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What Young, Healthy People Have to Fear From COVID-19

COVID-19 presents an array of health challenges that are serious, if not imminently fatal. The disease occasionally sends people’s immune system into a frenzy, wreaking havoc on their internal organs. Several studies of asymptomatic patients revealed that more than half of them had lung abnormalities. A March study published in the Journal of the American Heart Association found that 7 to 20 percent of sick patients showed heart damage associated with COVID-19.

As my colleague Ed Yong explained, many COVID-19 patients experience protracted illness. These “long-haulers” suffer from a diabolical grab bag of symptoms, including chronic fatigue, shortness of breath, unrelenting fevers, gastrointestinal problems, lost sense of smell, hallucinations, short-term-memory loss, bulging veins, bruising, gynecological problems, and an erratic heartbeat. And according to the neuroscientist David Putrino, chronic patients are typically young (the average age in his survey is 44), female, and formerly healthy.

We don’t know how many long-haulers are out there. But by combining the conclusion of several well-regarded studies, we can arrive at a decent estimate.

For men in their 30s, like me, about 1.2 percent of COVID-19 infections result in hospitalization, according to a July study published in Science. Once the disease has progressed to this point, the risk of chronic illness soars. Research from Italy found that roughly nine in 10 hospitalized patients said they still had symptoms after two months. A British study reported a similar risk of long-term illness.

Now the math: When you multiply the hospitalization rate for 30-something men (about 1.2 percent) by the chronic-illness rate of hospitalized patients (almost 90 percent), you get about 1 percent. That means a guy my age has one-in-100 chance of developing a long-term illness after contracting COVID-19. For context, the estimated infection-fatality rate for somebody in their 60s is 0.7 percent, according to the same study in Science.

More frightening than what we’re learning now is what we cannot yet know: the truly long-term—as in, decades-long—implications of this disease for the body. “We know that hepatitis C leads to liver cancer, we know that human papillomavirus leads to cervical cancer, we know that HIV leads to certain cancers,” Howard Forman, a health-policy professor at Yale, told James Hamblin and Katherine Wells of The Atlantic. “We have no idea whether having had this infection means that, 10 years from now, you have an elevated risk of lymphoma.”‪

Why would scott Atlas, the White House, or anybody for that matter dismiss the threat to young people? One answer is that they want to convince Americans that if a bunch of teens and 20-somethings get infected, the U.S. will move closer to the ultimate goal of achieving “herd immunity.” Briefly, that means the point at which a disease, like COVID-19, can no longer trigger an epidemic outbreak, because enough of the population has already developed immunity. Atlas has argued that, if herd immunity is an inevitable destination, we should perhaps put our foot on the accelerator.

But the case for herd immunity rests on two dubious assumptions. The first is that the disease isn’t risky to the people it doesn’t kill—which we know to be false.

“If you’re signing up for herd immunity, you’re also signing up for a huge number of hospitalizations, and a substantial fraction of those people will be sick for months,” says Marm Kilpatrick, an infectious-disease researcher at  UC Santa Cruz. “Do the symptoms last three months? Six months? Three years? Nobody knows, but I wouldn’t want my pandemic plan to be, Let’s have hundreds of thousands of young people with lifelong illnesses. I wouldn’t want to tell 30-to-50-year-olds that we’ve signed them up for a high risk of heart disease and chronic organ damage.”

The second dubious assumption is that it’s easy to distinguish between the high-risk group and the low-risk group.

“The most simplistic way to protect the vulnerable is to divide the population by age, but you can’t choose an arbitrary cutoff and say ‘Let’s protect everybody under age 65,’ because nothing magic happens at age 65,” says Andrew Levin, an economist at Dartmouth. “The average person who is 64.9 years old has the exact same health risks as somebody who is 65. So it’s very difficult to divide populations into safe and not-safe categories.”

Besides, the U.S. is not, for the most part, spatially segregated by age. Restaurants and stores serve old and young patrons, and there are tens of millions of multigenerational households. Evidence that young and old people mingle constantly can be seen in the recent COVID-19 death data: A southern surge that started among young people spread to older populations, who died in disproportionate numbers. “There is the assumption that we can start cocooning the elderly, but we have no new innovation here,” says Natalie Dean, an assistant biostatistics professor at the University of Florida. “Are they saying we should try harder to protect old people? What does ‘trying harder’ even look like, compared to now? I just don’t understand the argument.”

Herd immunity is an inoperable plan, teetering on a false assumption of elderly-cocooning, which encourages young people to play craps with the long-term health of their internal organs. The choice is yours. You can listen to the scientists. Or you can roll the dice with your guts.

Source: https://www.theatlantic.com/ideas/archive/2020/09/what-young-healthy-people-have-fear-covid-19/616087/

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