We all want to put COVID behind us. It’s been a long, overwhelming two and half years with over one million lives lost. But sadly, COVID is not done with us. Many are convinced it’s “just like the flu.” But the flu doesn’t cause increased risks to our health after it’s resolved. COVID does. It’s not just the actual infection we need to worry about, but the potential life altering consequences that can occur after the acute phase has resolved.
It is estimated that 84.7 million people in the United States have been infected with COVID-19 since the start of the pandemic. It is widely understood that due to home testing and lack of reporting results, that amount pales in comparison to the actual quantity of people that have had COVID. Studies are now revealing that as many as 10-30% of people that had the virus experience some type of symptom of long COVID.
While there is no official definition for long COVID, healthcare providers across the country diagnose patients based on a wide variety of symptoms that can include fatigue, brain fog, and memory issues. New information also sheds light on the increased risk of developing issues related to the heart, kidneys, stroke, and more. One significant finding that after one year, those who had COVID-19 were 63% more likely to have some kind of cardiovascular issue, resulting in about 45 additional cases per 1,000 people. Risks were elevated even among people who did not have severe COVID-19, according to the American Heart Association.
Long COVID has become so prevalent and in some cases, debilitating, that in July 2021 the CDC officially included long COVID as a disability protected under the Americans with Disabilities Act. Long COVID—or post-COVID conditions—is a wide range of new, returning or ongoing health problems people may experience more than four weeks after being first infected with SARS-CoV-2. There are a wide range of symptoms that are slowly revealing themselves to be associated with long COVID, with one large meta-analysis of 25 studies outlining that the prevalence of long COVID may be as high as 80% of those that have been infected with the virus. Even people who did not have any symptoms can experience long COVID, according to the Centers for Disease Control and Prevention. The CDC shares:
- Post-COVID conditions can include a wide range of ongoing health problems; these conditions can last weeks, months, or years.
- Post-COVID conditions are found more often in people who had severe COVID-19 illness, but anyone who has been infected with the virus that causes COVID-19 can experience post-COVID conditions, even people who had mild illness or no symptoms from COVID-19.
- People who are not vaccinated against COVID-19 and become infected may also be at higher risk of developing post-COVID conditions compared to people who were vaccinated and had breakthrough infections.
- There is no single test for post-COVID conditions. While most people with post-COVID conditions have evidence of infection or COVID-19 illness, in some cases, a person with post-COVID conditions may not have tested positive for the virus or known they were infected.
A new CDC review also postulates that long COVID may even lead to death. “The overall risk factors for mortality with long COVID are going to be important and evolving,” said Mady Hornig, a physician-scientist at the Columbia University Mailman School of Public Health who is researching long COVID. The CDC is still collecting and revising data, but NCHS has so far identified 60 death certificates that list long COVID or similar terminology in 2021 and another 60 during the first five months of 2022. The topic of death certificates and how deaths are reported has been a hot topic throughout the pandemic. Some have asserted that medical institutions logged deaths as COVID related in an effort to cash in on available relief funds. Yet, the process of recording deaths had not change from prior to the pandemic. What isn’t widely shared is that when an individual passes away, they most often have multiple health factors in play- some which directly cause the death, and others that contribute. They all go on the death certificate. You can read the instructions on how death certificates are completed, here. The new CDC review is exploring all death certificates with COVID listed as a variable to better understand the true impact of COVID.
Because so many are now testing at home, the actual numbers of new cases has become harder to define. After the last surge, positive infections dropped from several a day to a few a week. But the last two weeks we’ve seen a significant increase again. Numbers are definitely on the rise, up to 100,000 a day, with many believing the actual numbers could be five times as high. Thankfully due to vaccines and treatments, deaths have risen slightly but still destroy 300 lives daily.
Many experts are pushing back on claims the numbers no longer matter. “The bunk that cases are not important is preposterous,” Eric Topol, professor of molecular medicine at Scripps Research, wrote last month. “They are infections that beget more cases, they beget long Covid, they beget sickness, hospitalizations and deaths. They are also the underpinning of new variants.”
Even if one does not get severely ill oneself, more cases mean more chances for the virus to spread to someone who is more vulnerable, like the elderly or immunocompromised. While deaths are way down from their peak earlier in the pandemic, there are still around 300 people dying from the virus every day, a number that would have proved shocking in a pre-COVID-19 world.”
Cases alone no longer tell the story.
Next week I’ll discuss the signs and symptoms of long COVID and all the areas it can impact.