Stan and Clarence chat with Dr. Jay Desai and Kate Murray about long covid.Dr. Desai - experienced epidemiologist - serves as the Section Manager of Chronic Disease and Environmental Epidemiology at the Minnesota Department of Health.Kate Murray serves as a Program Coordinator for Long Covid and Post Covid Conditions at the Minnesota Department of Health.Listen along as these two share their wealth of knowledge on the lasting effects of covid.Join the conversation at healthchatterpodcast.comBrought to you in support of Hue-MAN, who is Creating Healthy Communities through Innovative Partnerships.More about their work can be found at http://huemanpartnership.org/
Welcome to Health Chatter. Today's show is on long COVID. And we've got two great experts with us today that will be sharing their thoughts about it. We've got a great crew that always puts our shows in really good, good shape. And they include Maddie Levine-Wolf, Aaron Collins, Sheridan Nygaard, Deandra, Howard, and Matthew Campbell. Thanks to all of you guys.
They either are involved in research for the background for the show or marketing or production. So it's a great, wonderful crew and thank you very, very, very much. Clarence Jones is my partner in crime on this show. It's a great, great honor to work with him. Wolde's episodes. This is episode 68, which is amazing. We've been at it that long. So Clarence, it's always great. So thank you.
And then of course, there's Human Partnership, which is a community organization involved in health issues in our community. They're a great organization. They help sponsor our health chatter broadcast for you, the listening audience, to thank you To them, you can check them out at humanpartnership.org. So thank you to everybody.
So, all right, today we have two great guests, colleagues of mine that I have worked with for a long time, Jay Desai and Kate Murray. Jay heads up the chronic disease epidemiologist at the Minnesota Department of Health.
He received his doctorate in epidemiology from the University of Minnesota, currently leads the Minnesota Department of Health Long COVID Program, along with other things, sickle cell data collection, Minnesota cancer reporting system, et cetera. He's been involved in a lot of things.
I worked with Jay when he was at the health department on his first round, when he was involved with the diabetes unit, and we were great, great colleagues. I've always been impressed with Jay because somehow or other, he always asks the good, hard question. And we don't always have the answers, but at any rate, he always asks some really great questions. So thanks, Jay, for being with us.
Kate Murray, Program Manager for Long COVID and Post-COVID Conditions at the Minnesota Department of Health. She spent a long time dealing with COVID at the Department of Health, a 20-month assignment at the Department of Health when everything was going kind of crazy and everything was, there were a lot of things to do for sure.
She holds a Master of Public Health in Administration and Policy from the University of Minnesota and a Bachelor of Science in Biology and Health Sciences from South Dakota State University. So I want to thank you both sincerely for being on Health Chatter. So I'm going to start this off by asking this simple question. Long COVID. So here we go.
It's like, I don't understand why we don't have long flu, long cold. long allergies, long whatever. So what is this deal with long? Is it just something that was dubbed for COVID? Or what's the deal here? Where did this long idea come from? Because people get sick and they have these symptoms afterwards on a lot of different, a variety of different diseases and entities. But
Why long specifically for COVID? Do either one of you have an idea on that one?
Yeah, that's a great question, Stan. And actually, this is not a new phenomenon. There is long flu. There is.
Oh, there is.
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.
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.
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.
So this idea of long is not new, but maybe it's more in front of our faces just because of what COVID did for all of us. All right, so Jay, pick this off. What exactly is long COVID?
My that's that's the question that we're still trying to figure out. Right. And so there are a couple of definitions that get used out there. One is by the CDC. And it is a definition of people still experiencing symptoms after a covid infection. So you have to have had covid four weeks or longer. after a COVID infection.
So after the acute phase and those symptoms, there's a whole variety of symptoms that we can get into that later. I mean, there's probably over 200 different symptoms that have been reported and some are more common than others. The things that you hear about loss of taste, loss of smell, brain fog, fatigue are some of the more common ones that you hear, but there's still a variety of symptoms, um,
So four weeks or longer is the CDC's definition. The World Health Organization has a definition of 12 weeks or longer, so about three months. where the symptoms are persistent for that length. So in general, those are sort of the predominant definitions of long COVID, of what we'd be looking for. But again, it is a symptom-based condition right now.
There isn't a biologic test that you can take that tells you whether you have it or not. It's just how these different symptoms present and how long they last.
So who tells you, in other words? And I'll talk about that because I have one of them, And it's an interesting one. Clarence, go ahead.
Yeah. So I'd like to go back again, Jay, to what you were trying to talk about, some of the symptoms of long COVID. So when you get COVID, can you tell if you're going to have just regular COVID or long-term COVID?
You know, some of the symptoms that you have during the acute phase, so within four weeks after being infected, some of those continue to persist. beyond those four weeks or even beyond the three months. So often those symptoms can be very similar. But then there could be symptoms that come up that you didn't have during the acute phase as well.
And so that's what also makes it kind of challenging is you could have some new symptoms that are presenting or that just you begin paying attention to and recognizing after your acute symptoms have gone away, that you've still got some of these lingering things like fatigue, um, that you don't expect to have. So, um, so they can be similar. They just carry on.
Yeah. Let me, let me, let me, let me go a little bit further. I think a lot of people during this period of time, um, didn't get COVID, but they had some other kind of strange things happening during this period of time. Were there other viruses that came up during this period that we don't talk about as much?
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.
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?
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.
Yeah, and this is a concern that is probably going to be growing as we aren't testing as often. And so people are going to be feeling these symptoms, right? They may be mild, moderate, may even be asymptomatic, but could still be related to COVID. We're just not testing for them anymore.
And so just trying to be more aware that if you feel bad at some point, and then it continues that maybe there was something COVID related that happened.
So let's talk about testing a little bit because I certainly remember when I was at the health department, all the different types of testing, everything from the tests not being available yet to tests where you would go to a clinic or a particular site, all the way down to at-home tests. And one of the things that...
that really was curious to me was, you know, access, you know, this whole, this whole idea of access to the tests, you know, like, I remember, you know, schlepping to the airport, because, you know, my wife and I, we had to get over to Israel, because a family member had passed away, we had an Oh, my God, the testing that we had to go through before traveling, and then when we were there, and then before we came back, and
I also remember, and this is me talking now, I also remember at the very, very front end of COVID, I had a cough that I swear to God, it must have lasted forever. It just seemed like it would not go away. And this is before COVID really started hitting the scene, so to speak. And so now I reflect back and I'm thinking, Wow. Might I have had it back then. All right.
So let's talk about long COVID as it relates to testing. Okay. So it's like, for instance, if I were to have long COVID, should I continue to test every once in a while just to see if I'm harboring anything? Or should I just go with the flow at this point?
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.
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
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.
Okay, so Kate, so for our listening audience, if you have symptoms of, you know, any of the symptoms, we'll get into that in a moment here, any of the symptoms of long COVID, but you're over that acute stage, is it fair to say that you are not contagious?
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.
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.
Yeah. Well, my dog has not picked up on it for sure. Okay. Clarence, go ahead.
So, you know, this is really kind of an overwhelming topic. Okay. Let me tell you why, because Jay has already said, Kate, you probably too have said you got over 200 symptoms. you know, that would indicate this. And, you know, with so much going on, I mean, it seems like, well, even if a bump comes up on my nose, I mean, should I be testing for COVID? I mean, it's, you know what I'm saying?
I mean, it's like, it gets to be very, very overwhelming. And so my question to you You know, in very simply and I come and I come from a community perspective is, you know, really, what should we be doing? I mean, you know, you know, saying we know that it exists. We know that it impacts us. I mean, what should we really be doing? I mean, there's so much fake news going out here.
You know, it's good to hear from you what, you know, bottom line kind of sort of what we should do.
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.
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.
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.
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
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.
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
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.
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,
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.
So, all right. So here's a personal story. So for listening audience, I, my wife and I both got COVID when we were on vacation up in, in Alaska. And, you know, of course you gotta go through the whole nine yards of isolating and that whole thing. For my wife, she got over it and that was it. For me, I lost my sense of taste and smell. Okay, so now at first,
I asked myself, well, geez, you know, this isn't so unusual because I have allergies, too. You know, and sometimes when you have allergies, you can't always smell really well or taste very well. But now it's been lingering on. And it's an interesting phenomenon because you still feel hungry. You know, you want to eat.
But you could be eating garbage for all that matter because you can't taste anything. There are certain things though, for those of you who might be suffering from this, there are certain things that have a tendency to help. Lemon drops, believe it or not, because it has a stronger taste to it, helps. And it also helps to create more saliva. And also ironically, I can taste pickles
of all things, you know, so between lemon drops and pickles, I'm having a really hell of a good time. But it is, for those of you who have these particular symptoms, it is getting better. It's slow, but it's getting better. The other thing that I've noticed, and this would be something to maybe look into is what your brain remembers. Like my brain remembers a good chocolate bar.
It really remembers that. And so even though I might not taste it, physically per se, when I chomp down on a good chocolate bar, I can kind of taste it because I think my brain is telling me what I should remember. OK, so I think it works hand in hand with these things. The one thing you have to be careful of, though, with certainly with taste and smell is if you can't smell for sure.
It's like if all of a sudden you have a gas leak or something in your home, you have to be really careful. OK, because I I'll tell you right now, I wouldn't I wouldn't smell that. OK, Clarence, take it away.
Jay, I want to talk to you about research. Okay. Is there a certain demographic that is experiencing long COVID more than other people? Well, I think when COVID first came out, you know, it was a lot of the older people they got, you know, they got it, those kind of things. But now with long COVID, is there a demographical shift or is it the same or is it all over the board? What do you see? Well,
So everybody can get COVID, right? So people talk about COVID is just like the flu, but it's not like the flu, right? The flu and some of those other respiratory viruses tend to impact much younger children and much older adults, people whose immune system is probably not fully developed or compromised. COVID affects all age ranges and perhaps in different ways because of underlying mechanisms.
So the working age adults are also the ones who are really feeling it. We don't With long COVID, there may be symptoms in younger children, but we don't see a lot of that. But we do see it within adolescents. So people who are 11, 12, and going on up, they tend to recover more quickly.
But some of them can still be really impacted, particularly those who are involved in different kinds of sports activities really need to be careful and pay attention to that. So, I mean, generally speaking, I would say, yes, it impacts everybody across the ages, but some may have more significant impacts, probably also because of the kind of activities they do and the work that they do.
And I want to get back a little bit to the question about symptoms and that there's a lot of different symptoms. As Kate mentioned, really the key is not ignoring, not trying to ignore that if you're feeling more tired than usual, if you maybe can't concentrate, that really paying attention to that.
and those symptoms, and talking to your doctor about those, because often people don't, because they might be more mild or moderate, but they are still impactful on your everyday life. So paying attention to those.
All right. So Kate, chime in here a little bit, okay? Because I know that you've been involved with this, you know, with everything public health oriented wise, and the response to it wise. So Chime in here on, all right, what is it that the essence of what we really need to know around this whole thing at this point?
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.
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.
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.
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.
But we're certainly interested in understanding better how long COVID is impacting different communities across our state.
I appreciate that because I think that part of what you just said was that for a lot of folks, and I think one of you mentioned this before, a lot of people are so interested in just pushing through it. You know, it's just like, well, you know, life is tough anyway. You know, so I mean, I'm already feeling fog brain, you know, just those kinds of things. But in terms of
experiencing those things, you know, we want to know that if we are experiencing those things, is it, can we spread it? You know what I mean? I mean, we just don't know. And I think that that's what's good about this conversation is that we're just chatting about this and we understand the uncertainty about a lot of stuff.
I mean, you talk about a lot of things that, you know, even now you're uncertain about, or we're uncertain about, or the scientists are uncertain about, and it's good to be able to say that.
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.
So, Jay, you know, grants, you know, so I don't know where the grants are coming from to like the Department of Health. Are they CDC oriented grants or? NIH or both. But my question is, what are the questions that we are really, really focusing on on the front end here, research-wise, and hopefully getting some answers?
So like in the research that the two of you are involved in right now, what's, I guess, what are the defining questions? Because apparently there are a lot of them. but what are the defining questions for the grants and the research that you guys are doing?
So, you know, there's, they're similar for a lot of things, right? First of all, can we even, is there even a clinical definition? Can we even identify what long COVID truly is? And, you know, we gave you a definition that was time-based between- Right, four months or whatever, yeah. But other than that, it's really broad because there's so many different symptoms.
There's just so much we don't know. And so since we don't really have a clear clinical definition or from a public health perspective, what we call a definition where we can monitor it on a population basis, we also don't have a solid sense of evidence. What's the real burden of long COVID in our communities?
We hear numbers ranging from anywhere from 5% to 30% of people may be experiencing these longer-term types of post-COVID symptoms. But from a researcher perspective, that depends on the kind of study that was done, the population you're studying. I mean, there's all kinds of other factors. And since there's not a test, we just don't have a clear idea of what the real burden is yet.
So we're still working on that. So that's the first question. The second question is, what is the underlying cause? You know, what's going on with long COVID? And, you know, Kate can talk a little bit more about this, but, you know, right now there's at least three different kinds of, it may be multiple things going on, multiple underlying causes, right?
um and so it's not just one thing right we know that it gets triggered by covet with the infection but it could cause different pathways within the body that lead to different symptoms um and so we're trying to tease that out the providers that we work with are trying to tease that out because then it gets on to the next question what do you do about it yeah right and um and so that so those that's the next question and right now
you have to understand sort of the cause. Right now you're treating symptoms that people are having and using methods to treat different symptoms. And so there's still a lot. We don't have... a cure or anything like that for long COVID yet.
So that's where research is going on too, trying to figure out what kinds of treatments are out there that can maybe minimize the symptoms that people are feeling and, and, and help it go away, you know, other than at least for the beginning part, making sure people rest and those kinds of things. But yeah, So there's these research questions that you're talking about that are driving interest.
We don't have answers to those yet. We're still working on that, trying to figure some of those pieces out. So this gets back, Clarence, to your comment about transparency and just being honest about what we know and what we don't know when we're talking about this.
I appreciate that. Let me ask, let me do a follow up question. the long COVID versus the vaccination rates, okay? People that are experiencing long COVID, how many vaccines did they take? I mean, do people that have taken less vaccine get long COVID more than people that have taken more vaccines? I mean, I don't know. I'm just I'm just trying to figure it out.
I mean, we have to I think we have to five vaccines now. Right. So if you get five, maybe you won't get it. I don't know. But I'm just but those are the kind of questions people are going to ask. Like, well, if I take enough vaccines that I won't get it. And I mean, so can you help me?
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.
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.
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.
Thank you. So do you think that, you know, from a prevention standpoint, vaccinations hopefully will prevent you from getting it, or if you do get it, your case hopefully will not lend itself to you being hospitalized or the severity of it would be reduced significantly. Do you anticipate that vaccines down the pike will focus on some of these symptoms that we're seeing for long COVID as well?
And put that, put those, whatever they're able to do, into the vaccine so that not only can you prevent from getting it, but if you do get it, you're not gonna have a severe case. And hopefully you won't experience some of the long COVID experiences. And use me as a guinea pig, for God's sakes. I mean, I've been up to date on vaccines in the whole nine yards. I get COVID, okay?
Fortunately, it wasn't severe in my estimation, but yet I have long COVID, a long COVID symptom. So I'm just wondering, might the research lend itself to preventing the disease altogether, and if you get it, mild and addressing symptoms? Do you think that that's down the pike or who knows?
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.
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.
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.
Yeah, yeah.
Clarence?
I want to ask this question. So there are a lot of people that are not dealing with COVID or long COVID, right? I mean, they just taking it through. What are the health issues that will emerge besides death for people that don't address this issue? Because I'm telling you, there's still people there that say it's fake news and all this kind of stuff.
And so by not addressing this issue, not being open about it, what are some of the major issues that will emerge, health issues that will emerge as a result of not taking care of this issue? Besides death.
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.
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.
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.
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.
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.
I think one of the symptoms that I've noticed is that I'm adverse to mowing the lawn. It just came out of nowhere.
You still walk Murphy, though. You still walk Murphy. Yeah, yeah, yeah.
Go ahead. Kate actually read my mind when she was talking about some of these other economic issues. And we need to pay attention to those on an individual level also.
You know, if you are experiencing some of these, you know, within shortly after the acute infection, some of these issues around not being able to think about getting tired and you're pushing through it because you have to work, right? We have certain populations that can't afford not to work. They don't have paid leave. Right.
And and and so but they go and by the end of the day, they're just exhausted or even in their work. It could be dangerous. Right. If you're not thinking straight anymore. And so you do need to pay attention to that. And we're working to help providers recognize that, too.
Because then you may need some documentation to work with your employer to get some accommodations, whether it's shorter hours, some breaks, some other things, right? These are real life issues that people are experiencing some of these symptoms, even though they may resolve after a while, during that short term period, these are still significant things they have to take care of.
And then for the long-term stuff, as Kate knows, because we get testimonies from people writing into us all the time, there are people who just have to stop working, period. The disability is so bad because of this. that that's a whole nother group, you know, who are severely impacted that we have to think about how do we support them clinically and at home moving forward.
I don't know, Kate may have more to add to that.
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.
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.
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.
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.
Yeah. So let me do this real quick. This is just to satisfy my curiosity, okay? What are some of the ongoing studies around long COVID? I mean, I'm just interested in what's being studied about it.
You mean, like, are you talking more the clinical side of things?
We're going to get more clinical. We're going to get some of the research-y kind of things.
There's so much out there.
I know, I know. Just a couple. Just a couple is fine.
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.
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
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.
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.
You know, one thing that's really struck me is the effect that COVID overall has had on our lifestyles. So think about just how we go about doing work now, okay? We're not interacting in person anymore. I mean, everything, you know, a good portion is done via, you know, Zoom, for instance.
And I just wonder whether or not that might be studied as well, the social impact that COVID in the long term has or will have on all of us going forward. There are occupations that obviously require person to person contact.
But, you know, it's like if I were at the health department now, and if I had a question, you know, for either one of you, I just, you know, it'd be nice to just be able to, you know, run over to your office and say, hey, you know, JAK, what do you think? That doesn't exist or it doesn't exist in the same way. And I just wonder whether or not long COVID will address that type of thing as well.
So, Stan, what you're bringing up is probably a podcast in and of itself.
Absolutely.
Talking about how people are being the whole... hybrid teleworking situation and how that's impacting whatever on so many different uh levels uh not just sort of the the biologic level um and uh so yeah that that's that's a great podcast topic
Yeah, and there probably isn't a lot to talk about yet because we don't know the answers yet.
Well, you know, I mean, we talk about stuff, right? I mean, when we were young growing up and starting our careers, it was having those mentors that you could be in person with. It was your colleagues that were young like you that you would start networking with, right? All that kind of stuff is changing.
In terms of, you know, the role of long COVID in that, you know, I'm not, I think that's kind of a separate issue. And, you know, how COVID has changed our health behaviors, I think, and how that might impact long COVID. As you mentioned earlier, we still are struggling with this idea of misinformation around COVID, different access and awareness within particular communities, issues around
whether people should get vaccinated or not, right? So those kinds of things that have come up because of the COVID pandemic, we're still trying to figure out how to address those and what the impact of that is gonna be on long COVID, right?
If people aren't getting vaccinated, if people can't go in, not only to get tested, but to get vaccinated and then to perhaps even talk to a provider about this, where even providers may not be fully aware of what's going on with long COVID. I think those are all things that and then and then COVID fatigue. All right. The pandemic fatigue.
All these things are significant public health and individual level issues that we have to combat and that could result in, you know, More long COVID than there needs to be, right? More COVID than there needs to be, more long COVID than there needs to be, unless we can start figuring out ways to bring it back into people's frame that it's still a significant issue.
Just because it's not as much COVID going on as there used to be, it's still there and it's not going away.
Yeah, yeah.
You know, I thought it was interesting when you talked about COVID fatigue. It just kind of, you know, in my mind, it just went two different places. Yeah, we do have fatigue from COVID, but we also are fatigued by all the COVID information. Right. You know, so it's like, man, you know, at some point, like, you know, let me just die. I don't know. I died, but you know what I'm saying?
Let me just, you know what I'm saying? It's just, it's, but I think it's important to continuously try to find ways ways to engage people in a positive information so that they can understand how important and how vital this information is. And I mean, so, yeah.
Yeah. And I mean, there's still there's still things that came out of the pandemic that we're slowing down on. Right. We're we're behaving as if we did before the pandemic, not that, you know, this might be the season when everybody's getting together and big family get togethers or going out to concerts or events. And, you know, you might want to think twice about some of that still.
The idea of masking, if not, you know. For others, at least, you know, well, for others, right, if you feel like you're getting sick or something, staying away from others, masking, you know, those things are still going to be helpful. But we're not really thinking about that stuff as much anymore.
And from a long COVID perspective, those are things that can help reduce or prevent the onset of more long COVID and then long COVID. Stan, you're on mute.
I put it on mute because Murphy was barking. So here's an important thing for all of us. It's we as human beings don't get sick just from COVID or we don't continue to get sick because of COVID. of just because of long COVID. We get sick from other things too, okay? And we shouldn't ignore those things. You know, I certainly was aware of that, you know, working in the cardiovascular unit.
It's like, you know, people didn't show up at the emergency room with, you know, potential stroke or heart attack because they were thinking that, you know, I don't wanna get close to anybody who's got COVID. But we as human beings get sick from other things too. What I think is encouraging, I mean, there's always a silver lining here.
You know, for years and years, when you work in the health department, there's kind of like the infectious disease unit is over here, and the chronic disease unit is over here, right? And, you know, it's like, yeah, you know, they're great colleagues, but you don't talk that much. Okay. This would be perhaps a way that we really do talk because COVID certainly has implications.
If you're diabetic or if you have heart disease or chronic disease, it can complicate that. And so this might be a true opportunity to really link all the different health entities that we deal with together and and use COVID as the excuse. I don't care, but maybe the time has come that we do do that.
You know, Stan, you know, let me say this real quick. You know, Jay, when you were introduced, Stan said you were, you know, you were the epidemiologist. And I couldn't spell that word for a long, long time anyway. But, you know, chronic diseases. How is this, you know, you said sickle cell. I mean, you just started, you know, Stan missed a whole lot of things that are underneath your leadership.
How has it affected those issues or those diseases? Yeah. Is there anything that has emerged that you want to, I mean, that you're gonna talk about? Any particular disease?
Well, not a... a disease in particular, you know, I mean, we did mention earlier that it looks like, um, the virus itself may be impacting issues around diabetes, uh, blood pressure, kidney disease, stroke, Kate mentioned microclots potentially what it has done. And then a lot of these other conditions, obviously cancer, asthma, diabetes, blood pressure, um,
Sickle cell disease, you know, these are all conditions, chronic conditions that make you more susceptible to infection and to other things, right? So there's more, hopefully more attention to that, right?
One of the things for diabetes has always been getting an annual flu shot and getting a pneumonia vaccination on a more regular basis, but people don't do it, even though, you know, it's an issue. So maybe COVID can help raise the profile. It's going to be added to that.
Correct, correct.
Yeah. But what it has allowed, I do think both in our public health world is to have more conversations across conversations around the relationships between chronic disease and infectious disease, post-infectious disease. And so I think there's a real opportunity for us to grow that kind of connection moving forward.
And by the same token, I think that's gonna be happening within hopefully the healthcare provider system too. Because that's still, just as we are in public health, When you're looking at something like an infectious disease, you're not necessarily thinking about other chronic conditions or potentially longer-term chronic conditions, but now you need to.
So I'm not sure that that's, you know, there's obvious changes yet, but I can see it as an opportunity to grow some of the more collaborative, more thinking about that together moving in the future.
You know, I never heard the connection between the shots that you mentioned and diabetes. Oh, I've never heard that. I mean, I think that's that's that's quite interesting information for me.
Yeah. And, you know, I started working in diabetes in 1995 and it was a recommendation back then. And it's now almost 2025. And you haven't heard about it. You know, it's like I don't know what to say.
Kate, last thoughts.
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
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.
Great, great. Well, you know, I thank you both. This is an ongoing subject. I hope that we can put some of the information from the health department on our website so people have access to that information through another venue. I hope too that Kate and Jay, you'll be in contact with us with a simple email. Stan, we got to do another podcast quick because we got some really good information
that I think the public would be interested in. So we reserve that right one way or the other to circle back to you on COVID. With regards to vaccinations, I've been reminding people to get vaccinated. People are spending more time, like Jay had said, indoors now because it's starting to get a little cooler. which increases the possibility of spread of illness.
So now's a good time to get vaccinated, cross-check with your physician on flu, COVID, RSV vaccination, and also pneumococcal vaccinations as well. I do encourage you to check with your physician beforehand. With that, I would like to say thank you to everybody for listening to our show. Our next show will be on the cancer plan from the state of Minnesota.
We talked about some of the various other plans, and now we're going to be focusing on cancer. That's the next show for Health Chatter. So everybody, keep health chatting on.