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There's More to COVID than the Death Rate

The goal of medicine is not just to save lives but also to reduce the burden of disease and prevent disability. Vaccines do that too.

This article was originally posted in the Montreal Gazette.


If someone tries to convince you not to get vaccinated against COVID-19 at some point they might tell you the mortality rate from this disease is so low that vaccination does not matter. First, it’s worth pointing out that there have been more than 6 million officially reported COVID deaths worldwide, and estimates suggest the vaccination campaign saved anywhere between 14 million and 20 million lives. But the argument of a low mortality rate is flawed for another important reason that goes beyond these facts. It ignores that the goal of medicine is not just to save lives but also to reduce the burden of disease and prevent disability. Fortunately, the vaccines do that too.

It is easy to forget that one of the major issues regarding COVID-19 infection is the vascular side-effects. While the virus is a respiratory infection, it can also damage the heart, cause a stroke and lead to blood clots. While some people are focused only on mortality numbers, we should remember that one might survive a bout with COVID-19 but be left with long-term complications. One may survive a stroke only to be left with permanent disability. One may survive a heart attack only to be left with heart failure.

Most people seem to have underestimated the cardiac complications of COVID-19. While many have become fixated on the issue of post-vaccine myocarditis, they have failed to realize that post-infection cardiac damage is orders of magnitude more common. In fact, myocarditis post vaccine is extremely rare, generally mild, short lived, and seems to have been largely confined to the group of young adult men and was possibly just a consequence of the shorter vaccine interval used during the initial vaccination. It is worth noting that there was no signal for an excess myocarditis risk in the pediatric trials.

In fact, recent data in the Journal of the American Medical Associationdemonstrate that COVID vaccination is likely protective in terms of heart attack and stroke. Researchers in Korea used the country’s national patient registry to analyze data on over 200,000 patients who caught COVID during the study period from July 2020 to December 2021. Their analysis found that vaccination reduced the risk of being hospitalized with a heart attack or stroke to a large degree. In fact, the relative risk of hospitalization was less than half in the vaccination group compared to the unvaccinated group. More interestingly, this benefit was consistent across multiple subgroups and held true in both men and women, young and old, and those who did and didn’t have other pre-existing medical problems.

It is easy to become complacent and think COVID-19 is no worse than a cold. It is true that your individual risk of death or a serious complication is relatively low. But small risks add up when applied to an entire population. Heart attacks and strokes, even non-fatal ones, put a significant strain on the health care system, use up resources and can leave people with long-term disability. Reducing the population risk of these outcomes is significant and not something to be casually dismissed.

Many people are concerned about the side-effects of vaccination, when they should be more worried about the side-effects of COVID infections. People need to worry less about the vaccines damaging their hearts when the virus is the much greater danger. In fact, this most recent data show us that the vaccines make it less likely that you will suffer a heart attack or stroke post infection. While most people will recover after a COVID infection, some will not — and it makes sense to try to limit the risks of having a post-COVID heart attack or stroke. Fortunately, if you’re vaccinated, you’re less likely to have either one.


@DrLabos

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