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Underlying health conditions-the "truth"
Some time ago, @chilling pronounced that it was important to recognise that, for the vast majority of us, we need to realise that Covid usually only proves fatal for people with at least 4 underlying health conditions.
He also clearly believes that "truth" is an absolute. Whereas, as @Haysie (IMO quite rightly) pointed out, that is a naive position.
I'm sure a lot of people's first thought was:-"4 underlying health conditions! I don't even know anyone with 4. That is not relevant to me."
Now, I think @chilling does not fully understand some of the stuff he puts on here. But, I don't think he makes a habit of peddling completely false information. So-that led me to look into some stuff. What I discovered surprised me, so I thought I would share.
The starting point is that there is absolutely no medical or scientific consensus as to what amounts to an underlying health condition. Rather more surprisingly, what (for example) the US and the UK now believe counts has totally changed in the last 10 years. For example, my "underlying health conditions" have, in the last 10 years, risen from 0 to 4. Without my health changing.
Look at my 4 "health conditions", These are gleaned either from current CDC guidelines, or equivalent UK guidelines.
1. My weight/BMI index. 10 years ago, I weighed 3 stone more than I do now. However, I was not "morbidly obese". For this to apply, I would have needed to weigh over 21.5 stone, and have a BMI over 40. No longer. "Morbidly obese" has been replaced, and is now called various different things. For someone of 5 foot 8 (like me), the benchmark is no longer a BMI of 40. It is either 25 or 30 (it varies according to the expert). To put that into perspective, the benchmark is now somewhere between 12 stone and 14.5 stone.
2. Alcohol consumption. 10 years ago, the "safe" level of drinking in the UK for males was 21 units a week. In most of the world, it is still 21 units a week. Many experts 10 years ago believed that it was only at over 50 units a week there was a problem.
Now? The UK guideline is now 14 units per week. Which, incidentally, is still not applicable to me. But the new extra rule is that, as well as the 14, you should also not drink 6 or more units in a single day. Ever drink 3 pints of decent beer? Half a bottle of decent wine? Weekly? Fail.
3. Smoking. 10 years ago the benchmark was how long since you last smoked. Experts varied, but likely to be 2-3 years. Now? If you have ever smoked, that counts as an underlying health condition. My last cigarette was in 2006. Every life insurer will rate me as a non-smoker. But not the CDC.
4. There are various health conditions that appear to have changed. Now if you have ever had them, that counts. So-I had pneumonia. At 3 months old. In 1963.
There are others that beggar belief. Did you know that being over 65 years of age is a "health condition"? Whereas I think being over 65 is great, particularly when you consider the alternative.
"Truth" changes in an ever-changing world. And never assume that it does not affect you.
He also clearly believes that "truth" is an absolute. Whereas, as @Haysie (IMO quite rightly) pointed out, that is a naive position.
I'm sure a lot of people's first thought was:-"4 underlying health conditions! I don't even know anyone with 4. That is not relevant to me."
Now, I think @chilling does not fully understand some of the stuff he puts on here. But, I don't think he makes a habit of peddling completely false information. So-that led me to look into some stuff. What I discovered surprised me, so I thought I would share.
The starting point is that there is absolutely no medical or scientific consensus as to what amounts to an underlying health condition. Rather more surprisingly, what (for example) the US and the UK now believe counts has totally changed in the last 10 years. For example, my "underlying health conditions" have, in the last 10 years, risen from 0 to 4. Without my health changing.
Look at my 4 "health conditions", These are gleaned either from current CDC guidelines, or equivalent UK guidelines.
1. My weight/BMI index. 10 years ago, I weighed 3 stone more than I do now. However, I was not "morbidly obese". For this to apply, I would have needed to weigh over 21.5 stone, and have a BMI over 40. No longer. "Morbidly obese" has been replaced, and is now called various different things. For someone of 5 foot 8 (like me), the benchmark is no longer a BMI of 40. It is either 25 or 30 (it varies according to the expert). To put that into perspective, the benchmark is now somewhere between 12 stone and 14.5 stone.
2. Alcohol consumption. 10 years ago, the "safe" level of drinking in the UK for males was 21 units a week. In most of the world, it is still 21 units a week. Many experts 10 years ago believed that it was only at over 50 units a week there was a problem.
Now? The UK guideline is now 14 units per week. Which, incidentally, is still not applicable to me. But the new extra rule is that, as well as the 14, you should also not drink 6 or more units in a single day. Ever drink 3 pints of decent beer? Half a bottle of decent wine? Weekly? Fail.
3. Smoking. 10 years ago the benchmark was how long since you last smoked. Experts varied, but likely to be 2-3 years. Now? If you have ever smoked, that counts as an underlying health condition. My last cigarette was in 2006. Every life insurer will rate me as a non-smoker. But not the CDC.
4. There are various health conditions that appear to have changed. Now if you have ever had them, that counts. So-I had pneumonia. At 3 months old. In 1963.
There are others that beggar belief. Did you know that being over 65 years of age is a "health condition"? Whereas I think being over 65 is great, particularly when you consider the alternative.
"Truth" changes in an ever-changing world. And never assume that it does not affect you.
Comments
I wonder why they have changed so much?
The CT in me says to sell more drugs/charge more for insurance,etc.
There's nearly always money involved.
But that might just be me...........
But the insurance industry have not gone down this line at all. I don't think the root of this has anything to do with money.
Control? Not so sure
They want to turn old defunct cash machines into pop in health checker booths so no more going to the Doctor. just checkin !
Except, sadly that the NHS will do quite a few things to stop you actually seeing a GP...
Having 4 underlining health conditions contributing to over 75% of your COVID deaths, came from a lead US health source. Condescending as usual.
Obesity costs the NHS more than smokers,mainly because there are more illnesses relating to obesity than smoking.
You don’t see many 7or 8 year olds smoking, but with obesity,that’s not the case.
Set them for life.
Check your ‘ peddling’ facts.
Genes .
For instance,some can smoke for a few years and develop cancer through doing that.
Some can smoke their whole life and never develop cancer.
Same with drink, heavy or light drinking,some develop life threatening illnesses , some don’t.
This is the area that has been studied for years, and they still don’t know why some folks get ill and some don’t. Illnesses that are inherited are a big part of the science research.
Not saying it should be (I'm not). Just that it is.
Reason is simple. And, indeed was the point I was making. Life is vague. Truth is vague.
Not saying it should be (I'm not). Just that it is.
‘ chilling pronounced’ about underlining health conditions.
Not the director of the CDC then, Rochelle Walensky? Joker.
Not the director of the CDC then, Rochelle Walensky? Joker.
You didn't quote your source.
Nevertheless, I was sure your statement would have had a factual basis.
Therefore, it necessarily followed that, while the statement was factually correct, it was causing me to misunderstand the basis on which underlying health conditions were calculated. So i checked.
For you, that may well be "joker".
For me, it is "deductive reasoning", followed by "presenting empirical evidence to show why "underlying health conditions" have no precise definition, and have changed sufficiently to show why your statement is both factually correct and gives rise to very different conclusions than you (or me) might first think".
Yours is more concise. Still think mine has the edge, though
Nevertheless, I was sure your statement would have had a factual basis.
Therefore, it necessarily followed that, while the statement was factually correct, it was causing me to misunderstand the basis on which underlying health conditions were calculated. So i checked.
For you, that may well be "joker".
For me, it is "deductive reasoning", followed by "presenting empirical evidence to show why "underlying health conditions" have no precise definition, and have changed sufficiently to show why your statement is both factually correct and gives rise to very different conclusions than you (or me) might first think".
Yours is more concise. Still think mine has the edge, though
It wasn’t even stated in one of my posts.
It was a vid VespaPX posted.
@Essexphil , get off the pitch ffs,bring the tea lady on.
Like whether it really was a penalty, offside, or a justified sending off, may be coloured by which team you support, and both sides will claim to be telling the truth, but never agree.
Your opinion of the performance of the government may be biased in respect of the party that you usually vote for, yet we all believe our own truth.
If you read an article in The Daily Express regarding this government, and read a similar article in The Mirror, you may be forgiven for thinking that each article was describing a different government. Yet both journalists would be claiming to be telling the truth.
The truth is anything but simple, and straightforward.
Let's take Civil and Criminal Court cases as an example.
In the former, 2 sides tell different versions of the truth. And a Judge decides which version he prefers. The winner is not "right", the loser not "wrong". No more than, on balance, 1 side was more than 50% believable on the day. And the other, less than 50%.
Criminal cases are even more ridiculous. You see the people found Not Guilty proclaiming that "justice" and "truth" have won the day. Get a grip-all that was proved is that the other side could not prove beyond reasonable doubt that they were Guilty
Or, as 1 of the Solicitors who trained me used to say:-
"In our adversarial Court system, 1 man's justice necessitates another man's injustice".
Mind you, he also used to yearn for the days when the Solicitor was the only person in the village who could read and write. I think the internet would have blown his mind
This continues after the verdict has been reached, the case appealed, and the matter settled.
Going off on a tangent.
I sometimes wonder how the police solved any crimes before the technology we have today came into use.
They seem to rely on modern technology to solve a very high percentage of crimes.
I was reading a book the other day, where they were able to tell that a guy was lying, by examining his smart meter, and could pinpoint the time that he arrived home and showered to wash his wifes blood off, and wash the clothes he was wearing.
In the same book they were able to tell that a woman was lying in her account.
They had CCTV footage confirming the times that she arrived and left a murder victims home.
She claimed that just prior to leaving she walked with the victim to the shore, and left while he was still alive.
They could tell from his StepsApp that the last step he took was 90 minutes before she left.
Where will it end?
You need to be able to make judgements without absolute certainty in order to navigate simple daily life. Any of your electrical appliances can start a fire, your boiler could poison you with carbon monoxide - that doesn't stop us from declaring those things "safe" on average, and giving people confidence to install heating and lighting.
You can't be the expert on everything so we're reliant on others to tell us what is safe, or what might improve our health. That makes us vulnerable to misinformation of course, but not everyone is out to trip us up. Let's dig deeper into the things we care about, place trust in others for the things we don't and make our judgements from there.
So back to the subject of the "underlying health conditions" or risk factors. Everyone likes to think they're healthy if they have no current symptoms, but it ignores the fact that you are at risk. Everyone is healthy until they're not.
It doesn't really matter what the accepted line for morbidly obese is, simply that there is a healthy range and the further you get from the range (underweight or overweight), the more likely you are to have or develop issues. Just because one expert might draw the line in a different place, or that the BMI isn't the best measure for an individual, it doesn't break the overall principles or guidance. I've heard people argue they can be fat and healthy, which is fine, but they might be healthier (or at lower risk) without the fat.
You seem to suggest that pneumonia is less relevant as it's from 60 years ago and when you were very small. Hasn't killed me yet so won't kill me now. To assess your own risk get some scans done, it might show you have significant lung scarring, it might show you have none. It doesn't negate the point that having had pneumonia at some point in the past is increasing the risk on average, and is more relevant when a respiratory virus is doing the rounds.
Likewise, being over 65 might be "great" but you'll have to use all of your powers of persuasion to state that on average people over 65 are healthier than those under. Even you might need to concede that the older you are over 65, the higher your mortality rate - and if that classifies it as being a 'health condition', so be it, we understand what it means.
Just because it's difficult to establish absolute truth, or 100% certainty, does not mean we'd do better to ignore everything we know in the moment.
1. No-I am not saying we need 100% certainty. What we do need is information presented in such a way as we can make judgments on what people actually mean, and not what we think they might mean. Rest of the first, and 2nd paragraphs-totally agree.
2. Third paragraph. Agree Would only add that there are some occasions when (for example for political purposes) people do things that unintentionally cause people to read information incorrectly. I will come back to that. Agree with 4th paragraph.
3. I particularly agree with the points you make about the "accepted line" for morbidly obese. It is exactly correct your point about the range. It is exactly my point that it should not be some arbitrary line drawn in the sand saying "health condition" and "not health condition". As you say, it is the range that is important
4. In relation to pneumonia, you misunderstand what I am trying to say. I am saying that pneumonia 60 years ago is, all other things being equal, less relevant than pneumonia last month. But no more than that. Is it potentially relevant when you contract Covid? Of course it is. The only reason I don't know the answer about lung scarring is this. I suffered quite badly from Covid. Most parts of my body had more severe reactions than the average. The 1 part of my body that got it less severely was my lungs. Which is almost certainly entirely due to luck. But, believe me, it was at the forefront of my mind at the time.
5. The only bits I disagree with in the rest of your post on the 65 bit "we know what it means" and your conclusion. I wish you were correct. You should be correct. But I will explain why I disagree.
(1). The starting point is the arbitrary line drawn in the sand. Medical science is far more nuanced than "health condition" and "not health condition". Once you start condensing a range into just 2 categories, it becomes distinctly less scientific
(2) There has clearly been a seismic shift in where people have decided that line to be placed. I am not a scientist. But, to give a distinctly unscientific example, it seems to me that the line has been moved from (say) an additional 1% chance of death or more from a condition this year, to (say) an additional 0.1% chance this year. There is a simple reason why my guesstimated are unscientific-there is no science in the placing of the line. Compare and contrast with the enormous wealth of scientific info on all the relevant conditions.
(3) I am not saying the line is in the wrong place now. What I am saying is that lots of people are ignoring what medical experts are saying. Simply because no-one is told about how the line has moved. And thinking what experts are saying in no way applies to them. When it does. The information is not "wrong". But people are making incorrect assumptions about whether it is relevant to them. Because (regardless of anything else) lots of people have gone from 1 side of a line to another. Without realising.
What I would say is that when the government or whoever speak to millions of people at once, it's necessary to make simplifications. Yes when you talk in generalities you lose the scientific nuance, but the messaging is more effective when you can get it right for the majority by making shortcuts to illustrate the point.
For an individual these things are still generally true, but less relevant, it's the old adage "age is just a number" - age is a shortcut for all the other things associated with age, if you don't have any of those things at say 70 and are equally as fit as the average 40 year old, then where the line is set doesn't matter at all. What I meant by "we know what it means" is that when all over 65s are lumped together we should know that a 65 year old is not taken to be equivalent to an 85 year old in terms of health. Some people can work until they're 80, others need to retire before 60, but somehow we have to set the retirement age for all.
I'd like to think there was some rationale behind where lines are placed, at an inflection point or where a gradient becomes noticeable steeper, but again and as you say the actual line placing is less relevant than where we are on the distribution - unless something fundamental has changed - for example pre-covid we might have said it was very dangerous for someone aged 110 to go into a crowded space, and at the height of covid we might now revise that to 65 or 70 or whatever. We've always known that 110 year olds would be more vulnerable than 70 than 40, but the environment has changed, so the stakes have increased for each category.
So you're right, I think I did miss the point you were trying to make, which was to highlight that "underlying health conditions" are wider than the obvious and most hazardous ones, and people may need to be more cautious than they'd realised - and that's a fair point. The state of the individual hasn't changed but they are at greater risk now because the environment has changed. I thought you were suggesting that there is no truth so we can't trust anyone and people are arbitrarily drawing lines. Apologies!