Long Covid & Mitigation: references below!

1, Vaccination is still very effective at reducing death & hospitalisations but unfortunately with the current variants like BA.5 it’s now less effective at preventing the initial infection

2, About 20% of all people who catch Covid (including mild cases) develop Long Covid https://tinyurl.com/cdclongcovid. Many studies suggest that the incidence of Long Covid is higher; analyzing data from 31 different studies found that 49% of Covid survivors had Long Covid Symptoms https://tinyurl.com/jidlongcovid

3, Vaccination doesn’t too much if you get infected. A huge study published in Nature found that it only reduced the incidence of Long Covid by 15% https://tinyurl.com/naturelongcovid

4, Long Covid symptoms can be very severe go past the lungs. The virus is neuroinvasive & can affect most organ systems of the body.

-Cardiovascular damage: 5% of all people who had Covid end up with cardiovascular issues within 12 months including atrial fibrillation, myocarditis, stroke,, coronary disease & heart failure https://tinyurl.com/naturelongcovidheart

-Inability to Work: a study on 4,000 people in 56 countries found that 1 in 5 people are unable to work at the 6 month mark https://tinyurl.com/lancetwork & https://tinyurl.com/forbeswork

-Diabetes: A massive study on 200,000 people published in The Lancet found that people who had had Covid were 40% more likely to develop diabetes within a year than people who had not https://tinyurl.com/naturediabetes & https://tinyurl.com/thelancetdiabetes

-Suicide: A study in the British Medical Journal of 150,000 COVID survivors (hospitalized & not) found that had 10-15x higher risk of considering suicide after 1 year https://tinyurl.com/bmjsuicide

-Brain Damage: A study published in Nature found Covid infection is associated with reduction in gray matter & and brain size https://tinyurl.com/naturebrain. A study published in Cell found mild respiratory Covid infection caused brain inflammation https://tinyurl.com/cellmyelin

-Memory problems, depression, & anxiety are frequently seen in Long Covid https://tinyurl.com/neuropsychiatriccovid & tinyurl.com/covidpetscan

5, Risk of Long Covid goes up with repeated infections. We do not yet know how much that risk increases each time but should probably try to limit the number of times we get infected

AEROSOL BASED TRANSMISSION OF COVID

6, We now know that Covid is primarily spread through the air through virus particles, aerosols, & droplets exhaled while breathing, talking or yelling. The best resource here is https://tinyurl.com/FAQ-aerosols (FAQs on Protecting Yourself from COVID-19 Aerosol Transmission). More at https://tinyurl.com/cdccovidtransmission & https://tinyurl.com/naturecovidtransmission

7, Aerosols behave like cigarette smoke, remaining in the air for a long time. Air mitigation is important; we need to move fresh air into our indoor spaces.

VENTILATION, C02 DETECTION, FILTRATION

Fortunately there are relatively unobtrusive & inexpensive measures that can be implemented.

8, How much ventilation is enough? We can quantify this by using Carbon Dioxide as a proxy. CO2 isn’t harmful in itself, but humans exhale both CO2 & aerosols at the same time so if CO2 levels are high then aerosol levels will be high as well. Monitor CO2 levels with inexpensive, low maintenance detectors to determine whether ventilation needs to be improved

9, Monitoring CO2 levels & then improving ventilation to lower those levels when needed is not a radical approach. For example, the school system in the UK currently equipping all classrooms with CO2 detectors

Gov.uk Press release: All schools to receive carbon dioxide monitors https://tinyurl.com/ukgovc02

Curbing COVID-19 in schools https://tinyurl.com/imperialcollegeco2

Teacher’s union guidelines for using CO2 detectors in classrooms https://tinyurl.com/teachersunionco2

10, Indoor spaces can often reach 1,500-2000+ ppm or if there are multiple people in a room. Several different targets for maximum CO2 levels have been proposed.

U of T Epidemiologist Colin Furness recommends keeping indoor spaces at less than 600 ppm https://www.youtube.com/watch?v=fHa0akoLDPQ. In UK classrooms the target concentration is 800 ppm or less.

11, Ventilation can easily be improved in most situations by opening windows &/or increasing fresh air intake in the HVAC system

13, The inclusion of HEPA filters (which remove aerosols from the air) add an added layer of safety

A 3 STEP PLAN

1, Measure CO2 concentrations in common areas by installing CO2 detectors. These sensors typically last years & have very low maintenance costs.

2, If CO2 concentrations are more than 800 ppm improve ventilation by opening a window, doors, or changing HVAC settings

3, Use HEPA filters to filter aerosols out of the air for added safety

P.S. My interview with U of T Epidemiologist Colin Furness is here https://www.youtube.com/watch?v=fHa0akoLDPQ