Cat in the Hat 🐈‍⬛ 🎩 🇬🇧 Profile picture
Mar 28 20 tweets 9 min read Read on X
🚨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

Mar 29
🚨 Indoor AIRBORNE Risk Assessment in the context of SARS-CoV-2 from the World Health Organisation (@WHO)

For clean air advocates, this is HUGE!

The WHO are finally saying, loud & proud: COVID IS AIRBORNE.

Let’s take a closer look at the details…🧵

🔗 iris.who.int/handle/10665/3…
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Foreword:

“We live immersed in an ocean of air, yet we hardly ever notice its presence. However, without air we would simply not be able to survive.”

“We must reshape & redesign the building environment, while focusing on optimizing indoor ventilation and the air we breathe.” Image
Introduction:

This purpose of this document is to introduce “an innovative method to quantify the risk of SARS-CoV-2 airborne transmission in indoor settings, thereby providing an alternative approach to developing ventilation requirements that lower the risk of infection.” Image
Read 28 tweets
Mar 7
MEASLES, a thread🧵

Having successfully eliminated measles in the UK back in 2017, it’s now back with a vengeance.

Cases have risen to a 10-year high & a National Health Emergency has been declared.

Here’s a whistlestop tour of everything you need to know about measles. Image
MEASLES CASES IN ENGLAND

▪️In the 5 months since 1 Oct 2023, 733 measles cases have been reported, a 10-year high.

▪️239 new cases have been reported in Feb so far (data still incomplete).

▪️The majority (63%) of cases are in children under 10 yrs.

🔗 gov.uk/government/pub…
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INFECTIOUSNESS

Measles is one of the world’s MOST infectious diseases.

It transmits very easily from person to person (the infected person is infectious from 4 days BEFORE the rash appears).

On average, each person with measles will infect 15 other (unvaxxed) people. Image
Read 24 tweets
Mar 2
COVID + THE BRAIN 🧠

There’s been a flurry of new studies published in recent weeks about Covid’s detrimental impact on the brain.

This is the aspect of Covid which concerns me most, but which many people seem to be blissfully unaware of.

So let’s dig into what we know… 🧵 Image
It’s important to note that this is not new news… we’ve known about Covid’s impact on the brain for a long time.

1. This article from Dr @zalaly provides an excellent summary of the mounting evidence about how Covid leaves its mark on the brain.

🔗 theconversation.com/mounting-resea…
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2. This is one of the new studies published this week (29 Feb 2024).

Researchers found that those with Long Covid had measurable memory & cognitive deficits equivalent to a difference of 6 IQ points which lasted for a year or more after infection.

🔗 amp.theguardian.com/society/2024/f…
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Read 34 tweets
Feb 28
It’s incredibly disappointing to read @LibDems policy motion for tackling persistent absence in schools.

It completely FAILS to address the primary cause of persistent absence…

You can read the policy here (p32): 🔗

@EdwardJDavey @munirawilson

🧵 libdems.org.uk/fileadmin/grou…
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So what is the primary cause of persistent absence?

Let’s look at the government’s own data from the last academic year (2022/23).

It’s right there in black & white:

‘Both overall absence & persistent absence rates have been driven by ILLNESS during the 2022/23 academic year.’ Image
In case you’re wondering, this is *not* normal.

Pupil absences due to illness alone increased to an average of 3.9% across the 2022/23 academic year, compared with a pre-pandemic average of 2.6%.

That’s a 50% rise!

Children never used to be sick nearly as much as this. Image
Read 26 tweets
Feb 28
Does anyone know of a medical reason why the recently updated guidance for measles infection control in healthcare settings states that:

“FFP3 respirators must NEVER be worn by an infectious patient”

Guidance is here:
🔗 england.nhs.uk/long-read/guid…
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I can understand powered respirator hoods not being allowed since the air exiting the PAPR hoods is not filtered & therefore doesn’t provide any ‘outbound’ protection.

Similarly with valved FFP3 masks.

But, as long as the FFP3 mask isn’t valved, why would it not be allowed?
If they mean that *valved* respirators are not allowed (as per guidance below), why don’t they clearly specify that?

To put a blanket ban on ALL FFP3 respirators for patients known to be infected with an extremely contagious airborne disease seems v odd.

england.nhs.uk/wp-content/upl…
Image
Read 4 tweets
Feb 22
Rishi Sunak met King Charles at Buckingham Palace yesterday afternoon for the first time since his cancer diagnosis.

🔗

Now, do you see what I see?! 👀

It’s a HEPA air filter, prominently positioned in the background of many of the photos!

1/ bbc.co.uk/news/uk-683632…
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It’s BRILLIANT to see a HEPA air filter so prominently positioned.

I wonder if it was a coincidence or intentionally placed within camera shot?

I’d like to think it was intentional and that the King is subtly sending us a message of support for clean indoor air!

2/ Image
I don’t know what cancer treatments the King is undertaking but it’s possible he is on immunosuppression drugs leaving him clinically vulnerable.

It would have been good to see him wearing a mask too - but even without a mask, clean air can help reduce his risk.

3/
Read 29 tweets

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