Here are some interesting public health developments related to the COVID pandemic
Long COVID
The WHO has released its first document on “Long COVID” the term being given to describe the symptoms that persist after infection with COVID19. In this document, the definition is very broad, but as more experience is gained it can be expected that the definition will become more specific
There have now been more than 200 million cases and 4.5 million deaths reported from COVID19. The true number is likely to be far greater. The death rate approximates 2%. Of those who recover, a percentage experience persistent symptoms, with studies indicating rates of between 10 and 30 %. There are a variety of symptoms reported (listed in the WHO report’s Appendix). Profound lethargy and continuing tiredness seem to be the most common and debilitating problems. It is not unlike the symptoms experienced by many patients recovering from Dengue, Ross River Virus or Epstein-Barr virus infection. Long Covid may turn out to be one of the most troubling legacies of the COVID19 pandemic.
The final wording of the WHO definition is:
“Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms include fatigue, shortness of breath, cognitive dysfunction but also others (see Table 3 and Annex 2) which generally have an impact on everyday functioning. Symptoms may be new onset, following initial recovery from an acute COVID-19 episode, or persist from the initial illness. Symptoms may also fluctuate or relapse over time. A separate definition may be applicable for children.”
Role of Vaccination and COVID19 transmission within families
The study by Nordstrom 2021, Association Between Risk of COVID-19 Infection in Nonimmune Individuals and COVID-19 Immunity in Their Family Members published in JAMA Internal Medicine on October 11, 2021, is an important study.
The study documents the reduction in risk of transmission of the virus to unvaccinated members of a family where some have had the vaccine. This cohort study came from Sweden and used a population of 1.5 million persons in 800,000 families. The authors found that family members without immunity had a 45% to 97% lower risk of contracting COVID-19 as the number of immune family members increased. This study is a further demonstration of the value of vaccination as a key strategy for decreasing the transmission of the virus within families.
References
- A clinical case definition of the post-COVID-19 condition by a Delphi consensus, 6 October 2021 (pdf)
- Nordström P, et al. Association Between Risk of COVID-19 Infection in Nonimmune Individuals and COVID-19 Immunity in Their Family Members. JAMA Intern Med 2021.
Colin Binns, MBBS, PhD
Editor-in-Chief, Asia-Pacific Journal of Public Health
School of Public Health, Curtin University, Perth, Australia
Wah Yun Low, PhD
Managing Editor, Asia-Pacific Journal of Public Health
President, Asia-Pacific Academic Consortium for Public Health
Deputy Executive Director, Asia Europe Institute
University of Malaya, Kuala Lumpur, Malaysia
Victor Hoe Chee Wai, MBBS, PhD
Webmaster, Asia-Pacific Academic Consortium for Public Health
Department of Social and Preventive Medicine, Faculty of Medicine
University of Malaya, Kuala Lumpur, Malaysia
