By Rowenna Hoskin | Science Editor
Herd-immunity has leached back into the public consciousness. Originally the British government aimed to use herd-immunity as a solution to COVID-19 back in March, leading to the disastrous R-rate and gut-wrenching death rate. Once again, people are debating whether or not herd immunity would be the answer – specifically within the young demographic – where individuals contact COVID-19 and develop immunity saving others, more at risk individuals from the virus.
While it may sound like a good idea considering the low death rate in the younger population, contracting covid-19 at any age and fitness level can have much wider effects that previously considered. Long-term COVID-19 is a disastrously debilitating consequence of the virus and is much more common than one may think.
As time goes on, researchers are collating more data and estimates suggest that there could already be millions of people around the world living with “long covid.” Personal stories and scientific data all point towards this being a debilitating syndrome which follows a COVID-19 infection.
While there is not yet an official clinical definition of long covid, there are growing numbers of people who are reporting the same overlapping symptoms weeks, sometimes months, after their initial infection. Prolonged chest pains, shortness of breath and fatigue are the most commonly mentioned symptoms, others suffer lasting damage to their hearts and lungs, and even blood clots which can cause strokes.
“Everyone has fatigue and headache – that’s virtually universal,” says Tim Spector at King’s College London. He has been using the Covid Symptom Study app to analyse the reported symptoms of over 4 million users.
“People are getting rashes, fevers, hair loss, pins and needles, muscle pains, diarrhoea … everything on our list,” says Spector.
Findings presented at the 29th Congress of European Academy of Dermatology and Venereology have pointed towards many long-term covid sufferers having persistent rash-like eruptions – scaly, papules and plaques – which can last from 12 days to 130 days.
Many sufferers develop ‘covid toes’ or chilblains, the swelling to the feet and hands which can be immensely painful.
“We’re not sure what the longer-term implications of that inflammation will be,” says Jennifer Ross at the University of Washington in Seattle.
“The skin is potentially a visible window into inflammation that could be going on in the body,” said senior author Esther E. Freeman, MD, PhD, director of Global Health Dermatology at MGH.
Daniel, a 28 year old environmental researcher, told CNN health that since he recovered from the initial infection 4 months ago, he has been plagued with extreme tiredness and fatigue. His brain is foggy and he finds it difficult to speak, read and write due to short-term memory problems.
“Breathing has been very difficult,” he said. “I don’t feel like I have my full breath capacity. If I go for a walk for one minute, I’ll be really exhausted.”
“Two weeks ago I had a crushing sensation in my chest,” he said. “It felt like I couldn’t breath. That was the worst part.” While driving, he says he felt faint and had to pull over onto the side of the road in fear of blacking out at the wheel; an ambulance had to come to pick him up due to the extent of his quickly deteriorated health.
Daniel joined a Long Covid Support Group where he has shared his experience with more than 6,000 others who are suffering similar symptoms following COVID-19.
Another long-covid sufferer, Heather-Elizabeth Brown, has been hospitalised twice for complications related to her blood clots. She has had to have speech and physical therapy, mental health support and says that she has to take 15 different medications in order to manage her COVID-19 symptoms and their complications.
Another problematic aspect of long-term covid is that the symptoms can temporarily disappear, luring the patient into a false sense of security that the worst is over, only to return.
These long-term symptoms can develop in patients who had mild COVID-19 as well as in patients who had severer cases. Researchers say that due to the wide range of symptoms it is not yet clear as to whether long-term covid is a single syndrome or many conditions.
“88% – proportion of people hospitalised with covid-19 in an Italian study who still had symptoms after two months.” Reports by the US Centers for Disease Cotnrol and Prevention (CDC) suggests that some adults have developed a rare outcome of the virus – multisystem inflammatory syndrome. Not all of the adults who developed this had pre-existing health conditions and many get negative tests before they develop symptoms.
“There are the symptoms of not feeling well and not being able to do things, and then there’s the organ damage … a scan shows cardiac inflammation or lung damage, for example,” says Nisreen Alwan at the University of Southampton. She is still suffering symptoms of COVID-19 months after her initial infection.
Betty Raman at the University of Oxford and her colleagues have examined 58 people with moderate or severe covid-19. MRI scans revealed tissue abnormalities in the lungs of 60% of individuals, in the lungs of 29%, in the hearts of 26% and in the livers of 10%. Persistent breathlessness was a symptom for 64% of people and 55% had extreme fatigue.
While there is no clear data on the number of long-term sufferers, many different studies imply that long-covid is more common that initially thought.
The information from the Covid Symptom Study app suggests that long covid can occur in anyone over the age of 18, says Spector.
Ross hopes that the research and growing understanding surrounding long-term COVID-19 will shut down the idea of herd immunity as a solution to the pandemic. “There’s potential for harm even in folks who don’t have an initially severe infection,” she says. “It’s a cautionary message to all of us to do what we can to prevent infection.”
The only way out of this pandemic is to reduce the spread of the virus. This does not mean sacrificing the health and well being of the healthy population, it means enforcing better social distancing and better track and trace methods – it means finding a cure. In the meantime, let’s stay away from the concept of herd immunity and each other in order to reduce the strain on the NHS.Science and Technology Rowenna Hoskin