The Guardian view on long Covid: an unknown enemy
How do you tackle a problem when you don’t know what it is? Covid-19 was an unknown enemy, but was quickly identified. Long Covid, its equally unwelcome offspring, is a lesser threat, but is proving harder to pin down. Doctors are clear that it is widespread – yet are not sure how common it is, or how to respond.
This is in part because it is an umbrella term for a wide range of symptoms; the World Health Organization says that up to 200 have been recorded, with shortness of breath, brain fog and fatigue the most common, while others range from loss of smell and tinnitus to stomach aches and depression. It may be that five or six separate syndromes are involved. Most of the symptoms have numerous potential nonCovid causes, making it still harder to isolate which are related to the infection.
What is clear is that it is common. There are an estimated 2 million sufferers in the UK with continuing or returning symptoms more than 12 weeks after falling ill. With almost 3.5 million people in the UK reported to have Covid in mid-July, that number will grow. In the US, official data has shown that one in five adults who have had Covid still suffer symptoms after 12 weeks.
Some evidence suggests that those who were more acutely ill with Covid are more likely to suffer from lingering or recurring symptoms, and that older people and those with comorbidities are also likely to be worse affected. Vaccination appears to offer a slight protective effect. None of this is surprising. But some very fit people who did not appear to be severely ill have been hit too. Women seem to be more likely to suffer than men.
Scientists are delving into possible explanations for ongoing problems – such as pockets of the virus remaining in the gut, or the virus triggering an autoimmune disease – and doctors are trialling different treatments. Yet the Royal College of Nursing has warned that services in Britain are woefully inadequate. Though long Covid clinics have now been set up by the NHS, demand far outstrips supply, and the treatments offered vary widely. Thousands of sufferers are travelling abroad to try unproven treatments, at huge expense, from sheer desperation.
In many regards, long Covid has echoes of existing autoimmune diseases and (usually post-viral) conditions such as ME/CFS, which are complex, poorly understood, hard to diagnose and tough to treat. The biggest difference may be that Covid’s seriousness and its spread have ensured greater attention and resources this time; patients with ME/CFS and some autoimmune illnesses who have long complained about the lack of interest and investment in research hope that it may lead to breakthroughs that could help them.
But even if those materialise, there will be no miracle cure. Some may gradually recover with little help; others may benefit from a variety of treatments. Those who are still unwell need other forms of help. Shamefully, even British doctors left with long Covid after working on the frontline in the pandemic say that they have been denied disability benefits.
The Long Covid Support group says that delays to or denial of personal independence payments are affecting the recovery of patients as well as their state of mind. An appropriate response to long Covid must mean supporting people as well as trying to cure them, through measures such as flexible working and financial help.