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Long Covid Syndrome: Its High time we talk about the elephant in the room

Strengthening the Primary Health care system can no longer be overlooked.

by Dr. Pooja Tripathi
March 4, 2021
in Guest, Covid-19, Featured, Health, Opinion, Vaccine
Reading Time: 4 mins read
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TED Guest Coloumn, New Delhi: On 24th February, the WHO drew attention to the post-Covid-19 syndrome that many people suffer from – so-called ‘Long-Covid’ – after being infected with the virus. WHO report mentioned that the Post- COVID burden is real and significant: about one in ten Covid-19 sufferers remains unwell after 12 weeks, and many for much longer. A new guidance document on Long-COVID is now being sent by the health organisation to European decision-makers.

As with any new disease, so much was and remains unknown. As the pandemic has evolved, professionals and patients alike have mapped a path in the dark. We need to listen to the sufferers of the post-Covid-19 syndrome, and we need to understand the long-term consequences of the disease.

What is Long Covid?

As the name suggests, some people — even those who have suffered from mild versions of the disease — continue to experience symptoms after their initial recovery.

These people sometimes describe themselves as “long hauliers” and the condition has been called post-COVID-19 syndrome or “long COVID-19.”

Older people and people with many serious medical conditions are the most likely to experience lingering COVID-19 symptoms, but even young, otherwise healthy people can feel unwell for weeks to months after infection. According to Lancet, the list of persisting symptoms reported by patients is extensive, including chronic cough, shortness of breath, chest tightness, cognitive dysfunction, and extreme fatigue. Termed long COVID or post-COVID-19 syndrome, the implications and consequences of such ongoing clinical manifestations are a growing health concern.

Some long-term signs and symptoms have stretched over months like Muscle pain or headache, pounding heartbeat, loss of memory and unable to focus/concentrate.

More serious long-term complications are less common but have been reported. These have been noted to affect different organ systems in the body. These include:

  • Cardiovascular: inflammation of the heart muscle
  • Respiratory: Lung function abnormalities
  • Renal: acute kidney injury
  • Dermatologic: rash, hair loss
  • Neurological: smell and taste problems, sleep issues, difficulty with concentration, memory problems
  • Psychiatric: depression, anxiety, changes in mood

Long COVID Alliance-The leaders of 50 organizations and patient groups coming together to study the long-term effects of COVID 19

The announcement of the formation of an alliance including a network of patient-advocates, scientists, public health and disease experts, and drug developers who have joined together to leverage their collective knowledge and resources to educate policymakers and accelerate research that will address the challenges faced by ‘COVID long hauliers’ and related post-viral illnesses.

The key recommendations that laid the foundation for the new Long COVID Alliance are:

  • Health equity and confronting systemic bias and racism in the Long COVID response;
  • Facilitating data harmonization (i.e., combine data from different sources and provide users with a comparable view of data from different studies);
  • Deploying financial resources from the NIH to create a public-private post-viral research infrastructure and translate research results into treatments and cures for millions;
  • Providing expert guidance and resources to media and policymakers;
  • Expanding public-private partnerships;
  • Leveraging existing post-viral disease knowledge and infrastructure;
  • Connecting policymakers with patients and scientists; and
  • Ensuring meaningful patient participation.

The development of a Primary Healthcare system is the key to fight Long COVID Syndrome

As with every epidemic, some die, some become a carrier, some recover, and the luckiest live through infection giving further insight to science. This is exactly what, we are seeing before our eyes. The health specialists thought recovery to be a one-off process. It was doubted that it may lead to long term effects and after a year of Pandemic, this is exactly what we are seeing. Although the initial epidemiological data showed that Covid-19 is more severe in immunocompromised people, men and those with pre-existing conditions such as heart and lung disease, not everyone with severe disease had these risk factors or dragged post-recovery effects. The novel coronavirus has novel symptoms, prognosis or outcome.

We don’t have all the answers. We don’t yet know what percentage of patients have these longer-term effects. But we’re learning fast.

The right way to approach any novel health condition is consultation, recognition, research and rehabilitation. As we learn more, we need to make sure that patients who have had suspected or confirmed COVID-19 and who have persistent symptoms – new or changing – should have access to follow-up care. Prolonged follow-up care needs efficient infrastructure and fewer leakages in the health care delivery system supported by extensive data collection and periodic research reports. This is where primary health care has a particularly strong role to play.

As the massive, wearisome effort to stop the novel coronavirus pandemic results for the whole year are before us with new strains developing, it’s worth pausing to remember the successful eradication of another highly infectious and deadly virus: smallpox. The means of smallpox eradication—Understanding the viral load, meticulous surveillance, careful contact tracing, targeted vaccinations, and international cooperation—are worth remembering. They are precisely the tools that need to be sharpened and used to address the long-term effects of the COVID-19 pandemic,

We come to the start point again- Strengthening the Primary Health care system can no longer be overlooked.

Dr. Pooja Tripathi

Dr. Pooja Tripathi

Dr Pooja Tripathi is a public health professional. She has previously worked with Gates Foundation & World Bank's Global HIV/AIDS Program and has penned a book 'Scratch to Success- Routine Immunization in India'.

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