Uk News Long Covid is real, but we need to stop scaring people by saying it's more common than it is United Kingdom news
PremierLeague-News.Com - The popular image of people confined to their homes by fatigue or brain fog is real, but most of the cases of long Covid are people with genuine but not life-ruining symptoms
PremierLeague-News.Com - Breaking Sport Transfer News ! Long Covid is a controversial topic. One statistician I know messaged me to say “I’ll never do any work on it, because I predict it will become toxic.” On the one hand, you have people saying that it’s not real; on the other, you have people warning that “at least” 20 per cent of Covid patients will get it and that it “wreaks” damage on the body.I wanted to try to find out what we actually know about it, and how worried we ought to be. After all, the large majority of British people have now had Covid. If a huge percentage of them either have or are going to get long Covid, and long Covid is debilitating, then we ought to worry.But I am confused. I am completely convinced that long Covid is real: I know at least three people who have suffered badly with it. Two of them – both healthcare workers – caught the disease in the first wave. The other, an academic, got it in 2021. Their experiences sounded pretty awful: overpowering fatigue, muscle aches and headaches, concentration difficulties and the cognitive slowness known as “brain fog”.That said, I have also known hundreds of people who’ve had Covid – I find it easier to count people I know who haven’t – and yet I only know three with what I think of as long Covid. This seems strange, on the face of it, because I’ve read things in places such as the New York Times, that “more than one in five adult Covid survivors” could develop long Covid. But that doesn’t gibe with my own experience. If that 20 per cent figure is right, I should know at least dozens of long Covid sufferers. Of course, my experience isn’t a reliable guide. There could be all sorts of reasons why my social circles might not be representative. But it did make me wonder. So: what’s going on?How long is long Covid?In short, the trouble is that there is a commonly held, colloquial definition of long Covid, and there are also several different sets of diagnostic criteria which scientists and statisticians use and sometimes refer to as long Covid. The colloquial definition and the diagnostic criteria differ widely, but the public conversation often elides that difference. For example, not everyone agrees on how “long” long Covid has to be. The New York Times story was reporting on a study published in May by the US Centres for Disease Control. It did indeed find that one adult in every five have “post-Covid conditions, or long Covid”.But the CDC study defines long Covid as being “persistent symptoms, or the onset of long-term symptoms, ≥4 weeks after acute Covid-19”. That is, if you still have symptoms, or you get new symptoms, four or more weeks after being diagnosed with Covid, you would be classified as having long Covid.Other research uses other definitions. The UK’s National Institute for Health and Care Excellence (NICE) uses the term “long Covid” to refer to two different things: symptoms of Covid that take a long time to get better (more than four weeks after infection), and a post-Covid-19 syndrome that continues for more than 12 weeks. The World Health Organisation (WHO) also uses a 12-week definition.Of course, there will be more people who are still ill after four weeks than there are who are ill after 12: mercifully, people tend to get better. And there will be fewer still who are still suffering after 12 months, or two years. So we have to be careful: if we talk about the number of people who have it at four weeks, but mentally picture people who are unwell for months, then we’ll overestimate how common it is.What symptoms?The most common symptoms for patients in the CDC study were “respiratory symptoms” and “musculoskeletal pain”. A persistent cough, or nagging muscle aches, would both fit those conditions.This isn’t to belittle the experience of people who have those symptoms: a cough that lasted for four weeks would be no laughing matter, and presumably many patients had a worse outcome than that. But when most of us talk about “long Covid”, we tend to think of something that lasts for months and that puts people out of action. Meanwhile, the stories in the news tend to be about people who’ve had months of fatigue, pain and cognitive issues, not the people who have more headaches than normal: we tend instead to hear about people who have “unrelenting and crushing fatigue and anxiety” and who have to quit their jobs.That’s completely understandable, but it does mean that, again, if when we talk about “long Covid” we think of the sort of people who get long-lasting, devastating health impacts – brain fog, fatigue, chronic pain – but use the numbers that apply to people who’ve had real but not necessarily life-limiting symptoms, we’ll overestimate the seriousness of the situation.What do we actually know?It’s complicated. “Everyone researching this has some list of symptoms that they’ve got people to report,” says Kevin McConway, a professor emeritus of statistics at the Open University.
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.” They also have different methods – some are simple self-reported data, others compare to a control group; some track symptoms over time, others ask people to recall symptoms over the last 12 months. Correspondingly, they have different outcomes.For instance, the React study by Imperial College London took a list of 39 symptoms and counted subjects as having long Covid if they had at least one of them more than 12 weeks after initial diagnosis. It found that 38 per cent of patients fit the criteria.By comparison, a study using the ZOE app run by King’s College London followed people who were diagnosed with Covid, and found that 13 per cent still had symptoms after four weeks, but that only 2.3 per cent did after 12 weeks.When two large national studies disagree on the prevalence of a disorder by a factor of 15, something interesting is going on.The UK’s Office for National Statistics keeps track of how many people have long Covid in this country. They say that, according to people’s own reports, around 2 million people – 3.1 per cent of the population – have the condition, as of 1 May 2022.That’s an awful lot. But we need to unpack it a bit. If we use the 12-week definition of long Covid, the number drops to 1.4 million. That’s still huge, but it’s also worth remembering that an absolutely staggering number of people in this country have had Covid. If you look at the Cambridge MRC Biostatistics Unit’s estimates, they think that there have been about 58 million Covid infections in England alone. The population of England is around 55 million. Of course, lots of people have had it twice, but still, McConway thinks that 90 per cent of us have had the infection at least once. Of all the people who’ve had Covid, only about 2.4 per cent of them now have long Covid, if we use the 12-week figure.But that’s a very different statistic to how many people will still be unwell after 12 weeks – we’re well into the third year of the pandemic, now, and there will be many people (including all three of the people I know who had long Covid) who had it and have now, mercifully, got better.Should we worry?The question we probably want answered is: if I get Covid now, what are the chances I go on to get long Covid? Daniel Ayoubkhani, a statistician at the ONS who’s been looking into the numbers around long Covid, thinks that a good range is about 10 to 30 per cent. That’s the number who will still have some symptom, whether loss of taste or smell, or a persistent cough or aches, after 12 weeks.But again, that’s not what most of us think of when we think of long Covid. Ayoubkhani points out according to ONS figures that about 70 per cent of long Covid sufferers report having their day-to-day activities affected by the condition, but that the number who say that it limits it by “a lot” is smaller: about one in five. That would translate to somewhere around the 2 to 6 per cent mark at 12 weeks. It’s also worth being clear that vaccination reduces your risk of long Covid, perhaps significantly. Ayoubkhani says that the ONS’s own research finds that being double-jabbed reduces your chance of long Covid by 50 per cent, and triple jabbed even further (it varies somewhat depending on the variant, but that’s the ballpark), although other studies suggest a smaller effect.The hard thing is that so far, it’s been very difficult to establish a clear physical cause for long Covid, just as it has been for the obviously similar condition of ME/CFS. One study found essentially no physical differences between long Covid sufferers and controls. That doesn’t make it any less real – “If someone reports symptoms, you can’t deny they have them,” says Ayoubkhani. “If they say they have fatigue, headache, anxiety, then they have those symptoms.” But it makes it harder to know what to do. There are various hypotheses – it’s an autoimmune reaction, it’s to do with inflammation; Ayoubkhani is interested in the theory that it’s a reactivation of dormant Epstein-Barr virus. But there’s not great evidence for any of them so far.None of this is to belittle the risk of long Covid. It’s real and affects millions of people in Britain. But I do worry that the conflating of a media image of long Covid, of people confined to their homes for months with fatigue or brain fog, with a set of diagnostic criteria that can mean “having a persistent cough for four weeks”, is in danger of frightening people more than is necessary.
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