Thread by @jenbrea

Please stop telling young people they should avoid #COVIDー19 infection to protect the old. Tell them to protect themselves.

Long-term symptoms 6+ mo post-infection:

EBV: 11%
Q fever: 11%
Ross River Virus: 11%
West Nile Virus: 31%
SARS: 87%
Ebola: 90%
COVID-19: We have no idea

In general, the topic of long-term, post-infectious sequelae is not well-studied, probably for the same reasons #MECFS has not been well-studied. But maybe a few hundred million people being infected by a novel, zoonotic virus will (unfortunately) change things.

The quality of data by infectious agent varies––a lot. By the time we start worrying about survivors, the pandemic apparatus has usually long moved on and the money just isn't there to study the people left behind.

But here are some studies that should give us all pause to think.

And to start including MORBIDITY, DISABILITY, as well as MORTALITY in all of our #COVID19 public health messages.

Many of those who are long-term ill from these infections experience symptoms very similar to "chronic fatigue syndrome" #MECFS. If that doesn't strike fear into the heart of all the 20-something's living it up this weekend in New York, Chicago, etc., it damn well should.

First, here's how bad it can get: ted.com/talks/jennifer…

WEST NILE VIRUS

"Among a cohort of participants with a history of WNV infection, 31% (44/140) reported experiencing fatigue postinfection that inhibited their daily activities."

ncbi.nlm.nih.gov/pmc/articles/P…

"The average length of fatigue duration was 5 years with a range of 6 months to 10 years."

Of those with fatigue postinfection, 28 (64%) met the CDC's case definition of chronic fatigue syndrome

"West Nile virus (WNV) RNA was demonstrated in 5 of 25 (20%) urine samples collected from convalescent patients 573 to 2,452 days (1.6 to 6.7 years) after WNV infection."

ncbi.nlm.nih.gov/pmc/articles/P…

"Females, those YOUNGER THAN 50 YEARS OF AGE of age, and those with symptomatic clinical WNV disease were significantly more likely to report fatigue."

SARS: multiple studies showing that at 6 months, post-SARS patients have lower SF-36 scores, lower mean 6 minute walk distance, and muscle involvement (myalgia) in 50.8%

thorax.bmj.com/content/60/5/3…

EBV, Q-FEVER, ROSS RIVER: Three completely unrelated infectious agents. 11% meet criteria for chronic fatigue syndrome 6 months later.

Only risk factor? SEVERITY of the initial infection.

bmj.com/content/333/75…

EBOLA: "Prevalence of Post-Ebola Syndrome was estimated to be 90%" Symptoms included: "neurological system (eyes problem, headache, sleep disorder, and unusual tiredness) and musculoskeletal system (abdominal pain, chest pain, and joints pains)." hindawi.com/journals/bmri/…

A lot of people have responded to this thread by saying, "But we have to protect the old, too!" Yes, of course. And millions of chronically ill, disabled children, teens and adults, too.

AND we have to protect the young and healthy, who either haven't heard or don't give a sh** about the people they might infect, because we've failed (long before this moment) to warn them of what can happen when they get sick:

https://twitter.com/spiderstumbled/status/1238901967944122370

Also, the possible neurological complications of #COVID-19 don't sound so great:

https://twitter.com/jenbrea/status/1239265035412631552?s=20