World Health Organization-WHO Is Letting Down 'Long Covid Patients'
- 'The WHO Is Letting Down Long Covid Patients,' The Guardian, Oct. 17, 2021. Ziyad Al-Aly, Opinion.
Failure to recognize the scope of the illness will harm countless people around the globe.
The WHO recently released its clinical case definition for what it called “post-Covid-19 condition”. This definition is too little too late, its myopic scope does not recognize the breadth of disability and disease caused by long Covid and its long term implications on quality of life and life expectancy. The millions of people around the globe suffering from long Covid deserve better. It is unclear why the WHO definition snubs and does not embrace the term “long Covid”. The term was coined by patients who also refer to themselves as long-haulers.
These patients-advocates-researchers galvanized attention around the existence of this disease and brought long Covid to the spotlight.
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[‘Long haul’ COVID-19 sufferers take a page from AIDS/HIV activism to be heard, LA Times, 4/26/21],
https://www.latimes.com/california/story/2021-04-26/activists-and-advocates-find-their-voice-in-the-long-haul
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In a short few months, they created a formidable patient-led advocacy and research movement that changed the arc of medical history. They were the first to survey their membership and catalogue the broad array of clinical problems caused by Covid-19. Their contributions will go down in the annals of history as an important inflection point. Arguably, without them long Covid would have remained a peripheral condition disregarded by governments, health systems and academic research as a fringe problem. They represent the 21st century version of the brave HIV-Aids activists who changed the ways in which governments and the public dealt with HIV-Aids. These are the Larry Kramer of Covid-19.
They deserve enormous respect, and recognition, not only by including a few of them on the WHO panel, but also by recognizing that without them none of us would be talking about long Covid. They should be celebrated and recognized as heroes. The term “long Covid” should be officially embraced by the WHO. Beyond its lack of embrace for the patient-created name, the WHO definition is solely based on symptomatology, ignoring a lot of the long-lasting clinical manifestations caused by Covid-19, including new onset diabetes, heart disease, kidney disease. These are chronic conditions that will scar affected individuals for a lifetime. They affect not only quality of life but also life expectancy.
Given the millions of people affected around the globe, this will certainly result in a rise in the global and national burdens of these diseases, putting additional strain on already overwhelmed health systems.
This deserves recognition now to ensure that our governments and health systems are prepared to deal with the tide of patients with these chronic conditions. Failure to recognize that the long-term ramifications of Covid-19 also include development of new onset chronic metabolic and cardiovascular disease will leave us yet again unprepared to deal with the huge after-effects of Covid-19 – a critical public health crisis that will reverberate for decades to come. The downstream consequences of long Covid will not only shape health outcomes, but will also have broad economic, social, political and global security implications. The WHO definition also conditions the diagnosis on the idea that symptoms cannot be explained by an alternative diagnosis, which makes long Covid a diagnosis of exclusion – further marginalizing this disease.
I worry that this myopic definition of long Covid may be used by governments and health insurers to debase the disease and deny insurance coverage...
https://www.theguardian.com/commentisfree/2021/oct/17/who-long-covid-patients
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- The debilitating effects of long Covid have just begun to hit economies. A study of German footballers revealed they still weren’t fighting fit six months after recovering from infection, Oct. 17, 2021,
https://www.theguardian.com/commentisfree/2021/oct/17/the-debilitating-effects-of-long-covid-have-just-begun-to-hit-economies
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- CNN, Eight Months of Long Covid Brought Me To The Brink, July 23, 2021,
https://www.cnn.com/2021/07/23/opinions/long-covid-symptoms-brought-me-to-the-brink-stephens/index.html
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Last edited Mon Oct 18, 2021, 04:43 PM - Edit history (2)
- Douglas McClain with his wife. When Douglas contracted Covid, his symptoms were downplayed and dismissed.
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- 'I figured you were OK”: 'Black patients’ COVID symptoms more often dismissed, downplayed. When Douglas McClain contracted COVID-19, his experience with the health care system mirrored that of far too many Black people.' North Carolina Health News, May 24, 2021. -Ed.
As the number of COVID-19 cases ticked up last fall, Douglas McClain’s wife and mother convinced him to take a flu shot for the first time ever, believing it might offer him an extra measure of protection against the coronavirus. A few days later, the 53-year-old Charlottean developed typical flu symptoms that got progressively worse and forced him to take a few days off from his finance job. Out of an abundance of caution, McClain took a COVID-19 test. The results were positive. Then he started to get really sick. He lost his appetite, suffered extreme fatigue and was gasping for breath. On Sept. 19, he finally decided to go to the emergency room near his home in South Charlotte, thinking the medical staff would recognize the severity of his condition and treat him accordingly.
He could not have been more wrong. McClain’s wife drove him to the ER around 9:30 in the morning and waited in the parking lot while the medical staff checked him in and gave him a chest X-ray. Then, they put him on an ER cot, hooked him up to a pulse oximeter and left him unattended for several hours. At the time, McClain didn’t know that an oxygen saturation level below 95 was a reason for concern and below 90 required medical intervention. The alarm went off repeatedly as his oxygen levels dipped into the 70s and 80s. It was early afternoon before McClain had a chance to speak with a health care worker. “I asked her why nobody ever came to check on me when the alarm kept going off,” he recalls. “She said ‘I saw you go to the bathroom so I figured you were OK.’”
Hours later, another nurse nonchalantly told McClain his x-rays showed mild inflammation in one lung, handed him a prescription for steroids and sent him home. *The cost of being dismissed: Decades of research shows that Black patients receive inferior medical care to white patients. The pandemic has placed that phenomenon in stark relief. There are countless reports of Black and Brown people having their symptoms dismissed or being turned away from emergency rooms and hospitals despite exhibiting severe signs of COVID. These treatment disparities, in addition to lack of access to quality care, account for the higher infection rates, illness severity and deaths among people of color. When McClain returned home, his condition continued to worsen. He labored to get up the stairs, walk down the hallway and even get into bed. “At that point I couldn’t even put together a 5-minute conversation without seeming like I’d just ran a marathon.”
During a telehealth visit a few days later, his primary care doctor pleaded with him to return to the hospital. Still seething over the callousness with which he had been treated, McClain refused. “They left me there like I was something contagious. Sure I had COVID, but that’s why I was in the hospital. I didn’t want to experience that again.” - Receiving appropriate care: McClain knew he ultimately had no choice. He wouldn’t survive without medical attention, so he went to a different hospital where he had a markedly different experience.. *Long Covid's disproportionate impact: A March report from the Greenlining Inst. concluded COVID-19 health care costs have already resulted in severe debt & unemployment for some people & threatens to worsen health disparities, as higher numbers of people of color are left uninsured & unemployed.
Coronavirus’ high toll on the Black community is well-documented. Now, researchers & clinicians are increasingly concerned that systemic health care bias, lack of insurance & unemployment will also create similar disparities for long COVID, too...
More, https://www.northcarolinahealthnews.org/2021/05/24/black-patients-covid-symptoms-more-often-dismissed-downplayed/
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