still help!)

I wasn't trying to change your mind on anything covid related; just about how we all let anecdotes convince us of pre-existing beliefs.

And even if you personally didn't need that lesson, I still think it needed to be explained for anyone reading your comments considering their implication that a one off pizza event was enough to impact your views (even if that's not how you intended the comment to mean).

Edit to add: of course, the mechanisms behind cognitive biases can be helpful! If a doctor says X will help and then X does help, it's good that our brains automatically process that as being more likely true than if it hadn't worked. But they can be unhelpful, too.


> And that bet paid off for us.

You don't know that, since you don't know that you have Covid-19, nor do you know that your zinc consumption had anything to do with whether or not you had it, or recovery from it.


I do know that "bet paid off for us."

I know that because it wasn't a one time incident. We continued to consciously and intentionally consume zinc-rich foods at a greater rate than normal and it successfully alleviated symptoms that had us concerned. It did so consistently for some period of time until those symptoms finally resolved. We pay very close attention to our diets because of the medical situation. So I know we were consuming abnormally high levels of zinc for some weeks.

Your framing seems to suggest you think I am saying zinc helped "cure" us of the infection. That's not what I'm saying. I'm saying it helped mitigate the worst of our symptoms, which is a completely different claim.

You are correct that I don't know for absolute certain that we had Covid-19 because that was never verified by testing. I've already made that clear and also made it clear that I'm not suggesting treatment to anyone else.

I'm aware there are people promoting zinc as a means to cure Covid-19. I'm not remotely suggesting that.

Even if you accept that I'm correct about having it and I'm correct about zinc helping us, the only takeaway here is that zinc may mitigate some symptoms in some populations, especially populations prone to nutrient deficiencies.

If you have any reason to believe you are zinc deficient, zinc is a good thing to take to treat your deficiency. If you aren't deficient, I'm not recommending it for any purpose.

This is a consistent stance of mine and has been for many years: It's a good thing to determine if you have deficiencies and redress those deficiencies. Otherwise, I absolutely don't recommend any kind of supplement at all. I think it's a dangerous practice to take supplements if you aren't deficient.


> successfully alleviated symptoms

Again, you don't know that. You can't establish causation, particularly when N=2, and even more so when you do not know whether or not you had Covid-19.

Yes, I understand you fully acknowledge you may not have had it, but that acknowledgement contradicts that claim that zinc consumption alleviated its effects. What you can say is that you may have had Covid-19, and increased zinc consumption may have helped.


Look, I don't know what the disconnect is here.

I have a genetic disorder. My son has a genetic disorder. We use diet to mitigate health issues regularly.

I do know for an absolute fact what I have stated as clearly as I can figure out how to state: that increased zinc consumption mitigated the unusual problems we were having that aren't typical for us and which we firmly believe were due to Covid-19.

I have stated clearly that we were never tested, so, no, I can't prove we had it. I can still believe we had it and I don't think it should be anywhere near this much drama to say I believe we had it when I've stated clearly that this is a belief unverified by testing, so I certainly cannot prove it.

I have stated clearly -- and repeatedly -- that my anecdote isn't a recommendation for treatment.

I think it did mitigate symptoms from Covid-19. I admit I can't prove it was Covid-19. I've stated that repeatedly.

And whatever was wrong with us, zinc helped.

You are entirely free to think it's worthless data because we were never tested. I've done everything in my power to distinguish as clearly as I can my opinion from verifiable fact. I am telling you "zinc helped" is in the category of fact in my mind and what it helped with was "probably Covid-19" is my opinion.

I'm planning to walk away at this point. It never ceases to amaze me how much other people have some big problem with me having opinions about my own health status like me thinking about my own health is some kind of serious crime on the order of impersonating a surgeon.


The disconnect is that we disagree on how to establish causation. I follow what I believe to be the generally accepted standard that when dealing with only two people, it’s not valid to assume that medical intervention x, later followed by health status y is not enough to establish that x causes y. It appears you do think that’s a valid way to establish causation, hence we disagree.


That's a reasonable position. The problem here is you and other people hound me and insist I must be wrong and have no right to state my opinion about my health, no matter how carefully I qualify it.

That's not a reasonable position.

I get that you disagree. I expect people to not be convinced that I'm right. Skepticism is warranted.

What's not warranted is harassment.

Repeatedly insisting that I cannot possibly know what I believe to be true when I have already agreed with you that my statements are opinion, inference, etc and unverified by testing is harassment.

I have my reasons why I am confident in my conclusions. No one cares to hear those reasons. They just want me to capitulate, admit defeat and announce that I'm wrong and stupid -- both factually and morally -- for engaging in the same behavior many other people engage in on a regular basis without being similarly mistreated. (That behavior being telling an anecdote about my health and stating a personal opinion about my own experience.)

I'm not capitulating. No one is required to agree with me or be at all interested in what I think about my own health or about health generally. But, like any other human, I am entitled to have an opinion about my own health. I'm not going to pretend that I think you are right when I don't think you are right just because you insist over and over again that my opinion is, in your opinion, factually wrong.

You are not more right than me. Just as I cannot prove I had Covid-19, you cannot prove I did not. Thus you cannot prove my opinion is factually wrong anymore than I can prove it is factually right, yet you feel some strange compulsion to try to insist that your unprovable opinion about my life is somehow more right than my unprovable opinion about my own life.


The article clearly establishes that the medical research community is aware of the potential link between blood and feet issues. From the article:

Recently, there’s been speculation that some of COVID-19’s seemingly disparate symptoms may stem from trouble in the blood. Blood clots, for example, are showing up in cases of COVID-19 frequently enough for clinicians to take notice. “There’s something unique about the coagulation system in these patients,” says nephrologist Kathleen Liu, MD ’99, PhD ’97, MAS ’07, a UCSF professor of medicine. In caring for COVID-19 patients on dialysis machines, she’s been surprised to see blood clots block dialysis tubes more than usual. Clotted tubes are common, she says, “but this is extreme.”

That may be because, as growing evidence suggests, SARS-CoV-2 can infect cells in the walls of blood vessels that help regulate blood flow and coagulation, or clotting. If true, this behavior could explain some of the virus’s weirder (and rarer) manifestations, such as heart attacks, strokes, and even “COVID toes.”


Thank you. I missed that, obviously.


>I paid accident claims for five years. As part of that job, I read medical records all day. I paid for foot amputations and we had to sometimes try to decide "Was this really an accident? Or was this really a complication of diabetes?"

How long has it been since you last worked in insurance?


I am having difficulty following this. Your son felt vastly better after consuming zinc/cheese. What was wrong with your son?


That's not something I care to discuss further on HN. You can email me.


Fair enough - I won't email to follow up. It's a personal question and that didn't occur to me when I wrote my previous comment.


>I'm somewhat aghast to see this article talking like we don't already know that detail.

It's an article, not a news story or a scientific paper. So it's neither about breaking news nor innovative research results.

So, they don't presume what the public knows at any substantial level (heck, many still don't know/believe the virus is not real).

I, on the other hand, am more aghast for the use of the word aghast for such a trivial matter :-)


> If you have basic knowledge of that sort, you can kind of skim until the mid point, where we find the above factoid.

Well maybe you skimmed a little too much, because the article clearly talks about the negative effects of an overactive immune system response being characteristic in some patients, and there was plenty of evidence of that in some people's wrecked lungs. Part of the therapy is to guide and even suppress the complex immune system response to keep people's bodies from destroying themselves.

Your comment didn't mention any of that and might be read by some as a "move along, nothing to see here." I think this is definitely not the case and people would be better served to read the article itself instead of your comment dismissing it and instructing them to skip over the section about immune system response.


I wasn't instructing anyone to do any such thing. Another way to frame my point: If the start of the article bores you to tears, hang in there. It gets meatier.


I can only go by what you wrote.

> If you have basic knowledge of that sort, you can kind of skim until the mid point, where we find the above factoid.

I replied to your comment because I read the article first and actually did learn this bit about the immune system response which is in the first half. If I had read your comment first I would likely would have skimmed the article (or even skipped it altogether) and missed it. In that situation your comment would have directed me away from learning something new. I'll continue to try to read articles before comments in the future.


Nasim Taleb had a good point on the most recent EconTalk [0] about covid: We kinda know what the morality rate is, but we have no idea what the morbidity of covid looks like.

All the co-morbidities are essentially unknown and are likely to stay that way for a while. These side effects take time to suss out; more than the nine months we've had with covid.

With the unknown and potentially unbounded risks we are staring at, Taleb says that over-reaction is the best strategy. He and Russ Roberts go on to talk about the basic issues with statistics in these cases, a good trip back to the first week of any stats course that everyone promptly ignores.

[0] https://www.econtalk.org/nassim-nicholas-taleb-on-the-pandem...


Balgair says: >"We kinda know what the morality rate is, but ..."<

"Morality rate", hmmm...I like it, but maybe for another article!8-))


Mainstream (and that includes many politicians) still think of it as respiratory. All the other effects are not yet mainstream knowledge.


Coronaviruses in cats primarily attack the blood.

Has been speculated on since as early as March (that I've seen) with more evidence in support since then that this strain of human coronavirus is behaving like that.

Explains the majority of symptoms. Low pulse ox, feet, brain, lung, kidney, etc etc.


> Ventilators aren't really fixing it. The lack of oxygen is probably more about what it does to the blood (than what it does to the lungs).

That's not right. It causes cytokine storms just like any other major repiratory virus. Ventilators do help, lots of people survive on them. They are a critically important piece of the treatment puzzle.

I don't think statements like that are very helpful. It's on the spectrum toward conspiracy nonsense.

> I'm somewhat aghast to see this article talking like we don't already know that detail.

It's not a scientific study, it's a review piece for general readers.


Yes, COVID-19 is a bad one but it’s just another virus at the end of the day. I feel they act as we rediscovering everything about viruses for sensationalism.


Yes, but downplaying the fact that it’s new and that there’s a lot of unknown unknowns about it and its effects mid/long term is dangerous. Not all viruses are the same, and it takes time to observe and study them.

This is IMO the other important reason why it’s important to stop the spread, besides overloading hospitals.


Another way to look at it is that many people who were previously ignorant regarding most things we know about viruses are learning quickly and because they are novel to them, they find them sensationable.


Blood clots might be caused by a change in angiogenesis that appears to be correlated with COVID-19. I found this autopsy analysis by an MD to be very enlightening:

https://youtu.be/1HTionnTT9I


I'd previously read that COVID-19 might be a cardiovascular disease, which would account for the blood clots and heart stuff.

From the OC:

Marcus plans to also start collecting data from wearable devices, including Fitbits and Zio patches, which wirelessly monitor heart rhythms. “There may be large numbers of people who are suffering from cardiovascular effects of COVID-19 in the absence of other symptoms,” Marcus says. “I’m worried we’re missing those cases.”

I have no idea what it means to regard COVID-19 in cardiovascular vs respiratory terms. I'm just repeating what I think I've read. I really don't understand this stuff.


If I get Covid19, my plan is to take aspirin wile at home. If I need to go the Emergency Room, then I'll leave it to the doctors to decide what I should get, but before I need urgent care, I'll use aspirin.


Any scientific backing for this?


The Cleveland Clinic recommends against it:

https://www.cleveland.com/coronavirus/2020/05/taking-daily-a...


That link specifically states don't take it every day as a preventative measure in case you might end up getting Covid-19, not don't take it when you know you have it, like the grandparent said they were going to do.

It says don't do it because there are risks of gastrointestinal and brain bleeding, which would be a bad thing to risk if you don't currently have an illness.

It even links to the following article from the Mayo Clinic, which goes over the pros and cons of taking aspirin daily to prevent blood clots and heart attacks, and has recommendations for classes of people that they recommend should take aspirin every day. so I'd think if you have an active illness known to cause blood clots, it's probably worth risking the bleeding risks from the other.

https://www.mayoclinic.org/diseases-conditions/heart-disease...

From the article: "Guidelines are varied between organizations, but they're evolving as more research is done. The benefits of daily aspirin therapy don't outweigh the risk of bleeding in people with a low risk of heart attacks. The higher your risk of heart attack, the more likely it is that the benefits of daily aspirin outweigh the risk of bleeding."

Anecdote is not data, but for awhile in my 20s I used to take aspirin pretty much every day just because I had constant issues with headaches. I think I did get an ulcer during that time, but it healed in time, once I stopped taking aspirin so often. Better than dying of a blood clot from a virus that still doesn't have a solid treatment, especially if you have to stay home and self-treat it.


They have no choice but to say that. Just like in criminal justice one is assumed innocent until proven guilty (beyond any reasonable doubt), in the medical field a drug is assumed harmful until proven beneficial (beyond a certain p-value). As long as the proof of the benefit is not out there (and peer-reviewed), a medical professional needs to give more weight to the known risks vs the unproven potential benefits. They might lose their license if they do otherwise.

But while they may need to think about their license, I need to think about my survival. And here I'm talking about my own survival. I'm not advising anyone else to do the same. I'm not a doctor, and even if I claimed I were one, nobody should just take a random guy's advice over the internet.

That said, my thought process is this: it is aspirin we are talking about, not cyanide. I have taken aspirin many times in my life, including several times recently. The benefit is not proven because doing medical trials is expensive. But the benefit is plausible enough that someone started just such a trial [1]. Separately, the benefits of other blood thinners are considered so great that they are part of the standard of care for Covid19 patients in some hospitals, such as MassGeneral [2]. So, my own assessment of that taking aspirin has for me a higher potential benefit than the potential risk.

But again, this is just for me, not offering advice to other people.

[1] https://clinicaltrials.gov/ct2/show/NCT04365309

[2] https://www.massgeneral.org/assets/MGH/pdf/news/coronavirus/...


How is your argument different from the people claiming that Chinese medicine cures covid-19? We don't have any proof that it doesn't, but 96% of covid-19 patients in Wuhan received it and they were cured! Yay!


I don't know much about Chinese medicine or about the claim that it may cure Covid19, so I can't comment on this.

If you are alluding however that I'm committing the base rate fallacy, then I'm not. My argument is not statistical in nature.

My argument is this: I know more about my body than the FDA. The FDA makes decisions that affects hundreds of millions of people and cannot know how each will respond to a drug (like aspirin). I however know how my body responds to aspirin because I have taken it and I know I tolerate it well.

So, although both the FDA and I are making a risk-reward analysis, my problem is much more narrow and I have a lot more information about it. I do not need to employ double-blind clinical trials or know anything about t-statistics and p-values.

If I were to start recommending aspirin to HN readers, then I'd start becoming a bit like the FDA, and I would need to resort to statistical arguments. But I'm not recommending aspirin to anyone. I'm just showing people the way I'm carrying my personal risk-reward analysis. This could be useful.


I apologize for not finding a way to frame that more neutrally. I did not reply to your comment because I think you are free to do as you see fit for yourself. Me providing the link to someone else was not intended to be some passive-aggressive dismissal of your choice.

The Cleveland Clinic is a fairly big name, respected clinic. I think of it as a reliable source. I was just trying to sum up a lengthy piece briefly, which is always fraught with potential problems.

I do a lot of making my own health decisions of that sort. I'm routinely attacked for saying anything at all about my thinking about my own health. I wish it were easier to have meaningful discourse of that sort in a responsible fashion without people acting like "You are evil incarnate and practicing medicine without a license for leaving comments on the internet." I have no idea how we get there from here.


I agree with your reasoning. Also the link the parent provided was referring to taking it as a preventative measure, before you know you have Covid-19, not once you know you have it.


It's plausible but hasn't been adequately tested to say one way or the other.

https://link.springer.com/article/10.1007/s40265-020-01365-1


Influenza does this stuff too, and we happily refer to influenza as a respiratory virus.


Yup. For example, there's a well-established effect where influenza causes heart attacks and strokes, big enough that the severity of the influenza season has a noticable effect on heart attack deaths. This is, naturally, taken into account when calculating the number of influenza deaths. The differencce is that instead of this being spun as proof that influenza is more deadly than people think, since Covid the press has been spinning it as proof it's leas deadly and that the official flu stats are overstating the number of deaths. For instance, this article - which was quite popular on HN - outright claimed that widespread flu deaths didn't exist because doctors didn't see people dying because of the flu and the CDC was misleading the public by claiming otherwise: https://blogs.scientificamerican.com/observations/comparing-...


But on an apples to apples comparison, aren’t there very few flu deaths confirmed by testing?

And what you cite can’t be proof that the flu is more deadly than people think. If what you say is true, those deaths are in the numbers used for the death rate of the flu.

The point of that article is that perhaps our algorithms for estimating flu deaths are wrong.

Edit: Can someone explain the downvotes? Any error in my reasoning is not obvious to me. The claim above was that:

1. Heart attacks are included in flu death estimations

2. This should make the public think the flu is more deadly than they believe

That seems contradictory, as the public’s belief about the deadliness of the flu comes in stats from point #1. As for the article, the author made no real attempt to rebut its central claim.


> aren’t there very few flu deaths confirmed by testing?

Is this true? An anecdote, but both times I and/or my partner had fever and flu-like symptoms, a flu test was the first thing performed by the doctor.


Yup! Only about 20% of flu deaths are confirmed by test. The rest are estimated by an algorithm (which the OP alluded to)

Sorry for AMP link, canonical url is paywalled: https://www.google.com/amp/s/www.washingtonpost.com/business...

The CDC explains its methodology here. There are valid reasons to assume influenza deaths are higher than confirmed tested deaths. But many of these apply to coronavirus as well: https://www.cdc.gov/flu/about/burden/how-cdc-estimates.htm


Direct quote from the article:

"Clinicians, too, were seeing surprising numbers of COVID-19 patients develop heart problems – muscle weakness, inflammation, arrhythmias, even heart attacks. “We’re not used to respiratory viruses having such dire consequences on the heart in such apparently high numbers,” says cardiologist Gregory Marcus, MD. Many patients whose hearts acted up also had failing lungs. But others had no other symptoms or, like Dowd, only mild ones."


Project FEAR has crossed the Atlantic.


[citation needed]


Maybe i can dig out the MRI scans of my heart, so you can see the scar tissue that an influenza infection left.


Friendly reminder that even if flu was the direct cause of you having scar tissue on the heart, it's a single data point rather than a great citation.

edit: good citation provided by twic below



Excellent source, thanks!

I wasn't the one who asked for citation, and didn't mean to imply that you were wrong at all in my comment just that one patient's example isn't a good way of proving something about a disease.

I've edited out the quick CDC quote of my last comment since your citation is much better.


Every other source online says that you can’t get Covid from eating, but this one says your stomach cells are particularly susceptible.

> Gut specialists are finding that 20% to 40% of people with the disease experience diarrhea, nausea, or vomiting before other symptoms, says gastroenterologist Michael Kattah, MD, PhD, a UCSF assistant professor. If you swallow virus particles, he says, there’s a good chance they will infect cells lining your stomach, small intestine, or colon. As in the lungs and heart, these cells are studded with vulnerable ACE2 portals.

In that case, is the info about not getting it from eating as thoughtless and parroting as saying masks don’t work, or is this article fake news? It makes a huge life changing difference to know for high risk people


So there are a few unknowns:

1. Does the virus remain infectious in food? In particular, does hot or reheated food affect it?

2. The digestive process produces more acid. Will that kill the virus?

3. Will the virus even touch the wall of the stomach? It may be in food after chewing, rather than directly on the stomach wall

There are some reasons to think that swallowing virus replicating in your throat is different than having some inside a chewed up piece of food surrounded by saliva.

We don’t know of course, and someone super high risk should perhaps avoid takeout salads. But as of yet we haven’t had any case cluster reports where a superspreader cook spread the virus to their colleagues + customers via food. No country has reported a single instance of a traced infection via takeout.

This doesn’t mean it’s impossible, as contact tracing is not perfect. But the lack of any evidence so far is suggestive.


Interesting explanation for why children rarely get sick or transmit this disease:

> Fattahi’s team has found evidence suggesting that male sex hormones such as testosterone may increase the number of ACE2 receptors that cells produce, which could help explain why SARS-CoV-2 seems to wreak greater havoc on men than on women and why kids rarely get sick.


This is only true for Children under 10. Children over 10 transmit contract and transmit at similar rates. Considering 11 is when puberty kicks in for many kids, this appears to support Fattahi's findings.

(https://www.nytimes.com/2020/07/18/health/coronavirus-childr...)


That article puts people in 10 year bins, so it is not useful to determine what the cutoff age should be with more granularity than 10 years of age.

However, Sweden did not close school for children through 14 years of age.

https://www.sciencemag.org/news/2020/05/how-sweden-wasted-ra...

And their excess mortality rates for that age group are indistinguishable from other European countries:

https://euromomo.eu/graphs-and-maps

When you go to that link, near the bottom select graphs by age and see that Sweden ages 0-14 looks like all the other countries shown there. I think that is a pretty good indication. We have a country that kept their schools open and a number of countries that did not, and the results look the same.

EDIT: in fact, the excess mortality for that age group looks indistinguishable from other years.


The article based on studies by UCSF is a good read for many who are not understanding the basics of what is happening. I would suggest giving this out to friends and family who have concocted their own version of science and are refusing to wear a mask.


If a lot of the damage is often caused by an overreacting immune system, why isn't this disease harder on younger people who presumably have stronger immune systems? Kind of like the Spanish flu? This doesn't add up for me and this article doesn't dwell on that either.


There is still no proof for this but some scientists suggest people over 80 years old came in contact with a similar virus when they were young and now their immune system is overreacting (like when the second sting of a wasp can be much worst that the first).

In the Netherlands they found out by coincidence that some people who have a broken TLR7 gene don't fight the virus so the virus hits them very hard.

So there may be multiple reasons.


The issue with young people and the Spanish flu wasn’t “they have stronger immune systems so they cytokine storm harder and die in greater rates”, it was that there was an earlier endemic flu like 40 years before and basically everyone over like ~40 had been exposed to it and they had immunity, and anyone under that age had not been exposed so they lacked immunity.


I've seen the idea of cross-reactivity and T-cell immunity being passed around.

I think the idea is that younger, healthier people with better immune systems are able to prevent the virus from replicating as much, whereas sluggish immune systems and bodies that are highly inflamed like overweight ppl, diabetics, etc. (high leptin, also related to il-6) get overwhelmed.

T-cell immunity/cross-reactivity meaning that most people have the ability to fight the virus from exposure to other coronaviruses.

I think a major component of the death toll from the pandemic is basically a consequence of obesity. I'm suspicious that govt interventions, planning, etc make that much difference when the US is an order of magnitude more obese than Japan, for example.


That hasn't really been seen in the data though. Yes, obesity has been linked to more severe cases, but some of the hardest hit, highest mortality rate areas, like NYC and Italy, are markedly lower in their rates of obesity that other areas with lower mortality rates.


The article suggests a lack of ACE2 cell receptors in young people could contribute why the disease isn't as hard on them.


That's for the very young, ie children, at least from what I gathered.


Always interesting to learn more about the virus and that there is a lot of knowledge about handling ventilators. But even so, the numbers from New York say that 80% of people over 80 years do not make it once they are on the ventilator.

Source: https://www.google.dk/amp/s/www.washingtonpost.com/health/el...

I do hope that more attention will be focused on telling that this virus is both causing respiratory issues and heart issues. The leading comorbidities data from New York says it very clearly.

Source: https://www.the-hospitalist.org/hospitalist/article/220457/c...


I will get beat up for bringing this up, but I think that these facilities are operating in bubbles / silos. The reason I believe this, is that for months everything discussed in the article has also been discussed by an ER doctor in Riverside, CA that makes Youtube videos in his down time. [1] He is just reading the research available on nih.gov and a few other sites. What would it take to get all of the medical research groups to start collaborating on a common platform? Is the issue that they do not have a platform to share findings, theories, tests, or is everyone depending on the scientific review process and waiting for peer reviewed papers? Should we set up a forum for all the medical groups to share findings, theories, debate theories, etc?

[1] - https://www.youtube.com/user/MEDCRAMvideos/videos


The article is a summary of research findings over the course of the pandemic. What makes you think the research is happening in a silo? it's not. Medical researchers, just like, uh, that guy you saw on YouTube, are quite capable of reading the research on nih.gov and capable of discussing and sharing findings with each other.

The article even says "By June, clinicians were swapping journal papers, news stories, and tweets describing more than three dozen ways that COVID-19, the disease the coronavirus causes, appears to manifest itself."


I see each group reaching the same or similar conclusions, but months apart. This suggest to me they are not collaborating with one another. It feels to me like there is a gap.

Think of it this way. If there were a giant asteroid heading towards earth and we have a limited time to solve this problem, would I want 500 teams all operating by themselves and using the incredibly slow process of sharing data via NIH / NIST and other research paper repositories, or would I want them all in a war room (virtual or physical) and someone coordinating the effort to risk rank all the solutions and quickly form action plans? My vote is the latter. It feels like the scientific community may have artificially painted themselves into a corner because of something like the banana ladder conundrum. [1] meaning, doing it that way because that is the way it has always been done.

[1] - https://security.stackexchange.com/questions/33470/what-tech...


I think the issue here is less that they are arriving at the same conclusion months apart, and more that the reporting makes it sound like a sudden, recent revelation rather than a consensus that has been building for months and months.


they're not _independently_ reaching similar conclusions months apart, they're strengthening (and writing about) the same conclusion from the same and more data.


Peer review is the heart and soul of scientific research. I do think there is room to speed up collaboration, but we should not compromise the rigidity of the scientific method, especially with as many unknowns as with the current coronavirus, establishing definite knowns is very valuable.


This is a summary article. Those clinicians reached their conclusions months ago.


This article claims that they are able to isolate live virus from stool, which seems to contradict the observations here: https://www.nature.com/articles/s41586-020-2196-x


I'm surprised to read the stuff about asymptomatic cases. I thought the current thinking was that asymptomatic people are really pre-symptomatic, because of the incubation period. In other words, truly asymptomatic cases are rare. Am I wrong about that?


Yes you are wrong, though I suppose what you consider "rare" could be arbitrary. It seems that asymptomatic cases are anywhere from 20-40% of cases, although even that could be low, given that you are more likely to be missed if you have no symptoms prompting you to get tested.


Hard to know without widespread testing, and it depends how people define asymptomatic.

But cruise ship cases seem to indicate people with no true visible symptoms. There was a cruise ship with universal masking and a 80+% asymptomatic rate after 28 days.

Now, these patients may well have symptoms such as ground glass opacities in the lungs. But you can’t exactly feel that, so that’s some of the ambiguity.


Some people just have very mild symptoms that they don't recognise. A lot of people don't notice their temperature is raised for a day or so.

Some lists of symptoms don't include anosmia or diarrhoea, so people have symptoms but don't think these are covid-19 symptoms.


This is potentially concerning, but it's worth playing devil's advocate. What are the confounders? Most people have been more sedentary than usual this year. What impact does that have on circulation?


Does this mean that it's possible blood thinners could help some patients with covid-19?


Zinc


[flagged]


You perhaps haven’t been reading any of the papers coming out of Europe?

In my submission history you can see just yesterday an MRI study out of Europe. 78% of patients had cardiovascular involvement, 60% of patients still had heart inflammation.

These were 100 Germans, tested 2-3 months after diagnosis. And 2/3rd of the cases in the study were mild at home cases, no hospitalization. There was no large difference in heart involvement between groups.

A fairly large amount of the literature on these effects is actually from Europe as you got hit a month before the US, so there’s been more time to write studies.

I would not say you have any evidence in support of your position. I certainly have not heard of any studies finding covid to be a multi fanged beast in america and a mere respiratory virus in the rest of the world.

Edit: the paper: https://jamanetwork.com/journals/jamacardiology/fullarticle/...


I doubt the virus is still around 2-3 months later in their bodies. These effects are likely due to the hyperinflammation triggered later on during the course of the disease, if I am to follow the mechanism described in the well-detailed paper in Cell from a few weeks ago.

The virus is still a coronavirus (neural invasion, also noted for SARS-CoV-2, is also a feature of regular coronaviruses). These effects, although possibly severe and worthy of concern, are second-order effects.


"the virus is still a coronavirus"

That's always something i wonder every time i read about covid-19 : are we sure that those effects aren't also observed with other coronaviruses, maybe on a different intensity, but we just never had so much scrutiny for thoses virus as we have on this one in particular ?

Diarrheas etc are common symptoms of many viral infections, and people die from side effects of the flu or the cold every year ( old people most of the time).

Is the difference qualitative or quantitative ?


I can say for sure on neural invasion because I found a paper describing the phenomenon from 2018, which described (IIRC, on hospitalized patients) neural invasions by "human coronavirus".

Took a while to dig through my post history, but here's the paper I mentioned:

https://www.frontiersin.org/articles/10.3389/fncel.2018.0038...


It's somewhat similar to the mutant behavior of FCoV, which can cause feline infectious peritonitis. Regular FCoV causes some gastrointestinal and respiratory issues, but upon mutation starts breaking down cells and causing issues in the circulatory system, ultimately causing death.

https://www.sheltermedicine.com/library/resources/?r=feline-...


I agree, I do not think the heart inflammation suggests active virus. But my point was to show the commentor I replied to that the effects in Europe are not limited to respiratory effects.

They were under the impression only Americans had widespread non-respiratory symptoms of coronavirus.


This is a completely unsupported position composed of biased, speculative nonsense. Much of the science about impacts beyond basic respiratory problems is coming from Europe, "recorded" on europeans. Example, just today, this rather concerning study on (German) people having cardiovascular issues still months after testing positive... https://jamanetwork.com/journals/jamacardiology/fullarticle/...


> We don't hear anything like this in Europe from the vast majority of patients that beat Covid.

That is because the news flows in only one direction, not because it's not happening. It's not being very well reported even here, but it's definitely happening; I have heard several friends-of-friends who now have long term post-covid conditions, including some previously very fit.


As regards obesity the US might be out in front but many other countries are catching up fast. When I was a kid here in the UK large people were unusual, but now they're everywhere, albeit fewer in rich areas as it's certainly class-related. I don't see that there's any particular point to be made about the US and obesity other than that certain factors behind it are perhaps more exaggerated - in the US and everywhere else it's a function of class, cheapness, quality and availability of food, education, and to a degree also culture.


? Media isnt mentioning it a lot and still does faulty reporting all the time ("respiratory virus"). But there have been numerous studies and articles spread in Europe about exactly these effects.

Example: https://www.tagesschau.de/investigativ/kontraste/coronavirus...


Calling it a respiratory virus is not faulty, because that's its primary means of transmission. It's just that the symptoms go well beyond that.


USA is huge, its over 260 Million People. The country itself spannes different regions and zones.

It is quite closed minded to reduce this to 'the U.S. is a sick country'


USA has around 330 million.


hui sry!

I have to update the number in my head :D


Can you expand on your point about American pharmaceudical consumption? It reeks of the naturalist fallacy but I realize you were mainly mentioning it as part of a broader statement so I'd like to hear more.


Stuff like "well I'm getting on a flight, time to pop a couple of xanax" seems much more common in films/TV that America exports than, say, real life in the UK.

I know plenty of people who use illegal drugs but still have that perception of America thanks to Hollywood/etc.

Personally, I don't know the data between countries, and while I've been to the US a bunch of times I've never tried to obtain medicine there legally or illegally. But I have found a big difference between UK ("You want valium? Are you sure? OK, here are 4x 2mg pills") vs France/Belgium ("Do you mean 10mg, I don't think valium comes that weak..." before realising they could prescribe 2mg indeed, and multiple times I've asked for a controlled drug in FR/BE and had the doctor reply "how many boxes" without even asking why I wanted it. Purely anecdotal, though.)


This sort of behavior is only common among the people who write screenplays.


Even for non-pillpopping writers, I imagine it's often more interesting to make a character take drugs/medicine than not.

Ultimately, a lot of the world's views of America are shaped by the versions we see in fiction - I've been to the US from Europe more than most people I know, and I have plenty of American friends/colleagues. But still, I spend more time watching fictional versions of America on my TV than I do experiencing America myself.


>It reeks of the naturalist fallacy

The naturalist fallacy is often actual empirical reality (sometimes natural states are better).

It's just the fact that it's not always the case, which makes it a fallacy.

But in the case, overloading on drugs for every BS annoyance, and having them needlessly pushed by doctors on payola and gifts from pharmaceuticals, is worse than not doing it.


Very seldom is anything "always the case," and almost anything in the realm of drugs or similar interventions becomes bad if done in excess.


And that's the point the grandparent made: in the US, pharmaceutical drug use, is done in excess (considering e.g. Europe as the baseline).


Normalizing obesity because you can take some drugs to stay alive (artificially lowering your cholesterol, blood pressure, etc) might not be the smartest idea ever. But yeah, maybe it's the naturalist fallacy. To each their own.


Would those obese people be better off with bad cholesterol, blood pressure, etc.? It seems like you're trying to avoid outright saying we should just let fat people die as an example to everyone else.


What? How on earth would you conclude this from that I wrote?

I was replying to the idea that it is the "naturalist fallacy" to say that it is better to be develop good habits (in this case, eat better), than to just take some drugs and maintain the bad habits. Obese people should take the drugs, I don't wish for anyone to die. Even better for them would be to lose the weight.

The US has a huge (pun intended) obesity problem, and it seems related to worse health outcomes across several dimensions. This is just a fact.


> The US has a huge (pun intended) obesity problem, and it seems related to worse health outcomes across several dimensions. This is just a fact.

Yes. Nobody wants to talk about the elephant in the room. In a just society, we'd make the obese pay for their cost to the non-obese population.


I don’t have any special insight, but in my part of the world that’s definitely a common perception of the USA, usually attributed to lax regulation around what kind of pharmaceutical advertising os permitted.


According to these sources:

https://www.cdc.gov/nchs/fastats/drug-use-therapeutic.htm

https://ec.europa.eu/eurostat/statistics-explained/index.php...

they don't seem ahead.

The data sources are not 100% comparable so make of that what you will.


It's an interesting topic because I've heard a South African joke that every American has a pharmacy in their house (talking about over the counter meds in that case) so I guess it's a common perception around the world. It's funny because most Americans have the opposite view (except regarding mental health medicine for some reason), if I had to summarize the attitude it's essentially "I hate being sick and I've got shit to do".


It's not so much about 'hate being sick and got shit to do' and more about 'I hate feeling sick but going to the doctor will cost me a small fortune, so I'll stick to over the counter medicine until I feel so bad I can't avoid it'.


- the municipal water supplies are full of pharma drugs, as is our meat supply

- UCSF, the paper author, consider HFCS to be a poison and likely explains why there was no obesity in 60's photos, yet over half of Americans today. As a result, a huge number are on blood pressure and other drugs, which also end up in the water supply.


> UCSF, the paper author, consider HFCS to be a poison and likely explains why there was no obesity in 60's photos

I presume you're referring to Dr. Lustig of UCSF's research on sugar, or more specifically his position that fructose is a toxin akin to ethanol due to how similarly they're processed by the liver.

If so, Dr. Lustig is careful to point out that this is not an HFCS-specific issue. Sugar and HFCS both contain fructose, and are essentially identical in this regard. This kind of misinformed demonizing of HFCS results in people thinking sweets are perfectly safe as long as they contain sugar and not HFCS, UCSF does not back such a position AFAIK.


You're missing the point by focusong on the chemical reaction in isolation.

HFCS has replaced fat as the basis of many processed foods because corn is subsidized in the US.

As a result, the majority of Americans are obese from eating pounds of HFCS weekly.


I'm not missing that point, and actually agree with you re: HFCS replacing fat in processed foods.

You're just being harmfully imprecise with your claim, because it implies non-HFCS sweeteners aren't poison - according to UCSF no less. The fructose is the poison, and it's not HFCS-specific. It happens that HFCS is the thing that's everywhere thanks to corn subsidies, sure, but there's still plenty of non-HFCS fructose sources on the shelves of stores that are equally harmful. You're not in the clear by specifically avoiding HFCS.

I observe overweight strangers in the grocery store checkout isle extolling the virtues of eating sugar but not HFCS as they toss candy on the conveyor about once a month. It's rather depressing.

Edit: BTW I suspect you're shadow-banned in case you didn't know, as your comments in this thread have been immediately [dead]. Looking at your general comments history there's a lot of [dead].


I have definitely binged out on sugar candy, and felt like I was recovering from a hangover afterwards.


If you haven't seen/heard any of Lustig's talks on the subject, he makes a very compelling argument re: fructose being a toxin. They're readily available on youtube.

Excess fructose consumption is implicated in causing non-alcoholic fatty liver disease, which affects about 20-25% of people in Europe, and 30-40% of adults in the US. [0]

This statistic alone gives me cause for grave concern WRT covid-19 outcomes for those 30-40% of American adults should they get infected.

[0] https://en.wikipedia.org/wiki/Non-alcoholic_fatty_liver_dise...


I hear about it every day in Sweden. It's one of the hot topics here.


[flagged]


I read a lot on this topic, and while I don’t disagree some people are dealing with serious long term effects, your assessment is wildly overblown and offered without qualification. I’m aware of cases that are dealing with serious short to medium term effects. There’s no doubt this is real, but the likelihood of their occurrence is a topic of research. Furthermore, the 1+ year outcomes have not been measured in any meaningful way. Conjecture is not evidence.


I read scientific papers that are published in journals as a hobby. If you think my assessment is wildly overblown, then you might not actually be listening to the CDC, the thousands of researchers out there across hundreds of labs and universities, and everyone else trying to keep everyone safe.

If you think I'm wrong, you should be able to quote legitimate sources on why COVID is not incredibly dangerous and should not be taken as a serious threat to life and liberty.

I know you didn't intend on sounding like this, but you're veering into COVID denier territory, the kind of nay-saying that Trump et al are fueling on Twitter and Facebook. COVID is an extreme threat, according to the science, short, medium, and long term.


As you're reading those papers, take into account the probabilities of different outcomes instead of assuming that the worst case applies across the board.


Then feel free to actually bring proper argumentation instead of throwing some weird sentences out into the outernet...


There is a difference between "reading" and "unserstanding".


This made my morning.


> I know you didn't intend on sounding like this, but you're veering into COVID denier territory, the kind of nay-saying that Trump et al are fueling on Twitter and Facebook

You're trying to sound like you're being reasonable, but you're trying to discredit someone as being a "COVID denier" and Donald Trump, neither of which are necessarily true, and certainly don't seem true about the OP. The use of "veering" is simply guilt by association. Your thinking that you're more intelligent than other because you've read papers just comes off as you being full of yourself.


I'd rather be unreasonable and "wrong" but alive than reasonable and "right" but permanently scarred and/or dead.

COVID is a serious threat, and people need to stop taking it lightly. I do not believe devin is a COVID denier, but he is using language that is dangerously close to being misinterpreted as being one, at least, in my opinion.

It isn't a question of who is more intelligent, it is a question of what does the science say, and what is the most accurate interpretation of it. I stick with what I said originally: we're fucked.

Arguably, it is now worse than the Spanish Flu. The 1918 pandemic killed about 3% of the world population, which COVID is unlikely to reach; however, some projections (on the outside) give about that many people that could be infected before this is over. Some people may never show any long term damage from being infected, but it seems that most people infected eventually will.

Why is that important? Because those people will be a strain on an already screwed up healthcare system, potentially, for the rest of their lives. So either healthcare internationally is revolutionized to such an extent that this isn't an issue, or it is going to cause extreme pressure on the world economy, especially in countries like the US.

We currently do not know how many people will make it out with no scars, we may not know the full extent of the damage for another 10-20 years. The more we understand of SARS-CoV-2, the worse it looks.

COVID doesn't care what your race is, your gender, your political affiliation. Please, all of you, keep yourselves safe.


> COVID is a serious threat, and people need to stop taking it lightly. I do not believe devin is a COVID denier, but he is using language that is dangerously close to being misinterpreted as being one, at least, in my opinion.

So what's your point? That's a totally useless argument. If he's not a COVID denier, as you put it, what purpose does it serve to suggest that he's adjacent to COVID denial besides to discredit him based on your sensibilities?

> It isn't a question of who is more intelligent, it is a question of what does the science say, and what is the most accurate interpretation of it. I stick with what I said originally: we're fucked.

Science, by definition, isn't correct. This is why, contrary to what most people think, including those who wear suits and ties, scientists don't just all come to the same conclusions. I think you can agree with that because you use the phrase "accurate interpretation". The reason I'm saying your rationale here is utterly useless is that it's ignoring the epistemology of what it is to have an accurate interpretation of scientific data. How exactly do you know that your interpretation is more accurate than someone elses? That's the real question. Pointing to science and stating that you are correct really doesn't demonstrate anything other than that perhaps your understanding of science is misguided.

> Arguably, it is now worse than the Spanish Flu.

You're right, it is arguable.

> The 1918 pandemic killed about 3% of the world population, which COVID is unlikely to reach; however, some projections (on the outside) give about that many people that could be infected before this is over.

How does "worse than the Spanish Flu" precede this? What you just said here seems to totally contradict what you said prior.

SARS-Cov-2 doesn't kill everyone that it infects. Not even close. Given its mortality rate, the only way it could approach killing 3% of the global population is if 100% of people were infected, which never happens. Even if we saw a 3% global die-off, which won't happen in part because we seem to be keeping overall deaths down despite having sharp increases in confirmed cases, it disproportionately affects the elderly and those with preexisting conditions. The Spanish Flu, which is believed to have been a form of H1N1, disproportionately killed young people. I know this sounds callous, but a virus that spares the lives of people with more years ahead of them seems preferable over one that kills people in their prime.

I really would like to understand what your measure is that brought you to your conclusion that COVID-19 is "worse than the Spanish Flu" because, from most measures I can tell, it's not as bad. Are you judging this by the fact that the virus seems to be causing organ damage? I can kind of see that but my last point still stands IMO since those whom are getting organ damage are a percentage of ICU patients, something between 20 and 30 percent, which is large but that doesn't represent even close to a majority of people who are contracting the virus.

Don't get me wrong, it's bad, but somehow that doesn't sound worse to me than 3% of the global population getting wiped out. It remains to be seen if we will ever approach that with COVID-19.

> We currently do not know how many people will make it out with no scars, we may not know the full extent of the damage for another 10-20 years. The more we understand of SARS-CoV-2, the worse it looks.

That's totally valid.


> How exactly do you know that your interpretation is more accurate than someone elses?

I don't. However, given the severity of the outcome of contracting COVID, would you rather play it safe, or be secure in your interpretation (which is less severe than mine)?

> ... disproportionately killed young people. I know this sounds callous, but a virus that spares the lives of people with more years ahead of them seems preferable over one that kills people in their prime.

Younger people are also dropping dead from COVID, and being scarred for life by it, far more than the original numbers in March and April indicated. You don't need to just be worried about your grandparents, you need to be worried about yourself just as much.

Being elderly, and all the comorbidities that are associated with older people, just increase an already significant chance of unfavorable outcome.

> I really would like to understand what your measure is that brought you to your conclusion that COVID-19 is "worse than the Spanish Flu" because, from most measures I can tell, it's not as bad.

Lets try this another way. Do you know why the US military switched from 7.62 to 5.56? If you kill a soldier, hes dead, the body will be dealt with after the battle. If you wound a soldier, now another, healthy, soldier is trying to pull him out of the fray to save his life.

Spanish Flu is that 7.62, SARS is that 5.56. We are now going to have to spend significantly more resources than we would have otherwise to deal with the outcome of SARS, and it would be barbaric of us not to.

People will be suffering from heart, lung, even brain damage for the rest of their lives. This is happening during a time that, pre-COVID, the healthcare system in many countries, the US included, was coming off the rails.

SARS couldn't have come at a worse time. We don't have the medical system to deal with what we have now, how are we going to possibly deal with this new thing?

We couldn't even get proper insurance reform to go through with Obamacare without a full-scale partisan war happening in Congress. We're going to have to have something at least that big to tackle the eventual outcome of this.

If COVID would have killed people like the Spanish Flu did, then the worst we'd have to work with is the number of people missing from society, the brothers, sisters, mothers, fathers that aren't here anymore. But, this? We have to worry about something we don't understand and can't easily predict, something that could get much worse, and is getting worse.

We have to worry about something that may never go away. What if this becomes a SARS season, every year, like the Flu season? They are working on a vaccine, but it isn't here yet, and from the papers I have read, they have indicated that this may be very difficult given some people do not have useful immune responses, and we don't have an accurate idea of what percentage of the population has this issue; relying on herd immunity to save us doesn't seem to be working.

Any reasonable person should be absolutely terrified. However, what I see is a lot of unreasonable people that are not taking this as what may be the worst threat to society in our lifetimes, something that can only be compared to things we read about in history books.


Thats not the coronavirus, thats life... in the end you are surely dead ;-)


Surely. But in the meantime I'm still rolling that delicious phrase "the fuckening" around my mouth. Makes reading all the rest of the comments on this article worthwhile.


I just came back from hiking vacation with my wife who had COVID-19 in April. It looks like she will have to get back in queue and wait for the next turn.


You've somehow summed up a long and elaborate article containing a multitude of stories and detailing multiple seemingly detached symptoms into a "tl;dr we're fucked". Seriously, how did you manage to do that?


It's called "pessimism".


It could easily read as sarcasm depending on the reader's point of view.


Dear reader, it's ok, you can skip the comments here. Just read the article and move on


It's only been an hour, and insightful comments take more time to type out than ignorant speculation. Have some faith that this community isn't just another Reddit.


This applies to most of the stories on HN nowadays


> If we did a mass testing campaign on 300 million Americans right now, I think the rate of asymptomatic infection would be somewhere between 50% and 80% of cases

Wow that’s incredible. 200 million Americans could have the virus.


That's not what it says. It says if you tested everyone, out of those who tested positive, 50-80% would be asymptomatic, not 50-80% of the whole population.


Ah, thanks for the clarification. That was indeed not obvious to me the way they worded it.


They mean 50-80% of cases, not 50-80% of Americans.


No. 50-80% of cases are asymptomatic, not 50-80% of the nation is infected asymptomatically.




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