Scientists tell us that there are about fifty different symptoms associated with Long Covid, with some surveys identifying more than one hundred. Common are fatigue, breathlessness, headaches, chest pains, palpitations and dizziness.
In March this year, 53-year-old Derek Draper, a former British journalist and political adviser, returned home after spending twelve months in hospital. A year before, he had been admitted with coronavirus symptoms and was soon on machines delivering oxygen while in a coma. His doctors later told him that he was the most seriously ill person they had seen who remained alive. Although the virus has not been present in Draper’s body since the late summer, it has led to kidney failure, damage to his liver and pancreas and heart failure. He also has holes in his lungs, following bacterial pneumonia and several infections. It’s unlikely that he will make a full recovery, but there was one ray of light; everything was provided free of charge on Britain’s National Health Service (NHS), saving him and his TV-personality wife from financial Armageddon.
Although severely damaged, in many ways Draper is lucky. According to the World Health Organisation, there have been more than 156 million confirmed cases of Covid-19 globally, with more than 3.2 million deaths, a death-rate of about 2%. Without the care and attention from the NHS, Draper would have joined this list.
Draper, of course, represents the extreme case of the long-term effects of Covid-19. But there are many who had a mild version of the coronavirus but nevertheless continue to suffer some form of after-effects. For weeks and even months after the initial infection is thought to have subsided, these patients are reporting a wide range of persistent symptoms, revealing that in many cases Covid-19 is turning out to be a long-term illness. While Covid-19 itself can last up to four weeks, symptoms persisting twelve weeks or more are classed as “post-Covid-19 syndrome”, or as many are now calling it, “Long Covid”.
Scientists tell us that there are about fifty different symptoms associated with Long Covid, with some surveys identifying more than one hundred. Common are fatigue, breathlessness, headaches, chest pains, palpitations and dizziness. A current difficulty engaging scientist’s minds is just how common Long Covid is, or how serious a problem it is likely to be, both for individual patients and wider society as a whole. There are certainly plenty of anecdotes around. In July last year, a professor of epidemiology at UK’s Liverpool School of Tropical Medicine, Paul Garner, described how ninety-five days after the onset of Covid-19 he still found himself unable to get out of bed for more than three hours at a time. He suffered from pain in his arms and legs, experienced palpitations and was addled with “brain fog”. When he updated on his condition a few months later, six months after his initial infection, he was still suffering.
According to some estimates, one in ten of those in the UK who tested positive for Covid-19 experience some form of symptom for twelve weeks or longer. One survey involving 3,700 patients found that people were still suffering symptoms up to seven months after infection and a fifth had not been able to return to previous levels of work for six months. Another report showed that patients can have enduring neurological problems that affect their memory, attention and sense of smell more than six months after infection of Covid-19.
As a new disease, research into Long Covid is still in its infancy and nobody has any clear idea of how long the condition will last. This hasn’t stopped alarming comparisons being made with the far smaller SARS outbreak which occurred between 2002 and 2004. SARS is a related coronavirus, which at the time showed signs of similar long-term problems, leaving some people unable to work for up to thirty-six months after infection. Some 40% of those who recovered from SARS still suffered chronic fatigue for more than four years.
So what causes Long Covid? Some scientists are suggesting that the coronavirus can “hide” in the body, rather like those viruses that cause glandular fever, or herpes viruses that hide or stay in a latent state before reactivating. Another possibility is that Long Covid could be the result of a persistent immune response triggered by the virus that then causes inflammation and damage to other parts of the body. A serious concern is the blood clotting noticed in many patients, possibly caused by one of the cell types in the virus being able to infect the lining of the blood vessels. This could explain how the blood supply, clotting in different organs, results in heart disease in one person and a stroke in another.
The economic fallout of Covid-19 has already been huge around the world, with many countries reporting sharp drops in their GDP. While there is no way of telling exactly what the economic damage from the pandemic will be, there is widespread agreement among economists that it will have a severe economic impact on the world economy. If the current estimate of a loss of 4.5% of global GDP in 2021 materialises, this would result in almost 4 trillion US dollars in lost economic output. At the individual level, Pew Research Centre reported last month that 44% of Americans believed that it will take them three years or more to get back to where they were a year ago, with about one-in-ten who don’t think their finances will ever recover.
Last month the IMF raised its growth forecast for India for this year to 12.5%, after economic indicators improved significantly in January and February. But the mounting stress of the alarming outbreak in the past few weeks has taken a toll, with an index of business activity tracked by Nomura registering its biggest drop in 12 months in the first week of April. While there’s no clear data of Long Covid in India, it will do nothing to improve these figures. If the UK figures of those getting some form of Long Covid are applied to India’s huge population, many millions will not be able to return to work for months, if not years, resulting in a massive drop in economic activity. An Anglo-Iraqi academic at UK’s University of Southampton, Dr Nisreen Alwan, posted on Twitter last month: “World leaders should be horrified at the thought of Long Covid that will cripple countries with phenomenal rates of infection, particularly those struggling health services and no social security. Do they really think it’ll be over after the massive wave of death? No it won’t.” She’s probably right!
There are, however, glimmers of hope. While Derek Draper, according to his wife, remains in a serious and incapacitated condition, earlier this year Paul Garner reported that his health had finally returned. Scientists and Health Authorities around the world will be hoping that others may soon follow him.
John Dobson is a former British diplomat, who also worked in UK Prime Minister John Major’s office between 1995 and 1998.