56 Comments
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Yakov Miroslavic's avatar

There's entire internet communities full of people who wear N95 or FFP3 respirator masks to avoid catching covid. Check out reddit.com/r/ZeroCovidCommunity

Some people on there are healthcare workers, teachers, service staff or others who work with the public. Through a combination of masking and ventilation many of them have avoided catching covid. It's possible. Of course it often harms you social life but so do getting long covid.

Nora Abercrombie's avatar

It's SO easy to avoid COVID. Just wear a KN-95 or FFP2 respirator indoors at all times. Eating out is tricky but ask for a straw and slip your fork under the mask. It's fine. Also saves on lipstick.

Dating is tricker but just keep in mind that whoever doesn't mask properly is going to be an idiot in a few years, and turn you into their caretaker.

Otto the Renunciant's avatar

I don't think slipping a fork or straw under a mask should be viewed as a safe strategy. It's definitely safer than eating in a restaurant unmasked, but I wouldn't call it safe. The safest way to navigate restaurants is to go for outdoor seating. That still has some risks, but greatly reduced.

Nora Abercrombie's avatar

I totally agree. I have not eaten in a restaurant indoors since 2019. I find that there are lots of places that have a patio AND I can share a meal with friends via zoom. However, I have also been slipping forks and straws now and again, albeit in not crowded indoor spaces, and I have yet to get COVID. Of course, I am also vaccinated. Of course, I also hold my breath and exhale just as I put the mask back in place.

Otto the Renunciant's avatar

By the way, if you haven't heard, there was a new study that came out not too long ago showing that azelastine reduces chances of getting Covid by ~70%. Azelastine is an OTC antihistamine. Just spreading the word to other Covid cautious people who may not have heard about it.

Keep Going's avatar

These cognitive deficits from mild infections were not detected during the omicron period (Fig. 2 or S2 from that article). Yeah, there was still a deficit for participants with unresolved symptoms after 12 weeks. However, less than 3% of all participants with Omicron had unresolved symptoms, while more than 10% experienced them during the early COVID periods. So, it's definitely incorrect to extrapolate these estimates to the future like that.

Thomas F. Varley, PhD's avatar

I assume that when you say"that article" you are talking about Hampshire et al.,? What I see is:

"In analyses that were stratified according to variant period, illness duration was associated, in graded fashion, with deficits in the global cognitive score as compared with the no–Covid-19 group. The mean global cognitive score was lower among participants with unresolved persistent symptoms than among those in the no–Covid-19 group in all the variant periods (original virus, −0.32 SD; alpha variant, −0.33 SD; delta variant, −0.26 SD; and omicron variant, −0.16 SD)."

With post-omicron patients who had resolved symptoms showing no cognitive deficit. A 3% rate of lingering symptoms in the post-omicron era is consistent with other studies (see: https://www.nejm.org/doi/full/10.1056/NEJMoa2403211).

A 3% rate isn't something I would brush off. If a drug produces a given side-effect 3% of the time would be considered a "common" effect (see: https://cioms.ch/wp-content/uploads/2017/01/Group5_Pharmacovigilance.pdf page 122).

Assuming a base rate of 1 COVID infection per year and a 3% rate of post-COVID symptoms, your odds of lingering symptoms after 10 years are about 1 in 4 (assuming the risks don't compound, which does not seem to be the case to me -- see the Stats Can. and Al Aly papers).

That seems pretty bad to me.

Keep Going's avatar

Yeah, I was talking about the NEJM study.

I definitely agree that 3% rate isn't something to brush off, it's really significant. I only said that it is incorrect to extrapolate a constant average reduction in cognitive scores into the future assuming that people are infected every year or two on average (it doesn't matter), because the effect wasn't even constant for the duration of the study.

The odds of 1 in 4 are correct only if you're describing the likelihood of ever experiencing symptoms or if we assume that individuals with lingering symptoms will never recover, which doesn’t seem to be the case. For example, in the UK, there was also the ONS infection survey, which is similarly designed to the REACT cohort used for that NEJM study. The main difference is that the REACT study renewed its pool of participants every few months, while the ONS study attempted to maintain its participants, although there was still some degree of turnover. They found that the number of people with persistent symptoms after covid actually became smaller in 2023 compared to 2022.

https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk/30march2023

A recent study from the Netherlands (https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(25)00264-9/fulltext) also shows that a year after infections during the fall-winter of 2023, the rates of long-term symptoms that can be attributed to covid weren't statistically detectable after one year in a cohort of 5000+ people. So, it shows no increase overall after one year. And also a survey from the Netherlands shows the same trend as in the UK. It's more likely that there is an equilibrium instead of the steady increase, some people get infected, some people stop experiencing it.

https://www.rivm.nl/gezondheidsonderzoek-covid-19/kwartaalonderzoek-volwassenen/post-covid

Agentic Partners's avatar

Excellent statical and fact based rebuttal. You should do a write up.

Wired Earp's avatar

Brain damage is even more likely from Omicron strains, see https://onlinelibrary.wiley.com/doi/10.1002/mco2.508

What's notable about the Statistics Canada survey that estimates a 37% risk of "lingering symptoms" after three infections is that it was replicated to an estimate of 38% in a separate survey of health workers in Quebec. It is definitely correct to extrapolate more, not less, problems in the future. https://ici.radio-canada.ca/nouvelle/2116352/covid-longue-sras-cov2-pandemie-risque

Thomas F. Varley, PhD's avatar

Thanks for this - I will check this out and may update the article if this seems like strong enough replication/confirmatory evidence.

Keep Going's avatar

I don't see how you can compare the likelihood of damage after omicron vs earlier variants when this study included only patients after omicron infections. Also, studies of hospitalized patients can't tell us anything about the general prevalence anyway.

If we take the results of that Statistics Canada survey at face value, it also shows that as of June 2023, about 1 in 3 Canadians have never been infected, with only about 0.2 reinfections per person. You can't claim these results are inaccurate while using their long covid rate estimates, because they are calculated directly from them. Apart from the low detection rates, they surveyed participants long after they actually had covid, and they also had a really low response rate. That creates a large selection bias. It's been repeatedly shown that individuals with long-term health issues are more likely to respond to these surveys than those without such issues, for example, https://about.hse.ie/news/hse-publishes-findings-of-survey-examining-the-long-term-impact-of-acute-covid-19-disease/.

When detection rates are low, it is more likely that the more severe cases of covid are recorded, while milder cases go undetected. So, instead of comparing infected individuals to uninfected, we end up comparing detected cases vs undetected cases. In this scenario, we can't conclude that the infection is the cause of the observed outcomes. And what is the best predictor of post-covid lingering symptoms in that survey of health workers in Quebec? Right, the severity of acute disease, 2% rate in participants with mild disease and up to 25% in those who were hospitalized. https://www.inspq.qc.ca/publications/3510

It is also unclear how reliable these self-reported outcomes are without a control group. Just compare it to the study of healthcare workers selected to participate in the BCG vaccine trial. The biggest differences are that the selection was done before catching covid, not after, and the symptoms that people had even before the disease were taken into account, because participants were examined and followed for the whole duration.

https://www.sciencedirect.com/science/article/pii/S0163445324002019

Chris Buck's avatar

Trender challenged volunteers with original Wuhan strain and some of them had cognitive deficits a year later. It's not just an omicron thing.

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00421-8/fulltext

Keep Going's avatar

I've heard about that study as well. The thing is that it doesn't really show that the infected volunteers had cognitive deficits. They found the difference between the infected and uninfected groups, but participants in the uninfected group actually improved their scores because of the learning effect, while infected participants mostly kept their scores the same, with no consistent statistically significant decline. So, I don't think it's fair to say that they detected deficits. It's like if we have two groups starting an experiment with $100 each, then finishing with $100 and $150, and we claim that the first group lost 50 bucks. It doesn't sound right. I think the learning effect doesn't allow us to make any sound conclusions here, we don't know what would've happened without it.

Chris Buck's avatar

Averages aren't the right way of looking at this question. As an analogy, if the question were "does covid cause people to go on ventilators" you wouldn't argue that the average covid infection doesn't cause people to go on ventilators, so it must not be causing respiratory failure. You would see that people who don't have covid are at close to 0% chance of needing a ventilator, while people with covid have a few percent risk of needing a ventilator. It's more appropriate to look at the top left panel of Trender Figure 1 and see that volunteers with relatively high and long-lasting viral loads had significant (blue) cognitive deficits relative to their own baseline. The hypothesis isn't that covid infection guarantees cognitive deficits, the hypothesis is that it's a form of Russian roulette. Trender supports the latter hypothesis.

Dr Chris Earl MOL-BIO's avatar

Microbiologist here. Thank you for sharing this important work and for giving a balanced assessment of the different types of, at times, conflicting information that we have to work with. Great job.

BaDonkeyKong's avatar

You can protect your brain from COVID by masking

Tina B's avatar

My recovery has been sllooowwww. Three years later im mostly myself. Lots of sleep. Brain exercises (puzzles, reading, brain games) reduced stress, no alcohol etc. Lots of patience.

Mental health, social interactions, all the things are noticeably different with the public. It’s hard to quantify.

Brandie Persons's avatar

I try to explain to people that most of us need not worry about the acute infection symptoms but the long term damage is epic…nobody will listen it's driving me insane.

Sewa Luna's avatar

I totally agree with masking as an effective preventative measure and have been so frustrated to learn that the masks themselves are a source of toxins like microplastics, phthalates, and pfas. It feels like we just can't win! https://www.sciencedirect.com/science/article/pii/S0147651323013623

krr_mcc's avatar

Good. Maybe I'll die faster and skip the medical bankruptcy homelessness senior citizen portion of my life

Diet Wyatt's avatar

I know this is anecdotal but I’ve had covid every year since 2020 and have been getting treated for inexplainable brain fog lol

I haven’t been the same since and just had an mri done to tell me nothing is wrong 😑

And then ssris and I’m being gaslit into depression but it’s covid - thanks for shedding light so maybe there can be treatment. I don’t drink or smoke but have been experimenting with psychedelics, lions mane and Niacin to create new neurons / links in hopes of getting back to normal. I’m more retarded than ever before and it’s costed me a career and sense of self.

Adrienne!'s avatar

please don’t use the R-slur to describe your brain fog. Please consider wearing a mask to prevent further contraction and spread of this deadly and disabling airborne virus. Consider adding NAC to your supplement regimen (I’m not a doctor, this is not medical advice, but studies suggest that NAC can help prevent cardiovascular damage from COVID and can contribute to long-term healing from post-viral symptoms).

Diet Wyatt's avatar

thank you

I think the damage is done

If Covid persists year after year, then we’ll all have early dementia and there’s nothing that can reverse the scarring from the infection. Nac may reduce the amount of damage done by reducing inflammation when you get infected. We need a cure.

Minor Heretic's avatar

One thing that people noticed early in the pandemic was that the number of traffic deaths in the US went up by 20%. Some researchers looked into it and found that getting Covid, regardless of vaccination status, increased a person’s chance of crashing their car by at least 25%. This tracks with orbitofrontal cortex damage, that being the region that calculates risk and consequences. On top of everything else, our population is becoming risk blind.

User's avatar
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Jan 30
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Minor Heretic's avatar

It’s not me that connected increased car crashes with Covid. It was a group of epidemiologists who studied large groups of people with and without Covid and did a statistical analysis. Being scientists, they didn’t put a single number on it, but they put a lower bound on the effect of 25%. The upper bound on their error bar was 50%. It’s a significant finding.

What has also been established independently by multiple researchers all over the world is that Covid causes brain damage in 100% of cases. Multiple researchers have found shrinkage and hypo metabolism in the orbitofrontal cortex. The function of the OFC is well established.

It’s not a coincidence that people with degraded risk assessment abilities and reduced fear of risk are worse at driving.

User's avatar
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Jan 30
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Minor Heretic's avatar

I’m not a mind reader, but you are giving every indication of being anxious about this, to the point of denying scientific method in favor of magical thinking.

I’m not referring to one isolated study, or bleeding edge research. The orbitofrontal cortex has been studied for decades. MRI and PET/CT scans of the brain are not novel. When a number of independent research teams do case/control studies of people with or without Covid and register significant changes in brain volume and metabolism, that’s real information. When scientists do rigorous analyses of hundreds of thousands of cases and find major changes in cognitive performance or life outcomes, that’s real information.

Science is a never ending process of the refinement of our understanding of the world. After six years we have reached enough of an understanding of the effects of Covid to warrant avoiding it at the cost of convenience and social conformity. If you have any regard for your immune system, vascular system, and brain, you should make the effort to avoid being infected.

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Feb 5
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Minor Heretic's avatar

Careful, straw men are flammable.

TRT's avatar

Backed up by work I know has been done but has not yet been published. It has been presented to civil servants in the UK health ministry, up to cabinet level. The UK’s policies on human tissue and access to medical histories of postmortem tissue donors especially aborted foetal tissue, makes this work long, painstaking, statistically weakened and difficult.

Blasé's avatar

This is something that I presumed was happening to me, although it's difficult to separate the effects of computer-dependence/social-media/AI on my perceived quality of cognition and mental health from long-covid/post-COVID-syndrome... Maybe I'm just grasping for straws too.

This all also reminds me of how urban Romans all eventually had lead-poisoning, which according to some led to a significant decrease in cognition.

Bart Bounds's avatar

Curious if any studies you refer to seperated vaxxed from unvaxxed.

From what I can tell, ones own cells producing a synthetic spike protein that crosses the blood brain barrier with increased amounts due to adjuvants opening the BBB, would be an important distinction.

Indeed, it seems a lot of people have brain damage now. Anecdotally, I only see this amongst people who recieved the vaxx and not at all among those who did not.

Childrens immune challenges are amplified by adjuvants in all vaccines. Indeed, that is exactly their function.

Serafina Purcell's avatar

It took me 2 years to fully recover. The cognitive impact has been huge. And still persists. The just its a cold people can go jump off a cliff.

Bart Bounds's avatar

Did you recieve any of the mRNA injections?

김영민 (Young Min Kim)'s avatar

I often write about how life escapes our rigid equations, and your essay highlights a dark new variable: Accumulated Cognitive Debt. We’ve treated the pandemic as a solved formula once deaths dropped, but your data on infants and the elderly shows that the 'long-tail' risks are the real emergency. As a father to Sophie and Tony, the section on 'COVID-babies' is particularly haunting. It suggests that the next generation may be starting with a 'narrowed field' of awareness before they even have a chance to engage with the world. A powerful call for humility and vigilance.