New focus on battling long Covid underscores infection’s persistent risk

covid19-300x193Even as the coronavirus pandemic’s pause shows signs of faltering, medical experts are continuing their deeper digs into the novel infection’s long-term effects including how to treat debilitating long and medium Covid and the calamitous intersection between Covid and chronic conditions like diabetes.

The Biden Administration — taking fierce criticism for not acting sooner and more aggressively — has announced plans to kick start the research to combat long Covid, a condition that may affect as many as 23 million Americans who have suffered infections ranging from severe to mild and still have not shaken the disease’s harms. As the Washington Post reported:

“Experts who have been studying the condition, which is linked to fatigue, brain fog and other symptoms that can linger for weeks, months or even years, hailed Biden for assembling a government-wide effort to combat long Covid. They said it was an overdue recognition of the condition’s impact and reach. But many also said the administration must go further in devoting resources and making long covid a priority, reiterating that millions of people are eager for immediate treatment and help.

“‘It’s ‘a landmark moment in long Covid,’ said Harlan M. Krumholz, a professor of medicine at the Yale School of Medicine. ‘The White House [is] formally recognizing the magnitude of this health threat and formally committing to advancing knowledge in this area while simultaneously providing support for people who are suffering.’”

Under an order from the president, the newspaper reported, the sprawling Health and Human Services agency will “coordinate a government-wide action plan to address long covid … [issuing] a report in 120 days detailing available services and support for those who suffer from long Covid, accelerate efforts to enroll participants in a clinical research study and pursue federal protections for people with the condition. The government will expand a nationwide network of long Covid clinics being run through the Department of Veterans Affairs, with officials saying they are already providing new insights on how to care for long Covid patients. Federal officials will also launch a new initiative, dubbed the ‘Health+ project,’ to solicit feedback from people living with long covid and use it to shape practices at clinics nationwide.”

The administration had relied on the National Institutes of Health to study long Covid under a billion-dollar-plus research plan in which administrators hoped to enroll tens of thousands of participants. But that plan has plodded along, say critics, who note that it has enrolled only a fraction of its hoped-for study subjects. Advocates say the NIH has earned a reputation of late for being too bureaucratic, academic, and unresponsive to patients’ urgent need for treatment.

Long Covid research is gaining more attention

Patients, in fact, may be breaking ground with other researchers and clinicians by taking an activist role in long Covid’s study. Their aggressive campaigning in ways echoes, perhaps, the zeal with which the HIV-AIDS community battled that once-mysterious viral illness and prodded medical scientists to develop therapies that turned it from a lethal to a chronic condition treated with prescription medications.

Besides the damages caused by long Covid, experts continue to delve into the coronavirus’ harms on the:

Big concerns about diabetics and Covid infection

The coronavirus has savaged patients with diabetes, especially blacks and Latinos who have the chronic condition and are less likely, due to inequities in the U.S. health system, to get it treated and maintain some control of it, the New York Times reported:

“After older people and nursing home residents, perhaps no group has been harder hit by the pandemic than people with diabetes. Several studies suggest that 30% to 40% of all coronavirus deaths in the United States have occurred among people with diabetes …People with poorly controlled diabetes are especially vulnerable to severe illness from Covid, partly because diabetes impairs the immune system but also because those with the disease often struggle with high blood pressure, obesity and other underlying medical conditions that can seriously worsen a coronavirus infection. ‘It’s hard to overstate just how devastating the pandemic has been for Americans with diabetes,’ said Dr. Giuseppina Imperatore, who oversees diabetes prevention and treatment at the Centers for Disease Control and Prevention.

“Diabetes patients hospitalized with Covid spend more time in the I.C.U., are more likely to be intubated and are less likely to survive, according to several studiesone of which found that 20% of hospitalized coronavirus patients with diabetes died within a month of admission … Diabetes is a pernicious disease that is at once ubiquitous and invisible, partly because most people with the condition do not appear outwardly ill. It affects 34 million Americans, or 13% of all adults …”

The newspaper noted this of the menace that the coronavirus has posed to patients of color with diabetes:

“Like the pandemic, which has had an outsize toll on communities of color, the burden of diabetes falls more heavily on Latino and black Americans, highlighting systemic failures in health care delivery that have also made the coronavirus far deadlier for the poor, said Nadia Islam, a medical sociologist at NYU Langone Health. ‘It’s not that diabetes itself makes Covid inherently worse but rather uncontrolled diabetes, which is really a proxy for other markers of disadvantage,’ she said.

“Compounding the concerns, some studies suggest that a coronavirus infection can heighten the risk of developing type 2 diabetes, a disease that is largely preventable through a healthy diet and exercise. Type 1, by contrast, is a genetic disorder that tends to emerge early in life and is sometimes referred to as juvenile diabetes. More than 90% of all diabetes cases in the United States are type 2. One study published last month found that patients who recovered from Covid were 40% more likely to be diagnosed with type 2 diabetes within 12 months compared with the uninfected, though researchers have yet to determine a connection between the two conditions.

“Over the past two years, doctors have also reported a sharp rise in young people being diagnosed with type 2 diabetes, an increase that many believe is tied to the drastic spike in childhood obesity during the pandemic. ‘We’ve seen kids coming in so sick and dehydrated that they sometimes require I.C.U. care,’ said Dr. Daniel Hsia, a diabetes specialist at the Pennington Medical Research Center at Louisiana State University. About 1.5 million Americans are diagnosed with diabetes each year, according to the [federal Centers for Disease Control and Prevention], and roughly 96 million, about one in three adults, are at high risk for developing the disease.”

Is the pandemic lull giving way?

As far as the pandemic’s current state, the metrics, though still good overall, are renewing concern, as the New York Times reported with this summary:

“After two months of sustained declines, reports of new coronavirus cases in the United States have been generally flat in the past two weeks. The outlook at the state level is mixed. New virus cases have increased recently in about half of all states and territories, particularly in the Northeast where the BA.2 subvariant is widespread. But cases have decreased in the other half of the states.

“Even as case reports have leveled off some, coronavirus hospitalizations across the country have continued to decrease. Hospitalizations have fallen to an average of roughly 15,000 per day in the past two weeks, the lowest they have been since the first weeks of the coronavirus pandemic. Deaths also remain on the decline. Around 600 deaths from Covid are being reported each day, a decrease of more than 75% from the peak in February amid the Omicron surge…”

We are not done with pandemic and we all would be wise to recognize this, including sustaining the money to battle the disease. Regular folks appear to be having varied reactions to health officials easing coronavirus measures. But those with heightened vulnerability to the virus — those who are older, immunocompromised, overweight, and with underlying conditions, or individuals from hard-hit communities of color — still may be staying careful, including by keeping on their masks. Those using public transportation also must keep their masks on for a while longer.

A word to the wise: Don’t toss out those masks yet. The savvy will want to build up their supply, nabbing test kits, too (free from the federal government, including a second round of them, and delivered to your door). Just in case.

The vaccines remain life changers and life savers. If you have not gotten your shots, please do so, boosters and all, pronto. If you haven’t chatted with your doctor for a bit, you should — especially about whether your individual health would benefit from an additional dose of vaccine and when might be the time to get it. If you have been exposed or think you have gotten infected, please get tested — and quarantine or isolate to protect yourself and others.

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