This report by Pam Belluck in The New York Times brings up a serious problem that’s not getting enough attention:
Significant numbers of coronavirus patients experience long-term symptoms that send them back to the hospital, taxing an already overburdened health system.
There is a tendency to focus on the big aspects of the pandemic story — the rising infection and death numbers, the rush to get vaccines out to people, just where the virus is spreading, what actions are being taken to control it, and the threatened collapse of the healthcare system’s ability to meet rising demand for treatment.
There’s an additional concern that’s getting a lower priority, but it’s still serious for the people involved and for the long-term strains it is going to put on healthcare: the long haulers.
They are the people who get sick and do not fully recover, or have repeat bouts of infection. We don’t know yet if vaccination can help these individuals or what other kinds of therapy they will need.
The person referred to in the headline has been going through this:
But since getting sick with the coronavirus in March, Mr. Long, 54, has fallen into a distressing new cycle — one that so far has landed him in the hospital seven times.
Periodically since his initial five-day hospitalization, his lungs begin filling again; he starts coughing uncontrollably and runs a low fever. Roughly 18 days later, he spews up greenish-yellow fluid, signaling yet another bout of pneumonia.
Soon, his oxygen levels drop and his heart rate accelerates to compensate, sending him to a hospital near his home in Clarkston, Mich., for several days, sometimes in intensive care.
Long may be an extreme case, but not an exceptional one.
A study by the Centers for Disease Control and Prevention of 106,543 coronavirus patients initially hospitalized between March and July found that one in 11 was readmitted within two months of being discharged, with 1.6 percent of patients readmitted more than once.
In another study of 1,775 coronavirus patients discharged from 132 V.A. hospitals in the pandemic’s early months, nearly a fifth were rehospitalized within 60 days. More than 22 percent of them needed intensive care, and 7 percent required ventilators.
And in a report on 1,250 patients discharged from 38 Michigan hospitals from mid-March to July, 15 percent were rehospitalized within 60 days.
Some of the effects of covid-19 infection that have been noted range from things like organ damage in severe cases, to unsuspected heart damage in mild cases. There will be more to investigate as the pandemic continues. We are long way from a complete understanding of all the things this virus does.
Weaponized Stupid
These long-term consequences are getting ignored by the liars and deniers, the people who dismiss any reports on the pandemic as fear-mongering by the liberal media, Democrats, Big Pharma, etc.
It is an article of faith with too many that:
- the virus is no worse than the flu
- hardly anyone catches it
- masks don’t work; social distancing isolation kills more people
- we just need to get through it and everything will be fine (herd immunity)
- most people have a mild case, if at all, and get over it.
- the vaccines are fake/more dangerous than the disease, a scam
- the crazier the CT, the more likely it is to be true
- the only people who have to worry are those with pre-existing conditions like age, diabetes, obesity, being black or Native American, etc. (There’s one particular pre-existing condition that has no obvious signs: a particular set of genetic variations.)
Ignorance is not only bliss; too often it becomes arrogance and over-confidence. Politicized pandemic bullying ridicules people for ‘living in fear’, being called sheeple or worse for believing in a “liberal hoax”. It engenders all kinds of paranoia, CT and counter-productive behavior. It has real consequences. The virus does not care about political beliefs or party affiliation.
People protest being ‘controlled’ — but they never seem to have a coherent explanation for the what the control is supposed to accomplish if it’s not actually about dealing with the pandemic. Distrust of all government and authority has become a knee-jerk reaction.
And let us not forget the damage from the anti-vaxxers. Kerry Kennedy Meltzer, an internal medicine resident physician at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, is having serious issues with her uncle Robert Kennedy.
His concern — that the Covid vaccine is potentially unsafe, and hasn’t been properly tested — is widespread, and dangerously wrong. According to a report published by the Kaiser Family Foundation on Dec. 15, roughly a quarter of Americans say they “probably or definitely would not get a COVID-19 vaccine even if it were available for free and deemed safe by scientists.”
If this number holds, then Dr. Anthony Fauci’s estimate that at least 75 percent of Americans must be vaccinated for the country to achieve herd immunity, and effectively end person-to-person spread of the disease, could be unachievable.
For some explicit advice on vaccination questions, see this Opinion piece by Dr. Aaron E. Carroll: Don’t Worry Too Much About Covid Vaccine Allergic Reactions
Aaron E. Carroll is a contributing opinion writer. He is a professor of pediatrics at Indiana University School of Medicine and the Regenstrief Institute who blogs on health research and policy at The Incidental Economist. @aaronecarroll
Why knowing history matters
Americans have forgotten that the viral plagues that vaccines now control sometimes came with long-term consequences for the survivors. The one that comes to mind is polio. I’m old enough to remember when people ended up in Iron Lungs, sometimes for life because of it.
Rows of iron lungs filled hospital wards at the height of the polio outbreaks of the 1940s and 1950s, helping children, and some adults, with bulbar polio and bulbospinal polio. A polio patient with a paralyzed diaphragm would typically spend two weeks inside an iron lung while recovering.[37][38]
Polio can also cause other forms of paralysis and reappear years later as post-polio syndrome. It’s too soon to know if covid-19 will have its own set of chronic health effects, but we cannot ignore the possibility.
It’s about the future
What this means is that we will need to plan going forward how to accommodate those people who end up with chronic complications from covid-19. We not only have to include this in further healthcare reform efforts, we have to consider the long-term economic impacts. The obvious corollary is that every dollar spent on prevention of infection now will have a multiplier effect on savings down the road.
We also have to address the political and financial incentives that drive the pandemic of weaponized stupid: the fear and distrust of ‘elites’, the loss of faith in government, the toleration of open incompetence and corruption in government, the mass dissemination of disinformation, and the authoritarian motives behind it.
Closing down Fox, Sinclair, OANN, Newsmax, talk radio and the GOP in general could be justified as a public health measure, if people would take the body count and the connections seriously enough. It would be the modern equivalent of “removing the pump handle.”
It has been shown that supplying people with facts is not enough to change minds; it often ends up reinforcing the embrace of disinformation instead. The information here will probably be dismissed as lies by the true disbelievers. Any prevention and education programs going forward will have to take that into account.
The New York Times article has a list of previous articles on this problem, something that is becoming increasingly significant as the pandemic progresses and we gain more experience with it. In reverse chronological order (most recent to oldest):
Experts like Dr. Fauci and others like President Elect Biden are warning that the darkest days lie ahead of us. For some, the darkness will never fully lift even if they do survive their initial infection.
Wear a mask. Practice social distancing. Avoid gatherings. Get vaccinated. Dying from covid-19 is not pleasant. Increasingly, it appears living with it is not either.
UPDATE: ICYMI, Mark Sumner has a post on some of the more serious complications from covid-19 infection, including psychosis. (As if we didn’t have enough to worry about Trump.) As he mentions, covid-19 is more than a simple respiratory virus. It attacks the body in a whole variety of ways we are still trying to figure out.