The Times - UK (2020-10-15)

10 2GM Thursday October 15 2020 | the times

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Anybody could be at risk from so-called

long Covid which appears to affect

organs throughout the body, according

to the first expert review of the

condition.

Tens of thousands of people have

reported lingering symptoms after

infection with Covid-19, whether or not

they required hospital treatment.

Young children, elderly people in

care homes and members of the

military are among those who have

been affected, researchers said.

“We cannot assume that groups who

are at low risk of life threatening disease

and death during acute infections are

also at low risk of ongoing Covid,”

Elaine Maxwell, the report’s author,

said.

“There are people who never had any

support in hospital, never had a test,

have no record of ever having had Cov-

id-19, except their own personal history.

that people may be suffering from more

than one syndrome at the same time,

further complicating the picture.”

While warning against overuse of the

term long Covid, the researchers called

for a working diagnosis to be coded into

patients’ health records if they believed

that their symptoms were linked to

the virus, whether or not they had ever

tested positive. This, they said, would

Seasonal cheer A passer-by can’t resist a snap of a lush harvest display outside a restaurant in St Albans, Hertfordshire

Long Covid can affect even those

who had virus mildly, study finds

Kat Lay Health Correspondent They may be suffering far more than
somebody who’s ventilated for 21 days.”
The review, Living with Covid,
published today by the National Insti-
tute for Health Research, involved
evaluation of scientific studies on
patients with lingering problems
post-infection, and interviews with
those patients.
The reviewers concluded that there
could be four separate syndromes.
Patients who required intense hospi-
tal treatment might be suffering from
“post-critical care syndrome” in which
the body becomes deconditioned
through lack of movement. Others
might have post-viral fatigue, perman-
ent organ damage, or long-term Covid
consisting of a “rollercoaster” of symp-
toms that “move around the body”.
Patients commonly report symp-
toms arising in one part of the body,
abating and then new symptoms in a
different part of the body, they said.
Dr Maxwell added: “We also suggest

allow better research from a fuller pool

of participants and more concrete

conclusions on how best to help those

people.

Dr Maxwell said: “People without a

clear diagnosis told us they’re often not

believed by health services.

“We were told that someone diag-

nosed by their GP as having long Covid,

who is in month seven [of the illness],

called an ambulance because of a new

symptom and fainting and dizziness,

and was told by the ambulance crews

that it was caused by a panic attack.”

Last week Sir Simon Stevens, chief

executive of NHS England, announced

£10 million of funding for long Covid

clinics that he expected to see “hun-

dreds of thousands” of people.

Dr Philip Pearson, a review steering

group member, said: “We mustn’t

assume long Covid is all one thing, or we

run the risk of falling into the trap of...

applying to patients a sort of ‘one size

doesn’t really fit anyone’ kind of plan.”

Lingering symptoms

Shortness

of breath

Foggy

thinking

Persistent

loss of sense

of smell

Racing

heartbeat

Fatigue

Aching

joints

Damage

to heart,

lungs,

kidneys,

and brain

PETER CZIBORRA/REUTERS

Equal risk to

life for men

and women

Katie Gibbons

Men and women are as likely as each

other to die of coronavirus, researchers

have found.

The study also showed England and

Wales to be among the countries with

the highest numbers of excess deaths

during the first wave of the pandemic.

A team at Imperial College London

analysed weekly death data from 19

European countries plus Australia and

New Zealand between midFebruary

and the end of May.

Alongside Spain, England and Wales

experienced the largest increase in

mortality, with nearly 100 excess

deaths per 100,000 people, they found.

When compared with the number

expected without the pandemic, this is

an increase of 37 per cent for England

and Wales and 38 per cent for Spain.

In Scotland the rate was 84 per

100,000 people, 28 per cent more than

the average expected deaths.

The results, published in the journal

Nature Medicine, showed little differ-

ence in death rates for men and women

— 105,800 deaths were men and

100,000 women, despite coronavirus

having a more severe effect on men.

Majid Ezzati, a professor at Imperial’s

school of public health and senior

author of the study, said the figures

could be the result of missed diagnoses

in care homes. “In some countries the

number of women in care homes is

larger. Testing may have been quite

restricted there and it may be that some

infections were missed,” he said.

He added that women tended to live

longer than men, and other medical

causes may have contributed.

The study contradicts a large body of

data that found men were more likely

than women to die from the disease.

Jonathan Pearson-Stuttard, a co-

author also from Imperial’s school of

public health, said the first wave had

shown “just how frail and vulnerable

our society and our economy is to our

public’s ill health”, adding: “On many

aspects, our public health has lagged

behind other countries for some years.”

The researchers said nations with the

most excess deaths were those that had

had lower investment in healthcare.

Pandemic caused rise in heart disease deaths

Katie Gibbons

Hundreds of people under the age of 65

have died from heart and circulatory

diseases as a direct consequence of the

pandemic, a charity has calculated.

During the first peak there were

almost 2,800 deaths in the under-

age group where the underlying causes

were heart and circulatory diseases, an

analysis of official data for England and

Wales shows.

This is about 420 more deaths than

expected. From May to July almost

3,100 deaths were registered in this

group, about 350 more than expected.

The British Heart Foundation said

that there were no excess deaths

between January and March. The char-

ity said that the number could rise,

however, as the NHS faces a second

surge of Covid-19 cases amid the usual

winter pressures.

It urged people to seek medical help

if they had any troubling symptoms.

Sonya Babu-Narayan, the charity’s

associate medical director, said: “These

figures further highlight that delays in

care are likely contributing to more

deaths than we would expect to see.”

She said that it was “vitally important

that people don’t let the fear of catching

coronavirus put them off seeking medi-

cal help”. The warning comes as leading

respiratory charities called on the NHS

in England to outline how it plans to

address the growing backlog of basic

care. Asthma UK and the British Lung

Foundation said that winter was the

deadliest season for people with lung

conditions. The organisations said that

basic care was the best way to prevent

hospital admissions for such people.

Alison Cook, director of policy and

external affairs at the Royal College of

Surgeons, said: “Failure to prepare for

the predictable seasonal spike in respir-

atory admissions, by ensuring people

with lung disease are as well as possible,

could threaten to overwhelm the NHS

this winter.”

Alert on herd

immunity

Eighty experts have written to The

Lancet arguing that the herd

immunity approach to the

coronavirus is a “dangerous

fallacy” that is “unsupported by

scientific evidence”.

They said it was critical to act

decisively and urgently and called

for measures that suppress and

control transmission, supported by

financial and social programmes

to address “inequities that have

been amplified by the pandemic”.

The signatories include Charles

Swanton, of the Crick Institute,

Trisha Greenhalgh, of Oxford

University, and Devi Sridhar, of

the University of Edinburgh. Their

letter refers to “renewed interest in

a so-called herd immunity

approach, which suggests allowing

a large uncontrolled outbreak in

the low-risk population while

protecting the vulnerable. They

say that there is no evidence for

lasting protective immunity to

Sars-Cov-2 after natural infection.

Instead, they say, waning

immunity as a result of natural

infection could result in repeated

waves of transmission over several

years and put vulnerable

populations at risk indefinitely.

Students skew results

Some areas could be pushed into a

higher tier of Covid-19 restrictions

by positive test results from

students that are wrongly recorded

against their family home address

when they are away at university,

experts warned. Richmond council

in southwest London saw cases

rise from 78.8 to 130.8 per 100,

people in two weeks but said that

16 per cent of its cases involved

students living away from home.

Lockdown pollution fall

Global carbon dioxide emissions

fell by 9 per cent — or 1.5 billion

tonnes — in the first first half of

the year compared with last year,

with transport pollution down by

40 per cent, a study published in

Nature Communications found. In

April, when many large countries

were in lockdown, emissions

dropped by 17 per cent but they

had returned to normal levels by

July, the academics reported.

‘Moonshot’ diverted

A pilot study for Operation

Moonshot that tested people who

showed no symptoms of Covid-

has switched to symptomatic

testing to meet demand. The

study, run by Salford city council

and the local NHS, had been

collecting weekly saliva samples

from participants since the plans

were announced last month. This

week the team was told that the

study was being “refocused”.

Used test kits ‘blunder’

Students have been forced to

self-isolate after 25 used testing

kits were handed out by council

workers in the Selly Oak area of

Birmingham. Sophie Dunne and

Tasha Ashbridge, second-year

medical students, said they

realised that their swabs had been

used but said that five students

had used them. Birmingham

council said: “The circumstances

are being reviewed.”

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