Why young adults don’t have a get-out-of-Covid-free card

As the pandemic lumbers onward, we’re hearing more about long Covid–the debilitating long-term effects that some people experience after the disease has passed. Here’s what I’ve been able to scrape together:

No one who catches the virus knows what card they’ll pull out of the Covid deck. Some people have no symptoms, some people get sick and recover, and some people die. As far as most discussions are concerned, that’s it. Cards distributed. Can we play something else, please? 

Well, no, we can’t, because that middle group isn’t done drawing cards. Some of them recover fully, regardless of whether they had serious cases or mild ones, and some–even people who had mild cases–don’t go back to being the people they were before they got sick. And that includes young adults, the people we thought had a get-out-of-jail-free card for this disease. 

The symptoms of long Covid range all over the place. They can include exhaustion, brain fog, memory problems, breathlessness, depression, hair loss, concentration problems, loss of the senses of taste and smell, joint pain, muscle aches, chest pain, chills, sweats, digestive issues, coughs. Trouble going upstairs and trouble walking to the end of the street (the road, the lane, the whatever) get mentioned a lot. Fatigue sounds like the most common symptom.

Some people slowly get better and move on. Some improve a bit and slip back a bit and improve again and slip back again. Some seem to be stuck at the bottom. And it goes on for months. 

Does it get better? We don’t know yet. 

Semi-relevant photo: This is called honesty. I can’t recommend it highly enough, especially to politicians in the middle of a pandemic. It’s out of season at the moment, but let’s not draw any overarching conclusions from that. 

The Covid Symptom Study app–that’s not the official British test and trace app but it’s been downloaded by 3 million people and one cockatoo–says one person in twenty has long-term symptoms. Another app, this one in Scotland and Wales, comes up with one in ten having symptoms for longer than three weeks, some of them for months.

An article in the BMJ quotes Tim Spector, of the Covid Symptom Study, saying that if your version of Covid includes “a persistent cough, hoarse voice, headache, diarrhoea, skipping meals, and shortness of breath in the first week, you are two to three times more likely to get longer term symptoms.” 

Long Covid seems to be about twice as common in women as in men.

Or in one Paris hospital, four times more common. The same hospital said the average age of the long-haulers they saw was forty.

I know. The numbers are all over the place. These are early reports, a lot of them involving a small number of cases. They’re not carefully designed studies. It’s too early for that.

Another study said a third of patients who had mild symptoms hadn’t gotten back to their pre-Covid health after two to three weeks. The older the patient, the more likely that was, but a quarter of the people between eighteen and thirty-four hadn’t bounced back.

Many long-haulers report that many doctors don’t take them or their symptoms seriously–especially if they’re women. And gee, no, we wouldn’t want to draw any overarching conclusions from that either.

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Meanwhile, back at the Journal of the American Medical Association, a study reports that older people are underrepresented in trials of both Covid vaccines and treatments. 

Why’s that when they’re the most vulnerable to the disease? Because participation often depends on not having other diseases, or on having smart phones or internet access. 

That causes a problem, because older patients may need higher or lower doses of a vaccine or a medicine. Get it wrong and a cure or vaccine can be either toxic or useless.

Dr. Sharon Inouye said, “To be sure, some exclusions are needed to protect the health and safety of older adults—such as poorly controlled comorbidities. However, many are not well-justified, and appear to be more for expediency or convenience of the trialists.”

Did you say something about overarching conclusions?

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Okay, how much do masks, handwashing, and keeping a distance from people limit the spread of Covid? Considerably, according to a study in Thailand.

Wearing a mask all the time lowers the risk by 77%. Wearing it only part of the time you’re with someone does fuck-all. So that business about putting on a mask at a restaurant when you head for the toilets, then taking it off so you can sit back down and shovel food into your face? Useless. 

Keeping a meter away from people reduces infection by 85% and keeping contact down to fifteen minutes or less reduced the risk by 76%. Frequent handwashing? That reduced it by 66%. Add those all together and Covid will end up owing us. Or doesn’t it work that way?

If you’re wondering whether they’re talking about reducing the risk of passing on the disease or of getting it, I wondered the same thing.

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Researchers at Oxford University suggest that the best use of limited Covid testing resources would be to test people who are the most likely to pass on the disease–healthcare workers, transport workers, social care workers, delivery drivers, people who go to large gatherings, people in large cities–and to do it at regular intervals.

Random testing, they say, wastes resources.

Are we going to listen to them? Probably not. What do they know anyway?

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An anti-Covid nasal spray that’s been tested ferrets looks promising. It interacts with cells in the nasal cavity, waking up the immune system, which then kicks in and–

Okay, let’s not pretend I understand this. I’ll quote: It “kicks in like a defence shield which is broad-sprectrum and non-specific.” So presumably it slaughters anything it finds that looks suspicious. It’s odd how a moderately nonviolent person like my own bad-tempered self turns bloodthirsty when we’re discussing the immune system.

It’s too early to know if it’ll translate to humans. Or cause us to grow a glossy fur coat. 

“The hope is that it will reduce the duration and severity of the symptoms and if you reduce the number of viral particles in the nose, the hope is that it would reduce transmission – although they haven’t done those studies yet.” 

Hang onto that word hope. We need as much of it as we can get these days.

Stay well, people. I don’t have so many readers that I can afford to lose any.

Freedom, survival, and flag waving: It’s the pandemic news from Britain

A reporter asked Boris Johnson (although not in these words) whether the mess we call our Covid test and trace system might explain why Italy and Germany have lower infection rates. 

Britain’s a “freedom-loving country,” Johnson explained, “and if you look at the history of this country in the last 300 years, virtually every advance, from freedom of speech to democracy, has come from this.”

In other words, “I may not approve of the coronavirus, but I will defend to the death our right to respond with complete incompetence, as well as my right to give fat contracts to my friends and respond to pointed questions with irrelevant answers.”

Wave that flag, folks. Strike up the band. There’s money to be made.

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Irrelevant photo: Orange berries. What would you do without me to explain these thing to you?

England’s Covid tracing app, let’s call it App 2 point 0h-Yes-We-Will, is up and running. The older one, App 1 point 0h-No-You-Won’t crashed into the brick wall of reality when it was tested on the Isle of Wight, leaving barely enough shards to make fun of. But take heart: 2 point 0h-Yes-We-Will is off to a roaring start.

  • Android users were able to download the trial version, so of course some of them did. They hated it. 
  • iPhone users who left a hyphen out of the app’s name got the New Zealand version. None of them came within two meters–or several thousand miles–of anyone on the system. This may be the fastest way to stop the spread.
  • NHS workers who downloaded the app and brought their phones to work were told they’d been exposed, even though they were wearing protective gear. 
  • People with older phones were sent into the outer darkness–that place where apps are unavailable and contact with the rest of the human race has to be made in person. “Older” is defined as prior to 2018.
  • People who had symptoms but tested negative can’t enter that into the app. It only accepted positive. But since they’ve been tested, the isolate-yourself countdown began. And couldn’t be turned off.
  • People who took tests outside of the privatized testing system–through NHS England, for example–couldn’t enter them into the app. That was tens of thousands of results that were missed. Daily. 
  • Users could only mark themselves down as infectious if they’ve been tested. The idea–probably a reasonable one, given what the world’s like–was to keep a bunch of wiseasses from saying they were infectious for the sheer joy of sending people home to isolate needlessly and, basically, shutting the country down because it sounded like a fun thing to do on a Saturday night. But since the testing system’s broken and tests are hard to get, people who genuinely were infectious couldn’t prove it to the app. 

Other than that, though, it’s going well. Except for Downing Street at first saying the app couldn’t trace contacts and then having to explain that, well, yes, actually it can. And will. And sing “There’ll Always Be an England” while it does it. 

You have to love these people. I’m not sure what they thought the point of the app was if it couldn’t trace contacts, and whoever they threw out in front of the press apparently didn’t stop to wonder. By now, I expect everyone at the press conference was too punchy to think of the question until it was too late to ask it.

I’ve scrupulously listed the app’s problems in the past tense, although I’d bet a batch of very good brownies that most–possibly all–of them could be hurled into the present tense without damaging my credibility even a small amount.

My credibility’s limited, I know, but I still have more than the people running the country.

Britain, by the way, has more test capacity than Germany, Ireland, South Africa, Spain, or South Korea. And in spite of that, people can’t get tested. 

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A study said the privatized network of Covid testing labs “bypassed accreditation and raises quality concerns.” It also criticized the system of having people do their own swabs, saying it can lead to useless samples. 

When you do the test, you’re told to swab either your tonsils or their last known address. My tonsils still live with me, as they have for 73 years now, so I know they’re somewhere in Cornwall. But we don’t have the kind of relationship where we do a lot of hand-holding, so when I took a test I couldn’t tell if I was mopping my own tonsils or someone else’s. 

I’m relieved to hear that’s a flaw in the system, not a personal failing.

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Chancellor Rishi Sunak told us that there’s no “risk-free solution” to Covid and we all have to “learn to live with” it. Human contact is important. Spending money is also important, although I don’t think he exactly said that, but all the same the economy needs us. “Lives can no longer be put on hold,” he said. Britons should learn to live “without fear.”

Personally, I’m more interested in still being alive by the time this ends–assuming it does end–than in being fearless. Preferably with my lungs, heart, kidneys, brain and other body parts still working at full capacity, and with my energy in the functional zone. Also with my sense of taste and smell intact. Fear can be crippling, but its gift is that it can also keep us from crippling or killing ourselves–from walking off cliffs, say. It’s like pain. No one likes it, but it offers us important information. 

I can live with a reasonable amount of fear, especially if it means continuing to live.

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I can’t speak to Sunak’s genuine competence, but he’s the one member of this government who at least projects the image of it, leading to rumors that he may turn out to be Boris Johnson’s replacement–assuming, of course, that the Tories break with recent tradition and select for competence when they choose their next leader. He may be signaling here that he leans toward the libertarian wing of the party–the let ’em wander free, the virus will take care of itself wing. 

Never say it can’t get any worse.

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Enough with the politicians. Let’s visit the scientists: 

A Centers for Disease Control study found a correlation between eating out and catching Covid. That’s not proof, it’s just correlation, as in the two seem to be lining up more than is statistically likely. But it’s worth noticing.

Eating out included eating indoors, on patios, and outdoors. 

What’s the difference between a patio and outdoors? Damned if I know. I thought they were both outdoors.

Which should warn you about how little I know.

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A new Covid test can be done at home and it takes only fifteen minutes. What’s more, it’s cheap, although the article I saw didn’t say how cheap. The problem? It only detects the virus in people with a high viral load. The team that developed it talks about it as complementing existing tests, not replacing them, and says the people with the largest viral load are the people most likely to transmit the virus.

For some time now, I’ve been reading about fifteen-minute tests, half-hour tests, and instant tests that can be done only by large, bearded men with divining rods, but they’re always in development, or about to be set loose in the world but not quite yet. Or that they’re available on the internet but their accuracy ranges from who knows to don’t ask me. 

Then they drop out of sight. The only one that’s resurfaced is the sniffer dogs. Fido’s working in a pilot project in an airport in Finland. Do not go through a Finnish airport with dog biscuits in your pocket.

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Speaking of viral load, a study in Detroit found the viral load decreasing in hospitalized patients between April and June, and that lined up neatly with a lower number of deaths. They’re not sure why the viral load was lower, but it might be a result of social distancing, lockdown, and face masks–especially when they’re worn over the parts of the face that we breathe through.

Does anyone know why we keep talking about face masks? Is there some other part of the anatomy a mask could cover? The eyes are a possibility, but they’re generally located on the face.

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The city of Manaus, in Brazil, may have reached herd immunity: 66% of the population may have Covid antibodies. (Yes, but do notice that the word may squeezed itself in there not once but twice.) Getting to that point involved mass graves, overwhelmed hospitals, and corpses piled in refrigerated trucks. People there are still dying of Covid, but the numbers are going down. 

As soon as that went public, experts jumped in to warn against thinking that herd immunity is a viable strategy. 

Florian Krammer, professor of microbiology at Mount Sinai Hospital in New York, tweeted, “Community immunity via natural infection is not a strategy, it’s a sign that a government failed to control an outbreak and is paying for that in lives lost.” 

And after all those deaths, immunity to Covid may be short-term. No one knows yet.

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I said earlier that I wanted to get out of this mess with my sense of smell intact. Why do I care? Not only because I like food and if you lose your sense of smell your sense of taste goes with it, but because its loss may indicate some serious long-term losses.

Yeah, sorry, yet another study. Those scientists. They will keep worrying about this thing. How are we supposed to live without fear when they keep scaring the shit out of us?

This study takes off from Covid’s demonstrated ability to get into the brain and insult the cells. That’s is childish, I know, but brain cells aren’t used to it and they’re sensitive. Insult them enough and they die. 

True, Covid knows how to do insults. One of its insults involves starving the cells of oxygen, and that would probably upset anyone, so maybe we can cut the brain cells a little slack here.

Covid does less drastic things as well. The loss of smell is one, and the study treats that as a neurological symptom and an indicator that Covid’s up to something in the brain and nervous system. The loss of smell, it says, is caused by an inflammation that could cause long-term neurological problems.

Inflammation, it turns out, causes a variety of neurodegenerative diseases, including Parkinson’s, and 90% of people who get Parkinson’s report a loss of the sense of smell in the early stages. After the Spanish flu epidemic of 1918, survivors had two or three times the risk of developing Parkinson’s.

So yes, even those of us who don’t speak science are starting to see a pattern.

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From the Department of What’s It Going to Take, People? comes the story of a gospel choir in Spain that scheduled an outdoor concert in September and then rehearsed for it indoors.

Members did the recommended stuff–kept a distance, washed their hands, and wore masks for most of the rehearsal. They even did a temperature check as people arrived. What they didn’t do was open the windows–there were moths out there, and mosquitoes. So they turned on the air conditioning, because hey, it was hot.

When the article was written, thirty of the choir’s forty-one members had tested positive.

Exactly what a gospel choir in Spain sings I don’t know. I’m probably defining gospel in American. 

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And from the Department of Good News at the End of a Post comes this: A study estimates that England’s decision to house the homeless in unused hotel rooms during lockdown may have saved 266 lives and avoided 21,000 infections, 1,164 hospitalizations, and 338 intensive care admissions among the homeless alone. That doesn’t count the people they’d have gone on to infect.

I’ve been trying to find out if the program’s still going on. I think so, but I can’t swear to it.