“We were leaden-footed for weeks, to the point where each step meant a determined effort,” Miss Goring recalled. “It also was very difficult to remember any simple thing, even for five minutes.”
What’s striking about reading these accounts ten months into a new pandemic, is the historical echo they provide of “Long Covid”—that mysterious affliction, or afflictions, that dogs some patients who were infected with the SARS-CoV-2 virus long after any initial symptoms have subsided, and apparently long after the virus has left their body. “Day 163 post Covid,” tweeted one Long Covid sufferer on Sept. 16. “I managed to walk for 20 mins without chest pain while keeping my heart rate below 120.”
So much for the "malady of modern urban society" trope. Inconvenient facts that go against the narrative are so easily ignored.In what is now Tanzania, to the north, post-viral syndrome has been blamed for triggering the worst famine in a century—the so-called “famine of corms”—after debilitating lethargy prevented flu survivors from planting when the rains came at the end of 1918. “Agriculture suffered particular disruption because, not only did the epidemic coincide with the planting season in some parts of the country, but in others it came at the time for harvesting and sheep-shearing.” Kathleen Brant, who lived on a farm in Taranaki, New Zealand, told Rice, the historian, about the “legion” problems farmers in her district encountered following the pandemic, even though all patients survived: “The effects of loss of production were felt for a long time.”
Weird how this "leading researcher" who made so much noise about not being able to research exactly this never actually has his expertise on the topic acknowledged. This is Wessely's jam, he has very loudly been "the" expert on this very topic for years, decades even. Yet this expertise is only ever acknowledged in very narrow confines, never dares pretend he knows anything about this whenever he actually should have something to say.Nevertheless, given the tens of millions who have already been infected by SARS-CoV-2, even a small minority could amount to substantial misery, not to mention social and economic fallout—as it did 100 years ago. That’s reason enough, says psychiatrist Simon Wessely of King’s College London, “to investigate the Long Covid cases with the same rigour and vigour that studies like PHOSP-COVID are investigating the hospitalised cases.”
Not nearly as bad as I expected, I've seen far worse.
But this tells me what I have suspected for a while: that what will make the difference here is the sheer number of physicians who are themselves affected, on top of seeing people close to them being affected. They only speak through anecdotes here, but the number is surprisingly high. Talking about colleagues or friends they respect who they can't bring themselves to gaslight, even anonymously. Without this, nothing would have changed. If medicine had protected their
I especially liked calling this "red flags".The medical student who admitted they suffered from a prolonged post-viral syndrome did suddenly have their credibility reduced.
It seems that some physicians aren't even willing to believe their own.
Background: Preclinical and clinical investigations have argued for nervous system involvement in SARS-CoV-2 infection and for long term sequalae including neurological manifestations.
Methods: A sample of 208 previously hospitalized COVID-19 patients, 165 patients were re-assessed at 6 months according to a structured standardized clinical protocol. Premorbid comorbidities and clinical status, severity of COVID-19 disease, complications during and after hospitalization were recorded.
Results: At 6-month follow-up after hospitalisation due to COVID-19 disease, patients displayed a wide array of neurological symptoms, being fatigue (34%), memory/attention (31%), and sleep disorders (30%) the most frequent. Subjects reporting neurological symptoms were affected by more severe respiratory SARS-CoV-2 infection parameters during hospitalisation. At neurological examination, 37.4% of patients exhibited neurological abnormalities, being cognitive deficits (17.5%), hyposmia (15.7%) and postural tremor (13.8%) the most common. Patients with cognitive deficits at follow-up were comparable for age, sex and pre-admission comorbidities but experienced worse respiratory SARS-CoV-2 infection disease and longer hospitalisation.
Not sure how they determined what symptoms to ask for. Always the limiting factor with symptoms that can't be measured.Conclusions: Long term neurological manifestations after hospitalization due to COVID-19 infection affects one third of survivors. Multiple neurological abnormalities including mild cognitive impairment are associated with severity of respiratory SARS-CoV-2 infection.
The medical student who admitted they suffered from a prolonged post-viral syndrome did suddenly have their credibility reduced.
It seems that some physicians aren't even willing to believe their own.
Rachel and a colleague then triage the patient with a lengthy questionnaire before deciding a treatment plan, which is mainly symptom-management therapy delivered either face-to-face, over the phone or virtually.
The Covid After-Care team has dedicated physios, occupational therapists, dietitians and those who specialise in respiratory or neurology.
Patients are also encouraged to keep a ‘fatigue diary’ to understand how they are feeling and why.
Rachel said: “People have a really good day and think ‘I’m fine’ and then over-do it and it sets them back quite massively for a week or so. It’s really detrimental to recovery.”
The clinicians all agree that the process to rehabilitate long Covid patients appears to be a slow one.
Dr Halpin said: “What we are finding most effective is understanding that this is going to be quite a long recovery and having rehabilitation appropriate to that means taking things quite steadily, aiming for gradual improvements.”
No one is learning a damn thing out of sheer stubbornness. Nearly a year in and nothing to show for it. Circular failure.Rachel said: “We haven’t had anyone come out the other end yet. It’s a really slow rehabilitation.
“We hope these patients are going to recover - but there’s no timescale. We’ve never treated anything like it before.
“We’re trying not to compare it to chronic fatigue or ME because this could be something purely Covid-related.
“It’s about trying to stay positive though and hoping it will improve. But I can’t offer reassurance to the patients. We can support them as best we can but only time will tell.”
If it's true that up to 10% of people face a long or very long recovery from Covid-19, the fact that the UK is heading rapidly towards reporting 60,000 new cases per day is terrifying. And that's only people who're symptomatic, or have enough reason to think they've been exposed that they come forward for testing. Thousands of new people each day who're likely to be incapacitated – some for weeks, some for months, and the unlucky ones possibly for good.
Rachel said: “We haven’t had anyone come out the other end yet. It’s a really slow rehabilitation.
After nearly 4 decades of ME and all its delights, I am still surprised by how resistant to the obvious medicine can be.The level of idiocy and incompetence is astonishing.