Emergence of a Deadly Coronavirus

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Michelle Wilson got COVID three years ago. She's still waiting for her brain and nervous system to recover.

Wilson's memory is spotty, she's frequently in pain, and even a short walk leaves her exhausted.

"I actually bought a cane that turns into a seat so I can go to the botanical garden," she says.

It's a big change for Wilson, 66, who had worked as a nurse at Barnes-Jewish Hospital in St. Louis. But after years of waiting to get better, she says she's realized something:

"This might be as good as it gets."

It's a story shared by a growing number of COVID "long-haulers" — those patients who suffer from persistent symptoms long after the initial infection has passed. Many of those symptoms, experts say, appear to be tied to COVID's effects on the brain and nervous system.

Michelle Wilson receives a coronavirus vaccine at Barnes-Jewish Hospital in St. Louis, Mo. Wilson had gotten COVID earlier in the pandemic, before vaccines were available.

Government surveys suggest that millions of people in the U.S. are living with neurological symptoms linked to long COVID. Many, like Wilson, were infected before vaccines became available.

Michelle Wilson got COVID three years ago. She's still waiting for her brain and nervous system to recover.

Wilson's memory is spotty, she's frequently in pain, and even a short walk leaves her exhausted.

"I actually bought a cane that turns into a seat so I can go to the botanical garden," she says.

It's a big change for Wilson, 66, who had worked as a nurse at Barnes-Jewish Hospital in St. Louis. But after years of waiting to get better, she says she's realized something:

"This might be as good as it gets."

It's a story shared by a growing number of COVID "long-haulers" — those patients who suffer from persistent symptoms long after the initial infection has passed. Many of those symptoms, experts say, appear to be tied to COVID's effects on the brain and nervous system.

"It's a public health crisis," says Dr. Robyn Klein, who directs the Center for Neuroimmunology and Infectious Diseases at Washington University School of Medicine in St. Louis.

There are a lot of people suffering and those people need treatment yesterday," says Dr. Ziyad Al-Aly, who holds positions at both Washington University and the Veterans Affairs St. Louis Health Care System.

But treatment remains a distant promise.

"There's still a ton we don't know," says Dr. Troy Torgerson of the Allen Institute for Immunology in Seattle. Scientists are "nibbling away" at the problem, he says.

The virus appears to do most of its damage to the brain indirectly, scientists say.

An infection in the body triggers an immune response that leads to inflammation in the brain. And the inflammation can persist long after the virus has apparently been cleared, scientists say.

The brain may be especially vulnerable to COVID because the disease appears to weaken the blood-brain barrier, which usually protects the organ from both germs and the immune cells that follow them.

Another possibility is that COVID-related inflammation affects the vagus nerve, which carries signals between the body and brain that are important to memory and attention.

From lungs to brain
Early in the pandemic, doctors tended to focus on what COVID did to a person's lungs.

In those days, Wilson was working in the post-anesthesia care unit at Barnes-Jewish Hospital.

"I got people ready for surgery, and woke them up after their surgeries," she says. "I loved that job."

But the job put her in close proximity to lots of potentially infected patients. And in November of 2020, Wilson got the disease.

When the symptoms grew worse, she went to the emergency department at her own hospital.

"I had bilateral pneumonia and I was in sepsis by that time," she says. "My blood pressure was really low and I had an irregular heartbeat”.

People with neurological symptoms do get better, he says, but full recovery is rare.

Three years after getting COVID, Wilson continues to struggle with a range of symptoms, including an unreliable memory.

"I have trouble with word retrieval, concept retrieval — and sometimes, like, remembering where I was going," she says.

Wilson also has problems sleeping at night, a condition Al-Aly says affects about 40 percent of people with long COVID.

Poor sleep can also contribute to the pain that many long COVID patients report.

When Wilson first came home from the hospital, she was in agony.

"The pain across my chest and in my arms was so bad that I slept with pillows under both arms because I couldn't stand my arms to touch my chest," she says.

Now Wilson is able to do things like make breakfast or take a shower — so long as she takes her pain meds.

Immune system gone wrong?
There's growing evidence that even a mild case of COVID can cause long-term changes to the immune system that affect the brain and nervous system.

Torgerson of the Allen Institute was part of a team that studied blood samples from 55 people who had symptoms at least 60 days after a COVID infection.

"We saw persistent ongoing immune activation in about half," he says, even though only a handful had been sick enough to be hospitalized.

Once the immune system gets fired up, Torgerson says, it can affect the brain even if the virus itself doesn't infect brain cells.

Long COVID also has some striking similarities to autoimmune diseases, which occur when the immune system mistakenly attacks healthy cells, Torgerson says.


A mouse model of COVID
To learn more about how long COVID affects a human brain, scientists have been studying mice that develop a mild version of the disease.

"Those animals have cognitive deficits a month after they were infected," Klein says. "They no longer have virus, they're no longer ill. But they can't remember and recognize things."

One reason may be that the infection weakens the blood-brain barrier in these animals, Klein says, allowing the body's immune response to affect brain cells.

The result is inflammation that causes subtle but significant changes in the brain.

"It's not like there's a multitude of dying neurons," Klein says. "What there is, is elimination of the connections between neurons."

Klein suspects that something similar is happening to the synaptic connections in the brains of people who get long COVID. And she says it appears this can happen even in people who don't get very sick.

"You and I may handle viruses differently," she says. "I may end up getting more inflammation in my brain than you because we have a different genetic makeup."

One way to protect the brain after an infection may be with drugs that reduce inflammation — and studies to test that idea are already underway. In the meantime, vaccination offers a way for people to reduce their risk of developing long COVID.

Michelle Wilson, though, got infected before vaccination was an option. And she'd like a treatment that can undo what COVID has done to her brain.

"We don't know everything about COVID yet," she says, "So I have hope."

A small and preliminary study published Monday seems to indicate that patients receiving the drug Paxlovid are far more likely to experience Covid rebound than those who did not take it.

That conclusion runs counter to previous statements by Pfizer, which makes Paxlovid, and by researchers at the Food and Drug Administration who have argued that while it is not uncommon for people with Covid to have symptoms reemerge after they seem to have recovered, it is not clear that Paxlovid increases the risk of this occurring.

The study’s authors and outside experts emphasize that there is no question that Paxlovid is a useful drug that can help keep patients infected with the SARS-CoV-2 virus from being hospitalized. But some also wondered if the results might be an indicator that the current dosing duration of Paxlovid — daily, for five days — is not long enough.

In the study, published in the Annals of Internal Medicine, a peer-reviewed journal, researchers followed 142 people who were enrolled in an ongoing study of Covid from March 2022 to May 2023. Participants were not randomly assigned to receive Paxlovid or a placebo, making it difficult to draw firm conclusions

The 72 people in the study who received Paxlovid were on average almost two decades older, had received more vaccinations, and were more likely to have suppressed immune systems than those who did not.

But the difference was stark. Fifteen people, or 21%, of those who took Paxlovid had their viral levels increase again after they seemed to have gotten better. That compared to one, or 1.8%, of those who did not receive Paxlovid.

We got shots for Flu, COVID-19, and RSV in October, all on different days.

(Different days because, apparently, of availability issues for the hospital where we get our healthcare.)

Being concerned about spreading COVID-19 is reportedlysooo last season.

As the U.S. heads into the fourth holiday season since the pandemic's onset, most Americans aren’t worried about COVID-19 spread or prevention during the holidays this year, a new study has revealed.

Many people have not received the latest vaccine, according to KFF’s latest COVID-19 Vaccine Monitor survey — which could be a reflection of the decreased concern.

About half of adults surveyed said they do not plan to get the newest COVID vaccine that was released this fall.

A quarter of the respondents said they intend to get the latest vaccine — but only two in 10 adults have already received it.

The largest adopters of the vaccine include Democrats and people who are age 65 and older, the survey revealed.

About half (52%) of people who were previously vaccinated admitted they haven’t received the latest vaccine due to a lack of worry about COVID-19.

Only about three in 10 people are worried about spreading COVID to friends and family over the holidays or becoming seriously sick from the virus.

The public is divided on taking precautions, the survey found: Half of adults say they plan to attempt to limit the spread with at least one safety procedure, including avoiding large gatherings, wearing a mask or testing for COVID before visiting friends and family.

The other half do not plan to implement any precautions at all.

The KFF report findings are based on responses from a nationally representative sample of roughly 1,400 adults who were interviewed online and by telephone between Oct. 31 and Nov. 7, the group's website says.

Fox News contributor Dr. Nicole Saphier reacted to the survey results in an exchange with Fox News Digital, noting that concern about COVID during the holidays has "certainly evolved" over the last few years.

As we enter this holiday season, the majority of people have already had at least one COVID infection, most of which likely only experienced mild to moderate symptoms," she said.

Saphier pointed out that the greatest fear at the beginning of the pandemic was the unknown — which prompted the public to take extra care when heading into the 2020 holidays.

The doctor added that, as with every holiday season, other viruses such as the flu and RSV are also waiting to "wreak havoc," which has pulled COVID out of the spotlight.

"COVID is no longer the outlier, [but] rather just another virus among the masses," she said.

Ahead of the approaching holidays and a potential rise in cases this winter, the government is once again allowing households to order a fresh wave of four COVID-19 tests for free online.

The website, covidtests.gov, remains one of the last remaining ways Americans can secure free at-home rapid test after the end of the public health emergency last spring ended the requirement for insurance companies to cover eight tests per month.

The test ordering site relaunched last month, offering four tests per household, and will now offer an additional four tests per household for anyone who has already ordered -- or eight tests per household for anyone who hasn't placed an order yet this fall.

Since September, about 14.5 million households have ordered tests, for a total of 58 million tests shipped, according to the Administration for Strategic Preparedness and Response, or ASPR, a department within the Department of Health and Human Services.

Some of the free tests that the government has stockpiled are also up against impending expiration dates, another reason to move the tests along, O'Connell said. The Food and Drug Administration recently extended expiration dates for many at-home tests, but they still have a relatively short shelf life.

"We know that the tests are going to be good for the next several months. They're not going to be good forever. And so we think it's important that we go ahead and have them in the hands of the American people so they can use them and protect themselves as we head into the winter," O'Connell said.

The tests will come from a $600 million investment in domestic test manufacturers, which will yield around 200 million tests and replenish the federal stockpile. Tests ordered from covidtests.gov will be pulled from that stockpile.

The funding for the $600 million investment will come from money that was left over from a past supplemental COVID-19 bill.

Incidence of a COVID-19 variant appears to have increased threefold in the U.S. in recent weeks, federal tracking showed.

The BA.2.86 variant – a mutated COVID-19 strain previously thought to be uncommon – is projected to account for nearly one-tenth of circulating viruses, according to the Center for Disease Control and Prevention’s Nowcast variant tracker posted Monday. Two weeks ago, the variant made up 3% of cases. These figures are based on estimates of circulating variants.

“The numbers are less important,” Dr. Perry Halkitis, dean of the Rutgers School of Public Health in New Jersey, told USA TODAY. “The pattern is more important. And it looks like it's growing.”

The most recent estimate that BA.2.86 makes up 9% of COVID-19 cases is not a firm number. Health officials say the variant probably accounts for 5% to 15% of circulating variants in the U.S.

Testing is considered a less reliable indicator of disease prevalence. But the increase in hospitalizations and deaths from COVID-19 should cause concern, Halkitis said. Colder temperatures in densely populated regions such as the New York area may account for increases in the Northeast in recent days, he said.

The COVID-19 virus, like other viruses, is constantly changing through mutations that make it easier to spread or are resistant to medicines or vaccines.

BA.2.86 comes from the BA.2 lineage, and it’s a subvariant of omicron, which came to dominate cases two years ago. BA.2.86 also has an offshoot, JN.1, but it appears rare for now.

Updated COVID-19 vaccines are expected to increase protection against BA.2.86, the CDC said.

BA.2.86 doesn’t appear to be driving increases in infections or hospitalizations, the CDC said. The CDC and the World Health Organization believe the variant’s risk to public health is low for severe illness compared with other variants. But on Aug. 21, WHO reclassified BA.2.86 as a "variant of interest" amid global increases.

CDC data showed the Northeastern region, including New Jersey and New York, saw 13% of cases derived from BA.2.86, the highest figures recorded for the variant.

In a statement, the New York State Department of Health said the BA.2.86 variant has been detected in state wastewater, a tool for COVID-19 surveillance, since late August and has been increasing in proportion over recent months.

New York health officials said BA.2.86 cases are increasing across the state. But they added they anticipated the increase because BA.2.86 reportedly is more transmissible than other circulating variants.

The New Jersey Department of Health has noted increasing numbers of BA.2.86 specimens since mid-October, department spokesperson Dalya Ewais wrote in an email. New Jersey is expected to see similar trends as the CDC's Nowcast estimates for the region, she added. Still, she said, BA.2.86 isn't likely to reach levels of the first COVID-19 outbreak in spring 2020, or the omicron variant.

Health officials from New Jersey and New York encouraged people to stay up to date on COVID-19 vaccines. If symptoms develop, people should get tested and stay home.