Thread by @fearnley_k

1/ Public health messaging has failed to warn the public on:

➡️ Long term infection harms

➡️ How to protect oneself from infection

Given we’re at the start of a new wave, case numbers & rates of hospitalisation are rapidly rising, here’s a

⚠️ public health warning ⚠️

🧵

This message is important to everyone, but is especially pertinent to those who erroneously believe #LongCovid is ‘just tiredness after infection’ and it won’t happen to them because they’ve had it and ‘it was just a cold’

First let’s discuss #LongCovid.

Long Covid is a chronic, multi organ, physical condition, currently absent of treatment or cure.

Latest figures show 2M ppl in the UK are affected. 376K have now been unwell for >2 yrs. While some slowly improve, recovery is not guaranteed.

To help understand symptoms of Long Covid, it helps to understand what could be causing it.

All of the following have been found in Long Covid. All are interlinked. All will be contributing to symptoms.

🦠 Viral persistence

🩸 Widespread blood inflammation and abnormal clotting

💥 Immune system dysfunction

It is likely the former is driving the latter.

Viral persistence - whether that be in the form of replicating virus lingering in immune privilege sites, lingering viral debris, or in the case of vax long-haul, synthetic vaccine spike - is likely driving downstream processes of abnormal clotting and autoimmunity.

Microclots have been found in the blood of every long hauler tested.

Microclots block tiny blood vessels called capillaries and cause tissue hypoxia. Because blood vessels are found throughout the entire body, any organ can be affected. Here are a few common examples…

Microclots in the lungs 🫁 often cause symptoms of ongoing breathlessness.

If blood flow is compromised, limb extremities can often turn blue.🦵

Microclots in the brain 🧠 , can cause stroke like symptoms, including pins and needles in the face and transient loss of speech.

It is often reported that patients with #LongCovid experience fatigue.

The word fatigue is misleading.

Those with Long Covid are not just fatigued, their TISSUES ARE OXYGEN STARVED. Impaired blood flow and oxygenation of tissues results in impaired energy metabolism.

Microclots don’t just block capillaries and impair blood flow to organs & tissues, they trap immunogenic material which triggers the immune system & irritates the inner lining of blood vessels.

This causes widespread inflammation of blood vessels throughout the body.

Brain inflammation 🧠 is not uncommon. Patients hallucinate, become intolerant of light and sound, and find it difficult to regulate their emotions. Memory, concentration and cognition can, and are commonly, affected.

Below: PET imaging showing ‘profound’ and ‘widespread’ neuroinflammation in the brains of two Long Covid patients experiencing neurocognitive symptoms 15mths and 24mths post acute infection.

Inflammation of the muscles of the heart heart 🫀is also very common (pericarditis & myocarditis). This presents with cardiac chest pain, which may be worse when lying down

Impaired blood flow to the heart (microvascular angina) is also common & again causes cardiac chest pain

Nerves are also damaged in Long Covid which can result in small fibre neuropathy.

Patients often report pins and needles in the limbs, burning or pain.

Patients often experience dysautomnia. This describes this dysfunction of the autonomic nervous system which usually regulates bodily functions under subconscious control, such as regulation of heart rate, breathing rate and digestion.

It is not uncommon for Long Haulers to have higher than normal resting heart rates (eg 100bpm), which increase disproportionately on minimal exertion (160bpm walking between rooms in home) or increase >30 bpm on standing (POTS).

Patients may find themselves breathless - not only because they have microclots in the lungs - but bc the neurological control of their breathing has been affected.

If the autonomic nerves which control digestion are affected, pts often report reflux, nausea & gut dysmotility.

Ongoing pathological processes driving Long Covid, can damage hearing 👂 and vision 👁 👁.

Hearing loss and tinnitus are common.

Patients often report a decline in their vision, blurred vision, increased floaters and specked/snowstorm vision.

Reinfection with #SARSCoV2, regardless of a person's vaccination status, has been shown to increase the risk of all-cause mortality, hospitalisation, at least one sequelae, and sequelae in different organ systems compared to the first infection news-medical.net/news/20220620/…

And to all those who say ‘Mate, I’ve had it, I’ve had worse colds.’

Firstly, just because you didn’t develop #LongCovid in around one or two, do you not think round three will be the same.

Every time you get reinfected you play Russian roulette.

Secondly, we do not yet know the long, long term harms of this virus. But they are predictable.

We know viruses which persist in the body can cause increased risk of cancer and neurodegenerative disease.

https://twitter.com/fearnley_k/status/1532300485062971398

History teaches us to be cautious

https://twitter.com/upupaep55949188/status/1519447035929407490

It is not my intention to scaremonger. Despite our collective wish to return to normality #CovidIsNotOver, and it is dangerous and irresponsible of politicians and senior officials to suggest otherwise.

Vaccine protection is waning; new variants pose increased risk of vaccine escape; treatments for acute covid are not yet widely or easily accessible; service provision is already failing to meet current demands; and Long Covid is currently absent of treatment or cure.

I urge you to exercise caution. Go about your business, but do all you can to avoid infection. #COVIDisAirborne which means it is carried in the air we breathe. #WearAMask😷 esp when in indoor public spaces. We all collectively wish for a return to normality but #CovidIsNotOver

For anyone interested. A useful thread on #viralpersistence

https://twitter.com/fearnley_k/status/1529409852912680960

This recent article also provides a bite-sized useful summary on causes of Long Covid. science.org/content/articl…