"The official U.S. death toll from coronavirus is now 170,000, and is likely to grow to 227,000 by November. The global toll is 750,000. But those figures may massively underestimate the ultimate public-health trauma." Chronic covid, a thread (1/x): nymag.com/intelligencer/…
"In the spring, our picture of the disease was dominated by hospitalizations, deaths, and recoveries; most Americans following things closely probably understood the full course of illness to last about a month, start to finish."
"Over the last few months, however, we’ve heard more and more stories about coronavirus “long-haulers,” but I don’t think our collective understanding of the disease has properly incorporated those stories, in part because most accounts have been, to this point, anecdotal."
"The result has been that the experiences of those suffering in these extended and often confusing ways appear to the rest of us like eerie outliers, tragic but unusual."
"But we are beginning to get more systematic research into the aftereffects of COVID-19, and it suggests the possibility that these post-recovery complications may prove to be a dramatically more significant health trauma to the country, and the world, than the death toll."
87 percent of Italian patients who had “recovered” from the disease after hospitalization reported at least one ongoing symptom of the disease. jamanetwork.com/journals/jama/…
"78 percent of recovered German patients were found, two months later, to have suffered structural changes to their hearts." statnews.com/2020/07/27/cov…
"The study focused largely on those with asymptomatic or mild cases, and in follow-ups 76 percent exhibited a biomarker associated with cardiac injury following a heart attack."
"Another study, of 1,200 patients hospitalized across 69 countries, found that 55 percent had long-term damage to their hearts." hartfordhealthcare.org/services/heart…
"Subtracting those whose hearts may have had preexisting damage, the study found 46 percent of previously healthy patients showed some amount of long-term scarring and dysfunction."
"Another study of COVID-19 patients found that roughly 90% of those with 'severe' cases, 75% of those with “moderate” cases, and 60% of those with 'mild' cases were still experiencing at least one symptom after three months." medrxiv.org/content/10.110…
"Experts now believe that as many as one in three patients could suffer neurological or psychological aftereffects, according to STAT News. 'It’s not only an acute problem,' one critical-care physician told STAT. 'This is going to be a chronic illness.'" statnews.com/2020/08/12/aft…
"This is a shift in conceptual perspective that isn’t just about kind — acute versus chronic — but scale."
"Assuming the early research holds, even somewhat, it would mean a long-term impact staggeringly larger than the acute crisis we have all been living through in terror. It would mean these long-term effects aren’t medical curiosities but in fact the most common outcome, by far."
"Today in the U.S., the fatality rate is about 0.25%; at its peak it was about one percent. If three-quarters of those who get sick exhibit heart-attack-like heart damage, that means 75 times as many people would be made long-term coronary patients than died from the disease."
"The German finding is so striking it would be foolish to assume it was representative without further confirmation; but even if it is off by a factor of five, it would still suggest 15 times as many people might emerge from COVID-19 with lasting heart damage than would die."
"Mercifully, there are some reasons to think this early research may not hold up, at least precisely. The studies have been small, and they have been few, and research that focuses on those patients who got most sick, at first, may not prove representative."
"And since it is still only nine months since the disease announced itself, and only about six months since it arrived in full force in Europe and the United States, we don’t know for sure whether these conditions will taper, or linger indefinitely."
"It is certainly possible, and perhaps even likely, that most of these complications will resolve themselves relatively quickly — if on a timeframe of months rather than weeks. Indeed, many viruses do produce impacts like this, which then dissipate."
"But a suggestive comparison is to the aftereffects of SARS-CoV-2’s close cousin, SARS-CoV-1: About 20 percent of those infected with the first SARS suffered lasting lung damage, and those left with lung lesions by that disease still had them 15 years later."
"As with everything else having to do with this disease, it is not just rates that matter, but levels."
"If 20% of those who fall sick get enduring health problems, that means one thing for a pandemic like SARS-CoV-1, which infected less than 10,000 worldwide. It means a very different thing for a pandemic this size—with more than 5 million confirmed cases just within the U.S."
"And even if the lingering disease proliferates at only a few multiples of the volume of deaths, the whole picture of the pandemic begins to look very different—and the failure to suppress the disease spread, as every one of our peer countries has done, even more catastrophic."
"Perhaps 45 million Americans have now been infected by SARS-CoV-2, counting those without a confirmed positive test. That is an alarmingly high number of potential chronic cases." (x/x)
