sábado, 29 de mayo de 2021

sábado, mayo 29, 2021

 Long covid

Health care and workplaces must adjust for long covid

1.5% of working-age people have lasting symptoms


As the world enters the second year of the pandemic, two crises are unfolding. 

The more urgent and visible one is in poor countries like India, where a surge of covid-19 cases is threatening to overwhelm the state. 

India is recording more than 350,000 cases a day, and many more than that are thought to be going undetected. 

The suffering is grievous. 

Oxygen supplies at Indian hospitals are running far short of what is needed, and crematoriums are overwhelmed.

The other crisis is more subtle. 

This is long covid, which is becoming apparent in rich countries like America, Britain and Israel that have largely vaccinated their way out of the pandemic, but which will affect poor ones, too. 

Post-covid syndrome, to give it its formal name, is a set of symptoms affecting any part of the body that persist for at least three months after a bout of covid-19. 

Three stand out: breathlessness, fatigue and “brain fog”. 

In Britain three in every five people with long covid say their usual activities are somewhat limited, and one in five says they are limited “a lot”—which often means being unable to do even a part-time, desk-based job.

The numbers are chilling. 

Half a million people in Britain have had long covid for more than six months. 

Their chances of full recovery are probably slim. 

The vast majority are in their working-age prime. 

At the last count (which does not fully take in the country’s second wave) 1.1% of Britain’s population had had long covid for at least three months—a group that includes 1.5% of those of working age. 

About 15% of Britain’s population had been infected by then. 

Applying this rate to global covid-19 cases, numbering an estimated 1.2bn so far, suggests that more than 80m people may already have long covid.

The costs of the condition have yet to be tallied, but they will be huge. 

Britain’s National Institute for Health Research found that, in 80% of sufferers, the illness affected the ability to work. 

Over a third said it had weighed on their finances.

As yet, long covid has no cure. 

What scientists know so far about the disease points to it being a combination of a persistent viral infection (for which a drug may be found at some point), a chronic autoimmune disorder (which would need expensive, complex care like that for rheumatoid arthritis or multiple sclerosis) and lingering damage to some tissues caused by the original covid-19 infection. 

Medicines for the first two of these causes may ultimately be found. 

America alone has put $1.15bn into research. 

At the moment, though, sufferers need months of rehabilitation to help them cope.

Health-care systems and employers must prepare to assist long-covid sufferers, including those who have no proof of past infection because they were not able to be tested. 

Prompt rehabilitative care can prevent a downward spiral in personal health and finances. 

Dedicated long-covid clinics will speed things up. 

As things now stand, patients often bounce from one specialist to another in search of a diagnosis.

Employers, for their part, must rethink how to accommodate workers with a disability that flares up in unpredictable bouts. 

Governments can help, with incentives that encourage sufferers to stay in work and employers to cater to their condition. 

If governments miss the boat, millions of young and mid-career workers could permanently drop out of the labour force. 

One approach could draw on a scheme for disability benefits that is used in the Netherlands. 

Dutch employers and employees who are too unwell to work as normal are required to come up jointly with a plan on how the sick employee can return to work under new conditions. 

Remote working and flexible schedules would make it easier for long-covid sufferers to work at least part-time. 

Many of them will improve, though even that can take months.

Lots of mistakes were made in the pandemic’s acute phase. 

But that came out of the blue. 

There is no excuse for failing to respond to long covid. 

And there is no time to waste. 

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