How much should we still worry about catching COVID? [Links and Discussion Thread]

By MichaelStJules @ 2021-08-29T06:06 (+21)

[Cross-posted to LessWrong. Consider checking comments there, too.]

I've decided to collect research on the risks of COVID, especially among vaccinated people and for long COVID. Please share more in the comments, and it would be helpful to categorize them according to the section headings of this post. Other discussion about the evidence and research is also welcome in the comments.

I've included quotes of estimates for the three links in the section "Overall how bad it is to catch COVID".

I'm not committing to updating the post with more links beyond the ones I've already included (although I might); I encourage readers to check the comments instead.

EDIT: Check the COVID-19 tag on LessWrong.

Overall how bad it is to catch COVID

I've come across three estimates for the number of expected quality of life adjusted days lost to (long) COVID for fully vaccinated people. I think the main reasons for the discrepancies between the first and second are higher risks of long COVID conditional on COVID and higher risks of long COVID becoming basically permanent conditional on long COVID in the first link. Some potential symptoms like fatigue and brain fog would reduce your productivity.

1. https://www.mattbell.us/delta-and-long-covid/ 

For fully vaccinated people catching Delta:

If you’re a 35 year old woman, and your risk of ending up with lifelong long COVID from catching COVID is 2.8%, then catching COVID would be the same, statistically speaking, as losing (50 years * 0.18 * 0.028 * 365 days/year) = ~90 days of your life.

(...)

A 35 year old woman runs about an 0.5% chance of the "worst case scenario" outcome if she gets Delta.  For comparison, 0.5% is about 42x your chance of dying in a car crash in the next year.  

Also, see these two figures (derived in the article) for risks of multi-year long COVID or worst case multi-year long COVID by age and gender among vaccinated people, and the rest of the key takeaways at the start of the article.
 

2. https://www.lesswrong.com/posts/9xd5ArGud8897q5on/delta-strain-fact-dump-and-some-policy-takeaways?commentId=rGZiHcuzt7bh7sXmL

For fully vaccinated people:

My new estimate from the calculation is 3.0 to 11.7 quality-adjusted days lost to long-term sequelae, with my all-things-considered mean at 45. 

3. https://www.lesswrong.com/posts/9xd5ArGud8897q5on/delta-strain-fact-dump-and-some-policy-takeaways

That being said, we can still roughly estimate risk from definitely having Delta. A healthy 30yo probably has about 4x (3x-10x) less risk than before, due to vaccination, despite Delta causing higher mortality. It almost entirely comes from Long COVID. In absolute terms this is ~4 expected days of life, plus 1/200th of your future productivity and vitality. You can shorthand this to about 1-4 weeks of life lost if you expect to otherwise live a full life—obviously, it costs less if you expect to live less less time. This translates to microCOVIDs at roughly 1 hour of your life lost every 1k-5k uCOVIDs. Risk of death goes up by 3x for every decade in age, but Long COVID probably only scales at ~~1.5x per decade, so for people over 60 mortality starts becoming more relevant. All these calculations are "creative" so please don't take them as definites.

Also see the discussion in the comments.

Research summaries and papers

I give more weight to lower estimated risks, because I expect that larger estimated risks are probably more biased upwards due to inadequate matching/controlling/adjusting for confounders or unrepresentative samples, since I don't think the confounders they're matching/controlling/adjusting for are likely to introduce downward bias.

1. Existing research on Long COVID (research summaries)
2. Causation or confounding: why controls are critical for characterizing long COVID (includes multiple long COVID risk estimates from different papers)
3. https://www.lesswrong.com/posts/6uwLq8kofo4Tzxfe2/long-covid-is-not-necessarily-your-biggest-problem
4. https://astralcodexten.substack.com/p/peer-review-long-covid-much-more  (pay-walled)
5. https://www.lesswrong.com/posts/9xd5ArGud8897q5on/delta-strain-fact-dump-and-some-policy-takeaways
6. High-dimensional characterization of post-acute sequelae of COVID-19 (one of the highest quality papers and one of the lowest risk estimates)
7. Vox: Should vaccinated people worry about long Covid?
8. Vox: Long Covid isn’t as unique as we thought
9. https://www.facebook.com/groups/bountiedrationality/posts/2991716701072373/ (post about risks among vaccinated people with multiple papers discussed)
10. https://www.lesswrong.com/posts/rbeFZr5pqCTCfKiW4/covid-delta-advice-i-m-currently-giving-to-friends?commentId=6cL9NXFmtiGtmSfw2 (links + a few research summaries)

Managing your COVID budget

1. https://www.microcovid.org (risk of catching COVID from different activities)
2. https://www.lesswrong.com/posts/9xd5ArGud8897q5on/delta-strain-fact-dump-and-some-policy-takeaways
3. https://www.lesswrong.com/posts/rbeFZr5pqCTCfKiW4/covid-delta-advice-i-m-currently-giving-to-friends
4. https://www.lesswrong.com/posts/cpKpJgjzezyxvjryN/exercise-trade-offs