The most alarming problem about Long Covid: Chronic Fatigue Syndrome

‘The main problem with Long COVID is its complexity: dozens of symptoms, different causes, different treatments, vaccine protection, Delta variant, age impact, gender impact, evolution over time…

‘This complexity is crippling. We think “Hmmm Long COVID is bad but how bad? I don’t know… Maybe we should avoid it? But how careful should we be? I don’t know. Is it worth keeping masks? Staying indoors? I don’t know...” So how can we simplify things?

‘By looking at the most alarming problem that Long COVID most likely causes: Chronic Fatigue Syndrome. There are other problems, such as unregistered deaths, post-intensive care syndrome, chronic loss of smell... But they’re too much, and I don’t think they change our takeaways, so we will look at them in the premium deep dive this week, along with other things.’

Read here (Uncharted Territories, Sept 13, 2021)

Delta variant: Everything you need to know -- Tomas Pueyo

‘Delta is a deadly variant. It spreads like wildfire and kills efficiently. We need to be careful.

If you’re an individual

‘If you’re vaccinated, you’re mostly safe, especially with mRNA vaccines. Keep your guard up for now, avoid events that might become super-spreaders, but you don’t need to worry much more than that. If you’re not vaccinated though, this is a much more dangerous time than March 2020. The transmission rate is higher than it used to be, and if you catch Delta, you’re much more likely to die—or get Long COVID. You should be extra careful, only hang out with other vaccinated people, and avoid dangerous events.’

If you’re a community leader

‘If you’re in charge of a community, you have two goals:

1. ‘Vaccinate, vaccinate, vaccinate. The lives of your community depend on it. Any vaccine that works is better than none. If people are opting out, try to lure them in. Most are not anti-vaxxers, but rather they’re on the fence, or simply don’t see the benefit worth the cost. So change their calculation. Create lotteries. The Ohio one, among the first, probably didn’t work, but the cost is paltry compared to the cost of deaths and closing the economy this Fall.
2. ‘Keep Delta at bay as much as you can while vaccinations proceed. An elimination strategy will be best. Good border fences and test-trace-isolate programs are your best tools. Super-spreader events should still be avoided. Masks indoors and in crowds should be mandatory. Great ventilation is a must. 

‘However, if you have vaccinated everybody that wants to be vaccinated, and the rest simply doesn’t want to get vaccinated, then the calculation changes drastically. If your location values the freedom of its people to make the wrong decisions (as long as they don’t impact others), then you might consider opening up the economy. Delta will tear through those unvaccinated, but that’s their prerogative. Maybe the reality will hit better then.

‘But it really depends on each society. Opening up without full vaccination would infect some of those vaccinated, about 10% of them would get long COVID7, and about 0.3% of them would die8.

‘So here each society needs to decide. Say 40% don’t want to vaccinate. Is the freedom of 40% to not vaccinate worth the deaths and Long COVID of those vaccinated? Otherwise, are you willing to force people to vaccinate? Are you going to keep the country closed until there’s a booster vaccine? Will you be able to get your fences and test-trace-isolate programs to work?’

If you’re in charge of vaccine policy

‘An R0 of 8 is bad news for herd immunity. It puts its threshold at ~90% of people protected, which is impossible to reach if vaccines are only 65% protective of infection. Booster shots are necessary. Let’s accelerate their testing, approval, release, and deployment.

‘Also, support vaccine mix-and-match. In most countries, today, if you need a boost you are forced to take the same vaccine. But mixing types likely protects you better and is as safe as using the same type.’

If you’re in a developing country

‘We don’t pay enough attention to developing countries. Most of the science and media focuses where the money is, in developed economies. But Delta is very hard in developing countries, especially in dense urban areas where the poor are forced to work but live in close quarters with many others. India, Argentina, Tunisia, South Africa, and Indonesia are very sad examples of this. 

‘Unfortunately, there’s not many special tricks that poor countries can pull. They tend to have a younger population, which helps. The one thing they have going on for them is that they tend to be warmer and more humid, which helps against COVID. Also, thanks to a warmer weather, they can have more events outdoors. This is the one thing they can leverage: have as many of your gatherings outside, while you do everything you can to vaccinate your population, and delay as much as you can the arrival of Delta with strong fences. 

‘Let’s hope vaccine production keeps growing and people the world over can get vaccinated before the fall.’

Read here (Uncharted Waters, Aug 11, 2021)

Covid FAQ Summer 2021, Part 1: Tomas Pueyo

‘You shared the last article about the Delta Variant so much that nearly 400,000 people read it. Thanks for spreading the word on something so important. You also asked so many good questions that I have tried to answer as many as I could in this article. It’s so long that I split it in two pieces. This 1st piece covers these questions:

1. What’s the update on the Delta variant and cases worldwide?
2. Am I safe if I’m vaccinated? What activities can I go to? Why are there still cases in very vaccinated countries?
3. I’m vaxxed. Can I go to an indoor event if I get masked?
4. When will we leave this behind? when we’re all vaccinated?
5. Can vaccines stop the pandemic?
6. Do we know more about vaccine effectiveness?
7. Should vaccines be fractionalized?
8. Should I get a booster shot?
9. Should I mix-and-match?

Read here (Uncharted Territories, Aug 11, 2021)

Note: Part 2 is only premier, paid subscribers

The mental pitfalls of Covid: Tomas Pueyo

‘If a handful of governments had failed, it would be easy to single them out. Instead, the failure was widespread. Most Western governments failed to contain the virus. When so many humans fail, they are not at fault. Politicians are humans. They’re flawed, biased, like you and me. Their failures are understandable.

‘What failed is the system. Systems should be designed to eliminate human failure. Here, they didn’t. Why have western democracies been so bad at incorporating information quickly? Why was decision-making so poor? Why were they so bad at coordinating citizens, which at the end of it is their sole function?

‘Covid is bad, but thankfully its Infection Fatality Rate is not civilization-threatening. Many upcoming challenges will threaten the collapse of our civilizations, from Global Warming to low fertility, inequality or AI. If our governments have been exposed to be incapable of solving even COVID, what will they do about these more important problems?’

Also discussed why politicians made the errors they made, and what that tells us about ourselves and how to prepare for the future: 

1. Not doing a cost-benefit analysis
2. Not accounting for confidence
3. Dogmatism
4. Social proof
5. Availability bias
6. Authority
7. Escalation of commitment & confirmation bias
8. Reinventing the wheel
9. Desensitization (and hedonic adaptation, framing, storytelling, and anchoring)

Read here (Uncharted Territories, May 25, 2021)

The top 25 mistakes of Covid mismanagement: Tomas Pueyo

We need to learn the lessons so that these widespread governmental failures don’t happen again. Here are the top 25 mistakes of COVID management I see so far, from least important to most.

25. Infection parties
24. Immunity passports
23. Not knowing who to trust
22. Underestimating people’s willingness to do the right thing
21. Lying to the public
20. PCR test management
19. Letting states fend for themselves
18. Forgetting that good fences make good neighbors
17. Storytelling against reality
16. Not adapting to lower income areas
15. Missing that the virus would mutate
14. Not understanding exponentials
13. Not realizing the value of time has changed
12. Be unable to make decisions under uncertainty
11. Misunderstanding individual freedom
10. Making privacy sacred
9. Challenge trials
8. Seeing nails everywhere
7. Aerosols, outdoors, masks, and superspreaders
6. Regionalism
5. Applying developed country logic to emerging economies
4. Not understanding that rapid tests were a game changer
3. Vaccine management
2. Failing at test-trace-isolate
1. Not learning fast enough

Read here (Read here (Uncharted Waters, May 13, 2021)

The fail West: They knew. They ignored. The reckoning, One year in. By Tomas Pueyo

‘Soon, over 1.5 million people will have died of Covid in Western countries. 1.5 million futile, needless deaths. 1.5 million wasted lives. Meanwhile, in a block of Asia-Pacific countries with a population over twice as big, they lost 18,000 people. 

‘For today, we’re going to expose the failures, expose the excuses, expose the lies, expose what we knew one year ago that we didn’t learn fast enough, and the true reasons why the West failed.‘

Read here (Uncharted Territories, May 6, 2021)