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Please share more of your understanding of the risks of long covid for teens and young adults. The closest parallel I can draw is Lyme Disease. I know people's lives who've been so significantly compromised from Lyme, and others who've recovered well. We still hike but are so much more cautious. Is that how we should think of Covid exposure for adolescents?

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Great question. We lack a lot of info about this, but what I would say is that all infections (flu, hand foot and mouth, strep, mono) have been linked with severe and unusual long term complications such as myalgic encephalitis (chronic fatigue) or autonomic dysfunction and the missing piece of information is do severe long term complications from covid occur more frequently than this relevant baseline for other infections. My guess is no. Certainly we have a lot of these upsetting cases now in the context of >30 million new cases of the infection suddenly, but moving forward as we hopefully see community transmission slow as vaccination spreads and we will see far fewer cases of rare long term problems develop. We will also learn more. I am not sure that’s helpful but it’s how I think about long covid in otherwise healthy teens and adults... :)

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Thank you, this is helpful! I did not know that all viruses create some autoimmune responses -- that is scary and reassuring simultaneously. I appreciate your generosity in sharing your expertise.

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Dr. Fradin - Thank you for this and for all the other insightful content you’ve provided over the pandemic! 

I caught up with some friends quarantining outside London and DC this past week. They were shocked to hear that people where I live in Texas (a major metro area) were wearing masks. “But the news says people in Texas aren’t wearing masks?” I was flabbergasted that two highly educated individuals were making simplified assumptions about such a large population (Texas is the size of France). 

I think schools where we live have brilliantly achieved the middle ground. For anyone interested in an on-the-ground anecdote to provide a tiny bit of nuance to their perspective of life in Texas: My kids are in K & 1st in public school. Their schools have universal masking (face shields only for snack and limited other times in 1st; no masks or face shields only at lunch); partitions between every workspace and lunch spot; daily health screener for each child that must be completed by guardian before school; certain screener responses trigger consultation with school nurse who determines whether covid test and/or quarantine is required before returning to school; no guardians allowed in the school buildings (except in the front office to pick up/drop off if necessary) all year; frequent sanitizing of everything of course; each Kinder kid does all indoor activities within a cohort for weeks at a time; classes rotate through recess locations so multiple classes aren't playing together; etc.

My concern is that we as a society are not bothering to look behind the oversimplified and disserving notions about life in other parts of the country. For example, are there people who are writing off Texas as anti-maskers and thus failing to examine the mitigation strategies that are being taken in schools where I live (16th most populous county in America) that have led to in-person school since September with very few cases of in-school transmission? The middle ground is being achieved in certain places -- I think our biases may be getting in the way of us seeing it and learning from each other.

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I hear you! Thanks for chiming in! I agree that the bias is a problem and often it all gets oversimplified, perhaps the media doesn’t help with this. In blue states or red states there are people behaving irresponsibly and cautiously. The out or school behaviors are what drive spread and those are even more difficult to understand or quantify.

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