RUBY:

From Schwartz Media I’m Ruby Jones, this is 7am.

Over the past few months we’ve all become familiar with the short-term symptoms of Covid-19.

But what about the long term consequences of contracting the virus?

Today, senior reporter for The Saturday Paper, Rick Morton, on the people who call themselves coronavirus ‘long-haulers’ ...and the emerging research into their ongoing symptoms.

RUBY:

Rick, can you tell me about Hannah Davis?

RICK:

So Hannah Davis lives in the United States of America and she's a kind of an algorithmic researcher; she uses data and kind of coding systems to visualise stuff in really interesting ways. She was fit and healthy, just a normal 30 something year old person and then she got coronavirus, which was about four months ago now.

Archival tape -- Hannah Davis:

“I was under the assumption that it was going to be very mild. That's what they were telling us. The first symptom I had actually was really bizarre. I couldn't read or pass a text message and I immediately thought COVID because I was in one of the biggest hot spots at the time in Brooklyn. And it turned out to be true. This was March 25th.”

RICK:

So she's been diagnosed. She had the infection. She, quote unquote, recovered. And for four months since then, she's been experiencing this near daily fever.

Archival tape -- Hannah Davis:

“It really is unlike anything I've ever physically experienced before. It's a really, really bizarre virus. And many people say that kind of same thing. You just… you don't have the linear progression, the relapses are a strong indicator of COVID.”

RICK:

Essential tremors, gastrointestinal issues, severe headaches. She's got a heart rate above 150, quite often just got viral arthritis, heart palpitations, muscle aches. And as she says, ‘I'm feeling like my body has forgotten to breathe’. And that's crucial because what she explains is more than just her story.

RUBY:

So are there other people in a similar situation to Hannah? Are we seeing other patients who have had Covid-19 going on to experience these longer term health effects?

RICK:

Yes, and not just small numbers of them. Thousands, tens of thousands of them. And they call themselves COVID ‘long haulers’. They're in these chat groups, they’re in Facebook pages and they're on Slack, talking about their symptoms, and they're reporting a strange medley of often debilitating ones that have caused them daily pain, confusion and really deepening concern because they don't know what's going on, and at the moment, nor does medical science - although those things are starting to catch up.

So Hannah is actually one of the team who established the network patient led research for COVID-19, which is one of the places that's hoping to coordinate that laundry list of ailments associated with what they call post-COVID and direct research to unpick the mystery. When you read through these forums and I've spent the whole week doing it, you see someone pop up and say, ‘hey, is anyone else losing their hair?’ And then all of these people are saying, ‘hey, that happened to me, too. I can't believe it, I thought I was the only one’.

RUBY:

So if that's what people are self reporting, what does the science say? Are there studies that are quantifying these experiences?

RICK:

There’s quite a lot of them now. And we're seeing more and more by the day. On July 9, the United States' National Institute of Allergy and Infectious Diseases director Anthony Fauci said, anecdotally at least...

Archival tape -- Anthony Fauci:

“If you look anecdotally, there is no question that there are a considerable number of individuals who have a post viral syndrome that really in many respects can incapacitate them for weeks and weeks following so-called recovery and clearing of the virus...”

RICK:

And in fact, he mentioned these chat groups

Archival tape -- Anthony Fauci:

“In fact there are chat groups that you can click in on and see people who’ve recovered who really do not get back to normal.”

RICK:

The virus also causes a strange hypercoagulative state in the blood, according to Anthony Fauci, which leads to clotting and not just run of the mill kind of clotting - people have been reporting seeing clots come out of patients that almost...well, they do, they stick in the tubes, in hospital. And we're finding clots in the kind of beginnings of the carotid artery in the neck, which is really uncommon in viruses. So we've got this strange clotting condition, the virus wreaks havoc on the kidneys.

The pathogen can compel the wrong type of immune response, resulting in what we call cytokine storms of proteins - some proteins - called interleukins, which inflamed tissue and organs and can lead to multi organ failure. So it's the wrong kind of immune response. These things are meant to kind of fight off infection and disease, but they're being kind of weaponized against us. Less than a week ago, the Center for Disease Control, the CDC in the United States of America, issued an early release paper regarding long term health problems...

Archival tape -- Unidentified Reporter:

“Doctors are discovering more about COVID-19 and its effects on the body every single day…”

RICK:

… They found - even in symptomatic adults who had not been hospitalized - the CDC reported it might take weeks for resolution of symptoms and return to usual health.

Archival tape -- Unidentified Reporter:

“Coronavirus sufferers reported debilitating symptoms for weeks or months after they’d recovered from the virus.”

Archival tape -- Unidentified Reporter:

“In this region there is a spike in psychosis, kidney disease, spinal infections, strokes, chronic tiredness, mobility issues.”

RICK:

And then there's something even more worrying. There's increasing research suggesting that COVID could also be impacting the brain and our neurology. And by impacting, I mean, the virus is in our brains.

RUBY:

We’ll be back in a moment.

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RUBY:

Rick, there's a lot of research going on right now into the long-term Impacts of COVID-19. Can you tell me what we know about the potential neurological effects of the virus?

RICK:

Yeah, so the thing that really kind of put all this together for me was this paper, a review of the neurological implications published in May in clinical neurology and neurosurgery. And they kind of pulled together 67 different studies. And they noted that this most recent virus, the one that is affecting the world right now, may have a higher affinity for targets in the central nervous system than all the other coronaviruses.

The most interesting thing that stood out to me reading on these papers is that there is a very real possibility that at least some of the patients who have had acute respiratory distress syndrome, is that they may have had this distress not because their lungs were completely pummeled and damaged, which is what we're seeing in autopsies anyway, but also because the virus had been in the brain and had completely shut down or at least led to the death of neuronal cells in the cardiovascular center of the brain, which is the medulla oblongata. And that's the architecture in our head that allows us to breathe without thinking about it. That's why we breathe when we’re asleep. So the virus is actually in there. So that's really interesting. If you ask me, quite terrifying.

RUBY:

Yeah for sure. And so do we know why Covid might be having these impacts on the brain?

RICK:

Yeah so it's kind of the most interesting question right now. Right. So because your brain -- your brain is 1.4 kilograms on average of gray matter locked away in your skull. Right. So there's a thing called the blood brain barrier, which is kind of meant to keep the two systems separate. And, you know, when blood gets into the brain, it slows down the rate of flow quite substantially.

So the virus can get into the blood and then be taken out anywhere along through this system, including the capillary network, which is one theory scientists have for how it can get into the brain, through... it slows down, it seizes receptors. That's how it gets into the body in the first place, through the ACE2. And then it just does its harpooning trick. It's got these spikes on the surface of the virus and it just goes and sticks itself into the cell. And that's how it then gets into the brain.

The other theory is one I find particularly interesting, is that this coronavirus lands in humans through the nose because one of the first signs that you might have coronavirus infection is that you lose your sense of smell or taste. And that's where the olfactory bulb is kept, at the back of the nasal cavity. So the virus can actually bypass the blood brain barrier completely if it comes in through the back of the nasal cavity and sneaks in via what we call the cribriform plate, which is a kind of like a sieve at the back of this cavity. And that way wouldn't need to be in the circulation at all.

RUBY:

Mmm, right.

RICK:

So here’s where it gets really interesting, though, like this is the stuff that kind of blows my mind. Like, yes, this is a kind of a horrifying story in the impacts. But, you know, in some ways it's quite marvelous to...to think about how these really ancient viral genomes operate. So once it gets into the brain, and this has been found in other coronaviruses, the virus can hijack the actual system that gives you and I thought and action.

So the reason we think anything at all is because we have synapses in our brains which pass these little chemical signals between the neurons. And that's how anything happens. So there's little charge and it jumps across this little tiny gap. It's, you know, I think 1/80th the size of a human hair. But the virus can hijack that. It’s trans synaptic transmission, is what they call it. And so it just jumps across the neurons just like a thought would, except this is a, you know, a viral particle.

RUBY:

So if the virus is impacting our neurological systems, that’s a serious and scary thing. But how common is it for a person with Covid to experience these kinds of symptoms?

RICK:

I guess that's the great concern right now, right? So we've never been here before. We don't know how long this pandemic is going to last, let alone how long the effects of coronavirus will last, because we've only had it for six months. So much of the scientific literature is still emerging. But, you know, there was one journal article. It's the largest study we've had today of about 143 patients in Italy published in the Journal of the American Medical Association, which showed that 84 percent had at least one persistent symptom months after recovery from coronavirus.

And so, you know, this data’s starting to come out. And I spoke to in Australia, I spoke to the Nobel Prize winning scientist, Professor Peter Doherty, who won that award for his work on discovering how the immune system recognized certain antigens in invading viruses, which was a remarkable discovery and helps us to this day with dealing with the coronavirus.

Archival tape -- Peter Doherty:

“We know what those... what sort of consequences you might see in sort of cardiac damage and respiratory and lung damage we’re seeing now - I don't think we understand any of the neurological manifestations at this stage.”

RICK:

He said he doubts that it's neuronal outfall, which is the loss of neurons in the brain, certainly to any significant level, but it's something.

Archival tape -- Peter Doherty:

“What we also don't know is what the consequences, the long term contracts of the inflammatory type syndrome might be, whether you're going to see more rheumatoid arthritis later on in these people or you're going to see more chronic inflammatory autoimmune type diseases, that could be completely normal. I really don't know.”

RICK:

And the more he thinks about it, the more he thinks that maybe asymptomatic people that we've been telling ourselves all along didn't show symptoms, maybe they were never totally asymptomatic after all, maybe they were showing symptoms. He, you know, either way, he said, I think we will see a long term disease burden out of this pandemic. And it's a whole big experiment. And, you know, he said a lousy one.

Archival tape -- Peter Doherty:

“But I think we will see a long term disease burden out of it. Hopefully for the future we'll handle that with vaccination. I doubt the virus is just going to go away…”

RUBY:

Mm hmm. Yeah. So we're still very much in the unknown, then. What will happen next?

RICK:

We just have to look and look and look and research. In human history, I think it’s fair to say, that we have never seen a scientific turnaround in terms of a global effort to study something to the nth degree within days of the first genome of this virus being produced by chinese scientists in early January. We have never seen a global scientific effort like this, not even during the space race or, you know, when we split the atom. This is huge.

There are papers being published in every conceivable direction, looking at every conceivable impact of this thing. So, you know, in time we will have all things going well, a really good understanding of what it does and how we may end up living with it. But part of that story will always remain a mystery, I think, until the people who got coronavirus today, you know, until they turn 40 or 50 or 60 or 70 or 80 because, you know, maybe they've got a chronic condition, but maybe they've got a condition that comes back after lying dormant, which is also indicated in some of the evidence.

RUBY:

Rick, thank you so much for talking to me today.

RICK:

Thanks, Ruby. I appreciate it.

RUBY:

The recording of Hannah Davis in this episode originally aired on the podcast Culturally Relevant with David Chen, on the episode Living with COVID-19 for over 100 days, on July 10, 2020.

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RUBY:

Also in the news…

The Queensland government has declared all of NSW and the ACT a Covid-19 hotspot, and closed the borders to travellers from those regions.

Meanwhile the NSW government announced that all visitors or returning residents from Victoria will be forced to quarantine in hotels for 14 days upon arrival.

Most businesses in Melbourne will be forced to close from today, under the state’s stage four lockdown. Workers will need to carry permits to prove they’re going to work in an essential industry.

Victoria recorded a new record of 725 cases of Covid-19 yesterday and 15 deaths.

And Lebanon’s capital Beirut has been rocked by a massive blast, killing close to 100 and injuring thousands. The cause of the blast, which occurred close to the city’s port and sent shockwaves throughout the region, has not yet been identified.

I’m Ruby Jones, this is 7am. See ya tomorrow.