Long Covid is Now the Biggest Pandemic Risk for Most People

January 18, 2024 1:08 PM

Where the drop in severe-COVID incidence is clear and prominent, the drop in long-COVID cases is neither as certain nor as significant. Plenty of new cases of the chronic condition are still appearing with each passing wave—even as millions of people who developed it in years past continue to suffer its long-term effects. In a way, the shrinking of severe disease has made long COVID’s dangers more stark: Nowadays, “long COVID to me still feels like the biggest risk for most people,” Matt Durstenfeld, a cardiologist at UC San Francisco, told me—in part because it does not spare the young and healthy as readily as severe disease does. Acute disease, by definition, eventually comes to a close; as a chronic condition, long COVID means debilitation that, for many people, may never fully end. And that lingering burden, more than any other, may come to define what living with this virus long term will cost.
posted by folklore724 (33 comments total)

Ungated.

Did we discuss here the finding that one of the reasons for extreme exhaustion after even tiny physical exertions during Long COVID is due to the cells having their mitochondria fucked up and cells damaged in ways they hadn't seen before?

Because if we haven't, this is the perfect thread in which to mention that.
posted by hippybear at 1:15 PM on January 18 [22 favorites]

This just popped up in my news feed: Long Covid explanation in new study possibly paves way for tests and treatments

Scientists have identified a persistent change in a handful of blood proteins in people with long Covid that indicates that an important part of their immune system remains on high alert for months after an acute infection.

The findings, published Thursday in the journal Science, could help explain what causes the persistent fatigue, brain fog and other debilitating symptoms of long Covid, as well as pave the way for diagnostic tests and potentially, a long-awaited treatment, experts say.
...
Repeated blood samples turned up important differences in their blood: A group of proteins indicated that a part of the body’s immune system called the complement system remained activated long after it should have returned to normal.
posted by polecat at 1:27 PM on January 18 [7 favorites]

Katherine Wu, and the Atlantic by proxy, will be panicking about this for eternity.
posted by Galvanic at 2:19 PM on January 18 [8 favorites]

Katherine Wu, and the Atlantic by proxy, will be panicking about this for eternity.

I don't know if "panicking" is the right term, but this article sure was digging hard for the negative perspective at all moments.
posted by Dip Flash at 2:37 PM on January 18 [5 favorites]

Here is one of several videos in my feed over the last few days going crazy about red blotches on Trump’s hands.

The preferred explanation seems to be syphilis, which I think is absurd.

It’s far more likely IMO, that he’s taking blood thinners in an attempt to compensate for the vasculitis of long Covid.

We saw very similar blotches on Mitch McConnell's hands around the same time he was complaining about the Covid that was rife in the Trump White House and how careless they were being, and we all know about his subsequent frozen spells right in the middle of speeches where he just stops talking or responding in any way, and has to be escorted off stage.

Trump's dementia seems to be accelerating, and I think the accelerant is probably long Covid.
posted by jamjam at 2:59 PM on January 18 [6 favorites]

Trump's dementia seems to be accelerating, and I think the accelerant is probably long Covid.

Dementia accelerating isn't exactly unusual, I'm not sure there's any particular reason to put the blame on COVID?
posted by BungaDunga at 3:12 PM on January 18 [29 favorites]

In and of itself, speculating on Trump's dementia is borderline conspiracy theory conversation.

Like, I get that things are going awry in ways we can describe in a variety of ways, but the whole old age degradation of either of our current US Presidential candidates is speculation pretty much dominated by wholesale batshit insanery at this point.

So let's either back up statements about anyone's mental decline with reliable articles pointing to evidence, or let's not make that declaration a part of the public record of this website which will be consulted in the future when analyzing the current moment.
posted by hippybear at 3:17 PM on January 18 [28 favorites]

yeah, the description of that mitochondria/post-exertional malaise thing is a pretty good fit for what I started experiencing a month or two after what was a pretty mild case of COVID in the summer of 2022. (I'm healthy and had all shots prior to getting ill). What I experience is sort of a flu-y ache in the big muscle areas - eg quads, gluts - several hours or even days after even just moderate exertion (like a moderate walk). Particularly the morning after exercise. Not during the exercise itself, strangely.

It's not severe or debilitating, amen, and if it really bugs me, a prescription anti-inflammatory brings relief. No general fatigue or brain fog. I am a trifle nervous about what it might have done to my heart.

If what i have is a very mild example of long COVID... them my heartfelt condolences to those who have been walloped by it.
posted by Artful Codger at 3:37 PM on January 18 [9 favorites]

So the NIH has started some studies, and maybe you can be a part of them if you're having things going on.

If you have things going on, maybe do some searching and find a way to get into a study.

If nothing else, getting into a study means you might get testing and results you couldn't get before.

Beyond that, it might mean getting medications [Ed note: or a placebo].

Like, I don't know. My sister was on oxygen for 2 years but just recently got off and maybe it was long COVID but I have no real clue.

I guess if you're suffering, do some more in-depth searching. Maybe you can end up in a research group. And while that is not any guarantee of anything... as someone who has a thing going on which has no diagnosis, participating in something which might move things toward a diagnosis would feel valuable to me, personally.
posted by hippybear at 3:49 PM on January 18 [5 favorites]

potentially of interest: BBI Viruses and Vaccines Seminar
(academic "viruses and vaccines" seminar about long covid, longitudinal studies, sex-based differences, etc.)
posted by nickzoic at 3:56 PM on January 18

I hope that research makes some dent in the lingering question of why COVID and Long COVID affect some people more severely than others, even among people who share so many genetic and environmental factors in common. I recall back in 2021 or early 2022, the NY Times ran a story about a typical American family -- mother, father, two kids -- who live together in a private home, and when they all tested positive at the same time one member showed no symptoms, one showed typical flu symptoms, and one of the children needed medical breathing intervention.

See also for example, Dianna Cowern aka Physics Girl: In 2022 she was in good general health without the typical risk factors, but then was hit with basically every possible immune complication from long COVID, with intestinal issues besides.
posted by The Pluto Gangsta at 7:02 PM on January 18 [6 favorites]

While not NE Journal of Medicine, Scientific American is not a tabloid:

Vaccination Dramatically Lowers Long COVID Risk


(well not just yet, sigh, but worth consideration)
posted by sammyo at 8:50 PM on January 18 [3 favorites]

And as much as wrong and evil, well just wrong, I'd like to see a follow up on the guy that got 90 shots to sell fake cards to antivaxers.
posted by sammyo at 8:54 PM on January 18 [4 favorites]

Long COVID is a worry. The other real worry is that strong viral infections lead to autoimmune disorders. My 18 yo daughter was diagnosed with Type 1 Diabetes out of the clear blue last summer. Her pediatrician said they'd seen a rise in these diagnoses, along with autoimmune disorders, since the onset of COVID. We got the early vaccines and we keep getting them.
posted by PuppyCat at 7:44 AM on January 19 [8 favorites]

Dementia accelerating isn't exactly unusual, I'm not sure there's any particular reason to put the blame on COVID?

I mean, other than karma, eh?
posted by thecincinnatikid at 7:57 AM on January 19 [1 favorite]

I would have thought an airborne virus that is easily transmitted and carries with it a non-zero chance of DEBILITATING, LONG TERM, CHRONIC ILLNESS even in people who were otherwise healthy would cause us as a society to have a good look at shoring up the social safety net because it's the quintessential catastrophic-risk-that-could-happen-to-anyone. And even if you want to declare this particular pandemic over, there are all sorts of similar "fuck you" health conditions that are just as life-impacting and can similarly happen to anyone and which could benefit from some sort of raised awareness that might lead to better collective risk mitigation.
posted by RonButNotStupid at 8:34 AM on January 19 [11 favorites]

I would have thought an airborne virus that is easily transmitted and carries with it a non-zero chance of DEBILITATING, LONG TERM, CHRONIC ILLNESS even in people who were otherwise healthy would cause us as a society to have a good look at shoring up the social safety net because it's the quintessential catastrophic-risk-that-could-happen-to-anyone.

That's literally every virus we have. It's all a roll of the dice on whether you pick up CFS/ME from whatever virus infects you. Protestants who hold political hegemony don't care because of the Just World mind virus.

Why would this time be any different?
posted by Your Childhood Pet Rock at 9:28 AM on January 19 [7 favorites]

PSA for those with COVID or any virus: REST. If you feel like you are pushing through tiredness to work, consider that doing so could lead to long term disability.

People who already have long COVID, also, can have their symptoms vastly worsened or vastly ameliorated by rest and careful pacing of activity.

This includes cognitive activity. A friend with long COVID described trying to work as "staring into the sun". An excellent metaphor, because staring into the sun is bad for you and can cause irreversible damage.

I get that capitalism and the economy means sometimes there's no alternative. But in those situations, lean on anyone you have to help, consider spending money you have to avoid overexertion (e.g. grocery delivery with easy to eat meals, laundry service, cleaning, ride shares). Think about it like paying to fix your car so the problems don't get worse and leave you unable to commute.

Overexertion is the enemy. Get a heart rate monitor, live and die by it, even if it means sitting down for five minutes every block.

Trust me on this one, the worst case is far worse than the short term consequences of properly resting.
posted by lookoutbelow at 9:45 AM on January 19 [17 favorites]

If you have Covid now: a short course of metformin may reduce risk of developing long term symptoms; the anti-inflammatory, antiviral diabetes drug inhibits SARS-CoV-2 replication.
posted by Iris Gambol at 10:18 AM on January 19 [1 favorite]

Why would this time be any different?

I dunno. Maybe the unprecedentedness of the pandemic?

It's still extremely depressing how fast we went from "the world will never be the same" in March of 2020 to talking about long covid is for pessimistic worrywarts who look for negativity everywhere don't want to accept that things are back to normal.
posted by RonButNotStupid at 1:02 PM on January 19 [14 favorites]

It's still extremely depressing how fast we went from "the world will never be the same" in March of 2020 to talking about long covid is for pessimistic worrywarts who look for negativity everywhere don't want to accept that things are back to normal.

You can entirely blame the Trump and Johnson administrations for this. They both were shit with their messaging, providing deeply conflicting statements and never being clear that what they were saying was based on the best available information at the time, and instead making gigantic proclamations.

The entire "don't mask, no wait mask!" that the US government delivered to the US public in mid 2020 was based entirely upon Trump pulling down pandemic stockpiles that had been developed before his tenure literally months before a global pandemic presented itself, as a "cost saving measure."

A cost saving measure taken after congress had handed industry and capitalists the largest tax cut ever and added nearly 2 trillion dollars to the national debt.

Trump's messaging across the entire pandemic was one of feeling outraged and personally faulted by the virus, and it is that spirit contained within what he was putting out into the world that has colored the entire global conversation about what measures need to be taken, even to this day.

If there had been messaging from the outset that this is a collective problem and we all hold each other carefully in each others' arms and together we can defeat this but selfish action will doom us all...

But that isn't what happened. And this is the world we live in.

I really invite anyone who wants to change the messaging to find a way to make the new appeal toward masking not one of finger pointing and accusation but instead an invitation toward collective protection. Because I am not sure scolding others for bad behavior, after having bad behavior modeled for the entire world often live on camera, is going to succeed.
posted by hippybear at 1:20 PM on January 19 [3 favorites]

We had signs that said "My mask protects you. Your mask protects me." all over the place. Lots of people used to genuinely embrace that idea. Not anymore.

I'm not scolding. I'm just stating what happened.
posted by hydropsyche at 1:35 PM on January 19 [14 favorites]

Because I am not sure scolding others for bad behavior, after having bad behavior modeled for the entire world often live on camera, is going to succeed.
Naw. I just wear a mask. I figure I'm saving someone's grandparent somewhere, once in a while.
posted by Flight Hardware, do not touch at 2:56 PM on January 19 [9 favorites]

You can entirely blame the Trump and Johnson administrations for this.

I would have been inclined to agree with you a few years ago, but now I favor the more cynical perspective that human nature is resistant to change. I mean yeah, Trump didn't handle the pandemic well (to put it mildly) but most of the world isn't masking at this point, even countries with governments that had clear messaging on masks, and where the population was largely compliant. Globally, most people wanted to get back to normal as soon as possible - I don't actually think most people ever thought "the world will never be the same" (or wanted this outcome).
posted by coffeecat at 3:44 PM on January 20 [6 favorites]

Seriously, I would love to know what language I can use to get people of good will and good intentions to again take COVID seriously, including the now clearly defined risk of Long COVID, that won't get me accused of shaming, celebrating, self-righteousness, hypocrisy, fear-mongering or whatever else society comes up with next. I have many colleagues and students out sick right now or in the slow, miserable process of recovering. I have family members sick on the other side of the world on a once in a lifetime type trip. It's terrifying, horrifying, depressing as hell. Tell me the magic words that are okay to say, and I will say them.
posted by hydropsyche at 5:35 PM on January 20 [11 favorites]

When I hear someone request that people be nicer to people about the importance of masking and the continued threat of COVID, the undercurrent also seems to be, "Stop making me feel bad. You're making me feel bad. I don't want to feel bad. Be nice to me even though I won't change my ways or make an effort."*


*this also applies to those who hold shitty views and the people who want us to be nicer to the racists/misogynists because we might make them worse, nvm that that is not on us
posted by Kitteh at 4:45 AM on January 21 [6 favorites]

What I don't get is why this isn't stronger in public health messaging:

"In line with that logic, a glut of studies has shown that vaccination—especially recent and repeated vaccination—can reduce a person’s chances of developing long COVID. “There is near universal agreement on that,” Ziyad Al-Aly, an epidemiologist and a clinician at Washington University in St. Louis, told me."

As of Dec, only 19% of Americans got the new booster. That means there are a lot of people out there who aren't anti-Vax who haven't bothered - there is definitely a wide swath of the population that, once they realized the vaccines wouldn't prevent infections 100%, concluded that they didn't make any difference for relatively healthy people. "Significantly reduce your risk of Long Covid - get the booster!" should be on billboards, the tagline for PSA commercials, etc.
posted by coffeecat at 8:03 AM on January 21 [8 favorites]

Nobody should be made to feel bad for taking more precautions, or for advocating for society in general to take those precautions.

Personally I think a lot of the desires that are expressed in these threads are so impossible as to be kind of abstract, but that's an opinion and regardless, back to my first point, people shouldn't be made to feel bad for expressing reasonable (if unlikely) wishes. It's unfortunate that this is clearly the case.
posted by Dip Flash at 8:03 AM on January 21 [1 favorite]

Also tho it's not as EASY to get the booster any more. It was free, it was on corner pop ups and at vaccination events, in many drugstores. I don't want to pin vaccine blehness on only people's lack of caring. Believe it or not but a $30 copay is a significant burden for some of my friends.

Coupled with people having been vaccinated/boosted 4 times plus sometimes also having had covid and sailing through it, it would be hard for me to imagine human nature responding much differently.
posted by tiny frying pan at 8:55 AM on January 21 [2 favorites]

And California and Oregon (NYT) have given up on having the asymptomatic quarantine, because what good does it do to try that anyway. Greaaaaaaaaaat.
posted by jenfullmoon at 10:18 AM on January 21 [2 favorites]

Though on a positive (har) note, after five people in my show came down with covid over the weekend, literally EVERYBODY came in wearing a mask tonight. Nobody was told to, they all did it on their own. Huzzah.
posted by jenfullmoon at 10:20 PM on January 21 [4 favorites]

Long COVID is associated with severe cognitive slowing: a multicentre cross-sectional study (The Lancet)

COVID is bad for your brain. If you like your brain, maybe try not to get it?
posted by hydropsyche at 4:34 AM on January 29 [2 favorites]

As an anecdotal measure of "how concerned are most people right now," I recently had a couple of flights on Airbus 321s (so about 180 passengers, I think). On each flight, there were well under 10 people wearing masks, probably closer to 5.
posted by Dip Flash at 6:05 PM on January 31