Ian Welsh

The horizon is not so far as we can see, but as far as we can imagine

Category: Covid–19 Page 2 of 20

The Pandemic Is Not Over And Neither Is Long Covid

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On April 5, 2023

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One problem with covering Covid right now is that it’s becoming harder and harder to get good stats, because governments want to pretend it’s over. In Canada, the best reporting provincial government is Quebec, so we’ll look at that and I’m quite sure this is effectively the picture everywhere, though the bumps may not synchronize. The important line is the orange one, that’s excess mortality. It’s over 35%. And these numbers are a known understatement.

This is typical of the charts I’ve seen tracking Covid—the numbers aren’t at peak, but they are as high or higher than they were for most of the official pandemic.

Meanwhile there is Long Covid. A Danish study:

As part of an effort to better flesh out the burden of long COVID, Danish researchers today reported a threefold increase in extended sick leave, defined as lasting longer than 30 days, in people who had recovered from COVID, compared to workers who weren’t infected.

From the Independent:

Some 1.9 mln people across the UK are currently estimated to be suffering from #longCOVID, or 2.9% of the population. The figure is up from 689,000 at the start of January and 514,000 in September 2022

From the BBC:

the number of children under 16 with self-reported Long Covid of any duration ‘increased from 77,000 in October 2021, to 119,000 in January 2022

So we decided to pretend the plague was over and stopped doing the anti-plague stuff like masking:

Covid is still a thing. What’s as bad, maybe worse, is the hospital crush. Politicians pretend Covid is over, but hospitals still have to deal with it, not just in terms of patients but in terms of sick doctors, nurses and other staff. Last year I went to a cancer clinic and had to wait many hours. I asked why? “Three of the four doctors are out with Covid.”

Oh.

Where I live wait times in emergency departments are often 8 hours, sometimes more. They were a couple hours or less before Covid and strangely, now that Covid is “over” they haven’t gone back to 2 hours.

Test times, surgery times, everything times are delayed, and as a result people become more seriously ill or die. Excess deaths from Covid are vastly overstated if they only include Covid and Covid-related damage, because patients with heart and cancer and other problems are dying due to delayed care.

The decision has been made to just live with the plague. If we want to do that, and we clearly do, then we have to adjust our society. We have to train more doctors and nurses and other hospital staff like technicians. We have to increase hospital budgets. We need more long-term care beds and we need to make support available to people with long Covid who can’t work: both financial and outpatient nursing care.

But to do that, as with doing anything, we’d have to spend quite a bit more money on healthcare, and since the only place to get money from is the rich, the poor and middle class being tapped out, that means taxing the rich, which is verboten.

The human propensity to just pretend that problems they don’t want to exist don’t exist in is full display now with respect to Covid, as it has been for generations with respect to climate and environmental collapse. The problem is that some problems don’t care if we don’t want them to exist, they still exist and they get worse (see those increases in people with Long Covid or all the fires and droughts and whatnot from early climate change.)

There is a real world, and sticking our heads in the sand doesn’t make it go away. But it does kill a lot of people and make a lot of other people disabled.

As usual, none of these problems can truly be dealt with while our current elites are in power. If we want them fixed, our elites have to go and be entirely replaced.

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I’m Just Embarrassed For Humanity At This Point

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On February 3, 2023

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I was thinking today about China giving up on Zero Covid. They were responding to significant public protests. The CCP isn’t democratic by our standards, but they actually care a great deal about public opinion, especially “expressed” public opinion.

What’s embarrassing, however, is the failure to spend the two years Zero-Covid bought fixing infrastructure. We know, at this point, that ventilation, HEPA filtering and UV radiation work. (This is what the rich gave themselves at Davos, so don’t waste anyone’s time arguing.)

There was a time, basically in the Victorian era, where we rebuilt all of the water infrastructure because we had finally got it thru our thick skulls that disease spread thru water. We did it, and it made a huge difference.

I think particularly of China because no other major country even really tried. China had the time, and they have the industrial resources to do what is necessary (also, refit buildings with water traps, those little u-bends you see  under your sink or by your toilet.) They’re the largest manufacturing nation in the world, and they had spare housing workers hanging around.

Clean the air flow in buildings. Even just putting a HEPA filter in a classroom, without any other changes, drops Covid massively.

Now, this is a symptom of a larger problem. We have known about climate change for decades. The science was clear and known to the educated public by the late 70s, before there was a huge push for climate denialism backed by big money. There were some obvious easy solutions that amounted to “change infrastructure to use less energy.” Every building in developed country could have been made to use vastly less energy, and since we had an unemployment crisis combined with an energy crisis, it would have been the obvious right thing to do. Instead we did demand restriction through wage suppression, which had the side-benefit of making the rich a lot richer.

It has remained the right thing to do for decades. AOC’s New Green Deal is just a version of what everyone with sense has known needed to be done. I put out a similar plan first in the early 2000s at BOPNews, but I was nowhere near the first.

This is just embarrassing. We know what’s wrong, we know how to do some of the major steps required to fix it and we don’t do anything. Zero Covid was, on top of that run incompetently (but China gets points for at least trying till they gave up.)

Embarrassing. I’m just embarrassed for our leadership, who are psychopathic morons, even the ones who sometimes try to do the right thing, and I’m embarrassed or humanity, given how human social dynamics lead to such terrible leadership, over and over. Periods with competent leadership are rare, those where the leadership is both competent and non-psychopathic rarer still (in the US, this period in the 20th century arguably only exists for the period where FDR was in charge, and was marred even then by the sad fact that he was racist, particularly against Japanese (ironically because he liked the Chinese.) Truman, despite his good reputation, was a disaster.)

But this is a human problem which has gone on for about eight thousand years, and maybe longer.

The entire shit-show is just embarrassing and pathetic.

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Britain Stops Making Vaccine Available (But the Rich Will Still Get It)

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On February 1, 2023

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So, here we go:

Now, I want to point out again, that at Davos, where the rich and powerful meet to decide the fate of the world, everyone has to be vaccinated, and has to be tested and if they aren’t or they test positive, their badges are deactivated.

In other words, the rich get vaccinated. Current vaccines are pretty shitty, because they haven’t been keeping up with the mutation speed, but they’re still better than nothing, and do reduce the seriousness of cases.

But that’s not really the point: the point is that for the rich the cost of vaccine (Modern is raising it from $26 to $110 to $130 in the US) is meaningless to our lords and masters: they don’t even notice $120: they spend more, much more, for lunch. But to ordinary people such a price can be the difference between eating or paying the rent. If it has to go, it goes.

One policy for the rich, who can afford bespoke medicine, and another for the plebes.

This is also terrible public health policy. While the vaccines don’t prevent spread, they do reduce viral load in infected individuals, and thus reduce the odds people around them will get infected. Mass vaccination (note that it is voluntary) is a good thing.

Leaving aside the whole “death” thing, there has been so much disabling due to Covid that the Bank of England, hardly touchy-feely compassionate sorts have noticed it with alarm, so even if you, like our lords and masters, are functionally a psychopath, this is going to continue to cause disaster in the economy.

But then labor shortages and supply chain problems have been used as an excuse to raise prices much higher than cost increases, so from the point of view of the ruling class, who is this their problem? They’re getting richer; they make sure the people around them are tested and vaccinated and most of them can work from home and even before Covid lived inside carefully vetted bubbles. And if they do get sick, they’ll get the best care, far better than you will.

So, really, Covid continues to be win-win-win for the ruling class and who cares if it’s a mass death, mass disabling event of the sheep they rule over?

WIN! From WIN to WIN. That’s what it’s like to be in the ruling class. Even a pandemic that kills millions is just another profit opportunity.

Too bad you aren’t a member.

The results of the work I do, like this article, are free, but food isn’t, so if you value my work, please DONATE or SUBSCRIBE.

Consequences Of The End of Zero Covid In China

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On December 20, 2022

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Back in November I wrote that China’s Zero Covid policy was the right thing done the wrong way. Briefly after, consequent to some protests against Zero-Covid, China basically abandoned the policy.

The main problem is the same that exists in almost every country: even the most competent elites in the world today are, when not graded on a scale, incompetent buffoons incapable of running anything properly. Zero-Covid should have been about making necessary infrastructure changes to clean air so that over time restrictions could be eased.

This does not mean Zero-Covid did not have benefits: by shifting the oncoming wave downstream, China has significantly decreased mortality. Current protocols mean that Covid is much less deadly than if they’d given up early. A lot more people are vaccinated and the protocols for treating Covid are much better than earlier.

But massive public health measures should have been an opportunity, again, for improving infrastructure.

In the short term I would suggest that this will cause a supply shock, not make one less likely. If you need things made in China, stock up with a two to three month supply.

 

(I am fundraising to determine how much I’ll write this year. If you value my writing and want more of it, please consider donating. Alas, I’m neither God nor Beast.)

There will obviously be a wave of hospitalizations in China. Their hospital capacity per capita is much lower than most of the West’s. They do have the ability build temporary hospitals fast, but the choke-point isn’t facilities, it is trained staff. The CCP has plenty of warm bodies they can throw at low skill hospital jobs, but no great surplus of doctors and nurses.

The longer term consequence is the same as the longer-term consequence in the West. The best reason to do Zero-Covid was never about short term deaths, it was about avoiding Long Covid and a population which gets infected over and over again by a virus which screws up immune systems and damages organs, including the brain. The population level effects of Long Covid will be massive. The UK and US already have about 2% of their workforce disabled because of it.

China is a decade out from the start of a demographic crisis, with an aging workforce. Their dependency ratio (the number of people working / number of people not working but who must be supported) will rise and keep rising.

Long Covid will have a devastating effect on the population. There is no particular reason to expect Covid to miraculously disappear. We’ve had chronic serious diseases that lasted for centuries or millennia and the damage Long Covid does is not a serious enough evolutionary disadvantage for there to be significant pressure for its reduction. Indeed, if, as seems to be the case, much of it is related to immune dis-regulation, it’s likely to be selected for.

China’s elites policy was the right one, but public health measures at massive scale are what you do to buy time to clean up the water/air/find a cure. Since no cure has been found for Covid, and there is no cure on the horizon, well, infrastructure needed to be changed.

China isn’t worse about this than most other places. There has been no mass refitting of ventilation infrastructure in almost any major country (Japan seems to be a partial exception).

But it is tragic to see incompetence and short-sightedness destroy the last major uninfected pool of people in the post-Covid world.

China will pay a grave price for this, and Western triumphalism at the end of Zero-Covid is like cheering when the last stronghold falls to an invader. “It was so embarassing that they were holding out when we surrendered so easily.”

Pathetic and sad.

The Long Term Effects of Covid On the Economy Are Going To Be Devastating

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On December 14, 2022

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An estimate, but…

2 million to 4 million full-time workers are out of the labor force due to long Covid. (To be counted in the labor force, an individual must have a job or be actively looking for work.)

The midpoint of her estimate — 3 million workers — accounts for 1.8% of the entire U.S. civilian labor force. The figure may “sound unbelievably high” but is consistent with the impact in other major economies like the United Kingdom, Bach wrote in an August report. The figures are also likely conservative, since they exclude workers over age 65, she said.

As she says, this correlates to estimates elsewhere.

I want to be as clear as possible about this: the effect of Long Covid on the economy is going to dwarf that of closures or of  Covid TrueZero (a policy of cleaning up our air with filters and UV light, while using proper N95 masks, travel bans and other public health measures in the meantime.) Remember, Long Covid is still going on. It could go on for years, or even decades. There is no guarantee it mutates into a form which does not cause immunity and organ damage.

Further, the effect of Covid on people over 50 is going to be massive, and that means you if you’re under 50 when you get to being over 50, because the evidence coming in is that Covid damages the immune system: depletes t-cells and disorganizes recognition of pathogens.

That effect becomes more pronounced as you get older, and the tipping point is somewhere around the age of 50. This is going to lead to a further significant decline in lifespans if we can’t find a cure, but don’t assume we will: we’ve spent trillions and not found a cure for cancer and our society has passed its tipping point and is now in decline (this is true globally.)

 

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China did ZeroCovid STUPID, as a number of people have pointed out, and have now reduced their efforts. We’ll see if they stay reduced after the Chinese population discovers what happens when you “let’er rip”, but if China continues, that’s the end of one of the last major population blocs which wasn’t riddled with Covid. Remember, again, that Covid can do significant damage which you don’t notice, that has no symptoms now. But it will later.

China’s Zero Covid policy was the right policy, done wrong, and when you do the right thing the wrong way, you discredit it. China’s anti-Covid policies took longer to be discredited than Western ones because while stupid they weren’t as stupid as ours, but they still overly relied on lockdowns rather than infrastructure improvement and refused to use n95 masks.

So, globally, this is going to lead to long term economic issues, both in lack of workers and supporting unhealthy people, or just letting them suffer and die, which will still have economic effects. (It’s obvious that en-masse we don’t really care about the morality of it).

And you, personally, will probably live less years and be less healthy. The more times you get infected, the more true this will be.

 

China’s Zero-Covid Is the Right Policy Done Stupid (How China/The West Could Kill Covid)

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On November 29, 2022

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Imagine policy on two axes: Good vs. Bad Policy, and either type of policy done well vs. done badly.

Invading Iraq was Bad Policy, and it was done badly beyond the initial conquest.

Quantitative easing was Bad Policy (unless you were very rich, it was good for the rich and bad for everyone else) and it was done well: It saved the rich then made them much richer. (They aren’t concerned about long term downsides.)

Social Security, Medicare, or Canada’s Universal Health care system (when first created and for a few decades afterwards) was Good Policy done well.

Zero-Covid in China is Good Policy, but in most cities, and generally across the country, it has been done badly. (A lot of these criticism are taken from Naomi Wu, who is worth reading — don’t be fooled by her appearance.)

Understand first that China doesn’t have nearly as many hospital beds, and especially ICU beds, per capita, as most of the West. If Covid gets out of control, a higher percentage of people will die than did in most Western countries. Indeed, probably many more. Even if they only lost as many as the US has so far, we’re talking about five million people or so, but it would easily be double that.

Second, understand that China has an onrushing demographic issue and is still a manufacturing state. They need workers. They fundamentally regard their population as a productive asset, while most Western elites regard their populations as passive assets to be consumed. (One argument for why Japan has handled Covid better than most developed nations is that they need their population. They regard the people as a productive asset.)

A third principle to understand: Long Covid would disable a lot of Chinese. That number, today, would probably be around 40-50 million, and would increase every day. Again, in China, people are productive assets, and you especially don’t want working age people disabled.

There is also a moral argument: Stopping people from dying or being disabled is ethically the right thing to do.

Keeping Covid under control via a “Zero Covid” policy is thus firmly in the Good Policy bucket. Even if there are some short- and mid-term economic costs (and actually, in a lot of metrics, China has done better economically than the “let’er’rip” countries) the long-term costs are much more significant.

Now the next thing to understand is that the way most people think of China, in terms of authoritarianism, is essentially wrong. Oh, China is an authoritarian one-party state, for sure, but regional elites have a lot of freedom. Only about 30 percent of the overall government budget is controlled from the center, for example. In the US, that figure is about 45 percent. States and cities are often rich, not poor (i.e., they have discretionary money), but they also have a lot of policy freedom within the guidelines set from the center.

So, different cities have done Zero-Covid differently. In Shenzen, where Naomi Wu comes from, there has been a total of one week in full lockdown. That’s it. Other cities have had more. When Hong Kong and Shanghai lost control in the summer, they had not been doing the same thing as most cities – they, in fact, didn’t lock down early, or totally, but tried a more “Western” approach.

We’re now seeing some fairly significant anti-Zero-Covid protests in some cities, including Beijing. This thread is a fairly good and balanced summary:

The issue isn’t that Zero-Covid is Bad Policy, it is that it has been done stupidly. To pick out a few major points:

One: Surgical masks are still being used. n95 masks are much more effective, and China has the capacity to manufacture them on a mass scale, almost trivially.

Two: Most Chinese homes don’t have p-traps (that little bend in your pipes under your sinks and toilet). P-traps keep water in the trap so that fumes from the sewer system below don’t get into your house. Not only does that mean your home smells better, it’s reduces disease transmission significantly.

Three: There is no mass move to install proper filtration or use of ultraviolet light in ventilation systems.

All of these actions would be low-hanging fruit for China. They can easily manufacture and install p-traps, filtration, and UV: China is the manufacturing capital of the world, and with the construction slow down there are plenty of people who need the work and are capable of doing it with respect to upgrading ventilation. It would be a win/win — more economic activity and an improved chance of achieving Zero-Covid.

Public health methods like testing, track and trace, and lockdowns work, but the real method is to fix the air quality and transmission through structural changes — exactly as we did in the 19th and early to mid-20th century to defeat diseases like Cholera, but with the water and sewage systems. Studies on the effectiveness of filtration, p-traps, n95 masks, proper ventilation, and so on show decreases in transmission that are massive — often over 90 percent.

Public health measures like mass testing and lockdown should be largely temporary; you use them until you figure out how to deal with a disease more permanently. In Covid’s case, that is NOT going to be vaccines. While they are helpful, they are not a silver bullet. Instead, what is required is the infrastructure transformation — make buildings and cities more healthy, thus reducing transmission massively (and in the meantime, for mitigation, move to n95 masks).

China has no excuses here: The science is clear and they have the industrial and installation capacity.

For China to achieve “Zero Covid,” they must move beyond emergency public health measures to permanent fixes. We know how to do it, and they actually have the capacity to do it.

That would be Good Policy, done well.

China’s mistake is trying to control Covid, not end it. The West’s mistake is not even trying to control it, let alone end it.

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Every Covid Infection Does More Damage & Makes You Less Healthy and More Likely to Die

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On November 14, 2022

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Okay. From very early on in the plague, I’ve been saying getting infected multiple times was a terrible idea, and a worse plan.

The key to being right in advance is being willing to run before things are completely proven, but when they are obvious. It was obvious that reinfections were terrible for people. Now the firm data is coming in. (Read the entire thing here.

“Compared to those with no reinfection, those who had reinfection exhibited an increased risk of all-cause mortality” of over 2x those with no reinfection. Three times for hospitalization, heart problems, and blood clotting. There was also increased incidence of diabetes, fatigue, kidney problems, mental health disorders, musculoskeletal problems, neurologic disorders, and lung problems.

I mean, one might be tempted to just say, “Reinfection makes you more likely to have all health problems,” and not be too far wrong. It may be that things get better, but this study found increased risks right out to six months, which is as far as it studied.

Bonus! As I’ve said almost right from the start, each reinfection makes things worse.

Every time you get infected by Covid, it has a chance to do even more damage, and if that damage heals after the acute phase, it’s damn slow — if.

Now, let’s talk about “immunity debt.” The way the immune system works isn’t like going to the gym, and slowly getting stronger by lifting heavier weights. Instead, it’s like cops or customs agents with mug shots. “If you see this guy, shoot him.” One thing Covid does to evade immunity is mess up the mug shots so that they aren’t recognized. This means that you get other diseases after Covid, to which you were previously immune — because it’s messed up the recognition system. This is probably a big part of why there are so many auto-immune disorders popping up in Covid survivors; mess up the mug shots enough, and the immune system will start going after innocent civilians, i.e., parts of your own body. (Having had  ulcerative colitis when I was young, I can tell you this can be more not-fun than most of you can imagine.)

Getting Covid is very likely to make your immune system worse, not better, and the above is only one mechanism by which this is true.

Too much of the Covid debate has centered on vaccines, which were not, and are not, a silver-bullet. The best results have been in countries that took public health measure approaches, of which vaccines are only a small part.

But for you individually, the “takeaway” is simple: don’t get multiple infections. Don’t let your kids get multiple infections. No matter how strong the social pressure, short of “lose your job” (and maybe not even then, if you can easily get another), do not stop protecting yourself, whatever level you consider appropriate. (I don’t wear masks outside unless it’s a crowded locale, for example, and I keep my tiny apartment ventilated all times. Most people should have a HEPA air purifier running all the time where they live, and your employer should be doing something similar if you work inside.)

Covid is already causing a permanent reduction in lifespans and an increase in illness. It’s not just Covid infections clogging up hospitals, it’s people with other illnesses getting them at increased rates. Keep protecting yourself.

And remember, with proper public health measures, we probably could have ended this plague in the first four months or so. Our lords and masters chose not to. Stupid? Evil? Why not both? I have suspicions (Covid made them a lot richer), but at the end of the day, they were okay with you and the people you care about dying or having serious health problems, likely for the rest of your lives.

Remember how much they were and are willing to hurt and kill you. Remember, also, this goes for all parties in power or near power in most countries. This certainly isn’t significantly different between Democrats and Republicans in the US.

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Covid Variants Continue Immune, Vaccine and Treatment Resistance Evolution

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On October 13, 2022

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From Salon:

BQ.1 and BQ.1.1 are both spreading extremely fast in parts of Europe. According to Cornelius Roemer, a viral evolution expert at the University of Basel, the number of BQ.1.1 infections has been doubling every week. That kind of exponential growth is sure to drive the variant to becoming dominant globally in short order.

“The degree of immune escape and evasion is amazing right now, crazy,” Yunlong Richard Cao, an immunologist at Peking University in Beijing, told Nature this week. Cao co-authored a paper, which has yet to be peer-reviewed, that seems to show previous infections by BA.5 and antibody drugs, including Evusheld and Bebtelovimab, aren’t enough to stop a BQ.1 infection.

“Such rapid and simultaneous emergence of multiple variants with enormous growth advantages is unprecedented,” Cao and his colleagues warned in the study. “These results suggest that current herd immunity and BA.5 vaccine boosters may not provide sufficiently broad protection against infection.”

Meanwhile, BA.2.75.2, an offshoot of the Centaurus omicron subvariant, also shows stark ability to evade antibodies.

So. Expect a bad winter. Remember that this exponential increase in new variants has always preceeded a new variant becoming dominant, and that given international travel, they always spread. If you get a vaccine, get a bi-valent one, but I’d suggest filtering enclosed areas and that wearing n95 masks is a good idea. Remember that even a mild case of Covid can lead to invisible organ damage, especially to the brain and heart, and that repeated infections have a good chance of giving you long Covid.

This isn’t a game, and it isn’t about ideological talking points or culture war bullshit. This is a disease, which because we refuse to take the steps necessary to eliminate it, that keeps mutating to avoid whatever half-assed steps we are taking, and which can seriously fuck you up.

Be well.

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