My family Christmas in Yorkshire was wonderful despite my apprehension about high Covid-19 rates. The week after was marred by headaches, illness and even death. I had Covid-19 for the second time. My second encounter has been dominated by fatigue and reduced concentration, which have not yet resolved more than two weeks later. I'm worried that this could last for several months or longer.
Three months from the start of Covid-19 is when the World Health Organization defines long Covid. More than 1.3 million people in the UK had symptoms for four weeks or more after Covid-19, of which 892,000 people had symptoms that persisted for at least 12 weeks, and 506,000 had symptoms for at least one, according to the Office for National Statistics. According to Dr. Heightman, most commonly reported are breathlessness, fatigue, cough, myalgia, chest pain, headaches, and brain fog. Many other symptoms may be present.
Covid has been absent from government briefings over the course of the Pandemic. This is a major failure and shows how difficult it is to identify and deal with chronic conditions. Acute effects such as infections, hospitalisations and deaths have been the focus of our reports, media, funding and research throughout the pandemic.
We may not know the scale of the problem because of this. The estimates for long Covid are based on an ongoing survey and may not be representative of the whole population. National and international long Covid surveillance is lacking despite major research studies funded by the National Institute for Health Research. We've sought short-term fixes for Covid-19 and long Covid. There are many reasons for this, including short news and political cycles, chronic under funding and under-prioritisation of prevention.
Prevailing ways of thinking in science, healthcare and policy have not helped. An outdated classification distinguishes diseases as either organic or functional. Heart attacks, arthritis and bowel cancer are some of the organic conditions that cause changes in the body.
Irritable bowel syndrome and chronic fatigue syndrome do not necessarily cause changes to be detected by tests or the right test is not yet available. Stigma and misconception may lead to functional conditions being overlooked, which is familiar to many with long Covid.
Monitoring and prevention of death has always been prioritised over morbidity. There have been attempts to change this. The Global Burden of Disease Study is a measurement of morbidity and mortality that was conceived in 1990 and attempts to capture the impact of diseases on people's lives. Cross-country comparisons of Covid-19 mortality need to be applied to long Covid as well.
When I was in medical school, the way we trained health professionals was similar to what we are doing now. We neglect conditions like long Covid when we see disease as acute v chronic. Patients, health professionals, and researchers with chronic disease experience must be brought together to prepare for a potential epidemic.
In the UK, 90 dedicated long Covid clinics have been established, but research and data are needed to inform patient services in real time. The Stimulate-ICP study involves a trial to evaluate a community-based, comprehensive MRI to rule out multi-organ impairment caused by Co. The trial will look at the effects of three months of treatment on Covid symptoms, mental health, and return to work.
This is a start, but we need to do more. Long Covid would benefit from public health and prevention perspectives. Patients have been left on their own for too long because of the way we think about disease and the way we focus on the short term. Lere Fisher told me that he had to nurse himself back to health. Patients and health professionals face difficulties knowing what to do for long Covid. Patients named the new disease. It is time for the health systems to count it.
The Stimulate-ICP study is being led by the professor of clinical data science at University College London.
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