# Long COVID 'May Be Four Syndromes'



## Northerner (Oct 16, 2020)

The condition commonly called 'long COVID' may not be one syndrome but possibly up to four different syndromes, according to a new review.

The finding comes from a dynamic themed review of available scientific evidence published by the National Institute for Health Research (NIHR).

The paper, _Living with COVID19_ draws on the latest expert consensus and published evidence, as well as the experience of patients.

It formed the first output from the NIHR Centre for Engagement and Dissemination (NIHR CED) which is working towards a real-time knowledge base in what is an emerging field.

It is estimated that as many as 60,000 people in the UK may have long COVID.









						Long COVID 'May Be Four Syndromes'
					

Review of ongoing COVID published by the National Institute for Health Research says wide range of symptoms creates diagnostic uncertainty.



					www.medscape.com


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## mikeyB (Oct 16, 2020)

Big deal. I’m getting very tired of all this crap talked about COVID. It’s not special. It’s been known for half a century that infectious mononucleosis (glandular fever) can cause long term debility, its long been suggested that T1 diabetes needs a viral trigger to start it off, the occasionally fatal and always serious Guillain-Barré syndrome is triggered by infection.

Don’t worry, all these will be ascribed to Covid before long and be ascribed to “long COVID “. It’s all b****cks. Dressing up known complications of viral infections as post Covid debases proper medicine, to say nothing of frightening people. We’ve happily trundled on for decades knowing about all these post viral conditions. None of them are common.

I say again, this virus is nothing special, and does  nothing to the body that countless viruses haven’t done before. But rarely, as with COVID.


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## Amity Island (Oct 16, 2020)

mikeyB said:


> Big deal. I’m getting very tired of all this crap talked about COVID. It’s not special. It’s been known for half a century that infectious mononucleosis (glandular fever) can cause long term debility, its long been suggested that T1 diabetes needs a viral trigger to start it off, the occasionally fatal and always serious Guillain-Barré syndrome is triggered by infection.
> 
> Don’t worry, all these will be ascribed to Covid before long and be ascribed to “long COVID “. It’s all b****cks. Dressing up known complications of viral infections as post Covid debases proper medicine, to say nothing of frightening people. We’ve happily trundled on for decades knowing about all these post viral conditions. None of them are common.
> 
> I say again, this virus is nothing special, and does  nothing to the body that countless viruses haven’t done before. But rarely, as with COVID.


MikeyB,
They have to keep the fear campaign going for as long as possilbe, otherwise how can they still justify the lockdowns? In the early days it was supposed to be about preventing deaths and hospitalisations, now they are actually trying to eradicate it!!! by imposing relentless lockdowns. Even _with_ a safe and effective vaccine (even at 70% effective) we can't eradicate the virus. it's an impossible task. You have to ask yourself what is it all for?

It's been turned into a *casedemic*.

On this planet, in every country, in every other situation before, never has anyone attempted to track, test and trace a virus _after_ the main death cases have dropped off and then kept it going for months (perhaps years) with daily case reports. As you said, normally after a pandemic, life goes on and we never get to know of the after effects, they've never been relayed to us on a 24hr daily basis.  They could have made the same problems out of any other virus before, had the same lockdowns, daily case reports.

Nobody is talking of the huge spikes in cases of unemployment, business closures, social disruption etc etc Why don't they do a 24hr a day daily report on those, with all the fancy stats and fear about how bad it could be tomorrow?


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## Ditto (Oct 16, 2020)

Today I'm frightened. I wasn't before because I think my family have had it already. My brother now tells me we can go blind, or completely deaf or lose a set of toes... agh, we already had that worry, well not the deaf.. good grief, I don't like being scared. My family haven't taken any notice of lockdown, all have carried on regardless and are continuing to do so. I might take to locking up the bungalow and dealing with them on the front path if they have to call round for one thing or another! They know I'm eccentric anyways.

edit/ 
In a nutshell what is long covid. I can't be bothered logging in to read the article, I'm so depressed doing anything is a chore. I have inertia.


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## trophywench (Oct 16, 2020)

Long Covid in a nutshell, is people who have definitely had Covid but suffer rather different and weird after effects, from the things people usually get after other viruses.


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## Docb (Oct 17, 2020)

I'm guessing @mikeyB that you might find this chap's analysis quite persuasive.









						What SAGE Has Got Wrong
					

by Mike Yeadon Chief Medical Officer, Professor Chris Whitty, and Chief Scientific Adviser, Sir Patrick Vallance, give a Coronavirus Data




					lockdownsceptics.org


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## grovesy (Oct 17, 2020)

trophywench said:


> Long Covid in a nutshell, is people who have definitely had Covid but suffer rather different and weird after effects, from the things people usually get after other viruses.


Some these people did not not have definite diagnosis as many were not admitted to hospital or in the early months of the pandemic could not get tests.


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## Amity Island (Oct 17, 2020)

Docb said:


> I'm guessing @mikeyB that you might find this chap's analysis quite persuasive.
> 
> 
> 
> ...


So "SAGE is useless".

You have to ask then, are they unwittingly useless? or are their intentions based in some way on personal interests in creating a country primed for large scale vaccine distribution or moving Doctors appointments online?

Are there some vested interests in their policies and advice or other aims?


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## Docb (Oct 17, 2020)

Nothing is useless but it is easy to oversell the usefulness of something.  I am sure that those who set it up invited the people they guessed would be useful.  Time will tell whether they were good or bad guessers.

By the way, I don't endorse the thesis put forward in the article I pointed to.  It has merit, about as much merit as the thesis it decries.  Same with all this stuff, the extremes are interesting but woe betide you if you do all your planning based on one extreme, whatever extreme it is.


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## Amity Island (Oct 17, 2020)

Docb said:


> Nothing is useless


Ha Ha, very true...even a sweeping brush with no head can be put to some use. Perhaps he should of used another word?


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## mikeyB (Oct 17, 2020)

The writer of the article doesn’t say Sage are useless deliberately, or have some ulterior motive. They don’t have the right knowledge or skills. Or common sense. It’s not common sense to try and eliminate this virus, and it’s not common sense to test everybody. And testing, as he explains, doesn't tell you how many have been infected.

Just as long as the media and government go with the idea that this is a “deadly” virus, and this is the biggest threat to the UK. It isn’t either. I said this right at the start of the epidemic, and I haven’t changed my view.

The government are in a bind. They have to be seen to be trying to eliminate this virus, but as well keep the economy going. There is no chance that the virus will be eliminated - we’ll just assimilate it into our collection of respiratory viruses.

The biggest threat to the UK is a no deal Brexit.  Which is odd, because the government hasn’t listened to any competent  economic advice, but seem to be happy to listen to medical advice. They know bugger all about either.


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## Amity Island (Oct 17, 2020)

mikeyB said:


> The government are in a bind.


Only becasue they decided to use lockdowns, for reasons unknown to us.


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## Eddy Edson (Oct 18, 2020)

New study by a bunch of experts in the field, which may be a better guide than people pontificating about stuff on the Internet:



			https://www.medrxiv.org/content/10.1101/2020.10.14.20212555v1.full.pdf
		


*Multi-organ impairment in low-risk individuals with long COVID *

_Findings: Between April and September 2020, 201 individuals (mean age 44 (SD 11.0) years, 70% female, 87% white, 31% healthcare workers) completed assessments following SARS-CoV-2 infection (median 140, IQR 105-160 days after initial symptoms). 

The prevalence of pre-existing conditions (obesity: 20%, hypertension: 6%; diabetes: 2%; heart disease: 4%) was low, and only 18% of individuals had been hospitalised with COVID-19. 

Fatigue (98%), muscle aches (88%), breathlessness (87%), and headaches (83%) were the most frequently reported symptoms. Ongoing cardiorespiratory (92%) and gastrointestinal (73%) symptoms were common, and 42% of individuals had ten or more symptoms. 

There was evidence of mild organ impairment in heart (32%), lungs (33%), kidneys (12%), liver (10%), pancreas (17%), and spleen (6%). Single (66%) and multi-organ (25%) impairment was observed, and was significantly associated with risk of prior COVID-19  hospitalisation (p<0.05). 

 Interpretation: In a young, low-risk population with ongoing symptoms, almost 70% of  individuals have impairment in one or more organs four months after initial symptoms of  SARS-CoV-2 infection. There are implications not only for burden of long COVID but also  public health approaches which have assumed low risk in young people with no comorbidities. 

Conclusions: Long COVID has a physiological basis, with measurable patient-reported outcomes and organ impairment. Medium- and long-term evaluation and monitoring of multi-organ function beyond symptoms and blood investigations is likely to be required, even in lower risk individuals. Health system responses should emphasise suppression of population infection rates, as well as management of pre- and post-COVID-19 risk factors and chronic diseases. _


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## Docb (Oct 18, 2020)

The only query I would have is whether the subjects in the study were randomly selected from the population at large or from a cohort who were already under investigation for reporting lasting symptoms.  

If they were randomly selected from anybody who met the selection criteria, then it gives real food for thought.


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## Eddy Edson (Oct 18, 2020)

Docb said:


> The only query I would have is whether the subjects in the study were randomly selected from the population at large or from a cohort who were already under investigation for reporting lasting symptoms.
> 
> If they were randomly selected from anybody who met the selection criteria, then it gives real food for thought.



From the Methods section, eligibility was basically just having a COVID-19 diagnosis:

_In an ongoing, prospective study, 201 participants were enrolled at two UK sites  (Perspectum, Oxford and Mayo Clinic Healthcare, London) between April 2020 and August 2020 and completed baseline assessment by 14 September 2020 (Figure 1). Participants 1 were eligible for enrolment if they tested positive by the oro/nasopharyngeal throat swab for SARS-CoV-2 by reverse-transcriptase-polymerase-chain reaction (n=62), a positive antibody test (n=63), or had typical symptoms and were determined to have COVID-19 by two independent clinicians (n=73). Exclusion criteria were symptoms of active respiratory viral infection (temperature >37.8°C or three or more episodes of coughing in 24 hours); discharged from hospital in the last 7 days; and contraindications to MRI, including implanted  pacemakers, defibrillators, other metallic implanted devices; claustrophobia. _

They call the selection "pragmatic", meaning that there were different diagnostic methods, partly due to test availability etc limitations at some points during the study. So maybe a bit loose.

And from what I can find in the pre-print it's not clear whether or how there was a sub-selection from amongst the "eligible" group. You'd hope to see that made clearer in updates to this pre-print.


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## Eddy Edson (Oct 18, 2020)

I'll also just drop this stuff here as food for though for any anti-lockdowners:


__ https://twitter.com/i/web/status/1317302087860932610

Victoria, coming to the end of 100+ days of a brutally strict lockdown:



700 cases per day at peak, down to 1 or 2 now.

Caused by a badly designed, underfunded, crappy bureaucrat-infested, centralised public health system with weak poliitcal oversight. Fixed by a brutally simple everybody-shares-the-pain lockdown supported by the Premier standing up and repeating the same message over & over & over and answering every media question, every day for 100+ days.


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## grovesy (Oct 18, 2020)

Eddy Edson said:


> I'll also just drop this stuff here as food for though for any anti-lockdowners:
> 
> 
> __ https://twitter.com/i/web/status/1317302087860932610
> ...


Is this your health system or ours you are on about?


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## Eddy Edson (Oct 18, 2020)

grovesy said:


> Is this your health system or ours you are on about?



Victoria. Couldn't comment on any similarities to England


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## Docb (Oct 18, 2020)

Coming back to the reference you put up @Eddy Edson.  I think we picked up on the same point.  Are they reporting that they have found underlying physiological changes in people who were reporting lasting after effects from a COVID infection or are they reporting underlying physiological changes in a random bunch of people who they were quite sure had had COVID.  Difficult to decide from the wording of the preprint and there are very different implications depending on the answer to that question.


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## Robin (Oct 18, 2020)

Docb said:


> Coming back to the reference you put up @Eddy Edson.  I think we picked up on the same point.  Are they reporting that they have found underlying physiological changes in people who were reporting lasting after effects from a COVID infection or are they reporting underlying physiological changes in a random bunch of people who they were quite sure had had COVID.  Difficult to decide from the wording of the preprint and there are very different implications depending on the answer to that question.


Also, if they asked for volunteers, more people who have lasting problems would normally volunteer, than people who had it, got over it and went on their merry way, wouldn’t you think?


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## Docb (Oct 18, 2020)

Absolutely @Robin.  My guess is that they have recruited from people who have reported lasting symptoms after being clearly infected with COVID and have demonstrated that in the majority of cases their symptoms are related to identifiable physiological damage.  That is an important observation in its own right.


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## Eddy Edson (Oct 18, 2020)

Robin said:


> Also, if they asked for volunteers, more people who have lasting problems would normally volunteer, than people who had it, got over it and went on their merry way, wouldn’t you think?



FWIW I've asked one of the authors about this on Twitter. 

In this:


__ https://twitter.com/i/web/status/1317574120499040256
he says  "This was a study recruiting individuals who were symptomatic after recovery from COVID."  I don't know what "symptomatic after recovery" actually means.

The clinical trial registration https://clinicaltrials.gov/ct2/show/NCT04369807 says this:  _Participants will be recovered or recovering from COVID-19 disease, at least age 18 years and invited to partake in this study. Participants will previously have experienced symptomatic and confirmed COVID-19 disease and will be outpatients able to breath independently without oxygen. Participants will have been discharged back into the community with no respiratory symptoms for at least 7 days. _

.. which, like the pre-print, doesn't say anything much about whether they had symptoms of anything at time of recruitment.

See if he responds ...


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## Eddy Edson (Oct 18, 2020)

Docb said:


> My guess is that they have recruited from people who have reported lasting symptoms after being clearly infected with COVID and have demonstrated that in the majority of cases their symptoms are related to identifiable physiological damage.  That is an important observation in its own right.



I guess that must be what it is - the general recovered population surely wouldn't have such a high proportion still symptomatic.

And the Interpretation says: _In a young, low-risk population *with ongoing symptoms*, almost 70% of individuals have impairment in one or more organs four months after initial symptoms of SARS-CoV-2 infection._

I do think it's weird not to report the full selection criteria and stats, particularly as they are trying to make a health policy point. If they found say  just 1% of recovered patients stil symptomatic at 4 months it's obviously much less of a policy deal than if it were say 50%.


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## Amity Island (Oct 18, 2020)

Eddy Edson said:


> I'll also just drop this stuff here as food for though for any anti-lockdowners.


Hi Eddy,
It's not making any sense to me what you are saying. The information you are referencing to to validate the lockdowns wasn't known to anybody in March when the worldwide lockdown strategy was used. Or are you saying they _did_ know about all the possible long term effects then, and that is why they decided to use lockdowns from the outset?

I'm still trying to figure out why every country on the planet, at the same time decided to use lockdowns? when it's never ever been done before for anything?

As far as I am aware, the only basis for the lockdwon was Fergusson's model?  How reliable was it?


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## Bruce Stephens (Oct 18, 2020)

Amity Island said:


> I'm still trying to figure out why every country on the planet, at the same time decided to use lockdowns?



Every country didn't do that (and not all have), and we didn't do it at the same time.

And why? Because it's kind of an obvious intervention. It's obviously horribly expensive (in lots of ways) so there's a really high bar for using it, but what Lombardy saw in March was surely high enough to justify it? What else could they have tried, once people were dying because there weren't enough ventilators?


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## Amity Island (Oct 18, 2020)

Bruce Stephens said:


> Every country didn't do that (and not all have), and we didn't do it at the same time.


OK, figure of speech, *except for Sweeden and South Korea? Who have kept it under control without lockdowns.
OK. figure of speech, *within a couple of weeks of each other.


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## Docb (Oct 18, 2020)

I do wish people would stop talking about lockdowns as if the term had some meaning.  Just about every country (including Sweden and South Korea) have introduced restrictions of some form or other although with widely varying extents and effectiveness.  None of them, except maybe Spain has come anywhere near to anything that could be called a lockdown.


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## Amity Island (Oct 18, 2020)

Docb said:


> I do wish people would stop talking about lockdowns as if the term had some meaning.  Just about every country (including Sweden and South Korea) have introduced restrictions of some form or other although with widely varying extents and effectiveness.  None of them, except maybe Spain has come anywhere near to anything that could be called a lockdown.


DocB, that's two gud 'uns you've mentioned this week! with the "useless" yesterday and the "lockdowns" today. The "restrictions" have been devastating for business, peoples health plus the estimated 70,000 excess deaths caused by the lockdown.  Like Brexit, there are 2 "camps" with the for and against "lockdowns".

I did find this article, which gives quite a balanced view in discussing it. I think it summarises with the "moral" question about whether it is ("restrictions") all worth it or even appropriate?

And, should we be be using this strategy everytime in the future for any other coronaviruses?





__





						Register to read | Financial Times
					

News, analysis and comment from the Financial Times, the worldʼs leading global business publication




					ftalphaville.ft.com


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## Amity Island (Oct 18, 2020)

For me, there is a much more compelling reason -- more compelling than the Fergusson Model -- for why the "lockdown/restictions" strategy was used in Britain (and across the world).

A week or so before the first known case of covid19 in Wuhan, the UN made this statement:

*Geneva, 26 November 2019 – *On the eve of a year in which nations are due to strengthen their Paris climate pledges, a new UN Environment Programme (UNEP) report warns that unless global greenhouse gas emissions fall by 7.6 per cent each year between 2020 and 2030, the world will miss the opportunity to get on track towards the 1.5°C temperature goal of the Paris Agreement.  *2020 is a critical year for climate action*.

A 7% reduction in CO2 emissions is indeed the quoted level of CO2 reductions made in 2020 since all the travel and social restrictions were put into place.

This means we need to maintain the same decrease every year as if we were living in lockdown.

This is just my opinion of course, others may prefer to stick to the "long covid19" repsonse, but let's see how this all plays out over the next 10 years.....









						Cut global emissions by 7.6 percent every year for next decade to meet 1.5°C Paris target - UN report
					

On current unconditional pledges, the world is heading for a 3.2°C temperature rise Technologies and policy knowledge exist to cut emissions, but transformations must begin now G20 nations account for 78 per cent of all emissions, but 15 G20 members have not committed to a timeline for net-zero...




					www.unenvironment.org


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## Minky (Oct 18, 2020)

Long Covid symptoms sound very like Post Sepsis Syndrome which I have. Two years come December, still have memory blanks, lose words for things, fatigue overcomes some days. When husband talked about taking the small awning for caravan, I had to look at photos to find what it looked like. I’d quite forgotten we had one. Remembered our big awning. Small? Complete blank.


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## Eddy Edson (Oct 18, 2020)

Amity Island said:


> For me, there is a much more compelling reason -- more compelling than the Fergusson Model -- for why the "lockdown/restictions" strategy was used in Britatin (and across the world).
> 
> A week or so before the first known case of covid19 in Wuhan, the UN made this statement:
> 
> ...



Why has it taken the Internet so long to merge climate and COVID-19 conspiracy theories???


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## Amity Island (Oct 18, 2020)

Eddy Edson said:


> Why has it taken the Internet so long to merge climate and COVID-19 conspiracy theories???


Hi Eddy,

Can you explain a bit more about these conspiracy theories you mention?

I don't follow consipracy theories so you would be "elightening" us all if you could share them with us, are you saying about covid19 being fake or global warming being fake are these the theories?


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## Eddy Edson (Oct 19, 2020)

Amity Island said:


> Hi Eddy,
> 
> Can you explain a bit more about these conspiracy theories you mention?
> 
> I don't follow consipracy theories so you would be "elightening" us all if you could share them with us, are you saying about covid19 being fake or global warming being fake are these the theories?



Well, the COVID-19 conspiracy theories which ignore or misrepresent the science and say that it's not a big problem and lockdowns etc are a stealth social engineering by a powerful cabal intent on destroying freedom blah blah blah, and the climate conspiracies which do pretty much the same kind of thing. And apparently promoted by some of the same groups.

The UN/WHO/IPCC tend to figure largely - international groups seeking to impose World Government, blah blah etc etc.

BTW, having worked for the UN in NY for quite a few years, I'm pretty confident that any stealth coup involving it or any of its agencies would probably be directed mainly towards forcing people to take very long coffee breaks, while making sure that bars and restaurants continue to be quite well managed.


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## Docb (Oct 19, 2020)

Eddy Edson said:


> BTW, having worked for the UN in NY for quite a few years, I'm pretty confident that any stealth coup involving it or any of its agencies would probably be directed mainly towards forcing people to take very long coffee breaks, while making sure that bars and restaurants continue to be quite well managed.



There's an observation from somebody who has operated in the real world!


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## Amity Island (Oct 19, 2020)

Eddy Edson said:


> Well, the COVID-19 conspiracy theories which ignore or misrepresent the science and say that it's not a big problem and lockdowns etc are a stealth social engineering by a powerful cabal intent on destroying freedom blah blah blah, and the climate conspiracies which do pretty much the same kind of thing. And apparently promoted by some of the same groups.
> 
> The UN/WHO/IPCC tend to figure largely - international groups seeking to impose World Government, blah blah etc etc.
> 
> BTW, having worked for the UN in NY for quite a few years, I'm pretty confident that any stealth coup involving it or any of its agencies would probably be directed mainly towards forcing people to take very long coffee breaks, while making sure that bars and restaurants continue to be quite well managed.


Hi Eddy,

You see; (and yes I do operate in the real world) I don't see it that way at all. I don't see it as conspiracy at all, nor that covid19 is fake or that global warming is fake either and I don't see it as a "stealth" coup either, to impose world government. I don't see anything being done by "stealth" either. I see the current restrictions/strategies heavily influenced by the climate change agenda, which as the UN say publicly (not by stealth) that  *"2020 is a critical year for climate action"*. 

More accurately, I see this as very matter of fact. It's abundantly clear what the current 2020 aims are, it's more of a concerted target, an aim so to speak. No "stealth" conspiracy or "world government" conspiracy about it.

Below is one example from thousands, which mirror the same message, which to me paints it very clear about what is happening at the moment. This is a quote from of  António Guterres, the ninth Secretary-General of the United Nations.

_"Everything we do during and after this crisis must be with a strong focus on building more equal, inclusive and sustainable economies and societies that are more resilient in the face of pandemics, climate change, and the many other global challenges we face." _nb He is talking to someone when he says this, not just fantasy.

If this quote alone (among thousands of similar official quotes) doesn't make it clear about what their aim is, then nothing will.

Regarding whether or not large world wide organisations have any influence on government policies and on leaders of big business, they do, there would be no point to them if they didn't and governments and business leaders wouldn't be going to DAVOS every year.


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