Eating vegetables and drinking coffee are associated with diminished risk of COVID-19 in the UK health biobank. As a coffee drinker, I find this encouraging (even if the reduction is modest).
Eating at least "... 0.67 servings/d of vegetables (cooked or raw, excluding potatoes) was associated with a lower risk of COVID-19 infection." 2/3 of a serving a day? Do a lot of people in the UK eat one serving of a vegetable less than 2 out of 3 days?
Of course, this is associational, not experimental, so causality is not demonstrated.
At first glance these both sound like indicators of socioeconomic status, but I see in the paper that the authors made an effort to control for this. That said, no posthoc control is ever really perfect, but still, perhaps these are indeed general things that associate with COVID-19 outcomes. Coffee, I know, has been the subject of very close research for a very long time, and the last I checked in on that research it was closely associated with good healthcare outcomes when other factors are controlled. Likewise, eating more vegetables provides nutritional benefits. So I think--as you may be saying as well--that this may suggest it's worth exploring further how COVID-19 outcomes relate to overall nutrition. I have a feeling that all of this--including any blood glucose link--may be just part of a bigger picture. It's rarely ever just one thing that is the root cause of complex disease.
Also, funny point re:vegetable-eating frequency. I guess part of it also depends on what you classify as a vegetable, and how you define a serving. The vegetable "fixins" on a Big Mac might not be quite enough to hit one. A lot of people make meals out of fast food and takeout frequently, where vegetables might be infrequently present or perhaps just an afterthought. I'm not a nutrition researcher though, so, I'll try to stay in my lane and not speculate. There are enough people out there making wild claims that bridge COVID-19 and nutrition research, I don't need to be one of them.
I was saying back in January of 2020 that we needed a rapid antigen test, costing $1. Honored that you agree.
I've also had a very hard time figuring out how weekly tests matter, given the incubation period of this virus (which is seemingly even shorter for the Delta variant).
You wrote, "Even if the test result is very fresh, 40% of those negative results might actually be people who are positive. By comparison, vaccination prevents 85% of cases—meaning that vaccinated people are about 15% as likely to be positive as unvaccinated people are. A random person who has received a negative test but is unvaccinated might well be more likely to be infected than a random vaccinated person." Aren't you comparing apples to oranges? 85% is the degree of protection (and that's not a very hard number) for the mRNA vaccines used in the USA. 40% is the *lower bound* of the false negative results of PCR tests. Comparing failure to detect actual viral infections with the *ratio* of the probability of being infected between vaccinated and non-vaccinated people ... I fail to see how they're directly commensurable.
(Why compare the worst PCR results with the best vaccine? Why not compare the 5% number to Sinovac's or Janssen's vaccine?)
"By the way, if you’re vaccinated, and you feel sick? Go get tested. It’s really important." I have hay fever. As I type this, I'm slightly sniffly. I suppose I could get tested every day, but in practice, given the current costs, I don't want to. One problem with COVID-19 is that it causes so many, and such diverse, symptoms. The only distinctive one I am aware of is losing smell and/or taste, pretty rare otherwise.
Well, a couple things here. In the US, overwhelmingly, vaccinated people have mRNA vaccines. The number of Johnson and Johnson vaccines is several orders of magnitude lower, such that a random vaccinated person is much more likely to be mRNA vaccinated. If I wanted to be especially rigorous I would find the average protection level with a "generic" vaccine and use that but since there is such a difference in uptake between the two major classes of vaccine, I don't think that would make a dent. The typical vaccinated person is about 85% protected.
Now as for how this compares--I could have showed my work a little better here. Let's start with some fixed probability that a random person is infected with COVID-19, and we'll just call that X for the sake of this. For a vaccinated person, X is 15% of what it would be if the person is unvaccinated, so it's 0.15X. If the person has been tested just moments ago and got a negative result, the odds are a range between 0.05X and 0.4X--and in this instance I am more concerned with the highest estimate of the danger because I cannot be sure just how well their test was conducted. Plus, we know that since tests are not instantaneous, with more chances to get infected post-test, the tested unvaccinated person's "safety" is never going to be at that 0.05X number. It's always going to be higher. So I don't think the low end is useful to use there.
We suffer in this attempt to estimate from the fact that testing accuracy is not well-understood while vaccine protection is well-understood. I'm pretty confident that vaccine-mediated protection is between 80 and 90%, such that the average value of 85% is reasonable to use so I feel pretty certain that the odds of a vaccinated person having COVID-19 are around 0.15X. I'm not confident at all that any spot in the range of false negativity is "the" number, so I started with the worst-case scenario but also considered the low end later on.
As for hay fever, I think your best bet is actually to take something for your allergies. COVID-19 won't respond to antihistamines, because it doesn't activate histamine pathways. What's more, testing really should apply to any new or unusual symptoms. Since you typically have this allergic reaction, it's neither new nor unusual, and if you're slightly sniffly every day, but experience nothing else, you can be reasonably sure (provided you've had at least one test) that you don't need a new COVID-19 test. If that pattern changes and you develop sudden fever, cough, worsening congestion, etc., then it's a good time for a repeat test. It's not the easiest situation to navigate, but it doesn't have to be one where you're completely uncertain of what to do.
Relevant to your August 11 column: https://www.mdpi.com/2072-6643/13/6/2114/htm
Eating vegetables and drinking coffee are associated with diminished risk of COVID-19 in the UK health biobank. As a coffee drinker, I find this encouraging (even if the reduction is modest).
Eating at least "... 0.67 servings/d of vegetables (cooked or raw, excluding potatoes) was associated with a lower risk of COVID-19 infection." 2/3 of a serving a day? Do a lot of people in the UK eat one serving of a vegetable less than 2 out of 3 days?
Of course, this is associational, not experimental, so causality is not demonstrated.
At first glance these both sound like indicators of socioeconomic status, but I see in the paper that the authors made an effort to control for this. That said, no posthoc control is ever really perfect, but still, perhaps these are indeed general things that associate with COVID-19 outcomes. Coffee, I know, has been the subject of very close research for a very long time, and the last I checked in on that research it was closely associated with good healthcare outcomes when other factors are controlled. Likewise, eating more vegetables provides nutritional benefits. So I think--as you may be saying as well--that this may suggest it's worth exploring further how COVID-19 outcomes relate to overall nutrition. I have a feeling that all of this--including any blood glucose link--may be just part of a bigger picture. It's rarely ever just one thing that is the root cause of complex disease.
Also, funny point re:vegetable-eating frequency. I guess part of it also depends on what you classify as a vegetable, and how you define a serving. The vegetable "fixins" on a Big Mac might not be quite enough to hit one. A lot of people make meals out of fast food and takeout frequently, where vegetables might be infrequently present or perhaps just an afterthought. I'm not a nutrition researcher though, so, I'll try to stay in my lane and not speculate. There are enough people out there making wild claims that bridge COVID-19 and nutrition research, I don't need to be one of them.
Interesting stuff here!
I was saying back in January of 2020 that we needed a rapid antigen test, costing $1. Honored that you agree.
I've also had a very hard time figuring out how weekly tests matter, given the incubation period of this virus (which is seemingly even shorter for the Delta variant).
You wrote, "Even if the test result is very fresh, 40% of those negative results might actually be people who are positive. By comparison, vaccination prevents 85% of cases—meaning that vaccinated people are about 15% as likely to be positive as unvaccinated people are. A random person who has received a negative test but is unvaccinated might well be more likely to be infected than a random vaccinated person." Aren't you comparing apples to oranges? 85% is the degree of protection (and that's not a very hard number) for the mRNA vaccines used in the USA. 40% is the *lower bound* of the false negative results of PCR tests. Comparing failure to detect actual viral infections with the *ratio* of the probability of being infected between vaccinated and non-vaccinated people ... I fail to see how they're directly commensurable.
(Why compare the worst PCR results with the best vaccine? Why not compare the 5% number to Sinovac's or Janssen's vaccine?)
"By the way, if you’re vaccinated, and you feel sick? Go get tested. It’s really important." I have hay fever. As I type this, I'm slightly sniffly. I suppose I could get tested every day, but in practice, given the current costs, I don't want to. One problem with COVID-19 is that it causes so many, and such diverse, symptoms. The only distinctive one I am aware of is losing smell and/or taste, pretty rare otherwise.
Well, a couple things here. In the US, overwhelmingly, vaccinated people have mRNA vaccines. The number of Johnson and Johnson vaccines is several orders of magnitude lower, such that a random vaccinated person is much more likely to be mRNA vaccinated. If I wanted to be especially rigorous I would find the average protection level with a "generic" vaccine and use that but since there is such a difference in uptake between the two major classes of vaccine, I don't think that would make a dent. The typical vaccinated person is about 85% protected.
Now as for how this compares--I could have showed my work a little better here. Let's start with some fixed probability that a random person is infected with COVID-19, and we'll just call that X for the sake of this. For a vaccinated person, X is 15% of what it would be if the person is unvaccinated, so it's 0.15X. If the person has been tested just moments ago and got a negative result, the odds are a range between 0.05X and 0.4X--and in this instance I am more concerned with the highest estimate of the danger because I cannot be sure just how well their test was conducted. Plus, we know that since tests are not instantaneous, with more chances to get infected post-test, the tested unvaccinated person's "safety" is never going to be at that 0.05X number. It's always going to be higher. So I don't think the low end is useful to use there.
We suffer in this attempt to estimate from the fact that testing accuracy is not well-understood while vaccine protection is well-understood. I'm pretty confident that vaccine-mediated protection is between 80 and 90%, such that the average value of 85% is reasonable to use so I feel pretty certain that the odds of a vaccinated person having COVID-19 are around 0.15X. I'm not confident at all that any spot in the range of false negativity is "the" number, so I started with the worst-case scenario but also considered the low end later on.
Re:testing, it's worth looking at the CDC's definition of symptomatic. It won't help you in particular to differentiate hay fever from COVID-19, but it's useful in general: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
As for hay fever, I think your best bet is actually to take something for your allergies. COVID-19 won't respond to antihistamines, because it doesn't activate histamine pathways. What's more, testing really should apply to any new or unusual symptoms. Since you typically have this allergic reaction, it's neither new nor unusual, and if you're slightly sniffly every day, but experience nothing else, you can be reasonably sure (provided you've had at least one test) that you don't need a new COVID-19 test. If that pattern changes and you develop sudden fever, cough, worsening congestion, etc., then it's a good time for a repeat test. It's not the easiest situation to navigate, but it doesn't have to be one where you're completely uncertain of what to do.