9.13.22

Long COVID is Cause for Continued Caution

By this point we’ve all heard of “long COVID,” also called “long-haul COVID,” “post-acute sequelae of SARS CoV-2,” or “post-COVID-19 syndrome”. Quite simply, it means that some people who have had COVID-19 often feel sick long after they’ve stopped testing positive. 

Symptoms of post-COVID-19 syndrome include: 

  • Intense fatigue 
  • Fever
  • Shortness of breath or coughing
  • Neurological issues, such as poor sleep, headaches, and trouble concentrating (“brain fog”)
  • Joint pain
  • Heart problems, like a fast heartbeat or chest pain
  • Dizziness upon standing up from sitting position or sitting up from lying down
  • Skin rashes
  • Changes in menstruation
  • Symptoms that worsen after mental or physical effort

We can’t currently predict who will develop long COVID. While some patients are more susceptible, long COVID can happen to anyone who has contracted COVID-19, regardless of the severity of their illness. As of February 2022, the Government Accountability Office estimated that between 10 to 30 percent of COVID survivors had developed the condition. That’s between 7 and 23 million Americans

Unfortunately, many people assume that they won’t develop these symptoms because they are young and healthy. It’s important to understand the reality of post-COVID-19 syndrome and continue supporting healthcare solutions for people suffering from it. 

What Are Post-Acute Infection Syndromes?

Long COVID is considered a post-acute infection syndrome (PAIS). But what does that mean? 

Let’s break it down. “Post-acute infection” means that it occurs after the acute stages of an infection from a virus, bacteria, or parasite. A “syndrome” is a group of symptoms that appear together and indicate a condition with an unknown origin. Even though PAISs seem to have a known origin – an infection – we don’t know why or how they happen.

Syndromes are not diseases. Diseases have accepted diagnostic characteristics and accepted treatments. Post-acute infection syndromes have neither. Even when patients do receive a diagnosis, they can only treat their symptoms, not the root of the illness. 

The medical community has known about PAISs since the 1930s. They have been documented in connection with the Epstein-Barr virus, dengue virus, cytomegalovirus, and enteroviruses, among others. While they are still poorly understood, we do know this much: PAISs are costly illnesses. 

For many patients, their long COVID journey will be difficult and expensive. Their utilization of health care services will increase as they attempt to get a diagnosis. They will have more frequent lab work. They may end up taking more medications. They may become disabled and require in-home services, durable medical equipment, mental health treatment, or physical therapy. 

Avoiding Long COVID 

So how can we help patients avoid long COVID? The answers are simple, and the same ones public health officials have been promoting for years. 

  • Encourage patients to get vaccinated. Patients who are not vaccinated before contracting COVID-19 seem to be at higher risk. Patients who are not vaccinated are also more likely to be hospitalized, and patients who are hospitalized with COVID-19 are more likely to suffer from long COVID. Make sure patients get boosters when they need them and understand their vaccination schedules. 
  • Support individual protection. Mask and testing mandates may be fading away, but that doesn’t mean the pandemic is over. Wearing a tight-fitting N95 or KN95 mask helps reduce transmission. COVID testing before attending social events is helpful, even if it doesn’t catch every case. Counsel patients to stay home if they feel sick. Make sure telehealth options remain available.

Helping Those with Long COVID

One sign of long COVID’s severity is that it is considered an accepted disability under the Americans with Disabilities Act (ADA). If long COVID limits one or more of a person’s major life activities, then they are covered by the ADA and may request reasonable accommodations at work and at school.

But that only goes so far. How will patients with chronic fatigue attend doctor’s appointments? How will they get their medications? 

You guessed it: they’ll depend on the same healthcare solutions that were so important during the early days of the pandemic. Telehealth appointments and in-home care will continue to be key for long COVID patients, as well as for others with PAISs, chronic fatigue, or other disabilities. Home prescription delivery will help patients stay on their regular maintenance medications as well as new ones to combat their symptoms. 

It is essential that healthcare organizations continue to fund solutions like these. There are millions of Americans who are already suffering from long COVID, and nobody knows how long their symptoms will last. Supporting telehealth for another three to twelve months won’t be enough for these patients. 

Takeaways

COVID-19 is still considered a novel virus. We do not know the long-term impact of infection. Do not assume that getting COVID is like getting a cold. Many people who were previously healthy are now suffering from chronic symptoms of fatigue, headaches, pain, and dizziness long after “recovering” from their initial infection. 

Take action to protect those who are medically vulnerable: children, the elderly, and people with weakened immune systems. Stay up to date on your boosters. Be aware of infection and hospitalization rates in your area. And continue to support solutions that help not only patients currently suffering with long COVID, but also those trying to avoid infection altogether.