Our battle is only at the end of the beginning. The next front is Long Covid

Matthew d'Ancona
·4-min read
 (Evening Standard)
(Evening Standard)

As revellers celebrated the latest landmark in the phased relaxation of lockdown —not least in Soho — the Government yesterday announced another remarkable achievement in its vaccine roll-out strategy. Ahead of the target date of April 15, all people over 50 or in high-risk groups have been offered the jab — and, of the 32 million who have received the first dose, 7.6 million have already been given the second.

Boris Johnson has a weakness for boosterish language but, for once, his celebration of “another hugely significant milestone” was justified. The vaccine will now become available to those in their late forties — many of whom have already been given the first jab, thanks to the efficient deployment of unused doses by primary care networks. Although the prospective introduction of Covid-status certificates remains contentious, the principal indicators suggest that, broadly speaking, we are on track for exit from lockdown according to the roadmap unveiled by the Prime Minister on February 22.

Yet it is precisely at such moments that we must be most wary and most candid. None of this good news is remotely tarnished by vigilance; quite the opposite, in fact. It is incumbent upon ministers, the NHS and citizens alike to remain wary of the insidiousness of the virus and the ever-changing nature of its threat.

Last week, a cross-party group of 32 MPs and 33 peers wrote to Mr Johnson seeking better and more regular data on long Covid, after the Office for National Statistics disclosed that at least 1.1 million people were already suffering from the syndrome — many more than expected. As has been shown by the case of Derek Draper — movingly described by his TV presenter wife Kate Garraway in a recent ITV documentary — the condition, in extreme cases, can be extraordinarily serious. More often, the symptoms are less severe, but still debilitating.

They can vary from pain, “brain fog” and persistent fatigue, to shortness of breath, depleted mobility and serious deterioration of eyesight. Only gradually are clinicians learning about the syndrome and — as they are the first to admit — their understanding is very far from complete. In this respect, long Covid has much in common with myalgic encephalomyelitis (chronic fatigue syndrome), which is frequently triggered by viral illness and for which, as yet, no approved treatments have been developed.

The clear and present danger is as follows: for the next few months, the most important demographic division in this country, as elsewhere, will be between the vaccinated and the unvaccinated. The young, naturally the most exuberant as lockdown is relaxed, will also be the last cohort to receive the jab.

This reflects their much lower vulnerability to serious illness: a great many have been surprised to discover that they are, or have been, infected by the virus, which they experienced asymptomatically or assumed was a regular cold or flu. The sting in the tail, however, is that long Covid frequently afflicts those whose initial bout with the pathogen has been relatively mild. It can be merciless with the young, as well as the old. Women appear to be at greater risk — possibly because of connections between X chromosomes (of which they have two) and auto-immune conditions.

Two immediate conclusions follow: the first is that, even if they are (wrongly) nonchalant about Covid itself, young people should beware its potential long-term effects, and seek the jab with as much alacrity as their parents and grandparents.

Second: we must now take Covid seriously as a chronic condition, as well as a potentially lethal respiratory illness. Quite rightly, the first year of the pandemic has been a global battle to save lives. But, as is becoming ever more clear, it must also be approached as a battle to help those who suffer the effects of long Covid lead a manageable, decent life.

Already, NHS England has announced the launch of more than 70 clinics dedicated to the treatment of the syndrome — a good start, but only a start. Thousands more home carers, district nurses and physiotherapists will be needed, and indefinitely so. These are precisely the kinds of services that are routinely cut when chancellors decide to tighten the nation’s belt: but it would be a false economy to reduce such provision.

Virologists talk of long Covid as the “next front”. Let us hope that the first phase of the pandemic is indeed gradually drawing to a close; but let us also be realistic and strategic about the much longer haul that lies ahead.

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