…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.”

*

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 hours. An 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.”

Apologies.

 

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.