Great post. You are so correct about the issue of public trust. Of how by now that most of the serious health journalists have identified who the Cassandras are, but there is always the tendency to sensationalism...
That's true. But I think there's also an effect that a lot of the serious health journalists aren't on this beat any more, so intentionally or not it often gets written up by people with a tolerance for clickbaiting.
But don't forget the effect of bad actors on public trust - the politicisers (especially those who lean libertarian), the anti-science crowd, and the anti-vaccine activists.
Very useful, thanks. Linearised graphical data was a godsend as the variants came through. Before vaccination we only had lockdown. Even after widespread vaccination, hospitalisation had too strong a relationship with death, depending on the rising variant. These days we think more about morbidity than death. And at least anecdotally in my daily contacts, the relationship between hospitalisation and morbidity is much less instructive. Oncoming 'waves' are still worth knowing about.
Ok, but in the opening of the abstract "approximately 10% of COVID-19 cases will go on to develop new or persistent long-term symptoms". I don't think it's at all helpful putting numbers like that out there that don't pass a basic smell test in the vaxxed/omicron era https://bristoliver.substack.com/p/long-covid-moonshot
Maybe so. It is hard to know in my view what is helpful and what is not... yes, 'new or persistent' - vey sweeping. A large proportion of UK population though has not been vaccinated for a very long time - presumably the 'immunity landscape' cannot be modelled easily?
PS Eric Topol has only very recently but to his credit, taken Public Health on board.
Whilst it's true that in the UK, vaccination has been confined to the elderly and the immunosuppressed (with only a fraction of those offered vaccination taking up the offer), it would be wrong to think that in the general population the majority haven't had their immunity boosted by exposure to the virus in the intervening period. The immune systems of the population which hasn't recently been vaccinated will still be responding with the expected secondary immune responses, modifying and boosting their immunity in response to each new encounter with the virus. For some this will be as a result of subclinical infections that they may be unaware of, for others they will have had an obvious respiratory infection from which they made a normal recovery.
All true... yes, but new variants proceed according to variable geographical and community 'immunity landscapes'. As a Public Health issue it seems to me odd to ignore post-viral consequences. I am not qualified to comment on the paper flagged up by Topol. His understanding of the inflammatory background common in chronic ill health is worth taking note of. I think of young relatives who have already suffered a dent in their health.
Enough people I know have experienced really quite nasty re-infection, enough to want to dodge more obvious risks if possible.
Wastewater in Scotland last year was informative I guess when there was very widespread re-infection? Harder to keep track in England. Have we lost interest in some of the more serious perhaps cumulative post-viral consequences; they disappear into the 'noise'?
Great post. You are so correct about the issue of public trust. Of how by now that most of the serious health journalists have identified who the Cassandras are, but there is always the tendency to sensationalism...
That's true. But I think there's also an effect that a lot of the serious health journalists aren't on this beat any more, so intentionally or not it often gets written up by people with a tolerance for clickbaiting.
But don't forget the effect of bad actors on public trust - the politicisers (especially those who lean libertarian), the anti-science crowd, and the anti-vaccine activists.
Sure, and I'm happy to push back on those guys too https://bristoliver.substack.com/p/fool-me-tice-shame-on-you But I think it's easier to fight those guys if you maintain standards on your own side
Sorry, that was meant to be a response to Mark Wright.
Very useful, thanks. Linearised graphical data was a godsend as the variants came through. Before vaccination we only had lockdown. Even after widespread vaccination, hospitalisation had too strong a relationship with death, depending on the rising variant. These days we think more about morbidity than death. And at least anecdotally in my daily contacts, the relationship between hospitalisation and morbidity is much less instructive. Oncoming 'waves' are still worth knowing about.
I think waves are worth knowing about, but I think we have to be clear what we mean by a wave these days ..
fwiw this review has just come to my attention, h/t Eric Topol. I have little grasp though of what it means for Public Health. https://onlinelibrary.wiley.com/doi/full/10.1111/pcn.13855
Ok, but in the opening of the abstract "approximately 10% of COVID-19 cases will go on to develop new or persistent long-term symptoms". I don't think it's at all helpful putting numbers like that out there that don't pass a basic smell test in the vaxxed/omicron era https://bristoliver.substack.com/p/long-covid-moonshot
Maybe so. It is hard to know in my view what is helpful and what is not... yes, 'new or persistent' - vey sweeping. A large proportion of UK population though has not been vaccinated for a very long time - presumably the 'immunity landscape' cannot be modelled easily?
PS Eric Topol has only very recently but to his credit, taken Public Health on board.
Whilst it's true that in the UK, vaccination has been confined to the elderly and the immunosuppressed (with only a fraction of those offered vaccination taking up the offer), it would be wrong to think that in the general population the majority haven't had their immunity boosted by exposure to the virus in the intervening period. The immune systems of the population which hasn't recently been vaccinated will still be responding with the expected secondary immune responses, modifying and boosting their immunity in response to each new encounter with the virus. For some this will be as a result of subclinical infections that they may be unaware of, for others they will have had an obvious respiratory infection from which they made a normal recovery.
All true... yes, but new variants proceed according to variable geographical and community 'immunity landscapes'. As a Public Health issue it seems to me odd to ignore post-viral consequences. I am not qualified to comment on the paper flagged up by Topol. His understanding of the inflammatory background common in chronic ill health is worth taking note of. I think of young relatives who have already suffered a dent in their health.
Enough people I know have experienced really quite nasty re-infection, enough to want to dodge more obvious risks if possible.
Wastewater in Scotland last year was informative I guess when there was very widespread re-infection? Harder to keep track in England. Have we lost interest in some of the more serious perhaps cumulative post-viral consequences; they disappear into the 'noise'?
I find Bob Hawkins substack "Seeing the Forest for the Trees" and his regular Covid situation report is a good summary of the UK situation. https://bhawkins3.substack.com/p/covid-situation-report-jun-19-2025
Yes, likewise,
Sorry, that was a draft, could have been better put. The last line still holds though.