Long Covid Facts

While many people recover from Covid-19 without further problems, some report having long-term health problems. A large range of symptoms are reported by these sufferers, for varying periods after the infection. Symptoms typically fall into four groups.

Types of Long Covid

Post intensive care syndrome (PICS)
Critically ill patients can suffer a range of health problems after a long time in hospital. This can include muscle weakness, and anxiety or another mental health problem. They may also have memory problems, which can affect whether they can return to work.

Post viral fatigue syndrome (PVFS)
Similar to problems following enteritis or rubella, fatigue and 'brain fog' may make it difficult to concentrate or remember things. 

Permanent organ damage (POD)
The lungs and heart, and also liver and pancreas, may have permanent damage.

Long-term Covid syndrome (LTCS)
This group report 'floating' symptoms which mean they do not fit into the other three groups. They suffer illness linked to one part of the body (e.g. respiratory system, brain, cardiovascular system and heart, kidneys, gut, liver or skin), which later abates, but then new symptoms arise in a different part of the body.

Why does this happen? 
Latest: A small study (at Stellenbosch University, South Africa) comparing blood collected from 11 people with long Covid and 13 healthy individuals found that those with long Covid have a large amount of tiny clots of inflammatory molecules trapped in their bloodstream. These blockages have the potential to disrupt the body's ability to distribute oxygen and vital nutrients, which could explain - or help to explain - the most common symptoms of fatigue, headaches and breathing difficulties. Some of the trapped molecules contain clotting proteins such as fibrinogen (helps the body to make clots to stop bleeding) and alpha(2)-antiplasmin (helps prevent blood clots from breaking down). Under normal conditions, the body maintains a balance of clotting and anti-clotting material to help the body reduce blood loss after injury, and preventing clots from growing too large and restricting oxygen flow. High amounts of alpha(2)-antiplasmin stuck in the blood mean the body's ability to break down clots is severely reduced. Other recent studies have also highlighted that the body's clotting system could be involved, while Covid itself has been linked to clotting disorders during the initial infection. More research with larger samples is needed to confirm these findings, and research to identify the type of treatment for the problem.

There are three possible reasons, and long covid may even be a combination of these.

1. Direct damage by the virus. For example, the heart and lungs can be permanently damaged, which could explain prolonged shortness of breath and chest pains. 
2. It is even possible that the virus could hide in some body tissues, and continually reactivate; some studies are looking into this possibility.
3.  Inadvertent damage that the body can do when it responds to the virus.

Long Covid is less common than first feared.
Initially it was unclear how many people might be affected, nor how long symptoms might last and whether there might be permanent damage. It it is possible to have serious Covid-19 symptoms and not experience long-term syndromes, and for those with mild cases to develop one of the syndromes.

The UK Office for National Statistics (ONS) has been monitoring this, by testing people at random which ensures that the comparison between Covid sufferers and non-sufferers is good. Additionally they carry out long-term follow-ups of those with long covid. Their latest (September 2021), large and comprehensive analysis suggests that one in 40 (2.5%) people with coronavirus has symptoms lasting at least three months.

Those most likely to suffer long-term (at least 3 months after infection) health conditions are:

• Women aged 35 to 69
• Those aged 50 to 69
• People with high levels of virus in their body when testing positive.

Long Covid in children: An Australian study indicates that long covid symptoms in children and teens resolve in four to twelve weeks.

Sources: BBC News 18 Sept. 2021 (link). Article in Daily Mail, (link) 15 Oct. 2020. Article in New Scientist, 31 Oct. 2020. Article in Daily Mail (link) 5 Oct. 2021.

The Perils of MisInformation

Social media networks are playing an increasing role in spreading misinformation about coronavirus Covid-19, and the vaccines that have been developed to prevent infection.

Despite the widespread availability of vaccines in the US, only about half of the people are fully vaccinated. Many of the unvaccinated don't plan to get the vaccine.

A handful of influencers on Facebook, Twitter and other social media are responsible for falsely claiming that the virus does not exist, and that vaccines will harm you. Influencers can reach millions of people, some directly but also many indirectly as people forward their posts to others.

Tagging posts as False often happens after the post has been forwarded multiple times. The problem is how to identify such material quickly and reduce its spread to a minimum.

Social media platforms want to continue to allow "free speech" but in most countries free speech exemptions must also take account of laws controlling certain views, especially if it involves endangering others. Social media platforms also encourage people to participate in debate by bringing to your attention emotional content that encourages people to respond.

Social media platforms, governments and sociologists are currently grappling with how to allow and even encourage free debate, without trolling others for simply holding opposing views, or spreading misinformation that has harmful effects on other people.

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Wider Fit Ladies Shoe Brands in UK

 As we get older, our feet get wider and an added complication is that many people develop bunions (this is now known to be down to genetics and not wearing the wrong footwear). Many high fashion brands don't come in wider sizes, and until recently the styles on offer veered to the 'comfy' rather than the stylish. Here are the ones available in the UK that I have discovered.

• James Inglis Collections from Italy and USA. Free specialist fitting service. Extra narrow to extra wide widths. Sizes 4 to 10 including 1/2 sizes.
• Van-Dal Width fittings are slightly more generous than usual. Van Dal 'D' fit is wider than the average high street shoe. Van-Dal E fit are classed as wide fitting. Van-Dal EE fit are wider again; they also tend to have a lower heel.
• Hotter Offer four width fittings - Slim, Standard, Wide and Extra Wide in UK whole and half sizes.
• Sole Bliss On-trend shoes for women with bunions, wide feet and sensitive soles. Initial range focused on heels, but now offer flats, sandals and trainers.

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Fraudsters Try to Hack Into What'sApp Accounts

If you use What'sApp - please read on.

There have been recent reports of a WhatsApp scam where fraudsters are attempting to hack into people's WhatsApp accounts.

What you get: A text is  received from WhatsApp containing a code with the instruction to tap on to a link so the phone can be verified. This is then followed by another message which appears to be from a contact in your phone, but is actually from fraudsters asking you to forward the code to them saying it was sent to you in error.

What actually happens: Scammers have already hacked your contact's account and are trying to set up WhatsApp using your number on a new device. If successful, they will be able to hack your WhatsApp account as well.

What you should do: If you receive a message like this, ignore it and send a message (not usingWhatsApp) to your contact letting them know they have been hacked.

Protecting yourself in future: As a precaution against this type of scam, you can enable 'Two-Step Verification'. Here you create a unique PIN which will be required if you need to register your phone number with WhatsApp again, and, on occasions, be asked for it before you use WhatsApp.

Here's how to do it: Go to Settings > Account > Two-Step Verification within the App.

For extra security you can set your privacy settings on WhatsApp so only your contacts can see your Last Seen (the last time you used WhatsApp); Profile Photo; About; Groups and Status. To do this go to Settings > Account > Privacy and selecting 'My Contacts' against each one.

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What Do We Know About Covid-19

Although we only became aware of Covid-19 (SARS-Cov-2) in early 2020, scientists and researchers have now traced back to its early origins. 

Coronaviruses are widespread among many different mammals. SARS-Cov-1 came to humans from the Asian civet. Middle Eastern Respiratory Syndrome (MERS) came via dromedary camels. Covid-19 came directly from horseshoe bats.

Around the world, scientists have been studying coronaviruses for some years, in order to better understand how they function and how to develop vaccines against them. To do this they deliberately try to make existing microbes more infectious or deadly. This 'gain-of-function' research is used to work out well before it happens in nature (a) which viruses are likely to cause pandemics and (b) develop ways to stop this happening. 

While no serious scientist is claiming that such an engineered virus has been deliberately released, some are concerned that there may have been an accidental release. They note that the Covid-19 virus has multiple odd characteristics which make it well adapted to humans, while poorly adapted to bats, which are thought to be the original host species. Other scientists feel a natural origin is much more likely, and the 'lab leak' theory underestimates the power of natural selection.

Whichever of these views is correct we may never know. However to avoid the risks for future, serious bio-leaks, it is important that these labs operate with open scrutiny and accountability.

When did the virus first infect people?

In 2012, six mine workers in China had Covid-like symptoms after visiting a bat cave, but it seems no reports identified the cause.

2019 Nov.: Three researchers from the Wuhan laboratory fell ill around the time the pandemic appears to have begun.

In many countries, including the UK, the variety of virus mutations identified during early sampling was almost as great as the variety seen across the whole world. This suggests that the virus entered the UK many times independently, rather than via any one 'patient zero' case that seeded the UK national epidemic.

2019 Dec. 31: Chinese authorities notified the World Health Organisation (WHO) of a new and dangerous viral form of pneumonia recently found in Wuhan. At this point it had no name.

2020 Jan. 13: UK health bodies notified GP practices describing the new virus. As there were only three flights from Wuhan to the UK each week, the likely impact was estimated to be Very Low. 

2020 Jan. 20: With rapidly rising infections , the Chinese Health Commission confirmed it could spread between humans. At this time the Lunar Holiday season meant around 2 billion trips were made by people visiting families. On the 24th, train and plane journeys were cancelled to and from Wuhan. The process of lockdown had begun.

2020 Jan. 29: First confirmed cases in the UK were a Chinese couple staying in York. UK health bodies started to advise travellers from Wuhan to the UK to self-isolate for fourteen days, even if they had no symptoms.

2020 Feb. 5: WHO confirms there is no known effective treatment. It was becoming obvious that the virus was spreading rapidly, with many people showing no symptoms, which made isolating affected people more difficult. Later in Feb., France, Italy and Spain all reported cases, including within country infection.

2020 Mar. Many people returning to the UK from skiing holidays were coming down with coughs and fevers. Limited testing masked the true infection rate. Mar. 5. First UK death. Mar. 17: People advised to avoid going out, and self-isolate if anyone in a household had symptoms. Mar. 18: Schools closed.

SARS-Cov-2 now designated a pandemic by WHO.

2020 Apr. Now clear that for most people the virus irritates the upper airway, producing a dry cough, loss of taste and smell, and fever. Many have headaches, while for a few, the virus attacks the digestive tract. Four out of five start to recover after 4 or 5 days. In the rest (mostly middle-aged or over, overweight and male) , the virus attacks the lung tissue and treatment was limited.

2021 June. Now the most commonly reported symptoms are a cough, headache and fatigue. It is likely that this is due to the virus infecting younger and healthier people who have strong immune systems. But given the rate of spread of the Delta variant, it's possible many people believe they have a cold or hay fever, potentially putting others at risk of infection.

Herd immunity: The Delta variant is far more infectious than previous variants, so a higher rate of population immunity (85%) is needed to stop it spreading. This cannot be achieved by only vaccinating the adult population, and at least some of the under-18s will need to be vaccinated.

Impact on NHS: June 2021 Covid infections are at the same level at mid-December 2020, when hospitals were overwhelmed with severe cases and many deaths, but far fewer people now need hospital treatment and very few die, since the majority of current cases are in younger groups who have less risk of getting seriously ill. If more elderly people get infected, hospital cases (and deaths) will rise. 

Long Covid June 2021: Office of National Statistics survey show more than one million Britons are currently suffering from long Covid, with two-thirds of these having symptoms that impact on daily life. Early studies suggest that vaccines cut the risk of long Covid by around 50 per cent.

ACE-2 cells: Identified that Covid-19 binds frighteningly well to ACE-2 cells, which help regulate blood flow through body tissues. Men have more ACE-2 coating their cells, and children much less. This partly explains the pattern of (especially older) men often suffering more severe infections and children having minimal symptoms. Other factors such as poor housing, multi-generational living, and working in high contact jobs (care home assistants, cleaners and porters in hospitals) prior to wearing protective clothing are likely to account for the black, Asian and other ethnic minorities suffering more severely. 

Community lockdowns were effective in slowing transmission, and therefore reducing hospitalisations and deaths. But we don't see immediate benefits as some people are already infected (and passing the virus on to others) before they show symptoms. 

Main source:  Intensive Care: a GP, a Community & Covid-19 by Gavin Francis, Profile Books, 2021.