Submitted by Stephanie Paulmeno, Greenwich Health Dept, Submitted by Dr. Stephanie Paulmeno, DNP, RN, NHA, CPH, CCM, CDP, Public Health Promotion Specialist
A great deal of global research has been undertaken since SARS-Co-V-2 (COVID-19) first emerged in efforts to understand the nuances of the virus in all its variations (mutations), as well as the implications of high morbidity and mortality we were seeing. We have witnessed both far too often across the world, the country, our state, and our county, as well as right here in Greenwich.
As COVID-19 became pandemic (worldwide), we found that most people recovered well within a few days to a few weeks after becoming ill, but way too many ended up with an array of symptoms that lingered for weeks, months, and now years.
Some who developed the wide-ranging symptoms of Long-COVID never even realized that they had contracted COVID-19 in the first place.
If you recall, many people remained asymptomatic and were surprised when tested for some reason other than being ill or exposed, and were found to be COVID-positive. As we learned over time, a COVID-19 infection affects so many organs and body tissues that, in its Long-COVID rendition, it seems to result in subsequent diagnoses of more than one illness, while still others ended up developing new health conditions post-COVID-19 that they never had before becoming infected, i.e.: diabetes heart and blood vessel diseases, respiratory conditions, etc.
According to the CDC, there is no test that will pinpoint the long-lasting and diverse symptoms that resulted in one’s diagnosis of Long-COVID following a COVID-19 infection. Despite extreme and debilitating symptoms, diagnostic tests often remain within normal levels (Americans with Disabilities Act) qualifying illness (Long COVID or Post-COVID Conditions.
The impact can be so severe and persistent, that Long-COVID became an ADA (Americans with Disabilities Act) qualifying illness. Guidance on “Long COVID” as a Disability Under the ADA, Section 504, and Section 1557
The earliest case emerged in January 2019 when we did not know how to combat the virus. We had no targeted COVID-19 medications or treatments and vaccines had not yet been created. Now, several years later, we have all those things at our disposal.
Our numbers and rates of infection have dropped dramatically, but we many people are now impacted and suffering with what is called Long-COVID, or Long-Haul-COVID; a condition where COVID recovery fails to occur after at least four weeks. Long-COVID, and its associated symptoms are seen across the globe to the tune of 65 million people.
Long COVID: New research, common symptoms, long-term effects and treatments with Akiko Iwasaki, PhD
Along the way, researchers were looking at the characteristics of those who seemed most at risk for contracting COVID-19: Blacks, Hispanics and Indigenous people; the elderly, people with underlying conditions such as heart and lung diseases, diabetes, immune disorders, and those taking medications or treatments that could impair their immune systems, as well those who were pregnant.
A great deal of public health education was put forth alerting those at highest risk to take active precautions including wearing a mask, remaining socially separated, avoiding enclosed indoor places, washing your hands frequently, avoiding touching your face, cleaning frequently-touched surfaces, and, when the miracle vaccines were created, people were urged to get vaccinated and boosted. With some exceptions, Connecticut did well in these areas and as a result we fared well as a State.
An interesting finding that was in the research of Dr. Siwen Wang, a physician and research fellow at the Harvard T.H. Chan School of Public Health was the apparent protective factor of a good night’s sleep ( ‘Simple steps’ to improve sleep could help prevent long COVID (healio.com)). She and her colleagues used the Nurses’ Health Study II (2015-2021) (Nurses’ Health Study | (nurseshealthstudy.org)) that looked at the sleep habits of the 1,979 nurses in this study. The study began pre-pandemic and then expanded to examine the outcomes of those who had good sleep histories and their rates of developing Long-COVID symptoms following infection.
Within this study group (which included all white female nurses), the research indicated that having healthy sleep practices before becoming COVID-19 infected may have helped prevent against Long-COVID in these nurses.
Those who reported adhering to most aspects of good sleep practices before becoming infected with COVID-19 had about a 30% lower risk for acquiring Long-COVID when compared with people who did not demonstrate healthy sleep habits. That raised the question in my mind of how many working nurses got good quality sleep during the pandemic. The researchers noted in their report that good sleep quality during the pandemic, and little to no daytime dysfunction in the pre-pandemic were also independently linked to a lower risk for Long-COVID.
COVID-19 continues to circulate, people are still being hospitalized with it here in Connecticut, and people are still succumbing to it. If you think improving your sleep will be a protective factor, these are Dr. Wang’s suggestions; setting a regular bedtime; shutting off your screens and removing electronic devices before bedtime; and avoiding caffeine, large meals, and alcohol late in the day. These can all help to improve sleep and may act reduce your risk of contracting Long-COVID.