Yet Long Covid is a major problem, with the ONS (Office for National Statistics) estimating hundreds of thousands of people suffering from ongoing symptoms after COVID-19. How concerned should we be, with restrictions planned to be removed on 19 July?
Given high numbers of people impacted, the NHS has set up more than 60 specialist clinics across England. These assessment centres “are taking referrals from GPs for people experiencing brain fog, anxiety, depression, breathlessness, fatigue and other debilitating symptoms”.
So what is Long Covid? How does it arise? How many people does it affect? How concerned should we be with restrictions planned to be removed in England on 19 July?
WHAT IS LONG COVID?
There is no universal definition for Long Covid, but two definitions are in common use in the UK:
- Symptoms of COVID-19, or attributed to it, lasting more than 4 weeks. The ONS estimates nearly a million people are currently suffering, with another million previously affected.
- Lasting more than 12 weeks (or 3 months), which is also called Post-COVID Syndrome. Some 856,000 people per ONS.
‘Long haulers’ is another term in use. Some sufferers have been impacted for over a year. ONS estimates some 385,000 people, who would have caught the disease at the start of the pandemic last spring.
HOW DOES LONG COVID ARISE?
 |
| ACE2 binds to virus spike proteins |
“ACE2 is also present in many cell types and tissues including the lungs, heart, blood vessels, kidneys, liver and gastrointestinal tract”. And the brain.
If the virus gets into the blood stream, such as when lung cells explode after infection, the virus can permeate around the body. It then attacks and damages cells in other organs that have the ACE2 receptor.
Furthermore the virus causes micro-clotting in the blood. This can block small blood vessels, such as in the lungs. As the blood flows around the body , microclots and larger clots can cause additional damage to organs. Microclots can cause rashes to appear on skin, and be a key factor in severe disease.
As a result COVID-19 can cause five groups of long-term problems for people recovering from infection:
- Continuation of basic COVID-19 symptoms such as loss of taste and smell
- Post-viral fatigue, as can happen after any severe viral infection
- Pain and discomfort
- Loss or impairment of bodily function, such as heart palpitations
- Mental health issues, such as depression and anxiety
The NHS has published a long list of symptoms for Long Covid.
HOW MANY PEOPLE DOES IT AFFECT?
As indicated above, millions of people have been and will be affected by Long Covid. Many of those recovering have symptoms lasting more than twelve weeks, and a significant number more than a year.
The ONS estimates from their recent sample that in the UK:
- 535,000 people are impacted by fatigue
- 397,000 by shortness of breath
- 309,000 by muscle ache
- 295,000 difficulty concentrating
As a result:
- Some 178,000 people have had their ability to undertake their day-to-day activities "limited a lot". This is more than the number of deaths so far in the UK
- 634,000 have their day-to-day activities adversely affected by symptoms. An even bigger problem
The ZOE symptoms study for King’s College London estimated "around one in seven had symptoms lasting for at least 4 weeks, with around one in 20 staying ill for 8 weeks and one in fifty suffering for longer than 12 weeks"
The ONS reports that the problem is more acute in females and over 35s, plus some other groups. Long Covid can impact all ages, including children, for which there are now support groups in UK and North America
It is too early to know what impact vaccinations will have on Long Covid numbers. People can suffer from it even when they have not been hospitalised. As vaccines are not totally effective to prevent severe disease, they would not be expected to be totally effective against Long Covid either. Without vaccination, children will continue bearing the same risk as now.
HOW CONCERNED SHOULD WE BE?
Long Covid is clearly a serious problem, badly affecting many more people than have been hospitalised or died. Adults and children. For many, a living death.
The numbers are going to be in some way proportional to cases. With case rates continuing to rise, despite vaccination, the number of new Long Covid sufferers will continue to rise too. Especially if all remaining restrictions are removed and case numbers allowed to rise unchecked.
The Government always talks about not allowing the NHS to be overrun, with the focus on hospitals. But as the specialist Covid centres require a referral from a GP, it is no wonder GPs are struggling to provide the service for other health conditions. Added to which is increasing strain on specialist NHS services involved. An increasing workload will only make matters worse across many parts of the NHS, reducing availability for people with other health conditions.
The Government has indicated that in removing legal restrictions on 19 July, simple mitigations such as masks on public transport will no longer be required. That will allow case rates to continue to rise until ‘herd immunity’ is reached across two groups, whether that is by vaccination or infection:
- Adults, of which many are yet unvaccinated
- Children, who are unvaccinated
This is asking for trouble, with Long Covid numbers continuing to rise for some time. Putting additional strain on GPs and other NHS services, in addition to adversely affecting the lives of thousands more people, their families and employers.
The new Health Secretary Sajid Javid is right to indicate that restrictions need to be balanced against the other health and economic factors which would improve from removing restrictions. But Long Covid needs to be taken into account in striking the right balance.
 |
| A 3-ply medical mask |
Does that mean removing simple and cheap mitigations such as masks and social distancing, where practical?
Given the numbers and risks involved with Long Covid, we ought to be concerned, and act accordingly.
What do you think?
No comments:
Post a Comment