Fewer people are dying but we still need to worry about long Covid

When ‘Freedom Day’ rolled around and I saw the coverage of packed pubs and nightclubs, one part of me was happy to see people out and enjoying themselves again – a picture of normality we’ve not had in what seems like forever.

But a bigger part of me was really anxious about what it might mean for rising cases of long Covid – a long-term condition where people with confirmed or suspected Covid-19 report ongoing symptoms lasting more than several weeks or months.

It’s already a massive problem.

The Office of National Statistics reported last month that almost one million people in the UK were living with ongoing symptoms after Covid-19 in the four-week period ending 6 June – 33,000 of them under 16 and another 200,000 between 17 and 35 years old.

Of those million, almost 400,000 had been living with symptoms – most commonly fatigue, breathlessness, muscle aches and brain fog – for more than a year and over 600,000 said symptoms negatively impacted their daily lives.

As a member of Independent SAGE – a group that publishes advice aimed toward the UK Government and the public regarding the pandemic – and someone who has been following Covid-19 closely over the past 18 months, I strongly believe that long Covid must factor into policy decisions.

But the formal roadmap criteria currently only explicitly considers hospitalisations, and how these are affected positively by current vaccines or negatively by variants, even though Chris Whitty and SAGE have all warned about long Covid’s potential long term awful impact on a generation of young people.

The problem has been that long Covid is hard to measure because it takes several months to establish (by definition), it can appear in so many different ways and there is no simple test for it.

Because of this, and because it only started being recognised as a serious problem last summer, it’s not included in any of the Government’s daily or weekly statistics, which typically include new infections, hospitalisations, deaths, vaccinations and demographic data on spread.

It’s more common in people between 35 and 69, women, health and social care workers and people from more deprived communities

But it matters. Almost half a million of those living with long Covid were 17 to 50 years of age – impacting people’s ability to study or work.

Take the NHS, for example. A previous set of ONS statistics released in April revealed that 122,000 people with long Covid were health care workers. Long Covid has become a major new chronic disease: compared to the million with long Covid, about 260,000 people get diagnosed with diabetes and almost 480,000 people with heart disease each year.

So what exactly is long Covid? It’s often used as an umbrella term for all types of ongoing health problems experienced by people who have had Covid-19. One category is ongoing health problems in people who have needed to go to hospital – about half of them have continuing problems like organ damage.

For people with Covid-19 who do not need hospital, somewhere between 20% to 35% of them go on to develop symptoms that last for several months or longer.

Symptoms can cluster into groups: respiratory (breathlessness, chest tightness, inability to exercise), tiredness (fatigue, muscle aches, difficulty sleeping) and neurological (brain fog, problems concentrating, dizziness) but over 200 different symptoms have been reported, such as gut problems, menstrual changes, itchy skin and tinnitus.

It’s more common in people between 35 and 69, women, health and social care workers and people from more deprived communities, but it also affects around 7% to 15% of people under 16 and maybe 20% of young adults, according to ONS statistics released in April.

New studies of brain scans found persisting changes to the brain following even mild Covid-19 infection, in which parts of the brain associated with smell and memory became thinner. Another recent study done as part of Horizon’s Great British Intelligence Test found that people who had had Covid-19 had worse scores on cognitive tests than those who hadn’t, although differences are small for people who didn’t need hospital.

We still don’t know enough about whether the disease has implications for people’s health years after initial infection, but we know that organ damage is a concern.

Why would we let the disease run rampant by removing almost all public health measures when there’s still so much we don’t know about long-term impact? It seems too risky to me.

The Academy of Medical Sciences, in a report commissioned by Patrick Vallance, estimated a summer peak of perhaps 20,000 people with new Covid-19 infections developing long Covid every day.

It is an important chronic disease that severely impacts the quality of life – and ability to work and learn – of many sufferers

If we see another 2million Covid infections just this summer, even if a very conservative estimate of 10% to 20% went on to develop long Covid, that’s another 200,000 to 400,000 people who will find their daily lives affected by ongoing symptoms for several months and longer.  

There is as yet no treatment for long Covid, only ongoing support to help people manage their day-to-day symptoms. An already stretched NHS is struggling with this influx of patients with a new, complex, chronic disease that impacts many people’s ability to work, exercise, socialise or otherwise live their lives.

So while hospital ICUs might not be overwhelmed with Covid-19 patients this summer, hundreds of thousands of new people needing care for long Covid will impact services for those with chronic conditions. Yet another reason why long Covid needs to factor into policy making.

But these hundreds of thousands of new cases of long Covid are preventable.

Full vaccination greatly reduces your chance of getting infected and, if you do develop symptoms of Covid-19, further reduces your chance of developing long Covid. But only around 55% of our whole population is fully vaccinated, mostly adults over 40.

Somehow, the Government has decided that a few million new infections – largely in unvaccinated and unprotected younger people – don’t matter because very few will die. 

Long Covid matters. It is an important chronic disease that severely impacts the quality of life – and ability to work and learn – of many sufferers.

As Shu-Ti Chiou, adjunct Associate Professor of the Institute of Public Health at the National Yang Ming University in Taiwan, described the UK’s recent easing of lockdown restrictions: ‘It’s unethical to take the umbrella away from persons not having a raincoat while it’s raining very hard. Take it only when the rain is small and everyone has a raincoat.’

Keeping some public health measures to contain infections and giving time for the two doses of vaccine to be offered to everyone over 12 years old must be the right thing to do.

By choosing not to do this, we will end up with hundreds of thousands more, mostly young, people with a preventable chronic disease.

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