Experts From The Long COVID: “So Incredibly Clear What’s at Stake”

Because of his diligent efforts, Colin Furness has survived this far into the epidemic without testing positive for the coronavirus.

Furness, PhD, an epidemiologist and assistant professor at the Faculty of Information at the University of Toronto, is determined to do everything in his power to prevent infection and, consequently, any long-term symptoms, including the syndrome known as long COVID. Furness is an expert at the intersection of infectious diseases and organisational decision-making.

Furness, a vocal proponent of COVID-19 prevention, wears a N95 or N99 respirator mask whenever he shares the air with others, including when giving lectures at universities. He keeps an eye on the airflow in the classroom using a carbon dioxide detector. He has received four vaccinations so far—two doses and two boosters—and walks to work rather than taking public transportation, a luxury he is quick to point out not everyone enjoys. To ensure that his fifth-grader never has to remove his mask at school, he refuses to eat indoors at eateries and meets his 10-year-old son for lunch outside.

It’s unusual, he says, to be on high alert while it seems that most people have recovered from the pandemic. However, Furness says that among the long-term impacts, the persistent brain damage suffered by millions of COVID patients worldwide are the ones that frighten him the most.

According to estimates, more than a third of those who have COVID-19 also have neurological side effects such brain fog three months after infection. Additionally, according to some research, two-thirds of individuals with extended COVID continue to experience neurological symptoms beyond six months. This, according to experts and campaigners, must be taken into account at every stage of the pandemic response, from public health education and prevention through treatment, social support, and health care reform.

According to Furness, who frequently follows coronavirus research on Twitter, COVID-19 can injure the brain in a number of ways, one of which being inflammation that causes cell dysregulation, a condition in which the body’s cells behave inappropriately.

He claims that the virus can have unpredictable and disorganised effects.

“It’s like letting loose a herd of snakes in a business complex. People start yelling, and the machines stop. Therefore, if your brain is an office building and the workers are the brain cells, and you release this [virus], everyone start shouting and running around, and while nobody is killed, nobody is getting any work done, according to Furness.

It is a terrifying metaphor for lost productivity. According to recent research, COVID continues to kill up to 400 people in the United States every day and prevents 2 million to 4 million Americans from working.

Furness has been stepping up his call for additional preventative measures and care in light of emerging data that COVID-19 not only contributes to mild cognitive impairment but is also connected to long-term disorders including new-onset Alzheimer’s and Parkinson’s diseases.

For instance, he urged Ontario’s government last month to begin creating room for more dementia beds as well as long-term care institutions that focus on brain health for an ageing population. Ontario is Canada’s most populous province.

However, the coronavirus does not only affect older people’s cognitive abilities; according to Joanna Hellmuth, MD, a neurologist and researcher at the University of California, San Francisco who focuses on post-viral cognitive conditions, researchers studying COVID-19 still need to better define risk factors regardless of age.

According to her, “This is a real issue, but there’s this added layer of injustice that’s happening because of cultural factors that compel us to stigmatise people with cognitive illnesses.” There is a subtext that asks, “Is this psychosomatic if you’re younger? People are hesitant to seek treatment since many doctors promote that story and some patients don’t even buy it.

Still, there is a paucity of instruments for assessing the cognitive symptoms of long-term COVID. The Montreal Cognitive Assessment, one of the most commonly utilised tests, was created for older individuals, ages 55 to 85, with more advanced impairments, according to Anne Bhéreur, MD, a family physician in Quebec with a long history of COVID.

The 46-year-old claims she has been physically and intellectually affected with brain fog and myalgic encephalomyelitis, often known as chronic fatigue syndrome, or ME/CFS, a frequent ailment for long COVID patients, ever since receiving COVID-19 while working in palliative care in December 2020. The ease with which she used to be able to perform the most fundamental cognitive skills, such as reading and writing, is among the many things she has lost (including the capacity to speak without routine Botox injections into her injured vocal chords).

She claims she turns into “a dummy” when she experiences ME/CFS-related crashes, also known as post-exertional malaise, following even light physical or mental activity. Bhéreur has been out of a job for about two years.

Long COVID treatments, as well as those for the majority of brain disorders, remain elusive. Ziyad Al-Aly, MD, a clinical epidemiologist and an active long-COVID researcher at Washington University in St. Louis, asserts that additional study is necessary to effectively treat long COVID as well as to better understand it.

“There are absolutely no medications on the entire list of treatments for long-term COVID. This is a massive disaster in my opinion, he adds. We also require vaccines that are intended to safeguard us against chronic COVID in addition to severe sickness during the acute phase.

Governments should take other measures in addition to funding and accelerating clinical therapy trials, according to Hannah Davis, co-founder of the Patient-Led Research Collaborative and a pioneer in long COVID campaigning during the pandemic who also has long COVID.

The New York City-based artificial intelligence expert and co-author of several lengthy COVID studies called for immediate action in testimony before the House Select Subcommittee on the Coronavirus Crisis in July. He called for paid leave to rest during the first few weeks of illness, the reform of unemployment and disability benefits, and other financial assistance for the millions of patients unable to support or care for themselves. I definitely think a transitional stage group home situation is necessary, she says. “There are persons who live alone, who are unable to operate independently, and who require substantial support. That’s just going to increase, in my opinion.

And yet, according to Davis, “everyone’s sense of risk is messed up right now,” which is one of the largest gaps in addressing how long COVID is dealt with. “People who are now contracting long-term COVID after receiving a vaccination and booster shot, or who become reinfected, are furious,” she claims.

30% of all adults who have ever experienced COVID had long-lasting COVID symptoms, according to recent survey data from the CDC and the U.S. Census Bureau. According to a federal analysis released in March, “long COVID has the potential to harm up to 23 million Americans.” Acting on these large numbers “doesn’t feel alarming,” according to Davis.

According to Andrew Ewing, PhD, a professor of chemistry and molecular biology at Sweden’s University of Gothenburg and an outspoken supporter of COVID-19 prevention, symptoms of brain fog brought on by COVID are comparable to those of a concussion. The fact that every time someone gets it, it’s like experiencing repeated head trauma, even if it’s still unclear exactly how damage occurs or how brain cells are destroyed, is one of the things he finds most unsettling about the illness.

Ewing, who thinks people should continue concealing, socially isolating, and isolating for longer times following infection, adds, “That’s what we need to avoid.” These naive “let it rip” types are missing that, I said.

Remaining cautious is simply a no-brainer for researchers, advocates, and observers who follow studies on COVID’s neurological pathways and symptoms. We wouldn’t need mask restrictions, claims Furness, if everyone were “truly fully informed”—I mean “really fully informed”—and understood things the same way I did. They wouldn’t be necessary because the issues at hand would be abundantly obvious.

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