In the ‘Horizon’ programme on BBC2 last night, which provided several updates on the coronavirus crisis, there was a hugely encouraging short discussion on Long Covid and its similarities with ME/CFS and other viral fatigue syndromes.
In this five-minute segment, presenter Dr Xand Van Tulleken talks to Dr David Strain, a senior clinical lecturer at the University of Exeter Medical School, who works in the city’s NHS specialist service for people with ME/CFS.
Watch the the discussion with Dr Strain HERE The interview runs from 43:03 – 48.14. The relevant clip has also been captured on YouTube by Broken Battery:
We may be coming off the peak of the second wave but that means that many of us who have had the infection might be worried about Long Covid. It’s one of the more surprising and unwelcome things about the infection. I got Covid in April and it left me with a heart arrhythmia and fatigue and exhaustion for many months afterwards.
Dr David Strain is the BMA’s lead on the NHS’s Long Covid Taskforce.
David, thank you very much for coming in. Are my symptoms typical of the kind of things that you are seeing?
Your symptoms are very typical. We do see many patients who present with these cardiac problems or with breathing problems and then a fatigue.
There are two real types of Long Covid.
There’s Long Covid that can be attributed to a really bad case of Covid in the first instance. So they’re the people who ended up in ITU, they’re the people who got pulmonary scarring. They might have had small spots in the brain or small spots in the body, and it’s left them with long-term consequences afterwards.
And then the surprising group that came out of this are people like yourself who didn’t get particularly bad Covid. But we’re getting many people who two to three months later are still left with this chronic, debilitating fatigue.
Really? So even if you haven’t had been in intensive care, you haven’t been severely short of breath, you haven’t had that severe, immediate organ damage, you can still have very, very protracted consequences?
Absolutely. If anything, we’re seeing it more commonly in the younger patients, the fitter, the more active. The ones who may have got over the initial disease very quickly but have been left with these long,debilitating symptoms. We have some patients who caught Covid in March and are still not able to function for a full day.
What we think is happening is the virus is affecting the mitochondrial cells. So the mitochondrial cells are effectively the battery that every single cell has that keeps it charged, that keeps it able to do things.
Long Covid is effectively like having a run-down battery. We’ve all seen a smart phone that’s seen three or four years worth of use and it will die in about 15 minutes use after you take it off the charger. Long Covid leaves your cells in exactly that same position. Just a walk to the kitchen and you will start to feel tired and exhausted
I definitely felt that. When I woke up in the morning I felt ‘Great! I can attack the day. It’s going to be fine.” And I'd ride my bike to work and be shattered by the time I got there – almost in tears, I was so tired.
One of the key things that we’re recommending is that people stay within their energy envelope. So, if you know you are going to be exhausted after you walk a mile, stop 200 yards short, sit down, rest. Let your battery recharge naturally.
Is there anything you can do to reduce your chances of having Long Covid?
One of the common features in our studies of people who have got Long Covid is that they are people who, when the caught it in the first instance, tried to work through it.
They tried to say ‘Oh it’s only a mild disease, I’ll shrug it off and I’ll get off’. And the result is that they have been left with much more lasting consequences. So the one piece of advice I would say is that, if anyone tests positive, if anyone has got even the mildest symptoms, take it easy. Go easy on yourself because the more chances you get to recover today means the better you will be over the next few months and few years.
This has perhaps been under-emphasised. How important it is, even if you have a mild case of Covid, that you rest and take the time to recuperate, maybe much longer than you would naturally be inclined to do.
Yes, if you do catch Covid, you need to take it easy, you need to sit back and relax, two maybe three or four weeks before you try to re-engage as you would normally have done previously.
Before this coronavirus came along, you had worked on chronic fatigue syndrome, on M.E. – on the things that we sort of associate with viral infections that affect people for a long time. Has the emergence of Long covid changed the landscape for people with those conditions?
It’s the silver lining to this whole outbreak! That people who have been shouting about M.E. and CFS for the last 20 years are suddenly being heard. One of the studies that we’re planning is going to be directly comparing patients with Long Covid with patients with chronic fatigue syndrome because we think there are going to be some similarities.
The two main areas that we’re going to be looking at are in the mitochondria, the batteries that we spoke about, that we know are affected by Long Covid, and then the other place that we’re interested in is the microcirculation, the smallest blood vessels – the ones that are responsible for delivering the oxygen, the nutrients and the hormones to your tissues.
The hope is that as we develop a treatment for Long Covid that can then carry over and we can then start treating these people who have had CFS or ME for the last 20 years and have been left with what is a life-changing physical illness that they have struggled to have even accepted as a disease in its own right.
XVT: So interesting! David, thank you very much.
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