Autumn’s chill and respiratory viruses usually arrive hand in hand. While most people who “catch a cold” don’t test for SARS-CoV-2 (COVID) any more, many who do find that their at-home tests are negative even on day 3 or 4 after symptom onset. To be clear, one in ten people infected with any COVID variant is at risk for Long Covid (LC). The only way to avoid LC is to not get COVID in the first place. Masking in public settings and testing can help with that. There is a vast difference between the Rapid Antigen Tests (RATs) and the Polymerase Chain Reaction (PCR) tests. This excellent article from Amanda Blum at Lifehacker outlines why PCR tests are preferrable and which ones are available for home use.
There are reasons why many of the LC community (400 million globally; and 17 million in the USA, myself included) take testing and other measures to avoid repeat infections seriously. Even “mild” cases may not feel mild and severe cases often require hospitalization. Severe illness from COVID is possible regardless of health status but the medically vulnerable are especially at risk. Being female, age 65+, having had severe COVID illness (whether hospitalized or not), and having repeat infections are additional risk factors. Even though the pandemic is now endemic, over 10,000 people died in the U.S. (from acute infection) in the last three months; over 5,000 have died from LC (likely a massive undercount).
Anyone (including children) can experience Long Covid (LC) after just one acute COVID infection, and repeat infection does not confer COVID immunity. Keeping vaccinations up to date can help prevent severe illness, hospitalization, and death, but a recent study indicates that LC can occur regardless of vaccination status. It is possible to become infected after vaccination, and people with LC may be more vulnerable to post vaccination syndrome (PVS). According to one study, patients with PVS report poor quality of life, high symptom burden, and increased psychological and social distress despite having tried many largely unsuccessful treatment strategies.
The COVID virus is constantly spawning new variants, some highly transmissible, and asymptomatic transmission is common. It spreads by both droplet and airborne aerosol transmission. So, it can be contracted by simply breathing the air that other infected people exhale (even if they are asymptomatic). From the CDC website: “Most people with Long COVID experience symptoms days after first learning they had COVID-19, but some people who later develop Long COVID do not know when they were infected. People can be reinfected with SARS-CoV-2 multiple times. Each time a person is infected with SARS-CoV-2, they have a risk of developing Long COVID. Long COVID symptoms and conditions can emerge, persist, resolve, and reemerge over weeks and months. These symptoms and conditions can range from mild to severe, may require comprehensive care, and can even result in a disability.”
There is a common myth that LC is limited to those with known comorbidities, like diabetes or heart disease. In fact, the demographic most often diagnosed with LC is the age range 40-49. There are developing concerns about the economic impact and disability claims as LC numbers are increasing. This video features three prominent LC researchers discussing the risk from experiencing multiple infections. It is truly worth watching to learn more about the relationship between reinfection and Long Covid.
I realize that most people are incredibly sick of talking about, getting, or trying to avoid getting COVID. I’m still talking about it here because I hope to help others understand that endemic or not, this virus is still affecting millions of people from all walks of life, and no one is immune from the possibility of Long Covid. At-home PCR tests can help to open the door for safer socialization. While the initial cost of these test kits may be daunting, it could be a life saving investment. I can’t wait to get one.
Thank you for reading! Next time in the LC Series I will say more about MCAS.
Please Note: The Long Covid series is intended to be both a memoir and an educational resource for the “living well” aspect of our mission. It is hoped that the content will increase empathy, support, and understanding for those living with chronic conditions.
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