The cost of the long COVID

A COVID patient. REMKO DE WAAL / ANP / AFP via Getty Images

The mysterious constellation of overwhelming symptoms has struck millions of people, and no one can say how long they will last. Here’s all you need to know:

How many people are affected?

The CDC and states do not track long cases of COVID, so there are no hard numbers, but many studies indicate the problem is deep and wide. A University of Washington study found that 30% of people with COVID still had symptoms after six months; a study from Imperial College London showed that almost 15% reported three or more symptoms after 12 weeks. Early research indicates that between 10 and 30 percent of people who contract COVID-19 may face long-term problems. More than 42 million Americans are known to have tested positive for COVID, and the actual total is undoubtedly much higher. So even at the low estimate of 10%, this means that millions of people in the United States and around the world are ‘long haul’, facing chronic symptoms that can impair their ability to work, to do. exercise or lead a normal life. Doctors who treat longtime COVID patients say the costs of their future care and lost productivity could be staggering. “I don’t think anyone really understands the magnitude of this,” said Denyse Lutchmansingh, who oversees the post-COVID-19 recovery program at Yale-New Haven Hospital. “The majority of my patients are in the prime of their working lives, and they are debilitated.”

What are the symptoms of long COVID?

Hundreds of symptoms have been reported. Some of the most common are nerve and muscle pain, persistent fatigue, difficulty breathing, heart palpitations, loss of smell and taste, and gastrointestinal distress. The problems that plague post-COVID patients range from impaired metabolic function and kidney damage to problems with blood clotting and menstrual changes. The virus “can affect almost any organ system,” said Ziyad Al-Aly, who studies long-distance patients in the Veterans Affairs Ministry’s health system. Then there are the neurological symptoms, which can be the most debilitating. They include trouble sleeping, dizziness, numbness in the limbs, anxiety, and brain fog marked by confusion, memory loss, and inability to concentrate. The worst cases “really look like dementia,” said Jördis Frommhold, head of a German long-term COVID study, which cites patients as young as 18 who “can’t form sentences.” Cassandra Hernandez, a 38-year-old nurse in San Antonio, went from preparing for her master’s degree to forgetting “how to use a fork” and struggled to read at the fifth grade level. “It’s embarrassing,” she said.

What is causing these problems?

There are several dominant theories. One is that they are caused by fragments or stores of viruses that persist in the body. Another possible cause is persistent inflammation or damage from the initial infection, affecting blood vessels, nerve pathways, or other areas of the body. The dominant theory is that the long COVID is an autoimmune disease triggered by infection with an unknown virus, in which the victims’ enhanced immune system continues to attack healthy tissue after the initial infection has cleared. Or it could be a combination of these factors. Whatever the cause, the long COVID reflects other mysterious chronic illnesses triggered by viral and bacterial infections. Among them is myalgic encephalomyelitis / chronic fatigue syndrome (ME / CFS), whose cases have been linked to outbreaks of SARS, Ebola and other viruses. There are no known markers as to who will develop a long COVID, which affects many people without previous health problems – and many whose initial infections were mild or asymptomatic.

Are long-term COVID patients improving?

The range is wide. Some patients largely revert to their old selves within three or four months. Many show significant improvement but have persistent problems. But some remain considerably weakened after a year or more, and struggle to keep their jobs. “A lot of us can’t afford our medications or our groceries, and many of us become homeless,” said Amanda Finley, an archaeologist from Kansas City who founded a Facebook discussion group for them. long-haul after suffering from persistent symptoms including brain fog. , heart palpitations, fatigue and shortness of breath. Treatment usually involves managing symptoms with physical therapy, cognitive exercises, and other treatments. “It’s a long process, and people have to make a lot of behavior and life adjustments,” said David Putrino, a rehabilitation specialist who treats lengthy COVID patients at Mount Sinai Hospital in New York City.

What can be done?

In February, the National Institutes of Health launched a $ 1.2 billion initiative to study the causes and treatment of long-term COVID. The American Medical Association and the CDC have launched initiatives to educate physicians about identifying and treating the disease. And across the country, hospitals have set up dozens of integrated long-term COVID clinics, where specialists from various fields study the syndrome and refine treatments. “Our clinical model is constantly evolving as we learn more from our patients,” said Lutchmansingh of Yale. Experts warn that we are only beginning to factor in the social and financial costs. “We’re going to need resources for many years to treat these patients,” Putrino said.

Long COVID and the vaccinated

Do vaccines affect the chances of developing a long COVID? Evidence is emerging that vaccination dramatically reduces the risk of persistent symptoms, but that some vaccinated people who get breakthrough infections actually become long-haul. In a small Israeli study, 19% of people with breakthrough infections had persistent symptoms at six weeks, and long COVID clinics in the United States say some of their new cases are from people vaccinated. Researchers still do not know how vaccination affects these persistent symptoms; are they softer and will they resolve faster? Some doctors believe that by reducing the severity of infection, vaccines will reduce the risk of long-term COVID – and a new UK study of 1.2 million adults found that fully vaccinated people cut their chances of getting sick by half. ” have symptoms four weeks after becoming ill. Some experts predict that the prevalence of long-term COVID will decrease as our immune system becomes more familiar with the virus through vaccinations, boosters, and natural exposures. But Zijian Chen, medical director of the Mount Sinai Post-COVID Care Center, says that’s just an educated guess. “It is too early to tell,” he said.

This article first appeared in the latest issue of The week magazine. If you want to read more, you can try six risk-free issues of the magazine. here.

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