Although Covid-19 hospitalizations and deaths are currently the most dramatic and sobering statistic reported regarding the novel coronavirus pandemic, the lingering impact on the health of those who survive the virus (called “long-haul” recovery by these survivors) is just now beginning to be assessed.
According to the World Health Organization (WHO), patients with Covid-19 typically recover from the disease in about two weeks' time, but there are a number of patients who have had Covid-19 for months—and experts aren't entirely sure why they can't shake the disease.
One reason for the lag in reporting on this phenomenon of long-haul recovery from Covid-19 is that epidemiologists are racing to develop a vaccine, while doctors and hospitals and are presently overwhelmed with treating the immediate presentations of acute and critical cases of this novel coronavirus.
Researchers are just beginning to look at long-term effects arising from novel Covid-19 exposure.
It is important to not only study Covid-19 hospitalization outcomes, but to also survey the entire landscape of consequences experienced from weathering this new coronavirus.
The Atlantic reports that some patients in online Covid-19 support groups are reporting that they've been experiencing symptoms of the disease for one to three months—this is why some have begun calling themselves Covid-19 "long-haulers" or "long-termers."
Hours after British Prime Minister Boris Johnson instated stringent social-distancing measures to halt the SARS-CoV-2 coronavirus, LeClerc, a Glasgow-based journalist, arrived home feeling shivery and flushed. Over the next few days, she developed a cough, chest pain, aching joints, and a prickling sensation on her skin. After a week of bed rest, she started improving. But on day 12, every old symptom returned, amplified and with reinforcements: She spiked an intermittent fever, lost her sense of taste and smell, and struggled to breathe.
When I spoke with LeClerc on day 66, she was still experiencing waves of symptoms. “Before this, I was a fit, healthy 32-year-old,” she said. “Now I’ve been reduced to not being able to stand up in the shower without feeling fatigued. I’ve tried going to the supermarket and I’m in bed for days afterwards. It’s like nothing I’ve ever experienced before.”
Despite her best efforts, LeClerc has not been able to get a test, but “every doctor I’ve spoken to says there’s no shadow of a doubt that this has been COVID,” she said. Today is day 80.
Although the US population is daily at an ever higher danger of exposure to Covid-19 from the rising number of asymptomatic carriers of the virus, the long-term effects — on the health of Americans, the national health-care system, and the economy of a population vulnerable to exposure to varying levels of coronavirus infirmity — have yet to be calculated.
According to Reuters “Where U.S. coronavirus cases are on the rise” The United States saw a 46% increase in new cases of COVID-19 in the week ended June 28 compared to the previous seven days, with 21 states reporting positivity test rates above the level that the World Health Organization has flagged as concerning.
Nationally, 7% of diagnostic tests came back positive last week, up from 5% the prior week, according to a Reuters analysis of data from The COVID Tracking Project, a volunteer-run effort to track the outbreak.
The World Health Organization considers a positivity rate above 5% to be a cause for concern because it suggests there are more cases in the community that have not yet been uncovered.
According to The Republic article “Will My Covid Symptoms Ever End? Among the long-haul survivors of the pandemic:”
Amy Watson, a preschool teacher in Portland, Oregon, had been fighting a low-grade fever for almost a month when doctors started talking to her about cancer.
It was April 9, right around the time that coronavirus cases were peaking across the United States. She’d fallen ill in mid-March with a fever and flu symptoms, just two days after the state had shut down schools. At that point, as we all are now deeply aware, there was a woeful shortage of coronavirus tests, and only frontline workers and patients sick enough to be hospitalized could get one. Watson called an advice nurse, who told her to assume she had the coronavirus and isolate for two weeks.
Most health guidelines at the time stated that “mild” cases of Covid-19 should only last around two weeks. But Watson’s illness lingered. So her doctor thought that having a fever for as long as she did—79 days, ultimately—was a sign she could have leukemia or lymphoma. She got a comprehensive workup that day and tested negative for everything. She finally became eligible for a coronavirus test a month after first getting sick, because she has asthma. Her test, unsurprisingly, was positive.
(Ms. Watson has created a Facebook group: Long Haul COVID Fighters.)
You can find information on these “long haul” effects in this white paper: “What Does COVID-19 Recovery Actually Look Like? An Analysis of the Prolonged COVID-19 Symptoms Survey” which was conducted by a patient-led research team.
This report was originally Released: May 11th, 2020. Generated from survey data organized by a decentralized team of COVID-19 patients, exported on May 2, 2020 from 640 Responses
A survey participant summarized the fluctuations of symptoms commonly shared by many COVID-19 patients as follows:
“The symptoms were like a game of whack-a-mole. Different ones would surge at different times and in different places in my body. “
- Over half of respondents (57.8%) listed at least one pre-existing condition, with the most prevalent conditions being asthma and vitamin D deficiency. Our analyses suggest pre-existing asthma might prolong recovery time.
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The vast majority of participants with symptoms experienced fluctuations both in the type (70% reporting) and intensity (89% reporting) of symptoms over the course of being symptomatic.
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At the time they took the survey, 90.6% of the respondents had not recovered. For the 60 respondents who had recovered, the average length of time of being symptomatic was 27 days. The respondents who had not recovered had been experiencing symptoms for an average of 40 days, with a large proportion experiencing symptoms for 5-7 weeks. Our “survival analysis”, shows that the chance of full recovery by day 50 is smaller than 20%. (Recovery was Self-Interpreted for this Survey).
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On Symptoms (See the Symptoms Section for additional information)
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A slightly elevated temperature (above 98.6°F but below 100.1°F) was more commonly reported than higher temperatures (100.1°F and above).
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In addition to the more widely recognized COVID-19 symptoms such as fever/elevated temperature, cough, and shortness of breath, the other symptoms that were highly reported by participants included fatigue (varying in severity), brain fog/concentration challenges, chills/sweats, trouble sleeping, and a loss of appetite.
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It is interesting to note that neurological symptoms were consistently reported by patients for eight weeks, specifically brain fog/concentration challenges and trouble sleeping.
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Patients from this survey indicate that their first week of experiencing symptoms had milder/fewer symptoms than weeks 2 and 3. Gastrointestinal symptoms and chills/sweats seem to occur more often in weeks 1-2 and respiratory symptoms appear relatively consistent through weeks 3-4.
The unorthodox lingering effects experienced from a brush with Covid-19 are just beginning to be documented, and as yet are not well understood by the medical establishment or researchers.
It “has been like nothing else on Earth,” said Paul Garner, who has previously endured dengue fever and malaria, and is currently on day 77 of COVID-19. Garner, an infectious-diseases professor at the Liverpool School of Tropical Medicine, leads a renowned organization that reviews scientific evidence on preventing and treating infections.
He tested negative on day 63. He had waited to get a COVID-19 test partly to preserve them for health-care workers, and partly because, at one point, he thought he was going to die. “I knew I had the disease; it couldn’t have been anything else,” he told me. I asked him why he thought his symptoms had persisted. “I honestly don’t know,” he said. “I don’t understand what’s happening in my body.”
If one consults an online dashboard that informs of the number of confirmed Covid-19 cases, hospitalizations, deaths, and recoveries — you can see that extended recovery from Covid-19 falls into none of these categories. Long-haul recoverers are presently neglected to a statistical limbo, uncounted, and thus overlooked.
Angela Aston, a 49-year-old RN in Texas who contracted the new coronavirus in late March while treating a patient with Covid-19, had returned to work on April 23 after she was free of a fever for 72 hours. However, toward the end of her shift, she felt "shaky and weak," Aston said. The next day, Aston again had a fever and shortness of breath. "I was confused [and] anxious," she said.
Aston's been retested for the new coronavirus three times, and received one negative result—followed by two positive results. She said she hasn't returned to work since she began feeling symptoms again in late April because her doctors are unsure of whether she's still infectious.
"The [CDC's] return-to-work guidelines say three days no fever, but those guidelines are not appropriate for me," Aston said. "People freak out if a person with recent Covid-19 has an elevated temperature and wants to be around them. Even if it has been 10 days with no fever."
Pandemic Control 101:
- Test (everyone)
- Trace (contacts of positive testing persons)
- Isolate (those testing positive and their contacts)
In the United States we have the knowledge necessary to mitigate the spread of a pandemic.
However, there is not only a lack of political will to carry out the basics of pandemic prevention here, but there is also a veritable torrent of science denial and politicization railing against implementing the basics required of us as a country to bring this raging pandemic under control.
As of today, the official Covid-19 American death toll is at 129,000...and rising.
The long-term impact on those who’ve been exposed to Covid-19 is still being calculated.
Without comprehensive national testing, the number of Covid-19 positive citizens is unknown. The number of long-haul Covid-19 survivors is unknown. The long-term impact on America and Americans of “opening up for business” while a pandemic still burns across the landscape is yet to be calculated and is also unknown.
The most effective way for a nation to approach the possible serious long-term effects on a country populated with long-haul recovering Covid-19 patients should be to first safeguard the majority of its citizens from contracting Covid-19.
It is of critical importance to elect a resolute presidential candidate like Joe Biden, and equip him with both a House and a Senate, that can enact scientifically-validated public health policies (and the attendant requisite economic policies) that will begin to put America on the “road to recovery.”
In the meantime, what can be done to prevent the spread of the coronavirus? How can people protect themselves?
- Stay home except for essential needs/activities.
- Practice physical distancing – stay 6 feet away from people.
- Wear a cloth face mask if you leave home.
- Wash hands with soap and water for at least 20 seconds.
- Clean and disinfect frequently touched surfaces daily.
- Avoid touching eyes, nose or mouth.
- Cover your cough or sneeze with a tissue or your elbow or a tissue. Wash hands afterward.
- Stay home and away from people if you become sick with respiratory symptoms like fever and cough.
- Follow guidance from public health officials.
...and, take care.
Links to Coronavirus Resources
CDC — Facts About Coronavirus
CDC — Updated Preparedness and Response Framework for Influenza Pandemic, 2014 (.pdf)
Homeland Security National Strategy for Pandemic Influenza, 2005 (.pdf)
Coronavirus Resources — Benefits.gov
Big List of Covid-19 Assistance Programs — Institute for Local Self-Reliance
All Searches for “Covid-19” at the Lancet’s Peer-Reviewed eClinicalMedicine Site
r/COVID19 — Reddit
(A well-administered and curated forum with links to the newest peer-reviewed research, any posts linking to non-scientific sources are immediately removed.)