This week we Fred and I discuss the long tail of COVID19 that is impacting many people with “Long COVID” discussing some of the theories, what symptoms people see include fatigue, headache, dyspnea and anosmia and was more likely with increasing age and body mass index and female gender
Based on the most recent published papers we are seeing an incidence of 2-5% at 12 weeks post recovery. So with 32 Million people in the US who have had COVID19, the low end of people suffering from this is 640,000 people. That’s more than the 500k newly diagnosed heart failure patients we diagnose each year in the US
Raw Transcript
Nick van Terheyden
Hi, this is Dr. Nick, I’m the incrementalist here with incremental insights for better business better health.
Fred Goldstein
And I’m Fred Goldstein with accountable health here helping employers work on their employee health improvement programs and employee benefits. So Nick, one of the areas we’ve touched on a few times a little bit is this idea of individuals who have COVID for extended periods after being infected, called long COVID, which I think was called long haulers. But obviously, as you’ve talked about different names for that, what really is happening in that area? Well, I
Nick van Terheyden
wish we knew I know, there’s lots of theories about you know, what could be causing it, I think one of the things that’s worth understanding a little bit, so people may or may not have heard about the ACE inhibitors, that’s the blood pressure medication that people use. And those receptors for that particular molecule actually live in lots of different places. And it turns out that the virus has, for want of a better turn the key that fits into that particular receptor, which means that it can potentially, and I think, based on some of the science that we’ve seen, is getting locked into cells in lots of different places, which may or may not explain it. I’m not saying it does, but it does sort of lends some level of understanding as to why, what do we see? Well, you and I were both part of a long standing work. And I think the first signal that I personally saw was the survey of the students at one of the universities that we’re walking, working out, that looked at those that had had COVID-19. And I think almost at that time, certainly none had been hospitalized. We’re not talking major infection, they’re pretty much in isolation, mild symptoms, yet they looked at a 60 to 70% incidence of all sorts of symptoms, you know, everything from fatigue, to headaches, dismay, or or shortness of breath, even anosmia, which is, you know, loss of this smell sense. And I don’t know, some people may listen to that and say, Wow, that, you know, great, I’ve, I don’t smell anymore. That’s really bad news for lots of reasons aside for the fact that I love smelling, especially whiskey. Let’s be clear. So.
Fred Goldstein
So the important point, Nick, was that was well after the infection. Right,
Nick van Terheyden
right. Yeah, so exactly what right, so that was the other sort of outstanding data point in this set, which showed that this was lasting weeks out, we’re talking. And based on the data in the published studies, we’re seeing at least 12 weeks, and in many cases much longer. Now, I think there’s a tail. So what you see is this sort of decline in the numbers, you know, variation in the symptoms. But first of all, you see an extraordinary high percentage of people that have some level of long symptoms, even if you have mild disease with you know, very little symptomology, you still experience brain fog as an example, we’ve got all of these symptoms. And right now, based on the most recent study that I can find the covered 12 weeks, so 12 weeks passed, you know, any recovery, so you’re essentially through the disease saw a rate of anywhere from two to 5% of people? Well, if we multiply that up, just for the United States where you know, 32 million or so you’re talking 640,000 people that are suffering long COVID and could be going on for a long time. Just to be clear, we only see 500,000 new heart failure patients each year. So that’s more than the heart failure problem. This is a big problem.
Fred Goldstein
Yeah, and it’s been interesting to read more about it and look at it, because there’s also this issue that many providers have sort of poo pooed the idea initially, and patients, individuals want to their physician, and we’re told our there’s nothing to it, but now they’re realizing it’s real. We’re starting to see these clinics just focused on this issue set up, you’ve got the long COVID support group, which is at long covid.org, I believe. And that’s got 1000s of people who have joined that. So it is a real problem. And what we need to consider is that people have focused on the deaths, and it’s been huge in 350 plus 1000 at this point, which is a enormous number in it in the most cell. And while that death rate has gone down considerably as we get the vaccine out into the risk populations, individuals getting infected could potentially suffer from this, and have these long standing issues. So there’s a lot more to be learned about this and understood, but it just points to the fact why it’s still so important to get yourself vaccinated and keep practicing those safe behaviors.
Nick van Terheyden
So I great points, Fred, what one of the things that sort of stands out in that whole, long COVID is, you know, the brain health and for me, the mental health is part of that. So I’m not talking brain fog, or the sort of neuro symptoms that we’re seeing. But it’s it’s also the impact on people’s mental health, which for me, is a big area.
Fred Goldstein
Yeah, if you think about that, such a great point to raise Nick, that if you’re struggling with these types of issues for extended periods of time, it creates incredible anxiety can create depression. Actually, I believe there was an individual in Texas, if I remember, who had the ringing in his ears, the tinnitus from this, and actually committed suicide based on it, because he just couldn’t deal with it. So it’s a major issue. Please don’t forget everybody, that this causes severe problems that may be extended.
Nick van Terheyden
Right. And, you know, so as you rightly say, important to get vaccinated to prevent the disease. You know, for those that are worrying about, well, if I get vaccinated, I still get COVID. Because that’s one of the, you know, potential outcomes. I don’t think we fully know. But based on other experiences, typically you don’t get the security I have the disease if you’ve been vaccinated. So as an example, if you have the flu vaccine, you get flu, you tend to get mild symptoms, and we don’t see the sort of long term consequences as much. We don’t know that for sure. But we know that preventing it is absolutely our best pathway.
Fred Goldstein
Yeah, this is something we’ve really got to monitor. And obviously the scientists are through it through research etc. To better understand what’s going on, why it’s going on, and how we can hopefully help these individuals who are struggling with this. So this is Fred Goldstein with accountable health. Thanks so much for joining us this week. If you’d like more information, please go to accountable health LLC COMM
Nick van Terheyden
And this is Dr. Nick. I’m the incrementalist here with incremental insights for better business, better health.
