#LongCOVID two years on

Many viral infections do not leave a long-lasting effect. We normally expect that after a common cold we recover quickly and do not have any symptoms after few days. Influenza typically lasts 3-7 days, although cough and malaise can persist for more than 2 weeks, particularly in elderly or immuno-compromised people.

At the other extreme, infection with chickenpox often leaves people with a long persisting viral infection which is dormant but can resurface later in life as shingles. And, infection with Human Immunodeficiency Virus (HIV) leads to life-long disease, AIDS, drastically affecting health and reducing life expectancy.

We have been aware of #LongCOVID from early stages of the pandemic. The first use of the word was on Twitter, on 20th May 2020, almost exactly 2 years ago:

https://twitter.com/elisaperego78/status/1263172084055838721?s=20&t=lAYgdaxSlxsSElrVfTnVvA

We still continue to learn about the #LongCOVID, its frequency, length and severity. A non-insiginificant proportion of those who had symptomatic COVID, can still experience some symptoms weeks if not months after the infection. For some, Long COVID means a long-lasting debilitating condition.

Although the Long COVID experience is real for many people, both the government and large parts of the society have largely ignored it so far. However, there is a growing realisation that it might have a major impact, not only on affected individuals, but on the whole society and particular on the economy.

#LongCOVID is not likely to go away soon. The society and the government seem to have accepted that SARS-CoV-2 will be with us for a long time, even if at relatively low levels. The transition to the “endemic” state has been hailed as a success. And indeed, it seems an improvement on the “pandemic” state characterised by repeated, large scale outbreaks.

But the word “endemic” means “always present” (“en” – meaning “in”, “demos” – meaning “population”, so something that is continuously “in population”).

Thus, the virus, SARS-CoV-2, is likely to persist in the population, with reinfections continuously affecting . In this situation, we will see a continuously increasing number of people with #LongCOVID. These people will be ill for a long time, putting increasing stress on – already stretched – health systems.

And these people might not be able to work. We might already see this effect, not only in the sharp increase of people outside the workforce in 2020 – caused directly by the pandemic – but in the latest rapid increase on the graph below:

The Bank of England report also shows a more detailed plot comparing predictions and actual data for the number of people in work:

Number of people in work

Not only we see the rapid drop in 2020 caused by the pandemic itself, but a continuing decline after the initial shock. This means that in terms of the number of people in work there is no post-pandemic recovery – worse, we see a continuing decrease. And the gap between the extrapolated trend and reality is nearly 10 million people by now!

It might take a while to understand what impact can be attributed to #LongCOVID (as opposed to the general NHS malfunctioning or other factors), but it is clear that there is a continuing – and increasing – problem. It has massive implications for the economy and for social care – people not working are not producing but also not earning. They need financial, social and health support.

Not only the economics and the society as a whole are affected, but the individuals will experience problems beyond the actual illness. We might increasingly see the situations as shown in the tweet below.

when an application for life insurance – needed for mortgage application – might be rejected for people who had particularly nasty bout of COVID.

So, what can we do? Firstly, we need to recognise that #LongCOVID exists and that it needs to be dealt with. The All-Party Parliamentary Group on Coronavirus has already produced a report and a list of recommendations. Hopefully, the government will take these recommendations on board and establish a system to support the #LongCOVID sufferers.

Is there anything else we can do as individuals? #LongCOVID seems to be related to a “post-viral fatigue” caused by a response of immune system to the viral infection. The risk factors appear to be age, obesity, asthma, and severity of the actual COVID infection.

Thus, anything we can do to strengthen our immune system – food, exercise, healthy lifestyle – is likely to make us less prone to experience #LongCOVID. Vaccination – even if not protecting us completely from infection – reduces the risk of severe COVID infection. Mask wearing and personal hygiene will reduce the number of reinfections with SARS-CoV-2 variants.

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