IQ decline & Global cognitive deficits, Covid still isn’t the Flu, “Natural immunity” sucks and more
Bonus chats, DMs and the worst articles of 2024 so far
Welcome to the latest issue of the Covid-Is-Not-Over newsletter! I’ve turned on the chat and direct messaging features, which you can read more about here. Feel free to chat or DM, I’m always happy to hear from my readers.
What a world we live in when it’s impossible to distinguish between the satire of Breaking: Coworker who gave entire office Covid promoted for never taking a day off and the perfectly straight faced Lockdown destroyed our ability to speak to one another or A Spike in Heart Disease Deaths Since Covid Is Puzzling Scientists.
Which plays into this week’s mini-theme. It’s well established that Covid can cause cognitive deficits. Maybe that’s what we’re seeing out there amongst all these article writers. It must be. Evidence that perhaps everyone else in the world is cognitively deficited? Or maybe it’s just me?
I invite everyone to “enjoy” a list of the worst articles on Covid I’ve seen so far this year which I’ve collected at the end of the issue. Maybe I’ll make this a regular feature and we can give a prize at the end of the year.
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As most have probably noticed, there is no paid subscription option for this newsletter. However, Substack does have an option where subscribers can pledge to subscribe “just in case” and a few kind subscribers have made that pledge. I very much appreciated the vote of confidence in what I’m doing here. What I’ve decided to do on a trial basis is to set up a “tip jar” on the Ko-fi platform. I’m not anticipating a huge surge of income from using Ko-fi but whatever revenue I do end up with, I plan to spend on supporting artists on Bandcamp. Sadly, who knows how long that will seem like a good idea.
COVID-19 linked to global cognitive deficits, equivalent to brain aging by twenty years, study finds / Essanews (original research article)
The study involved a control group of 2927 individuals and 351 patients who had been hospitalized due to COVID-19. Participants were examined on average 384 days after hospital admission. Tests included serum biomarkers and neuroimaging.
Findings of the study indicated that COVID-19 is associated with both subjective and objectively measurable cognitive deficits. These can affect accuracy and reaction speed. The most affected were patients who experienced encephalopathy or cerebrovascular complications. Some patients demonstrated deficits equivalent to an aging brain of twenty years.
Even fully recovered survivors of mild COVID can lose IQ points, study suggests by Mary Van Beusekom / CIDRAP
Mild cognitive decline was noted after infection with the wild-type virus and with each variant, including B.1.1.529 (Omicron). Relative to uninfected participants, cognitive deficit (3-point loss in IQ) was seen even in participants who had had completely recovered from mild COVID-19.
Participants with persistent symptoms had the equivalent of a 6-point loss in IQ, while those who had been admitted to an intensive care unit (ICU) experienced the equivalent of a 9-point loss in IQ.
Mounting research shows that COVID-19 leaves its mark on the brain, including with significant drops in IQ scores by Ziyad Al-Aly / The Conversation
Here are some of the most important studies to date documenting how COVID-19 affects brain health:
Large epidemiological analyses showed that people who had COVID-19 were at an increased risk of cognitive deficits, such as memory problems.
Imaging studies done in people before and after their COVID-19 infections show shrinkage of brain volume and altered brain structure after infection.
A study of people with mild to moderate COVID-19 showed significant prolonged inflammation of the brain and changes that are commensurate with seven years of brain aging.
Severe COVID-19 that requires hospitalization or intensive care may result in cognitive deficits and other brain damage that are equivalent to 20 years of aging.
Laboratory experiments in human and mouse brain organoids designed to emulate changes in the human brain showed that SARS-CoV-2 infection triggers the fusion of brain cells. This effectively short-circuits brain electrical activity and compromises function.
Autopsy studies of people who had severe COVID-19 but died months later from other causes showed that the virus was still present in brain tissue. This provides evidence that contrary to its name, SARS-CoV-2 is not only a respiratory virus, but it can also enter the brain in some individuals. But whether the persistence of the virus in brain tissue is driving some of the brain problems seen in people who have had COVID-19 is not yet clear.
Studies show that even when the virus is mild and exclusively confined to the lungs, it can still provoke inflammation in the brain and impair brain cells’ ability to regenerate.
COVID-19 can also disrupt the blood brain barrier, the shield that protects the nervous system – which is the control and command center of our bodies – making it “leaky.” Studies using imaging to assess the brains of people hospitalized with COVID-19 showed disrupted or leaky blood brain barriers in those who experienced brain fog.
A large preliminary analysis pooling together data from 11 studies encompassing almost 1 million people with COVID-19 and more than 6 million uninfected individuals showed that COVID-19 increased the risk of development of new-onset dementia in people older than 60 years of age.
Long Covid and Cognitive Deficits by Eric Topol / Ground Truths
The 2 new studies are the largest to date to prospectively assess Covid impact on cognitive function, and both are consistent in showing declines as compared with controls without Covid. The assessment of cognition in the cohort from England was more in-depth, but of shorter duration, and demonstrated the favorable effect of symptom resolution. The extrapolation to a loss of 3 to 9 IQ points is difficult contextualize, and the risk of long-term sequelae is unknown. It is worthwhile noting that these IQ score losses represent averages, and there is considerable variability in cognitive deficit. In contrast, the Norwegian study only got into memory but had much longer, serial assessment up to 3 years. None of this is good news for Long Covid and the brain, folks. …
Unfortunately, there will continue to be people who will attempt to dismiss or discount the important effects of Covid on cognitive function. Just the opposite of denialism is what is needed—to recognize this cognitive impairment is real, that millions of people are affected, and much more needs to be done to find effective treatments of Long Covid and understand its longer term impact, particularly neurologic.
Long Covid and Impaired Cognition — More Evidence and More Work to Do by Ziyad Al-Aly, Clifford J. Rosen / NEJM
The SARS-CoV-2 pandemic produced in its wake millions of persons affected with long Covid, some of whom have had or are currently having cognitive challenges. A deeper understanding of the biology of cognitive dysfunction after SARS-CoV-2 infection and how best to prevent and treat it are critical for addressing the needs of affected persons and preserving the cognitive health of populations.
Why Are We Still Flu-ifying COVID? By Katherine J. Wu / The Atlantic (non-paywall version)
Early in the pandemic, public-health experts hoped that COVID’s tragedies would prompt a rethinking of all respiratory illnesses. The pandemic showed what mitigations could do: During the first year of the crisis, isolation, masking, distancing, and shutdowns brought flu transmission to a near halt, and may have driven an entire lineage of the virus to extinction—something “that never, in my wildest dreams, did I ever think would be possible,” Landon told me.
Most of those measures weren’t sustainable. But America’s leaders blew right past a middle ground. The U.S. could have built and maintained systems in which everyone had free access to treatments, tests, and vaccines for a longer list of pathogens; it might have invested in widespread ventilation improvements, or enacted universal sick leave. American homes might have been stocked with tests for a multitude of infectious microbes, and masks to wear when people started to cough. Vaccine requirements in health-care settings and schools might have expanded. Instead, “we seem to be in a more 2019-like place than a future where we’re preventing giving each other colds as much as we could,” Bhattacharyya told me.
That means a return to a world in which tens of thousands of Americans die each year of flu and RSV, as they did in the 2010s. With COVID here to stay, every winter for the foreseeable future will layer on yet another respiratory virus—and a particularly deadly, disabling, and transmissible one at that. The math is simple: “The risk has overall increased for everyone,” Landon said. That straightforward addition could have inspired us to expand our capacity for preserving health and life. Instead, our tolerance for suffering seems to be the only thing that’s grown.
Protection of natural infection against reinfection with SARS-CoV-2 JN.1 variant by Hiam Chemaitelly, Peter Coyle, et al. / medRxiv
Figure S2 and Table S1, respectively, show the study population selection process and characteristics. The study population was broadly representative of Qatar’s population. The overall effectiveness of previous infection in preventing reinfection with JN.1, regardless of symptoms, was estimated at 1.8% (95% CI: −9.3-12.6%)
Want to Fix Public Health? Stop Thinking Like a Doctor. by Eric Reinhart / The Nation
Public health, by contrast, is about treating populations. As with medicine, the goal of public health is to enable individuals to be free of health limitations that curtail their ability to live as they please. But public health pursues this by very different means. The task is not to help individuals accommodate to oppressive social or labor contexts. It is instead to use the power of government to change conditions that are constraining people’s freedom. The core tools of public health, then, are not just vaccines or lab tests but also policies pertaining to corporate regulation and consumer safety standards; labor protections; public jobs and housing programs; investments in community health workers, decriminalization, and decarceration; and civil rights lawsuits.
Public health doesn’t meet people where they are at; it enables them to move freely by altering their environment to facilitate risk-reducing behaviors, such as staying home from work when sick without fear of lost income. It’s not about individual risk tolerance, but about government making use of population-level tools—such as infrastructural investments in clean air and water—to lower the level of risk to which individuals are exposed by living in society. To do this effectively, public health prioritizes protections for those whose freedom is most obstructed by the current state of affairs: those who are immunocompromised, elderly, or incarcerated; migrant agricultural workers; people of color; and others especially exposed to harm. Public health should do this not simply out of altruism but because it recognizes that allowing harm to fall on vulnerable groups will ultimately return as multiplying harm for society. Public health thus requires seeing the world “from below,” rather than through the eyes of bankers, economists, or opinion writers at national newspapers.
Race, racism, and COVID-19 in the US: Lessons to be learned / Medical Xpress
In a publication in The BMJ, Keisha Bentley-Edwards at Duke University, North Carolina, and colleagues argue that systemic racism and economic inequality are at the root of disparity in COVID-19 outcomes and suggest ways to distribute resources more equitably. …
"Rather than waiting for the next pandemic to address systemic failures, the US must start working now to achieve equitable health outcomes for racialized and poor Americans," the authors write.
Efforts must be built on anti-racist action, they say, and include resisting the compulsion to pathologize racialized minority behavior without assessing structural drivers to health inequities, separating health insurance from employment, including vulnerable populations in vaccine trials and rethinking vaccine distribution, and improving conditions for incarcerated people.
Report: Minority UK health workers faced harassment, bias during pandemic by Stephanie Soucheray / CIDRAP
Ethnic minority National Health Service (NHS) staff in the United Kingdom were more likely to face workplace harassment, discrimination, and lack of personal protective equipment (PPE) than their White colleagues during the pandemic, reveals new research in Occupational & Environmental Medicine.
Healthcare staff from monitory ethnic groups make up 25% of the NHS workforce in England, and nearly 50% in London. As in the United States, minority staff were more likely to be frontline workers during the early months of the pandemic, and were over-represented in deaths due to COVID-19.
A pandemic that won’t go away – as COVID enters its 5th year, NZ needs a realistic strategy by Michael Baker, Amanda Kvalsvig, Matire Harwood / The Conversation
As we enter the fifth pandemic year, we need a change in thinking about COVID-19. This infection has pathological features in common with the other severe coronaviruses (SARS and MERS).
It is wishful thinking to imagine it will suddenly transform into a common cold coronavirus. As a recent review article concluded:
“Transition from a pandemic to future endemic existence of SARS-CoV-2 is likely to be long and erratic […] endemic SARS-CoV-2 is by far not a synonym for safe infections, mild COVID-19 or a low population mortality and morbidity burden.”
In the face of this continuing pandemic threat, we need a response that is evidence-informed rather than evidence-ignored.
The medical gaslighting of long COVID patients could be nearing its end by Stephen Lubet / The Hill
Angela Vazquez knew something was wrong in March 2020, but she didn’t have a name for it. An early COVID-19 patient, her relatively mild case of the virus progressed into an “increasingly scary set of symptoms,” including seizures, heart palpitations, shortness of breath and confusion. A serious athlete for decades past, she became unable even to walk for days at a time. Doctors were not much help.
As Vazquez put it, she was “medically gaslighted,” with her persistent symptoms brushed off as anxiety or depression.
Vazquez was only one of a multitude of COVID-19 “long haulers,” by now comprising over 6 percent of American adults, who have developed the baffling condition called “long COVID.”
Millions of Americans suffer from long COVID. Why do treatments remain out of reach? by Eduardo Cuevas, Karen Weintraub / USA Today
Federal estimates suggest at least 16 million Americans have long COVID and maybe 4 million of them, like Blatz, who contracted his only COVID infection in November 2022, are disabled by it.
Along with other patient advocates and doctors, Blatz says the pace of government-funded research has been too slow and too small to address a problem of this magnitude. Many with long COVID have been left with debilitating conditions with no benefits yet seen from hundreds of millions of tax dollars poured into understanding and treating the chronic disease.
Changes in vaccine attitudes and recommendations among US Healthcare Personnel during the COVID-19 pandemic by Matthew Z. Dudley, Holly B. Schuh, et al. / npj Vaccines
Although most HCP are vaccinated and boosted against COVID-19 and strongly recommend their patients vaccinate, the strength of HCP recommendations (for both COVID-19 and other routine vaccines) has dwindled over the course of the pandemic, along with trust in CDC. HCP averaged about six hours per week talking with patients about vaccines, much of which was uncompensated. Additional regularly updated online resources from trusted medical sources that clarify progressing science and address dynamic public concerns are needed to improve vaccine confidence among HCP and help them support their patients’ decision-making.
Worst Covid-Related Articles So Far in 2024
Are We Thinking of Virus Symptoms Wrongly? | Psychology Today Canada
Lack of virus exposure due to Covid may be driving 'never-ending' colds, experts warn
The Covid extremists can’t bear that nobody is listening to them
‘More complicated than many realize’: An infectious-disease doctor on hospitals under pressure | TVO Today (no mention of long covid, long term health issues, etc.)
A Spike in Heart Disease Deaths Since Covid Is Puzzling Scientists
A little bit of metal. Dreaming Neon Black by Nevermore.