World still suffering malign legacy of Covid-19 pandemic

Debate remains over long Covid and global response to future disease outbreak

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  This year marks five years since the World Health Organisation declared a Public Health Emergency of International Concern on January 30, 2020. The National looks at some of the most striking images taken during the Covid-19 pandemic. All photos: Getty Images

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  A pedestrian walks along a near-deserted street during a lockdown imposed in 2021 in Mumbai, India

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  An elderly woman wears a face shield as she attends Eid Al Adha prayers at a mosque in Yogyakarta, Indonesia, in 2021

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  An aerial view of Queen Square in Bristol, England, where hearts were sprayed on to the grass in an effort to encourage social distancing in 2020

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  Medical staff in protective gear move a Covid patient from an ambulance into hospital in Seoul, South Korea, in 2020

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  A Civil Protection member in a hangar where 18 coffins of victims of Covid-19 wait to be transported to Florence by the Italian Army in Ponte San Pietro in 2020

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  Military vehicles cross an empty Westminster Bridge in London in March 2020

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  Dental nurses embrace before treating a possible Covid-positive dental patient in Wrexham, Wales, in 2020

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  A health worker passes a vial got be used in a nucleic acid test to detect Covid-19 in Beijing, China, in 2022

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  A giant television beside a motorway urges people to stay home in Manchester in the early days of the outbreak

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  Firefighters prepare to disinfect Wuhan Tianhe International Airport in 2020 in Wuhan, China's Hubei province

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  A sign reminding the public of new social-distancing rules displayed at Manly Beach in Sydney in 2020

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  A woman lights a candle to commemorate victims of the pandemic at Prague Castle in the Czech Republic in 2021

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  Staff members of the Tokyo metropolitan government hold signs as they call for people to stay home in 2020

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  A man waves from a bus carrying passengers who disembarked the quarantined Diamond Princess cruise ship, as he leaves Daikoku Pier in Yokohama, Japan, in 2020

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  About 3,000 people gather in Stockholm, Sweden, to demonstrate against so-called vaccine passes in 2022

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  People rush to board buses to return to their native villages in Ghaziabad, on the outskirts New Delhi in 2020

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  Medical volunteers after taking blood and throat mucous samples from visitors to test them for Covid-19 in Berlin in 2020

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  Members of the Bangkok Metropolitan Authority sanitise classrooms at a school in Bangkok, Thailand, in 2021

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.”