We're On a Road to Nowhere
As the Delta variant devastates the US, it might be tempting to overlook the not so immediate consequences for the living: more sick kids, long-haulers syndrome, and Covid psychosis.
Last week cases in the US moved above 100,000 a day for the first time since February, higher than the levels of last summer when vaccines were not available. We keep seeing this headline, or some version of it everywhere. But, what we are not seeing is the less than immediate impact on the nation of dealing with the fallout of another round of Covid infections, and the lingering sub-symptoms that don’t appear deadly but have drastically changed many lives.
Last week I published my account of struggling with long-hauler Covid symptoms on and off since March of 2020 and I was surprised to hear how many others were also suffering from similar problems. I had documented a majority of my initial infection in real-time because I thought that would be the most critical aspect of the pandemic. It turns out that the millions of victims of this virus who are not hospitalized or critical are still left with lingering illness and subsequent problems that we may not even know about, yet.
The unofficial term for those who are still suffering from the fallout of the initial Covid infection is “long-haulers,” and they tend to experience lingering health problems long after recovering from the coronavirus infection. Researchers have found that 50 to 80 percent of people who were infected also experience symptoms up three months later, even after fighting off the virus.
These symptoms can be life-altering, and perhaps the most frustrating aspect is how unpredictable the ongoing medical issues can be. Additionally, many people who experience long-term symptoms had mild or moderate cases of COVID-19 and didn’t require hospitalization or extraordinary treatment initially.
In general, the long-term effects of COVID-19 can vary. The most common lingering symptoms include:
Fatigue
Shortness of breath
Cough
Joint pain
Chest pain
Some people have reported other long-term symptoms, including:
Difficulty with thinking and concentration (sometimes called “brain fog”)
Depression
Muscle pain
Headache
Intermittent fever
Heart palpitations
While COVID-19 first affects lung function, some people have reported serious lingering symptoms that affect other body organs, including:
Cardiovascular: Inflammation of the heart muscle
Respiratory: Lung function abnormalities
Renal: Acute kidney injury
Dermatologic: Rash, hair loss
Neurological: Smell and taste problems, sleep issues, difficulty concentrating, memory problems
Psychiatric: Depression, anxiety, mood changes
In the meantime, healthcare providers are doing their best to treat the symptoms and support long-haulers in their recovery, but the information on what is actually happening is still limited. The recommendation in most emergency rooms for anyone suffering from these conditions is to manage the symptoms with a primary care physician, which means that most people will remain in the dark about what is happening and be left to manage the fallout on their own.
Another particularly frightening aspect of the latest Covid variant is the effect it appears to be having on children; a consequence we were lucky enough to avoid in mass numbers during the initial waves. In addition to more infections in younger people this time around, doctors are now saying they are seeing more cases of COVID-19 psychosis in children with the Delta variant.
Psychosis is a mental disorder in which patients have an impaired sense of reality and the symptoms can include hallucinations, delusions, talking incoherently, and agitation. A handful of these cases so far have been adults in their 30s, 40s, and 50s, who had never been diagnosed with a mental health illness but developed psychosis within weeks after testing positive for COVID-19. Most of these documented patients with new cases of psychosis originally had mild symptoms of COVID-19.
Los Angeles emergency room physician Dr. Michael Daignault said he’s seen COVID psychosis before, but usually in adults who are long-haulers, saying “We’re learning something new from COVID every day.” According to Daignault, COVID-19 psychosis tends to show up sooner in children. “I think that their brains are just more susceptible to inflammation in the central nervous system, which is leading to these cases of psychosis in kids,” Dr. Daignault said.
Parents are also preparing to send their kids back to school in just a few weeks, with various school districts taking drastically different approaches to protecting the health of kids and educators. While the Center for Disease Control and Prevention (DCD) has issued guidelines, the suggestions remain very broad and some states are refusing to impose even the most basic precautions within their public school systems.
We are also on the verge of losing what little information we have at this point, as eight states have changed their COVID-19 data reporting as of Aug. 3. Nebraska stopped updating its data dashboard entirely on June 30, around the same time that the state's governor, Pete Ricketts, ended the state of emergency, despite the impending new wave expected from the Delta variant.
Nebraska's health districts were publicly reporting COVID-19 statistics for counties with fewer than 20,000 residents but the executive order requiring that recently expired and was not renewed. "It's a bad idea to not report data so others can't analyze it," Dr. Bob Rauner, chief medical officer of OneHealth Nebraska and president of the Partnership for a Healthy Lincoln.
This drastic decrease of available data, which can arguably be labeled a political stunt, will not only fail to keep everyone notified about the ongoing emergency caused by the Delta variant. It will also have a profound impact and delay on getting valuable data to researchers seeking to further define the problem of the long-haulers syndrome.
Florida, which Thursday reported a record number of COVID-19 hospitalizations as cases continue to spike, also stopped dashboard updates in July and now only releases a PDF with updates once a week. South Dakota and Iowa are also reporting only once a week, but unlike Florida, these states are maintaining their data dashboards. Alaska, Maine, Michigan, and Oklahoma have all reduced their updates to three times a week or fewer. Additionally, most states stopped reporting COVID-19 data on weekends over the last month.
This also poses several immediate obstacles such as the issue of uneven reporting that makes it more difficult to track hotspots. It’s also much more difficult for researchers and the public to truly assess how it’s progressing or regressing as a whole. The data halt also complicates data reporting for organizations and resource outlets that independently collect and visualize data so Americans can make informed decisions.
Ultimately, the national counts from any given day are drastically incomplete, which means that in order to overcome the data gaps, everyone needs to rely on seven-day totals and averages, which can be misleading and under-representative. If you compare the issue to a cross-country road trip that began with many maps, instruments, and navigation tools, you would have to imagine everyone on the trip ditching all of their equipment around West Virginia and relying only on giant road signs that warn of immediate danger.
This means that not only will many warnings be missed or ignored due to human error, we will have no way to really trace where we have been and what we saw there. These types of observations are a crucial tool for those who are suffering these long-term effects that have no current understanding of the cause. More importantly, some medical solutions to remedy the syndrome could be lost, or at the very least, delayed. We have just thrown our map out the window, even though we don’t know where we are.
As destructive as this path appears to be for all of those who will lose their lives to the Delta variant, those numbers will pale in comparison to the millions who will lose their livelihoods as a result of suffering a myriad of long-hauler symptoms, or worse, psychosis. It’s also worth noting that in this road trip metaphor, instead of driving with a car full of adults who are responsible for their own decision to ditch the map, we have got a bunch of kids with us. In the immortal words of David Byrne: “We’re on a road to nowhere…” and we are now traveling with a school bus full of children who never asked to take this trip.
Amee Vanderpool writes the SHERO Newsletter and is an attorney, published author, contributor to newspapers and magazines, and analyst for BBC radio. She can be reached at avanderpool@gmail.com or follow her on Twitter @girlsreallyrule.
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Great article Amee. I love that you incorporated the Talking Heads song. Perfect. I am worried for the children. I wish that if not for anyone else, people would get vaccinated for the children. Thank you for bringing awareness to this issue. I wish you all the best.
Living the nightmare of the after effects. As discussed prior infected mid July fully vaccinated beginning of April delta takes no prisoners.