Recommendations for healthcare

Letter to infection control

Healthcare organizations should immediately implement a number of strategies that are both ethical to help prevent disease spread among staff, patients, and the community and are fiscally advisable to reduce hospital costs in the long run.

• Stockpile N95s.
• Purchase more PAPRs.
• Review shortages during prior surges with pharmacy and materials management and increase stock appropriately. There is currently a shortage of BD BACTEC Blood Culture Systems. Most generic medications used in the US begin as APIs in China, are shipped to India for manufacturing and packaging, and then travel to the US in the cargo holds of passenger flights. There are many points of failure along these supply chains, including government decisions NOT to export to protect their own populations.
• Mandate respiratory protection during pandemics and the normal cold/flu season. This is where I expect to see Standard Precautions going in the future.

There really are just two choices. Implement measures to protect staff, patients, and the public and perhaps delay the most severe impacts on healthcare organizations or continue as we are acting as if everything is normal and expedite their failure. Temporal discounting is our Achille’s heel.

Nothing more than

I thought there were two, “good” and “bad”

More COVID resources

Pandemic Patients

Our understanding of the association between COVID-19 infection and long-term health complications is continually evolving, and this document will be updated as new information becomes available. While the intent of this document is to provide an extensive overview, it should not be considered a comprehensive list of the potential consequences of COVID-19 infections.

This document reviews literature published up until February 25, 2024.

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the damage done by COVID-19 is cumulative (Bowe et al., 2022). Even someone who recovers from an asymptomatic (Ma et al., 2023) or mild case (Novak et al., 2022) of COVID-19 is at risk of developing one or more PCCs.

In fact, a recent review by Boufidou et al. (2023) noted that those who were reinfected were more prone to developing long-term symptoms—in comparison to those who were only infected once—and more prone to “various complications, including potential cardiac, pulmonary, or neurological problems” (p. 7). Even asymptomatic SARS-CoV-2 infections can result in long-term symptoms such as fatigue, loss of taste or smell, or chronic cough (Ma et al., 2023).

Critically, the increased risk of developing PCCs after reinfection may represent a more recent change in the pathology of SARS-CoV-2; in contrast to earlier variants of COVID-19, which had lower rates of reinfection and a higher risk of developing chronic symptoms after the first infection relative to reinfection. The emergence of Omicron BA variants appears to represent a shift in this pattern (Hadley et al., 2023).

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everyone is at higher risk of adverse health effects after SARS-CoV-2 infection. For example, even mild to moderate cases of COVID-19 are leaving firefighters with long-term deficits in their cardiorespiratory fitness (D’Isabel et al., 2023).

A Reddit community for the COVID cautious

Zero COVID

Covid is not over, because long covid has no cure.

The virus may not kill the victim but instead make them disabled with crushing fatigue, debilitating brain fog or over 200 other recorded problems. People with long covid often lose the ability to work or even get out of bed. About half of long covid is ME/CFS [ref1 ref2 ref3 ref4], which is the extremely disabling disease causing fatigue and brain fog.

Somewhere between 5% and 20% of covid infections become long covid. For reference a "medically rare event" is considered 0.1%. Long covid isn't rare. Serious disability from long covid isn't rare. Vaccines and antivirals reduce the chances a little bit but are not a solution on their own. Long covid lasts for years. Most never recover but instead will be disabled and chronically ill for the rest of their lives. Scientific research into treatments is only just starting and will be many years before it produces results.

The only thing left then to not get covid in the first place. Or if you've already had it to not get it again, as we know the damage to the body accumulates with repeat infections. Not getting it again also gives you the best chance of recovery if you already have long covid.

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The five pillars of prevention are: 

1. clean air, 
2. masks, 
3. testing, 
4. physical distancing and 
5. vaccination. 

We must also redouble efforts into research, for example better ways of cleaning the air, better vaccines, better tests.