8% citizens have close contacts for whom COVID-induced conditions persisted for over a year or have become permanent

February 10, 2022, New Delhi: The COVID virus can lead to levels of damage physically, mentally and emotionally even after recovery, which means that the individual might be suffering from a condition called Long COVID. There has been an increase in discussion among people on LocalCircles platform sharing how they or someone in their social network are facing Long COVID. One of the LocalCircles members shared with the community that even after recovering from COVID, they have been living with headaches, a weird fuzzy sensation, pain in the center of the chest, heart pounding, fatigue ranging from being mild, bone-deep exhaustion that lasts for days that overall trigger stress physically, mentally, emotionally, and other depressive episodes. The latest research by the Washington University School of Medicine, which analysed long-term effects in people's hearts found that people who have had COVID are at increased risk of developing cardiovascular complications within the first month to a year after infection. Such complications include disruptive heart rhythms, inflammation of the heart, blood clots, stroke, coronary artery disease, heart attack, heart failure or even death, it added. Another journal published by American Medical Association (JAMA) recently reported that people who required ICU care during the COVID treatment continued to have physical, psychological symptoms for over a year. Of those, 74% of patients reported physical symptoms like weakness, joint pain and 26% reported mental symptoms such as anxiety and depression while 16% complained of cognitive symptoms.

Not knowing how much longer Long COVID would last and what long-term effects it would have on an individual's life can trigger serious health issues. A medical journal BMJ Open conducted a study, titled “Multiorgan impairment in low-risk individuals with post-COVID-19 syndrome: a prospective, community-based study", and concluded that in individuals at low-risk of COVID-19 mortality with ongoing symptoms, 70% have impairment in 1 or more organs 4 months after initial COVID-19 symptoms. According to studies, not only do the lingering effects of COVID last for months after the virus subsides, but it also cuts across multiple organs like scarring of lungs, temporary loss of vision, cardiac arrest, acute kidney injury, a spike in blood sugar levels, crippling joining pains, intestinal ulcers, loss of memory, painful periods in women, notwithstanding mental health issues such as depression, anxiety, and panic attacks. Researchers from Zurich have found that low levels of certain antibodies were common in people who developed Long COVID.

Taking cognisance of the issues reported on COVID’s Long-term health effects, LocalCircles conducted a one-of-a-kind study to understand from citizens the prevalence of Long COVID syndrome on individuals in their close network who had been infected by the virus. It also sought to know the duration it took for them to recover fully, partially or if the symptoms have prolonged effects on their health. The survey received more than 19,500 responses from citizens across 327 districts of India. 68% respondents were men while 32% respondents were women. 47% respondents were from tier 1, 33% from tier 2 and 20% were from tier 3, 4 and rural districts.

65% surveyed have 1 or more individuals in their close network who have experienced Long COVID with symptoms persisting weeks after recovering from COVID

The first question in the survey asked citizens, “How many individuals in your close network (including yourself, family, friends, colleagues, neighbours) experienced a condition called Long COVID where 1 or more symptoms (fatigue, joint pain, muscle pain, cough, shortness of breath, concentration or sleep problems) persisted weeks after recovering from COVID?” In response, 2% of citizens said they know “10 or more” individuals who had similar symptoms weeks after COVID. 6% said they know “6-9” individuals, 21% said “3-5”, and 36% said “1 or 2”. Only 22% said “None of them” and 13% couldn’t say. On an aggregate basis, 65% of Indians have 1 or more individuals in their close network who have experienced Long COVID with symptoms persisting weeks after recovering from COVID. This question in the survey received 9,921 responses.

Of those who have had Long COVID, in about 8% people, COVID-induced ailments have become permanent; for most others, they took from 1 week to 1 year to resolve

The following question sought to understand the time it took for individuals to recover from COVID-induced ailments. The survey asked citizens, “In most of the cases of Long COVID in your close network, (including yourself, family, friends, colleagues, neighbours) how long on average did 1 or more COIVD long symptoms (fatigue, joint pain, muscle pain, cough, shortness of breath, concentration or sleep problems) persist?” In response, 21% said it lasted for “1-4 weeks”, 12% said “4-8 weeks”, 19% said “8-12 weeks”, 30% said “12-24 weeks”, and 6% said “24-48 weeks”. Notably, 8% of citizens said “COVID-induced conditions have become permanent for their contacts and another 6% said these conditions lasted 24-48 weeks.” 4% couldn’t say. This means that of those who have had Long COVID, in about 8% of people, COVID-induced ailments have become permanent. For most others, they took from 2 weeks to 1 year to resolve. This question in the survey received 9,802 responses.

In summary, the survey indicates that 65% of those surveyed have 1 or more individuals in their close network (including themselves, family, friends, colleagues, neighbours) who experienced Long COVID where 1 or more symptoms like fatigue, joint pain, muscle pain, cough, shortness of breath, concentration or sleep problems, which persisted weeks after the initial recovery period. This highlights the intensity of the disease and the severity of its attack on many individuals. While 82% of these individuals surveyed said their contacts suffering from long COVID recovered fully within 6 months, for 6% of them the recovery took 6 months to a year and for 8% of them, the COVID-induced conditions have become permanent.

The above survey covered only the conditions primarily induced from the alpha, beta and delta variants of SARS-CoV-2, the long-term impact of the Omicron variant will only be understood several months from now. However, given symptoms of illness previous variants have induced, the herd immunity approach that some countries are undertaking seems rather misplaced. The Central and State Governments must refer to these data points as they manage the pandemic as well as plan their healthcare initiatives going forward. Even if 2% of the COVID infected population of India ends up with long-term conditions, with 4 crores COVID cases, that amounts to 8 lakh citizens needing recurring healthcare services. And these are just those who are in the official counts, for there are many others who just have a condition now post COVID and no access to treatment.