Should I be worried about long COVID?

In February 2020 before the first North American lockdowns, Atlantic writer Dr. James Hamblin made an unnerving prediction: “You’re likely to get the Coronavirus.” He turned out to be correct. There have been billions of infections globally. About 60% of American adults now have antibodies, as do 75% of children. In our country, over 50% of Canadians have contracted the disease, but as with everywhere the actual number is likely much higher due to underreporting.

But the Atlantic has now revised its warning. As the headline on a piece by Katherine Wu from May 2022 reads: “You are going to get COVID again…and again…and again.” According to Wu, experts predict that you may now get COVID about as often as you get the flu: approximately once every two to five years, less frequently for adults than for children. 

That may not seem like a big deal if you’re one of millions who have experienced a mild case. The concern at this point is how re-infection changes your odds of dealing with another phenomena: long COVID.

Long COVID is still a mysterious condition, or more likely, a constellation of conditions. Typically it refers to when COVID symptoms fail to resolve after one month. In some more extreme cases the standard symptoms (coughing, fatigue, digestive issues, etc.) can last for years and affect organs such as the heart, brain, liver and kidneys in ways we don’t yet fully understand.

Accepted wisdom among infectious disease experts is that with each vaccination or infection, your ability to fight off the virus grows. Even over the long term thanks to players in your immune system known as T-Cells. It also appears this built up immunity mitigates your risk of long COVID. The issue is that, even though you’re better protected, multiple exposures could still “load the dice”, in the words of one researcher, with regards to the odds of eventually landing on long COVID or, for a smaller minority of cases, more severe disease.

It’s unclear exactly how long COVID and more severe disease are related but there does appear to be some relation. According to CDC data, 30% of hospitalized patients report symptoms that persisted for six months, which is a disproportionate amount of long COVID patients. The same data set suggests 13.3% of COVID patients had symptoms for longer than one month and 2.5% reported symptoms that persisted three months or longer. Again, these percentages refer to recorded cases which are fewer than total cases, which means that percentage is almost certainly lower.

The problem is “We don’t know if your risk of getting long COVID changes every time you get an infection — some immunologists believe it decreases, others believe it increases, and some believe it may be more random than that,” said David Steadson, a Swedish epidemiologist. The CDC estimates risk of long COVID every time you’re infected is about one-in-five. As Steadson calculated, if people keep getting reinfected, the odds of avoiding long COVID keep shrinking.

“Now, people do recover from long COVID,” Steadson told CityNews, as he himself did. But if you manage to avoid the disease, especially severe forms of the disease, you’re more likely to avoid long COVID. Which means the advice hasn’t changed: get fully vaccinated; not just to keep yourself safe, but everyone else. With less virus in the community, it means fewer infections, which means we’re all more likely to avoid long COVID. 

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