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Cat in the Hat 🐈‍⬛ 🎩 🇬🇧 Profile picture
@_CatintheHat
Mar 28, 2024 • 20 tweets • 9 min read • Read on X
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🚨NEW Report presents findings from a review of Long Covid to guide New Zealand’s Public Health response.

Report concludes that “preventative action is urgently needed”.

Let’s dive into the details as the findings are relevant for ALL countries.

🔗

/1 phcc.org.nz/briefing/long-…
Image
Below are some of the key findings of the report:

▪️Changes in health status following SARS-CoV-2 infection are common and can occur at any age.

▪️Symptoms are frequently experienced for months or years and can increase over time.

/2 • Several recent and well-designed cohort studies have reported central estimates ranging from 4 – 14% for ongoing symptoms per infection. • Long Covid includes a full spectrum of severity from hidden effects through mild and transient symptoms to life-changing and life-limiting conditions such as heart attacks and strokes, diabetes, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and neurological disorders. Commonly experienced symptoms such as fatigue and cognitive dysfunction have a high impact on quality of life. • Both SARS-CoV-2 infection and Long Covid are under-counted ...
▪️Future health impacts can be expected in addition to the effects that are already observed.

▪️ Some people who are currently well post-Covid are already expressing biomarkers of risk for cardiovascular disease, neurodegenerative disorders, autoimmune diseases & cancers.

/3 Future health impacts can be expected in addition to the effects that are already known and observed. • Some people who are currently well post-Covid are already expressing biomarkers of risk for cardiovascular disease, neurodegenerative disorders, a range of autoimmune diseases, and cancers: conditions that typically have latency periods lasting years or decades. • Early-life exposure to infections can have lasting impacts on developing tissues and organ systems. Already, several adverse effects of perinatal Covid-19 exposure have been described. • Pre-pandemic evidence shows the adverse ...
▪️Society, sector & workforce effects of Long Covid are costly and disruptive, and they worsen existing inequities.

▪️ The frequency of (often undiagnosed) cognitive impairment after a mild infection indicates a need for risk assessment of impacts on occupational safety.

/4 Society, sector, and workforce effects of Long Covid are costly and disruptive, and they worsen existing inequities. • Long Covid is associated with increased healthcare use, productivity loss, and workforce impacts, with implications for NZ workforces that experience high incidence of Covid-19 such as educators, healthcare workers, and prison workers. • The frequency of (often undiagnosed) cognitive impairment after a mild infection indicates a need for risk assessment of impacts on occupational safety and performance. Occupations of particular concern because of safety implications inclu...
▪️Because of rapid viral evolution, Covid-19 waves are not showing a consistent pattern of improvement over time.

▪️Without intervention to reduce cases, the prevalence of Long Covid is more likely to increase than to decrease.

/5 • Ongoing exposure to new, highly transmissible variants – in combination with the high incidence of Long Covid per infection and the long duration of symptoms – drives up the population prevalence. • Evolutionary biologists note that future variant scenarios include the possibility of both higher and lower disease severity with unpredictable impacts on Long Covid risk. • Lack of seasonality increases risk exposure and reduces recovery time between infections. • A high proportion of the NZ population has had Covid-19 at least once, and exposure to reinfection is continuing. Each infection i...
▪️When an infectious disease is common in the population, its long-term effects become common too.

▪️At a population level, modest-looking proportions of a post-infectious health risk readily translate into very large numbers.

/6 Image
The report concludes that:

“Our evidence summary strongly suggests that Long Covid is a major threat to individual health, societal wellbeing and economic performance.”

/7 Image
The Appendix of the report expands further on this important point:

“Choosing to ignore potential harms is indefensible when the risk can be reduced using a combination of new knowledge and well-established public-health approaches.”

/8 The size and complexity of the evidence that has accumulated after only four years of exposure to this new disease can be confronting. It appears to have had a paralysing effect on decision-makers in NZ and globally. As one global Long Covid expert observed in a landmark review: “The oncoming burden of Long Covid faced by patients, health-care providers, governments and economies is so large as to be unfathomable, which is possibly why minimal high-level planning is currently allocated to it”.17 Choosing to ignore potential harms is indefensible when the risk to New Zealanders can be reduc...
The authors recommend 3 immediate actions:

▪️Conducting a comprehensive Long Covid risk assessment.

▪️Rapidly reduce infection & reinfection rates using well-established public health & social measures.

▪️Expand Covid-19 vaccine eligibility and coverage.

/9 Image
Appendix 2 provides further details of the proposed components for Covid mitigation, including:

▪️Support for self-isolation of infected cases

▪️Improve indoor air quality

▪️Maintain mask use in high-risk indoor environments eg health care

▪️High & equitable vax coverage

/10 Image
Below is a press article about this report, highlighting the fact that, in terms of occupational risk, teachers are the most vulnerable to getting Covid - and, in turn, most at risk of getting Long Covid.

🔗

/11 rnz.co.nz/news/national/…
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Below is another press article which includes comments from NZ Education Institute president Mark Potter.

Potter revealed that his union had heard from a lot of teachers who were struggling to continue in the profession due to Long Covid.

🔗

/12 rnz.co.nz/news/national/…
Image
The chart of Covid case rates by occupational group can be found in the chart below, showing that teachers are at significantly higher risk of Covid infection than any other occupation.

(Source: )

/13 fyi.org.nz/request/20877/…

Image
One of the authors, @AmandaKvalsvig, tweeted earlier that schools MUST be made safe since they’re the hubs of their communities, linking public settings & households.

The only effective way to reduce Long Covid is to reduce Covid cases.

Schools are a great place to start.

/14
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In a previous paper (March 2023) also co-authored by @AmandaKvalsvig, she helped outline 7 goals for healthy schools.

As stated in the report, “these actions are highly feasible if the government steps up with a commitment to resource healthy schools.”

/15
This report is a truly outstanding piece of work and could form the blueprint for ANY government willing to confront the enormous health & economic challenges presented by repeated Covid infections and the resulting impact of Long Covid.

🔗

/16 phcc.org.nz/briefing/long-…
Image
Meanwhile, in the UK 🇬🇧, a paper was recently published by @CambridgeEcon on the economic burden of Long Covid.

The report estimates that, if the UK prevalence of Long Covid increases to 4m people by 2030, there will be a £2.7 BILLION loss in GDP & 311k job losses PER YEAR.

17/
Image
In the US 🇺🇸 , detailed evidence on the impact of Long Covid was presented a recent Senate Committee Hearing.

The opening speech below from @BernieSanders provided a compelling summary of the latest research.

More info at this link ⬇️

🔗

/18 sanders.senate.gov/op-eds/us-is-t…
And, in Canada 🇨🇦, a recent report from @StatCan_eng revealed that 1 in 9 Canadian adults have experienced the debilitating symptoms of Long Covid.

Of these, 7 in 10 Canadian adults with long term symptoms experience them on a daily or nearly daily basis.

/19
Covid & its longer term impact on our nation’s health is not going away.

‘Living with Covid’ shouldn’t mean just ignoring it.

It should mean making environments as safe as possible so we can all live our lives with less risk… less illness… less absence from school/work.

20/ Image

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More from @_CatintheHat

Cat in the Hat 🐈‍⬛ 🎩 🇬🇧 Profile picture
Mar 16
In honour of #LongCOVIDAwarenessDay, I’d like to present some important data from the latest GP-Patient survey.

This is a HUGE survey with a sample size of ~700K people in England (5x bigger than ONS’s Covid survey).

In this thread, I’ll walk you through some key findings…

/1 Image
According to the GP-Patient survey:

🚨4.2% of people say they DO have Long Covid. That equates to around 2.3M people in England.

🚨A further 9.5% (~5.3M) say they ‘don’t know’.

So potentially as many as 7.6M people in England either have Long Covid or suspect they might.

/2 Image
The fact that 9.5% of people said they “don’t know” if they have long Covid is actually not surprising.

It’s a HUGE number of people who suspect something isn’t right but don’t have clarity…

…and once you think about how Covid is diagnosed, it makes perfect sense.

/3
Read 23 tweets
Cat in the Hat 🐈‍⬛ 🎩 🇬🇧 Profile picture
Mar 14
CATA's reports are a truly remarkable piece of forensic investigation & took literally YEARS to put together.

The fact it’s taken so long is a fundamental part of the story.

For example: it took a whopping 27 MONTHS to extricate one document from the DHSC via an Fol request... Image
And it took 17 MONTHS to elicit a set of draft minutes from IPC Cell meetings which took place in Dec 2020 - and only following a direct order by the ICO.

This doc is one of the most damning pieces of evidence in the report as it reveals how minutes were fundamentally altered. Image
PHE & UKHSA have been similarly obstructive in providing information in a timely fashion.

The statutory requirement of FoIs is to provide the info requested within 20 working days…

…but it took over 300 WORKING DAYS (roughly 14 MONTHS) to finally extricate one key document. Image
Read 5 tweets
Cat in the Hat 🐈‍⬛ 🎩 🇬🇧 Profile picture
Mar 10
In 2023, the British Council for Offices (BCO) updated the ventilation guidance for offices:

💨 The *minimum* recommended ventilation rate was increased from 12 to 14 litres of outdoor air per sec per person.

Now guess what the ventilation rate is in a typical UK classroom…❓ Image
Since 2022, the Schools Air quality Monitoring for Health & Education (SAMHE) project has monitored indoor air quality in hundreds of schools across the UK.

Shockingly, their data revealed that the ventilation rate in a typical UK classroom is just 5.3 litres per sec per person. Image
Worse still, the data shows the average ventilation rate plummets to just 3.8 litres per sec per person in colder weather.

Now compare this to the MINIMUM recommended ventilation rate for offices of 14 litres per sec per person.

Schools are achieving just a fraction of this! Image
Read 18 tweets
Cat in the Hat 🐈‍⬛ 🎩 🇬🇧 Profile picture
Feb 22
FROM THE OLYMPICS TO NASA, WEARING MASKS IS BACK - EXCEPT IN HEALTHCARE

Brilliant article on how masking is increasingly popular with Olympic athletes, actors & astronauts wanting to avoid illness…

…but sadly, in hospitals, masking is rare & those who do are often gaslit.

🧵 Image
Here’s a link to the online version of this article by the brilliant Tess Finch Lees:
independent.ie/opinion/commen…
The link above is paywalled so here’s an archived link where you can read it for free:


(Please do also click the first link as well though to increase traffic & help persuade editors to publish more Covid stories like this).archive.ph/sfP52
Read 18 tweets
Cat in the Hat 🐈‍⬛ 🎩 🇬🇧 Profile picture
Feb 20
🏴󠁧󠁢󠁳󠁣󠁴󠁿 Something unusual & concerning in Scotland’s Covid data in the last few weeks.

There’s been a sharp rise in the proportion of hospitalised Covid cases which are children.

Currently over half of all Covid hospitalisations in Scotland are kids aged 0-14 years.

(h/t @gwladwr) Image
The data also shows that, since January, Covid incidence rates for these younger age groups have been going into the ‘high’ (dark blue) and ‘very high’ (purple) classifications, particularly the 1-4 years age group. Image
I’ve also taken a look at the England data and Covid positivity rates have been rising sharply in recent weeks in the 0-14 age groups.

Definitely one to watch in the coming weeks… Image
Read 4 tweets
Cat in the Hat 🐈‍⬛ 🎩 🇬🇧 Profile picture
Jan 30
🏴󠁧󠁢󠁥󠁮󠁧󠁿PUPIL ABSENCE - AUTUMN 2025

The DfE have now published pupil absence data for the Autumn term:

🔎 Pupil illness absence across the autumn term averaged out at 3.44% (compared to pre-pandemic average of 2.5%).

🔎 By the end of Nov, illness absence had soared to 4.7%.

🧵 Image
DfE commentary:

“The increases seen in the latter weeks of term were mainly driven by illness-related absence”

“This increase in absence is equivalent to approximately 500,000 less days in school compared to the previous autumn term.”

…e-education-statistics.service.gov.uk/find-statistic…Image
To anyone paying attention, these illness absence figures should not come as a surprise.

By early December, UKHSA was warning about how flu was spreading like wildfire through classrooms, leading to very high infection rates in school-age children (pink & green lines on chart). Image
Read 10 tweets

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