A lot of clever people are chasing the cause of long Covid, but so far the virus is outrunning them–and we’re talking about a virus, remember, that doesn’t have a degree in either science or medicine and that’s rumored to be illiterate.

Not that I’m making fun of those clever people. Long covid scares the bejeezus out of me and I’m grateful for the work they’re doing, but I’m also painfully aware that they haven’t even found all the puzzle pieces yet, never mind gotten them in the right place. 

Puzzle pieces? What happened to the chase metaphor? 

I couldn’t keep up with it and had to grab something else off the shelf where I store my cliches.

But back to our actual subject: The clever folk are at the stage where they have theories, but that’s not all bad. Theories open up possibilities and they’re a good place to start. Let’s check in with a few of them:

Pediatrician Danilo Buonsenso noticed that some of his patients–these are kids, remember, with their habit of showing up at pediatricians’ offices and licking their fingers before touching the toys–

Where were we? Some of his patients who’d had mild Covid cases were left short of breath, exhausted and sporting a variety of other symptoms. That’s not common in post-Covid kids, but what with him being a doctor and all, and one who specializes in infectious diseases (I know, I didn’t get around to mentioning that earlier)–well, the kids he’s most likely to see are the ones who are sick, which skews the sample.

As the article I stole this from explains it, “He now suspects that, in some of them, the cells and tissues that control blood flow are damaged and the blood’s tendency to clot is amplified. Minute blood clots, leftover from the viral assault or fueled by its aftermath, might be gumming up the body’s circulation, to disastrous effect from the brain to joints. ‘In some patients we have specific areas where no blood flow comes in’ or the flow is reduced, Buonsenso says. 

Another theory comes from  microbiologist Amy Proal: that the virus hangs on in the body after the acute stage of the infection is over. Studies show that “the virus is capable of persistence in a wide range of body sites,” she said. 

A third theory comes from Chansavath Phetsouphanh, who’s observed that the immune cells of long Covid patients are still on high alert as much as eight months after they first tested positive. 

A fourth theory comes from Nick Reynolds, who found amyloid clumps in the brains of people with the neurological symptoms of  long Covid. They’re similar to the clumps that cause Alzheimer’s disease and dementia. That doesn’t necessarily mean the patients will have lasting damage or that the drugs used to treat those diseases help in these different circumstances. On the other hand–well, who knows at this stage? It might.

Are any of the theories right? Are all of them showing us a small piece of a large picture? Tune in sometime later–possibly a lot later–for the next exciting episode of What’re We Going to Do to Get Out of This Mess? And keep in mind that once the clever people figure out what’s driving long Covid, they or some colleagues still need to figure out a treatment.

Don’t you just feel better after you hang around here? 

In the meantime, an assortment of studies are following up on the possibilities these theories raise. Wish them well, please. It won’t make any material difference, but it might make you feel like you contributed to the effort.

 

Numbers

How many people actually have long Covid? Answering that depends on how we define long Covid, but let’s set that aside. We’re not scientists–or most of us aren’t and anyone who is must be slumming. We can get away with being hazy when it suits us. 

In May, the U.S. Centers for Disease Control and Prevention rampaged through the medical records of some 2 million people and reported that at least 1 in 5 people who’d had Covid came away with long Covid symptoms. For some of them, that meant struggling but hanging onto their normal lives. For others, it meant struggling, only with nobut at the end of the sentence.  

In the UK, some 2 million people have long Covid according to the Office for National Statistics, which does have a definition of the thing but never mind what it is. We’re not scientists, remember? Or else we’re slumming and will have to put up with the way other people’s minds work. 

Proal (remember her?) said, “I consider Long Covid to be a massive emergency.”

 

Who’s most at risk of long Covid?

A small study from Japan found that being over 40 increased the odds. So did being over 60. Since I’m over both (it took a while, but I got there), this is not good news where I live. 

In contrast to other studies, it didn’t find sex to be a big factor, although long Covid seemed to have a harder psychological impact on women than on men. 

In contrast, a UK study found that being female, being in poor pre-pandemic mental and physical health, being obese, and having asthma all increased the odds of long Covid. 

Do the two studies contradict each other? Partially. The data they’re working from is sketchy, but the issue’s important enough to use it anyway. Take them for what they’re worth.

The UK study finds that between 7.8% and 17%of the people who reported having Covid also reported symptoms that lasted longer than longer than 12 weeks, and between 1.2% to 4.8% reported  that the symptoms were debilitating. 

Why the range? I haven’t a clue. I find numbers debilitating.

The numbers were lower when they worked from doctors’ records as opposed to self-reports, but that could be because doctors weren’t reporting long Covid before November 2020.

 

A shred of good news

The omicron variant may be less likely than delta to cause long Covid–20 to 50% lower. To put that another way, with omicron, 4.4% of cases turned into long Covid. With delta, that was 10.8%. But that’s still a shitload of people.

 

More numbers: What have vaccinations ever done for us?

Well, in the first year they were available, they prevented an estimated 19.8 million Covid deaths. That’s based on excess deaths in 185 countries and territories. 

Excess deaths? It’s the figure you use when you don’t have any other consistent or reliable way to count the pandemic’s impact. In rough terms, it compares deaths during the pandemic to deaths in some pre-pandemic year. It’s imperfect, but the other systems are even more so. If you don’t use it, you end up counting the number of people who (if they weren’t dead) could brag about having Covid listed on their death certificates. You miss a lot of people that way. You can also count the number who are known to have had Covid and who then went on to die, leaving you counting people who died because a brick fell on their head and missing some who died undiagnosed. Or you can count people who die within 28 days of a diagnosis and miss the ones who took too long to die as well as include a few who had unfortunate encounters with bricks.

The UK switched methods midway through the pandemic, probably because the government wanted it to look like fewer people had died and the new way yielded a lower number. 

Yeah, I have absolute faith in the people leading the country. They’ll do whatever works best for them and to hell with everything and everyone else.

Not only is none of the systems accurate, different countries rely on different definitions of a Covid death, raising hell with international studies. 

But let’s put death on the shelf for a minute and go back to vaccines and lives saved, which is what we’re pretending to talk about. The study estimates that 599,300 more lives would’ve been saved if the world, lower case, had met the World (upper case) Health Organization’s target of getting  two or more vaccine doses to 40% of the population of every country by the end of 2021. 

By now, 66% of the world’s population has received at least one dose of vaccine.

 

More numbers

In 2020 and 2021, Covid was the third leading cause of death in the United States, crossing the finish line after cancer and heart disease. So it gets a bronze medal and modest bragging rights, but not as much glory as it was hoping for.