Long Covid: A Stark Reality, a Call to Action

The risk of “Long Covid” symptoms increases every time you get infected.

Like a shitty game of viral Russian roulette, you never know when your luck will run out.

But what is Long Covid? How can we understand its effects when so much contradictory language has been used, and when the mechanisms for Long Covid are not well understood?

First, we need to be grateful to all the sufferers of Long Covid for speaking out, loudly, and demanding that their symptoms be taken seriously. Seriously, you people are unsung heroes, because of your early warning cries, research started into Long Covid much faster than it might have. And that gives us all a better chance of surviving and thriving in the years ahead.

How Can We Meet the Future with Compassion?

For this pandemic, and all those to come, we must build the resilience of an open heart and mind.

As for what Long Covid is, let’s turn to a 2023 study that attempts to analyze the mechanisms by which the disease causes damage:

“infection by SARS-CoV-2 leaves a lasting imprinting of variably apparent, radiologically detectable end-organ damage, including in the CNS, as well as immune subset perturbations, enhanced cytokine levels, including CCL11, and a range of pathologies relating to coagulopathy. There are possible roles also of EBV reactivation, persistent SARS-CoV-2, microbiota dysbiosis and low serum cortisol.” (Altmann et al., 2023)

The researchers don’t hold back from there, either. They go on to state that:

“the oncoming burden of long COVID faced by patients, health-care providers, governments and economies is so large as to be unfathomable, which is possibly why minimal high-level planning is currently allocated to it. If 10% of acute infections lead to persistent symptoms, it could be predicted that ~400 million individuals globally are in need of support for long COVID.” (Altmann et al., 2023)

Why isn’t this a bigger deal?

Part of the problem goes back to our human biases. We have a hard time connecting the dots to reality — more often than not, the picture we build of the world is one made of dots we placed ourselves.

But the symptoms of Long Covid are there. You may even be experiencing them without realizing it. Have you been experiencing problems with sleep, for instance?

In a 2023 study published in the Journal of Sleep Research, researchers “observed a high frequency of long-lasting sleep disturbances characterised by difficulty falling asleep or staying asleep and excessive daytime sleepiness in C-19 cases, which contrasts with previous studies that have failed to assess the frequency of sleep symptoms” (Merikanto et al., 2023, p. 5).

A detailed report on the treatment of chronic pain sufferers from the Committee on Advancing Pain Research, Care, and Education from the United States Institute of Medicine offers some insights into our problem.

Health professionals may hold negative attitudes toward people reporting pain and may regard pain as not worth their serious attention,” write the researchers (2011, Barriers to Effective Pain Care Para. 3).

This disconnect can be partly due to guilt on the part of the medical practitioners, who have been trained to “cure” rather than “care.” But it goes further, Patients “can be at a particular disadvantage if they are members of racial or ethnic minorities, female, children, or infirm elderly. They also may have less access to care… if they have, or are perceived to have, mental health problems” (2011). This sort of dismissal, incidentally, is one of the problems Long Covid sufferers face (Payne, 2022).

General Safety Measures We Need to Normalize

We’re all on the front lines of health and safety these days, so here’s what we can do.

Long Covid is finally being recognized more widely, but millions (especially the poor, women, and cultural minorities) are still going to be suffering in silence or obscurity.

But, steps are not being taken to ensure that more people don’t experience Long Covid symptoms in the first place. That’s a problem we need to start addressing.

Covid-19 and children

Birth defects and mortality for mothers

Research into the effects of Covid-19 on pregnant people and children is still forming, in part because this data is harder for researchers to acquire. Researchers also won’t start to have a fuller picture of potential serious consequences (like birth defects) until a higher number of children whose parents were infected become old enough for impairments to become recognized.

But, we do know is that the rate of birth defects appears to be higher in children whose parents were exposed to Covid-19, perhaps by as much as double the percentage (Edlow et al., 2022). As one limited 2022 study showed: “Our findings identifying an association between prenatal SARS-CoV-2 exposure and neurodevelopmental diagnoses at 12 months are consistent with a large body of literature… linking maternal viral infection and maternal immune activation with offspring neurodevelopmental disorders later in life” (Edlow et al., 2022, p. 6).

Basically, if a pregnant person’s immune system activates while pregnant, there’s a well-known increased likelihood of developmental problems for the child.

The Next Pandemic or: how we can change habits in order to outlast and overwhelm the rich bastards…

In the face of overwhelming greed, it’s more important than ever to make a stand.

With more specific regard to the effect COVID-19 infection has on the pregnant person themselves, a 2023 meta-study, collecting data from studies across the planet, provides this harrowing conclusion: “This analysis indicates that SARS-CoV-2 infection at any time during pregnancy increases the risk of maternal death, severe maternal morbidities and neonatal morbidity” (Smith et al., 2023).

Preterm babies are increasingly likely as well for Covid-infected parents, and the outcome of such cases is largely contingent upon class-based financial resources. Poor people will lose more children than those with the resources to provide the best care.

Effects of Covid in older children

It’s not just within the earliest phases of life that we see a significant problem emerging, either. With one in six children showing post-Covid effects that cannot be else wise explained, the risk of infection is not insignificant (Jiang et al., 2023).

There is some limited suggestion that kids with post-Covid symptoms improve over time (Pinto Pereira et al., 2023), but that data still runs up against the established dangers of repeat infections and the still significant portion of the population that does not see full recovery.

Even more alarming is research that suggests that children’s immune systems don’t learn from, and adapt to, Covid-19 in the same way an adult immune system does. This has both positive and negative aspects.

“Children have largely avoided severe COVID-19 symptoms because they have a strong initial ‘innate’ immune reaction that quickly defeats the virus. And now, researchers led by scientists at the Garvan Institute of Medical Research have uncovered what this might mean for the immune system. Unlike those of adults, children’s immune systems don’t remember the virus and don’t adapt, so when they’re next exposed to SARS-CoV-2, their body still treats it as a new threat.” (Children’s Immune Systems Do Not Develop ‘Adaptive’ Memory to Protect against Second Time SARS-CoV-2 Infection, 2023)

The short of the long (TLDR)

• Long Covid is a biologically verifiable product of infections by Covid-19, with increased risk coming from repeated infections.
• The disease has the potential to exacerbate or initiate a wide range of comorbid conditions that will drastically affect an individual’s wellbeing.
• Pregnant people are disproportionately at risk of death if they catch Covid, and there is a likelihood of increased birth defects in children (especially male babies) if their parent contracted Covid late in the pregnancy.
• Just as alarming is the information that kids aren’t as resilient to this disease as originally assumed.

Biased Towards Unbiased Data

Our biases can change, but first we have to recognize that they exist.

The psychological factor

“People tend to join together to either rejoice or commiserate about significant life events, such as a wedding, the arrival of a new child, or the death of a member of the family. Therefore, attending community events must inevitably become a regular part of one’s life” (Mohanraj & Singh, 2023). We know that people need socialization to be healthy — we know that mental health affects physical health; human beings are holistic entities.

So, what does this look like in the face of a pandemic, especially when Long Covid is now the third leading neurological disease in the United States.

Perhaps even more pressing, how can we unite against wealth-backed health policies when we’re afraid to be in the same room with one-another?

There isn’t a great answer. The best that I’ve come up with is this: talk to your friends and family about the realities of Covid. Talk to them until they’re sick of hearing about it, then keep talking to them until they start talking about it as well.

Model good masking habits. Make a point of thanking your friends and family for wearing masks. Encourage good behavior in your social group regarding self-quarantining when possible exposures occur. Avoid large gatherings with random groups and concentrate on building strong, regular meetings with smaller groups of trusted friends.

We need to start working on this now… because Covid-19 isn’t the last pandemic we’re going to see in our lifetimes (The 2021 Global Health Security Index).

Hi there! I’m Odin Halvorson, a librarian, independent scholar, film fanatic, fiction author, and tech enthusiast. If you like my work and want to support me, please consider subscribing!

References

• Altmann, D. M., Whettlock, E. M., Liu, S., Arachchillage, D. J., & Boyton, R. J. (2023). The immunology of long COVID. Nature Reviews Immunology, 1–17. https://doi.org/10.1038/s41577-023-00904-7
• Children’s immune systems do not develop ‘adaptive’ memory to protect against second time SARS-CoV-2 infection. (2023, January 26). News-Medical.Net. https://www.news-medical.net/news/20230126/Childrene28099s-immune-systems-do-not-develop-e28098adaptivee28099-memory-to-protect-against-second-time-SARS-CoV-2-infection.aspx
• Edlow, A. G., Castro, V. M., Shook, L. L., Kaimal, A. J., & Perlis, R. H. (2022). Neurodevelopmental Outcomes at 1 Year in Infants of Mothers Who Tested Positive for SARS-CoV-2 During Pregnancy. JAMA Network Open, 5(6), e2215787. https://doi.org/10.1001/jamanetworkopen.2022.15787
• Institute of Medicine (US) Committee on Advancing Pain Research, C. (2011). Care of People with Pain. In Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK92517/
• Jiang, L., Li, X., Nie, J., Tang, K., & Bhutta, Z. A. (2023). A Systematic Review of Persistent Clinical Features After SARS-CoV-2 in the Pediatric Population. Pediatrics, 152(2), e2022060351. https://doi.org/10.1542/peds.2022-060351
• Merikanto, I., Dauvilliers, Y., Chung, F., Wing, Y. K., De Gennaro, L., Holzinger, B., Bjorvatn, B., Morin, C. M., Penzel, T., Benedict, C., Koscec Bjelajac, A., Chan, N. Y., Espie, C. A., Hrubos-Strøm, H., Inoue, Y., Korman, M., Landtblom, A.-M., Léger, D., Matsui, K., … Partinen, M. (2023). Sleep symptoms are essential features of long-COVID — Comparing healthy controls with COVID-19 cases of different severity in the international COVID sleep study (ICOSS-II). Journal of Sleep Research, 32(1), e13754. https://doi.org/10.1111/jsr.13754
• Mohanraj, B., & Singh, A. C. (2023). Mental Health Post Pandemic: A Socio-Behavioural Perspective of Change in the Working Class. In R. Lathabhavan & P. C. Padhy (Eds.), Advances in Psychology, Mental Health, and Behavioral Studies (pp. 14–27). IGI Global. https://doi.org/10.4018/978-1-6684-7221-7.ch002
• Payne, D. (2022, August 14). ‘Left to rot’: The lonely plight of long Covid sufferers. POLITICO. https://www.politico.com/news/2022/08/14/left-to-rot-long-covid-patients-around-the-world-call-for-more-government-action-00051161
• Pinto Pereira, S. M., Shafran, R., Nugawela, M. D., Panagi, L., Hargreaves, D., Ladhani, S. N., Bennett, S. D., Chalder, T., Dalrymple, E., Ford, T., Heyman, I., McOwat, K., Rojas, N. K., Sharma, K., Simmons, R., White, S. R., & Stephenson, T. (2023). Natural course of health and well-being in non-hospitalised children and young people after testing for SARS-CoV-2: A prospective follow-up study over 12 months. The Lancet Regional Health — Europe, 25, 100554. https://doi.org/10.1016/j.lanepe.2022.100554
• Smith, E. R., Oakley, E., Grandner, G. W., Ferguson, K., Farooq, F., Afshar, Y., Ahlberg, M., Ahmadzia, H., Akelo, V., Aldrovandi, G., Tippett Barr, B. A., Bevilacqua, E., Brandt, J. S., Broutet, N., Fernández Buhigas, I., Carrillo, J., Clifton, R., Conry, J., Cosmi, E., … Tielsch, J. M. (2023). Adverse maternal, fetal, and newborn outcomes among pregnant women with SARS-CoV-2 infection: An individual participant data meta-analysis. BMJ Global Health, 8(1), e009495. https://doi.org/10.1136/bmjgh-2022-009495
• The 2021 Global Health Security Index. (n.d.). GHS Index. Retrieved August 16, 2023, from https://www.ghsindex.org/