The tragedy of the post-COVID “long haulers” – . Health Blog

Suppose you are suddenly hit by COVID-19. You get very sick for several weeks. When you wake up every morning you wonder if this day could be your last.

And then you turn the corner. Every day your worst symptoms – the fever, the terrible cough, the shortness of breath – improve a little. You win, beat a life threatening illness and no longer wonder if each day could be your last. In a week or two more, you'll be the old you.

But weeks go by and while the worst symptoms are gone, you are not the old you – not even around. You can't do your chores at home or at work: no energy. Even routine physical exertion like vacuuming can leave you feeling exhausted. They hurt everywhere. You have trouble focusing on something even while watching TV. you are unusually forgetful; You stumble upon simple calculations. Your brain feels like it's in a fog.

Your doctor congratulates you: the virus can no longer be detected in your body. That said, you should feel fine. But you don't feel good

The doctor suggests that you may be a little depressed or have a little PTSD due to the terrible experience of having COVID-19. Psychiatric treatment might help, since you have nothing to complain about physically. You try the treatment and it doesn't help.

How common are persistent COVID symptoms?

Tens of thousands of people in the United States suffer from such a persistent illness after COVID-19. In the US we call them post-COVID "long distance drivers". In the UK they are said to have "long-term COVID".

Published studies (see here and here) and surveys of patient groups show that 50% to 80% of patients continue to have bothersome symptoms three months after the onset of COVID-19 – even after tests no longer detect the virus in their bodies.

What persistent symptoms are common?

The most common symptoms are fatigue, body aches and pains, shortness of breath, difficulty concentrating, inability to move, headache and sleep disorders. Since COVID-19 is a new disease that began with an outbreak in China in December 2019, we have no information on long-term recovery rates.

Who is more likely to be a long-distance driver?

At the moment we cannot predict exactly who will be a long-distance rider. As a recent article published in Science Notes notes, people who are only marginally affected by COVID-19 may still have persistent symptoms, and people who have been seriously ill can return to normal two months later. However, persistent symptoms are more likely to occur in people over 50, in people with two or three chronic diseases, and in people with COVID-19.

There is no formal definition of the term "post-COVID long-distance driver". In my opinion, a reasonable definition would be anyone who has been diagnosed with, or is very likely to have been infected with the coronavirus causing COVID-19 and who has not returned to their pre-COVID-19 health and function after six months.

Long-distance drivers include two groups of people affected by the virus:

• People who have permanent damage to their lungs, heart, kidneys or brain that can affect their ability to function.
• Those who continue to experience debilitating symptoms even though these organs are undetectably damaged.

Dr. Anthony Fauci, director of the National Institute of Allergies and Infectious Diseases at the National Institutes of Health, has speculated that many in the second group will develop a condition known as myalgic encephalomyelitis / chronic fatigue syndrome (ME / CFS). ME / CFS can be triggered by other infectious diseases – such as mononucleosis, Lyme disease, and Severe Acute Respiratory Syndrome (SARS), another coronavirus disease. The National Academy of Medicine estimates that one to two million people in the United States live with ME / CFS.

Dr. Tedros Ghebreyesus, director of the World Health Organization, also expressed growing concern about the chronic diseases that may emerge after COVID-19, including ME / CFS.

What could be causing the symptoms that plague long-distance drivers?

Research is being carried out to test various theories. People with ME / CFS and possibly long distance drivers after COVID may have persistent low inflammation in the brain or decreased blood flow to the brain, or an autoimmune disease in which the body makes antibodies that attack the brain. or more of these anomalies.

The final result

How many people can be long distance drivers? We can only guess. There are currently more than seven million Americans infected with the virus. It is not unthinkable that 50 million Americans will eventually become infected. If only 5% develop persistent symptoms and most of the patients with symptoms have ME / CFS, we would double the number of Americans with ME / CFS in the next two years. Most people who developed ME / CFS prior to COVID-19 stay sick for many decades. Only time will tell if this is the case for the post-COVID cases of ME / CFS.

For this and many other reasons, even if we develop and deploy a very effective vaccine by the end of 2021, the strain on the American healthcare system and economy from the pandemic will not end soon.

Virtually every health professional I know believes that the pandemic in the United States could and should have been controlled better than before. Bad mistakes rarely lead to temporary damage.