Hi Siebe, I like your post and agree largely with your conclusions.
Currently I’m wondering if there are any studies being done that can adjust our knowledge about the probabilities of extreme tail risk events (e.g., covid causes SSPE-like illness in a substantial fraction of people, or that it contributes significantly to cancer risk like HPV, or...), and if long-covid researchers are keeping an eye out for these probabilities.
Hopefully, it’ll be easier for decision makers to spot tail risk events, but I’m not confident about this.
There have been some studies but I haven’t looked into it. There’s some using the VA dataset but I don’t trust the quality of that. Cardiovascular risk seems more likely than cancer risk.
There’s some speculation that a subset of people might develop AIDS, because SARS-CoV-2 can infect CD4 cells just like HIV and some patients seem to have really low lymphocytes counts, but probabilities are hard to estimate.
There’s increasing evidence that song healthy convalescents harbor persistent SARS-CoV-2:https://link.springer.com/article/10.1007/s11695-022-06338-9.
I think this will come out to 15-30% of the population, but there’s a small probability that it’s >90% once we start looking closely.
The only thing I see anyone talking about the comparison between SSPE and long-covid is this popular-level article from Peter Doherty, and he seems to be unaware of any evidences suggesting whether it’s likely or not (only, “hopefully unlikely”).
I used to believe that pandemics in themselves are not enough to be an extinction level event. Now I’m not quite sure...IF something attains the prevalency of Covid but leads to serious illness with a high mortality rate (eg. SSPE) in a large proportion of people (instead of the measles/SSPE relationship) several years down the line, the result is going to be catastropic (and I don’t see why there will be any evolutionary pressure that prevents a virus from behaving like this).
Information about viral persistence has been on the popular press for a while, but it didn’t impact the public perception of covid (at least, not enough to affect the trajectory of our pandemic policies).
I wonder if there are more follow-up autopsy studies on covid persistence (that would allow us to look really closely, and in all the organs including the brain). The logical next step is to check if the presence of persistent covid is different in people who recovered from covid, compared to those who died during hospitalisation.
I think it is justifiable to make “testing for presence of persistent covid virus” a standard procedure for all autopsies. It’ll make autopsies more expensive and resource consuming but I think it would likely still be a negligible proportion of societal resources...and might give us a quick answer on long covid and its associated risks (eg: it would sound like big trouble if ~80% of healthy people who died from drowning/vehicle accidents/homicide had viable covid reservoirs in their major organs...)
Of course, that requires a lot of influences on the policy makers. But maybe current long-covid research groups can do some follow up autopsy studies? That might be a start as well, at least in gauging how bad the situation can be.
Hi Siebe, I like your post and agree largely with your conclusions.
Currently I’m wondering if there are any studies being done that can adjust our knowledge about the probabilities of extreme tail risk events (e.g., covid causes SSPE-like illness in a substantial fraction of people, or that it contributes significantly to cancer risk like HPV, or...), and if long-covid researchers are keeping an eye out for these probabilities.
Hopefully, it’ll be easier for decision makers to spot tail risk events, but I’m not confident about this.
I don’t know about SSPE.
There have been some studies but I haven’t looked into it. There’s some using the VA dataset but I don’t trust the quality of that. Cardiovascular risk seems more likely than cancer risk.
There’s some speculation that a subset of people might develop AIDS, because SARS-CoV-2 can infect CD4 cells just like HIV and some patients seem to have really low lymphocytes counts, but probabilities are hard to estimate.
There’s increasing evidence that song healthy convalescents harbor persistent SARS-CoV-2:https://link.springer.com/article/10.1007/s11695-022-06338-9. I think this will come out to 15-30% of the population, but there’s a small probability that it’s >90% once we start looking closely.
The only thing I see anyone talking about the comparison between SSPE and long-covid is this popular-level article from Peter Doherty, and he seems to be unaware of any evidences suggesting whether it’s likely or not (only, “hopefully unlikely”).
https://www.doherty.edu.au/news-events/setting-it-straight/issue-114-persistence-of-sars-cov-2-and-long-covid-2-defective-virus-privil
I used to believe that pandemics in themselves are not enough to be an extinction level event. Now I’m not quite sure...IF something attains the prevalency of Covid but leads to serious illness with a high mortality rate (eg. SSPE) in a large proportion of people (instead of the measles/SSPE relationship) several years down the line, the result is going to be catastropic (and I don’t see why there will be any evolutionary pressure that prevents a virus from behaving like this).
On the other hand, some animal species seem to have handled their equivalent of HIVs...https://www.pnas.org/doi/10.1073/pnas.0700471104
Information about viral persistence has been on the popular press for a while, but it didn’t impact the public perception of covid (at least, not enough to affect the trajectory of our pandemic policies).
https://www.bloomberg.com/news/articles/2021-12-26/coronavirus-can-persist-for-months-after-traversing-entire-body
I wonder if there are more follow-up autopsy studies on covid persistence (that would allow us to look really closely, and in all the organs including the brain). The logical next step is to check if the presence of persistent covid is different in people who recovered from covid, compared to those who died during hospitalisation.
I think it is justifiable to make “testing for presence of persistent covid virus” a standard procedure for all autopsies. It’ll make autopsies more expensive and resource consuming but I think it would likely still be a negligible proportion of societal resources...and might give us a quick answer on long covid and its associated risks (eg: it would sound like big trouble if ~80% of healthy people who died from drowning/vehicle accidents/homicide had viable covid reservoirs in their major organs...)
Of course, that requires a lot of influences on the policy makers. But maybe current long-covid research groups can do some follow up autopsy studies? That might be a start as well, at least in gauging how bad the situation can be.