Emergence of a Deadly Coronavirus

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As for zero incentive in the US, there's clearly a big difference with the UK, as you point out, but I wouldn't say zero. People are known to look to any excuse for sympathy or attention at the best of times, it could be used as an excuse for not meeting deadlines, mental health/marriage problems and so on.

That's not to suggest people aren't suffering, but if it was a serious widespread problem I'd expect the MSM to be going overboard with it, which they are most definitely not, though maybe that's because the cost/benefit to the powers that be in doing so at this stage would be negative.

Another chapter of the pandemic is drawing to a close. Masking in hospitals is no longer mandatory. Instead, the decision will be up to individual operators.

As we approach three years since the pandemic started, one of the last COVID-era mandates is finally ending.

Starting Sunday, masks and face coverings will no longer be required in health care facilities in New York.

The end of the mandate affects hospitals, nursing homes, and treatment centers. State officials say each facility will be allowed to craft its own policy moving forward.

For New York City Health + Hospitals, it means masking will continue.

"That is wonderful that we can go back to some sort of normalcy because it's been very difficult the last few years living a life separate from everybody else," said a man named David from the Upper West Side.

All of these changes come as New York has seen a steady decline in transmission rates of COVID over the last two months.

"Most people now are just getting sniffles from it. They aren't coming down with anything serious anymore," said Anthony Stanhope of the Upper West Side.

On Friday, the city's vaccine mandate for workers also came to an end. Nearly 2,000 city employees who lost their jobs during the pandemic can now reapply.

Labor attorney Jon Bell told CBS2 the fired workers may have a difficult time trying to recoup back pay, even if they are rehired.

It's preposterous and I definitely never want to see this again. So for me this is a big win but it's not the end of the fight and I personally won't stop fighting until everybody gets the opportunity to get their jobs back and that we have it in writing that this can never happen to us again," said Sophy Medina, a firefighter.

The state has seen a steady decline in COVID transmission rates over the last two months.

New York state ends COVID mask mandate in health care facilities


Just sniffles? My sister, brother in law, and nephew had fever, chills, and body aches in December. My sister lost taste for a time and has caught 3 colds since that time. My nephew never vaxxed and my sister and and brother in law had not vaxxed in a long time.

The positivity rates and case numbers has cratered since that time but who knows they are only reporting PCR tests by people who tested positive at doctors offices and hospitals

In the early spring of 2020, the condition we now call long COVID didn’t have a name, much less a large community of patient advocates. For the most part, clinicians dismissed its symptoms, and researchers focused on SARS-CoV-2 infections’ short-term effects. Now, as the pandemic approaches the end of its third winter in the Northern Hemisphere, the chronic toll of the coronavirus is much more familiar. Long COVID has been acknowledged by prominent experts, national leaders, and the World Health Organization; the National Institutes of Health has set up a billion-dollar research program to understand how and in whom its symptoms unfurl. Hundreds of long-COVID clinics now freckle the American landscape, offering services in nearly every state; and recent data hint that well-vetted drugs to treat or prevent long COVID may someday be widespread. Long COVID and the people battling it are commanding more respect, says Hannah Davis, a co-founder of the Patient-Led Research Collaborative, who has had long COVID for nearly three years: Finally, many people “seem willing to understand.”

But for all the ground that’s been gained, the road ahead is arduous. Long COVID still lacks a universal clinical definition and a standard diagnosis protocol; there’s no consensus on its prevalence, or even what symptoms fall under its purview. Although experts now agree that long COVID<does not refer to a single illness, but rather is an umbrella term, like cancer they disagree on the number of subtypes that fall within it and how, exactly, each might manifest. Some risk factors—among them, a COVID hospitalization, female sex, and certain preexisting medical conditions—have been identified, but researchers are still trying to identify others amid fluctuating population immunity and the endless slog of viral variants. And for people who have long COVID now, or might develop it soon, the interventions are still scant. To this day, “when someone asks me, ‘How can I not get long COVID?’ I can still only say, ‘Don’t get COVID,’” says David Putrino, a neuroscientist and physical therapist who leads a long-COVID rehabilitation clinic at Mount Sinai’s Icahn School of Medicine.

As the world turns its gaze away from the coronavirus pandemic, with country after country declaring the virus “endemic” and allowing crisis-caliber interventions to lapse, long-COVID researchers, patients, and activists worry that even past progress could be undone. The momentum of the past three years now feels bittersweet, they told me, in that it represents what the community might lose. Experts can’t yet say whether the number of long-haulers will continue to increase, or offer a definitive prognosis for those who have been battling the condition for months or years. All that’s clear right now is that, despite America’s current stance on the coronavirus, long COVID is far from being beaten.

Despite an influx of resources into long-COVID research in recent months, data on the condition’s current reach remain a mess—and scientists still can’t fully quantify its risks.

Recent evidence from two long-term surveys have hinted that the pool of long-haulers might be shrinking, even as new infection rates remain sky-high:

Experts cautioned, however, that there are plenty of reasons to treat these patterns carefully—and to not assume that the trends will be sustained. It’s certainly better that these data aren’t showing a sustained, dramatic uptick in long-COVID cases. But that doesn’t mean the situation is improving. Throughout the pandemic, the size of the long-COVID pool has contracted or expanded for only two reasons: a change in the rate at which people enter, or at which they exit. Both figures are likely to be in constant flux, as surges of infections come and go, masking habits change, and vaccine and antiviral uptake fluctuates.

Recent counts of new long-COVID cases might also be undercounts, as testing slows and people encounter more challenges getting diagnosed. That said, it’s still possible that, on a case-by-case basis, the likelihood of any individual developing long COVID after a SARS-CoV-2 infection may have fallen since the pandemic’s start, says Deepti Gurdasani, a clinical epidemiologist at Queen Mary University of London and the University of New South Wales. Population immunity—especially acquired via vaccination—has, over the past three years, better steeled people’s bodies against the virus, and strong evidence supports the notion that vaccines can moderately reduce the risk of developing long COVID. Treatments and behavioral interventions that have become more commonplace may have chipped away at incidence as well. Antivirals can now help to corral the virus early in infection; ventilation, distancing, and masks—when they’re used—can trim the amount of virus that infiltrates the body. And if overall exposure to the virus can influence the likelihood of developing long COVID, that could help explain why so many debilitating cases arose at the very start of the pandemic, when interventions were few and far between, says Steven Deeks, a physician researcher at UC San Francisco.

There’s not much comfort to derive from those individual-level stats, though, when considering what’s happening on broader scales. Even if immunity makes the average infected person less likely to fall into the long-COVID pool, so many people have been catching the virus that the inbound rate still feels like a flood. “The level of infection in many countries has gone up substantially since 2021,” Gurdasani told me. The majority of long-COVID cases arise after mild infections, the sort for which our immune defenses fade most rapidly. Now that masking and physical distancing have fallen by the wayside, people may be getting exposed to higher viral doses than they were a year or two ago. In absolute terms, then, the number of people entering the long-COVID pool may not really be decreasing. Even if the pool were getting slightly smaller, its size would still be staggering, an ocean of patients with titanic needs. “Anecdotally, we still have an enormous waitlist to get into our clinic,” Putrino told me.

Deeks told me that he’s seen another possible reason for optimism: People with newer cases of long COVID might be experiencing less debilitating or faster-improving disease, based on what he’s seen. “The worst cases we’ve seen come from the first wave in 2020,” he said. But Putrino isn’t so sure. “If you put an Omicron long-COVID patient in front of me, versus one from the first wave, I wouldn’t be able to tell you who was who,” he said. The two cases would also be difficult to compare, because they’re separated by so much time. Long COVID’s symptoms can wax, wane, and qualitatively change; a couple of years into the future, some long-haulers who’ve just developed the condition may be in a spot that’s similar to where many veterans with the condition are now.

Experts’ understanding of how often people depart the long-COVID pool is also meager. Some long-haulers have undoubtedly seen improvement—but without clear lines distinguishing short COVID from medium and long COVID, entry and exit into these various groups is easy to over- or underestimate. What few data exist on the likelihood of recovery or remission is inconsistent, and not always rosy: Investigators of RECOVER, a large national study of long COVID, have calculated that about two-thirds of the long-haulers in their cohort do not return to baseline health. Putrino, who has worked with hundreds of long-haulers since the pandemic began, estimates that although most of his patients experience at least some benefit from a few months of rehabilitation, only about one-fifth to one-quarter of them eventually reach the point of feeling about as well as they did before catching the virus, while the majority hit a middling plateau. A small minority of the people he has treated, he told me, never seem to improve at all.

Even long-haulers who have noticed an improvement in their symptoms are wary of overconfidence. Some absolutely do experience what could be called recovery—but for others, the term has gotten loaded, almost a jinx. “If the question is, ‘Are you doing the things you were doing in 2019?’ the answer is largely no,” says JD Davids, a chronic-illness advocate based in New York. For some, he told me, “getting better” has been more defined by a resetting of expectations than a return to good health. Relapses are also not uncommon, especially after repeat encounters with the virus. Lisa McCorkell, a long-hauler and a co-founder of the Patient-Led Research Collaborative, has felt her symptoms partly abate since she first fell ill in the spring of 2020. But, she told me, she suspects that her condition is more likely to deteriorate than further improve—partly because of “how easy it is to get reinfected now.”

Last week, in his State of the Union address, President Joe Biden told the American public that “we have broken COVID’s grip on us.” Highlighting the declines in the rates of COVID deaths, the millions of lives saved, and the importance of remembering the more than 1 million lost, Biden reminded the nation of what was to come: “Soon we’ll end the public-health emergency.”

When the U.S.’s state of emergency was declared nearly three years ago, as hospitals were overrun and morgues overflowed, the focus was on severe, short-term disease. Perhaps in that sense, the emergency is close to being over, Deeks told me. But long COVID, though slower to command attention, has since become its own emergency, never formally declared; for the millions of Americans who have been affected by the condition, their relationship with the virus does not yet seem to be in a better place.

Even with many more health-care providers clued into long COVID’s ills, the waiting lists for rehabilitation and treatment remain untenable, Hannah Davis told me. “I consider myself someone who gets exceptional care compared to other people,” she said. “And still, I hear from my doctor every nine or 10 months.” Calling a wrap on COVID’s “emergency” phase could worsen that already skewed supply-demand ratio. Changes to the nation’s funding tactics could strip resources—among them, access to telehealth; Medicaid coverage; and affordable antivirals, tests, and vaccines—from vulnerable populations, including people of color, that aren’t getting their needs met even as things stand, McCorkell told me. And as clinicians internalize the message that the coronavirus has largely been addressed, attention to its chronic impacts may dwindle. At least one of the country's long-COVID clinics has, in recent months, announced plans to close, and Davis worries that more could follow soon.

Scientists researching long COVID are also expecting new challenges. Reduced access to testing will complicate efforts to figure out how many people are developing the condition, and who’s most at risk. Should researchers turn their scientific focus away from studying causes and cures for long COVID when the emergency declaration lifts, Davids and others worry that there will be ripple effects on the scientific community’s interest in other, neglected chronic illnesses, such as ME/CFS (myalgic encephalomyelitis or chronic fatigue syndrome), a diagnosis that many long-haulers have also received.

The end of the U.S.’s official crisis mode on COVID could stymie research in other ways as well. At Johns Hopkins University, the infectious-disease epidemiologists Priya Duggal, Shruti Mehta, and Bryan Lau have been running a large study to better understand the conditions and circumstances that lead to long COVID, and how symptoms evolve over time. In the past two years, they have gathered online survey data from thousands of people who both have and haven’t been infected, and who have and haven’t seen their symptoms rapidly resolve. But as of late, they’ve been struggling to recruit enough people who caught the virus and didn’t feel their symptoms linger.

Kate Porter, a Massachusetts-based marketing director, told me that she worries about her family’s future, should long COVID fade from the national discourse. She and her teenage daughter both caught the virus in the spring of 2020, and went on to develop chronic symptoms; their experience with the disease isn’t yet over. “Just because the emergency declaration is expiring, that doesn’t mean that suddenly people are magically going to get better and this issue is going to go away,” Porter told me. After months of relative improvement, her daughter is now fighting prolonged bouts of fatigue that are affecting her school life—and Porter isn’t sure how receptive people will be to her explanations, should their illnesses persist for years to come. “Two years from now, how am I going to explain, ‘Well, this is from COVID, five years ago’?” she said.

A condition that was once mired in skepticism, scorn, and gaslighting, long COVID now has recognition—but empathy for long-haulers could yet experience a backslide. Nisreen Alwan, a public-health researcher at the University of Southampton, in the U.K., and her colleagues have found that many long-haulers still worry about disclosing their condition, fearing that it could jeopardize their employment, social interactions, and more. Long COVID could soon be slated to become just one of many neglected chronic diseases, poorly understood and rarely discussed.

Davis doesn’t think that marginalization is inevitable. Her reasoning is grim: Other chronic illnesses have been easier to push to the sidelines, she said, on account of their smaller clinical footprint, but the pool of long-haulers is enormous—comprising millions of people in the U.S. alone. “I think it’s going to be impossible to ignore,” she told me. One way or another, the world will have no choice but to look.

Queen Camilla has tested positive for coronavirus nearly a year to the day after her first diagnosis with COVID-19 was announced.

Buckingham Palace shared the news in a statement on Monday.

"After suffering the symptoms of a cold, Her Majesty The Queen Consort has tested positive for the Covid virus," the palace said. "With regret, she has therefore cancelled all her public engagements for this week and sends her sincere apologies to those who had been due to attend them."

Last February, Clarence House announced that Queen Camilla, 75, tested positive for COVID. Camilla tested positive four days after her husband, who was then known as Prince Charles, entered self-isolation following his own positive coronavirus diagnosis.

About a month later, in March 2022, the then-Duchess of Cornwall discussed her lingering symptoms during a meeting at Clarence House.

"It's taken three weeks and still can't get shot of it," Camilla told rowers Kat Cordiner, Abby Johnston and Charlotte Irving, according to Hello! magazine. "Probably my voice might suddenly go, and I might start coughing and spluttering."

As of 14 February 2023, There are currently more than 34,679 cases reported in the United States per day, with test positivity of 10%. When test positivity is above 5%, transmission is considered uncontrolled. There are more than 330 deaths per day, a decrease of 28% over the past two weeks, and hospitalizations have declined by 5% over the last two weeks.

Since many are using home tests that are not reported through public health or are not testing at all, the official case counts underestimate the actual prevalence of COVID-19.

Since the government has decided to forget about COVID and move on, the actual scope of infections is UNKNOWN. My own belief is that the infection rate has soared but the threat these variant have fallen to the point that most people can now live with the disease. (But elderly and those with medical conditions are still vulnerable to severe sickness and death). But in general, the world has decided to move on.

If you fall into the vulnerable group, the best advice I can give is make sure you that your shots are up to date including the Omicron variant.

As of this posting, the estimated variants of COVID are at:

XBB.1.5 ----- 85.0 %
BQ.1.1 ------- 9.4 %
BQ.1 --------- 2.6 %
XBB ---------- 1.2 %
CH.1.1 ------- 1.9 %
BN.1 ---------- 0.4 %
BA.5 ---------- 0.1 %
BF.7 ---------- 0.1 %

In general, the U.S. has not been hit with a severe winter this year. Are temperatures in northern regions did not experience extreme cold and I feel this also was a contributing factor to the decline.

Source: What COVID-19 variants are going around in February 2023?

I hope for us seniors they do allow us to boost twice a year.

magz, I hope you and your husband recover quickly and get back to normal.

The mass testing and vaccine sites long have shuttered, masks are now optional, even in hospitals and nursing homes, and social distancing is becoming a distant memory.

Three years after COVID-19 first spread throughout Long Island and across the globe, life for most people has started to resemble its pre-pandemic form — filled with school activities, back-to-office and large gatherings.

This has not been a surge in COVID-19 cases, deaths and hospitalizations that marked previous seasons, giving infectious disease experts hope the disease is becoming more predictable and manageable. “We are in the best spot we have been in since the start of the pandemic,” said Dr. Bruce Farber, chief of public health and epidemiology at Northwell Health. “Rates have continued to fall, hospitalizations remain low. It's way too soon to say what would happen in the fall. But for right now, I'm very cautiously optimistic.”

The past three years left a lasting mark on Long Islanders, whether they spent the first few grueling months working, hunkering down at home or battling the mysterious, new — and deadly — respiratory disease.

More than 9,000 Long Islanders have died from COVID-19. Statewide, more than 61,000 COVID-related deaths have been recorded, according to state Health Department figures.

Health officials said there were important lessons learned as they scrambled to manage hospital patient overload, find enough tests to monitor the spread of the disease, and to roll out a vaccine to health care workers and then the public.

“We know there's going to be another pandemic, whether it's mild or severe, or flu or a new virus or a coronavirus,” said Dr. Lawrence Eisenstein, who served as Nassau County health commissioner during the first years of the pandemic.

Eisenstein, who is now vice president and chief public and community health officer at Catholic Health, advised individuals to become aware of health issues that could put them at greater risk during a pandemic. He added that government officials should create financial incentives to bring more nurses and others into the health care industry, which is suffering from staff shortages.

On March 11, 2020, the World Health Organization declared the coronavirus outbreak a pandemic. The NBA season was postponed, Broadway turned off its lights, and New York City's St. Patrick's Day Parade was canceled.

By April 10, Long Island’s hospitals were stretched to the limit. More than 4,000 COVID-19 patients were hospitalized. Those numbers subsided by the summer only to spike again in January 2021, when hospitalizations jumped back up to 1,701. The omicron variant produced another surge of cases, with 2,254 hospitalizations on Jan. 11, 2022.

This year, fewer than 700 COVID-19 patients were hospitalized on Long Island on Jan. 13, the highest number this winter.

The number of COVID-19 cases in New York appears to be the lowest in about a year. Only about 2% of test results recorded by the state in recent days are positive. Measuring the current level of COVID-19 in a community has become more complex, however, as more people use home tests rather than go to urgent care centers or physicians' offices, which report results to the state.

Even if the actual number of cases is much higher, health officials said the majority of people have no symptoms or a mild illness that can be treated at home. That is vastly different from the early days of the pandemic, when there were no vaccines and treatments were limited. Hospitalizations and deaths soared to a frightening level, and doctors tried to understand the new virus, known as SARS-CoV-2.

Doctors who track infectious diseases are generally reluctant to say COVID-19 has moved past the pandemic stage, which is marked by aggressive daily spread of the disease, to become an endemic, where its course is generally more predictable, such as the annual influenza season.

“Anytime someone thought we had an encouraging trend, the next thing you know, a new variant showed up and we had another surge,” said Dr. Alan Bulbin, an infectious disease specialist at Catholic Health. “I think it's probably a little more accurate this time to say these are the first real signs of what the endemic aspect of this virus's behavior really looks like going forward.”

Bulbin said if this course continues, COVID-19 is likely to fall into line with other respiratory viruses that tend to take hold in the fall and winter before they decline in the spring and summer.

Farber said a combination of immunity from both vaccines and recurrent infections has helped keep the surges down.

“Is COVID gone? No. Is COVID ever going to be gone? No,” Farber said. “Are you going to intermittently see people you know with COVID? Yes. Are they going to be in the hospital? Probably not, unless, they are the small, select group of people who are immunosuppressed, elderly, totally unvaccinated and are reluctant to get treatment quickly when the diagnosis is made.”

In spring 2020, hospitals struggled to manage patients who were severely ill with COVID-19. The idea of a vaccine for this novel coronavirus seemed light-years away. But less than 12 months later, two companies had received emergency authorization from the U.S. Food and Drug Administration for their shots.

Since then, more than 230 million people in the U.S., almost 70% of the population, have received their primary series of the vaccination, according to the Centers for Disease Control and Prevention.

Bulbin called it a “miraculous scientific achievement.”

But the initial positive reception to the vaccine has waned over time. Changing and sometimes confusing guidance over booster doses led fewer people to seek them out. And some people were frustrated that they still contracted COVID-19 even after getting vaccinated.

Experts contend the vaccine was never designed to completely protect against getting COVID-19, but lessen the severity of the disease to avoid hospitalization and even death.

In the early stages of the pandemic, all of the Island's available hospital spaces were transformed into COVID-19 wards. Bulbin pointed out that collaboration between health providers, government and industry was key to getting mass testing and vaccination sites up and running and accessible to as many people as possible.

“When that sort of effort is there and the power to accomplish things is there, look what happens,” he said.

State health officials said working closely with local agencies throughout the pandemic helped when they joined forces during the Mpox — formerly known as monkeypox — outbreak last year and when a case of polio was detected in Rockland County.

"We use what we had learned during COVID to be better communicators of health data both to physicians and the general public," said P. Bryon Backenson, director of the state Health Department's Bureau of Communicable Disease.

The government shutdown of schools and most businesses did help overwhelmed hospitals from being completely overrun with patients, Bulbin said.

“It was tough … being able to respond to the needs of all these people with the same problem was really unique, but I think what was done basically saved the health care system from complete collapse,” Bulbin said

Eisenstein said the pandemic put a spotlight on both the importance and shortage of health care workers, noting there should be more programs that give people incentives to pursue those careers.

“The projections on nursing shortages over the next 10 or 15 years are downright scary,” Eisenstein said.

The pandemic also highlighted the increased risks that people with underlying health issues such as diabetes and obesity face, he said. There needs to be an increased focus on preventive medicine and educating people about their risk factors, Eisenstein said.

“The trend holds true for almost everything in health care,” he said. “The higher your risk factors, the less likely you are to survive … we don’t know what the next crisis will be, but if people lower their own risk, they improve their odds.”

For many people, what started out as a relatively mild case of COVID-19 persisted into a lingering condition that took weeks or months before their suffering subsided -- some are yet to fully recover. They live with long COVID, a condition health care providers have struggled to understand and accurately diagnose since the COVID-19 pandemic was declared in March 2020.

While it's hard to put a number on what percentage of people will develop long COVID, since home tests and mild cases contribute to inaccurate case counts, somewhere between 10% of people who tested positive for COVID-19 but didn't need to be hospitalized, and 50 to 70% of people who were hospitalized, developed some degree of long COVID, according to a major review of long COVID research published earlier this year in Nature Reviews Microbiology.

Fortunately, rates of long COVID, also called "long-haul COVID" or "post-COVID conditions," may be declining. A Kaiser Family Foundation analysis of data from the US Centers for Disease Control and Prevention found that the number of people who reported COVID-19 symptoms that lasted longer than three months, currently or in the past, declined from 35% in June 2022 to 28% in January 2023.

The condition can be mildly bothersome or debilitating, running the gamut of loss of smell, nausea and constipation, to organ damage or life-changing mental or cognitive symptoms. Non-specific symptoms that can easily fall into the category of other health conditions, like breathlessness, chronic headaches and chest pain, can make accurately diagnosing long COVID feel like catching a shadow.

Despite what researchers are still trying to figure out, including more treatment options, better diagnostic tools and other factors, health care providers and scientists have made headway in their understanding of the condition. Here's a roundup of what we know today.

What are the symptoms of long COVID?
After an initial infection is cleared, COVID-19 can linger and affect just about every system of the body, depending on the person. Symptoms include heart or cardiovascular problems, respiratory issues, immune system effects, neurological symptoms and even some reproductive issues.

Dr. Nasia Safdar, medical director of infection control at the University of Wisconsin, told CNET in 2021, when scientists were first getting a grip on long COVID, that the key to discerning the condition is to pay attention to new symptoms that develop or ones that never go away, starting about 30 days post-infection. This separates long COVID from the initial viral infection itself.

While it's not a full list, some lingering symptoms of COVID-19, per the US Centers for Disease Control and Prevention and a review of long COVID research by Nature, include:

Difficulty thinking or concentrating ("brain fog")
Difficulty breathing, shortness of breath or cough
Fatigue
Chest pains
Headache or migraines
Fast-beating or pounding heart
Joint or muscle pain
"Pins-and-needles" feeling
Nausea, diarrhea or other gastrointestinal problems
Sleep problems
Dizziness upon standing (lightheadedness)
Mood changes, such as depression or anxiety
Change in sense of smell or taste
Reproductive system problems, including changes to the menstrual cycle and erectile dysfunction
In 2021, Safdar said the most common symptoms she saw in her work with patients were symptoms that affected "higher executive functions."

"Concentration, memory, being able to do your job the way you could before," Safdar said. "Those kinds of symptoms are hard for people to describe, but they've clearly noticed a change from the way they were before."

In 2023, cognitive impairment and neurological symptoms are still relatively common for those who experience effects post-COVID-19. The authors of the Nature review called them a "major feature of long COVID," with a meta-analysis finding fatigue in 32% of people with COVID-19 after 12 weeks, and cognitive impairment in 22%.

One set of symptoms of COVID-19 that affected many people sick from earlier variants is the loss of their sense of taste, smell or both. For some, ageusia (loss of taste) and anosmia (loss of smell) don't just affect how they enjoy their food or a favorite scent, but can meddle with their memories and mental health.

The 'typical' long COVID patient
People ages 36 to 50 were most likely to be diagnosed with long COVID, according to a Fair Health study. The study, which looked at data from more than 78,000 patients from October 2021 through January 2022, also found more diagnoses in women than in men, and that about 30% of people had no prior diagnosis with a chronic health condition.

Other factors that may make a person more likely to develop long COVID is being unvaccinated and having underlying health conditions pre-COVID-19, including type 2 diabetes and a past bout with Epstein-Barr virus (the virus that causes mono), according to the Nature review.

People who need to be hospitalized after contracting COVID-19 are also more likely to develop long COVID. Socio-economic factors also may make someone more susceptible, as having a lower income and being unable to take off work to rest increases the risk of long COVID, according to the Nature review.

In short, there is no "typical" patient with long COVID, since people with more mild cases can and do develop the condition, as do children. In children, those who have attention deficit hyperactivity disorder, chronic urticaria and allergic rhinitis (allergic reactions including hives and seasonal allergies) may be more likely to develop long COVID, research shows.

Causes of long COVID
The authors of the Nature review say that there are "likely multiple, potentially overlapping, causes of long COVID." Some of these mechanisms, they conclude, include viral persistence (the virus staying with the body's tissue), neuroinflammation, excessive blood clotting and autoimmunity or disruptions to immune response.

Dr. Devang Sanghavi, a critical care physician with the Mayo Clinic, told CNET in August 2022 that there are a few broad ways to consider the different causes of long COVID: People with severe enough afflictions that they developed organ or cell damage; people who were hospitalized and have lingering health effects from that hospitalization; and people who weren't hospitalized, but developed symptoms as a response to the virus. The last group, in particular, has been the focus of research into how some people's immune systems respond, or even over-respond, to the virus.

The different causes and mechanisms of lingering symptoms and health effects illustrate the complexity of COVID-19 and its ability as a respiratory virus to create lasting impacts on other parts of the body.

No long COVID 'test'
According to the CDC, there is no single test that can determine whether or not you have long COVID. Instead, a health care provider looks at your health history, including if, when and the likelihood you had COVID-19 (based on a positive test result, your symptoms or exposure history), and when symptoms of long COVID began.

This lack of any sort of definitive marker makes a long COVID diagnosis even more frustrating for people suffering. And while health care providers are more aware of its presence this year than earlier in the pandemic, blood work or other routine tests may turn up normal in patients with COVID-19, requiring them to do their own advocacy to get the treatment they need.

"One message that I would like to send out to these patients is that their symptoms are real," Sanghavi said of the difficulties of living with, diagnosing and treating long COVID.

"We may not have answers right now about why and how and what we can do to help them, but they should not be struggling and suffering alone," Sanghavi said.

Treatments
Because long COVID symptoms are so broad, there is no blanket treatment. Instead, treatment for long-haul COVID, according to Johns Hopkins Medicine, will likely involve doctors working to address your symptoms. Therapy will depend on your symptoms, and various breathing exercises, physical therapy or medications may be prescribed, per Johns Hopkins.

Because the symptoms of long COVID can overlap so evenly with symptoms of chronic fatigue syndrome (ME/CFS), another disabling and lasting health condition, strategies used for ME/CFS patients may also work for long COVID patients, according to Nature.

Trials on the effects of different drugs for treating long COVID, including anti-inflammatory and anticlotting medications and antihistamines, have also been started.


Preventing long COVID: The role of reinfection and vaccines
Researchers know that having a severe case of COVID-19 can make it more likely for a person to experience long COVID, and that vaccines reduce that risk of severe disease. While research is ongoing, Johns Hopkins Medicine says "it is likely that being vaccinated reduces the risk" of long COVID.

But research on how vaccines impact the symptoms of people who already have long COVID is unclear. One smaller study found that a little more than 16% of people experienced a relief of long COVID symptoms post-vaccine, but about 21% actually experienced a worsening of their symptoms. Most didn't experience a change. A review published online by The Lancet also found mixed results on vaccines for long COVID symptoms.

Because COVID-19 is still around, reports of people getting reinfected with COVID-19 a second, third or even fourth time are becoming more common. And early research, according to the authors of the Nature review, shows that there is an increasing risk of long COVID after second and third infections with COVID-19.