“The next public health disaster” could be Long Covid…

The coronavirus outbreak has been going on for almost four years, and new strains are likely to make this winter a hard one.

Researchers think that by now, most Americans have had COVID-19.

Studies show that getting more infections makes it more likely that something bad will happen, like being hospitalised or dying. The Centers for Disease Control and Prevention say that more than a million Americans have died because of the virus, and about 2,000 more die every week.

Long-term data shows that the virus is having a long-term, widespread, and maybe even more sneaky effect. It has been called “the next public health disaster waiting to happen” by medical experts.

Dr. Peter Hotez, co-director of the Center for Vaccine Development at Texas Children’s Hospital and a dean at Baylor College of Medicine, said, “This affects a lot of people.”

In a recent report, HHS said that number will “only keep going up” as long as COVID-19 is still being used.

“This could change the way we practise medicine in the same way that HIV/AIDS did,” Hotez said.

But long after COVID’s effects go far beyond what it does to people’s health, These effects include the labour gap, disability benefits, life insurance, household debt, lost retirement savings, and financial ruin.

David Cutler, an economist at Harvard University, said that long-term COVID is a $3.7 trillion drag on the U.S. economy, which is about 17% of our country’s economic output before the pandemic. In a July report, Cutler said that the total cost is almost as high as it was during the Great Recession.

Cutler changed the $3.7 trillion number by $1.1 trillion from a report he made in October 2020 because “long COVID is more common than we thought at the time.” Even that revised estimate is low. It is based on the 80.5 million confirmed U.S. COVID cases at the time the analysis was done, and it doesn’t take into account the number of cases that will come in the future.

$528 billion of the total comes from more money spent on health care. But lost earnings and a lower quality of life are other bad trickle-down effects that cost $997 billion and $2.2 trillion, respectively, for the American people.

What is COVID? “It depends on whom you ask.”

Even though there is still a lot we don’t know about “long COVID” (short for “post-acute sequelae of COVID,” or PASC), what we do know is shocking, say experts.

The condition can happen to anyone who has had COVID-19. The World Health Organization says that anyone can get it, no matter how bad their first infection was or what kind of virus they had. It affects people of all ages, even those who were healthy and fit before.

Studies show that women are more likely to get sick than men. One study found that adult women were twice as likely to have long-term symptoms. People of colour are also more likely to get sick because they are more likely to get a COVID-19 infection and have less access to high-quality health care. Bisexual and transgender people are also more likely to get sick because they have less access to care and are judged for their gender or sexuality, according to an HHS report from October.

But doctors haven’t agreed on a clear definition of long COVID, which makes it harder to diagnose and treat.

Dr. Greg Vanichkachorn, medical director of the Mayo Clinic’s COVID Activity Rehabilitation Program, said, “It depends on who you ask right now.”

Here are some of the things about which people have different ideas:

Doctors have yet to determine what causes long COVID.They come up with ideas: It could be an autoimmune disorder like lupus or rheumatoid arthritis, in which the virus is gone but the immune system stays active and attacks healthy cells by mistake. It could also be small blood clots in the brain that are too small to cause a stroke but big enough to cause neurological problems.
Key symptoms: The Rockefeller Foundation says that long-term COVID has been linked to more than 200 different symptoms. A recent global meta-analysis published in the Journal of the American Medical Association, a peer-reviewed journal, found that the most common symptoms are shortness of breath, fatigue, and problems sleeping or insomnia. Some of the others are anxiety, depression, body aches, headaches, heart palpitations, and “brain fog,” which means problems with thinking, focusing, communicating, understanding, remembering, and moving. Some people with this disease have problems with their heart, lungs, kidneys, skin, or brain.
Duration: There is no clear definition of how long someone’s symptoms must last for them to be called a “long COVID patient.” For example, the CDC says that a person has long-term symptoms if they last longer than one month after the first COVID-19 infection or start after one month. A three-month barometer is usually used by the WHO. Some may be used by different health clinics.
Experts do know that COVID symptoms can last for some people for months or even years. The meta-analysis found that about 15% of people who still had symptoms three months after an infection did so for at least another year after the infection.

The code that researchers and doctors use to talk about long-term COVID is only a year old.

In October 2021, the CDC gave the code (U09.9) its OK. According to the HHS report, having an official diagnosis makes it easier for patients to get long COVID-related treatments, apply for disability insurance, and request work accommodations.

But because of how vague it is, there isn’t yet a clear-cut, yes-or-no lab test for it.

Dr. Jeff Parsonnet, an infectious disease doctor who started the Post-Acute COVID Syndrome clinic at Dartmouth Hitchcock Medical Center, said, “There is no diagnostic test.” “It’s a clinical diagnosis, to be honest.”

Vanichkachorn of the Mayo Clinic said that sometimes this process is easy: a confirmed, positive COVID-19 test result, enough time after the initial infection, and persistent symptoms that are the same as those of hundreds of other long-term COVID patients may be enough.

But by the time Parsonnet sees a patient at the post-acute COVID syndrome clinic, they have often already been to a primary care doctor or a specialist for “all kinds of testing.” This could include pulmonary function tests or chest X-rays to look for heart or lung problems, magnetic resonance imaging (MRI) to look for brain inflammation, or a “tilt table” test to check for a possible autonomic disorder.

Medical experts say that these tests often come back negative, which is frustrating for patients and adds to their costs.

“In many cases, the diagnosis is long-term COVID because there is no other way to explain the condition,” said Alice Burns, associate director of The Henry J. Kaiser Family Foundation’s Program on Medicaid and the Uninsured. “It’s the diagnosis after all other diagnoses have been ruled out.”

Some doctors might not look at long-term COVID as a reason for health problems because of this.

Diana Güthe, the founder of Survivor Corps, said of the long list of symptoms, “There are a lot of doctors and other care providers who don’t want to give a label that means everything but the kitchen sink.” Survivor Corps is a group of about 250,000 people who support COVID. Güthe herself had severe diarrhoea and recovered.

Donna Pohl, who is 56 years old, went to see a neuromuscular specialist in the middle of November to treat nerve damage caused by long-term COVID. The trip wasn’t a success.

The specialist told Pohl, who lives in Bettendorf, Iowa, and was diagnosed with long-term COVID last December, “Everyone wants to blame COVID.” “We’re sick, not crazy or stupid.”

People, including family and friends, often think that symptoms are “byproducts of anxiety and depression, or even worse, laziness and an excuse not to work,” the HHS report said.

She said that neurologists would see Norpel twitch and then only pay attention to her migraines. When she mentioned long COVID during an appointment, she was told to stop reading about it.She said, “It was like Dr. Mansplaining.”

In August, she went to the Mayo Clinic, where she was told, “We believe you; you have long COVID.”

“When the doctors talked to me, I began to cry,” Norpel said.