Astral Codex Ten

Long COVID

16 min read

Long COVID

Article

Long COVID is a recurring concept in the Astral Codex Ten archive, appearing 6 times across 6 issues between September 02, 2021 and January 29, 2025. The archive places it in contexts such as “7.8% and 17% of patients seem to show at least one Long COVID symptom”; “The Dubious Origins Of Long COVID”; “complaining of Long COVID symptoms test negative for COVID”. It most often appears alongside Democrats, Republicans, British Office of National Statistics.

Metadata

  • Category: Concepts
  • Mention count: 6
  • Issue count: 6
  • First seen: September 02, 2021
  • Last seen: January 29, 2025

Appears In

Source Context

Recovered passages from the original issue text. When the raw archive preserved outbound links inside the source passage, they are listed directly under the quote.

Long COVID: Much More Than You Wanted To Know
September 02, 2021 · Original source
Like everyone else, I'm trying to figure out how cautious I should be around COVID. It seems like the most important concern for young vaccinated people like myself is the risk of Long COVID symptoms, so I spent a while trying to figure out what those were.
The British Office of National Statistics looks at people with a confirmed COVID test three months ago, and finds that 14% report having Long COVID symptoms, compared to 2% of a COVID-less control group. This is substantially lower than the earlier study, which found 33% at 6 months. Probably this is because the previous one asked about a bunch of symptoms, whereas this one just asked “Are you having Long COVID?” Lots of people who had some minor symptom or other might not have made the connection, or might have thought that their symptom didn’t qualify for a full diagnosis.
Inline links: The British Office of National Statistics
Sudre et al got data from some kind of UK COVID app with four million users. They chose 4,000 who met various criteria and asked them about long COVID symptoms. 13% reported symptoms after a month, and 2% after three months. This is a lot less than the other studies, so what’s up? I’m not sure, but I think it might be the exclusion criteria, as shown in Supplementary Table 2. When they look at everyone regardless of criteria, they find an estimate centered in the mid 20s, and then the criteria gradually pick away at that. One especially relevant one is that they have no gap in symptom reporting; maybe if you have chronic fatigue, you’re less likely to use an app regularly. But the three month data is still surprising.
Inline links: Sudre et al, Supplementary Table 2
Links For November
November 25, 2021 · Original source
Boris Johnson (left) is 5’9, so the guy in the middle must be gigantic. Who is he? Looks like it’s Milo Djukanovic, President of Montenegro, who’s 6’6 (198 cm). Is he the tallest world leader? It seems like he’s tied with his colleague across the border, Serbian president Aleksandar Vucic. Why are Balkan leaders so tall? As usual, the answer is “genetics”. This article says: It has been noted that men from Herzegovina are taller on average than men in other places—the average male height is just over six feet...Putting all the data together, researchers concluded that the most likely cause of larger-than-average height of Herzegovinian men is lifestyle during the Paleolithic—men hunted large animals such as mammoth for survival—such a diet, heavy in protein, combined with small population densities, would have provided ideal conditions for height selection, resulting in increasingly taller men who passed the trait down through their I-M170 chromosome to future generations. Some sources note that they manage to beat the Dutch despite the latter country’s much higher human development index. The Dutch are probably tall through a combination of nature and nurture; Balkan people are tall through nature alone. 7: Eliezer Yudkowsky doesn’t need more ego boosts, but an idea he had a couple of years ago - using strings of bright lights to provide a better and brighter experience for Seasonal Affective Disorder sufferers than regular light boxes - spread from him to the rationalist community to the wider world, and has finally gotten tested in a formal study (see Acknowledgments section). Results seem vaguely positive: "SAD symptoms of both groups improved similarly and considerably...exploratory analyses indicate that a higher illuminance is associated with a larger symptom improvement in the BROAD light therapy group" 8: Percent of people who choose woke options on polls very tentatively and preliminarily seems to be going down post-Trump (h/t Richard Hanania). 9: Twitter conspiracy theories 10: Did you know: all those reconstructions of “how classical art would have looked with the original paint” are probably inaccurate. There is no reason to think the Greeks and Romans used garish technicolor hues on their statues; what evidence we have suggest they were good at shading, and the statues were probably colored very tastefully. 11: Complaints about how Karl Friston uses the term “Markov blanket” 12: Trevor Klee on the claim that cyclosporine patients don’t get dementia. Apparently there was a big study where basically nobody on the immunosuppressant cyclosporine ever got dementia, and there are some theoretical reasons why cyclosporine might prevent neurodegeneration. But another study found people on cyclosporine got dementia at the usual rate. I think in a situation like this you should have a really high prior on “the people who got the crazy result bungled their study somehow”, but I’m interested in hearing what other people think. 13: Also from Trevor: a history of fluvoxamine treatment for COVID. 14: To tide you over until the next book review contest, here is awanderingmind’s review of The Conquest Of Bread. 15: Claims: cnbc.com/2021/11/05/sam…\nft.com/content/dcb75a… (better article, but paywalled)","username":"moskov","name":"Dustin Moskovitz","profile_image_url":"","date":"Fri Nov 05 15:49:46 +0000 2021","photos":[],"quoted_tweet":{},"reply_count":0,"retweet_count":184,"like_count":1188,"impression_count":0,"expanded_url":{"url":"https://www.ft.com/content/dcb75a56-ca23-439c-96db-56483979bf34","image":"https://bucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com/public/images/80a58c96-c72f-4301-b571-aa9384f132bd_2400x1350.jpeg","title":"Subscribe to read | Financial Times","description":"News, analysis and comment from the Financial Times, the worldʼs leading global business publication","domain":"ft.com"},"video_url":null,"belowTheFold":true}" data-component-name="Twitter2ToDOM"> 16: Big trial on Vitamin D for depression finds null result. Peter Attia tries to tear it apart here, but I am unconvinced, especially in the context of Vitamin D never working for any of the things people say it does besides the most boring aspects of bone health. 17: “California is actively considering the adoption of flawed and inequitable guidance on math curricula based on misleading data and inaccurate success metrics reported by San Francisco Unified School District (SFUSD)...Based on our review of the data, we found misleading, unsupported, and cherry-picked assertions of success for the new math program. We noted that overall test scores are down and enrollments in UC-approved advanced math classes have dropped as well.” It looks like San Francisco is trying the good old “lower standards, then when more kids meet the standards, claim your school reform plan worked” trick again. 18: A new study claims that self-reported “Long COVID” symptoms are more associated with believing you’ve had COVID than with actually having it (as measured by serologic testing), which sounds like pretty strong evidence that it’s psychsomatic. Expert reactions are mixed-to-negative, although the only one of these that doesn’t sound like excuse-making is Dr. Rossman’s about the unreliability of the tests. I haven’t confirmed test reliability stats but Philippe Lemoine also thinks this is a plausible confounder. 19: Noahpinion: What If Xi Jinping Just Isn’t That Competent? I appreciated this for making me think, and for underlining the extent of the difference between the Deng/Jiang/Hu era and what Xi’s doing. I especially appreciated this line, which I’d never thought about before: Xi presided over the end of China’s hypergrowth. To some extent this is not his fault. No country can grow at 10% forever, and there were many structural forces pushing downward on China’s numbers — the end of the demographic dividend, the exhaustion of rural surplus labor (the Lewis Turning Point), the saturation of export markets, and so on. But China is also slowing down earlier than South Korea, Taiwan, or Japan did in their day. China’s per capita GDP (at PPP) is still only about 1/3 that of a developed country, so if they stop catching up at about half of developed-country levels, that will not be a great showing. A big lesson of the past twenty years has been “actually liberal democracy isn’t necessary to reach developed-country status”, so it would be quite the twist if it turned out you needed liberal democracy to reach developed-country status. This gets pretty close to the great mystery of why some less-developed countries “catch up” and others don’t; whatever happens in China is going to be a really useful data point. 20: Variations on the fable of The Frog And The Scorpion. 21: You’ve probably heard about the University of Austin, the new project by a bunch of wokeness-critical academics to start a new university that won’t cancel people or force conformity (New York Post article, Politico article - these were the two least “you need to be super-outraged about this right now” articles I could find). Tyler Cowen and Larry Summers are involved; Steven Pinker was supposed to be but left for unclear reasons. My thoughts, in no particular order: Even forgetting the political aspect, attempts to start new universities are always welcome.
Inline links: Milo Djukanovic, Aleksandar Vucic, This article, in a formal study, Richard Hanania, Twitter conspiracy theories, There is no reason to think, Complaints about, cyclosporine patients don’t get dementia, a history of fluvoxamine treatment for COVID, The Conquest Of Bread, Vitamin D for depression, here, is trying, A new study, Expert reactions, Philippe Lemoine also thinks, What If Xi Jinping Just Isn’t That Competent?, Lewis Turning Point, slowing down earlier, per capita GDP (at PPP), the great mystery, Variations on the fable of The Frog And The Scorpion, New York Post article, Politico article
Why Do Transgender People Report Hypermobile Joints?
March 16, 2023 · Original source
Pirate Wires recently reported that transgender and bisexual people were more likely (20 - 25%) to report Long COVID compared to cisgender and straight people (~15%, yes, all these numbers are really high and you shouldn’t exactly believe them). There are lots of possible confounders, and I’ll post a replication attempt from the ACX survey data sometime, but a pretty plausible explanation is that some Long COVID is psychosomatic, all forms of neurodivergence correlate with each other, and so bi and trans people will report more of every psychosomatic condition.
Inline links: Pirate Wires recently reported
But Long COVID is maximally easy to psych yourself into thinking you have - it’s just fatigue - and Ehlers-Danlos is pretty hard. And Pirate Wires was able to find 1.25x relative risk for bi people and Long COVID, and Najafian found 132x relative risk for trans people and EDS. Also, many trans people are able to easily demonstrate skin/joint abnormalities that are obvious to anyone who looks at them - although it’s possible this is selection bias - a subgroup who have real EDS (at the same rate as cis people) and are very salient because of their gender identity, while cis people with EDS (and trans people with psychosomatic EDS) don’t talk about it as much.
Highlights From The Comments On Long COVID And Bisexuality
May 11, 2023 · Original source
If those people are saying they experience long COVID at a greater rate, it may be because that rate is closer to the true rate, and monosexual people are under-reporting because they are less likely to be aware they have long COVID symptoms (e.g. less likely to notice their brain fog), or more likely to explain their symptoms in more socially normal/acceptable ways (e.g. allergies).
It is bizarre and wrongheaded to insist that there should be one “real” Long COVID number and anyone who doesn’t get it is messing up. There are no universally-used case criteria for Long COVID. Different studies’ numbers change constantly based on how strict their criteria are, how they ask the question, how long after the COVID case they’re asking, what sample they’re asking, etc, etc, etc. So for example, Logue et al found 33% of patients had Long COVID symptoms by their definition; the British Office of National Statistics said 14%, Sudre et al said 2%, and the CDC said 20%. None of these people are lying or incompetent, it’s just that there’s no single “correct” definition of Long COVID or correct population to ask about it.
Inline links: Logue et al, Sudre et al
Original post: Replication Attempt - Bisexuality And Long COVID
Inline links: Replication Attempt - Bisexuality And Long COVID
Links For February 2024
February 29, 2024 · Original source
34: Mass Disabling Event Denial: we’ve talked before about how you would expect Long COVID to be causing a lot more problems than we hear about, and so either Long COVID is overhyped, or we’re bad at hearing about things. This article argues for the latter, suggesting that the disability data look exactly like they would if Long COVID was a huge and growing problem, and for some reason it’s just being ignored:
Inline links: Mass Disabling Event Denial
ACX Survey Results 2025
January 29, 2025 · Original source
There’s an outside chance of an apocalyptic scenario for Long COVID: if each case of COVID has an fixed percent chance of giving you the syndrome, and the syndrome lasts forever, then as more COVID cases happen (ie even though COVID is no longer pandemic, most people still get it once every few years), the amount of Long COVID keeps going up and up for decades, until deaths finally equal new cases. I think this is very unlikely but worth devoting a few brain cells to worrying about. On the question “Have you ever had Long COVID?” (not pictured), the survey results from 2022 → 2024 → 2025 went from 3.1% → 3.6% → 4.5%. On the question above, the number of people saying they were still fatigued went from 2.5% → 1.8% → 2.1%. These are obviously small and weak samples, but it seems like maybe people keep getting Long COVID, but for most of them it gets better after a year or two, so the amount of existing Long COVID cases stays pretty steady. On the same trio of surveys, this question went from 16.2% → 4.1% → 3.5%. Lower numbers mean older architecture, so this confirms the few polls I’ve cited suggesting most people prefer older. Obviously ACX is a selected population, but probably most of the selection is on things other than architecture taste. When I asked people to rank various styles of office buildings and houses, the winners were: This was overwhelmingly people’s favorite office building style, with almost twice as many votes as second place. And this was people’s favorite style of house, but a modernist house did come in a close second. I did another analysis and found that of people in the target demographic (Americans who voted and had a guide for their city) about 50% said it changed their vote, 30% said they weren’t convinced, and 20% said they didn’t know about it. Overall we changed about 500 people’s votes. This one surprised me, so halfway through I added a question asking people to guess what the answer would be. You got it pretty much exactly right (24.96%), so score one for the wisdom of crowds. I’m still interested to see what demographic characteristics predict overestimating vs. underestimating it. These answers also surprised me. In any ACX article related to crime, it feels like the comment section is full of people demanding tougher punishments - no, tougher than that - no, MAXIMUM TOUGHNESS! - with only a tiny number of dissenters. But actually, the silent majority is big softies. 86% want no jail time - not even a weekend - for a first offense shoplifter. And 66% want a month or less even for a ten-time offender! (though 1.3% of you do want death) This is the version of this question most relevant to San Francisco, where there usually aren’t open shelter beds. Same surprise as the previous question - the comment section demands MAXIMUM TOUGHNESS, but the survey takers are bleeding hearts. Most people chose either red (arrest harassers only) or orange (arrest harassers, institutionalize anyone who seems mentally ill), but to otherwise leave the encampment alone. I think this is both a clear right choice, and maybe politically impractical (the justice system doesn’t have the capacity to prove beyond a reasonable doubt which homeless people are harassers/mentally ill and which ones aren’t), so maybe the difference between this question and the comment section is what second-best option people choose when the clear right choice isn’t available. Among the 28 pp of readers who own crypto, 16 pp (57%) are only speculating; the other 12 pp (43%) used it for at least somewhat non-speculative uses - of which 5.7 pp (20%) were completely non-speculative and legal. Typical examples were VPNs, international transfers, drugs (including legal drugs that were just hard to get elsewhere), and donations. I’d heard some pretty crazy rumors about this, so I asked the 113 of you who had used ayahuasca to tell me your stories. 37 of you filled in the text box, of whom: 16 (43%) said it wasn’t too interesting.
Inline links: https://substackcdn.com/image/fetch/$s_!lvwf!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F339fb05a-65f2-4d2c-bc67-ea0870eb8006_2196x924.png, https://substackcdn.com/image/fetch/$s_!tkfl!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fff945734-1b43-4ddb-8f18-680c8024e41b_2196x1044.png, https://substackcdn.com/image/fetch/$s_!QilO!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4cdf58ca-5cf8-4663-839a-62146a5416c1_499x431.png, https://substackcdn.com/image/fetch/$s_!w0Ko!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F12b1a233-3757-46c2-ab6c-d2513dff5706_534x296.png, https://substackcdn.com/image/fetch/$s_!DV4F!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F766aa151-f5c4-400c-bf3a-c90e522054f5_2196x924.png, https://substackcdn.com/image/fetch/$s_!n6TU!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F24cb21c9-9def-426d-b1e4-b255a2f35cc0_2196x924.png, https://substackcdn.com/image/fetch/$s_!DXCl!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fc3779ccb-faba-4c71-9a5d-beda6700b3e5_2196x996.png, https://substackcdn.com/image/fetch/$s_!LSkY!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff6e54a9a-cdfc-4fe1-b25a-fedd1fcf7b9c_2196x996.png, https://substackcdn.com/image/fetch/$s_!TsMW!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F214e9a37-4ef5-4fe9-b06e-c3622703949c_764x381.png, https://substackcdn.com/image/fetch/$s_!MxMq!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F03d7cdeb-84f7-42f1-8282-237a7de953a0_2196x924.png, https://substackcdn.com/image/fetch/$s_!zGd1!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fef536767-311f-4597-a70b-670049dc0d26_2196x924.png