A possible treatment for long Covid brain fog 

A small study has identified two drugs, guanfacine and N-acetylcysteine, that may offer help for long Covid’s brain fog. In some cases they decreased it and in others flat-out eliminated it. And because  the drugs have already been approved for other uses (at least in the US, where the study was done; I’m not issuing guarantees about other countries), patients should be able to get them if they can find a doctor willing to prescribe them. 

Please note the if and the should in that sentence. It’s possible but not guaranteed. 

The results were strong enough that one of the researchers, Arman Fesharaki-Zadeh, went from researcher to advocate. 

“There’s a paucity of treatment out there for long Covid brain fog,” he said, “so when I kept seeing the benefits of this treatment in patients, I felt a sense of urgency to disseminate this information. You don’t need to wait to be part of a research trial. You can ask your physician—these drugs are affordable and widely available.” 

To confirm the findings, larger trials will have to be done, with a control group taking a placebo and lots of people in white lab coats looking important, but Fesharaki-Zadeh was convinced enough by the improvements that he’s gone on to use the combination with people whose symptoms are similar but were caused by Lyme disease and MS. He says the results are promising.

Irrelevant photo: Daffodils in February.

Other long Covid news

I’ve seen several articles lately about long Covid’s impact not on individuals but on society as a whole. The U.S. Government Accountability Office estimates that it has affected somewhere between 7.7 million to 23 million Americans. That’s a hell of a range, which probably testifies to how badly defined long Covid still is. 

A different study estimates that 500,000 people in the US aren’t working because of long Covid.

“It’s a pretty conservative estimate,” according to Gaurav Vasisht, a co-author of the second study. “It’s not capturing people who may have gone back to work and didn’t seek medical attention and may still be suffering, so you know, they’re just toughing it out.”

The good news is that the number of long Covid cases as a percentage of workers’ compensations has decreased. That change coincides with vaccines and treatments that can reduce the risk of long Covid becoming available.

What treatments? The article didn’t say, damn it. My best guess is they’re talking about antivirals.


A different study reports that in people whose mild Cofid cases left them with long Covid, the “vast majority” of the symptoms clears up after a year, and that vaccinated patients had a lower risk of breathing problems. 


Ah, but we have to balance out the good news, don’t we? A study that looked at a range of other studies saw that although most long Covid patients with mild cases recover, that’s not true of people with severe cases. 



Yet another study shows a healthy lifestyle coinciding with an almost 50% reduction in the chances of women getting long Covid. That’s not proof that the two are linked, only a bit of statistical flag-waving that says these two things live together, eat supper together, and leave for work together, so we could maybe assume they’re in a relationship, not just roommates. 

The lifestyle (damn, I hate that word) factors they took into account were maintaining a healthy weight, getting enough sleep, not smoking, drinking only moderately, exercising, and eating a good diet. 

Swearing seems to have no impact, one way or another. 

The slightly-more-than-half the group who did get long Covid got milder cases. 

Why did the study focus on women? The article didn’t say, but women are somewhat more susceptible to long Covid. That may or may not explain it. 


Vaccine news

India has become the first country to approve a nasal Covid vaccine. It can be used as both a booster and a primary vaccine. Because the vaccine sets up shop in the nasal cavities, which is where Covid likes to set up its own shop, it could keep Covid from spreading. Could. Potentially.

Watch this space. Watch several other spaces. Watch your nasal cavities. We’ll see what happens.


In China, researchers are at the animal testing stage of what they hope will be a universal Covid vaccine that targets a portion of the virus that has stayed stable across multiple mutations–11,650,487 of them if you’re counting. I’m not. I ran out of fingers somewhere around 12.

It needs more testing before it goes to human trials, but if I understand the article correctly, they’re hoping it will prevent breakthrough infections–the kind that dog people who’ve gotten the current vaccines. In other words, it could actually halt the spread of Covid–which (in spite of the way 90% of the people we all know are acting) ain’t over.


Non-vaccine news

We’ve got two items in this enticing little basket:

Number one is a spray that–if it works, of course–could keep Covid from getting any further than our breathing equipment. A group of engineers created “thin, thread-like strands of molecules called supramolecular filaments.” The idea is that you spray ‘em in your nose (or possibly mouth) and they block any virus from getting into your lungs.

Yes, you can still breathe through them.

The effect may only last an hour or two, but it would allow you to go into your nearest overcrowded venue and forget your worries for a while

How does it do that? Um, well, yeah. What do you say I quote?

“The filaments carry a receptor called angiotensin converting enzyme-2, or ACE2. These receptors are also found in cells in the nasal lining, the lung surface, and small intestine, and have many biological roles, such as regulating blood pressure and inflammation. The novel coronavirus enters our bodies primarily through interactions with this receptor. The virus’s characteristic spike protein clicks into this receptor, much like a key going into a lock, allowing it to enter the cell and replicate. Once the virus is locked into the cell, it prevents the cell from executing its normal functions, leading to and exacerbating infections.

“Researchers have long known that adding extra ACE2 into airways can block virus entry, essentially preventing the virus from binding with ACE2 in the lungs. However, since ACE2 has biological functions, simply delivering more ACE2 to the body may have unforeseeable complications. The research team’s newly engineered filament, called fACE2, serves as a decoy binding site for the virus, with each filament offering several receptors for the COVID-19 spike protein to attach to, and silences ACE2’s biological functions to avoid potential side effects.”

Like so many of the innovations I write about, though, it’s not yet ready for prime time.

Item number two in the basket is–oops, it’s very much the same but it’s coming from a different group. In fact, from more than one different group but still involving ACE2 receptors, decoys, all that stuff. 

Different delivery systems, different colors, slightly different mileage, but once you get past that they’re all related. Something seems to be happening here. Keep your eye on it.



Statistically speaking, what do we know about the pandemic? 

  • That at least 6.8 million people died of Covid and 752 million caught it. 
    • That those numbers massively undercount what happened. Multiply them by 2 or 3 and you’ll get a more realistic number. 
  • That the global GDP dropped by 3.1% in 2020. Compare that to a 1.3% drop during the 2009 crisis. It bounced back by 5.9% worldwide in 2021.
  • That 135 million jobs were lost in 2020. 
  • That in 2022, 56 million more people were out of work than before the pandemic, and 37 million are expected to still be out of work in 2023. How those numbers square with the 5.9% bounceback in GDP is anyone’s guess.
  • That in the US, Covid is the eighth leading cause of death among people between 0 and 19 years old. If we limit that to disease-related deaths, it’s the fifth, and it’s first among infection or respiratory diseases.

Sorry about the wonky spacing of the bullet points. I’m sure there’s a way to even them out but I haven’t found it.


A study of Covid in California prisons–do I need to mention that they’re crowded?–shows that vaccination and boosters reduced the spread of the omicron variant by 11% for each additional dose.

For the mathematically impaired, I’ll point out that 11% is not 100% but it’s also not 0%. That means breakthrough infections–the ones that push their nasty way in among the vaccinated–were common but they were less common than Covid cases would be without vaccinations. And the rate of serious illness was low.  In a bit more than five months, they clocked 22,334 confirmed omicron infections but only 31 hospitalizations and no Covid deaths.

People who’d been vaccinated were a bit less likely to transmit the disease–the number dropped from 36% to 28%–but the longer it had been since a person was vaccinated, the more the chances of transmitting the beast grew–6% every five weeks. People are at their least infections within two months of being vaccinated or getting a booster.

Having said all that, Covid was spreading widely in the prison population and Sophia Tan, the study’s first author, was calling for “new ideas. . . since the risk of infection in this vulnerable population remains so great.”

Covid: It ain’t over till it’s over…

…as the endlessly quotable Yogi Berra may or may not have said.

But forget Berra. The World Health Organization, a.k.a. WHO, isn’t as much fun to quote but it knows how to do footnotes, and that makes it more impressive. In its opinion, the pandemic isn’t over. Between the beginning of 2022 and late August, at least a million people around the world died of Covid. 

Or if you want to start counting at the beginning of the pandemic, that’s 6.45 million. Both numbers undercount the damage, but never mind that. Let’s work with what we’ve got.

”We have the tools that can actually prevent these deaths,” said Maria Van Kerkhove, WHO’s technical lead on Covid. “A lot of people are talking about living with COVID. But we need to live with this responsibly. A million deaths this year is not living with COVID. Having 15,000 deaths per week is not living with COVID-19 responsibly.”

In one recent week, more than 5.3 million new cases were reported worldwide, a number that doesn’t include people who registered positive only on a home test. Or who never tested.

“These are huge numbers, and that’s an underestimate,” said Van Kerkhove. “We do see this virus circulating really intensely around the world.”

Irrelevant photo: an orchid


That brings me to the question of why I keep banging on about Covid. Apologies if I’ve gotten boring–Notes isn’t supposed to be mindless, but it is supposed to be a fun read. The problem is that scientists keep coming up with new information. What I’m saying here is, Blame the scientists. If they weren’t so damn good at this, it wouldn’t end up in your inbox.

And if that isn’t a good enough reason, it’s because it still matters. Living with Covid doesn’t have to mean pretending it’s no danger.


Long Covid 

Let’s talk about long Covid. Again. Sorry to keep coming back to it, but not long ago someone challenged me on the extent of the problem (my thanks; it was an interesting discussion) and since long Covid’s hard to define and at least as hard to measure, I didn’t have great statistics to offer. But I have started to see some lately, so let’s play with numbers. They all involve money, since it can be counted, and when you’re dealing with something as hazy as long Covid that’s useful. Besides, as we all know, money matters more than life itself.

So let’s talk money: A report from the US estimates that 4 million people are out of work with long Covid, which could mean $170 billion in lost wages. In a year. The report’s author,  Katie Bach, said, “If this looks like other post-viral illnesses, some people will recover, but there will be this big stock of people who don’t, and it will just continue to grow over time.”

She called it “a shocking number.” 

In mid-2021, the Federal Reserve Bank of Minneapolis estimated that 26% of people with long Covid were out of work or had cut their working hoursAn international survey found that 22% of people with long Covid weren’t working and 45% had cut their hours, and a U.K. survey found 16% had reduced their hours and 20% were on paid sick leave. That was between April and May 2021.

Australia’s treasury reports that the country’s lost 3 million working days to long Covid. Or to put that another way, 31,000 people have missed work every day because of it. 


So how many people have long Covid? I’m not sure anybody has a reliable count, but the U.S. Centers for Disease Control estimate that 19% of people who’ve had Covid get long Covid symptoms. Unfortunately, the number’s less helpful number than it sounds like, because long Covid’s symptoms range from relatively mild to completely hair-raising and the duration ranges from weeks to the possibility of a life sentence.  


Are we having fun yet?

Evidence is growing that people who’ve had Covid face an increased risk of neurological and psychiatric problems as much as two years after their infection. That’s not the final word on the subject, but it comes from a study that followed 1.28 million cases over two years. It does seem to be a strong hint. 

The good news? Depression and anxiety are generally gone after two months and are no more common after Covid than after other respiratory infections. And kids are at the lowest risk for kids for later complications. 

End of good news.

Adults 64 and under showed an increased risk of brain fog–640 cases per 10,000 people vs 550 cases per. Over 65s? The number went up to 1,540 per compared to 1,230. For dementia (we’re still talking about the over 65s here) it was 450 instead of 330. Psychiatric disorders? That’s 85 instead of 60. 

Is there anything can we do about it? Hell yes. I’m going to petition the courts to lower my age.

Does the risk end after two years? We haven’t had enough time for anyone to find that out. 


A theory that’s loose on social media holds microclots responsible for long Covid, and some evidence does back that up, but (as one article says) hematologists worry that enthusiasm for the theory has gotten ahead of the data.

Danny Altmann, an immunologist at Imperial College London, said, “We’ve now got little scattered of bits of evidence. We’re all scuttling to try and put it together in some kind of consensus. We’re so far away from that. It’s very unsatisfying.”

But that’s not stopping a few medical groups from offering treatment to remove the clots, and some people with long Covid are desperate enough to try anything, which I can understand. But at least some treatments to get rid of clots risk messing with the blood’s ability to clot, and that (she said, indulging in a mild understatement) would not be a good thing.


How Covid’s changing

Its incubation period—the time between when a person gets infected and when they’re shedding enough of the virus to infect other people—is getting shorter, and the shorter that time that period is, the harder it is for vaccines to keep the virus from spreading.  

Yeah, that was news to me too. Measles and rubella have a two-week incubation period, which allows time for a vaccinated person’s immune memory cells to crank out antibodies and keep the person from passing the bug to other people. So vaccines for those diseases stop the spread. In contrast, a Covid vaccine, although it protects the wearer, doesn’t protect the wearer’s friends. Or enemies. 

On the bright  side, the shorter incubation time means people who test positive might not have to isolate themselves for as long.

Every cloud has a silver lining, but the problem with that is that silver linings are too heavy to float. Watch out for falling silver linings.


Expired tests

You may (or may not) remember that a while back I wrote about the expiration dates on Covid tests. After they pass those dates, I led you to believe (if and only if you read it, of course), they start to call in sick and miss work. Well, I need to update that. The U.S. Food and Drug Administration set the expiration dates in the early days of the pandemic, on the basis of the limited information that was available at the time, but manufacturers are testing aging tests them and some turn out to be good beyond their expiration dates.

How do you know if yours still good?

“To check whether your test kit is still good beyond the printed expiration date, you can search on the FDA’s “At-Home OTC COVID-19 Diagnostic Tests” website.

“Type in the brand name on the FDA site, and a link will appear showing a list of updated expiration dates.

“You may have to check the lot number on your package. For instance, say you’re trying to look up an iHealth COVID-19 test kit with lot number 222CO20208. Scroll down the document to find your lot number, and you’ll find that the original expiration date of Aug. 7 has been extended to Feb. 7, 2023.”



An update on Hafiza Qasimi

In early August, I wrote about Hafiza Qasimi, a woman artist fleeing Afghanistan after the Taliban destroyed her paintings and left her unable to work. The campaign to raise the 10,000 euros she needed to apply for a German visa has reached its goal. This allows her to demonstrate that she can support herself for her first year in the country. (The amount will be raised to 11,208 in January.)

In the meantime, Qasimi has reached Tehran. I have no idea how she did that. In Afghanistan, women aren’t allowed to either travel or leave the country unless they’re with their husband or a male a relative. But she managed it, she’s safe, and she’s been offered a three-month residency at a German art gallery is she can get that visa.

The group supporting her is trying to raise more than the 10,000 euro minimum so that she can afford health insurance and other basics. They’re also working with her on a grant application that would allow her to study at art school.

“This,” they say, “will provide her with the space she needs, as a free woman, to renew and develop her artistic work. We are full of confidence and look forward with Hafiza to the future.”

Her brother, who lives in Germany, will be flying to Tehran to see her for the first time in eight years.

If you want to contribute to the fundraising campaign, any amount will be welcome. And if you don’t (or would love to but can’t), that’s okay. Do what you can where you can and wish her joy in her freedom.