Kate Murray
Appearances
Health Chatter
Long Covid
or just learn to manage them better and figure out how they can still thrive while they're having these symptoms. So really just to believe that this is a real thing and take it seriously. And particularly if you find yourself struggling with this brain fog or fatigue, to seek care, but also to seek support.
Health Chatter
Long Covid
So for a lot of people, you know, help with childcare or household tasks, potentially workplace accommodations can really be a game changer for them as they recover. Because one of the other tricky parts of this too, and you, you know, alluded to this with the definition is that it's very nebulous. And there probably are going to be a lot of people who get COVID or some other infection
Health Chatter
Long Covid
And it's going to take them several weeks or maybe even a few months to get all the way better. But they may ultimately eventually return to baseline health. There is a subset of folks who are being disabled by these infections and their symptoms They may even seem like the acute infection resolves and they start having these new symptoms several weeks or even a few months later.
Health Chatter
Long Covid
And that's kind of this, it used to be called chronic fatigue syndrome. They now call it myalgic encephalomyelitis or ME-CFS. For those folks, their symptoms do not get better and they may even get worse to the point of disability. And what can hasten that trajectory is trying to push through those symptoms and trying to return to normal, go back to your exercise routine,
Health Chatter
Long Covid
You know, we've got, we see this in a lot of overachievers, frankly. They try to push through it and then they end up getting worse and worse. So definitely just pay attention and take it seriously. Stay up to date on your vaccinations and then seek that care and support if you need it.
Health Chatter
Long Covid
Well, I did want to follow up a little bit on Clarence's question, if I may. Sure. And just acknowledge that, you know, we know the pandemic had a disproportionate impact across communities for certain types of long COVID cases. People who have underlying conditions may be more susceptible to long-term complications.
Health Chatter
Long Covid
So there is a big equity piece that we think this is really kind of at the intersection of. It's interesting, we've heard anecdotally from a lot of our providers who work at the long COVID specialty centers that they are serving a very homogenous group of patients by and large. It's sort of the better educated, wealthy kind of suburban white folks who probably have more access to those resources.
Health Chatter
Long Covid
We do not think it's because they are being uniquely impacted by long COVID. We just know we are missing a lot of the folks who are being impacted by this.
Health Chatter
Long Covid
So that is part of why awareness is just a big priority for us because we know this is happening across communities, but because it's unfamiliar because of various stigmas around disability and how it's hard to talk about, maybe if your abilities have shifted, we're probably missing a lot of people.
Health Chatter
Long Covid
But we're certainly interested in understanding better how long COVID is impacting different communities across our state.
Health Chatter
Long Covid
Absolutely. We are learning a lot every week. Even there's more research coming out. There's still a lot that we don't know and definitely want to be real about that so that we aren't saying, oh, we're sure that this is the cause or this is the trajectory. And then we have to change that.
Health Chatter
Long Covid
Certainly the prevention piece is, of course, for public health. So that is top of mind. Evidence continues to emerge indicating that vaccination is protective against long COVID. It's not a magic bullet. It is not 100%. If you're up to date on your boosters, you're definitely not going to have long COVID, but it does show to have some protective factors.
Health Chatter
Long Covid
And the biggest waves of long COVID that we see are from the time before there were vaccines available. So several studies have come out even in the last few months showing that having those boosters is important as well. And it's really unvaccinated folks and folks who maybe only had one or two vaccines are having more long-term complications.
Health Chatter
Long Covid
So that is definitely one of the best tools in our toolbox to prevent long COVID is to continue staying up to date on vaccinations.
Health Chatter
Long Covid
You know, I think actually reformulating the vaccine to prevent long COVID, I'm not sure that that's necessarily the direction. You're right that it definitely can help reduce that severe infection, which will help reduce your chance of long-term complications.
Health Chatter
Long Covid
But there may be other means of prevention, and there are some clinical trials and other researchers exploring this, but things like Paxlovid during the acute infection may be protective against long-term complications. There have been some other studies showing potentially metformin during the acute infection can help prevent long COVID.
Health Chatter
Long Covid
So there are some other pieces in terms of treatment that may be protective as well. And that is one more reason why it's good to keep testing and keep those like rapid tests on hand because that can help increase access to those treatments and talk to a provider.
Health Chatter
Long Covid
Well, we do see, and Jay, feel free to tack on, again, these many symptoms that can crop up. One tricky thing about long COVID is that it's really an umbrella term that covers not only these symptoms, but some people will use it to describe other conditions that crop up after a COVID infection.
Health Chatter
Long Covid
So we are seeing some hints that people may be more susceptible to developing diabetes after a COVID infection. There may be other kidney issues, dementia. We also don't know the long term consequences of COVID infection. You know, you think of something like chickenpox later resulting in something like shingles or how polio 10 years later could have these chronic disease impacts.
Health Chatter
Long Covid
So we don't know what those really long term impacts of the COVID virus are yet. And also just from a non-clinical standpoint, there's research around some of the economic and just quality of life issues that people may experience if they have complications after COVID. So we know that for some people it's decreasing their quality of life. Stan, I'd argue you could be one of those people.
Health Chatter
Long Covid
Losing your sense of smell and taste, that erodes your quality of life. For people who just don't quite get back to baseline health, that impacts things like the economy, ultimately. We know a lot of people with long COVID lose their jobs or have to reduce their work hours. that impacts your wages and lost wages. And then finally, there's also just health care costs.
Health Chatter
Long Covid
You see people having more health care expenditures after a COVID infection. So there's also that impact and potentially people just needing more care down the road. So it is from there's the individual level, but then we can also think of it on kind of a systems and a societal level and even potentially impacting the global economy. Those estimates from Harvard are in the trillions.
Health Chatter
Long Covid
Yeah, and that group is, again, not a new phenomenon. Folks have experienced this after influenza as well, but it is a debilitating fatigue or even flu-like symptoms that crop up after any physical exertion or even mental and emotional exertion.
Health Chatter
Long Covid
Some people have what's called POTS, which is postural orthostatic tachycardia syndrome, meaning every time you change positions, your heart rate skyrockets and your blood pressure drops and you can even get dizzy to the point of fainting. So that's a result of your autonomic nervous system having dysfunction. And that could be damage from this ongoing inflammation from the virus.
Health Chatter
Long Covid
We're still understanding some of kind of those underlying mechanisms, as Jay mentioned, but these are really debilitating conditions. And so that's definitely of interest to us, that whole group of folks who have been largely ignored or even dismissed by medical establishment and really not part of public health so much, we cannot ignore them any longer.
Health Chatter
Long Covid
And whatever the next pandemic is going to be, because you know there's going to be another one in some of our lifetimes, this is going to come up again.
Health Chatter
Long Covid
NIH had over a billion dollars allocated for the RECOVER studies, which are kind of three part. They're doing observational studies of sort of the trajectory after COVID infection, but also looking at those underlying biological mechanisms. And there are several kind of going theories It's probably kind of a both and for some of these because long COVID is not just one condition.
Health Chatter
Long Covid
So they're trying to understand the viral persistence or the inflammation. For some folks, it's more like an autoimmune disorder. It seems to trigger the immune system to attack the body. There's theories around microclots. So they're trying to find those potential causes, but then also exploring some treatments that
Health Chatter
Long Covid
for hopefully not just symptoms, but as Jay mentioned, more upstream, what are the actual causes? So some clinical trials going on as well. There are folks who are looking at things like the economic impact, the workforce impact, impact on quality of life and disability claims.
Health Chatter
Long Covid
And from a public health perspective, as mentioned, we're just really interested in seeing how this is impacting communities and people after their COVID infection.
Health Chatter
Long Covid
Yeah, that's a great question, Stan. And actually, this is not a new phenomenon. There is long flu. There is.
Health Chatter
Long Covid
OK. Yeah. So post-infectious acute infection, chronic disease is not is not unique to COVID. In fact, a lot of the communities of folks who are disabled after things like influenza or other SARS viruses are MERS, a lot of viruses and some bacterial infections can result in these chronic diseases.
Health Chatter
Long Covid
So these advocacy groups, when the pandemic started, were the first to say, hey, you need to keep an eye out for these long-term impacts of this virus, especially as kind of a novel virus new to our bodies. And indeed, it looks like some of the earliest waves of COVID resulted in some of the biggest waves of long COVID as well.
Health Chatter
Long Covid
Stay up to date on your vaccinations. Keep an eye out for long-term symptoms after you're sick with COVID or any infectious disease and seek that help and support where you can. The last thing I will also add is we have a ton of good information on our website. We've got more background information there. We've got
Health Chatter
Long Covid
Lots of links to resources and support for folks, including clinics who have providers who know what's up about long COVID. So please do check out those resources. And one last plug for testing. There is the state of Minnesota currently still is sending free antigen tests to folks on a monthly basis. So you can go to sayyeshometest.org and order those tests.
Health Chatter
Long Covid
We are still seeing it with the more quote unquote milder variants like Omicron. But again, it's not a new phenomenon. But because of just the magnitude of infections and the number of people who have been impacted and even disabled by this, it's getting more attention than it has ever before.
Health Chatter
Long Covid
Go ahead, Kate. Certainly some people we know had co-infections with influenza and COVID. We also know there were probably a lot of people who did have COVID and maybe didn't get it confirmed by a test either because testing wasn't available. They didn't have access to testing. Maybe they tested once with a rapid antigen test, but it was too early for their viral load to actually be detected.
Health Chatter
Long Covid
So we do hear of a lot of people who are saying, well, I've got these complications, these issues that are happening, but I haven't had COVID, but I did have this really bad cough and respiratory infection and it just went on for weeks, you know?
Health Chatter
Long Covid
So that is one of the trickiest pieces, as Jay said, you know, one of the only things we know for sure about long COVID is that you had to have had a COVID infection first, and it can be really hard to actually confirm and measure who has had COVID at this point. Plus reinfections, you know, people are getting COVID two, three more times at this point.
Health Chatter
Long Covid
That's a good question. And there are still questions around sort of persistent positive tests because we know that for some folks, there's a window where it seems like it's resolved, but they're testing positive still. That said, we are seeing one of the going theories for long COVID is viral persistence.
Health Chatter
Long Covid
Now, particularly in the gut and in some other tissues where it might not even necessarily be replicating, but those proteins are still causing an immune response. And this inflammation and kind of over-response may be what's causing some of these subtypes of long COVID. So in terms of testing, I mean, you may not be still able to spread the infection if
Health Chatter
Long Covid
you know, it's gotten better, but I know that some of the guidelines for when to test and when to stop testing have shifted.
Health Chatter
Long Covid
I don't know if we know the answer to that yet. I think most people with long COVID do not generate enough virus that they could infect other people. It's interesting. They've experimented with even like COVID sniffing dogs and have found that these dogs can detect COVID in people with long COVID, but they test negative at that point.
Health Chatter
Long Covid
So they're not producing enough virus to spread the infection, but there's still some reaction going on inside their body. And indeed these dogs are picking up on it as well.
Health Chatter
Long Covid
Yeah, absolutely. And of course, that is what people always ask, like, well, then what if I think I have this or if I test positive for COVID, what should I be doing? And one, we do hope people keep testing because it is to confirm if you have a COVID infection or not and to tell a provider that you've tested positive so they can put it in your medical record.
Health Chatter
Long Covid
But also then just keeping an eye on symptoms as you recover. And if you have what seems like symptoms of long COVID, to talk to a provider if you can. Because of this nebulous nature of long COVID, a lot of these symptoms overlap with other chronic conditions. And so it is important that a provider rule out other things like diabetes or a thyroid issue or something else going on as well.
Health Chatter
Long Covid
I think the most extreme dramatic case of that we've heard was somebody who thought they had long COVID and kind of avoided care, but then it turned out to be a brain tumor. So you don't want to miss something really serious that's going on underneath if you're having these symptoms. And also, providers are still learning about long COVID.
Health Chatter
Long Covid
MDH is really trying to help spread the word about long COVID, including to providers, but there are providers out there who can help manage and even relieve some of the symptoms of long COVID. There are some medications, different therapies, even changes in diet that people can do that can help alleviate some of the symptoms of