PSA: COVID-19 isn’t “just a cold,” isn’t “a respiratory virus,” and “mild” doesn’t mean what you think it does.

If you “aren’t scared of COVID”, this thread is for you.
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Please R/T if it opens your eyes.
This thread is long, and hard to read - not just because of the technical language, but because “it’s just a cold,” “the vaccine protects me,” and “at least our children are safe” are comforting fairy tales.

I wish they were true.
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This virus is like measles and polio: a virus with long-term impact.

Even a “mild” case in a vaccinated individual can lead to long-term issues which cause a measurable uptick in all-cause mortality in the first 6 months, and get progressively worse with time.
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SARS-CoV-2 is a systemic disease which has multiple avenues to induce long-term impairment, attacking the brain, heart, lungs, blood, testes, colon, liver, and lymph nodes, causing persistent symptoms in more than half of patients by six months out.
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The CoVHORT study, limited to non-hospitalized patients in Arizona - “mild” cases - found a 68% prevalence of 1 or more Covid symptom after 30 days, rising to 77% after 60 days. (We will explore an explanation later).
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Bell et al, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0254347">https://journals.plos.org/plosone/a...
Post-acute sequelae of COVID-19 in a non-hospitalized cohort: Results from the Arizona CoVHORT

Clinical presentation, outcomes, and duration of COVID-19 has ranged dramatically. While some individuals recover quickly, others suffer from persistent symptoms, collectively known as long COVID, or...

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0254347
Despite a different definition of “symptoms”, the Bergen study in Norway found that 61% of patients had symptoms after six months, including 52% of patients aged 16-30 years who had not been hospitalized.
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Blomberg et al, https://www.nature.com/articles/s41591-021-01433-3">https://www.nature.com/articles/...
Long COVID in a prospective cohort of home-isolated patients

Nature Medicine - Analysis of a prospectively enrolled cohort of patients with SARS-CoV-2 infections in Bergen, Norway, reveals a high proportion of patients who experienced long COVID symptoms at...

https://www.nature.com/articles/s41591-021-01433-3
To prevent panic, @CDCgov has been using the term “mild” to describe any case of COVID-19 which does not require hospitalization.

#LongCOVID, however, is anything but “mild”, as the replies to @ahandvanish& #39;s thread make heartbreakingly clear.
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Davis https://twitter.com/ahandvanish/status/1423017721822949376">https://twitter.com/ahandvani...
A University of Washington study found that 30% of Covid patients had reduced Health Related Quality of Life, with 8% of the patients limited in routine daily activities.
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Logue et al https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2776560">https://jamanetwork.com/journals/...
Sequelae in Adults at 6 Months After COVID-19 Infection

This cohort study analyzed persistent symptoms among adults with coronavirus disease 2019 up to 9 months after illness onset.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2776560
These patients are struggling with real physical issues.

This Yale study demonstrated reduced aerobic capacity, oxygen extraction. and ventilatory efficiency in “mild” COVID patients even after recovery from their acute infection.
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Singh, et al https://journal.chestnet.org/article/S0012-3692(21)03635-7/fulltext">https://journal.chestnet.org/article/S...
Persistent Exertional Intolerance After COVID-19

Patients who have recovered from COVID-19 without cardiopulmonary disease demonstrate a marked reduction in peak VO2 from a peripheral rather than a central cardiac limit, along with an exaggerated...

https://journal.chestnet.org/article/S0012-3692(21)03635-7/fulltext
It’s also a vascular disease. A Columbia study found "significantly altered lipid metabolism" during acute disease, which "suggests a significant impact of SARS-CoV-2 infection on red blood cell structural membrane homeostasis."
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Thomas, et al https://pubs.acs.org/doi/10.1021/acs.jproteome.0c00606">https://pubs.acs.org/doi/10.10...
Evidence of Structural Protein Damage and Membrane Lipid Remodeling in Red Blood Cells from...

The SARS-CoV-2 beta coronavirus is the etiological driver of COVID-19 disease, which is primarily characterized by shortness of breath, persistent dry cough, and fever. Because they transport oxygen,...

https://pubs.acs.org/doi/10.1021/acs.jproteome.0c00606
Oregon Health & Science University found that “symptomatic or asymptomatic SARS-CoV-2 infection is associated with increased risk of [fatal] cardiovascular outcomes and has causal effect on all-cause mortality.”
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Tereschenko et al https://www.medrxiv.org/content/10.1101/2021.12.27.21268448v1">https://www.medrxiv.org/content/1...
Risk of Cardiovascular Events after Covid-19: a double-cohort study

Objective: To determine absolute and relative risks of either symptomatic or asymptomatic SARS-CoV-2 infection for late cardiovascular events and all-cause mortality. Methods: We conducted a retros...

https://www.medrxiv.org/content/10.1101/2021.12.27.21268448v1
Let’s review: SARS-CoV-2 causes an increase in mortality and reduced aerobic capacity even after asymptomatic cases, and remains in the body months after the initial infection.

No, it’s not “just a cold.”

But we’re just getting started. It gets worse. Way worse.
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The virus appears to be able to cross the blood-brain barrier and cause significant neurological damage.

The ability of the spike protein to cross the blood-brain barrier was demonstrated in mice at the University of Washington.
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Rhea, et al https://pubmed.ncbi.nlm.nih.gov/33328624/ ">https://pubmed.ncbi.nlm.nih.gov/33328624/...
The S1 protein of SARS-CoV-2 crosses the blood-brain barrier in mice - PubMed

It is unclear whether severe acute respiratory syndrome coronavirus 2, which causes coronavirus disease 2019, can enter the brain. Severe acute respiratory syndrome coronavirus 2 binds to cells via...

https://pubmed.ncbi.nlm.nih.gov/33328624/
A joint study by Stanford and Germany’s Saarland University found inflammation in the brain, and “show[ed] that peripheral T cells infiltrate the parenchyma.”
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Yang, et al https://www.nature.com/articles/s41586-021-03710-0">https://www.nature.com/articles/...
Dysregulation of brain and choroid plexus cell types in severe COVID-19

Nature - Single-nucleus transcriptomes of frontal cortex and choroid plexus samples from patients with COVID-19 reveal pathological cell states that are similar to those associated with human...

https://www.nature.com/articles/s41586-021-03710-0
For context, the parenchyma is the functional tissue of the brain - your neurons and glial cells. It isn’t normally where T cells are:

“In the brain of healthy individuals, T cells are only present sporadically in the parenchyma.”
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Evans, et al https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6751344/">https://www.ncbi.nlm.nih.gov/pmc/artic...
Protective and Regenerative Roles of T Cells in Central Nervous System Disorders

Pathogenic mechanisms of T cells in several central nervous system (CNS) disorders are well-established. However, more recent studies have uncovered compelling beneficial roles of T cells in neurol...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6751344/
The Stanford study also discovered microglia and astrocytes which displayed “features .. that have previously been reported in human neurodegenerative disease.”
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Yang, et al, above
Post-mortem neuropathology in Hamburg, Germany found “Infiltration by cytotoxic T lymphocytes .. in the brainstem and cerebellum, [with] meningeal cytotoxic T lymphocyte infiltration seen in 79% [of] patients.”
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Matschke, et al https://www.sciencedirect.com/science/article/pii/S1474442220303082#!">https://www.sciencedirect.com/science/a...
Neuropathology of patients with COVID-19 in Germany: a post-mortem case series

Prominent clinical symptoms of COVID-19 include CNS manifestations. However, it is unclear whether severe acute respiratory syndrome coronavirus 2 (SA…

https://www.sciencedirect.com/science/article/pii/S1474442220303082#
An autopsy of a 14-month-old at Brazil’s Federal University of Rio de Janeiro found that “The brain exhibited severe atrophy and neuronal loss.”
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Gomes, et al https://www.thelancet.com/journals/lanam/article/PIIS2667-193X(21)00038-7/fulltext">https://www.thelancet.com/journals/...
The UK Biobank COVID-19 re-imaging study compared before and after images of “mild” cases, and found “pronounced reduction in grey matter” and an “increase of diffusion indices, a marker of tissue damage” in specific regions of the brain.
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Douaud ++ https://www.medrxiv.org/content/10.1101/2021.06.11.21258690v3">https://www.medrxiv.org/content/1...
Brain imaging before and after COVID-19 in UK Biobank

There is strong evidence for brain-related pathologies in COVID-19, some of which could be a consequence of viral neurotropism, or of neuroinflammation following viral infection. Most brain imaging...

https://www.medrxiv.org/content/10.1101/2021.06.11.21258690v3
That seems to explain why there is evidence of persistent cognitive deficits in people who have recovered from SARS-CoV2 infection in Great Britain.
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Hampshire et al https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00324-2/fulltext">https://www.thelancet.com/journals/...
Cognitive deficits in people who have recovered from COVID-19

Interpretation. These results accord with reports of ‘Long Covid’ cognitive symptoms that persist into the early-chronic phase. They should act as a clarion call for further research with longitudi...

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00324-2/fulltext
Also worrisome are syncytia, where an infected cell extrudes its own spike protein and takes over its neighbors, fusing together to create a large multi-nucleus cell.

Delta& #39;s particular aptitude for this may partly explain its severity.
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Lightfoot https://www.news-medical.net/news/20211006/SARS-CoV-2-emerging-variants-display-enhanced-syncytia-formation.aspx">https://www.news-medical.net/news/2021...
SARS-CoV-2 emerging variants display enhanced syncytia formation

Researchers compared the replication and syncytia forming potential of Alpha, Beta, and D614G strains in human cell lines and primary airway cells.

https://www.news-medical.net/news/20211006/SARS-CoV-2-emerging-variants-display-enhanced-syncytia-formation.aspx
And, yes, syncytia formation can happen in neurons. For our visual learners, here is video of syncytia and apoptosis (cell death) in a (bat) brain:
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Aicher et al https://twitter.com/nytimes/status/1429604323047133185">https://twitter.com/nytimes/s...
Luckily, the University of Glasgow found that “Whilst Delta is optimised for fusion at the cell surface, Omicron .. achieves entry through endosomal fusion. This switch .. offers [an] explanation for [its] reduced syncytia formation.”
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Willet et al https://www.gla.ac.uk/media/Media_829360_smxx.pdf">https://www.gla.ac.uk/media/Med...
If you’re interested in further understanding the host of neurological symptoms and the mechanisms underlying them, this Nature article is an excellent primer:
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Marshall https://www.nature.com/articles/d41586-021-01693-6">https://www.nature.com/articles/...
COVID and the brain: researchers zero in on how damage occurs

Nature - Growing evidence suggests that the coronavirus causes ‘brain fog’ and other neurological symptoms through multiple mechanisms.

https://www.nature.com/articles/d41586-021-01693-6
Let’s review: SARS-CoV-2 can cross the blood-brain barrier, and even “mild” or asymptomatic cases can cause loss of neurons and persistent cognitive defects?

That doesn’t sound “mild” to me; I like my brain.

But it keeps getting worse.
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The brain isn’t the only organ affected: Testicular pathology has found evidence of “SARS-Cov-2 antigen in Leydig cells, Sertoli cells, spermatogonia, and fibroblasts” in post-morten examination.
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Duarte-Neto https://onlinelibrary.wiley.com/doi/10.1111/andr.13073">https://onlinelibrary.wiley.com/doi/10.11...
Testicular pathology in fatal COVID‐19: A descriptive autopsy study

Background Multi-organ damage is a common feature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, going beyond the initially observed severe pneumonia. Evidence that the...

https://onlinelibrary.wiley.com/doi/10.1111/andr.13073
A Duke pathology study in Singapore “detected SARS-CoV-2 .. in the colon, appendix, ileum, haemorrhoid, liver, gallbladder and lymph nodes .. suggesting widespread multiorgan involvement of the viral infection.”
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Cheung, et al #page1">https://gut.bmj.com/content/gutjnl/early/2021/06/13/gutjnl-2021-324280.full.pdf #page1">https://gut.bmj.com/content/g...
The same study found “evidence of residual virus in .. tissues during the convalescent phase, up to 6 months after recovery, in a non-postmortem setting,” suggesting that “a negative swab result might not necessarily indicate complete viral clearance from the body.”
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ibid
It also causes microclots: “Fibrin(ogen) amyloid microclots and platelet hyperactivation [were] observed in [Long COVID] patients,” in this work by Stellenbosch University of South Africa, which also explored potential treatments.
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Pretorius et al https://www.researchsquare.com/article/rs-1205453/v1">https://www.researchsquare.com/article/r...
Combined triple treatment of fibrin amyloid microclots and platelet pathology in individuals with...

We recognise that fibrin(ogen) amyloid microclots and platelet hyperactivation, that we have previously observed in COVID-19 and Long COVID/Post-Acute Sequelae of COVID-19 (PASC) patients, might form...

https://www.researchsquare.com/article/rs-1205453/v1
Let’s review - SARS-CoV2 attacks our veins, blood, heart, brain, testes, colon, appendix, liver, gallbladder and lymph nodes?

No, it’s not “just a respiratory virus”.

Not even close.
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There are also immunology implications:

Johns Hopkins& #39; @fitterhappierAJ found that “CD95-mediated [T cell] differentiation and death may be advancing T cells to greater effector acquisition, fewer numbers, and immune dysregulation.”
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Leonardi et al https://www.frontiersin.org/articles/10.3389/fimmu.2020.600405/full">https://www.frontiersin.org/articles/...
Akt-Fas to Quell Aberrant T Cell Differentiation and Apoptosis in Covid-19

1 IntroductionA remarkable feature of infection identified early in the pandemic was a relative lymphopenia in patients shown to correlate with poor outcomes (1-4). Whether this was due to direct...

https://www.frontiersin.org/articles/10.3389/fimmu.2020.600405/full
This Chinese military study of the initial Wuhan outbreak concluded that “T cell counts are reduced significantly in COVID-19 patients, and the surviving T cells appear functionally exhausted.”
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Diao et al https://www.frontiersin.org/articles/10.3389/fimmu.2020.00827/full">https://www.frontiersin.org/articles/...
Reduction and Functional Exhaustion of T Cells in Patients With Coronavirus Disease 2019 (COVID-19)

Background: The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed great threat to human health. T cells play a critical...

https://www.frontiersin.org/articles/10.3389/fimmu.2020.00827/full
The study authors went on to warn, “Non-ICU patients with total T cells counts lower than 800/μL may still require urgent intervention, even in the immediate absence of more severe symptoms due to a high risk for further deterioration in condition.”
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ibid
Those warnings have since been proven by discovery of autoimmune features.

This study of 177 Los Angeles healthcare workers found that all had persistent self-attacking antibodies at least 6 months after infection, regardless of illness severity.
(34/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">) …https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-021-03184-8">https://translational-medicine.biomedcentral.com/articles/...
Paradoxical sex-specific patterns of autoantibody response to SARS-CoV-2 infection - Journal of...

Background Pronounced sex differences in the susceptibility and response to SARS-CoV-2 infection remain poorly understood. Emerging evidence has highlighted the potential importance of autoimmune...

https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-021-03184-8
In the words of T-cell immunologist Dr. Leonardi ( @fitterhappierAJ)
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This Kaiser Permanente S.California study found that, although natural immunity provided substantial protection against reinfection, “Hospitalization was more common at suspected reinfection (11.4%) than initial infection (5.4%).”
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Slezak et al https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(21)00422-5/fulltext">https://www.clinicalmicrobiologyandinfection.com/article/S...
Rate and severity of suspected SARS-Cov-2 reinfection in a cohort of PCR-positive COVID-19 patients

To estimate the burden and severity of suspected reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(21)00422-5/fulltext
In fact, remember those cytokine storms? It turns out that even that even severe COVID-19 may not be a viral pneumonia, but an autoimmune attack of the lung.

(37/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">) https://twitter.com/DaveLeeERMD/status/1413816137570205697">https://twitter.com/DaveLeeER...
Let’s review - it’s autoimmune: SARS-CoV2 convinces our body to attack itself.

That might explain why the Arizona study saw more symptoms after 60 days than at 30 days.

It also means “natural immunity” isn’t something to count on.
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But if you’re counting on vaccination to feel safe, there’s even more bad news.

A study of Israel healthcare workers found that “Most breakthrough cases were mild or asymptomatic, although 19% had persistent symptoms (>6 weeks).”
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Bergwerk et al https://www.nejm.org/doi/full/10.1056/NEJMoa2109072#.YRK8mDsAjKw.twitter">https://www.nejm.org/doi/full/...
Covid-19 Breakthrough Infections in Vaccinated Health Care Workers | NEJM

Original Article from The New England Journal of Medicine — Covid-19 Breakthrough Infections in Vaccinated Health Care Workers

https://www.nejm.org/doi/full/10.1056/NEJMoa2109072#.YRK8mDsAjKw.twitter
Perhaps the most terrifying study is from Oxford University, which examined the effects of vaccination on long COVID symptoms, because not only did it find that vaccination does not protect against Long Covid, but that Long Covid symptoms become more likely over time:
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In the words of the study authors, “vaccination does not appear to be protective against .. long-COVID features, arrhythmia, joint pain, type 2 diabetes, liver disease, sleep disorders, and mood and anxiety disorders."
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Taquet, et al https://www.medrxiv.org/content/10.1101/2021.10.26.21265508v3.full-text">https://www.medrxiv.org/content/1...
Six-month sequelae of post-vaccination SARS-CoV-2 infection: a retrospective cohort study of 10,024...

Vaccination has proven effective against infection with SARS-CoV-2, as well as death and hospitalisation following COVID-19 illness. However, little is known about the effect of vaccination on other...

https://www.medrxiv.org/content/10.1101/2021.10.26.21265508v3.full-text
“The narrow confidence intervals rule out the possibility that these negative findings are merely a result of lack of statistical power. The inclusion of death in a composite endpoint with these outcomes rules out survivorship bias as an explanation.”
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ibid
That finding contradicts the findings from the UK Zoe app study, which found that “the odds of having symptoms for 28 days or more after post-vaccination infection were approximately halved by having two vaccine doses.”
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Antonelli et al https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00460-6/fulltext">https://www.thelancet.com/journals/...
Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID...

To minimise SARS-CoV-2 infection, at-risk populations must be targeted in efforts to boost vaccine effectiveness and infection control measures. Our findings might support caution around relaxing...

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00460-6/fulltext
However, the structural limitations of the Zoe study - discussed in detail by @dgurdasani1 in the linked thread - may explain why it is particularly susceptible to bias against detecting a progressive degenerative condition.
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Let’s review: we’ve now shown that vaccination appears to offer no protection against the long-term autoimmune effects of COVID - which we know causes T-cells to attack the lungs, and can cause T-cells to enter the brain.

Why are we letting this run wild?!
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You may think, at least our children are safe.

They are not.

The CDC is tracking incidence of a life-threatening multisystem inflammatory syndrome in children following an acute COVID-19 infection, with 5,973 cases as of November 30, 2021.
(46/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">) https://www.cdc.gov/mis/cases/index.html">https://www.cdc.gov/mis/cases...
Multisystem Inflammatory Syndrome(MIS)

Get information on Multisystem Inflammatory Syndrome (MIS), a recently reported condition associated with COVID-19.

https://www.cdc.gov/mis/cases/index.html
Children also suffer from Long Covid.

"More than half [of pediatric patients] reported at least one persisting symptom even 120 days [after] COVID-19, with 42.6% impaired by these symptoms during daily activities."
(47/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
Buonsenso et al https://doi.org/fv9t ">https://doi.org/fv9t"...
Preliminary Evidence on Long COVID in children

There is increasing evidence that adult patients diagnosed with acute COVID-19 suffer from Long COVID initially described in Italy. To date, data on Long COVID in children are lacking. We assessed...

https://doi.org/fv9t
Focusing exclusively on pediatric deaths is vastly underselling the danger to children.

Anybody telling you that SARS-CoV-2 is “just a cold” or “safe for children” is lying to you. They are ignoring the massive body of research that indicates that it is anything but.
(48/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
Since our vaccines don’t stop transmission, and don’t appear to stop long-term illness, a “vaccination only” strategy is not going to be sufficient to prevent mass disability.

This isn& #39;t something we want to expose our kids to.
(49/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
https://www.scientificamerican.com/article/a-tsunami-of-disability-is-coming-as-a-result-of-lsquo-long-covid-rsquo/">https://www.scientificamerican.com/article/a...
Let’s review: even for children and vaccinated people, a “mild” case of COVID causes symptoms that point to long-term autoimmune issues, potentially causing our own body to attack our brains, hearts, and lungs.

Scared? Good.

Now we’re ready to get to work.
(50/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
“This is the virus most Americans don’t know. We were born into a world where a virus was a thing you got over in a few weeks.” -- @sgeekfemale, to whom I owe a "thank you" for her editing assistance on this thread.
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The viruses they know in Kolkota, Kinshasa, and Wuhan are different: dangerous, lethal beasts.

Since 2020, the field has been leveled. Willing or no, we’ve rejoined the rest of the world. We are, all of us, vulnerable in the face of an unfamiliar threat.
(52/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
The first step is acknowledging the threat.

That means acknowledging that our response has been woefully inadequate, and that is going to be uncomfortable.

The thought that we could have prevented this, but didn’t, will feel unconscionable to some.
(53/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
The knowledge that we could start preventing this today, but haven’t, is unconscionable to me.

https://twitter.com/IanRicksecker/status/1426584062827712512
(54/https://twitter.com/IanRickse... class="Emoji" style="height:16px;" src=" https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
It’s time to quit pretending “it’s just a cold,” or that there is some magical law of viruses that will make it evolve to an acceptable level.

There’s no such law of evolution, just wishful thinking, easily disproven by:

Ebola. Smallpox. Marburg. Polio. Malaria.
(54/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
There are things we can do to reduce our individual risk, immediately.

That starts with wearing a good mask - an N95 or better - and choosing to avoid things like indoor dining and capacity-crowd stadiums.

(55/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">) https://twitter.com/LazarusLong13/status/1440398111445188618">https://twitter.com/LazarusLo...
This isn& #39;t a choice of "individual freedom" vs "public health". It isn& #39;t "authoritarian" to ask people to change their behavior in order to save lives.
(56/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">) https://www.thehastingscenter.org/individual-freedom-or-public-health-a-false-choice-in-the-covid-era/">https://www.thehastingscenter.org/individua...
Individual Freedom or Public Health? A False Choice in the Covid Era

When scientists first suggested population-wide social distancing as the only feasible way to suppress Covid-19, they were the first to admit it may not work in a free society. We are now months into...

https://www.thehastingscenter.org/individual-freedom-or-public-health-a-false-choice-in-the-covid-era/
As Arnold @Schwarzenegger argued so convincingly in @TheAtlantic, it is our patriotic duty:

"Generations of Americans made incredible sacrifices, and we’re going to throw fits about putting a mask over our mouth and nose?"
(57/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">) https://www.theatlantic.com/ideas/archive/2021/08/schwarzenegger-schmuck-mask-vaccines/619746/">https://www.theatlantic.com/ideas/arc...
Don’t Be a Schmuck. Put on a Mask.

Generations of Americans made incredible sacrifices, and we’re going to throw fits about putting a mask over our mouth and nose?

https://www.theatlantic.com/ideas/archive/2021/08/schwarzenegger-schmuck-mask-vaccines/619746/
“Those who would sacrifice essential liberty for a little bit of temporary security deserve neither!”

What is the essential liberty here?

It is the liberty to be able to breathe clean air, to live our lives without infecting our families and risking disability.
(58/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
To get there, we need to listen to our epidemiologists and public health experts - the ones who have been trying to tell us this since the beginning:
(59/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">) https://twitter.com/EpiEllie/status/1444088804961304581">https://twitter.com/EpiEllie/...
It is time -- long past time -- to give up on the lazy fantasy that we can let it become “endemic” and “uncontrolled” because it inconveniences us, because it is killing our political opponents, or because the virus will magically evolve to some “mild” state.
(60/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
It is time -- long past time -- to begin controlling this virus.
(61/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
It’s possible: Japan, New Zealand, and South Korea have done it.
(62/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
It saves lives:
(63/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
It’s even good for the economy:

"Globally, economic contraction and growth closely mirror increases and decreases in COVID-19 cases... Public health strategies that reduce SARS-CoV-2 transmission also safeguard the economy."
(64/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
Escandón et al https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06357-4">https://bmcinfectdis.biomedcentral.com/articles/...
COVID-19 false dichotomies and a comprehensive review of the evidence regarding public health,...

Scientists across disciplines, policymakers, and journalists have voiced frustration at the unprecedented polarization and misinformation around coronavirus disease 2019 (COVID-19) pandemic. Several...

https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06357-4
It’s time.
(Fin/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
Coda:

For those of you who are reading this having just received a positive COVID test, please don& #39;t despair.

I& #39;d like to direct you to @Survivor_Corps and their website -- I suggest you start at:

(66/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
https://www.survivorcorps.com/homecare ">https://www.survivorcorps.com/homecare&...
For anybody who has a COVID-positive person in the house, and needs to isolate safely, I recommend you to @CleanAirCrewOrg and their guide at:

(67/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">) https://cleanaircrew.org/someone-in-my-home-has-covid-how-do-we-isolate-safely/">https://cleanaircrew.org/someone-i...
Someone in my home has COVID. How do we isolate safely? - Clean Air Crew

When someone in your household needs to quarantine at home, you want them to be isolated from others as much as possible. Remember that the virus transmits predominantly through the air, so sanitiz...

https://cleanaircrew.org/someone-in-my-home-has-covid-how-do-we-isolate-safely/
For anybody who has a shared living space, such as a dorm room, who wants to mitigate risk in that space while still taking your masks off, eating, etc, I recommend this thread by @CorsIAQ:

(68/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">) https://twitter.com/CorsIAQ/status/1478567649915256832">https://twitter.com/CorsIAQ/s...
For school administrators and business owners who want to make their workplace safe for employees, customers, and students alike, I recommend @kprather88& #39;s thread on the mitigations she put in place at @UCSanDiego and in the @sdschools district:
(69/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">) https://twitter.com/kprather88/status/1424796471711264768">https://twitter.com/kprather8...
For parents looking to protect their children with quality masks, my family used @masknerd& #39;s detailed analysis to select one that fits our daughter. She loves it - and it& #39;s so comfortable she doesn& #39;t mind grabbing it even for outdoor play.
(70/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">) https://twitter.com/masknerd/status/1476668499649044484">https://twitter.com/masknerd/...
For those of you battling your own Long Covid symptoms, who read this and thought, "I feel seen", I recommend the great support community:

@long_covid
@patientled
@itsbodypolitic
@elisaperego78
@ahandvanish

Patient-led research into Long Covid inspired this thread.
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Update: in reviewing this thread, @dgurdasani1 pointed out an important nuance I& #39;d failed to mention.

The Oxford University paper& #39;s primary analysis counted a single dose as "vaccinated," which doesn& #39;t match our colloquial usage of the word to mean fully vaccinated.
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The paper& #39;s sub-analysis, however, showed protection against several persistent symptoms with 2-dose vaccination, even though the primary analysis didn& #39;t.

That& #39;s very good news!
(73/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
That corroborates the findings from the Université de Paris study which Professor Iwasaki ( @VirusesImmunity) described in this thread.

The graph of complete remission in her second tweet is of particular interest to anyone battling Long Covid.
(74/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">) https://twitter.com/VirusesImmunity/status/1444306456266825732">https://twitter.com/VirusesIm...
Anybody currently exposed or worried about their personal risk of Long Covid will be happy to read that the study found

"Vaccination reduced the symptoms of long COVID and doubled the remission rate of long COVID symptoms at 120 days."
(75/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
Tran, et al https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3932953">https://papers.ssrn.com/sol3/pape...
Let& #39;s review: vaccines do offer benefits against Long Covid, with a 2-dose sequence increasing the chances of full remission, and providing protection against a number of pernicious sequelae.
(76/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
This isn& #39;t "mild".

Don& #39;t just take my word for it:
(77/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">) https://www.bbc.com/news/world-59901547">https://www.bbc.com/news/worl...
Covid: Deadly Omicron should not be called mild, warns WHO

The WHO cautions that just like previous variants, Omicron is hospitalising and killing people.

https://www.bbc.com/news/world-59901547
I have deleted post 41 of the thread, so that it can no longer be used for anti-vaccine propaganda, with thanks to @kallmemeg for drawing my attention to the way it was being misused.

Posts 40-42 and 72-73 reference this study:

(78/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">)
Taquet, et al https://www.medrxiv.org/content/10.1101/2021.10.26.21265508v3.full-text">https://www.medrxiv.org/content/1...
Six-month sequelae of post-vaccination SARS-CoV-2 infection: a retrospective cohort study of 10,024...

Vaccination has proven effective against infection with SARS-CoV-2, as well as death and hospitalisation following COVID-19 illness. However, little is known about the effect of vaccination on other...

https://www.medrxiv.org/content/10.1101/2021.10.26.21265508v3.full-text
Adding this meta-analysis to the thread, so that people can find it in a single place:

(79/https://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="collectie" aria-label="Emoji: collectie">) https://twitter.com/ahandvanish/status/1478525881475907587">https://twitter.com/ahandvani...
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