Will vaccines protect us from ‘long-haul Covid’? We need answers | Long Covid
Since the earliest days of the pandemic, members of disability and chronic illness communities have warned that Covid-19 could be a mass-disabling event. Yet media stories and policy decisions have continued to focus on hospitalizations and deaths, largely ignoring “long Covid” – the patient-preferred term for the long-term symptoms that some patients have experienced following what can begin as a mild Covid infection. Pharmaceutical companies, health agencies and governments are confident that vaccines can decrease hospitalization and death rates, eventually ending the pandemic. But few are discussing long Covid within the context of vaccines or the pandemic’s resolution. Those of us who have experienced the long-term symptoms of Covid-19 find ourselves erased from the narrative once again, and wondering: can the vaccine prevent long Covid, and to what extent?
Discussions of Covid vaccine efficacy have focused on the vaccine’s ability to prevent severe illness, death and hospitalization. On 24 February, the New York Times reported that the Johnson & Johnson vaccine “strongly protects against severe illness”. Earlier this week, the Times’ David Leonhardt wrote of J&J’s vaccine: “The picture is murkier for mild cases, but they are not particularly worrisome.” (Full disclosure: I have done work as a video producer for a Covid news show produced by Johnson & Johnson.) The Centers for Disease Control and Prevention website states that the Pfizer-BioNTech vaccine appears to protect against “more serious outcomes” such as hospitalization or death. In a recent New York Times op-ed, the Georgetown University virologist Dr Angela Rasmussen explains that the purpose of the vaccines “is to prevent death and serious health complications that strain our overburdened healthcare system. This is undeniably good news, but it does not account for long-term outcomes from asymptomatic or mild infections.
A recent study from the University of Washington found that 30% of Covid patients surveyed still had persistent symptoms at nine months. The study is unique in that a majority of the patients surveyed (84.7%) “were outpatients with mild illness” as compared with past studies that have focused only on hospitalized patients. “Our research indicates that the health consequences of Covid-19 extend far beyond acute infection, even among those who experience mild illness,” the University of Washington researchers write.
Paola Garcia, 39, in New York, told me that her initial Covid symptoms mimicked those of a mild cold or flu; she dealt with a low fever, fatigue and mild shortness of breath, among other initially manageable issues. But those symptoms never went away. Garcia got sick on 20 March last year, and in addition to the symptoms she experienced at first, she has developed more serious symptoms, such as tremors, pericarditis, temperature dysregulation, hair loss, weight loss, nausea, fatigue and cognitive functioning issues.
Garcia is one of many long Covid patients who recall the early days of their virus as initially mild. Donn Seidholz, 67, in Omaha, told me that he tested positive for Covid-19 on 12 August after experiencing migraines, fatigue, brain fog, loss of taste and smell, and a racing heart. Seven months later, he still has not regained his sense of smell or taste, says his brain fog has become “debilitating” and reports ongoing and intermittent fatigue. Seidholz’s experience is common to many long Covid patients, and in some cases, mild symptoms can even lead to death.
Given the lasting potential impact of a mild Covid infection, the conversation around vaccine efficacy must consider whether the vaccine can prevent mild disease and infection. That being said, when trying to determine the prevalence of long Covid among non-severe cases, it is important to distinguish between non-hospitalized or “outpatient” cases and patients with initially “mild” symptoms. While some Covid patients weren’t hospitalized because their symptoms were mild, others were turned away due to overwhelmed healthcare systems, medical bias, or both.
“My symptoms were not mild,” says Leigh W Jerome, who sought care for Covid in New York in March and was sent home without a PCR test or medication. “I was told that in normal times I would be admitted, but these were not normal times.” She went on to develop bilateral pneumonia the following week, but remained untreated until September, when she began connecting with clinicians who had been recommended by other long Covid patients in the support group I run.
Because long Covid is new and widespread awareness is still limited, it’s unsurprising that discussions about vaccine efficacy and the pandemic’s resolution are failing to consider long-term illness and disability. But there are scientific and historical precedents for the idea that viruses can have…
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