Day: December 26, 2022

A British historian, an Italian archaeologist and an American preschool teacher have never met in person, but they share a prominent pandemic bond.

Plagued by eerily similar symptoms, the three women are credited with describing, naming and helping bring long COVID into the public’s consciousness in early 2020.

Rachel Pope, of Liverpool, took to Twitter in late March 2020 to describe her bedeviling symptoms, then unnamed, after a coronavirus infection. Elisa Perego in Italy first used the term “long COVID,” in a May tweet that year. Amy Watson in Portland, Oregon, got inspiration in naming her Facebook support group from the trucker cap she’d been wearing, and “long hauler” soon became part of the pandemic lexicon.

Nearly three years into the pandemic, scientists are still trying to figure out why some people get long COVID and why a small portion — including the three women — have lasting symptoms.

Millions of people worldwide have had long COVID, reporting various symptoms including fatigue, lung problems, and brain fog and other neurological symptoms. Evidence suggests most recover substantially within a year, but recent data show that it has contributed to more than 3,500 U.S. deaths.

Here’s some of the latest evidence:

Women more at risk?

Many studies and anecdotal evidence suggest that women are more likely than men to develop long COVID.

There could be biological reasons.

Women’s immune systems generally mount stronger reactions to viruses, bacteria, parasites and other germs, noted Sabra Klein, a Johns Hopkins professor who studies immunity.

Women are also much more likely than men to have autoimmune diseases, where the body mistakenly attacks its own healthy cells. Some scientists believe long COVID could result from an autoimmune response triggered by the virus.

Women’s bodies also tend to have more fat tissue and emerging research suggests the coronavirus may hide in fat after infection. Scientists also are studying whether women’s fluctuating hormone levels may increase the risks.

Another possible factor: Women are more likely than men to seek health care and often more attuned to changes in their bodies, Klein noted.

“I don’t think we should ignore that,” she said. Biology and behavior are probably both at play, Klein said.

It may thus be no coincidence that it was three women who helped shine the first light on long COVID.

Pope, 46, started chronicling what she was experiencing in March 2020: flu-like symptoms, then her lungs, heart and joints were affected. After a month she started having some “OK” days, but symptoms persisted.

She and some similarly ill colleagues connected with Perego on Twitter. “We started sort of coming together because it was literally the only place where we could do that,” Pope said. “In 2020, we would joke that we’d get together for Christmas and have a party,” Pope said. “Then obviously it went on, and I think we stopped joking.”

Watson started her virtual long haulers group that April. The others soon learned of that nickname and embraced it.

Mono virus

Several studies suggest the ubiquitous Epstein-Barr virus could play a role in some cases of long COVID.

Inflammation caused by coronavirus infection can activate herpes viruses, which remain in the body after causing an acute infection, said Dr. Timothy Henrich, a virus expert at the University of California, San Francisco.

Epstein-Barr virus is among the most common of these herpes viruses: An estimated 90% of the U.S. population has been infected with it. The virus can cause mononucleosis or symptoms that may be dismissed as a cold.

Henrich is among researchers who have found immune markers signaling Epstein-Barr reactivation in the blood of long COVID patients, particularly those with fatigue.

Not all long COVID patients have these markers. But it’s possible that Epstein-Barr is causing symptoms in those who do, although scientists say more study is needed.

Some scientists also believe that Epstein-Barr triggers chronic fatigue syndrome, a condition that bears many similarities to long COVID, but that also is unproven.

Obesity

Obesity is a risk factor for severe COVID-19 infections and scientists are trying to understand why.

Stanford University researchers are among those who have found evidence that the coronavirus can infect fat cells. In a recent study, they found the virus and signs of inflammation in fat tissue taken from people who had died from COVID.

Lab tests showed that the virus can reproduce in fat tissue. That raises the possibility that fat tissue could serve as a “reservoir,” potentially fueling long COVID.

Could removing fat tissue treat or prevent some cases of long COVID? It’s a tantalizing question, but the research is preliminary, said Dr. Catherine Blish, a Stanford infectious diseases professor and a senior author of the study.

Scientists at the University of Texas Southwestern Medical Center are studying leptin, a hormone produced by fat cells that can influence the body’s immune response and promote inflammation.

They plan to study whether injections of a manufactured antibody could reduce leptin levels — and in turn inflammation from coronavirus infections or long COVID.

“We have a good scientific basis together with some preliminary data to argue that we might be on the right track,” said Dr. Philipp Scherer.

Duration

It has been estimated that about 30% of people infected with the coronavirus will develop long COVID, based on data from earlier in the pandemic.

Most people who have lingering, recurrent or new symptoms after infection will recover after about three months. Among those with symptoms at three months, about 15% will continue to have symptoms for at least nine more months, according to a recent study in the Journal of the American Medical Association.

Figuring out who’s at risk for years-long symptoms “is such a complicated question,” said Dr. Lawrence Purpura, an infectious disease expert at Columbia University.

Those with severe infections seem to be more at risk for long COVID, although it can also affect people with mild infections. Those whose infections cause severe lung damage including scarring may experience breathlessness, coughing or fatigue for more than a year. And a smaller group of patients with mild initial COVID-19 infections may develop neurologic symptoms for more than a year, including chronic fatigue and brain fog, Purpura said.

“The majority of patients will eventually recover,” he said. “It’s important for people to know that.”

It’s small consolation for the three women who helped the world recognize long COVID.

Perego, 44, developed heart, lung and neurologic problems and remains seriously ill.

She knows that scientists have learned a lot in a short time, but she says “there is a gap” between long COVID research and medical care.

“We need to translate scientific knowledge into better treatment and policy,” she said.

Watson, approaching 50, says she has “never had any kind of recovery.” She has had severe migraines, plus digestive, nerve and foot problems. Recently she developed severe anemia.

She wishes the medical community had a more organized approach to treating long COVID. Doctors say not knowing the underlying cause or causes makes that difficult.

“I just want my life back,” Watson said, “and it’s not looking like that’s all that possible.”
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China said Monday it would scrap mandatory quarantine on arrival, further unwinding years of strict virus controls as the country battles a surge in cases.

Having mostly cut itself off from the rest of the world during the pandemic, China is now experiencing an unprecedented surge in infections after abruptly lifting restrictions that torpedoed the economy and sparked nationwide protests.

And in a sudden end to nearly three years of strict border controls, Beijing said late Monday it would scrap mandatory quarantines for overseas travelers.

Since March 2020, all passengers arriving in China have had to undergo mandatory centralized quarantine. This decreased from three weeks to one week this summer, and to five days last month.

But under new rules that will take effect January 8, when COVID-19 will be downgraded to a Class B infectious disease from Class A, they will no longer need to.

“According to the national health quarantine law, infectious disease quarantine measures will no longer be taken against inbound travelers and goods,” the National Health Commission (NHC) said.

The move is likely to be greeted with joy from Chinese citizens and diaspora unable to return and see relatives for much of the pandemic.

But it comes as China faces a wave of cases that studies have estimated could kill around one million people over the next few months.

Many are now grappling with shortages of medicine, while emergency medical facilities are strained by an influx of undervaccinated elderly patients.

“At present, COVID-19 prevention and control in China are facing a new situation and new tasks,” President Xi Jinping said in a directive Monday, according to state broadcaster CCTV.

“We should launch the patriotic health campaign in a more targeted way… fortify a community line of defense for epidemic prevention and control, and effectively protect people’s lives, safety and health,” he said.

‘Impossible’ to track

Hospitals and crematoriums across the country have been overflowing with COVID patients and victims, while the NHC on Sunday announced it would stop publishing daily nationwide infection and death statistics.

That decision followed concerns that the country’s wave of infections is not being accurately reflected in official statistics.

Beijing has admitted the scale of the outbreak has become “impossible” to track following the end of mandatory mass testing.

And last week, the government narrowed the criteria by which COVID-19 fatalities were counted — a move experts said would suppress the number of deaths attributable to the virus.

The winter surge comes ahead of two major public holidays next month, in which millions of people are expected to travel to their hometowns to reunite with relatives.

Authorities are expecting the virus to hit under-resourced rural areas hard, and on Monday called for the guaranteed supply of drugs and medical treatment during New Year’s Day and late January’s week-long Lunar New Year holiday.

In recent days, health officials in the wealthy coastal province Zhejiang estimated that one million residents were being infected per day.

The coastal city of Qingdao also predicted roughly 500,000 new daily infections and the southern manufacturing city of Dongguan eyed up to 300,000.

Unofficial surveys and modelling based on search engine terms suggest that the wave may have already peaked in some major cities like Beijing and Chongqing.

A poll of over 150,000 residents of the southwestern province of Sichuan organized by disease control officials showed that 63% had tested positive for COVID, and estimated that infections peaked Friday.

Only six COVID deaths have been officially reported since Beijing unwound most of its restrictions earlier this month.

But crematorium workers interviewed by AFP have reported an unusually high influx of bodies, while hospitals have said they are tallying multiple fatalities per day, as emergency wards fill up.

The main funeral service center in the southern metropolis of Guangzhou postponed all ceremonies until January 10 to focus on cremations due to the “large workload,” according to a notice published online Sunday.

China’s censors and mouthpieces have been working overtime to spin the decision to scrap strict travel curbs, quarantines and snap lockdowns as a victory, even as cases soar.
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