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Thursday, February 25, 2021

Covid-19: 'long Covid' could be more significant than risk of death

Professor Chris Whitty is Chief Medical Officer (CMO) for England, the UK government's Chief Medical Adviser and head of the public health profession. This is what he said on the fifth of May 2020, and subsequent events have, I think, shown him to be right:

'A significant proportion of people will not get this virus at all at any point in the epidemic which is going to go on for a long period of time. 

'Of those who do, some of them will get the virus without even knowing it, they will have the virus with no symptoms at all, asymptomatic carriage, and we know that happens.

'Of those who get symptoms, the great majority, probably 80%, will have a mild or moderate disease, might be bad enough for them to have to go to bed for a few days, not bad enough for them to have to go to the doctor. 

'An unfortunate minority will have to go as far as hospital; but the majority of those will just need oxygen and will then leave hospital; and then a minority of those will end up having to go to severe and critical care, and some of them sadly will die, but that’s a minority, it's 1%, or possibly even less than 1% overall, and even in the highest risk group, this is significantly less than 20%, i.e. the great majority of people, even the very highest groups, if they catch this virus will not die.'

(htp: 'Yohodi' - https://www.conservativewoman.co.uk/exclusive-your-cut-out-and-keep-guide-to-the-new-covid-rules/#comment-5281039280)

So it's entirely fair, if not popular with the censors 'fact-checkers' of the social and news media, to ask whether the right strategy has been adopted.

For example, the Government already had a contingency plan for a flu epidemic, drawn up in 2011 - https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/213717/dh_131040.pdf - in which the authors noted the costly and disruptive consequences of school closures (4.25), the importance to public morale of 'large public gatherings or crowded events' (4.21) and that face masks for the public tended not to be effective, because of incorrect habits of use (4.15).

Covid-19 spreads more easily than seasonal influenza and the mortality rate for those who have to be taken to hospital is higher - https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30527-0/fulltext - but it is now clear that old age and comorbidities (e.g. obesity, diabetes) are significant factors; those who are younger and in reasonable health have little to fear.

Aside from the impact on the economy, it's also clear that there is a clinical - even a mortality - cost in terms of patients with other medical needs having their treatment delayed or cancelled.

Let the sceptical questioning continue - especially from the Opposition in Parliament, who seem to have adopted the line that they would have done the same as HMG, only earlier and more drastically.

ADDENDUM

The debate may have to shift to a consideration of 'long Covid':

... we estimate that during the week commencing 22 November 2020, around 186,000 people in private households in England were living with symptoms that had persisted for between 5 and 12 weeks...
https://www.ons.gov.uk/news...

My brother in the USA tells me (see comment below):

Lots of very healthy younger people are having lasting lung damage. Several of my wife's patients still can't walk up stairs without stopping. Others are having massive blood clots in the extremities. I just heard of one case where a patient lost both hands and a leg.

5 comments:

Paddington said...

You can say that, but confirmed mortality in the US is still on the order of 1.5%

In addition, lots of very healthy younger people are having lasting lung damage. Several of my wife's patients still can't walk up stairs without stopping. Others are having massive blood clots in the extremities. I just heard of one case where a patient lost both hands and a leg.

Sackerson said...

This is not to minimise the riaks but address the strategy. I suppose that CV will become endemic so that must change how we tackle the risks. We can't shut the country like some Pacific islands have, and even if we did, what would happen when we reopened?

Whitty estimated 1%, you say 1.5% and of course he was speaking 9 months ago when we had yet to learn about 'long Covid'.

Sackerson said...

Long Covid: early days -

https://www.ons.gov.uk/news/statementsandletters/theprevalenceoflongcovidsymptomsandcovid19complications

Sackerson said...

JD comments:

I see you have added 'long covid' although I'm not sure anyone can identify exactly what that is but we can all understand how an illness can drag on for a long time. I am confident I can avoid covid and colds and flu generally by taking preventative measures: vitamin D3 supplement and zinc citrate every day plus fresh lemon juice with honey first thing before breakfast. It is very easy to remain healthy by avoiding processed food and simply cooking your own food. Interesting that TV programmes about cooking are interspersed with adverts for 'fast' food. Richard Ingrams once gave his definition of that "It is called fast food because it is not worth waiting for!"

Meanwhile if you check the ONS pages for notifiable diseases you will see that measles is on the list but covid is not. Conclusion? Measles is more dangerous than covid!

Paddington said...

@JD - " I am confident I can avoid covid and colds and flu generally by taking preventative measures: vitamin D3 supplement and zinc citrate every day plus fresh lemon juice with honey first thing before breakfast."

Good luck. The evidence is that those actions will not save you if you get near someone who is infected.

As for measles, it is much more contagious than COVID, but less lethal.