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Dr Elisa Perego Profile picture
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Apr 9 • 15 tweets • 7 min read
If we had followed a zero covid strategy like New Zealand and China, this pandemic could have been under control in 2020.
People have been lied to ("it's just a cold", it's "endemic") and pushed into mass infection, disability, and massive social disruption
We need accountability
And, yes, we knew it was a SARS disease on 31 December 2019, we suspected/knew it was airborne in early 2020, we knew it could cause a pandemic in January 2020, we knew it could affect the "young and healthy" in January 2020, we knew about post viral illness before the pandemic
We knew about SARS sequelae #longSARS before the pandemic, we knew people weren't recovering in "2 weeks" in March 2020, we knew covid wasn't a respiratory disease only in winter to spring 2020, and #LongCovid was an established phenomenon by May 2020
China is investigating a *SARS* outbreak (not the flu, sorry!).
As published on 31 December 2019

crisis24.garda.com/alerts/2019/12…
"A novel coronavirus outbreak of global health concern"

A SARS disease with a pandemic potential!

out on top @lancet on 24 January 2020

thelancet.com/journals/lance…
Clinical features of patients infected with the novel coronavirus: median age of the hospitalized patients was 49 years! More than half with no known commorbities

The disease is SARS like and not the seasonal flu!

Out in top @TheLancet in winter 2020

thelancet.com/journals/lance…
A family cluster of pneumonia associated with the novel coronavirus in Wuhan

What do I read? A 10-year-old with ground glass opacities visible on scan, and covid pneumonia?!

Out in top @TheLancet in February 2020

thelancet.com/journals/lance…
"A rampage through the body"

How covid kills. Pneumonia is just the tip of the iceberg.

A ferocious rampage from brain to toe.

Out in Science in April 2020. This isn't even the first article on the topic, but I find the title poignant!

science.org/doi/10.1126/sc…
Between February and March 2020, some small towns near hard-hit Bergamo, saw an increase in mortality of 2000%

Twenty times more than in previous years

One was San Giovanni Bianco

The old deads were exhumed to dispose of the new covid corpses

ilgiorno.it/bergamo/cronac…
18 March 2020: the Italian Army takes the coffins of the covid dead out of Bergamo and nearby areas.

Not only the healthcare system, but also the morgues and the local crematorium collapsed.

ilfoglio.it/cronaca/2021/0…
In late winter to spring 2020, patients from early hotspots were not recovering

They came together on social and other media to draw attention to covid as a prolonged, grave, multi-system disease, with multiple sequelae, even in the "young" and "healthy"

sciencedirect.com/science/articl…
By early June 2020, the prolonged "non-recovery" from covid, was in the international news

The disease was named #LongCovid or Long Haul Covid by patients themselves

Ed Yong, the Atlantic, was to win the Pulitzer prize for his covearge of #longhaulers

theatlantic.com/health/archive…
Long term disease from SARS-CoV-2 was formally recognized by the WHO on 21 August 2020 after a meeting with scientists, advocates, and patient researchers. Many other health bodies across the world followed suit soon after or in 2021

#LongCovid

who.int/director-gener…
On 9 July 2020, a research letter by Carfi et al is in @JAMANetwork

This paper came after many reports of prolonged disease written by patients themselves

It confirmed persistent symptoms ~60 days after onset in 88% of 143 hospitalized patients in Rome

jamanetwork.com/journals/jama/…
On 27 July 2020, Puntmann et al @JAMACardiology

Cardiac MRI revealed the cardiovascular outcome of 100 covid survivors: 78% had evidence of cardiac involvement, 60% of myocarditis

Cardiovascular issues were already widely reported by #LongCovid patients

jamanetwork.com/journals/jamac…

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More from @elisaperego78

Dr Elisa Perego Profile picture
Apr 11
It is now reported Queen Elizabeth is suffering from #LongCovid symptoms, like severe exhaustion. I find it troubling, from the interview, she seemed not really aware of the possibility of Long Covid even after a "mild" case, at the beginning

🧵

thedailybeast.com/queen-elizabet…
Apparently, the Queen insisted to keep working through symptoms in the early phase of the disease. She is now asking for confirmation that feeling rough after covid is "normal". I don't know how much of this is fully genuine (it's the press!). But just a few pointers.
#LongCovid is not uncommon. It can happen even after a "mild" case and even after a post-vaccination infection. Feeling rough, exhausted and sick is not unheard of for viral infections. This is especially the case of a severe, pandemic disease like covid.
Read 7 tweets
Dr Elisa Perego Profile picture
Apr 11
Your daily reminder that covid is not becoming "endemic".
In epidemiology, endemic means present in limited geographical area, at a baseline level, with no external imput.
Covid is a pandemic disease.

🧵
SARS-CoV-2 is evolving fast. It's not present at a stable, baseline level in any area. Cases go up and down hugely, and (for now) are coming in waves. International travel and a deeply interconnected world make it impossible to avoid "external input". Variants may travel globally
I see the chart tries a reclassification of influenza as an "endemic" disease (we all know influenza doesn't meet the criteria I outlined above!). And, lol we are really in an age of speed-of-light re-writing of epidemiology, public health, and recent pandemic history
Read 6 tweets
Dr Elisa Perego Profile picture
Apr 11
Many cyclists and bikers, including top C. Sagan and V. Nibali, are reporting prolonged symptoms and/or multiple SARS-CoV-2 infections. These are having a severe impact on their careers

"We probably underestimated the effects of the virus"

#LongCovid

meteoweb.eu/2022/04/colbre…
Note how the article (in Italian but one of the many on the topic) avoids to mention #LongCovid directly, although the link with covid is addressed. It also speaks of a mysterious flu-like illness that would have been massively hitting professionals in the last few months (uhm)
Thanks @Jennings18Karl for mentioning this issue a few days ago, too! This article in Italian is more explicit about the covid link
Read 4 tweets
Dr Elisa Perego Profile picture
Apr 11
Extremely concerning evidence from countries under scrutiny since 2020 for their inadequate approach to SARS-CoV-2: e.g. the UK in 2022, 160,000+ dead, 1.7+ million with #LongCovid, healthcare on the verge of collapse, chaos even at the airports!
We need accountability
This is by Hancock is basically the same tweet by @sajidjavid who succeeded Hancock as Health Minister. Obviously, both supervised the extremely faulty strategy who led to death, social disruption and #LongCovid in the UK

I answered here:

The disparaging of zero covid by those who chose the opposite strategy is obviously necessary. They have to defend themselves, especially if future inquiries into their choices are being carried out in the future

They are desperate to prove zero covid was impossible. It wasn't
Read 4 tweets
Dr Elisa Perego Profile picture
Apr 11
It was already established in the biomedical literature in 2020 that covid is not a respiratory disease only. The virus spreads via a predominantly airborne route i.e. through the air as cigarette smoke.
But the disease is multi-systemic, with a strong cardiovascular component.
Baffled governments and policy makers are still claiming covid is a respiratory disease, after the publications of hundreds of thousands of scientific publications on the topic.
The morbidity i.e. long term health effects i.e. #LongCovid is also massive and of severe concern.
Many people in the world including many children in the UK itself remain unvaccinated. Letting such a dangerous virus to spread unchecked will impact other countries too, including those less able to access vaccination.

#LongCovid
Read 4 tweets
Dr Elisa Perego Profile picture
Apr 11
I wouldn't be proud if I were Fauci to be in agreement with Wen. The world need competent, brave, emphatic leadership. We can't "live with the virus" as these people mean i.e. by accepting mass disability, increasing inequalities, healthcare disruption, #LongCovid, and death

🧵
Policy makers need to be crystal clear about the reality and severity of covid, the nature of the virus, its propensity for immune escape and fast evolution, and the great morbidity risk = #LongCovid. They need to be open about the risks of symptomatic breakthrough infections.
They need to be honest about the risk of #LongCovid after breakthrough infection. About inequalities around getting the vaccine and antivirals. About the chaotic disruption in every day life that will come with repeated infections, even if such infections are "mild" in many.
Read 6 tweets

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