*Experts answer questions about omicron variant and symptoms of the disease
Undoubtedly, the omicron variant has become the protagonist of the pandemic. It has led to an increase in the number of infections, and with it, hospitals have once again become overcrowded.
However, the long-term health cost for those who have acquired the SARS-CoV-2 virus goes beyond bills to be paid, as many people have symptoms that impair their long-term quality of life, and have been classified as acute post-COVID syndrome.
While it is true that infections have increased, it is also true that deaths have decreased, largely due to vaccination which, according to studies, helps to mitigate or eliminate symptoms in the medium and long term, said experts during an information session with the community, held by the Stanford University School of Medicine.
In the session titled "Addressing Prolonged COVID: Research, Treatment and Recovery. COVID-19 variant: updates on Omicron," Prasanna Jagannathan, M.D., assistant professor of medicine in Standford's division of infectious diseases and geographic medicine, predicts that by spring, California will begin to see a decline in the rate of cases, as well as hospitalizations and thus deaths.
"I think we're certainly hopeful that spring will give us some breathing room. This winter has been really difficult for everyone," he noted.
The expert recalled that studies by the Centers for Disease Control and Prevention (CDC) suggest that the Omicron variant is less severe than Delta, as it was found that among people who were hospitalized for Omicron, it was associated with 30 percent fewer admissions to intensive care units than patients who were hospitalized for the Delta variant.
Such a situation has also been observed at Stanford Hospital, Dr. Jagannathan said. However, although the Omicron variant is less deadly, more than 2,000 Americans die every day from COVID-19, so there are still questions about what the variant can actually cause, coupled with the number of patients who are not vaccinated.
He added that acquiring the virus gives certain immunity to the disease itself. However, it is not yet known for how long, nor its infectious capacity, so it is necessary to continue protecting oneself, first by getting vaccinated, followed by actions such as the use of masks.
"It has taught us a lot about the human immune response to infections and viruses, but I still think we are still often surprised when new data emerge, and Omicron is still relatively new. In general, vaccination provides a very good source of immunity, as does receiving a booster with an mRNA vaccine."
This, he said, has worked against the Delta variant as well as Omicron, so it is possible that it will work against the next variants, although this remains to be seen.
In view of this, he called on the eligible community that has not been immunized to consider the data and get vaccinated, get their two doses of an mRNA vaccine, and for those who already have them, get the booster.
Post-acute COVID-19 Syndrome
Dr. Héctor Fabio Bonilla, co-director of the Post Acute COVID-19 Syndrome Clinic at Stanford Hospital (PACS), pointed out that some people, weeks after having the disease, have presented symptoms such as extreme tiredness, headache, concentration problems, lack of memory and even respiratory or heart problems, depression and anguish.
All of these, he said, could be part of what is now known as post-acute COVID-19 syndrome, because for many, the feeling of discomfort does not pass, despite having been infected six months ago, or even a year or two ago.
These long-term effects have also been defined by the Centers for Disease Control and Prevention (CDC) and the U.S. National Institutes of Health (NIH) as a syndrome after 28 days after testing positive for the virus.
While the World Health Organization has defined it as such when symptoms have persisted 5 to 6 months after the onset of the disease.
Among the most common symptoms of this syndrome are extreme tiredness, disability due to muscle weakness, pain, persistent cough, severe headache, anxiety, depression, sleep disorders, "mental fog", memory loss, hair loss, or even heart problems - palpitations and chest pain - and kidney failure, among others.
Mental fog is a symptom where the patient cannot concentrate or starts reading and feels tired and forgets things. This is because the brain is compromised in those with COVID-19.
Recent evidence, he pointed out, has shown that in patients with COVID-19 the brain is affected, evidence that was compiled after sophisticated tests and studies that measure brain metabolism, and in which it has also been proven that the organ suffers from inflammation.
These inflammations that the body suffers from the virus can also be observed in the lungs, which can trigger pulmonary fibrosis, and with this, patients can present cerebrovascular accidents or it can trigger a systemic inflammatory syndrome.
In view of this, the doctor also made a call to opt for the vaccine, since so far it is the best weapon against these problems in the long term.
Dr. Bonilla explained that 37 percent of those who have had COVID-19 have at least one post-COVID symptom, which lasts between three and six months after the inflammation.
The pathobiology of post-acute COVID-19 syndrome is still under study, since it is not known what causes it, as it could be an overreaction of the immune system, viral particle reservoirs, genetic factors, autoantibodies, or mitochondrial dysfunctions.
Because the syndrome is still "new", little is known about how to treat it or how to support patients who suffer from it. Stanford Hospital Post Acute COVID-19 Syndrome Clinic (PACS), for assistance.
Finally, he called on everyone to understand and believe in those patients who have these types of symptoms, not to minimize them and to seek appropriate help.
Experience it firsthand
Dr. Margot Gage Witvliet experienced first-hand the disease and then the syndrome, which she called "Roller coaster. One of the worst rides of her life".
It was March 2020, and the doctor tested positive for the virus after returning from a work trip, quickly took a turn for the worse and required a trip to the hospital, where she fought for her life at every turn.
There, in the midst of medical devices and tubes, he began a video diary of his process, which can be found on YouTube. He managed to get ahead, but the struggle was just beginning, as he did not know the consequences and disorders that the disease would bring him.
Thus, after months of fighting for the doctors to believe in what he was going through, such as pain, fatigue, lack of oxygenation, among others, he managed to get through.
His experience has made him raise his voice on behalf of all those patients who suffer from the syndrome and are not properly cared for, or who are even mistreated by their treatment providers and people close to them, considering that they exaggerate their symptoms.
"Every time I saw my doctor he just didn't believe what I was saying. And when I came in with respiratory problems, with my oxygen levels sometimes dropping into the sixties, they assumed I was on drugs and it was very unfair. No sympathy at all."
"After my seizure, all I could do was sit in a dark room. I couldn't read. I couldn't write and I have my young children around me and I had a lot of neurological symptoms and what they didn't know is that they were my lifelines. My oldest daughter would read to me and I could stand it for small periods of time and I would color with my youngest daughter and that constituted my day."
In view of this, he reported that many physicians are still not taking the problem seriously, a situation that adds to the bias in healthcare, where there is real discrimination against women, people of color, older people, because of their sexual identity, educational level and socioeconomic status.
"We need to start working to make sure we all move forward believing our patients and listening to them. Especially those whose diseases are invisible. We need to do more to fix the healthcare system."
Doubts and more doubts
The Casa CÃrculo Cultural organization was able to get the experts to answer questions from the Redwood City community about COVID-19, including:
Q: My breathing is different than it was before I had COVID-19. Is that COVID-prolonged?
A: Yes, it is a symptom we see in these patients.
Q: How long do the after-effects of COVID last, such as anxiety, fatigue, dry throat and weakness, difficulty socializing or even returning to normal life?
A: 96 percent of patients recover within two years, but others take longer. We don't know how long. We have patients who continue with symptoms for more than 21 months.
Q: If my children get COVID, how long does it take before I can vaccinate them?
A: If your children are infected with COVID and are older than 5 years, you can wait 3 months before vaccinating them - this is only a recommendation: it is safe to vaccinate them at any time.
Q: How common are the symptoms of COVID-prolonged in young people?
A: In a study we conducted at Stanford, we found that COVID symptoms were quite common in young people: 30 percent of individuals with COVID had persistent symptoms 4 months later, most commonly fatigue, mental fogginess, and shortness of breath.
Q: Is prolonged COVID just the symptoms or are they carriers of the virus and can they still be contagious?
A: We are not clear what causes prolonged COVID. No persistent virus has been found in prolonged COVID. There is no evidence of transmission of infection.
Q: Once positive, how likely is it to become infected again?
A: Studies have shown that once infected, you are protected from getting another coronavirus for 4-6 months. This may be shorter or longer depending on the individual.
Q: What may be the future results of the COVID-prolonged study and when do the symptoms stop?
A: These studies are in progress and information is coming out. We found a lot of abnormalities, but we are putting these pieces together.
Q: Why is it that some people who have contracted COVID, and are asymptomatic, can be up to 3 or 4 months positive?
A: We don't know the answer yet, but it is possible that it is a "dead" virus or one that cannot be transmitted to others.
Q: Pfizer is working on a flu vaccine and COVID in one shot. Since COVID is such a new virus, do you think it is appropriate to mix the two in one vaccine or should they be separated? What about the reaction? How would you tell the difference between the two viruses?
A: There are many examples of combination vaccines, e.g., measles/mumps/rubella. Regarding this Pfizer trial, your questions are the exact reason why the trial should be done. Even if it sounds like a good idea to the scientists, we won't know if it is safe and effective until the trial is done.
Those who attended the event in person were presented with a pantry product card from Stanford Medicine and the Willow Market, located at 37 Willow St, Redwood City, CA 94063.
IF YOU BELIEVE YOU HAVE PROLONGED COVID CONTACT 650-736-5200 for more information.
You may be interested in: "Long COVID": Experiencing symptoms that won't go away.
