COVID-19 Survivors Face Lifetime of Disability

Yves here. The contrast between the Australian health officials highlighting that Covid-19 can do tons of lasting damage even if it doesn’t kill you versus the silence of the sainted Dr. Fauci and others on this topic is striking. More press on this issue could go a fair way in persuading mask refusniks to take precautions. But the US is busy chasing vaccine unicorns and playing catchup on testing.

By Leith van Onselen, Chief Economist at the MB Fund and MB Super. Leith has previously worked at the Australian Treasury, Victorian Treasury and Goldman Sachs. Originally published at MacroBusiness

The Australian Medical Association’s (AMA) vice-president Chris Moy says there is growing concern that COVID-19 may have long-term effects on internal organs. Heart disease, lung scarring, diabetes and damage to blood vessels are among the potential side-effects of COVID-19 that have been identified.

Australia’s acting chief medical officer, Paul Kelly, also stresses that young people should be mindful that they are at risk from COVID-19 and could potentially suffer a long-term disability if they contract the virus. Doctors warn that 20% to 30% of people who contracted the virus in March and April are still experiencing symptoms:

Scientists looking for a “signature” of COVID-19 in infected cases say it could reveal that even patients who have recovered develop disease risks they didn’t have before contracting the virus.

The research suggests that abnormalities detected in blood samples of infected patients are linked to diabetes, liver dysfunction, abnormal levels of cholesterol and higher risk of coronary heart disease.

The research, to be published shortly by the Australian National Phenome Centre, Addenbrookes Hospital in Cambridge in the UK and other agencies, may flag that COVID-19 infections could trigger a massive increase in the healthcare burden across the planet…

“We don’t know yet whether these long-term effects are permanent, but certainly there is evidence of long-term issues with lung damage and damage of the blood vessels around the body including the heart,” Professor Kelly said.

“This can be a very severe illness. Don’t take it lightly”…

In Australia, young people aged 20 to 29 are the most likely age group to contract the virus…

“We are very worried about the long-term effects of this coronavirus,” [Chris Moy] said. “The great fear in this is the unknown nature of this condition, which we haven’t really seen before. This is something that we could pay for later.”

I hope the herd immunity followers and the ‘let it rip’ brigade take note.

While the death rate from COVID-19 is relatively low, and mostly impacts the elderly, it’s the longer-term health impacts and costs on the community that are arguably of bigger concern.

The below BBC documentary, Surviving the Virus, examines the lasting effects and damage that COVID-19 can do, and makes for sober viewing.

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27 comments

  1. Synoia

    The research…are linked to diabetes, liver dysfunction, abnormal levels of cholesterol and higher risk of coronary heart disease.

    Reads as a profitable opportunity for the US Medical System to me.

    1. JBird4049

      If I was a cynical sort, I might think that a reason to downplay the consequences is to get that sweet, sweet profit.

      1. Synoia

        I am cynical. Especially about the US Medical Racket.

        Entangling the profit motive with medical care makes a joke of the Hippocratic Oath. It turns it into the Hypocritical Oath, where the most expensive treatment is proposed, because it delivers the most revenue.

        How can one possibly expect to trust a medical profession driven by greed? One of my neighbors is a Republican and a Doctor. He is one of the nastiest people I have ever met, with his views and attitude.

        The other was the owner of the Belfast department store in Johannesburg.

        Both self righteous to the core. Even the Afrikaans, Nationalist, Cabinet Minister I knew well in South Africa was a better person the those two.

  2. Jeotsu

    ~80% of population infected to reach “herd immunity” (assuming lasting immunity post-infection, which is a big assumption), coupled with a ~25% long-hauler/lasting health problems among the infected means 20% of the population disabled.

    That is catastrophe. And that’s not even considering how much worse it could get if C-19 becomes a seasonal endemic illness.

    A yet voices around the world — even here in NZ — are hectoring us about returning to normal, opening up, taking risks for the sake of the economy.

    I guess they are the sorts of people who would rush down the the beach when the tide suddenly recedes, obsessed by all the valuable shells they can collect to sell for profit. That line on the horizon? That roaring noise? Who cares about that? Profit!

    1. PlutoniumKun

      I honestly think that those medical practitioners (I’m looking at you, Sweden), who have advocated implicitly or explicitly for a herd immunity approach are guilty of ethical and medical malpractice. The essence of medical ethics should be ‘first, do no harm’. I don’t see any ethical difference between pursuing policies that deliberately infect people with a dangerous virus and advocating the mass uncontrolled use of an untried and untested drug or chemical.

      My own view is that too many in the medical profession simply have proven unable to shake the ‘flu’ conceptual model from their head – that this is a ‘one-off’ infection with no long term consequences. There was never any evidence for the conclusion that coronavirus acts on the body like the flu and not, for example, like polio or dengue. Too much policy was founded on what was simply an evidence-free assumption. The operating assumption should have been from the very beginning that minimising public exposure to high levels of the virus for as long as possible should have been the public health priority, with its geographical elimination the aim if at all possible. I can’t see any other approach consistent with basic ethics.

      And even if you ignored ethics took a crude economic cost-benefit approach, if you properly calculated the potential long tail risks, and the realistic possibility of lasting health impacts (which was highlighted from the very beginning by some observers based on apparent heart damage to Wuhan patients), then the NZ/Taiwan/South Korean approach is clearly the only way if at all possible.

      1. DJG

        Jeotsu and Plutonium Kun: Thanks. I’m also noticing at least on FB that well-meaning liberals are pretending that there’s such a thing as herd immunity and COVID. So it isn’t just the neoliberal Swedish government and rightwing English and U.S. politicians.

        “Herd immunity” has turned into a kind of meme–without evidence, with much chin-stroking, with little confirmation.

        It is one of the underlying reasons why so many school administrators and school boards in the US of A want to reopen the schools.

        You mention New Zealand, Taiwan, and South Korea. I have repeatedly had to point out in no uncertain terms to U.S. friends who mention Italy just how restrictive and severe the quarantine was in Italy–and how many rules and regulations still are in place. Few Americans have the resources, emotional and mental and moral, to do what the Taiwanese (so exotic!), New Zealanders (so far away, so Hobbity!), and Italians did (so irrational!). So here we are, eyes glued to screens to watch the catastrophe.

      2. Adam1

        But it’s just going to go away. All we need to do is click our heals 3 time and we’ll be back in Kansas Toto ;)

        1. JBird4049

          This could turn out to be like Smallpox. Every generation having its blinded and scarred survivors who have 20% of their young sent to the grave every 10-15 years. That is once the proper density of new victims was reached.

          Idiots.

  3. catsick

    Very interesting to watch the video as those two brothers have done a lot of kids tv programs over the years that my daughter has enjoyed such as the series for kids “Operation Ouch”, makes it a lot more honest when presented by someone that you have known has long presented in a non political way on basic medical issues and the fact that one of them got a serious dose shows how rampant it has been in the UK

  4. Redlife2017

    This was an excellent article and that documentary was outstanding. I had been avoiding watching that in the BBC iPlayer, but watching it now, it’s clearly a vital piece of documentary filmmaking that people need to see. My concerns with Covid-19 switched in late April to what the long-running implications of this disease would be.

    We still know so little about what this will do and people don’t seem to care if it hasn’t personally impacted them. I know someone at work whose husband is a long-hauler (4 months+ now) and they have 3 kids under 10. They hope he will get better, but as per the documentary, there are no answers from the doctors still. He may never get better…

  5. fresno dan

    https://www.yahoo.com/gma/widespread-covid-19-children-look-latest-data-schools-232323196–abc-news-topstories.html

    As of Aug. 9, children under the age of 18 accounted for 7.4% of reported COVID-19 cases and less than 1% of reported COVID-19 deaths, according to the CDC. As of Aug. 1, there were 616 reported COVID-19-associated hospitalizations in patients under 18 — nearly 1.4% of total hospitalizations.
    ….
    The CDC is also tracking what they call the multisystem inflammatory syndrome in children (MIS-C), a rare but severe condition that was reported several weeks after the onset of COVID-19 in children and adolescents.

    https://abc30.com/valley-childrens-covid-coronavirus-kids-fresno-county-children-can-get/6331756/
    Kids in the newborn-to-17 age range make up 8.7% of California’s COVID-19 cases. In Fresno County, they make up 12% of total positive cases.
    =================================================
    Children, mostly, don’t go out to bars. Using a 0 to 18 cohort I think makes for misleading results. Teenagers who have some autonomy for traveling and congregating are going to be more exposed and expose others more. Kids (under 12) have gotten shut down much more than their parents. We will now generate more data on how infectious covid 19 is to under 12 children, and how susceptible children are too it, and what the consequences are. And the rather strange lack of acknowledgement of the sequelae of covid in adults, I imagine will not be repeated when it happens to children.

    1. carl

      I think the shorthand belief around here is “kids don’t get it, and if they do, they don’t suffer any negative effects, so why not let them play together.” Similar to the “my friends and family don’t have it, so we can get together.” We have a long way to go.

    2. CuriosityConcern

      To add(or rephrase), I would suspect the 3+ victims who are normally healthy will keep enjoying good health, until a triggering event or perhaps for years. So they probably would not be assessed and also have this troublesome condition. The full extent of prevalence might be difficult to ascertain cause you would need thorough assessments before infection and after.

  6. Ignacio

    This is very good. It is not easy to find good statistical data on outcomes that do not involve hospitalization and such 20-30% figure provided here, even if it is not accurate given the many infected but indetected says this is indeed a big issue.

    It is a pity those cases are not being analysed as comprehensively as they should be when the effort is concentrated on the most demanding severe clinical cases.

    SARS CoV 2 in particular and Coronavirus in general interplay with our immune systems in ways that are unique to them and the results show a wide variation of outcomes that we cannot explain. Being infected becomes kind of a Russian roulette.

    A big effort should be devoted to try to understand these persistent or semi-persistent outcomes whose long term consequences are largely ignored.

    1. Peter Dorman

      I agree. The attention has centered on immediate treatment issues at the expense of longer term public health consequences. Yes, hospitalization rates and the severity of symptoms are important, but so are the effects this virus will have on individual and community health outcomes in the years to come.

      I’m reminded of the struggles I had working on occupational safety and health. I was up against the medicalized perspective that understanding occupational injuries and diseases meant simply knowing how to identify and treat them. NIOSH, for instance, allowed social scientists to have a say in the outcomes or burdens of disease but not etiology. I don’t know if this has changed in recent years, but I see the same footprint in the COVID-19 discourse. Look how long, for instance, it took to pivot from “children aren’t at risk from the virus” to “children are potentially important spreaders”. The first is all about treatment, or lack of need thereof, the second public health.

  7. The Rev Kev

    I was watching an interview with a Western Australian professor that is doing a study of these ‘long-haulers’ and it seems that he has no illusions about what is going on. When he came to talk about people being “recovered” from this virus, he took care to use air-quotes on that particular word.

    I see that in Victoria which is getting a hammering from this virus, that the Victorian government has launched a TV ad to get people to understand that this is no ordinary virus. Here is that ad-

    https://www.abc.net.au/news/2020-08-10/new-victorian-covid-19-public-health-ad-campaign/12542160?nw=0

  8. Kevin

    Why not discuss the long-term effects of influenza?

    “Generally, people breathe a huge sigh of relief after recovering from the flu. But according to the latest research, some strains of the flu virus can leave a lasting impression. Following infection, viruses like the H3N2 strain are shown to cause forgetfulness in mice for months after recovery. This means that as well as burdening the body with fevers, chills and aches, the flu can also trigger memory issues and minor brain damage.” (https://www.labmate-online.com/news/chromatography/1/breaking-news/does-the-flu-have-a-lasting-effect/45569)

    Kinda weird seeing this, isn’t it. Here are some more:

    – 5 Ways the Flu Can Affect Your Health Even After You Feel Better (https://www.health.com/condition/cold-flu-sinus/flu-long-term-effects)

    – Escaped the Lungs, but Stuck in the Brain! Influenza Associated Encephalitis in an Adult without Pulmonary Involvement (https://www.atsjournals.org/doi/10.1164/ajrccm-conference.2019.199.1_MeetingAbstracts.A6606)

    – University of Sydney researchers have established a link between influenza and devastating brain diseases in children. (https://www.myvmc.com/news/influenza-linked-deadly-brain-disease/)

    – Influenza virus associated encephalopathy (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2082798/) – Flu may impact brain health (https://www.eurekalert.org/pub_releases/2018-02/sfn-fmi022218.php)

    – SHORT AND LONG TERM EFFECTS OF INFLUENZA A ON LUNG FUNCTION (https://onlinelibrary.wiley.com/doi/abs/10.5694/j.1326-5377.1974.tb71201.x)

    – Can the Flu and Other Viruses Cause Neurodegeneration? Scientists may need to seriously reconsider the cast-aside hypothesis that pathogens can play a part in diseases such as Alzheimer’s and Parkinson’s. (https://www.the-scientist.com/features/can-the-flu-and-other-viruses-cause-neurodegeneration–65498)

    – Long-Term Neuroinflammation Induced by Influenza A Virus Infection and the Impact on Hippocampal Neuron Morphology and Function (https://pubmed.ncbi.nlm.nih.gov/29487124/)

    – This Is How Having The Flu Can Impact Your Mental Health (https://www.bustle.com/p/does-the-flu-affect-your-mental-health-brain-fog-can-impact-everyday-tasks-when-youre-sick-7992039)

    – 1 in 5 kids with flu had neurological symptoms during 2016-2017 season (https://www.healio.com/news/pediatrics/20190103/1-in-5-kids-with-flu-had-neurological-symptoms-during-20162017-season)

    – 7 Surprising Health Complications From Cold and Flu (https://www.everydayhealth.com/cold-flu-pictures/suprising-health-complications-from-cold-and-flu.aspx)

    – Many of these patients were survivors of viral diseases that had infected the brain and led to viral encephalitis. Viral encephalitis is brain swelling and damage, which can occur when a virus infects the central nervous system and ends up in the brain, a condition which can be disabling and often fatal. In fact, nearly every Spanish Influenza patient who had an acute episode of encephalitis (brain swelling and damage during infection) from the influenza virus went on to develop what was later termed “Viral Parkisonism”. Epidemiologists have determined that Spanish Influenza survivors have a 2-3x higher risk of developing Parkinson’s Disease, now termed Viral Parkinsonism, compared to those who did not come into contact with the virus. (https://massivesci.com/articles/viral-parkinsonism-parkinsons-disease-motor-neuron-substantia-nigra-spanish-flu-weev/)

    Also seeing all these niche studies on the “long-term” effects of Covid19 (interesting how we use the phrase “long-term” now), anyways, how about the ones of your pets catching Covid19…guess what, the seasonal flu can do that too ;)

    – Can dogs get the flu from humans? Yes, and your cat can too (https://www.insider.com/can-dogs-get-the-flu-from-humans)

    – New research indicates that the influenza virus can jump from humans to pet animals, raising the possibility of dangerous mutations (https://www.smithsonianmag.com/science-nature/can-you-give-the-flu-to-your-dog-or-cat-62496394/)

    1. Fritzi

      Lots of people suffer and die from things that might be avoidable or could at least be somewhat mitigated If society was aware of it and managed to conjure up the will.

      Where I live, some rightwingers complain because with covid there seems to be measurably less excess death.

      We kinda crushed the curve successfully (it’s rising again, but for now very slowly), and had pretty few deaths, as far as I can tell it seems to be actually true.

      But even true it does not mean what the rightwingers want it to mean.

      Not that covid is harmless, but that there were always tons of im many cases avoidable deaths that were flying under the radar, and now became visible.

      Lockdown meant much less death from traffic accidents (the least invisible of these deaths even in normal times, but still kinda fading into the background noise), a lot less deaths from all kinds of infectious diseases thanks to distancing and masks and increased hygiene, a lot less deaths from work related accidents and some less from risky recreational activities, even a bit less violent crimes, though we never had very much of that.

      Less infections is seemingly the biggest part, followed by work related accidents.

      The question now is, should we accept all of these deaths as unavoidable in the future?

      Some of them probably really are, but all of them?

      Perhaps covid revealed that we always had kind of a too cavalier Attitude.

      And this is not even going into the studies claiming massive reduction in deaths caused by pollution in regions where considerable parts of industry were shut down.

      1. JBird4049

        >>>The question now is, should we accept all of these deaths as unavoidable in the future?

        The Powers That Be accept these deaths because it is often more profitable to do so. Seriously. If we take overdoses and suicides including 2/3 of gun deaths, they are diseases of despair. It would be extremely easy or at least straightforward to reduce, even almost eliminate them, but that takes money as well as a functioning healthcare system. And that reduces profits. Can’t have that, can we?

        Until we break the power of the current ruling class, which means in part to break capitalism, we will be facing theses “excess” deaths. Really, they are profitable deaths for some which is why they are going to continue.

  9. furies

    “Why not discuss the long-term effects of influenza?”

    Maybe because the article is about covid?

  10. tj

    I had a “mild” case of Covid in March. Just two trips to ER, no overnight stay. Main issues during acute phase were shortness of breath (SOB) and rapid, irregular pulse. Five months later I still have intermittent SOB that waxes and wanes. Physical exertion seems to exacerbate it. Hoping that it’s a post-viral syndrome that will right itself 6-9 months post-acute phase. If it doesn’t self-clear by month nine I will try hyperbaric therapy. I feel at this point it’s some o2/co2 blood gas exchange issue vs. lung or heart issue. I have had lung functioning tests completed that I cleared and am on the schedule for cardiac tests to make sure the ticker is okay. I belong to 2 FB groups with thousands of people suffering many issues post-acute phase. Fit and active normally I have to moderate my activities currently and take it easy. I have never had a flu that has done this to me.

  11. Tim

    What is the endgame here?

    1. crush the curve? Seems failing outside of Asia. And needs track and trace for re-introductions from abroad, or very tight borders.

    2. heard immunity? A lot of people death or with complications. Not an option if the frequency of complications is right. And no guarantee that people are immune after infection.

    3. “lockdown-light” forever? Too high cost for society, so will eventually revert to 2.

    4. Track and trace korean-style, forever? Doable in any country with a decent government, and a relatively cooperative society.

    5. Vaccine? NC doesn’t seem to believe in a sufficient effective one.

    6. Any other options?

    So 4? It would also be useful in a future pandemic, which is not the case for any of the other options. It could even be used to limit seasonal flu.

    1. Grebo

      Another option is to develop—if possible—a cheap, fast, simple and reasonably accurate test for infectiousness.

      Everyone tests themselves every morning before going out and if they are positive they don’t. Positive test kits can be submitted to the authorities for a financial reward roughly equal to a day’s pay. Track’n’tracers swing into action. Employers are prohibited from firing positive employees but can also apply for compensation.

      Everyone else can go about their normal business. Tests can also be applied before and after travelling. Eventually the virus will die out.

  12. RBHoughton

    Thank you Yves and NC for this article and for circulating the link to the BBC film. I have sent it on to many many friends.

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