COVID why do suffers have such different outcomes

My point was that it’s not an automatic death sentence- far from it.

Yes of course I know that sadly a lot of folk have died but sad though that is, it’s only a small percentage of those who have had it and recovered.

I get as worried at the nightly news as anyone and I am doing my best not to catch it, but at the same time I have always felt that it’s important to keep things in perspective.

Just going back to the BAME issue, growstuff. I’d be interested in your take on a couple of things.

Firstly, the BAME classification is far to wide for any meaningful research into genetic factors, because it encompasses many different ethnic groups. It’s a political classification really.

People that would be classified as BAME in Britain are not being affected by COVID in the same way throughout the world. Some African and Asian countries have fairly low rates of death per 100,000 of the population. I know this might be due to reporting techniques but their overall death rates don’t seem much higher than normal.

Any thoughts?

Even if the majority make a full recovery, there's still a lot of death. Assuming the "99.5% survival rate" number is correct (and it's almostcertainly higher), this translates to an Infection Fatality Rate (IFR) of 0.5%. If we just didn't suppress the virus, this would kill up to 300,000 people in a country the size of the UK.

I don't understand how you can claim that Covid isn't wholly dangerous. Death is fairly serious.

It’s a very strange virus isn’t it, being neither wholly very dangerous nor wholly innocuous.

We already know that some groups of people are more susceptible to a bad outcome than others - certain ethnic groups, the overweight and of course older folk.

The amount of viral load has also been mentioned along with a lack of vitamin D, plus of course the much quoted ‘underlying conditions’.
Now we are hearing more about those who take longer to fully recover than others which can happen with other viral infections.

The nightly tv news can be very scary as they inevitably concentrate on the serious cases, but there is one fact which is the same today as it’s always been, and that is that the vast majority of people who contract Covid-19 make a full recovery.

Urmstongran

An over active immune system for one. Our daughter had (has) long Covid. Doctor told her this. She’s back at work now full time as a teacher since the NY and has just text ‘tired mum, which is to be expected but bit anxious again as chest ache back. Going to bed before 9pm’.

My daughter has long Covid too, and struggling through symptoms that seem to randomly appear around her body. The chest pain was a real worry, and she desperately tried to work out what aggravated it. Eventually GP diagnosed costochondritis which is inflammation of the sternum. Ibruprofen gel seemed to help , plus understanding that the breathing pain was the chest muscles and not the lungs.
She has started singing again on her choir zoom session!
Other symptoms are causing problems now.
I hope your daughter gets better soon.

Off at a tangent hers but a large number of people catch Covid in hospital, both staff and patients. Its logical really. Large numbers of people, already unwell in close proximity, sharing facilities, many with dementia, no way of letting fresh air into the rooms. Hospital acquired infection has been around forever, Covid is just more obvious.

I was thinking yesterday about this very issue. Perhaps its time for new hospitals to be designed with single, or at most double rooms with its own loo/shower. The old nightingale wards were outdated, maybe its time to mothball the four and six bedded bays with communal facilities.

This would solved so many issues. Infection control, noise levels, privacy, confidentiality, dignity and so much more.

I had the misfortune to have an overnight stay in hospital following gall bladder surgery. Although the lights were dimmed, the level of activity was high. It was not something I would wish to repeat. We are in the 21st century in one of the richest nations in the world. Why are we still exposing so many vulnerable people to the risks of communal living?

My cousin's daughter was diagnosed with Covid Christmas day. She lives with him with her 6 year old son. Neither he nor his grandson got it. He said it was 10 days of hell. Luckily she was treated at home . She is 30 . My cousin is 56. Neither smoke or drink. Both keep fit. She works in a nursery 3 children tested positive for Covid and their parents still sent them and didn't tell anyone. No idea how many they infected. It's idiots like this is why numbers are rising. My brother worked with someone 2 of his cousins both in their 30's died from Covid. One was a runner and the other weightlifter. Both super fit very health conscious. Rest of the family didn't get it.

Like several of people have said scientists will find out why it affects some and not others. But like other diseases it takes time to research.

We just have to take precautions and have the vaccine when we are offered it. Some through medical reasons won't be able to have it. So those of us who can have need to do so too protect them. Mind you there will be the idiots who wouldn't have it because they are idiots

This is probably not the same article, but it's an interesting, albeit long, read:

www.scientificamerican.com/article/why-some-people-get-terribly-sick-from-covid-19/

I wish I could remember where I read that some scientists are studying findings that those who develop more severe symptoms have more mutations in the area of the genome that controls the immune response.

PamelaJ1

sueDonim re. family members. Could it be something to do with lifestyle.
Families tend to have a similar diet, may smoke, etc. My family eat quite healthily, exercise regularly, don’t smoke. That gives us a head start.

I honestly don’t know! I know families who’ve all been exposed to CV yet only one person has developed symptoms and no one else had caught it from them, either.

It’s probably as mysterious as to why my brother never had any of the childhood diseases the rest of us four children got, apart from having Rubella. He didn’t even get chickenpox when his wife and two daughters all had it at the same time. If only they could bottle whatever is in his immune system.

Casdon

Yes growstuff, that has happened in the NHS and local authorities, there are individual risk assessments done, and ethnicity is taken into account in the scoring so that staff are protected. In the first wave it was an unpredicted consequence, and it was tragic that so many staff lost their lives.

That's good to hear. I wonder if all organisations are so conscientious.

I know that it's been an issue in schools (not just with BAME people, but others with identifiable risk factors) and I'm not sure it was ever resolved.

Yes growstuff, that has happened in the NHS and local authorities, there are individual risk assessments done, and ethnicity is taken into account in the scoring so that staff are protected. In the first wave it was an unpredicted consequence, and it was tragic that so many staff lost their lives.

There are two issues with BAME communities.

1 Are they being infected more frequently than others? If so, why? Is it their jobs, their living conditions, reluctance to take precautions or something else?

2 Are their outcomes worse than others? Again, why? Is it something genetic? Do they receive worse treatment? Are they in poorer health to start with? Or something else?

Whatever it is, the fact is that a disproportionate number from many ethnic backgrounds have died and it shouldn't be ignored. Policies might need to be adjusted to take them into account (despite the howls from those objecting to positive discrimination).

There is nothing unusual about that, Every illness has people getting it seriously and others lightly, even in the same family.

In the days before the measles jab, My slightly younger sister had measles far more severely than I did, while I had chicken pox far worse than she did.

Yes, there are major structural social and life style issues that affect large groups, but mainly it is just subtle changes in immune systems, genes, trivia.

Urmstongran

An over active immune system for one. Our daughter had (has) long Covid. Doctor told her this. She’s back at work now full time as a teacher since the NY and has just text ‘tired mum, which is to be expected but bit anxious again as chest ache back. Going to bed before 9pm’.

I hope she's had full blood tests to check that all her organs are functioning properly. If not, she should ask for them. Liver, heart and kidney damage can all cause fatigue and are manageable if diagnosed early enough.

MayBee70

Deedaa

I seem to remember reading that the longer you were in contact with someone with Covid the more of the virus you absorbed and the worse the effect was. It would follow that family members in close contact could make each other quite ill.

But what I don’t understand is that quite often family members don’t catch it at all even asymptotically. David Davis did a web chat with Dr John the other day and he’s adamant that most people are deficient in VitD and that the amount given to people in care homes is insufficient. (can’t believe I’m listening to David Davis!).

I'm not denying that, but there's more to it than lack of Vitamin D.

ACE2 receptors play an important part.

"Does everyone have the same number of ACE2 on their cells?
No. ACE2 is present in all people but the quantity can vary among individuals and in different tissues and cells. Some evidence suggests that ACE2 may be higher in patients with hypertension, diabetes and coronary heart disease. Studies have found that a lack of ACE2 (in mice) is associated with severe tissue injury in the heart, lungs and other tissue types."

Extract above, but read the whole article:

theconversation.com/what-is-the-ace2-receptor-how-is-it-connected-to-coronavirus-and-why-might-it-be-key-to-treating-covid-19-the-experts-explain-136928#:~:text=ACE2%20acts%20as%20the%20receptor,regulate%20functions%20in%20the%20cell.

An over active immune system for one. Our daughter had (has) long Covid. Doctor told her this. She’s back at work now full time as a teacher since the NY and has just text ‘tired mum, which is to be expected but bit anxious again as chest ache back. Going to bed before 9pm’.

Deedaa

I seem to remember reading that the longer you were in contact with someone with Covid the more of the virus you absorbed and the worse the effect was. It would follow that family members in close contact could make each other quite ill.

But what I don’t understand is that quite often family members don’t catch it at all even asymptotically. David Davis did a web chat with Dr John the other day and he’s adamant that most people are deficient in VitD and that the amount given to people in care homes is insufficient. (can’t believe I’m listening to David Davis!).

rosie1959, we just don't know enough yet.

It's a new (to us) virus and a changing picture as well, with the newer variants seeming to be far more contagious and some younger people becoming more seriously ill.

We do know of some influencing factors, like age (diminishing T cells), low Vitamin D levels, weight/obesity - but there must be many more.

My understanding is that it depends on how the body responds to the initial infection so in part at least it's down to the immune system. Vitamin d is key and people can be low at this time of year which is why the government have offered it free to those who are shielding. Professor Tim Spector of the Zoe App mentioned the importance of gut health last week, I can remember that he mentioned dark chocolate which is ok with me! The other issue people talk about is viral load, so health workers who get a lot of exposure may be more at risk of severe illness. This is how I interpret what I've read at the moment. But it is a really puzzling aspect of this awful disease.

Deedaa and cornishpasty I've read that's it thought it's to do with viral load too. It would certainly be consistent with households and educational settings (including schools and halls of residence) being the main places where infection takes place.

Some people are more susceptible for various reasons, such as age and underlying health conditions, but if they haven't been exposed to a high viral load, they're less likely to be badly affected. There's still a lot of research to be done.

Kandinsky It's scandalous that there seems to be little research into why certain ethnic groups are badly affected. It doesn't help the the Equalities Minister, Kemi Badenoch, has even denied that they are disproportionately affected.

Certain ethnic minority groups seem to be very badly affected - but that could just be lifestyle factors rather than genetic - the experts aren’t sure.

I thought it was due to viral load, a small amount of the virus would make the body start an anti-viral response and stop it spreading to other cells but a large amount at once, long contact or very close contact, would be overwhelming.

I cannot remember where I read this but was in the early days of the virus so thinking may have changed.

I seem to remember reading that the longer you were in contact with someone with Covid the more of the virus you absorbed and the worse the effect was. It would follow that family members in close contact could make each other quite ill.