This the confusion. Viruses don't necessarily evolve towards less virulence, but, of course, as people get vaccinated/infected the disease is experienced as less severe, on average, next time: how many pandemics end. People confuse the two mechanisms.https://twitter.com/zeynep/status/1445046912013459457 …
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Nomadic Quantum 🇨🇦 😷 💉 🦕 Retweeted Anthony J Leonardi, PhD, MS
It appears that reinfection with cov2 is statistically experienced as more severe rather than less severe, i.e. MORE likely to result in hospitalization. There are likely many ways for pandemics to end.
#covid19https://twitter.com/fitterhappierAJ/status/1445187429250572291 …Nomadic Quantum 🇨🇦 😷 💉 🦕 added,
Anthony J Leonardi, PhD, MS @fitterhappierAJIn a stark counter to those who claim reinfections will be milder and novelty is the determinant of severity, this study finds hospitalization is more common for cases of suspected reinfection than in primary infections h/t@lisa_iannattone https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(21)00422-5/fulltext … pic.twitter.com/gCNonYI3VWShow this thread3 replies 0 retweets 3 likes -
Or, you can actually read the paper! It's excellent news. They found a grand total of *315* reinfections out of 75,000+—almost certainly more occurred but didn't have any symptoms so not even tested, thus different denominator. The 315 were older & more likely immunocompromised.
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Are you disagreeing with what they wrote? They wrote that hospitalization was more common in reinfection than original infection. Do you disagree with that statement? There would be undetected cases in both groups.
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Part titled "Discussion" explains it in fairly accessible terms. Did not test asymptomatics, and thus missed mild/no symptom reinfections, found a tiny number of symptomatic reinfections among a weaker/older group—hence higher risk. That's called "conditional probability".
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Replying to @zeynep @nogenderid and
Vaccines work on the same principle! However, just like here, those who get sick/die after vaccine breakthrough are more likely to be older or immunocompromised! (Conditional probability again!) Hence important to vaccinate many, so this small group is better protected. Cheers!
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Replying to @zeynep @nogenderid and
The study doesn’t say that. The only detail it provides is that hospitalisation at reinfection was more common for those hospitalized at initial infection. But 29/36 hospitalisations had not been hospitalized the first time. They don’t say the hosp were older or immunosupp.pic.twitter.com/kMSoy4Gklw
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Replying to @lisa_iannattone @nogenderid and
Not only does it actually say that, you can see the tables yourself. PLUS, they were able to find a very tiny number of re-hospitalizations (29 in their 75,000+ sample) by also checking people who were hospitalized anyway—not even necessarily for COVID. Read the paper!pic.twitter.com/cWQ0jauCXs
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Replying to @zeynep @lisa_iannattone and
They combed records of 74,196 infected people. Found *only* 315 re-infected. In the first run, 4049 hospitalizations. Second round: only 29, and they don't even know if for COVID. Green is initial encounter, when the virus is novel. Red, same 75K people, virus no longer novel.pic.twitter.com/IkZwUuAXs6
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Replying to @zeynep @lisa_iannattone and
So, again the 29 re-hospitalized out of the mere 315 re-infections is slightly proportionally larger (29/315=9.2%) than 4094 hospitalized out of 74,196 initial infections (5.4%). As they say, the tiny group susceptible to reinfection is proportionally more immunocompromised!
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This is how conditional probability works, also for vaccines: if you look at severe outcomes for vaccinated people, they are pretty uncommon (as is reinfection as this paper states!) but when they do occur, more likely to be immunocompromised or otherwise higher-risk.
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Replying to @zeynep @lisa_iannattone and
PLUS, they explain they are missing all the mild/asymptomatic re-infections (because not tested) and even the 29 (compared to initial 4094) just happen to be in the hospital, they can't even say it's a COVID hospitalization but even assuming they all were, it's super uncommon!
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Replying to @zeynep @lisa_iannattone and
Hence excellent news, and great paper. Looking up conditional probability (sometimes called selecting on the dependent variable) would help clarify the misunderstanding, though the paper does explain the findings—assuming the audience understands conditional probability. Cheers!
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