Science
Long COVID’s daunting toll seen in study of pandemic’s earliest patients
COVID-19 sufferers in Wuhan have been among the many pandemic’s first victims, and a complete new examine finds {that a} 12 months after shaking the coronavirus, survivors have been extra possible than their uninfected friends to undergo from mobility issues, ache or discomfort, anxiousness and melancholy.
An in depth accounting of 1,276 individuals hospitalized for COVID-19 within the pandemic’s opening months reveals {that a} full 12 months later, nearly half continued to report not less than one lingering well being downside that’s now thought-about a symptom of “lengthy COVID.”
One out of 5 mentioned they’d continued fatigue and/or muscle weak point, and 17% mentioned they have been nonetheless experiencing sleep difficulties. Simply over one in 4 mentioned they have been struggling anxiousness or melancholy within the wake of their bout with the SARS-CoV-2 virus.
For the rising variety of sufferers who determine themselves as COVID “lengthy haulers,” the brand new accounting provides trigger for optimism — and concern. The interval from six to 12 months after an infection introduced enchancment for a lot of. However most sufferers scuffling with signs on the six-month mark weren’t but effectively six months later.
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The findings, catalogued by a staff of Chinese language researchers, have been revealed late Thursday within the medical journal Lancet.
“This isn’t excellent news,” mentioned David Putrino, a rehabilitation specialist who works with COVID lengthy haulers at Mount Sinai Hospital in New York. “If you happen to run the numbers right here, about one-third of the group that had persistent signs are getting higher after 12 months, whereas two-thirds usually are not.”
Putrino additionally known as the findings a “wake-up name” to public well being officers that even when the pandemic is over — a distant sufficient prospect within the midst of a fourth wave of infections — its downstream penalties won’t be.
“We’re going to want sources for a few years to return to cope with these sufferers,” he mentioned.
There can be a variety of them. Greater than 87,000 COVID-19 sufferers are being hospitalized every day in america, and a pair of.7 million have receiving hospital care previously 12 months alone.
The half who deal with persistent signs will present up in medical doctors’ workplaces with clusters of imprecise and perplexing complaints together with mind fog, coronary heart palpitations, ache and exhaustion. And regardless of rising proof that point and specialised therapy might help many to enhance, few may have the wherewithal to spend months in intensive rehabilitation for his or her signs, Putrino mentioned.
An editorial revealed alongside the brand new examine famous that solely 0.4% of COVID lengthy haulers are receiving rehabilitative therapy for his or her signs.
Whilst scientists puzzle over the widespread organic mechanisms of lengthy COVID’s various signs, healthcare suppliers “should acknowledge and validate the toll of the persistent signs of lengthy COVID on sufferers, and well being techniques should be ready to fulfill individualised, patient-oriented objectives, with an appropriately educated workforce,” Lancet’s editors wrote.
The brand new analysis additionally provided some glimmers of hope.
When the examine’s COVID-19 sufferers have been examined at six months, 68% mentioned they’d not less than one in every of 15 signs thought-about hallmarks of lengthy COVID, which is also referred to as Publish-Acute Sequelae of COVID, or PASC. At one 12 months, 49% have been nonetheless stricken by not less than a kind of signs.
The proportion of sufferers with ongoing muscle weak point and fatigue dropped from 52% to twenty% throughout that point. Sufferers experiencing lack of odor dropped from 11% to 4%, and people stricken with sleep issues fell from 27% to 17%. The 22% who reported hair loss at six months dwindled to 11% a full 12 months out.
On the identical time, the numbers of sufferers reporting respiratory difficulties noticed a slight enhance, rising from 26% at six months to 30% after a 12 months. Likewise, sufferers who reported new melancholy or anxiousness elevated from 23% to 26% throughout that interval.
Examine co-author Xiaoying Gu from the China-Japan Friendship Hospital in Beijing mentioned the slight uptick in anxiousness and melancholy was, like all of lengthy COVID’s signs, onerous to elucidate.
The psychiatric signs “could possibly be brought on by a organic course of linked to the virus an infection itself, or the physique’s immune response to it,” he mentioned. “Or they could possibly be linked to lowered social contact, loneliness, incomplete restoration of bodily well being or lack of employment related to sickness.”
Sufferers who required mechanical air flow have been extra possible than these with much less extreme sickness to have measurable lung impairment and irregular chest X-rays at each six and 12 months.
However within the tally of extra subjective lengthy COVID signs, the distinction between probably the most severely unwell and those that required no supplemental oxygen in any respect was very small.
That discovering underscores the truth that even sufferers who’re solely mildly unwell are liable to creating a spread of persistent signs.
Of the examine inhabitants’s 479 sufferers who held jobs when the pandemic struck, 88% had returned to work a 12 months after their sickness. Many of the 57 who didn’t return mentioned they both couldn’t or have been unwilling to do the duties required of them.
The findings from the Wuhan sufferers additionally tracked with the widespread statement that persistent post-COVID an infection signs are extra widespread in girls than in males. Girls who had been hospitalized for COVID-19 have been twice as possible as their male counterparts to report melancholy or anxiousness 12 months later. As well as, they have been shut to a few instances as prone to present proof of impaired lung operate, and 43% extra prone to report signs of fatigue and muscle weak point.
The entire examine’s contributors have been handled at a single hospital in Wuhan, the place reviews of a mysterious new type of pneumonia first surfaced in December 2019. The researchers adopted a big group of sufferers sickened within the first 5 months that the outbreak.
That makes the Lancet report one of many earliest and largest accounts of lingering COVID-19 signs to be tallied and vetted by different researchers, and the one one to match such sufferers to a bunch of uninfected friends matched on a variety of demographic and well being attributes.
One factor is already clear, the journal editors famous: “Lengthy COVID is a contemporary medical problem of the primary order.”
Science
Cluster of farmworkers diagnosed with rare animal-borne disease in Ventura County
A cluster of workers at Ventura County berry farms have been diagnosed with a rare disease often transmitted through sick animals’ urine, according to a public health advisory distributed to local doctors by county health officials Tuesday.
The bacterial infection, leptospirosis, has resulted in severe symptoms for some workers, including meningitis, an inflammation of the brain lining and spinal cord. Symptoms for mild cases included headaches and fevers.
The disease, which can be fatal, rarely spreads from human to human, according to the U.S. Centers for Disease Control and Prevention.
Ventura County Public Health has not given an official case count but said it had not identified any cases outside of the agriculture sector. The county’s agriculture commissioner was aware of 18 cases, the Ventura County Star reported.
The health department said it was first contacted by a local physician in October, who reported an unusual trend in symptoms among hospital patients.
After launching an investigation, the department identified leptospirosis as a probable cause of the illness and found most patients worked on caneberry farms that utilize hoop houses — greenhouse structures to shelter the crops.
As the investigation to identify any additional cases and the exact sources of exposure continues, Ventura County Public Health has asked healthcare providers to consider a leptospirosis diagnosis for sick agricultural workers, particularly berry harvesters.
Rodents are a common source and transmitter of disease, though other mammals — including livestock, cats and dogs — can transmit it as well.
The disease is spread through bodily fluids, such as urine, and is often contracted through cuts and abrasions that contact contaminated water and soil, where the bacteria can survive for months.
Humans can also contract the illness through contaminated food; however, the county health agency has found no known health risks to the general public, including through the contact or consumption of caneberries such as raspberries and blackberries.
Symptom onset typically occurs between two and 30 days after exposure, and symptoms can last for months if untreated, according to the CDC.
The illness often begins with mild symptoms, with fevers, chills, vomiting and headaches. Some cases can then enter a second, more severe phase that can result in kidney or liver failure.
Ventura County Public Health recommends agriculture and berry harvesters regularly rinse any cuts with soap and water and cover them with bandages. They also recommend wearing waterproof clothing and protection while working outdoors, including gloves and long-sleeve shirts and pants.
While there is no evidence of spread to the larger community, according to the department, residents should wash hands frequently and work to control rodents around their property if possible.
Pet owners can consult a veterinarian about leptospirosis vaccinations and should keep pets away from ponds, lakes and other natural bodies of water.
Science
Political stress: Can you stay engaged without sacrificing your mental health?
It’s been two weeks since Donald Trump won the presidential election, but Stacey Lamirand’s brain hasn’t stopped churning.
“I still think about the election all the time,” said the 60-year-old Bay Area resident, who wanted a Kamala Harris victory so badly that she flew to Pennsylvania and knocked on voters’ doors in the final days of the campaign. “I honestly don’t know what to do about that.”
Neither do the psychologists and political scientists who have been tracking the country’s slide toward toxic levels of partisanship.
Fully 69% of U.S. adults found the presidential election a significant source of stress in their lives, the American Psychological Assn. said in its latest Stress in America report.
The distress was present across the political spectrum, with 80% of Republicans, 79% of Democrats and 73% of independents surveyed saying they were stressed about the country’s future.
That’s unhealthy for the body politic — and for voters themselves. Stress can cause muscle tension, headaches, sleep problems and loss of appetite. Chronic stress can inflict more serious damage to the immune system and make people more vulnerable to heart attacks, strokes, diabetes, infertility, clinical anxiety, depression and other ailments.
In most circumstances, the sound medical advice is to disengage from the source of stress, therapists said. But when stress is coming from politics, that prescription pits the health of the individual against the health of the nation.
“I’m worried about people totally withdrawing from politics because it’s unpleasant,” said Aaron Weinschenk, a political scientist at the University of Wisconsin–Green Bay who studies political behavior and elections. “We don’t want them to do that. But we also don’t want them to feel sick.”
Modern life is full of stressors of all kinds: paying bills, pleasing difficult bosses, getting along with frenemies, caring for children or aging parents (or both).
The stress that stems from politics isn’t fundamentally different from other kinds of stress. What’s unique about it is the way it encompasses and enhances other sources of stress, said Brett Ford, a social psychologist at the University of Toronto who studies the link between emotions and political engagement.
For instance, she said, elections have the potential to make everyday stressors like money and health concerns more difficult to manage as candidates debate policies that could raise the price of gas or cut off access to certain kinds of medical care.
Layered on top of that is the fact that political disagreements have morphed into moral conflicts that are perceived as pitting good against evil.
“When someone comes into power who is not on the same page as you morally, that can hit very deeply,” Ford said.
Partisanship and polarization have raised the stakes as well. Voters who feel a strong connection to a political party become more invested in its success. That can make a loss at the ballot box feel like a personal defeat, she said.
There’s also the fact that we have limited control over the outcome of an election. A patient with heart disease can improve their prognosis by taking medicine, changing their diet, getting more exercise or quitting smoking. But a person with political stress is largely at the mercy of others.
“Politics is many forms of stress all rolled into one,” Ford said.
Weinschenk observed this firsthand the day after the election.
“I could feel it when I went into my classroom,” said the professor, whose research has found that people with political anxiety aren’t necessarily anxious in general. “I have a student who’s transgender and a couple of students who are gay. Their emotional state was so closed down.”
That’s almost to be expected in a place like Wisconsin, whose swing-state status caused residents to be bombarded with political messages. The more campaign ads a person is exposed to, the greater the risk of being diagnosed with anxiety, depression or another psychological ailment, according to a 2022 study in the journal PLOS One.
Political messages seem designed to keep voters “emotionally on edge,” said Vaile Wright, a licensed psychologist in Villa Park, Ill., and a member of the APA’s Stress in America team.
“It encourages emotion to drive our decision-making behavior, as opposed to logic,” Wright said. “When we’re really emotionally stimulated, it makes it so much more challenging to have civil conversation. For politicians, I think that’s powerful, because emotions can be very easily manipulated.”
Making voters feel anxious is a tried-and-true way to grab their attention, said Christopher Ojeda, a political scientist at UC Merced who studies mental health and politics.
“Feelings of anxiety can be mobilizing, definitely,” he said. “That’s why politicians make fear appeals — they want people to get engaged.”
On the other hand, “feelings of depression are demobilizing and take you out of the political system,” said Ojeda, author of “The Sad Citizen: How Politics is Depressing and Why it Matters.”
“What [these feelings] can tell you is, ‘Things aren’t going the way I want them to. Maybe I need to step back,’” he said.
Genessa Krasnow has been seeing a lot of that since the election.
The Seattle entrepreneur, who also campaigned for Harris, said it grates on her to see people laughing in restaurants “as if nothing had happened.” At a recent book club meeting, her fellow group members were willing to let her vent about politics for five minutes, but they weren’t interested in discussing ways they could counteract the incoming president.
“They’re in a state of disengagement,” said Krasnow, who is 56. She, meanwhile, is looking for new ways to reach young voters.
“I am exhausted. I am so sad,” she said. “But I don’t believe that disengaging is the answer.”
That’s the fundamental trade-off, Ojeda said, and there’s no one-size-fits-all solution.
“Everyone has to make a decision about how much engagement they can tolerate without undermining their psychological well-being,” he said.
Lamirand took steps to protect her mental health by cutting social media ties with people whose values aren’t aligned with hers. But she will remain politically active and expects to volunteer for phone-banking duty soon.
“Doing something is the only thing that allows me to feel better,” Lamirand said. “It allows me to feel some level of control.”
Ideally, Ford said, people would not have to choose between being politically active and preserving their mental health. She is investigating ways to help people feel hopeful, inspired and compassionate about political challenges, since these emotions can motivate action without triggering stress and anxiety.
“We want to counteract this pattern where the more involved you are, the worse you are,” Ford said.
The benefits would be felt across the political spectrum. In the APA survey, similar shares of Democrats, Republicans and independents agreed with statements like, “It causes me stress that politicians aren’t talking about the things that are most important to me,” and, “The political climate has caused strain between my family members and me.”
“Both sides are very invested in this country, and that is a good thing,” Wright said. “Antipathy and hopelessness really doesn’t serve us in the long run.”
Science
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