A friend was happy to hear that the pandemic was winding down (see old post below the ****), but was still worried about ‘long COVID’. He’d heard that it was very common and debilitating. So I looked up the latest [Nature vol. 616 pp. 228 – 229 ’23, Science vol. 379 pp. 1174 – 1175 ’23].
There have been a variety of definitions of long COVID, but anyone still symptomatic 3 months after the initial infection probably has it.
The first strain of the virus was called alpha, and 46% of those affected were still symptomatic at 3 months. So my friend was right. It made the news as it should have, everyone being concerned and worried about where the new pandemic was taking us. Alpha was replaced by the milder delta variant, and here long COVID dropped to 35%. Then the Omicron strain took over, and the risk of long COVID dropped to 14%. The paper noted that the risk of long COVID in 97,000 ‘healthy’ people infected with Omicron was 4.5%. No headlines trumpeted this. Good news just doesn’t sell.
Things are probably even better now as the new strain, XBB.1.16, is milder still and isn’t covered in the papers (it couldn’t be as it wasn’t around when the papers were written and submitted).
Now you don’t have to go to medical school to know that it takes longer to recover from a severe case (of anything) than a mild one. So the decline in the incidence of long COVID is another piece of evidence that the pandemic is winding down and that successive variants are less virulent (or the populace is becoming immunologically immune due to asymptomatic infections).
The symptoms of long COVID and chronic fatigue syndrome are the same.As a neurologist I saw a lot of people who were chronically tired and fatigued, because neurologists deal with muscle weakness and diseases like myasthenia gravis which are associated with fatigue. Once I ruled out neuromuscular disease as a cause, I had nothing to offer them (nor did medicine). Some of these patients were undoubtedly neurotic, but there was little question in my mind that many others had something wrong that medicine just hadn’t figured out yet — not that it hasn’t been trying.
Infections of almost any sort are associated with fatigue, most probably caused by components of the inflammatory response. Anyone who’s gone through mononucleosis knows this. The long search for an infectious cause of chronic fatigue syndrome (CFS) has had its ups and downs — particularly downs — see https://luysii.wordpress.com/2011/03/25/evil-scientists-create-virus-causing-chronic-fatigue-syndrome-in-lab/
At worst many people with these symptoms are written off as crazy; at best, diagnosed as depressed and given antidepressants. The fact that many of those given antidepressants feel better is far from conclusive, since most patients with chronic illnesses are somewhat depressed.
*****
The serious part of the pandemic is over, but the virus is here to stay
Massachusetts has some of the best statistics in the country on hospitalizations due to COVID-19. Everybody admitted to the hospital gets tested for the virus so they won’t spread it. However Massachusetts distinguishes people in the hospital withCOVID-19 from people in the hospital because of COVID-19. Statistics come out every Thursday usually after 5 PM — https://www.mass.gov/info-details/covid-19-response-reporting#covid-19-interactive-data-dashboard-
On 3 January ’23 there were 1,336 people hospitalized with COVID-19 and 437 hospitalized because of COVID-19.
On 9 May ’23 there were 172 people hospitalized with COVID-19 and 42 hospitalized because of COVID-19.
COVID-19 will always be with us, but it is acting differently than the season flu, as waves of high levels of mostly mild infections due to new variants (as shown by testing), without waves of hospitalization occur all year long, so the new variants are milder.
The latest strain is XBB.1.16 which now accounts for 11% of USA cases (without a surge in hospitalizations or deaths).
The virus is still a killer, but you have to be old (like my wife and I) or seriously ill with something else to die from it. That’s good news for just about everyone.
Remember when COVID-19 was being touted as a disease of the unvaccinated (by the CDC and everyone else) in an attempt to get people vaccinated. All year long the percentage of ‘fully vaccinated’ people hospitalized with/for COVID-19 in Massachusetts has ranged from 60 to 71%. Some humility is in order