The Covid Big Picture So Far: Part 1, The Science of Covid
Misinformation has led to an ableist & classist "back to normal" that puts business over the lives of poor and/or disabled people. We must share the science widely & how to protect our communities.
The novel Coronavirus (SARS-CoV-2) pandemic which causes the disease COVID-19 has swept the globe since early 2020, and has brought numerous issues of social, economic, and even environmental justice to the forefront of public debate. Unfortunately, as the needed public debate appears to be rapidly dwindling as corporations and politicians prematurely declare the pandemic “over”, many of these issues of justice are fading into the background again instead of being dealt with. With an expected severe Winter 2022-2023 flu season coming, we must reverse this trend by building a different take on Covid that focuses on justice for everyone.
If you don’t have the time to read the rest of this article, here’s my main points:
COVID-19 is not “just a cold” or even just a respiratory disease, but a cardiovascular disease that attacks multiple organs including the brain. We need to minimize infections to prevent “Long Covid” which is essentially long-term disability due to organ damage from the disease. This damage is not restricted to only elderly; even young, healthy folks and children are seeing these effects. We are looking at a mass death and disabling event that is not stopping, we must take action.
A “Vaccines-Plus” response is the best solution since COVID-19 primarily transmits via the air; we must promote vaccines in combination with masking, air filtration, and other actions. Some of these actions can be done individually and promoted in communities, but are most effective as part of a collective public health policy and response. We must demand government and business to act in cooperation with communities.
The current essay is Part 1 of a series which will focus on what we’ve learned about Covid from science — very important to share today as most media and organizations and political figures continue to downplay the severity of Covid and “Long Covid”. An upcoming Part 2 will discuss the larger public health policy response and demands we need to organize around (such as universal healthcare!). Part 3 will look at lessons from this pandemic on organizing for climate change and other global issues.
Let’s jump into the science now.
A Serious Cardiovascular Disease, Not “Just A Cold”
One of the biggest misunderstandings is that Covid is “only a cold”. The implication is that the Covid pandemic is overblown or not serious — but this ends up being dangerous misinformation that puts people at risk.
The initial acute infection can be serious enough, sometimes resulting in hospitalization and even death. While the chances of that are relatively low, when accumulated over the entire US population, we’re looking at over 1 million deaths since the pandemic began. Millions more face the much more common result: so-called “Long Covid,” the long-term, chronic form of Covid, which can even occur months after a “mild” infection that seems to have cleared up. Recent statistics from the UK suggest that 30% of Long Covid patients have now been suffering from symptoms for over two years, and recent mutations of the Covid virus seem to have much higher risk of causing Long Covid. In one of the first population-wide studies globally, it is estimated at least 2% of the entire population of Scotland is now dealing with some kind of Long Covid symptoms or disability, and that number is likely undercounted as not everyone is able to see a doctor and get formally diagnosed.
Covid is described as a “tornado in the body” because of how much damage can be done to multiple organs, and Long Covid seems to share a lot in common with myalgic encephalomyelitis/chronic fatigue syndrome. The sheer amount of damage to the body caused by Covid, especially after repeated infections, is leading experts to call the Long Covid pandemic “the greatest mass-disabling event in human history.”
Covid is best thought of as a blood vessel disease, and has been shown to cause heart damage, and other heart issues like clots, inflammation, arrhythmia and tachycardia. In fact, higher risk of blood clotting and arterial thrombosis has been seen months after patients’ initial infection. Latest studies (August 2023) show a 1-in-10 chance of developing hypertension after a Covid infection, increasing to 1-in-5 if hospitalized. Covid infections double your chance of blood clots in the lung or other lung symptoms. “Arterial hardening” after Covid infection is resulting in increased blood pressure and risk of heart attack or related problems. Concerns are growing that a “tsunami of heart attacks” due to Covid may be in our future if public protections and policy are not allowed to work and prevent infections.
The heart damage caused by Covid also appears to affect everyone, even those that seem young and healthy. For example, one recent scientific study showed a 30% increase in risk of heart attacks for age 25-44 due to damage from prior Covid infections. Heart damage (and therefore increased risk of heart attacks or other problems) was evident even in those that initially had “mild” cases, and even a year after “recovery”. This damage was even known in 2020, fairly early in the pandemic, leading many scientists at the time to conclude that young athletes were at risk for sudden heart attack due to damage from Covid infections. A new study in 2023 from Germany suggests “myocardal dysfunction” among athletes 2+ months out from infection showing the serious effects on the heart months beyond the initial infection. Nearly two million people died with cardiovascular-related disease in the first two years of the pandemic.
The cardiovascular nature of Covid illness means other organs can be damaged, including lungs (fibrosis), kidneys, and the gastrointestinal system, with both acute and long-term risks. In fact, preliminary data finds causal links between Covid illness and stomach, colorectal, and breast cancer, and Covid seems in particular to “facilitate” breast cancer, meaning folks may have increased chances of these forms of cancer after infection especially if it is a serious infection resulting in hospitalization.
Even the brain can be affected. Covid infections can cause inflammation of the brain and other symptoms — and the common symptoms of Covid “brain fog” appears to actually be brain damage similar to the brain damage found in Alzheimer’s patients or Parkinson’s disease. Preliminary research shows that the brain damage can persist beyond acute illness, and this brain damage is associated with memory loss that may result from damage to the hippocampus which is thought to be a primary part of memory formation. The cognitive impairment in youth seems to be more serious than elders, possibly due to auto-immune responses, in direct opposition to the “common sense” arguments that claimed youth weren’t affected. As a result, scientists are starting to think of Covid as a neurological disease affecting all ages, as much as cardiovascular.
Across all age ranges, there is a significant increase in the risk of developing diabetes after a Covid infection; One in 20 new cases of diabetes is linked to Covid infection, based on recent data. Many patients also experienced problems with cholesterol and triglycerides after a Covid infection, which raises the chances of serious heart-related issues over time. Thyroid disease is also linked with both acute and long Covid.
There is also increasing evidence that Covid damages the immune system itself, with patients exhibiting weakened immune systems and increased susceptibility to future infections for at least 8 months after even a “mild” case of Covid. There is greater risk of autoimmune disorders after Covid infections, and a stud released in July 2024 in Nature showed that Long Covid lung damage is due to chronic inflammation from an immune response. New research suggests that Covid infections harm the immune system in ways that prevent future vaccines from being as effective — recall that vaccines only stimulate your immune system to act, so if your immune system is damaged, it cannot respond as strong as it should and may result in more serious infections (as in the case with immunocompromised folks). Recent research (August 2023) is beginning to shed light on the mechanisms for how serious cases of Covid damages the immune system.
Early studies are showing impacts to fertility and changes to menstrual cycle due to previous Covid infections. Covid is now linked to stillbirth due to severe placental damage from an infection, and generally linked to adverse birth outcomes like “very low birthweight and very preterm birth”.
The scope of damage to the body caused by this virus is incredible.
Alarmingly, many Long Covid cases are occurring in younger folks, particularly kids. Recent studies have shown that even “mild” cases of Covid in children sometimes lead to “Long Covid” symptoms at least 6 months after infection, and that about 1 in 15 children with Covid develop neurological issues including seizures. In children especially, Covid also greatly increases the risk of developing Type 1 diabetes, putting them at risk of other diabetes-related diseases and further infections. Even “asymptomatic” cases in children find persistent infection in the tonsils where it can contribute to community spread as well as spread through the child’s lymphatic system, opening possible vulnerability to future infections (which may help explain recent spikes in RSV, flu, strep, and other viruses).
The seriousness of “Long Covid” complications has brought down the average life expectancy in the US by nearly 3 years, the first time life expectancy has gone down in decades. As a form of SARS, we can look to the long-term symptoms of SARS infection for an idea of what lies in the years and decades ahead.
How common is Long Covid?
Children made up 19% of all Covid infections as of early November 2022, and there is huge concern that many will face Long Covid. Data from the UK suggests that as many as 1 in 4 kids with Covid symptoms are developing some form of Long Covid, including heart inflammation; recent data shows even a 12-16% chance for Long Covid from the Omicron variant. Recent data suggests as many as 2 million people are facing some type of Long Covid symptoms, with 300,000 of them including teenagers saying it is bad enough to interfere with daily life. UK Channel 5 news also made a video about Long Covid patients that is worth watching to get a better idea of the symptoms and wide range of people affected. Children have significantly higher risks of developing new neurological or mental health conditions after a Covid infection.
The CDC previously recognized that 1 in 5 adults that catch Covid may develop Long Covid symptoms, although this was based on early data with the original variant. The “Omicron” variants still seem to result in at least 1 in 20 infected with Omicron developing Long Covid, with more recent research suggesting about a 10% (1 in 10) chance that is even higher after reinfection — still a very significant probability! This includes about a 1 in 20 odds for children and youth to get Long Covid symptoms that affect multiple parts of the body; youth are NOT immune or lower risk just because they are youth. At 1 in 20 odds, you could expect some 15-20 million Americans to face Long Covid disability over the coming years — if 1 in 10 is more likely, as recent research suggests, this could look more like 30-40 million Americans, many of whom will be in their prime working years, meaning we’re looking at a potentially gigantic wave of worker disability.
There is no known treatment for Long Covid at this time, and it is unclear how long it may last; some folks recover after months of treatment and therapy (which is now being euphemestically referred to as “medium Covid” to try to avoid the implications of “long”), but some are now living with over two years of Long Covid disability with no progress. It might have effects for years or decades more, even life-long disability for some. Early results suggest that the existing vaccines do provide some protection against Long Covid, adding another reason to get as many folks vaccinated as possible with at least 2 doses and new variant-specific boosters. Paxlovid also somewhat lower chances of Long Covid according to a recent VA study. But while current vaccines and treatments lower the odds, they do not completely remove the risk; the best way to prevent Long Covid is to not catch it in the first place. In other words — we need to prevent transmission too, not only rely on vaccines and treatments.
How does Covid spread? It is airborne.
Recent research has confirmed that Covid is airborne, and primarily transmits through the air via aersols. Early arguments that Covid transmitted through “droplets” were disproven, establishing that Covid is indeed airborne. These aerosols can linger in the air for up to 9 hours after the person who transmitted the virus has already left, if ventilation is poor.
This means you can potentially catch Covid simply by breathing. And that includes even if no one else is around while you are there — if someone infected was coughing in that elevator 10 minutes before you used it, for example, you could catch it. Since Covid persists in saliva for weeks after infection, even if asymptomatic initially, potentially infectious aerosols can be transmitted in the air by talking or eating in public spaces.
To lower the risk of transmission, this means we need to avoid infected air. This can be done two ways: (1) avoid it in the first place, if at all possible, by staying home or away from crowded or high-traffic areas; or (2) clean the air in some manner. Cleaning the air can take several forms, including good quality masks and respirators as well as HEPA filters and ventilation. Even if masking or cleaning the air, you still want to plan on minimizing your time in such places to minimize the transmission risk.
While some research suggests Covid can also spread via surfaces, this type of spread does seem less likely, so typical hygiene advice should otherwise be sufficient: wash your hands frequency, disinfect your cooking and eating spaces especially, cook food to recommended temperatures especially if handled by others. This helps prevent the spread of many other viruses and bacteria so should be standard practice anyway.
Variants and Repeated Infections
Research shows that repeated infections lead to significantly higher chances of complications, hospitalization, organ failure, and death. So even if an initial case is “mild” with little to no complications, this is not guaranteed to be the case with a second or third infection. Each infection essentially causes cumulative damage to the body, getting worse each time, increasing the risks for complications and even organ failure down the road if not immediately. This is very serious.
This is especially true as the original SARS-CoV-2 virus has mutated into many variants and even subvariants; as of 2022, most variants circulating are “subvariants” of the Omicron variant. The BA.2 subvariant and BA.2.12.1 sustained infections through the summer, and now we see the rise of BA.4 and BA.5 subvariants. There’s already growing concern that newly discovered variants such as BF.5, BQ.1, which may be immune-evasive, will become dominant this winter. The Biden regime is predicting a third of the US (over 100 million people!) to be infected this fall. These new variants mean that even more patients might face death or develop Long Covid next year than we can predict. The CDC has already reported (quietly, after the election) that infants under 6 months have seen an incredible spike in hospitalizations, 7-8 times normal rates, as recent as August 2022. With us seeing a new spike this fall as we move into winter, it is very concerning how many will be injured; infants are particularly at risk of long-term effects of viruses since they are still growing.
The Panic-Neglect Cycle and “Back to Normal”
One prominent question is: how did all of this death from Covid become so “normal”? There have been over 1 million deaths due to Covid since the pandemic began, and that number is probably an undercounting as the CDC is no longer tracking much of this data. Covid is the top cause of death for folks under age 50. Yet many seem to believe the pandemic to be “over” now despite the continuing number of deaths.
The widespread shrug appears to be an effect of the “Panic-Neglect Cycle” seen in past pandemics, although the cycle has historically not turned to “neglect” until the actual initial pandemic is over. Covid is sadly unique in that we’ve largely turned to neglect before the pandemic has even ended, which is allowing the virus to mutate to become more transmissible and deadly.
To be clear, the “neglect” comes not from the public as a whole but from government and political officials who have abdicated their duties during a crisis. Recent CDC guidelines are insufficient and have simply redefined “low” Covid spread as what used to be called “high” spread — driven by politicians wanting to declare the pandemic over as quickly as possible, not by science. This is why many scientists have recently denounced the CDC’s inadequate guidance. Some scientists even went as far as creating a new People’s CDC to issue more scientifically-correct guidance to protect people from the pandemic.
This is especially concerning as there are signs of great stress on the US healthcare system due to the pandemic. Hospitals are overwhelmed, with doctors and nurses quitting from exhaustion and lack of community support. From an article in The Atlantic entitled “What COVID Hospitalization Numbers Are Missing”: “Biden’s strategy overlooks a crucial truth: The health-care system is still in crisis mode. The ordeals of the past two years have tipped the system—and its people—into a chronic, cumulative state of overload that does not fully abate in the moments of respite between COVID waves.” At one time, we worked to “flatten the curve” and prevent hospital overflow, but this public messaging seems to have been entirely abandoned lest we admit that the pandemic is not yet over.
As public health protections are winding back under the political duopoly, we see the consequence of wealth inequality — wealthy families can afford treatment and time off work if they get sick, while poor families are most impacted without access to healthcare or time off work to recover. The Omicron variants have hit Black and Brown communities the hardest for these reasons. The US has so failed at containing the virus that while other countries are recovering, the US’s life expectancy continues to drop, a sign that Covid is causing significant death and disability among the US population. A recent study shows that over 250,000 children in the US have lost at least one primary caregiver due to Covid, which, besides the tragedy of losing a parent or other loved one in the first place, means that childcare and other services will be strained even more. At this point, most cities are still parroting the Biden administration’s talking point that we’re “open” and have no plans to reinstate a mask mandate.
With the expected winter surge in Covid — that is also seeing increased infections of flu and RSV forming a “tripledemic” — already beginning, it is vital that we organize for (1) immediate action to minimize transmission & protect folks, especially the most vulnerable; and (2) demand a National Health Service with a single payer system to ensure everyone can get treatment needed not only for the acute infection but so that anyone with Long Covid can get long-term treatment needed without worrying about medical debt or bankruptcy.
The next part of this series, Part 2, will discuss more about what’s needed to end the pandemic and break out of the “Neglect” cycle — the “Vaccines-Plus” strategy with demands for human economic rights to be protected.
Author’s Note: Updated January 18, 2023, to include links to a few more research articles and Part 2. Updated August 12, 2023, to include link to Part 3. Updated August 20, 2023, to include a link to new research on damage to the immune system, and August 23, 2023, to include new research on new-onset hypertension after infections. Updated September 21, 2023, to add link to new research on children developing neurological and mental health issues after infection. Updated July 21, 2024, with a link to new research in Nature showing Long Covid immune system response causes lung damage.
End Note, April 30, 2024: More research showing Covid boosters lowered risk of Long Covid by 25%.
End Note, August 6, 2024: New research increases our understanding of how the Covid spike protein contributes to heart disease and heart failure; notably, this effect is NOT caused by the vaccines which do not have full spike proteins, it only occurs from the virus.