Thread by @EthnicMediaSvc

Today at 11am PST we'll be looking at #LongCovid which studies show has potentially affected upwards of 23 million Americans. What are the symptoms? What can vaccines do? Watch the livestream 👉ethnicmediaservices.org/media-briefing… @CaliforniaDep11 @MichelleCHC_UCR

Welcome to today's briefing, "Long-Term COVID: The Next Pandemic?" co-hosted by EMS and @CaliforniaDep11's Vaccinate All 58 Campaign.

Today's speakers include Dr. Nisha Viswanathan, Director, UCLA Long COVID Program; Dr. Jose Luis Perez, Chief Medical Officer, South Central Family Health Center; & Michelle Burroughs, Director of Community Engagement and Outreach, @CHC_UCR

Our first speaker is Dr. Perez, who will provide an overview of long Covid and the role of #vaccines. The bottom line is that we don't have a lot of good answers for #LongCovid, says Perez.

First of all, there is no clear definition of Long Covid, though patients show on-going health problems. There is also no test, says Perez.

There are also many names for Long Covid, from post-Covid, to Long Covid and post-acute Covid. Symptoms include: tiredness/fatigue, feeling sick after physical/mental effort, fever, chest pain, and palpitations.

Perez says folks who used to be active often struggle with activities they used to do, and folks who were not as fit struggle even more.

Foggy brain and issues with concentration affect people's ability to maintain their work responsibilities. As does depression and anxiety, though Perez says it's unclear what is driving this latter.

Symptoms are vague and hard to explain, and can be related to other health conditions, says Perez.

This study from Brookings shows possibly 16 million Americans suffering from #LongCovid brookings.edu/research/new-d…

Another 4 million Americans are out of work due to the illness.

Those who have severe #LongCovid typically were infected in the early stages of the pandemic before #vaccines and other treatments were available.

Those who work in areas with lots of foot traffic are at greater risk of contracting the virus, says Perez, noting this group includes many Latinos and African Americans.

Importantly, Perez notes there is no cure at present for Long Covid. Transparency and realistic expectation setting is key for care providers, given the vagueness around this disease.

Perez' clinic, South Central Family Health Center provides care for vulnerable communities, which are often at higher risk of Covid and Long Covid.

Perez thinks #LongCovid is under-diagnosed, adding it is important to treat patients holistically and to continue training to providers in identifying the disease.

Important: prevent infection in the first place. Watch your distance, wash your hands, and wear a mask. The "Three W's." You prevent infections doing these things, says Perez.

And get #vaccinated! #Vaccines have prevented millions of infections, and can reduce your risk of developing Long Covid.

Many questions for Dr. Perez, including one from @AraceliMartinez of @LaOpinionLA, who asks which ethnic/age groups are showing the highest incidences of Long Covid. Perez says infections are riskiest for those who suffer from underlying conditions.

Another question around myths of Long Covid and changes to women's menstrual cycles. Perez says he has not had any patients with this experience, though there have been some reported cases. He says it's unclear what there is a direct connection.

Finally, how does one know if you have Long Covid? If you had moderate to severe Covid and experience foggy brain, shortness of breath or other symptoms, this could be an indicator of Long Covid -- though, again, there are no tests.

This is a new disease. It is amazing we've come this far in 3 years... the medical and research community has taken us a long way, but there are still many answers that remain out of reach, says Perez.

Our next presented is Dr. Nisha Viswanathan, Director, UCLA Long COVID Program. The program was created to determine if symptoms are truly Long Covid, and often many patients require long discussions around symptoms to rule out other potential issues.

Often primary doctors do not have the time to do these deep dives. Viswanathan references one patient who suffered a stroke, and that symptoms he was experiencing were tied to this rather than Long Covid.

We focus on a "symptoms based strategy" using knowledge of other conditions to help patients, says Viswanathan.

More research is needed to determine how well #vaccines and other treatments prevent Long Covid, says Viswanathan, who recommends that unvaccinated patients with symptoms of Long Covid get the vaccine.

We see the repurposing of existing medication in treating symptoms, which have been successful. Viswanathan mentions the use of anti-depressants in treating brain fog.

Pulmonary rehab and breath retraining, as well as mindfullness and mediation can also be helpful in managing Long Covid symptoms.

Another area of success are anti-inflammatory diets, including plant based diets with less meat, more nuts and reduced alcohol. But taking this variety of approaches can be tough, especially for low-income patients.

Social determinants of health — poverty, food deserts, etc — can complicate treatment of Long Covid, says Viswanathan. The challenges come in that each patient has different sets of resources.

We've had patients come in private jets, and others arrive by bus with no insurance. Patients will less financial means struggle between paying rent or purchasing medications. #inequality

Ultimately it is going to take a lot of efforts from health systems, governments and individuals to create more awareness and to drive research to find what helps, and how to get that help to people that need it.

Money question: Is there recovery from Long Covid? Viswanathan says she sees patients who are improving, though there are patients still struggling years after their infections.

Our final speaker is @MichelleCHC_UCR. The Black community worldwide has been disproportionately affected by Covid, says Burroughs. Many remain unvaccinated out of mistrust and fear.

There is a belief that Black lives are undervalued, and a fear of the unknown around development of the vaccine. "There are so many things swirling in conversation as it relates to the Black community."

Because of the disparities in delivery of care the impact of Long Covid could be more devastating to the Black community, says @MichelleCHC_UCR. Black people do not receive the same quality of care as whites, leading to higher mortality rates, up to 3.5x higher.

This is a real challenge that we continue to hear. "Blacks feel unheard," says @MichelleCHC_UCR. Primary care providers are failing to address symptoms of those presenting Long Covid like cases.

"We keep talking about health disparities, and doctors still are not hearing us. We need to stand out ground. If doctors are not listening, find someone who will," says @MichelleCHC_UCR, quoting participants in a recent town hall.

Increasing #diversity and educating care providers is also key. "As health care professionals, we should work to build trust," says @MichelleCHC_UCR.

#Longcovid is serious and we need to ensure as a society that we are caring for one another, @MichelleCHC_UCR concludes.

Less than 6% of doctors are Black, notes EMS moderator @sunita37. We need to grow a more diverse workforce, clearly, agrees @MichelleCHC_UCR

Are we as a nation prepared to deal with the onslaught of people who could present with Long Covid? "No, we are not prepared for what's to come... we have to work with out patients, we have to talk about the symptoms," says @MichelleCHC_UCR

We need to revisit how we do disability insurance, says Dr. Viswanathan. We have a system now that is all or nothing. Patients are either completely out of work, or working all the time. There needs to be more flexibility for handling Long Covid.

The frustration has been high, she adds. Often insurance denials hit patients of color on Medicaid. "That is heartbreaking... the people who need it the most" are being denied access, says Dr. Viswanathan

Dr. Perez says the larger question is around how society sees those who cannot work, treating it as a personal failing. "A lot of patients are afraid and ashamed of admitting they can't work."

Be respectful of the individual when they are unable to work as a result of physical/mental challenges, says Dr. Perez, saying he is optimistic about the science and less clear on how society will respond.

Thanks to today's tremendous speakers and to the @CaliforniaDep11 for organizing this important briefing. Visit ethnicmediaservices.org for reporting on this and other events.

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