"Long Covid" fails to correlate with having Covid19

Another study has failed to find a correlation between presenting "Long Covid" symptoms and having a prior history of Covid 19.

Bombshell: New Study on Long COVID in kids and young adults FAILS to link COVID to Long COVID | Vinay Prasad's Observations and Thoughts - Dr. Vinay Prasad

March31, 2023 - "A new paper out now from the Norwegians on Long COVID in kids and young adolescents takes a sledgehammer to the media narrative of the condition. TL:DR - Long covid has no link to prior COVID19, instead, initial symptom severity (of whatever virus you get), loneliness and poor physical activity are linked to the “post covid conditions”....

"The paper compares 300+ kids who definitely had COVID19 to 85 matched controls who definitely didn’t. It follows them on a battery of questionnaires and blood tests for 6 months. The cohort is well matched at baseline, and these kids were all selected because they sought PCR testing for COVID19. Ergo, many may have felt sick, and some of the people sick were sick with covid while others were sick with something else. This is similar to another paper on the topic that I discuss in this video [below - gd].

"The primary endpoint compares whether COVID19 is lined to post covid conditions and post infective fatigue syndrome, and the power calc is actually pretty decent— see paper. I say that because I see people (wrongly) saying it was underpowered.

"The first question is how many kids had Post Covid Conditions (PCC)?

• Covid group - 48.5%
• No covid group 47.1%.... No significant difference;

"Second question: how many kids have post-infective fatigue syndrome (PIFS)? The answer is 14.0% and 8.2%, and it is not significant.

"COVID19 had nothing do with either of these two conditions. Let’s me repeat that. Having had COVID19 had NOTHING TO DO with having symptoms consistent with “long covid.”

"The authors reference female sex, and indeed there was a numerical difference but it did not meet significance. Instead, initial severity of symptoms, loneliness and poor physical exercise were linked in multivariable analysis.... [F]atigue and neuroticism and emotional maladjustment and loneliness and depression are all linked. What you also see is that none of this has anything to do with prior COVID19....

"When you talk about Long COVID you have to have a control group..... With time, everyone will get COVID19 anyway, so studies from the past with controls might be the best we do. In the future, there will be no controls.

"Fear-mongering about LongCOVID in kids is not justified b/c they will all get it anyway, and many will suffer symptoms of long covid, but the two have nothing to do with each other. Randomized trials testing interventions— including counseling— are needed for people who suffer greatly from long covid. No intervention should be deployed outside of trials.

"Although not emphasized in the paper, there were no biochemical abnormality to explain long COVID, but this is partially moot b/c even COVID can’t explain long covid.

"The media have done a tremendous disservice with covering long COVID. The reason people inaccurately covered long COVID is that they needed to have it — they needed it to be scary — to justify continued restrictions in young populations.

"This study has limitations— the biggest is modest attrition, but the strengths are many compared to other papers. The control group & pre-specified power calc are the greatest strengths.... [T]he headlines should read: Well done Norwegian study cannot link the symptoms of long COVID to COVID19 in kids and adolescents. And the article should say: All kids will get COVID19 soon. There are few data to support vaccinating health[y] kids. We should let parents decide, and keep quiet, and in the meantime, learn to never restrict kids lives again. It’s just that simple."

Read more: https://vinayprasadmdmph.substack.com/p/bombshell-new-study-on-long-covid

Read study: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802893?s=03

Vinay Prasad, "What happens when you compare Long COVID to Long ANY OTHER VIRUS? NEW PAPER in JAMA NETWORK OPEN," YouTube, December 1, 2022:

Study finds little to no evidence masks stop Covid

A major review by the Cochrane Institute has found little to no evidence that surgical masks made any difference to Covid infection or death rates. 

Does this finally put the mask debate to bed? 'Gold standard' analysis of 78 studies and 1million people finds face coverings made 'little to no difference' to Covid infection or death rates | Daily Mail = Caitlin Tilley:

February 2, 2023 - "Masks made 'little to no difference' to Covid infection or death rates, according to one of the most comprehensive meta-analyses of face coverings. The research - carried out by the Cochrane Institute, the 'gold standard' of evidence-based reviews - looked at 78 global studies involving over a million people. Results indicated that surgical masks reduced the risk of catching 'Covid or a flu-like illness' by just five percent - a figure so low it may not be statistically significant. The researchers [also] said harms caused by masks - including hampering children's schooling - were poorly measured in the studies, meaning any small benefit on infection rates may be outweighed....

"While initially viewed as a virus prevention measure, masks have become a prominent symbol of the Covid culture wars in the US. Officials issued mixed messages about their effectiveness at the beginning of the pandemic. Studies that came later failed to show definitively that masks prevented Covid — yet millions of Americans were forced to abide by mandates. 

"Some of the researchers involved in the Cochrane review previously analyzed the evidence on masks in November 2020. That review was criticized because it did not include any studies from the Covid pandemic due to limited research at the time. A separate Danish study in the spring of 2020 with over 6,000 participants found that wearing a mask made no statistical difference to whether or not people got Covid. But its researchers struggled to find a prominent journal willing to publish the results. 

"The Cochrane researchers updated their review with 11 additional studies involving more than 600,000 people, bringing the total number of studies to 78. The analysis was published this week in the Cochrane Database of Systematic Reviews journal. Some of the additional studies looked at Covid, while others were conducted before the pandemic and looked at flu and other respiratory illnesses.  They included Covid pandemic trials - two from Mexico and one each from England, Norway, and Bangladesh, plus the Danish study.... The main outcomes the Cochrane researchers measured were the number of flu- and Covid-like illness cases and any adverse events that came about from the intervention.... The researchers noted a high risk of bias in the studies and a 'relatively low adherence with the interventions', making it difficult to draw firm conclusions....

"To compare the effect of masks on preventing the spread of Covid and flu, the Cochrane researchers looked at 12 trials — two in healthcare workers and 10 in the community. They found that in the community, wearing a face mask reduced the risk of catching either flu or Covid-like illness by five percent. The study suggested that there is actually a one percent increased risk of testing positive if you wore a mask, but the margins are too small to say this for certain. The team said both these results were 'moderate certainty evidence'.

"They also looked the effect of higher grade masks such as N95s compared to standard surgical masks but were less sure of their impact. The CDC only recommended that people wear N95s two years into the pandemic. This part of the analysis looked at five studies — four in healthcare workers and one in households — with 16,000 participants in total. They found that wearing a mask reduced chances of clinical respiratory illness by 30 percent. But Professor Carl Heneghan, of the University of Oxford, who was an unlisted author on the paper, recognized that 'harms were rarely measured and poorly reported', meaning it was 'very low‐certainty evidence'. N95 masks are even more uncomfortable than surgical masks because of their thick material and tight fit. Nurses who wore them for long periods of time during the pandemic reported cuts and scarring on their faces as a result....

"The debate around masks first turned sour in 2020 when health officials flip-flopped on their effectiveness.... The CDC website currently states that masks can help protect the wearer and others from Covid. The agency is still recommending Americans wear masks in places with high transmission levels, such as on public transport."

Read more: https://www.dailymail.co.uk/health/article-11702865/Masks-make-little-no-difference-Covid-infections-massive-cross-country-meta-analysis-finds.html

Read study: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006207.pub6/full

Why Fauci moved "herd immunity" goalposts

Why Did Fauci Move the Herd Immunity Goal Posts? | Medpage Today - Vinay Prasad MD, MPH:

December 29, 2020 - "As a former National Institutes of Health fellow, I have a profound reverence for Anthony Fauci, MD, the director of the National Institute of Allergy and Infectious Diseases.... At the same time, ... statements by Fauci raise a thorny and important question for scientists, doctors, and public health experts: Is it acceptable to distort the truth to get people to do what you want them to do?...

"Fauci told the New York Times that new science had changed his thinking on the herd immunity threshold.... Specifically, the fraction of people who would need immunity to SARS-CoV-2 (either through vaccination or recovery from prior infection) to extinguish the spread of the virus was initially estimated to be 60% to 70%. In recent weeks, Fauci had raised the percentage: from 70% to 75%, and then to  ... 80%, and 85%. Allow me to quote verbatim from the article, titled 'How Much Herd Immunity Is Enough?':

"When polls said only about half of all Americans would take a vaccine, I was saying herd immunity would take 70 to 75 percent," Fauci said. "Then, when newer surveys said 60 percent or more would take it, I thought, 'I can nudge this up a bit,' so I went to 80, 85."

"Of course, the herd immunity threshold is just an estimate, and the precise figure is contingent on population mixing and a host of other assumptions.... But, the two undeniable admissions in the Times article are 1) Fauci is, to some degree, basing his statements on what he thinks the public will accept, and to what degree his rhetoric might help vaccination efforts, and 2) this is the absolutely stunning part, he is admitting this openly to a reporter for the New York Times!

"This is not the first instance when Fauci made a public statement while considering, in part, what he believed people would do with the information. The first instance concerns masks and occurred during an interview on 60 Minutes in March.... Fauci would later clarify that his words were chosen to prevent a run on masks -- so that healthcare workers would get first priority -- but some have used this interview to question his veracity.

"Irrespective of your feelings in these specific cases, the core tension in both examples is whether we want scientific advisors and public health experts to report just the facts, as they see them, or do we want them to make the additional calculation of what the public would do with those facts, and use that to shape their comments, aiming to maximize the greater good? I believe that in 2020, scientists and public health experts can only report the complete, unvarnished truth, as they believe it to be. We cannot and must not attempt to distort our ideas in an effort to generate responses we think might occur. I hold this position for four reasons.

1. The information gap no longer exists. Experts are not inherently smarter, more analytical, or logical than members of the lay public. Perhaps in the past, they preferentially had access to certain types of insider information. In the modern world, due to the internet, this information gap no longer exists ... because too many in the public can directly interrogate the source material.... If an expert seeks to distort their view of the science to further a behavioral change amongst the public, the risk of detection is high -- at least by some in the public. As such, it runs the risk of immediate backlash and the ensuing loss of credibility.

2. It is not an easy game to play. Human beings are masterfully complex, and not easily predictable.... Fauci's messaging in March may have been intended to prevent a run on masks, but it also may, to some degree, have contributed to masks becoming one of the most polarized issues of 2020, and, in many quarters, fostered a deep suspicion and distrust of Fauci.... Admitting openly that you are selectively presenting your view of the herd immunity threshold based on your reading of what the public is ready to hear, and the way in which that percentage might affect vaccine uptake is a bold and unprecedented statement.... 

3. Loss of trust is incalculable. Once it is revealed that any individual has presented information selectively to get the listener to change their behavior -- that person will forever be viewed through that lens.... The moment the public believes that you might be withholding, selectively presenting, or distorting information to get them to behave a certain way, they will immediately put your comments through a translator. He might be saying this because it's what he believes, but what if he is saying it to change my behavior.... The moment you enter this state in a relationship, there is no path back, it is over. Trust is irrevocably broken. A new spokesperson is needed.

4. Distortion steals power from the people and gives it to scientists. In a prior column, I argued that 'Follow the Science' is an incoherent message. That's because science can tell you what might happen in varying scenarios, but science cannot tell you what to value. Science is necessary for sound policy, but it is not sufficient.... This means that scientists must not distort their view of a situation to get you to do the right thing... A scientist must always and only and indefatigably tell you the scientific truth, as best they see and understand it, but we all -- every last one of us who votes and participates in society -- we alone get to decide what the policy should be.

"As I stated at the outset, I have profound respect for Fauci for his career of service, and like many, I am a fan of his clear public speaking. Yet, these two events force us to ask whether fact manipulation is acceptable. I believe it cannot be. The public will not trust us, and should not trust us."

Read more: https://www.medpagetoday.com/opinion/vinay-prasad/90445

Pro-vaxxers not following the science, either

COVID Vax Opponents and Rigid Proponents...Are Both Anti-Science? | MedPage Today -  Vinay Prasad, MD:

May 4, 2021 - "In mid-April, vaccine scientists and regulators were alerted to six serious adverse events after administration of the Johnson & Johnson COVID-19 vaccine ... in women ages 18 to 48 ... similar to reports from Europe regarding the other adenoviral-based vaccine made by AstraZeneca. The syndrome is best described as vaccine-induced thrombocytopenia and thrombosis (VITT).... 

"VITT can result in death, but also, serious and irreversible neurological impairment in an otherwise young healthy individual. After the FDA and CDC were alerted to these six cases, the agencies called for a pause or moratorium to be placed on use of the J&J shot pending further review. A few days later, a panel of experts extended the pause by 1 week, during which time at least nine additional cases of the syndrome were identified. After a hearing to discuss the risk and benefit, the Advisory Committee of Immunology Practices (ACIP) voted to resume vaccination with J&J without any restrictions by age or gender, though they recommended placing a warning....

"The moment six cases were publicly reported and the pause was instituted, a large number of experts expressed anger on social media. They claimed the denominator was the seven million doses of the vaccine that had been administered, and this event rate -- less than one in a million -- was a trivial safety signal. Some were critical of the pause itself -- which I will discuss in the next section -- while others worked to immediately downplay concerns of the risk. A popular series of memes compared the risk of CVT and VITT to the risk of thrombosis from other events. One compared VITT to the risk of clot with oral contraception and thrombosis after COVID-19. These went viral (no pun intended).

"Unfortunately, these comparisons perpetuated at least five errors.

• First, one in a million was almost surely the wrong number. The moment a novel safety signal is identified, preliminary estimates of frequency are utterly unreliable.... There are likely more unreported cases, which will raise the numerator, and the denominator should not include all vaccinated individuals. The correct denominator is the fraction of vaccinated individuals in the demographic group experiencing the severe event -- in this case, women ages 18 to 48. I tweeted that I would not be surprised if the true incidence jumped one order of magnitude when we had more facts -- a prediction that has since been vindicated.
• Second, comparing the risk of CVT in the setting of VITT to a garden variety venous thromboembolism is misleading. A deep vein thrombosis of the leg is not comparable to one in the cerebral vein in the setting of runaway platelet activation. I have long wondered how much anatomy should be taught in medical school, but I can now confidently say we should definitely clarify the difference between veins that drain the brain and those that drain the leg.
• Third, comparing the risk of CVT and VITT after vaccination to the risk of clot after COVID-19 is inappropriate. Getting COVID-19 and getting vaccinated are different. A vaccine's risk cannot be changed, while the risk of COVID-19 can be altered or modified by behavior. In fact, the bulk of this past year has been making behavior changes to modify SARS-CoV-2 risk.
• Fourth, some numbers are simply wrong. A 16.5% risk of clot among someone with COVID-19 is an inflated figure that, as far as I can tell, comes from meta-analyses of ICU patients in the first wave. These analyses likely suffer from selection, surveillance, and ascertainment bias, among other problems.
• Fifth, comparing the risk of CVT and VITT to oral contraception was objectionable.... [I]nformation about the risk of clot is available before women start taking the pill and they can balance this against their other desires. With CVT and VITT, women did not know the precise risk, still don't know exactly, and these folks were essentially arguing against providing women that information.

"The first crux of the public communication failure is to ask why, when we hear of a novel adverse event, is the reaction of so many experts to downplay or trivialize the risk? Why construct minimizing memes when you have not even gathered all the relevant facts? The answer to this question warrants reflection, but I will offer a hypothesis. 

"In 2021, there is clearly a small, but vocal minority of individuals opposed to nearly all vaccinations.... In response, there is a group of individuals on the other extreme. To them, either one must embrace all vaccines for all indications for all ages, or one can be lumped with the other extreme. They favor universal child vaccination of SARS-CoV-2 via an EUA, even before they have the data for that claim. They were quick to embrace vaccination for pregnant woman prior to appropriate trials establishing safety. Suppressing critical thinking to extol vaccines is also wrong and may backfire, but I believe this explains why it occurs. It is, to some degree, a counter-movement against the anti-vaxxers, which can go too far.

"All of this discussion is not a referendum on the pause, which must be considered on its own merits.... [W]hether the FDA and CDC should have issued a total pause for J&J vaccine ... cannot be settled by rhetoric. It requires careful studies. Pauses have complex downstream effects. Yes, they may poison vaccine acceptance. On the other hand, inaction, while the tally of women with CVT and VITT rises, is also a dangerous game."

Read more: https://www.medpagetoday.com/infectiousdisease/covid19vaccine/92413