I have many thoughts on the findings re: long COVID in breakthrough infections.
On one hand, symptoms of long COVID are similar to symptoms of depression, anxiety, and various viral infections. I have to imagine that experiencing COVID following a breakthrough infection is a distressing experience, which could trigger depression or anxiety. And some viruses are circulating to an unusually high degree for the time of year due to the decrease in COVID restrictions. It may be that some of the reported post-acute symptoms are actually attributable to these other factors.
On the other, long COVID symptoms are sometimes reported as a "relapse" to previous COVID symptoms, or as new symptoms entirely, rather than persistent symptoms. I'm not sure if these types of occurrences would be adequately captured by this study.
The Israeli study doesn't say a lot about how often different individual symptoms occurred in people who took longer to recover. I'd be interested in more details in that regard. It's possible that certain kind of long COVID symptoms will be seen more or less often in vaccinated vs. unvaccinated people. Losing your sense of smell for several months would certainly decrease your quality quality of life, but it's less of a problem than losing your ability to work or take care of dependents for an extended period. And, regardless of symptoms, do these people eventually get at least somewhat better? Or will we have cases where we still have people who become disabled, and are still that way a year and a half later, as has been the case with infections in the unvaccinated?
Anyway, it seems clear that long COVID will still be a significant problem following breakthrough infections. Even if the incidence is somewhat lower, ~5-15% instead of ~10-30% isn't terribly comforting (unless the presentation of long COVID in vaccinated people is much more manageable, which seems unlikely). The U.S. welfare state, such as it is, can no more accommodate that level of disability than the healthcare system can a continual flood of severe acute disease.
Naturally, the question arises: if vaccination won't prevent long COVID, what will? Antivirals, maybe? If so, then it seems like frequent testing and early administration of medication, if in when it becomes available, will be key.
I have many thoughts on the findings re: long COVID in breakthrough infections.
On one hand, symptoms of long COVID are similar to symptoms of depression, anxiety, and various viral infections. I have to imagine that experiencing COVID following a breakthrough infection is a distressing experience, which could trigger depression or anxiety. And some viruses are circulating to an unusually high degree for the time of year due to the decrease in COVID restrictions. It may be that some of the reported post-acute symptoms are actually attributable to these other factors.
On the other, long COVID symptoms are sometimes reported as a "relapse" to previous COVID symptoms, or as new symptoms entirely, rather than persistent symptoms. I'm not sure if these types of occurrences would be adequately captured by this study.
Relatedly, a UK study recently found that full vaccination halves the risk of symptoms lasting beyond 28 days: https://www.thetimes.co.uk/article/two-vaccine-doses-halves-long-covid-risk-uk-study-finds-8f0bdx29m. This finding is not, of course, incompatible with those of the Israeli study.
The Israeli study doesn't say a lot about how often different individual symptoms occurred in people who took longer to recover. I'd be interested in more details in that regard. It's possible that certain kind of long COVID symptoms will be seen more or less often in vaccinated vs. unvaccinated people. Losing your sense of smell for several months would certainly decrease your quality quality of life, but it's less of a problem than losing your ability to work or take care of dependents for an extended period. And, regardless of symptoms, do these people eventually get at least somewhat better? Or will we have cases where we still have people who become disabled, and are still that way a year and a half later, as has been the case with infections in the unvaccinated?
Anyway, it seems clear that long COVID will still be a significant problem following breakthrough infections. Even if the incidence is somewhat lower, ~5-15% instead of ~10-30% isn't terribly comforting (unless the presentation of long COVID in vaccinated people is much more manageable, which seems unlikely). The U.S. welfare state, such as it is, can no more accommodate that level of disability than the healthcare system can a continual flood of severe acute disease.
Naturally, the question arises: if vaccination won't prevent long COVID, what will? Antivirals, maybe? If so, then it seems like frequent testing and early administration of medication, if in when it becomes available, will be key.