“No twenty-five-year-old thinks they’re going to end up on a ventilator. But tell them they’re going to have erectile dysfunction, their teeth will fall out, and they’ll never go to the gym again? They’ll get vaccinated and they’ll be double-masked.”
— Diana Berrent, of Survivor Corps, a “Long Covid” support group
I’ve recently caught wind of certain semi-educated citizens who consider the prospect of dying of Covid to be some sort of patriotic act. They’ve refused the vaccine for ostensibly political reasons. They’ve been blasé about exposing themselves to the virus. Now they’ve caught it and decided they’ll ride it wherever it takes them, including to the grave.
I don’t think they’ve thought this through.
Because death, it turns out, could be the least of their problems. They could be looking at chronic disability — a dreary future of lifestyle disruption, family trauma, economic hardship, and long-term relationships with the medical community.
Welcome to Long Covid, a catch-all name for a panoply of nasty health problems showing up in people who’ve supposedly gotten better.
Fewer than two percent of the people who get Covid die from it. And while that comes to almost 750,000 Americans who have indeed died — a spectacular tragedy — that leaves roughly 45 million who haven’t.
And it’s those 45 million survivors who will be turning our society upside down in the next few years, as they deal with the dizzying array of disturbing symptoms and conditions now surfacing in as many as a quarter of them.
A number of doctors on the front lines are raising the alarm, saying our healthcare system isn’t nearly equipped to handle the long-term medical fallout from what’s turning out to be an extremely clever disease. They are just now starting to figure out how it spreads, how it adjusts to antibodies, and how it wreaks such unforeseen havoc on its host humans.
But first, let’s be clear about what Long Covid isn’t. The term does not refer to the after-effects of a severe case of acute Covid. If you spent days or weeks on a ventilator and were, we may assume, near death from suffocation, then you’re surely in for some long-term effects, many of them crippling.
But that’s not Long Covid. According to some recent studies, Long Covid is happening to people who thought they’d gotten lucky, who skated through their infection like it was a minor cold, who had mild cases with no apparent ill effects. Weirdly, it’s also happening to those who never knew they’d even had Covid.
Many of these people were infected long before the vaccine came along, and had no political axe to grind whatsoever. Covid has always been a non-partisan ravager.
But the numbers are just now coming in. One study looks at the insurance claims of two million people who had presumably gotten over Covid. Apparently some 23 percent of them sought medical attention within a few months of their “recovery.” If we go back to our figure of 45 million— the number of Americans who’ve had Covid — that means roughly 11 million Americans could eventually have Long Covid symptoms.
Those symptoms are many, varied, and scary — a whole range of debilitators that can keep you home from work for a long time. Racing heart, shortness of breath, extreme fatigue, crippling headaches, brain fog. There are reports of serious organ damage — to the lungs, heart, brain, liver, vocal cords, esophagus, and probably more. There’s neurological damage resulting in drastic personality changes, explosive rages, and sometimes suicide.
So while the science around this won’t be settled for many years, it’s becoming evident that many of these people are far from “normal,” and it’s not clear how many of them will get back there any time soon. Not everyone gets the same symptoms, and the effects from person to person vary widely. But Long Covid can play ugly tricks on you.
It can, for instance, hack your autonomic nervous system, disrupting those functions that normally run on auto-pilot — your body temperature, blood pressure, digestion, hormone regulation, and other basics you never think about until they go awry.
Long Covid messes with the way these tasks are scheduled and calibrated, throwing them seriously out of whack. So maybe your heart gets confused. Maybe it can’t figure out how to allocate blood when you stand up or bend over. Maybe instead of sending blood to the right muscles it starts racing. Maybe you start gasping for breath. Maybe massive fatigue sets in. Maybe you can’t make it from the couch to the easy chair without passing out.
And physical exertion just makes it worse. Which means you can’t “fight” it — no amount of will power, exercise, sucking it up, or toughing it out makes a dent in the problem. It’s immune to macho posturing.
Nobody’s sure how long these symptoms last — the pandemic has been with us less than two years, so the sample size is still small. But the number of people with active symptoms is growing, and it’s anyone’s guess where they’ll be in five, ten, or twenty years. Or what new health conditions are yet to be uncovered.
With Long Covid, your quality of life will be heavily determined by the quality of your health insurance. With conditions like these, the medical bills can pile up really high, really fast. And since the doctors are still largely baffled about what they’re dealing with, they don’t know how to treat it. Which means a lot of costly trial and error.
The under-the-radar story of the pandemic has been the financial stress on Covid victims and their families. This stress is often tied directly to insurance — or lack of it — and Long Covid will make it considerably worse. The sharp divide between those who have and those who don’t have decent insurance will surely get sharper, and could well define our not-so-distant future.
Our healthcare system, as it’s now constructed, is overwhelmingly geared toward dealing with acute conditions, as opposed to chronic ones. While acute illness is a treatment problem, chronic illness is a long-term management problem, one for which most hospitals are largely unequipped. The prospect of a massive patient population needing long-term care for incurable chronic conditions will be, at minimum, a financial and logistical challenge of the first order.
Not to mention a political one. Long Covid may well turn out to be the worst legacy, by far, of the Trump presidency. Not just because Trump’s inaction literally killed so many people, but because he convinced so many of his mindless followers to underestimate the danger posed by a disease whose full viciousness is only now becoming evident.
And in light of this new information, the blizzard of lies still being spewed by FOX and other right-wing media must surely be criminal, if it wasn’t already. They’ve taught untold millions of gullible people to refuse masks and reject vaccination, practically inviting Long Covid into their lives. This will impose a significant burden on taxpayers for a long time to come. Tucker Carlson couldn’t care less.
The absurd confluence of Covid and politics will no doubt continue, leading the easily misguided to play foolish games with a disease for which dying might well be the lesser of two evils.
In the meantime, we’ll all remain hostage to their self-destructive resistance to vaccination. And to their insistence — even with Long Covid staring them right in the face — that there’s nothing to see here.
P.S. For much more on Long Covid, check out these pieces in The Atlantic, Rolling Stone, and especially The New Yorker.
Well written, per usual! Thank you.
ReplyDeleteWe might also consider this plausible countervailing narrative articulated well in an excerpt from the September 20th New Yorker article By Dhruv Khullar, which you commended to your readers:
Some physicians believe that the condition’s severity and scope have been overblown. In a recent column for the health-news site stat, Adam Gaffney, a critical-care physician, wrote that we need to “start thinking more critically—and speaking more cautiously—about long covid,” arguing that the narrative being spun about the long-term effects of infection is “getting ahead of the evidence.” A recent op-ed in the Wall Street Journal by the psychiatrist Jeremy Devine suggested that many long-covid symptoms may be “psychologically generated or caused by a physical illness unrelated to the prior infection.” Devine proposed that long covid is “largely an invention of vocal patient activist groups.”
Maybe so, but I'm reading the exact opposite -- that the "it's all in your head" argument was being shredded, both by patient groups and doctors. But you're right, I'm getting ahead of the evidence, mostly because the evidence is happening in real time, the sample size is still small, and the research studies are slower than the reality on the ground. The anecdotal evidence was compelling enough for me to want to tell the story.
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