People With ‘Medium COVID’ Are Caught in A Gray Area

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The inability to smell milk that has gone bad. A racing heartbeat. These are just a few COVID-19 symptoms that can linger after an initial coronavirus infection. Though they may not always amount to the debilitating cases of long COVID-19 that can leave people bedridden or unable to perform daily functions, it’s very common to take weeks to fully recover — a condition called as “medium COVID”, reports npr.

Road to recovery

“There could be more to help people understand that it’s not always a quick bounce back right away after the initial infection,” said Dr. Ben Abramoff, director of the Post-COVID Assessment and Recovery Clinic at Penn Medicine in Philadelphia. “This is still a very significant viral infection, and sometimes it’s just a more gradual recovery process than people’s previous viral illnesses.”

COVID-19 symptoms that last for weeks may come as a surprise to some, especially after recent messaging from health authorities. In December, the Centers for Disease Control and Prevention announced that those who test positive for the coronavirus can exit isolation after just five days if they are free of symptoms and continue to wear masks.

That recommendation is understandably focused on the period during which someone is contagious, and as a result, it doesn’t mention anything about lasting or recurring symptoms that might continue after the person is no longer infectious. But it can have the effect of suggesting that, for most people, the recovery process is, if not five days, pretty quick.

How doctors define long COVID-19

Since the Penn Post-COVID clinic opened in June 2020, Abramoff has seen about 1,100 patients at it. He said there is no official threshold at which someone officially becomes a long COVID-19 patient. If people have been feeling bad for only a few weeks, he considers that to be the tail end of the illness itself. The clinic isn’t really in the business of treating COVID-19 in its acute phase.

For those dealing with symptoms for months, the clinic takes a comprehensive approach, evaluating patients and referring them to specialists who can address their particular needs: a pulmonologist for breathing difficulty, a speech pathologist for someone struggling with cognitive issues, even social workers or other support staff who can help people navigate taking time off work and accessing various disability benefits.

But then there is that awkward gray area: people who have been feeling bad for six to eight weeks after their initial infection. Abramoff said when those people come into his clinic, which they often do, he generally sends them home and tells them to rest. They’ll likely get better on their own if they take it easy.

For people in that position, his best advice is to take a “watchful waiting” approach: Keep the lines of communication with a primary care doctor open, and be very careful about not rushing back to life as normal.

“You have got to build based on your tolerance,” he said. “People were very sick, even if they weren’t in the hospital.”

Other physicians have drawn a more definitive line demarcating when symptoms cross into long COVID-19. Stuart Katz, a cardiologist and professor at New York University’s Grossman School of Medicine, is a principal investigator on a $470 million long COVID-19 study funded by the National Institutes of Health that will collect data from nearly 60,000 long COVID-19 patients across 200 sites nationwide.

For the purposes of his study, Katz and his team will classify symptoms lasting more than 30 days as long COVID-19. Using that benchmark, he estimates that about 25% to 30% of people with COVID infections will have persisting symptoms.

But he said, the 30 days is an arbitrary cutoff point.

“There’s this whole spectrum of changing symptoms over time,” said Katz.

But even a small percentage of infected people dealing with medium-range symptoms would mean millions of people: The U.S. has recorded nearly 80 million coronavirus infections to date. If about 9% of those individuals dealt with symptoms for roughly two months, that’s 7 million people.

Aside from amounting to millions of people who feel ill and a lasting burden on the health care system, those numbers can add up to have a meaningful impact on the economy. Recent research from the Brookings Institution estimated that lasting COVID-19 symptoms could be responsible for up to 15% of the unfilled jobs in America’s labor market.

The point here is that even if you don’t have long COVID-19, it can still take a long time to recover. A bout of medium COVID can happen to anyone — and it’s important for patients, their families and their employers to understand that.

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Source: npr

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