What I wish you knew about (long) covid

While it is alluring to declare that the pandemic is over – unfortunately, it’s an illusion. We’re deluding ourselves, delaying, and not using the time when cheap measures still have a lot of effect. From the perspective of being (mildly) affected with long covid, and hearing heartbreaking stories of other people who’ve got it much worse, I have a hard time to put that together with the absolute refusal to even acknowledge, let alone do something about an event that might well turn out to be disabling the masses – in the US alone, it is estimated that about 16 million people have long covid, and that about 2-4 million are out of the workforce because of long covid (article, data source).

That alone should be enough to make you pause – after all, weren’t all the measures meant to protect the economy? Now we don’t have any, but the health crisis is clearly having an economic effect. (And as someone working with data, I’d also like to highlight that you can only estimate the effect of something if you’re gathering the data – e.g. in Switzerland, no one bothers to count the number of patients with long covid…)

Anyway, le’ts start from the beginning: How do I know the pandemic is not over? Well, the case numbers are up again, and no, the the 3rd wave in the same year clearly says it’s more than something seasonal.

But hey, if Covid really is like a cold, then this does not matter, right? Well, let me break it too you: Even after a mild or asymptomatic case of Covid,

  1. you might get long covid (symptoms persisting after 3 months or more, with severity ranging from almost no impairment to being completely bed-bound).
  2. your risk of any vascular emergency such as a stroke or a heart attack is increased.
  3. your brain matter changes (as such not necessarily worrying, except it seems to come with increased of neurological problems).

None of these points are anything near as ‘mild’ as we declare the pandemic to be. But let me elaborate:

Long Covid

Whenever you get infected – and sadly you can easily get reinfected, more easily with the latest variants, so don’t bank on “I won’t get it again, I’ve just had it” – you might get long covid. While likely there are some predispositions that make it more likely for you to get long covid, these are not well understood – and you can certainly get it if you are young or sporty or both. Data from the US and the UK suggest that after a Covid infection, about 1 in 5 people develop long covid, about 1 in 100 get it so severe that they are chronically ill and likely bed-bound (paper, article). The odds really are that bad.

Vascular issues

Strokes in under 30 year olds are not normal – neither are stillbirths or strokes. All of these point towards issues with blood clotting, to the point where it is debated whether covid should maybe be thought of as a vascular rather than a respiratory disease.

Two comments: Well done for the UK and US having gotten these large cohort studies underway, sadly not seeing many of those around here. Plus, in a similar vein, who knows whether monkeypox would have been a thing without covid paving the way? I’m pretty sure that covid is not good for your immune system.

What can you do?

While you most likely cannot influence politicians to advocate some mitigation measures, there are still many things you can do to protect yourself and the people around you:

  • Wear a mask (FFP2 / KN95) in indoor settings. I definitely wear a mask (have in fact never stopped wearing a mask) in places it does not cost me anything, such as the supermarket, or public transport. I’m starting to wear masks in other indoor settings again.
  • Get vaccinated. While the protection from vaccination for long covid is only slight, it does still protect you from severe acute illness, and there is a weak correlation between acute disease severity and getting long covid. Moreovery, you are infections for a shorter period of time if you are vaccinated, and therefore less likely to pass it on to other people (who might in turn get long covid).
  • Get boosted (see above; if available in your region, go for the latest bivalent shot with BA5).
  • Meet people outdoors if possible, rather than indoors.
  • Advocate for clean air – how about an air purifier in the cafeteria of your office? In the office itself? In the schoolroom of your kids? Or even at home for meeting friends. You can even make your own, when done properly these Corsi-Rosenthal boxes are very effective. Covid is airborne!
  • Give your mucosa in your nose a bit of help, either by rinsing your nose twice daily with salt water, or by using an anti-viral nasal spray. These things get rid of virus on your mucosa, and by removing those viruses, you might prevent infection, or at least severe disease (severity is correlated with viral load/the amount of virus you are exposed to initially). Do this before and after potential exposure (i.e. basically all the time). After potential exposure you can also use an anti-viral throat spray.
  • Get PCR-tested if you have any symptoms at all. The latest variants do not show up very well on lateral flow/self tests.

What does not help (much)

Disinfecting your hands and surfaces – well, it helps against other things, but it’s not much help against Covid. Neither is keeping a bit of a distance (mask and still keep your distance). It’s not a bad idea, but if you disinfect your hands while loudly and closely talking to other people – that won’t help.

What can you do if you get infected

You really gave it all, you were careful, and you still got it… you have my sympathy. It is a Sisiphus task to try and avoid infection in a society that does not care. Still, what can you do?

  • Isolate – don’t give it to other people. Stay home if you can, if not avoidable meet other people only with FFP2 masks on both sides and air purification.
    It’s a luxury, I know :-/
  • Give your nose and throat the same help as above with rinsing or anti-viral spraying. Apparently reducing the viral load also helps to bring severity down.
  • REST! This is the one I really mean. And I mean more like 19th century go-somewhere-for-several-weeks rest. Do not do any sports for 6 weeks at least.
    If you restart/do something strenuous, and it feels more strenuous than it should – stop! Otherwise you might well walk into a crash (this can be immediate or happen up to several days after the exerction, and might therefore be hard to realise). If you do this several times, you increase the risk of chronification, i.e. of getting long covid. Do not try to keep going, do not listen to people who say that sports and exercise and movement is necessary. You might regret it.

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