Five years ago today, the UAE recorded its first case of Covid-19, as the disease spread around the globe.
That case on January 29, 2020, was reported in the early days of a pandemic that, according to official figures, has killed more than seven million people worldwide, although the real figure is likely to be much higher.
Hundreds continue to die from Covid-19 each week, statistics from the World Health Organisation indicate, while some who survive the infection face a malign legacy of long Covid. Warnings over the risks of the lingering effects of Covid-19 began in February 2020 and, a month later, the first individual account of the condition was published. More than 400 million people have had long Covid, a study published in August in the Nature Medicine journal says.
“Long Covid can have devastating impacts on individual lives and, due to its complexity and prevalence, it also has major ramifications for health systems and economies,” the study says.
The economic effects were estimated in the study to be about $1 trillion, or one per cent of the global economy. Symptoms associated with long Covid, also called post-Covid syndrome, include fatigue, breathlessness, depression, chest pain, brain fog, and poor sleep.
Fatal cost of Covid-19
Typically, Covid-19 symptoms would completely clear up after 12 weeks, the UK's National Health Service explains. Those whose symptoms last longer are said to have long Covid.
Numerous causes have been discussed, including persistence of the virus in the patient’s body and inflammation of endothelial cells, which line blood vessels. According to Gavi, the Vaccine Alliance, one idea is that fragments of SARS-CoV-2, the virus that causes Covid-19, remain in the body and cause blood vessels to become inflamed, in turn causing microclots that restrict blood flow and mean that there is less oxygen for tissues.
There have been more than 777.3 million reported cases of Covid-19, according to the latest data from the WHO.
Changing attitudes
“I believe it’s time to stop using the term long Covid – it wrongly implies there is something unique, exceptional and somewhat sinister about longer-term symptoms associated with Covid-19,” Dr John Gerrard, chief health officer of the Australian state of Queensland at the time, said early last year.
Research led by Dr Gerrard – whose comments sparked a backlash – indicated that other viral illnesses, including influenza, could cause similar lingering symptoms. While there is no specific test for long Covid, Dr Bharat Pankhania, a senior clinical lecturer at the University of Exeter Medical School in the UK, said the condition, which he described as “a collection of signs and symptoms” was real. It is similar, he told The National, to the condition of post-viral fatigue.
“With respect to post-Covid infection, yes, this condition exists and in some people it’s aggravated by repeated infections,” he said. “Repeated infection equals repeated assaults on the blood vessels and organs. As a result, the consequences are cumulative.”
Vaccination could reduce the effects of long Covid and booster shots are important for those more vulnerable to the disease, Dr Pankhania said. Another debate centres on long Covid’s prevalence. In a major study published about a year ago by scientists at Imperial College London, 7.5 per cent of respondents reported that they still had symptoms 12 weeks after the initial infection, while 5 per cent were still affected after a year.
Growing in numbers
Even if only a very small proportion of people with Covid-19 end up with long Covid, there have been so many infections that “incredibly large” numbers may have the lingering condition, said Prof Ian Jones, a professor of virology at the University of Reading in the UK.
“Because of the breadth of the infection, the numbers are so much greater,” he added. “It’s essentially what you might call the leftover from a serious infection.”
While Covid-19 cases are still reported, attention has turned to how the world should respond in the event of another pandemic. Before this year’s World Health Assembly, to be held in Geneva in May, WHO member states are negotiating a pandemic preparedness framework or treaty. This aims to promote equitable access to, for example, vaccines, personal protective equipment and treatment.
How nations were affected
In a briefing document, the UK Chatham House think tank said that preparedness was not only about detecting and responding to outbreaks, but also ensuring access to diagnostic tools, vaccines and treatments was equitable. With Covid-19, the focus of wealthier nations on their own populations may have extended the pandemic’s effects, he added.
“National sovereignty must be respected, but the challenge is to ensure such concerns do not override the solidarity required for an adequate global response,” it said.
Prof Paul Hunter, an infectious diseases researcher and professor in medicine at the University of East Anglia in the UK, indicated there was a risk that efforts to be prepared for the next pandemic could fall away over time.
“Typically we’re always really well prepared for the next pandemic when the last pandemic has only just ended,” he said. “Everybody gears up during the pandemic and we learn the lessons, and over the years people make cuts to the preparedness.”
