COVID-19 Megathread 6: Return of the Omicron

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

After they said "Masks don't work" and "COVID is not airborne" while attempting to manipulate public opinion to prevent panic or a run on available masks or whatever, maybe they should refrain from trying the "white lie" strategy again.

As I said before, although you ignored it, no scientist ever gave those quotes.

The WHO is not "a scientist," it is an organization, but it was spreading this incorrect information back in March 2020, with literally those exact words in its public communications:

https://twitter.com/WHO/status/1243972193169616898

You could find similar things from the CDC for example (likewise not "a scientist," but an organization).

In fact, if you read the fine print in the picture embedded in the twee, they actually called the truth that COVID is in fact airborne to be "misinformation" !!!

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

The WHO is not "a scientist," it is an organization, but it was spreading this incorrect information back in March 2020, with literally those exact words in its public communications:

I don't know how to explain that WHO tweet. They shouldn't have posted that.

If you want to know why, read these two articles. It is an interesting example of how science works. Scientists are human and certainly can make mistakes in the short run. But the good thing about the scientific method is that in principle it is eventually self-correcting.

https://www.wired.com/story/the-teeny-tiny-scientific-screwup-that-helped-covid-kill/

https://www.nytimes.com/2021/05/07/opinion/coronavirus-airborne-transmission.html

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

Moderna did a review of people who were 13 months out from their trial and found only 1% breakthrough infection rate(162 out of 14,000) and even lower numbers of severe cases and hospitalizations.

That is nice, and certainly better than if it were higher, but it is not a particularly statistically useful way to look at it. The correct way to measure efficacy would be to compare to a control group, because during the period after they were vaccinated, the entire population did not become infected, only a sub-portion of it. You would also want to compare to an unvaxxinated control group within the study (which I don't think exists any more for obvious ethical reasons) rather than the general public, because there is probably selection bias - people who choose to participate in vaccine studies are likely to be more health conscious in general and more likely to exhibit behaviors such as consistent mask wearing and being more careful/conscientious than average.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

Population adjustment would suggest that far, far fewer Americans have died of COVID-19 than the Spanish flu.

Yeah, that is really the proper comparison, for purposes of looking at how bad it was relatively in terms of policy etc. Of course, in terms of raw human suffering, the raw absolute number of dead is certainly a relevant metric.

BTW, this is also a reminder of just how bad a real modern war could be. If you thought World War 1 and World War 2 were bad, just consider that world population has grown massively since either of those... A modern war - a real war, not something minor like disturbances we have seen in places like Iraq, Afghanistan, and Syria over the past twenty years - on the scale of the earlier World Wars could lead to devastation and destruction of a magnitude that nobody can truly contemplate or truly understand. Good thing we have avoided that. So far.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

https://twitter.com/mrsshap/status/1438214618623709186

its a good thing I am not a parent! If I were a parent and my child's school was closed over covid I would be banging on the front door, screaming and cursing, until they opened it.

You are right, it is a good thing you are not a parent, your reaction would make your kids seem like the adults in the family in comparison to you. Schools commonly closed in the past because of flu outbreaks, much less COVID.

From 2018, for example:

Schools Across the Country Are Closing Because of the Flu

It's not unusual for schools to periodically close during the winter months, but this season, schools across the country are canceling classes for a reason that has nothing to do with bad weather. As the flu epidemic continues to intensify, many schools are being forced to close due to the increasing number of sick kids and staff. While some have closed for just a day, others are closing for a week at a time in order to deal with this startling situation.

Although there's no official count for the number of schools closed because of the flu, there are reports of a variety of closures across 12 states. From Florida and Oklahoma to Illinois and Arkansas, officials are closing schools not only because of the number of students who are sick, but also to hopefully keep it from spreading.

Gull Lake Community Schools in Michigan were closed "due to high illness rates," while one school in Texas declared a "flu day" after state officials told anyone who was sick to stay home. In Arkansas, the Russellville School District closed all of its schools "due to the high number of students experiencing flu-like symptoms."

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

You are proving my point. It was never wide spread to close schools over every little risk.

COVID is not the flu. The point is that even over the flu, schools commonly closed in the past. So for schools to be closed over something much more serious such as COVID, you should be even less surprised.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

It's getting very late in the game-vaccinated people who have done everything right need to be able to live normal lives. If one more month would save lives then sure, but this can't go on forever. Very soon, there is no alternative but to let it rip among the unvaccinated-if they die sorry but they should have taken more personal responsibility for their health.

We pretty much have been letting it rip amongst the unvaccinated in the USA. That is what 2000 deaths a day is. Or, alternatively, it is almost equivalent to the number of US combat deaths in the 20 year long Afghan war, in a single day.

If 2 9/11s every 3 days, or almost 20 years worth of Afghan war combat deaths every day and having hospitals run out of ICU beds in many parts of the country isn't letting it rip, then I shudder to think of what letting it rip is.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

Well schools are open where I live and there is literally nothing you can do about it. hahaha

What a bizarre comment from a red avatar. You think you are owning the libs because schools are open or something?

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

If it mutates it mutates, that will happen regardless of how high cases are in the US and can't be used to guide policy for any one country.

Underrated point. The world needs a global policy towards COVID. This is, at present, totally lacking.

Viruses do not respect national borders, and even with extremely strong border restrictions it is difficult to impossible to totally restrict.

Just as it is absurd and ineffectual to have COVID policy set on a state/local level within the USA, it is absurd and ineffectual to have COVID policy set on the national level without international coordination and planning.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

I'm not sure if the US has so many spare vaccines they can do boosters and get billions of people in developing countries vaccinated but boosters seem wasteful since the double jabbed are so well protected. It's different for the double jabbed who are still old or vulnerable and for children who are of course not jabbed and so coukd use protection against Covid.

It is not an either/or. We could be producing much more vaccines if we wanted to. If we were taking this seriously, like we ought to be, the only thing that should be limiting vaccine production is if we run out of the raw materials needed to make more vaccines. As far as I am aware, that isn't the case.

In World War 2, the US Government didn't just sit back and say, "Hey Boeing, great job designing that B-17 bomber. Now we'll leave things up to you, and hope that you just make as many as you can with your existing productive capacity and run things yourself. And we have to prioritize protecting your intellectual property rights above winning the war, so we won't bother to re-purpose other non-Boeing factories to produce more."

Instead, the government stepped in and made sure that maximizing war production of all sorts of tanks, ships, planes, and munitions was the number one priority. Huge numbers of new plants were opened and existing plants were re-purposed to produce war materiel instead.

But today, we can't have that for vaccine production, because this would be government "interference" in the free market which would violate neoconservative economic dogma that Biden buys into, which goes back to the Reagan era.

And so we are not expanding production of vaccines any more than Moderna/Pfizer might wish to do so on their own volition in their own plants. We could be doing so, both by forcing more new plants in the USA to be opened, and also by finding a way around the intellectual property rights issue so that highly effective American vaccines (e.g. Moderna) could be manufactured in other countries as well.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

I just don't see how we will ever have another bad surge.

Delta basically infected most people who were unvaccinated.

90% of americans have either natural or vaccine antibodies.

I just don't see the math working out for another surge.

maybe a surge of breakthrough, mild cases.

The problem is that immunity doesn't appear to last forever. If it did, we could achieve herd immunity and everyone would just either get infected one time or else get vaccinated, and then we would be done with it forever. But immunity decreases over time. So people who have been previously infected will over time become infected again. And likewise with many people who are vaccinated (unless booster shots can solve that problem - we'll have to wait to find out the answer to that one).

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

Is it right that COVID-19 is easily identified in an autopsy?

I am getting a booster and at the first chance a flu shot so that I do not get a respiratory infection that can be confused with COVID-19. There are just too many fools in the county in which I live.

It is actually not necessarily a good idea to get your flu shot ASAP. Of course, you should get a flu shot (everyone should), but the question is when. Flu vaccines have diminishing efficacy with time similar to e.g. the Pfizer COVID vaccine. So ideally you should try to get your flu shot a bit before flu season hits its stride, but not too much before, that way you will have the strongest protection during the peak of the flu season.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

Have you read something that documents mass outbreaks among those who have had covid previously and/or been vaccinated? How many are left who have had neither? Does anyone know? I want the data and I want it now

There have been some mass outbreaks among heavily vaccinated populations. Here is a study about an outbreak in a prison, which was ~80% vaccinated. Overall, 93% of unvaccinated prisoners were infected, and 70% of vaccinated prisoners. Moderna was more protective than Pfizer, but even with Moderna 54% got infected, whereas 85% of Pfizer vaccinated prisoners were infected.

https://www.cdc.gov/mmwr/volumes/70/wr/mm7038e3.htm

So you can pretty clearly see the issue with waning immunity and reinfections from that.


Also... another thing I think probably a lot of people are not considering/understanding is that evolution of a new variant after Delta is not just a question of if the variant is vaccine resistant. It is also a question of whether it is DELTA ANTIBODY resistant. Different variants produce different antibodies upon infection, and someone who has been infected with Delta may be immune to re-infection with Delta specifically but not immune to re-infection with a different variant. Incidentally, that is part of the reason why we don't have a Delta-specific vaccine now and are still using the old vaccines, it is because if they made a Delta specific vaccine it would be less protective against other variants, since most other variants are more closely related to the original COVID strain than to Delta.

So, if hypothetically, the entire population were infected with Delta and became immune to that (and if that were permanent immunity), then what we would expect to probably happen would be for another variant that doesn't get defeated (or not as well/easily) by Delta antibodies to evolve. We should certainly worry about the possibility of vaccine resistant variants, but that is not the whole story, and we could have another wave hypothetically of some other variant through the unvaccinated population even if that other variant is not vaccine resistant at all.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

I am confused as to how omicron is killing people while at the same time, not resulting in many people needing ventilators?

Wasn't everyone that was dying of covid dying because they literally could not breath?

If people are dying, but not due to their lungs failing, what are they dying from re: covid?

What is omicron's upper respiratory/sinus nature targeting that is killing people?

Pre-Omicron variants of COVID-19 such as the Delta variant and going back to the original version were infectious because they spread well by docking to ACE-2 receptors in human cells. But in addition to that, they were helped in binding more efficiently to ACE-2 receptors by an interaction they had with TMPRSS2 proteins, which made the binding of the virus' spike protein with the ACE-2 receptors even more efficient.

Now, guess what particular cell in the human body just so happens happens to have a lot of TMPRSS2 proteins (as well as ACE-2).

...


That's right, the Alveoli cells in your lungs.

...

So this combination of lots of TMPRSS2 and ACE-2 in your lungs is what made previous variants of the virus so good at spreading rapidly in the lungs, and consequently at causing ARDS (Acute Respiratory Distress Syndrome). ARDS is what most people think of when they think of severe COVID symptoms, and that is what leads patients to be put on a ventilator and, if they are unlucky, to eventually drown to death in their own lung fluids.

What changed with Omicron is that it binds even more effectively with ACE-2 receptors than Delta and other variants. However, by sheer luck of the draw in the process of random mutation, it happens to have been the case that the same mutations that made Omicron even more efficient at infecting via ACE-2 also happen to have made it less efficient at using TTMPRSS2 proteins to help facilitate the process of infection/spread.

This is the thing that makes Omicron, on average, "milder" than Delta and other variants on the level of an individual person who is infected (albeit not necessarily for society and the healthcare system as a whole, given the rapid spread). We are VERY lucky that this happened to be the case, because if it were not the case, then Omicron would spread even more efficiently than Delta and other variants in the lungs, and presumably ARDS would be even more common than with Delta.

So what this means is that Omicron is less effective at infecting Alevoli (lung) cells because of all the TMPRSS2 in those, but is also (in general) more effective than previous variants at infecting most other cells in the human body - which tend to have large amounts of ACE-2, but which don't have much TMPRSS2.

However, I presume that over the last year or two you have probably read at least some articles about how COVID-19 infects other organs besides the lungs, such as your brain, heart, kidneys etc, and can cause organ damage, strokes, heart attacks, etc as a result.

Now, consider the fact that Omicron is more efficient at Delta in spreading within other organs, with the one major exception of the lungs. This means that although you would expect to see less frequent ARDS per infected patient, one would also expect to see at least as much frequency of other harmful effects of the virus, such as myocarditis, strokes, heart attacks, neurological symptsom, kidney failure, and other assorted organ damage. In fact, if anything, one would expect to see more of that and for those non-ARDS-related symptoms to be more harmful than with previous variants, due to the fact that Omicron spreads more efficiently in most other cell types besides the Alveoli.

So, the reason why patients are dying even when ventilator use is down is that you have less ARDS per infection, and consequently less need for other ventilators, but you still have all the other symptoms and organ damage that COVID can cause, and may well even have more of that than before per patient (although I don't think that is definitively known yet).

This is also the reason why anyone who thinks that Omicron is "just a cold" and you should "just get it over with" etc is taking a major risk with their health. Because, although it is true you are less likely to get ARDS from an Omicron infection (although there is still more than enough of that) than from other variants, you are probably at least as likely, if not more likely, to get other harmful symptoms from Omicron than you were from other variants that were less effective at spreading in non-lung cells. And if you get long term organ damage as a result of your infection, then you will be lowering your future life expectancy. Organ damage which you may get as a result of your Omicron infection then becomes is a "pre-existing condition" or "co-morbidity" which is likely to increase your chance of dying or suffering severe disease if you are subsequently re-infected with a different COVID-19 variant in the future. Repeat this cycle of being re-infected with different variants every year or so enough times, and your chances of getting a co-morbidity from a previous infection which makes your future infection worse starts to become something you ignore at your own peril.

Another thing that everyone should be aware of is that it's pretty likely that the next variant won't be related to Omicron, but is more likely to be related to one of the earlier variants (or to come out of left-field entirely). Why is that? Well, for one thing Omicron was not related to Delta. And Delta was not related to Alpha. So we have plenty of precedent at this point for new variants arising which are not related to the previously dominant variant.

There is also a logical reason why you would expect that to be the case. That is that by now - and certainly by the time this Omicron wave has receded - the great majority of people in the world, and certainly the great majority in the United States, will have some degree of immunity from a combination of previous infection and/or previous vaccination. And in particular, after the Omicron wave, most people will have some degree of immunity, if only temporarily, against Omicron itself in particular. If you have just been infected with Omicron, you are likely to have more immunity to another variant which is similar to Omicron than to another variant which is dissimilar from Omicron, and therefore not descending evolutionarily from Omicron.

So as a result, one of the main ways that new virus variants are likely to be more efficient at spreading than previous variants is not necessarily by being intrinsically more transmissible than previous variants, but rather by evading the immunity of people who were infected with previous variants. Other things equal, you would expect that a future variant which is related to Omicron to be less efficient at evading the immunity of people who have been recently infected with Omicron than a future variant which is un-related to Omicron.

And if a future variant is un-related to Omicron, it won't be descending from a virus with the mutations that make Omicron less effective at infecting the Alveoli with TMPRSS2. It will instead be evolutionary related to and descended from a previous variant like Delta, Alpha, Epsilon, Mu, the original variant, or whatever else out of left field. And if it is un-related to Omicron, then there is no particular reason to think that it will have the same mutations as Omicron which happen to make Omicron less efficient at infecting lung cells in particular (even while making Omicron more efficient at infecting human cells overall). And that means that the next variant is more likely to efficiently use TMPRSS2 to help infect lung cells and thus cause more ARDS again, similar to the other previous non-Omicron variants. Or maybe it won't. Maybe we'll get lucky. But maybe it will. There is no particular way to know in advance. Just, "do you feel lucky?"

Every other dominant variant, with the one exception of Omicron so far, has been more severe than the previous one, and we also know that other beta-coronaviruses such as MERS and SARS-1 are more severe and have higher fatality rates than COVID-19. That is worrisome, and means there is potential for things to get worse, even after (seemingly) getting temporarily better on the level of the infected individual spared of ARDS with Omicron. But that is also by no means guaranteed, and for all we know things could go the other way entirely.

So for the foreseeable future, it seems that we are likely to continue this cycle of having a couple new variants each year, which may be more severe or alternatively less severe. One would suspect that probably some will be more severe, some less. There will probably be some nothingburger waves with nothingburger variants, which then get followed up by a really horrendous wave. Or vice versa. Once an Omicron-like wave has swept through the population, the population will have some temporary immunity to an Omicron-like variant. So then a non-Omicron-like variant will evolve. Then the non-Omicron variant will sweep through the population, giving the population some temporary immunity against that. And then another new variant will evolve, which may be more like Omicron, or alternatively could be something else entirely.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

Because they're going to do literally the opposite of whatever the Dems are doing, purely for the sake of it. If Democrats started opening back up and saying the pandemic is over, wait a few months and you'd start seeing Republicans attacking that and wanting restrictions.

Unironically good analysis. It is a difficult situation with no easy choices and no easy answers. Democrats attempt at least somewhat to think through those choices and figure out which is the best (or rather, least bad) policy, and come to varying conclusions within some range. Republicans don't think at all though, they just look at the Democrats and do the opposite of whatever most of the Democrats seem to be doing.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

You still have to wear a mask in any Las Vegas casino.  
You can’t claim America is a free country while this is true.

lmao, that's the most hilarious thing I've read this week

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

However, cases are clearly falling so in the long-term the death toll from Omicron should be lower.

Unfortunately, that is probably incorrect because:

a) People will get (and already are getting) re-infected, and it does not appear to be the case that reinfections have a greatly lower fatality rate or morbidity rate as compared to initial infections. Partial immunity from antibodies seems like it may wane faster than with Delta, and there have been some studies suggesting that T cells don't provide strong or relatively long lasting immunity from an omicron infection unless it severe.

b) The fact that it is more contagious and infecting more people means that there are more hosts within which additional future variants can evolve, further increasing the probability that additional new variants which further evade prior immunity both from infection and from vaccines evolve.

The central problem is that immunity is short-lived. Unless and until something changes with respect to that, we are going to keep having additional waves over time.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

Recent deaths in Florida have been very, very low. That's another indicator that the continuing deaths probably are Delta.

lol Mr Scientist (that's a great nickname for you)




https://www.msn.com/en-us/health/medical/florida-covid-update-seven-day-death-average-is-the-highest-recorded-since-october/ar-AATldQz

Florida COVID update: Seven-day death average is the highest recorded since October

Michelle Marchante, Miami Herald - 41m ago

Florida on Monday reported 34,204 COVID-19 cases and 618 new deaths to the Centers for Disease Control and Prevention, according to Miami Herald calculations of CDC data.

The CDC backlogs cases and deaths for Florida on Mondays and Thursdays, when multiple days in the past had their totals changed. In August, Florida began reporting cases and deaths by the “case date” and “death date” rather than the date they were logged into the system.

Of the deaths added, about 98% occurred in the past 28 days and about 63% in the last two weeks, according to Miami Herald calculations of CDC data.

In the past seven days, the state has added 180 deaths, on average, the highest recorded since mid-October, according to Herald calculations. In the past seven days, the state has also added 26,854 cases per day, on average. Florida has recorded a total of at least 5,535,803 confirmed COVID cases and 65,265 deaths.

https://news.yahoo.com/covid-tallahassee-hospitals-report-highest-200559067.html?guccounter=1&guce_referrer=aHR0cHM6Ly9kdWNrZHVja2dvLmNvbS8&guce_referrer_sig=AQAAAEHrx_2_iEsB-k58aLvapCUchj81r-H72e7Y9lloQHbaePQmul7fTZH_Knv-SetH4DnSasctVd8sGmfT_upofKr2qpywlMWdRzYD8RBm_NrPZf-Lkm0Xy34-4SLKSmFM3PhxHq5GZXmlPs15nqkgCedKmJ8wJASaRVOKPhQ8zwdp

Tallahassee Democrat
COVID: Tallahassee hospitals report highest monthly death count since October; cases fall over 22%
Mike Stucka and Christopher Cann
Mon, January 31, 2022, 9:05 PM·6 min read

Tallahassee hospitals have reported their highest monthly count of COVID-related deaths since October, when the delta variant was raging through the community.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

Worldometer says Florida is averaging only 29 per day, and is declining.

Please tell me that you are not this dumb.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

Worldometer says Florida is averaging only 29 per day, and is declining.

Please tell me that you are not this dumb.

Just a few minutes ago, it fell to 22.

sigh

https://www.govtech.com/health/fla-changes-how-it-counts-covid-deaths-misleads-public

Fla. Changes How It Counts COVID Deaths, Misleads Public
As the COVID-19 delta variant has led to record infections and hospitalizations in Florida, the state's health agency has altered the way it reports COVID-related deaths, creating a misleading downward trend.
August 31, 2021 •
Sarah Blaskey, Ana Claudia Chacin, Devoun Cetoute, McClatchy Washington Bureau

(TNS) — As the delta variant spreads through Florida, data published by the Centers for Disease Control and Prevention suggest this could be the most serious and deadly surge in COVID-19 infections since the beginning of the pandemic.

As cases ballooned in August, however, the Florida Department of Health changed the way it reported death data to the CDC, giving the appearance of a pandemic in decline, an analysis of Florida data by the Miami Herald and el Nuevo Herald found.

On Monday, Florida death data would have shown an average of 262 daily deaths reported to the CDC over the previous week had the health department used its former reporting system, the Herald analysis showed. Instead, the Monday update from Florida showed just 46 “new deaths” per day over the previous seven days.

The dramatic difference is due to a small change in the fine print. Until three weeks ago, data collected by DOH and published on the CDC website counted deaths by the date they were recorded — a common method for producing daily stats used by most states. On Aug. 10, Florida switched its methodology and, along with just a handful of other states, began to tally new deaths by the date the person died.

If you chart deaths by Florida’s new method, based on date of death, it will generally appear — even during a spike like the present — that deaths are on a recent downslope. That’s because it takes time for deaths to be evaluated and death certificates processed. When those deaths finally are tallied, they are assigned to the actual data of death — creating a spike where there once existed a downslope and moving the downslope forward in time.

Shivani Patel, a social epidemiologist and assistant professor at Emory University called the move “extremely problematic,” especially since it came without warning or explanation during a rise in cases.

Patel said Florida death data now show an “artificial decline” in recent deaths and without an explanation or context, and “it would look like we are doing better than we are.”

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

You know the BlueAnon crowd will jump in and claim that it's somehow fake.

C'mon, make an effort. This is sad to see.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

People like you are why Republicans will win in 2022 and 24.

C'mon, don't make such patently obviously specious arguments like that. Everyone with half a brain knows that the reason why Republicans will win is because the US has a polarized FPTP 2 party electoral system, and whichever party doesn't control the Presidency is basically always going to lose as a result out of a mixture of complacency on its part and motivation on the part of he out-of-power party. Individual "issues" and people making claims about issues that you or anyone else may think are wrong are just the background noise upon on which that process occurs.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

No, it really does not exist.

You literally recced this.

You don't want to get long covid. Get your boosters!

A lot of people (none more than jamestroll) are being very cavalier about their long term health with regards to long covid.

If you are 20-30 years old, I think it is probably hard to truly imagine what it means to live to age 80 or so. Naturally, you tend to value the present, and undervalue the future (especially the far off future which does not quite seem real).

If the general public keeps getting COVID as often as currently, and if nothing else changes, people who are young today will get COVID 30, 40, 50, or maybe even more times in their life.

Even if any individual infection (in particular the earlier ones, when you are also younger) is likely to be mild, what are the cumulative effects over a long period of time of being infected, and then re-infected, and re-infected again and again? If your 4th infection is "mild" but does some small damage to your cardiovascular system which you would not really notice other than being a bit tired for a month, what effect does that cardiovascular damage have on the severity of your 26th re-infection which you get 2 decades later? Accumulating damage both to your cardiovascular system and to your brain/nervous system (2 areas where even mild COVID has been shown to do detectable damage) over an extended time seems like it can't be good.

Studies so far do not seem to be showing that risk of either long COVID or of serious illness/hospitalization goes down with repeated infections, and if anything it may even go up as some studies have found.

Suppose the probability of getting some significant form of long COVID is 5% (a reasonable conservative estimate, based on what I know). That means if you are infected once, there is a 95% chance that you will have no issues. Sounds like pretty good odds!

But if you get infected twice, and you have an (independent) 5% chance both times, you have a 9.75% chance of getting long COVID from at least one of the two infections.

The math can be hard to get intuitively (people are naturally not suited to understanding probabilities), so here are some specifics calculating that out for repeat infections.

Get infected 5 times - 23% chance of long COVID
Get infected 10 times - 40% chance of long COVID
Get infected 20 times - 64% chance of long COVID
Get infected 50 times - 92% chance of long COVID

92% chance is close to certain. Of course, this does assume that the probabilities of long COVID (or whatever other consequences) of infection are independent for each particular infection, but based on what is known so far, we don't really have any better hypothesis than that.

So the more you repeat something with a small (maybe even negligible?) chance of a bad outcome, the more certain it becomes that you will experience the bad outcome. In other words, you can only play Russian roulette so many times before something bad happens.

If we had vaccines that actually stop infection and transmission (supposedly nasal vaccines might do this, though even that is not certain), that could make a massive difference in avoiding these potentially devastating long term health effects, but Congress has stopped funding anything related to this thanks to Mitch McConnell and the Senate Republicans (all of whom are old, so do not need to worry about the possible cumulative effects of 50 lifetime reinfections since they will be dead long before they can be re-infected that many times).

Private pharmaceutical companies like Pfizer and Moderna also have 0 real incentive to develop vaccines that actually stop infection and transmission on their own without government support, because with the status quo they can make more money by constantly re-selling booster vaccines. Vaccines that are (relatively) effective against hospitalization but not against infection are the best possible business plan they could ever hope for.

Despite the fact that young people are more blase about COVID in general, it seems to me that in reality this is actually a much bigger problem for young people than for old people. Young people are being irrational and ignoring the future by pretending this problem does not exist rather than trying to do anything to deal with it.

Bottom line, if you care about your long term health and if you are a young person, you should really be wearing a high quality N95 or better mask any time you are in a public place indoors.

Ironically, if you are an old person, it is actually less important to wear a mask and protect yourself from repetitive re-infections, since you will be dead relatively sooner (compared to young people) regardless and the "long term" health effects you could potentially suffer will be less long than for young people. And as a society/government we should be requiring that air quality in all public indoor spaces be improved up to safer standards of ventilation and air filtration. This could avoid lots of infections, and hence could reduce the average number of infections the average person might get over the course of their life from 50 to 20 or 10 - which would make a tremendous difference if my math is even approximately right.