Compared to the worst of the pandemic, when vaccines and antiviral drugs were absent or in short supply. More than 10,000 people For a long time, when COVID-19 was largely unrecognized, millions of people were dying every day around the world, despite countless people becoming chronically ill. The prognosis for the average infection with this coronavirus has clearly improved.
Over the past four years, the likelihood of severe infection with coronavirus has decreased significantly. Even as the United States races through what could be the second-largest wave of SARS-CoV-2 infections, death rates continue to rise. remain near record lows. And while tens of thousands of Americans are still hospitalized each week with the coronavirus, emergency rooms and intensive care units are no longer routinely pushed into crisis mode. Even with the long-lasting coronavirus, new infections appear to be occurring less frequently than before.
However, while the decline in the incidence of severe COVID-19 infections is clear and significant, the decline in the number of long-term COVID-19 cases is less certain and significant.Many new cases chronic condition It still pops up every time a wave passes, even though millions of people who developed it in the past few years continue to suffer from its long-term effects.
In a sense, the decline in the number of seriously ill patients has made the long-term danger of the new coronavirus even more apparent. Today, “to me, prolonged COVID-19 feels like the biggest risk for most people,” Matt Durstenfeld, a cardiologist at the University of California, San Francisco, told me in part. Told. Because it doesn’t save young, healthy people as easily as it does serious illnesses. By definition, acute illnesses eventually end. As a chronic disease, prolonged exposure to COVID-19 means debilitation that will never fully end for many people. And this lingering burden, more than any other burden, may determine the cost of living with this virus long-term.
Most experts I spoke to for this article think it is unlikely that the average SARS-CoV-2 infection will develop into a longer-lasting COVID-19 infection than in the past.some research and data The set supports this idea. Anecdotally, doctors who run clinics told me that the pattern extends to their patient rosters. For example, the number of referrals to Alexandra Yontz’s COVID-19 clinic at Children’s National in Washington, D.C., has steadily declined over the past year, and the waiting list has shortened. Other experts said the situation is similar among adult patients at Yale University and the University of California, San Francisco. Lisa Saunders, an internist who runs a clinic at Yale University, told me that recent cases of long-term COVID-19 seem to be less debilitating than cases that developed in 2020. “Those who got the early versions definitely had the worst of it,” she said. she said.
This reflects how our relationship with COVID-19 has changed overall. Just as immunity protects the body from the most severe acute form of the coronavirus, it may also protect against certain types of long-lasting coronaviruses. (Most experts think so. long coronavirus When infected with a virus, our defenses are strong and fast-acting and can prevent the infection from spreading or prolonging, as was the case with the long-term coronavirus infection. The course of the disease also tends to end sooner with less virus accumulation, giving the immune system more time to mount a friendly fire campaign against other tissues, another potential trigger for chronic disease. There will be fewer reasons.
According to that logic, excessive the study showed it vaccination—Especially with the recent ones. repeated Vaccination—Can be done reduce The possibility that a person will develop the new coronavirus over a long period of time. “There’s almost universal agreement on that,” Ziyad Al-Aly, an epidemiologist and clinician at Washington University in St. Louis, told me. Some experts believe that antiviral drugs may be just as effective because they reduce the proportion of people with coronavirus who progress to severe disease, a risk factor for certain types of long-lasting coronavirus. I think so. Others point to a more recent possibility. variation of virusSome of them are less likely to penetrate deeply into the lungs or affect certain particularly susceptible organs, but they may also be less likely to cause chronic disease.
However, there is no consensus on any of these points, particularly on how much, if any, these interventions are helpful. Experts are divided on the effectiveness of even the vaccines that have the most evidence to support their protection. Some studies have found that vaccines reduce risk by: 15 percentothers are max. about 70%.Paxrobid is also at issue: some analyzes show that taking antiviral drugs early in infection is effective Helps prevent Long new coronavirus, found by others no effect at all. The implication that we have had coronavirus under control for a long time overstates how positive the overall picture is. Hannah Davis, one of the leaders of the Patient-Led Research Collaborative, who developed a lingering COVID-19 infection during the first months of the pandemic, says she sees how the most optimistic studies can garner media and public attention. He said he saw it with his own eyes. Because it’s such a touchy, difficult subject to understand, Davis said, “we still tend to overreact to good news and underreact to bad news.”
It’s no shock that research on the new coronavirus has been popping up all over the place for a long time. This condition does not yet have a universal definition or standard diagnostic method. When recruiting patients for research, research groups can rely on: clear set Different criteria inevitably lead to disparate and seemingly contradictory results. Vaccines, for example, may become less effective as studies examine a wider range of potential symptoms of long-term COVID-19 infection. The reason is simply that “vaccines don’t work for everything,” Al-Aly said.
It has become difficult to study for a long time about the coronavirus. Priya Duggal, an infectious disease epidemiologist at Johns Hopkins University, said that the less attention is given to the coronavirus, “the less likely it is that people will associate long-term symptoms with it.” Fewer people are getting tested for the virus. And some doctors still “don’t believe in the long-term nature of COVID-19. We hear that a lot,” Sanders said. The fact that fewer long-term cases of COVID-19 are coming to researchers and clinicians may be partially due to fewer diagnoses. Al-Aly is concerned that the situation could worsen further. Research into the new coronavirus is still progressing smoothly, but “momentum has stalled.”others share his concerns. Continued public apathy could deter journals from publishing high-profile papers on the topic and politicians from securing funding for future research. Dougall told me.
Currently, even though the possibility of new long-term infections with the new coronavirus has decreased, the incidence has not fallen to zero. And the speed of recovery remains slow, low and uncertain. Right now, “people are entering this category faster than people are exiting it,” Michael Peluso, a longtime coronavirus researcher at UCSF, told me.of CDC Household Pulse SurveyFor example, the percentage of American adults who currently report dealing with long-term COVID-19 infection has shown to have remained stable (about 5 to 6 percent) for more than a year, although , the numbers are have (Decreased from 2021 onwards).Prolonged COVID-19 is one of the most debilitating chronic diseases in the world today, and there is no guarantee of full recovery. Remaining rareThis seems to be especially true for people who have been living with this disease for a long time.
Accurate numbers on recovery are difficult to come by for the same reason that it is difficult to determine how effective preventive measures are.Some studies have reported the percentage much more optimistic than others. David Putrino, a physical therapist who runs the COVID-19 long-term care clinic at Mount Sinai Health System, said he and his colleagues have seen more than 3,000 long-term residents since the pandemic began. However, he told me that his best guess was that the prognosis was quite wrong. poor. About 20 percent of Putrino’s patients make a full recovery within the first few months, he told me. But beyond that, there are people who only experience partial symptom relief and “no matter what we try, we just can’t seem to even stop them from getting worse,” Putrino told me. told. ” Putrino and other experts say reports of high recovery rates may be confusing improvement with a return to baseline, or that people who no longer respond to follow-up are no longer participating. He said they may incorrectly assume that it is better than just that.
Davis is also concerned about the possibility of lower recovery rates.. Some researchers and clinicians are noticing that today’s long-term COVID-19 patients are more likely to present with certain illnesses than patients in the past. neurological symptoms-among them, brain fog and dizziness– That has been linked to a slower recovery trajectory, said Lekshmi Santosh, a pulmonologist at UCSF.
In any case, the recovery rate is still low enough that long-term COVID-19 clinics across the country remain fully booked, even those that are seeing a drop in demand. Currently, Putrino’s clinic has a waiting list of three to six months. The same is true for clinical trials investigating potential treatments. One is run by Mr. Peluso. Monoclonal antibody therapy research “We haven’t had any problems finding people who want to participate,” Peluso said.
The long-term decline in coronavirus incidence may also be short-lived. Viral evolution may constantly generate new variants or subvariants that have a higher risk of chronic problems. The protective effects of vaccination can also be very temporary, and the less people keep up to date with vaccinations, the more porous the immune safety net could become. Thus, although children appear less likely to develop long-term COVID-19 infections overall, they may remain worryingly vulnerable. Mr. Yontz said. Because they are born completely susceptible and vaccination rates among the youngest age groups remain very low. Still, young children who have had the coronavirus the longest may have to live with it the longest. Some of Yontz’s patients have only just entered elementary school, and he has already been ill for more than three years, or more than half of his life.
Long-term coronavirus infections may occur later. repeat infection And while several experts have told me they think the increased risk from each subsequent exposure is small, further exposures are concerning. In most cases, people around the world are suffering from multiple outbreaks as pathogens spread at breakneck speed more or less year-round, in populations where mitigation measures have been discontinued and annual vaccinations (where available) have been largely delayed. Has been exposed multiple times. . Additional infections can worsen symptoms or pull people out of remission in people living with coronavirus for long periods of time. Long-term COVID-19 inequalities will also widen as marginalized populations, who are less likely to receive vaccines and antiviral drugs and more likely to be exposed to the virus, continue to develop symptoms at higher rates. there’s a possibility that.
There is no question that COVID-19 has changed. This disease is much closer to home. The threat of severe disease has certainly not disappeared, but it is now decreasing in quantity. But it would be a mistake to ignore the dangers of the virus. Even if the number of new infections among long-term infected people continues to decline for some time, it is likely to stabilize at some point, Yontz said. These risks will continue to challenge us and increase costs. Long-lasting coronaviruses may not be as directly deadly as severe and acute coronaviruses. But people’s lives still depend on avoiding it, Putrino told me. “At least their lives as they know them now.”
