It's even worse than that; hazard ratio increases significantly with each re-infection

https://www.nature.com/articles/s41591-022-02051-3

> It's even worse than that; hazard ratio increases significantly with each re-infection https://www.nature.com/articles/s41591-022-02051-3

I don’t think this paper is a great source for that idea - the ratio of people with one infection (440,000) to people with three or more infections (1,000) is so different that I wonder if demographics or behavioral characteristics differ between the groups.

Empirically, their conclusion can’t really be true or each COVID-wave would be worse than the preceding one

I think most people I know have had it at least twice now - if symptoms were escalating with each infection it would be pretty big news.

Unless that damage that is accumulating doesn't lead to immediate visible effect but delayed worse outcomes, eg. early death via heart failure or stroke, long-term slightly reduced IQ, mildly worse blood circulation leading to subtle sexual dysfunction etc.

The linked paper says, "Compared to no reinfection, reinfection contributed additional risks of death [...], hospitalization [...] and sequelae [...]".

I need to read the full paper when I have more time, but it does not seem to be dealing with symptoms? And the sequelae seem most troubling since those could take a long time to manifest.

You’re reading that paper wrong. It says that the cumulative risk of death, long Covid, etc increases with the number of infections. Of course it does: the only was it wouldn’t would be if reinfections has zero or negative risk.

(I’m ignoring whether the paper is correct in the first place.)

I’m not sure what you think I’m saying wrong. Here is the salient quote from the abstract

“The evidence shows that reinfection further increases risks of death, hospitalization and sequelae in multiple organ systems in the acute and postacute phase.”

(Using made up numbers here)

Lets say that infection #1 puts the risk of outcome A at 40%

Infection #2 puts the risk of outcome A at 60%

Infection #3 puts the risk of outcome A at 70%

Each infection increases the risk of outcome A, but it isn't an increasing rate.

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This would be very different from

Infection #1 having a risk of outcome A at 10%

Infection #2 having a risk of outcome A at 30%

Infection #3 having a risk of outcome A at 70%

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The first case that I described matches Figure 5: https://www.nature.com/articles/s41591-022-02051-3/figures/5

Note the difference in the rate of increase between the infections.

Yes, multiple infections increases the risk. However, each subsequent infection has a lower rate of increase of the chance.

Or, as a more dramatic example, suppose infection #1 gives a 50% of long Covid. Infection #2, in a patient without long Covid, gives a 1% risk of long Covid. Your cumulative risk of long Covid after 2 infections is 50.5%, which is greater than 50%.

Yes. The question should be what's the amount of cured covid cases per capita between US and China? The difference is probably pretty big.