If getting infected with the SARS-CoV-2 virus was nothing more than a kind of flu that you could catch again just weeks after your last infection, that would be bad enough. If it was just something that involved a kind of Russian roulette where the bullet was hidden in a hundred barrels, that would be terrifying. But it’s worse than that.
Because for a lot of people an infection with COVID-19 means developing some symptoms of “long COVID.” Depending on the study and the criteria used, symptoms that linger beyond three months after the initial infection may affect as few as 10% of those infected, or as many as 43%. Considering that some of the first people to come down with COVID-19 in the United States are still displaying symptoms, there’s every reason to believe that some of those who contract long COVID may find themselves with possibly debilitating issues for the rest of their lives.
Many of those who have recovered from the “active” phase of COVID-19 find that they are left with a heart that races after even minor exertion, with pains at various locations, with crushing exhaustion, with that peculiar loss of the sense of smell, and with bouts of “brain fog” that make it hard to think clearly. In searching for the cause of these persistent symptoms, researchers have naturally looked at things we already know about the SARS-CoV-2 virus, from how it can cause the body to generate small blood clots to how it can damage the heart directly by disrupting calcium channels in cardiac cells.
But as this month’s issue of Scientific American reports, the truth may be that all of this is in the mind … or rather, in the brain. The cluster of persistent symptoms that we’ve come to identify as the lingering effects of a COVID-19 infection appear to be neurological.
COVID-19 is far from the first virus to leave behind lingering symptoms, and among viruses neurological damage is one of the better-known consequences. HIV is an example of another viral infection that generates neurological damage in the brain.
If you want to jolt someone who is indifferent to COVID into thinking again about the disease they are dismissing, try this sentence from the Scientific American article:
Research on other viruses, and on neurological damage from the human immunodeficiency virus (HIV) in particular, is guiding work on long COVID.
Someone who is blasé about infection may think again if they realize the closest analog isn’t the seasonal flu, but HIV. As one of the researchers says, “I now think of COVID as a neurological disease as much as I think of it as a pulmonary disease, and that's definitely true in long COVID.”
This is a lasting neurological condition that is already affecting tens of millions of Americans. In addition to brain fog that can be so lasting and intense it makes it difficult to hold down a job, long COVID can bring with it a butcher’s list of neuropsychiatric symptoms including: malaise, symptoms of PTSD, cognitive issues, and even psychosis.
As HuffPost reported on Friday, former Republican Sen. Jim Inhofe has blamed his retirement on long COVID. It’s not clear if Inhofe’s infection came before he voted against legislation to assist Americans during the pandemic, including voting against the Families First Coronavirus Response Act and the American Rescue Plan. Inhofe did not detail the symptoms he is still suffering, but they reportedly came after “a very mild case” of COVID-19.
One of the first people in the U.S. infected with COVID-19 recounts her ongoing issues as including “tremors, dramatic mood swings and painful hypersensitivity to sounds” in addition to “goldfish brain” that sometimes leaves her unable to string her thoughts together.
“The thing that bothered me the most was that I was really having trouble thinking, speaking, remembering—trying to complete a task and having no idea what it was,” said veterinarian Tara Ghormley. “Suddenly I had quite profound neurological deficits. Everything fell apart for me at that time. That was horribly traumatic ... it kind of broke me. I didn't feel like me.”
Researchers are now coming to understand that even the symptoms that seem most “physical,” like the persistent exhaustion and racing heart, are connected to neurological damage. The cause doesn’t seem to be oxygen deprivation generated by those micro-clots, or the direct effects of inflammation. Instead, the best candidate for what’s generating long COVID appears to be the “not that precise” work of immune cells called macrophages. These cells, once triggered by an infection, can consume far more cells than just those which are infected and trigger a “cytokine storm” similar to those associated with the deaths in the 1918 flu pandemic.
Markers of persistent inflammation appear to be present in the blood of many who are experiencing long COVID, perhaps triggered by fragments of viral protein remaining in the system. Studies have found lingering fragments of the virus in the brains of those with long COVID symptoms, and other studies have suggested that the virus gains access to the brain through the lining of the nose.
Vaccination appears to reduce, but not eliminate, the risk of developing long COVID. Repeated infection increases the risk.
Contrast all this with this astoundingly destructive article published in Time this week and entitled “The COVID-19 pandemic will be over when Americans think it is.” That article doesn’t just dismiss the lingering threat of the the virus and rewrite history to suggest that America experience some protracted universal “lock down” that never happened; it actively encourages contracting COVID-19 as somehow patriotic.
After three years of the imposition, followed by the gradual easing, of lockdowns, quarantine, isolation, testing, vaccination, and masking, how does the holdout one-third move the ingrained but obsolete “avoid exposure” paradigm to an endemic “accept exposure” reality?
If that sentence isn’t enough to leave you slack-jawed iby ts desire to get everyone to lower their guards and roll around in a virus that has already killed over 1 million Americans, try this one.
New courageous “accept exposure” policies, public education, and behavior change strategies are needed to capture the benefits of the new paradigm.
The “benefits of the new paradigm” apparently being that things look more “normal” as hundreds of millions of Americans suffer repeat infection and tens of millions more enroll on the list of those with long COVID. Oh, and it also does this for us:
This could be a major step in bridging our national COVID divide.
If that’s the divide between those who are living and those who are dead, or those who are carrying on and those who are suffering a lasting debilitating disease caused by possibly permanent brain damage—then it would absolutely accomplish that goal. Whatever other “benefit” it’s supposed to bring (other than making everyone equally at risk for horrific illness) isn’t clear.
Maybe it can only be seen through brain fog.