
Covid-19: What do we know about “long Covid”? - nico_h
https://www.bmj.com/content/370/bmj.m2815
======
DoreenMichele
We really need two things:

1\. Better systems for preventing transmission of disease generally as our
cultural default.

2\. Better models for helping people genuinely recover, something modern
medicine doesn't actually address for most diseases.

We have physical therapy for certain injuries. We don't really seem to have
something similar for infections. We think just treating the infection per se
is all we need to do. We generally do not school people on how to resolve the
issues left behind from antibiotic use, chemotherapy, etc.

~~~
nico_h
1: Masks! that seems to work.

2: Physiotherapy? Yoga?

3: there are articles about rehabilitation centers for ex-covid patients, in
europe + UK at least.

~~~
DoreenMichele
1\. Are you suggesting masks as a cultural norm for all eternity? I hope not.

I'm talking about sustainable permanent changes. I like contactless takeout,
like Little Caesar's pizza portal as one example.

2\. Neither of those are for infections per se.

3\. Thanks. I will look for such, but it probably sucks if the past 55 years
of my life is anything to judge by.

~~~
nfoz
> 1\. Are you suggesting masks as a cultural norm for all eternity? I hope
> not.

Well in some Asian cultures it was already normalized to wear a mask when you
have any kind of symptoms of anything contagious. I was hoping that convention
would move west even before this pandemic happened -- so I hope it stays with
us.

~~~
DoreenMichele
I think we are already far too accepting of the idea that it's just normal to
be germy and ill. I wish that expectation would change. I don't think it has
to be that way.

~~~
nico_h
There is a war between your immune system and your environment, with constant
escalation. Every time people meet they exchange germs. Most often it's
something your immune system has already seen, but sometimes you're tired or
it's something that's mutated or that's brand new.

Unless we live in a literal bubble with filtered air, we're going to be germy.

The safest way to not be germy is likely to live in a sunny dry place away
from people but then it's usually hot and maybe amazon doesn't deliver.

~~~
SpicyLemonZest
True eradication of most germs is probably impossible, given how hard it was
for smallpox and how hard it currently is for polio. But I don't think there's
any inherent reason why all remotely serious diseases couldn't be driven to
the level of tuberculosis - something that exists, endemic in every country,
but at such a low level that most people have no real expectation they might
catch it.

~~~
giantDinosaur
We can treat tuberculosis with antibiotics. Do you think we can just do the
same thing with e.g. malaria? The only diseases we've eliminated have been
from vaccines, and the diseases we control tend to be from either relatively
easy behavioural changes or medicine.

------
nico_h
"nearly nine in 10 patients (87%) discharged from a Rome hospital after
recovering from covid-19 were still experiencing at least one symptom 60 days
after onset. "

I don't understand how this illness is not taken more seriously in the west
given how little we know about it and what little we know tell us it's not a
recover / die kind of illness and more like a bell curve with recover / suffer
forever / die and suffer forever seems to be the fat part of it.,

~~~
ketamine__
Wouldn't you expect long-term side effects from hospitalization that likely
involved a ventilator and sedation? Not an expert here. Maybe someone else can
chime in?

~~~
jointpdf
This is presumably only one aspect of “long Covid”, but a study [0] that was
making the rounds a couple weeks ago found this (quoted from the accompanying
editorial)[1]:

> _”In 100 recovering patients included in the study, 67% of whom recovered at
> home, evaluated a mean of 71 days after confirmed COVID-19 diagnosis, 78%
> had demonstrable cardiac involvement via cardiac magnetic resonance imaging,
> 76% had detectable high-sensitivity troponin, and 60% had evidence of active
> myocardial inflammation by abnormal native T1 and T2.”_

> _”...if this high rate of risk is confirmed, the pathologic basis for
> progressive left ventricular dysfunction is validated, and especially if
> longitudinal assessment reveals new-onset heart failure in the recovery
> phase of COVID-19, then the crisis of COVID-19 will not abate but will
> instead shift to a new de novo incidence of heart failure and other chronic
> cardiovascular complications._ ”

In other words, even mild cases of Covid-19 are very frequently resulting in
heart inflammation and other forms of cardiac injury.

[0]:
[https://jamanetwork.com/journals/jamacardiology/fullarticle/...](https://jamanetwork.com/journals/jamacardiology/fullarticle/2768916)

[1]:
[https://jamanetwork.com/journals/jamacardiology/fullarticle/...](https://jamanetwork.com/journals/jamacardiology/fullarticle/2768915)

[2]: (another editorial, easier read)
[https://www.statnews.com/2020/07/27/covid19-concerns-
about-l...](https://www.statnews.com/2020/07/27/covid19-concerns-about-
lasting-heart-damage/)

------
latchkey
If you're interested in or even doubting the long term effects, follow one of
the larger (91k+ and growing) survivor groups [0]. It is anecdotal, but the
stories are very real and quite intense. Even odd things that you don't hear
about in the news, like excessive burping [1] and of course, the heart
breaking children tag [2].

You don't want this thing if you can help it.

[0]
[https://www.facebook.com/groups/COVID19survivorcorps/](https://www.facebook.com/groups/COVID19survivorcorps/)

[1]
[https://www.facebook.com/groups/COVID19survivorcorps/search/...](https://www.facebook.com/groups/COVID19survivorcorps/search/?query=burping&epa=SEARCH_BOX)

[2]
[https://www.facebook.com/groups/669615740453955/post_tags/?p...](https://www.facebook.com/groups/669615740453955/post_tags/?post_tag_id=704593920289470)

~~~
rtlfe
Groups like that are always populated by people with the worst of the worst
outcomes. There's no indication of how likely these problems actually are.

~~~
heavyset_go
On the other hand, those with conditions like fibromyalgia and chronic fatigue
syndrome were relegated to groups like that and it's only been as of late that
they've been taken more seriously. We're unfortunately seeing the same thing
happen to a lot of legitimate pain patients, as they're easier to dismiss than
those with obvious presentations of symptoms.

------
woke_neolib
The reports of pulmonary, neurological, and cardiac damage are pretty
troubling.

Ed Yong's Atlantic article about long-haulers is excellent:
[https://www.theatlantic.com/health/archive/2020/06/covid-19-...](https://www.theatlantic.com/health/archive/2020/06/covid-19-coronavirus-
longterm-symptoms-months/612679/)

Eric Topol's twitter is an excellent source for Covid science coverage:
[https://twitter.com/EricTopol](https://twitter.com/EricTopol)

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hprotagonist
More and more it's clear to me that the appropriate historical analog to
Covid19 is not the spanish flu. It's polio.

~~~
legerdemain
Notably, there is still no curative treatment for polio. If you do contract
it, it's still a roll of the dice whether you recover fully or develop
paralysis.

~~~
hprotagonist
and a ~10% CFR, whoof.

~~~
SpicyLemonZest
Although a direct comparison is hard, because most polio cases are believed to
be asymptomatic but broad screening is less common.

~~~
hprotagonist
well, the first part of that's shared, anyway.

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dariusj18
I know of at least one "long hauler." The descriptions they give are horrific.

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rgacote
Welcome to the newest "pre-existing condition" in American health care.

