Thinking Citizen Blog — Long Covid — What Is It? What Can Be Done? Who Knows?

Thinking Citizen Blog — Thursday is Health, Health Care, and Global Health Policy Day

Today’s Topic: Long Covid — What Is It? What Can Be Done? Who Knows?

It seems to me that just about any symptom can be attributed to “long Covid.” How can you know? From Wikipedia: “Long COVID can affect nearly every organ system, with sequelae including respiratory system disorders, nervous system and neurocognitive disorders, mental health disorders, metabolic disorders, cardiovascular disorders, gastrointestinal disorders, musculoskeletal pain, and anemia. A wide range of symptoms are commonly reported, including fatigue, malaise, headaches, shortness of breath, anosmia (loss of smell) parosma (distorted smell), muscle weakness, low fever, and cognitive dysfunction.” Apparently, the most common symptoms are fatigue and memory problems and the incidence post infection could be as high as 43%. Experts — please chime in; Correct, elaborate, elucidate.

A TYPICAL PATTERN — MILD SYMPTOMS FOLLOWED BY FATIGUE (from interview with Jason Maley, instructor, Harvard Medical School)

1. “Some people, for the initial two weeks of their infection, had just cold-like symptoms that lasted for three days. They felt like they were fine and then over the ensuing four months they are just so fatigued. They can barely breathe when they walk around, and they have these other severe symptoms that are really out of proportion to the initial symptoms.”

2. “Groups of patients follow different time courses. Some people, not uncommonly, are very slow to recover, and it takes them three to six months to get back to feeling like they have their normal level of energy and that their breathing is improving.

3. “Others are nine or 12 months out from their infection, and they still haven’t noticed any improvement. They’re exhausted all day long, and they have severe difficulty doing their jobs because of memory and thinking issues, breathing discomfort, and other symptoms.”

NB: The interview with Maley was from April 2021. What have we learned since? Experts?

NOT INFECTIOUS — APPARENTLY (Maley)

1. “They’re not infectious. Most patients who have this initial improvement and then have this worsening of symptoms often go back and get retested because they’re worried they might have gotten infected again, or they could be still infectious.”

2. “All of the patients I can think of who have done that have negative tests for their second test.”

3. “So we, for the most part, can’t detect any ongoing infection..”

CAUSATION UNCLEAR — many theories ( Maley)

1. “We’re seeing long COVID most often in people who did not have severe COVID initially, and there may be clues that the robustness of the immune response and subsequent persistent immune activation could drive symptoms.”

2. “Some have wondered if there could be low-level virus still present, although there isn’t evidence to prove that among our patients so far.”

3. “Then there’s the possibility that there was initial damage from the virus — such as damage to nerve pathways that are then very slow to recover. This could explain some of the profound neurologic symptoms and pain patients experience even after mild COVID, which can take many months to improve.”

Long COVID — Wikipedia

https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html

https://news.harvard.edu/gazette/story/2021/04/harvard-medical-school-expert-explains-long-covid/

https://www.ama-assn.org/delivering-care/public-health/what-doctors-wish-patients-knew-about-long-covid

https://www.cnbc.com/2022/05/10/experts-how-to-know-if-you-have-long-covid-and-what-to-do-about-it.html

LAST FOUR YEARS OF POSTS ORGANIZED THEMATICALLY

PDF with headlines — Google Drive

ATTACHMENTS BELOW:

#1 A graphic guide to justice (9 metaphors on one page).

#2 “39 Songs, Prayers, and Poems: the Keys to the Hearts of Seven Billion People” — Adams House Senior Common Room Presentation, 11/17/20

YOUR TURN

Please share the most interesting thing you learned in the last week related to health, health care or health care policy — the ethics, economics, politics, history…. Or the coolest, most important thing you learned in your life related to health are or health care policy that the rest of us may have missed. Or just some random health-related fact that blew you away.

This is your chance to make some one’s day. Or to cement in your mind something really important you might otherwise forget. Or to think more deeply than you otherwise would about something that matters.

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