The individual risk of death from a COVID-19 infection is now close to the flu thanks to vaccines, immunity, and treatment. However, death is not the only outcome of SARS-CoV-2. Long Covid—or the persistence of symptoms after an infection beyond three months—is still a threat to living a healthy and prosperous life.
This particular piece of writing needs to be an op-ed in major new outlets!
Every time I read one of your entries, I am reminded of how gifted you are at capturing the nuance in risk assessment that is so important for moving humanity forward with COVID's presence in the world. It's not binary--there is way more gray than black and white.
You are a gifted communicator, with an ability to convey complexity and--with a topic as polarized as covid responses--evaluate subjectively without judging others. I wish more people had access to and took the time to read your stuff, especially stuff like this.
"The individual risk of death from a COVID-19 infection is now close to the flu thanks to vaccines, immunity, and treatment.” Hey Katelyn, that’s not quite right in my opinion. The last numbers I saw from the CDC were 468 deaths a day or about 170,000 a year. Even if you look at the roughly 300+ it was averaging before the recent bump up, it would be near 110,000 a year. The CDC site showed the average deaths per year from flu in the 10 years prior to COVID, was about 30,000 with the worst of those years being 51,000. Don’t hold me precisely to those numbers but I am pretty sure I have them about right.By my arithmetic that means the “current” (468) COVID death rate is more than triple the risk of flu in its worst year and five and a half times the average flu rate. Using the lower number of 300 for COVID, of the last month or two, then the comparable relationships are over two, and about three and a half, times the numbers of flu deaths. I think that’s a lot more risky - not “close to". I make such a point of this because (1)for a long time I have been using that relationship as a benchmark for when I’d give up my extreme precautions and try to live a “normal” life again. I figure I could handle two times. I am older and thus the the death rates are doubtless higher in my bracket for both diseases, but, if the numbers are both understated than the relationship probably roughly holds and (2) I have seen/heard your comment or ones similar to it often enough to be bothered by it, since I think it makes light of what I consider to be justifiable cause for my (“paranoid") relatively extreme precautions.
PS Notwithstanding the above difference in opinion - one person’s “close to” can be another’s “much more” - I continue to respect, admire and appreciate the great work you are doing in communicating/educating us all.
This is the MOST HELPFUL piece about the long Covid risk that I have seen. I have a pre-existing condition that predisposes me to long Covid (ME/CFS), so I have been extra cautious. Last night I dreamt that I had accidentally pretty much given up mask wearing. While I will not do that, this research will likely help me feel more comfortable taking more risks, such as traveling. I am so grateful to you, Katelyn, for putting together this information (and all the previous Covid pieces as well) for all of us.
Your Long COVID article is the first clear presentation of the just-now-becoming-available studies. Your calculations comparing Long COVID risk to driving is especially apt. Most people have a clear understanding of the risks of driving. That the chance of having Long COVID is about twice that of having a very serious auto accident is extremely useful information
Thank you so much for this! For Hubby and I, long COVID has always been our primary concern. Are we any closer to figuring out what factors can predict long COVID?
Ok. Two questions, both from my son the data scientist who is "updating his priors"...
(As a young-ish adult with a friend group of pro-vax/booster youngsters, none of whom even really suffered much when they came down with Covid, he was at first very skeptical about even the existence of long covid (thought maybe psychosomatic), and we've had risk-assessment discussions where he's expressed concern that I'm over-weighting long covid risk compared to risks associated with isolation.)
(1) Where does the 18% come from when you say "If we take into account 3% of infections lead to long Covid and, of those, ~18% will have disease so severe that they are unable to work. So, the annual risk of severe long Covid (unable to work) is 1 in 370."
(2) Also the 3% number seems to be coming from the NHS data, which is "symptoms longer than 2 weeks" which may feel like "Long Covid" for HCW but I think most laypeople are thinking more like "more than 4 weeks" or having sequelae that bring on an entirely new disease (I have a friend who suddenly has diabetes, otherwise fit and average BMI).
Can you verify / explain?
If this gives you a headache, please skip it, he'll update his priors some other way. :D
The data you cite on the comparative risks of death from flu or COVID is from the UK. The US is running at about 150,000 deaths a year from COVID, probably about 3 times the annual deaths from the flu. Thus, your elaborating on the risk of death from the two causes in the US would be most welcome.
Does it make sense to breakdown odds of long covid based on age and male/female (and possibly underlying health conditions) to help people more fully understand their individual risk assessment?
Cancer patient here. It's nearly 4 months since my bivalent booster. I'm wondering about updated boosters for the elderly and immunocompromised. My oncologist hasn't heard anything yet.
Another wonderful piece, Dr. Jetelina. However, I think without broad agreement and standards on how to make a diagnosis of long COVID, the data (and risks) will remain suspect.
One thing not mentioned here, but which is apparently another factor among long Covid suffering is the number of people who commit suicide . Apparently some people experience excruciating pain from neuropathy that does not seem to be remediated by any current treatments. There may be other factors as well . But this indicates that there may be much more to some cases of long Covid than just feeling tired and sick.
"Of course, the more the virus mutates to become more contagious, the risk of infection (and thus long Covid) increases."
If someone has already had Covid without Long Covid, what are the odds that a future infection will trigger Long Covid? Given that most humans have already had Covid once, and that you mentioned that Omicron is less likely to lead to Long Covid than prior variants, I don't see that it necessarily follows that the risk of Long Covid increases with new virus mutations.
Also it was hard to tell, in the many studies you reported, how many were from unvaccinated populations. e.g. The Lancet article you mention showing Covid leading to a 3x risk of dying was entirely describing infections during the first year of Covid, almost entirely before vaccines and effective treatments. For people becoming infected post-vaccination these risks may be much lowered.
It should probably be stressed that a key difference between driving risk and covid risk is that there's a sophisticated, well regulated risk management infrastructure - car insurance - that helps to guarantee that you'll have adequate medical care, should you sustain an injury in a car accident. There are even controls in place that help make sure that those who engage in driving behaviors that increase risk to others pay proportionally more for the anticipated harm they might cause to others. For instance, if you get a speeding ticket or if you run a red light, your rates could go up. Insurance companies share info about you, by way of a database run by LexisNexis called CLUE (Comprehensive Loss Underwriting Exchange). Until something of this sort exists for URTI's - which can be thought of as "injuries" resulting from "collisions" between people - driving will always be "safer" than risking getting covid.
Long COVID: An update and gauging risk
This particular piece of writing needs to be an op-ed in major new outlets!
Every time I read one of your entries, I am reminded of how gifted you are at capturing the nuance in risk assessment that is so important for moving humanity forward with COVID's presence in the world. It's not binary--there is way more gray than black and white.
You are a gifted communicator, with an ability to convey complexity and--with a topic as polarized as covid responses--evaluate subjectively without judging others. I wish more people had access to and took the time to read your stuff, especially stuff like this.
"The individual risk of death from a COVID-19 infection is now close to the flu thanks to vaccines, immunity, and treatment.” Hey Katelyn, that’s not quite right in my opinion. The last numbers I saw from the CDC were 468 deaths a day or about 170,000 a year. Even if you look at the roughly 300+ it was averaging before the recent bump up, it would be near 110,000 a year. The CDC site showed the average deaths per year from flu in the 10 years prior to COVID, was about 30,000 with the worst of those years being 51,000. Don’t hold me precisely to those numbers but I am pretty sure I have them about right.By my arithmetic that means the “current” (468) COVID death rate is more than triple the risk of flu in its worst year and five and a half times the average flu rate. Using the lower number of 300 for COVID, of the last month or two, then the comparable relationships are over two, and about three and a half, times the numbers of flu deaths. I think that’s a lot more risky - not “close to". I make such a point of this because (1)for a long time I have been using that relationship as a benchmark for when I’d give up my extreme precautions and try to live a “normal” life again. I figure I could handle two times. I am older and thus the the death rates are doubtless higher in my bracket for both diseases, but, if the numbers are both understated than the relationship probably roughly holds and (2) I have seen/heard your comment or ones similar to it often enough to be bothered by it, since I think it makes light of what I consider to be justifiable cause for my (“paranoid") relatively extreme precautions.
PS Notwithstanding the above difference in opinion - one person’s “close to” can be another’s “much more” - I continue to respect, admire and appreciate the great work you are doing in communicating/educating us all.
This is the MOST HELPFUL piece about the long Covid risk that I have seen. I have a pre-existing condition that predisposes me to long Covid (ME/CFS), so I have been extra cautious. Last night I dreamt that I had accidentally pretty much given up mask wearing. While I will not do that, this research will likely help me feel more comfortable taking more risks, such as traveling. I am so grateful to you, Katelyn, for putting together this information (and all the previous Covid pieces as well) for all of us.
Your Long COVID article is the first clear presentation of the just-now-becoming-available studies. Your calculations comparing Long COVID risk to driving is especially apt. Most people have a clear understanding of the risks of driving. That the chance of having Long COVID is about twice that of having a very serious auto accident is extremely useful information
Thanks so much for this! Do we know if the risk is the same with every subsequent infection? Or does it change with reinfection?
Thank you so much for this! For Hubby and I, long COVID has always been our primary concern. Are we any closer to figuring out what factors can predict long COVID?
Ok. Two questions, both from my son the data scientist who is "updating his priors"...
(As a young-ish adult with a friend group of pro-vax/booster youngsters, none of whom even really suffered much when they came down with Covid, he was at first very skeptical about even the existence of long covid (thought maybe psychosomatic), and we've had risk-assessment discussions where he's expressed concern that I'm over-weighting long covid risk compared to risks associated with isolation.)
(1) Where does the 18% come from when you say "If we take into account 3% of infections lead to long Covid and, of those, ~18% will have disease so severe that they are unable to work. So, the annual risk of severe long Covid (unable to work) is 1 in 370."
(2) Also the 3% number seems to be coming from the NHS data, which is "symptoms longer than 2 weeks" which may feel like "Long Covid" for HCW but I think most laypeople are thinking more like "more than 4 weeks" or having sequelae that bring on an entirely new disease (I have a friend who suddenly has diabetes, otherwise fit and average BMI).
Can you verify / explain?
If this gives you a headache, please skip it, he'll update his priors some other way. :D
#momAlliance
#waitUntilYourKidsHaveAPhD
The data you cite on the comparative risks of death from flu or COVID is from the UK. The US is running at about 150,000 deaths a year from COVID, probably about 3 times the annual deaths from the flu. Thus, your elaborating on the risk of death from the two causes in the US would be most welcome.
Does it make sense to breakdown odds of long covid based on age and male/female (and possibly underlying health conditions) to help people more fully understand their individual risk assessment?
Yale recently published a report on case studies showing significant improvement in long covid brain fog by using two FDA approved medications. Worth a read and future report. https://medicine.yale.edu/news-article/potential-new-treatment-for-brain-fog-in-long-covid-patients/?utm_source=YaleToday&utm_medium=Email&utm_campaign=YT_YaleToday-Public_12-15-2022
Cancer patient here. It's nearly 4 months since my bivalent booster. I'm wondering about updated boosters for the elderly and immunocompromised. My oncologist hasn't heard anything yet.
Another wonderful piece, Dr. Jetelina. However, I think without broad agreement and standards on how to make a diagnosis of long COVID, the data (and risks) will remain suspect.
One thing not mentioned here, but which is apparently another factor among long Covid suffering is the number of people who commit suicide . Apparently some people experience excruciating pain from neuropathy that does not seem to be remediated by any current treatments. There may be other factors as well . But this indicates that there may be much more to some cases of long Covid than just feeling tired and sick.
I wanted to question one statement in your post:
"Of course, the more the virus mutates to become more contagious, the risk of infection (and thus long Covid) increases."
If someone has already had Covid without Long Covid, what are the odds that a future infection will trigger Long Covid? Given that most humans have already had Covid once, and that you mentioned that Omicron is less likely to lead to Long Covid than prior variants, I don't see that it necessarily follows that the risk of Long Covid increases with new virus mutations.
Also it was hard to tell, in the many studies you reported, how many were from unvaccinated populations. e.g. The Lancet article you mention showing Covid leading to a 3x risk of dying was entirely describing infections during the first year of Covid, almost entirely before vaccines and effective treatments. For people becoming infected post-vaccination these risks may be much lowered.
It should probably be stressed that a key difference between driving risk and covid risk is that there's a sophisticated, well regulated risk management infrastructure - car insurance - that helps to guarantee that you'll have adequate medical care, should you sustain an injury in a car accident. There are even controls in place that help make sure that those who engage in driving behaviors that increase risk to others pay proportionally more for the anticipated harm they might cause to others. For instance, if you get a speeding ticket or if you run a red light, your rates could go up. Insurance companies share info about you, by way of a database run by LexisNexis called CLUE (Comprehensive Loss Underwriting Exchange). Until something of this sort exists for URTI's - which can be thought of as "injuries" resulting from "collisions" between people - driving will always be "safer" than risking getting covid.
Are you sure about the dog bite numbers? One in 400 requiring reconstructive surgery seems quite high.