🚨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-…
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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/…
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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/…

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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-…
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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/
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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

Dec 11
This feels like an important breakthrough moment…

On the BBC News this evening, Medical Editor @BBCFergusWalsh clearly stated:

“As for facemasks, simple surgical masks are *not* good at stopping viruses. You really need a properly fitted tight respirator mask for that”…

/1
…which begs the question, why does the NHS infection control guidance STILL only recommend surgical masks for treating patients with airborne viruses like flu & Covid… and not proper FFP3 masks?

Even Baroness Hallett was rather perplexed by this during the Covid Inquiry.

/2
The IPC experts (Dr Warne & Dr Shin) who provided independent specialist advice to the Covid Inquiry both stated that IPC guidelines should be updated to recommend routine use of FFP3 masks when caring for patients with ANY respiratory virus.

So why has this not been done?

/3
Read 7 tweets
Dec 10
CEO, NHS Providers, @danielelkeles:

“It’s a v nasty variant of flu that we have this year.”

“We need to get back into the habit that, if you’re coughing & sneezing […] then you must wear a mask when you’re in public spaces.”

I’m so pleased to hear Daniel promoting masks BUT…
…I have 3 questions for @danielelkeles:

1️⃣ He only mentions that people who are sick “must wear a mask in public spaces”…

…but why did he not also suggest that people who are *not* sick should wear a mask to prevent themselves getting sick in the first place?!

Like this ⬇️ Image
2️⃣ Why didn’t @danielelkeles mention FFP masks?

Surgical masks DON’T protect against airborne transmission of flu.

“Live viruses could be detected in the air behind ALL surgical masks tested. By contrast, properly fitted respirators could provide at least a 100-fold reduction.” Image
Read 5 tweets
Dec 8
UK ‘SUPERFLU’ OUTBREAK

Schools in England & Wales have been forced to close amid escalating flu outbreaks with hundreds of pupils off sick at a time.

Simon Kidwell, headteacher of Hartford Manor Primary told BBC Breakfast: “The winter bugs spread really easily in schools”…

/1
Headteacher Simon Kidwell is not wrong.

Children are crammed into poorly ventilated classrooms, shoulder-to-shoulder with up to 29 other kids, for around 6 hours a day, 5 days a week.

It’s the perfect environment for airborne diseases to spread…

/2 Image
We had a big wave of Covid in Sept/Oct, followed in very quick succession by the current wave of flu and RSV.

It’s been one perpetual cycle of illness hammering schools.

I often hear people say: “oh, but it’s always been like this”.

But it *hasn’t* always been like this.

/3 Image
Read 18 tweets
Dec 4
NHS England: “It will not be possible to halt the spread of a new pandemic virus, and it would be a waste of public health resources and capacity to attempt to do so.”

This has got to be one of the most 🤯 things I’ve ever seen written down in an official document. Image
And this is an important point from @mdc_martinus ⬇️

The NHS constitution states that they’re meant to PREVENT health problems…

…so how can their pandemic response strategy say it’d be a WASTE of public health resources to attempt to halt the spread of a new pandemic virus?!
@mdc_martinus Here is the full letter from CATA (an alliance of medical organisations, royal colleges & trade unions) raising the alarm about the NHS pandemic response strategy to the Chair of the Covid Inquiry.

For more details, please read the excellent thread from @cv_cev linked below ⬇️ Image
Read 5 tweets
Nov 22
Two countries.

Two charts.

A very similar (and concerning) trend.

…………..

Can you think of anything that happened in 2020 which is still affecting huge swathes of people on an ongoing basis and which may help explain this worrying trend?

/1 Image
If you haven’t figured it out yet, here’s a little clue… 🔎

/2 Image
Still not worked it out?

Here’s another clue from Jim Reed, the BBC’s health reporter… 

/3
Read 10 tweets
Nov 12
PUPIL ATTENDANCE & ILLNESS

The government & media seem to believe that the significant rise in pupil absence compared to pre-pandemic is primarily driven by truancy.

They don’t seem to believe there is a GENUINE increase in illness.

So let’s take a closer look at the data… 🔎 Image
This chart shows emergency admissions for children with lower respiratory tract infections, broken down by school-age year group.

I’ve compared the 5 years before the pandemic started (2014/15 - 2018/19) to 2023/24 (most recent data published).

Do you notice anything? Image
The data is taken from the NHS Outcomes Framework.

It specifically charts Indicator 3.2: “Emergency admissions for children with lower respiratory tract infections (LRTIs)”.

You can find the raw data here:

digital.nhs.uk/data-and-infor…Image
Read 65 tweets

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