The world is four years in and we are only now just beginning to truly comprehend what COVID has left in its trail. Given the chance to say what disease sounds or is most foreboding, most of us would mention the big names like cancer, AIDS, Malaria or even Parkinson’s.
Of course, such opinions as these would depend on the amount of information one has about them and perhaps personal experiences so said opinions may be subjective.
Despite the tragic waves of COVID-19 that have hit the world since the first case was diagnosed in Hubei Province, nothing could’ve prepared scientists and professionals in the medical field for what would follow.
It has now emerged that the most prominent symptom of long COVID-19 is fatigue. Researchers at the University of Exeter and UCL found out that patients with long COVID had lower health-associated quality of life scores than patients with advanced-stage cancer (like stage IV lung cancer).
Furthermore, the impact that long COVID and its symptoms had on their daily lives was far worse than what was experienced by stroke patients and could only be compared to patients suffering from Parkinson’s disease.
According to the WHO, the exact number of people battling long COVID as a daily part of their life now is unknown. It is however estimated that about 10-20% of people who get exposed to SARS-CoV-2 go on to develop symptoms consistent with those of long COVID.
The likelihood of suffering from this post-COVID condition is not a factor of one’s age and neither is it determined by how severe a previous COVID-19 infection was. All of us are susceptible.
Working definition
Long COVID has gained quite the notoriety in the medical research industry. It goes by several names now including post-COVID condition, acute COVID, long haul COVID, post-acute COVID-19, chronic COVID and in reference to a subset of the disease, post-acute sequelae of SARS CoV-2 infection or PASC.
According to the CDC, long COVID is a wide range of new, returning, or ongoing health problems that people experience after being infected with the virus that causes COVID-19. Centre for Disease Control and Prevention. (2022). Long COVID or Post-COVID Conditions. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html
The WHO defines long COVID as the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanation.
A paper published in the Journal of American Medical Association titled Development of a Definition of Postacute Sequelae of SARS-CoV-2 Infection lists twelve main symptoms that people with long Covid exhibit.
They are Postexertional malaise, or the worsening of health after mental or physical activity, fatigue, brain fog, dizziness, gastrointestinal symptoms, heart palpitations, changes in sexual desire or capacity, loss of or change in smell or taste, thirst, chronic cough, chest pain and abnormal movements.
These symptoms mirror the symptoms of ME or myalgic encephalitis which sometimes occurs after a period of viral illness. It is also referred to as Chronic Fatigue Syndrome. The two conditions are however distinct from one another.
Long COVID Awareness in Africa
When the pandemic hit it was expected that it would devastate the continent. This however did not happen and far richer and more developed countries fared worse than African nations.
While this was at some point regarded as a COVID mystery, explanations now point to the fact that there was marked underreporting of incidences in most African countries. The pandemic did take a toll on Africa and its people…it just remained invisible.
What implications does this new information have on long COVID data?
It would follow, undoubtedly, that incidences of long COVID would also be underreported on the continent. The long COVID prevalence rate in Africa is actually comparable to the overall global rate.
The lay population in Africa hardly knows anything about the condition and this further exacerbates the situation. With poverty, hunger, political crisis and economic collapse, people simply have too many problems to be worried about the after-effects of COVID-19.
The fact that Africa has the lowest vaccination rates in the world is not encouraging either. According to the CDC, unvaccinated people who contract COVID run a higher risk of suffering from post-COVID conditions compared to their vaccinated counterparts.
South Africa was perhaps the hardest hit African country according to COVID-19 data, with their numbers accounting for about a third of the total thirteen million cases documented on the continent.
A study carried out in South Africa suggests that almost half the number of people who contracted COVID and received treatment in hospital as well as one in every five who recovered at home run the risk of getting long haul COVID.
The true burden of Post COVID Conditions in African countries needs to be better studied and documented. The condition is likely going to have serious repercussions on the continent unless rapid sensitization and awareness creation campaigns especially among healthcare providers and community health workers are adopted.
A shadow pandemic within a pandemic?
The whole world heaved a sigh of relief when the number of new infections started to reduce and the management of COVID-19 was better understood by healthcare professionals.
We got the vaccines and as progressively more people got fully ‘vaxxed’ and even received booster shots, everyone thought we finally had a handle on the pandemic.
We washed our hands, wore masks, kept social distance and disinfected every inch of our living spaces. The entire world had switched on the clean freak mode in whatever form each individual could muster.
As we settled into new anti-COVID routines and began re-building everything COVID-19 had disrupted, a brand new threat emerged in the form of long-haul COVID.
Long COVID has become so prevalent that it is suspected that millions are suffering the world over. In countries where the healthcare system has taken hits not just from COVID but also the tough economic times and dysfunctional systems, most long COVID cases are going unnoticed.
Imagine the African medical landscape and how receptive it would be to patients who are in most instances simply lethargic. It is in the long run unsustainable. Our healthcare systems would buckle under the pressure.
The cases of Leah Chebitwey and Wachuka Gichohi are a testament to just how harrowing the experience of living with long COVID can be. Financial ruin, emotional turmoil, mental strain and the overall social implications of dealing with chronic COVID are immense.
In certain respects, it is better to have an outright pandemic with obvious and quick-to-diagnose symptoms because the spur to action is faster and treatment can commence quickly.
PCC disables victims’ ability to work, think, or function normally. It can halve a nation’s workforce and research progress is slow. Continuous education is the only hope for raising awareness in African countries.
