Dr. Stephanie Paulmeno, Greenwich Department of Health
While on a sympathy call this weekend, a friend asked why I remain so focused on COVID in all my articles. I believe he said “obsessed with COVID.”
It was a good question and it gave me pause; I realized that I’ve probably never mentioned that the reason ALL my Health Department articles are COVID-19- related is because my position with the Greenwich Department of Health is funded through a COVID-19 grant. In other aspects of my work and personal life I am actually quite balanced, but I always maintain a healthy respect for contagious illnesses including COVID-19 in its many current and potential future variants. After all, I’m a highly educated healthcare professional who knows that COVID-19 has already infected between 104 million and 107.5 million Americans (that we know about); and so far it has taken the lives of over 1.1million of them; new cases continue to occur daily, both here and abroad (https://www.worldometers.info/coronavirus/#countries);
While the pandemic was officially declared ended in May 2023, the COVID-19 virus remains alive, well, and continuously capable of on-going mutations.
It is true that the rate of infections and deaths has slowed significantly but they remain on-going. Ambulance transports, ICU care and hospitalizations continue to be employed as needed. Here in our little state of Connecticut we’ve had over 983.5 thousand coronavirus cases, and we lost 12,354 friends, neighbors and loved ones of all ages to the still highly contagious viral disease we call COVID-19 (Connecticut COVID – Coronavirus Statistics – Worldometer (worldometers.info)). Almost 969.5 thousand of those people went on to recover, which was great; but now many of them are dealing with the confounding and persistent symptoms of long-COVID even over 3 years beyond the point when the pandemic began. This includes impacted children and teens along with adults.
Research from 31 international studies involving over 15,000 children has shown that over 16 % (nearly 1/5th) of children and teens who had COVID-19 continued to have symptoms including persistent fevers, sore throats, fatigue/tiredness, sleep problems, shortness of breath, headaches, abdominal pain, diarrhea, and muscle weakness that persisted for at least 3 months following becoming ill. The work of Dr. Melissa Stockwell, Chief of Child and Adolescent Health at the Columbia University Vagelos College of Physicians and Surgeons, and her team, are part of a large National Institutes of Health (NIH) study (RECOVER). They support this finding having identified that between 10% and 20% of youngsters develop long-COVID. She notes that it appears that children who are more severely ill with COVID-19 are at greater risk for progressing to long-COVID, but states that even those who were mildly ill or who had no symptoms at all can and have developed long-COVID. While it remains unclear if vaccination protects a child from developing long-COVID, it protects children (and others) from becoming severely ill; if one becomes severely ill, their risk for developing long-COVID is statistically higher (https://consumer.healthday.com/long-covid-2662268253.html).
A great deal of international research is occurring in efforts to understand and address the phenomenon of long-COVID. Most people who become ill get better within a few days to a couple of weeks. If symptoms persist beyond 4 weeks, you may have Long-COVID. Following an in-depth scientific review of worldwide research on this topic that was conducted by prominent UK researchers, Professor Dan Altmann, himself a researcher, stated that the burden of post-infection long-COVID is “so large as to be unfathomable” (Prof Danny Altmann: the burden of long COVID | RNZ). If the recently upgraded figure of 10% of acute COVID-19 infections lead to persistent symptoms (as earlier studies concluded could be the case), up to 400 million people across the world could require healthcare and other social supports as they fight to recover, sometimes over years, from long-Covid. Dr. Altmann advised, “The best way to not get long Covid is to not get Covid, and the best way to not get Covid is to be well vaccinated and boosted and have a good level of antibodies to stop the virus getting in”.
Leora Horwitz, MD, a NIH research study project leader, examined long-COVID data. She concurred that over 100 million Americans have been infected with SARS-Co-V-2, and that about 6% (now raised to 10%) of those people continue to experience the many and far-reaching adverse effects of long-COVID (Latest on Long COVID: NIH Study Leader Leora Horwitz, MD – (chcradio.com)). While there are over 200 long-COVID symptoms reported from across the globe, Dr. Horwitz’s study sought to identify and quantify the most prevalent and impactful of those symptoms. Her team sought to accumulate this knowledge in order to create a working definition of long-COVID that would help the medical community better define, describe, and diagnose this prolonged multi-symptom phenomenon. The most frequently reported symptoms in her study received the highest numerical score. This led to the identification of the 12 most common long-COVID symptoms (of the over 200 reported).. The participants in the NIH study sample were selected to reflect the characteristics of America’s diverse populations. It included 9,764 adults (8,646 with COVID-19 and 1,118 who were not COVID-19 positive).
12 most common symptoms of long-COVID:
- Post-exertional malaise (debilitating fatigue that worsens after physical or mental activity)
- Brain fog
- Gastrointestinal symptoms
- Heart palpitations
- Issues with sexual desire or capacity
- Loss of smell or taste
- Chronic cough
- Chest pain
- Abnormal movements
So, what are the take-away messages about COVID-19 and long-COVID for men, women, parents and teens?
- Do not mistake the declared end of the COVID-19 Pandemic Public Health Emergency to mean that we no longer have circulating COVID-19 variants in our communities. We do!
- Continue to use common-sense self-protections such as hand-washing, avoid touching your face, avoid crowded indoor places or consider using a mask when in such locations, use good respiratory hygiene practices and teach them to your children.
- Know if you are in a high-risk population so you can take special precautions (Black, Hispanic, from an Indigenous population; if you are overweight, pregnant, elderly; if you are unvaccinated or vaccinated but not boosted; if you have underlying health conditions (heart, lung, kidney, diabetes, cancer, an immune disorder, a condition or treatment for a condition that has impacted your immune system, etc.)
- Stay home/keep your kids home when sick.
- If you become sick or know that you have been exposed to someone with COVID-19, test yourself for COVID, not once but 2 or 3 times if you test negative; if you test positive notify your primary care provider to be assessed for an antiviral such as Paxlovid which can reduce the time you are ill.
- If you test positive for COVID-19, notify others with whom you (or your children) have been in contact so they can get tested.
- If you have had COVID-19 and your symptoms are lingering, see your primary care provider for assessment and diagnosis. Long-COVID can impact one’s ability to carry out many their life duties. In some cases, the diagnosed person may be eligible for an Americans With Disabilities Act (ADA) disability status (https://www.ada.gov/resources/2021-08-25-covid-qa/).