So I want to talk about the implications of the study on cognitive slowing that came out in the Lancet yesterday, because it is incredibly important. You should be VERY, VERY, VERY worried by this, because essentially what it shows is that the number of people with moderate to severe cognitive impairment has grown dramatically in just four years and is poised to grow further. A lot further. So a large study was done in BOTH the UK and Germany, that matched three cohorts of patients. The first one were folks with long covid (aka PCC). The second had had covid, but did not have long covid symptoms. The third were people who had not had covid.
In the control group (no covid) 4% had severe cognitive impairment already and 14.7% showed moderate cognitive impairment. The vast majority (3xs as many as have severe impairment) of those people have milder cognitive impairment, rather than severe. So without any other affects, about 19% of the population has some kind of cognitive slowing, due to disability, temporary health problems like chemo, dementia or MCI etc...
In the group with Long Covid, 9.3% of the population had moderate cognitive impairment and *53.5%* had Severe impairment, more than three standard deviations below the norm. This is a huge and appalling number.
Just as horrifying, but getting less attention, among those who DID NOT HAVE LONG COVID but had had covid had a 19.4% rate of severe impairment and a 9.7% rate of moderate impairment - which means that out of folks who have had covid but DID NOT GET LONG COVID, nearly a third of them are cognitively impaired, and a majority of those severely.
This study folllows on the heels of MANY MANY studies that show covid causes brain damage, and affects the brain seriously. So what does this mean for us as a society and what does it mean individually?
First, let's start with how many people this probably is. There's a lot of dispute over the number of people who get long covid, with estimates ranging in the vaccinated from 5%-25%+ A lot of it depends on how you identify long covid and frame the issue. What we do know is that when you ask people about symptoms, you get very high proportions, but generally if you ask people about whether they have long covid, you get low ones, which suggests it is underdiagnosed, rather than the opposite.
So let's pick a low-end number, suggesting that 10% of covid infections result in long covid (the US CDC says 20%, btw) - which lines up with a recent Canadian study that showed that long covid risk was cumulative, with a risk of 38% in people who had had covid three or more times.
At 0 infections, about 20% of the population has some kind of cognitive slowing. In the United States, with a population of 330 million, that's about 66 million people - of those 66 millions, 16.5 have severe impairment and just under 50 million have moderate impairment.
Now how does this bode for the future when you plug these numbers into the US population? I'll use conservative numbers and round down whenever possible. Remember, the US CDC estimates the prevalence of long covid at around 20%, but I'm going to say 10% to be conservative.
330 Million Americans, 90% have had covid, that gives us 297 Million Americans who have had covid, and if one in ten has long covid, that's just about 30 Million Americans with Long covid. 60.3% showed some kind of cognitive impairment, mostly severe, and that means 18.9 MILLION Americans have cognitive slowing due to Long Covid. In this case, a huge majority of them, more 5 out of six, have severe impairment.
But we aren't done. Because almost 30% of folks who had covid infections but did not have long covid ALSO had significant cognitive slowing. 90% of Americans, in the absence of any mitigation have had at least one case of covid. That equals 297 Million Americans. Of those 29% would have either moderate or severe cognitive impairment. That's 86 MILLION Americans, and again, a majority of them (twice as many) have severe impairment.
So using these numbers, the US has gone from 66 million people, mostly with moderate cognitive impairment and slowing, to 170 MILLION Americans with some kind of cognitive impairment, 88 Million of them with severe cognitive slowing and impairment, more than two or three standard deviations below the norm.
So not only have we more than doubled the number of cognitively disabled people in the US, we've increased the amount of people with severe cognitive impairment by FIVE TIMES WHAT IT WAS FOUR YEARS AGO. That is a huge and terrifying change.
But what does that cognitive slowing actually MEAN in day to day life? The study points out that it affects your response to stimulus - that is, your rapid response to complex situations, and your puzzle solving ability. For example, how do you make split second decisions while driving, or flying a plane, but also how do you make routine rapid decisions - for example how much change to give at the cash register or what how to respond when confronted with a challenging situation. It also tested how quickly people absorbed information - for example, how rapidly they could incorporate new things into their thinking, whether a sudden truck cutting them off or the sudden revelation of a new data point that requires response.
People in this study needed A LOT more time to process things correctly. They were unable to respond quickly and accurately in test situations - and test situations are generally LESS stressful than real life. This also had implications for people's ability to pay attention. If it is taking them a lot longer to absorb and process new information, then they are processing one concept while you are presenting another and more things are being missed. It is also easier for people to lose the thread of what is going on, when it is taking considerable time for them to absorb information.
So this has implications for pretty much everything in life. And we've been seeing these implications all through the system. For example, in the increase in driving accidents. From 2018 to 2022 the increase in fatal car accidents, even during periods with reduced driving due pandemic restrictions, increased by 16%. In the same period, the FAA found that aviation accidents and near misses had increased by 25% over a decade ago. And that makes perfect sense given the impact of covid on pilots and drivers. Because remember, MOST OF THESE PEOPLE EITHER DO NOT KNOW THEY ARE IMPAIRED OR DONT REALIZE HOW BAD IT IS.
It has implications for education as well - if almost half your students are cognitively impaired (and it is almost impossible to know what the rate of long covid is among children, who can't tell us they felt better two years ago because they were three then) and processing things much slower, they are going to struggle to understand, struggle to pay attention and struggle with impulse control when they have to make rapid decisions.
And this matches up really well with what teachers are telling us about kids now - that they are less in control, more likely to do dangerous or foolish things, less able to attend, unable to remember basic concepts, and unable to process information well. Over and over teachers have blamed this on the pandemic restrictions, but we know that test scores fell most in states that were closed the shortest time. This why the kids never seem to be catching up - because forced infection is harming their brains. And why kindergarteners who were babies during lockdowns are struggling now.
The implications for daily life are also huge - your accountant is typing in numbers rapidly and may miss a line or two because of cognitive slowing. An inspector misses a whole section of something. Your therapist can't process quickly enough to understand everything you've said. Your doctor misses the critical bit about your penicillin allergy. A person has to respond rapidly to a customer complaint or a situation in a workplace, and makes a bad choice - and now is embarassed and trying cover for their error. Life comes at you fast - but you can't do fast anymore. And this too dovetails with what we've been hearing - reports of unusually severe levels of errors across fields, declines in testing in multiple professions across the board.
And we're only four years in. A recent review of covid from Canada found that Long Covid risk was cumulative - that is, 38% of those who had had covid THREE OR MORE TIMES had long covid. Which gives you above a 50-50 chance of cognitive slowing.
There may be people completely immune to long covid, but probably not nearly enough. If we continue with unchecked covid spread, we are looking at a population that is severely cognitively damaged. We already have cognitive damage at levels never seen before in history. And we haven't got a CLUE what the long term implications of covid's role in our brains is - but we know some things. We know it increases your risk of Alzheimers and Parkinsons, and we also know that the covid virus makes nanotubes through your brain, and then sets up shop there, and is often found permanently in your brain.
One of the reasons I truly believe that covid is AS GREAT a threat to us as Climate change is, is this - we are going to need every bit of big brain power that humans have to get through the coming decades. Every time we throw human being's greatest advantage - our capacity to think things through and solve problems - in the trash can so that we can eat at Olive Garden and not wear masks, we risk our future.
Moreover, we have already done incalculable harm to many people, particularly those who are most vulnerable. While traffic accidents are up all across the board by 16%, they are up even more among the unvaccinated. And while you might not have a lot of empathy for adults who don't vaccinate, the vast majority of unvaccinated globally are either adults who have no access (including in the US now that we've ended pandemic supports) and CHILDREN. We are damaging our children's brains on a huge and unprecedented scale, and it may be the thing that destroys us.
Feeling this really hard because I can absolutely see my cognitive decline - not in terms of puzzles (I still completely rule in word games) but general forgetfulness and brain fog and difficulty focusing at work. But what shall one do with that?