Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day one nine
Speaker 1: since coronavirus was declared a global pandemic. Today's main story.
Speaker 1: Patients who suffer mild cases of COVID nineteen or have
Speaker 1: the virus without showing symptoms may think they got off easy,
Speaker 1: but we're learning now that even those people can suffer serious,
Speaker 1: long lasting consequences from the virus. But first, here's what
Speaker 1: happened in virus news today. The US is watching New
Speaker 1: York closely, as it's the last large school district in
Speaker 1: the country to say it will send students back to
Speaker 1: school this fall. Today, Governor Andrew Cuomo confirmed that, based
Speaker 1: on infection rates around the state, every school district can
Speaker 1: reopen in September. Governor Cuomo said every region in the
Speaker 1: state falls below the three percent infection rate threshold that
Speaker 1: had been established. He also said school openings would be
Speaker 1: revisited if infection rates spiked. Thailand will allow schools to
Speaker 1: fully reopen starting next Thursday. The Southeast Asian nation has
Speaker 1: not had a locally transmitted case for more than two months.
Speaker 1: All schools will be allowed to function without any capacity
Speaker 1: limits or social distancing rules. According to the Education Minister. Finally,
Speaker 1: in India, the country's all female army of contact tracers
Speaker 1: is going on strike. Months of harassment, low pay, and
Speaker 1: lack of protection from infection has wish them to the
Speaker 1: breaking point. About six hundred thousand of the country's one
Speaker 1: million accredited social health activists will strike today and tomorrow.
Speaker 1: They want better and on time pay, as well as
Speaker 1: a legal status that ensures minimum wages. Losing the asha's
Speaker 1: would not only threaten India's virus containment effort, but also
Speaker 1: impact the other essential health services they provide, from child
Speaker 1: vaccinations to tuberculosis control. The country's catastrophic coronavirus outbreak is
Speaker 1: now the third largest in the world. And now for
Speaker 1: today's main story. The coronavirus has been spreading worldwide for
Speaker 1: over seven months now, and more than eighteen million people
Speaker 1: are known to have been infected by it over that time.
Speaker 1: We've come to understand that in most people, the virus
Speaker 1: causes mild symptoms or none at all, at least at
Speaker 1: the time they have the virus, but even asymptomatic patients
Speaker 1: may suffer lingering effects. It's yet another of the pandemics mysteries.
Speaker 1: Bloomberg Senior editor Jason Gale explains it may contribute to
Speaker 1: the pandemics significant long term social and economic costs. First
Speaker 1: was like typical flu, like syndrome, but no shortage or
Speaker 1: breath particularly it's with fever and extreme fatigue basically. Dr
Speaker 1: Peter Piot is one of our generation's most celebrated microbiologists.
Speaker 1: In the mid ninet seventies, he was part of the
Speaker 1: team that isolated the bolivirus and to help control the
Speaker 1: first outbreak in what was then Zaire. Later he helped
Speaker 1: lead to fight against AIDS as President of International Aid
Speaker 1: Society and executive director of u n AS. For almost
Speaker 1: a decade it has been director of the London School
Speaker 1: of Hygiene and Tropical Medicine. So it was big news
Speaker 1: when he needed to be hospitalized for COVID nineteen almost
Speaker 1: five months ago. And that was ironically, after having spent
Speaker 1: most of my professional life fighting viruses. It was the
Speaker 1: first time ever I not seriously ill because my situation deteriorated.
Speaker 1: I was admitted to the hospital with my oxygen saturation
Speaker 1: was like eighty three on admission and thanks to oxygen
Speaker 1: I made it through seven days there. Peter is speaking
Speaker 1: in an interview with the New England Journal of Medicine.
Speaker 1: He told the journal last week that he developed pneumonia
Speaker 1: complicated by an aberrant hyper inflammatory response to this sas
Speaker 1: cove To virus, and it illustrated that COVID nineteen is
Speaker 1: far more than either you have a bit of the
Speaker 1: flu or you end up in intensive care and die.
Speaker 1: And then they often say, oh, that's people who are
Speaker 1: over seventy and or pre existing conditions, as if we
Speaker 1: don't count, you know, there are lots of people in
Speaker 1: between with this chronic condition and this long tail of
Speaker 1: in my case, pneumonia, of mutual fibrillation, extreme tachycardia all
Speaker 1: the time. Peter had an irregular and often rapid heart
Speaker 1: right that persisted for months after his acute illness. He's
Speaker 1: seventy one and he managed a five kilometer job the
Speaker 1: morning he was interviewed. Even still he gets fatigued. He
Speaker 1: says the ordeal changed his perspective. One viruses particularly sounds two. Well,
Speaker 1: first of all, it's something to avoid at all costs.
Speaker 1: I mean it's a bit of a lottery in a
Speaker 1: sense whether you'll develop an asymptomatic infection or serious illness
Speaker 1: like what I had. Of course there are risk factors
Speaker 1: being old, having diabetes hypertension, but I didn't have any
Speaker 1: of these underlying factors, and even young people today can
Speaker 1: die from it. There are many more and more examples,
Speaker 1: and that's particularly important to realize now that a lot
Speaker 1: of the infections are happening in young people, and the
Speaker 1: scientific evidence suggests a proportion of these patients may endure
Speaker 1: decades of chronic diseases. Doctors refer to these conditions as
Speaker 1: sequel I. When they persist in younger patients, the impact
Speaker 1: on society is much larger because people have to live
Speaker 1: longer with their disabling effects. The physician who treated UK
Speaker 1: Prime Minister Boris Johnson could COVID nineteen this generation's polio.
Speaker 1: Because of the physical, cognitive, and psychological disability, the illness
Speaker 1: will lead requiring long term healthcare. I think we will
Speaker 1: be faced as a medical community also were probably soon
Speaker 1: hundreds of thousands, if not millions, of people ultimately with
Speaker 1: chronic conditions with long term sequality, and I think it's
Speaker 1: important that we are prepared for the fallout of chronic
Speaker 1: illness mental health issues, and of course, in my particular case,
Speaker 1: I'm double motivated to defeat this epidemic. The coronavirus target
Speaker 1: cells line in the airway, sometimes triggering an overzealous immune
Speaker 1: response like what Peter Pond experienced that can weaken the
Speaker 1: muscles used for breathing and called scarring in the lungs
Speaker 1: of patients who experience even a mile about of COVID nineteen.
Speaker 1: The question is how will that affect lung capacity of
Speaker 1: the long term and what other lasting disabilities will COVID
Speaker 1: nineteen survivor's face. Dr Thomas Filets, President of the Infectious
Speaker 1: Diseases Society of America. He says, we can look for
Speaker 1: clues among people who were sickened by severe acute respiratory
Speaker 1: syndrome or SARS almost twenty years ago. We do know
Speaker 1: from studies about that infection that people who have had
Speaker 1: particularly long scarring from a STARS, that they can have
Speaker 1: persistent symptoms for years. And we're of even one study
Speaker 1: that looked at fifteen years later and some of these
Speaker 1: patients still had abnormalities of their lungs. And so this
Speaker 1: is something that we're going to have to whine closely,
Speaker 1: but I think we're already seeing it. We're seeing effects
Speaker 1: on the lungs We're seeing effects on the heart, on
Speaker 1: the neuro neurologic system, the emotional system, psychological system. So
Speaker 1: this is gonna have I think a significant burden on
Speaker 1: our health care system for years to come. In Wuhan,
Speaker 1: the Chinese city where saskovit too emerged late last year,
Speaker 1: more than a third of severe COVID nineteen patients had
Speaker 1: complications such as stroke, acute kidney injury, and post traumatic
Speaker 1: stress disorder. As the pandemic spread across the world, doctors
Speaker 1: have reported similar problems. For example, one center in Italy
Speaker 1: found that almost nine out of ten patients reported the
Speaker 1: persistence of at least one symptom some sixty days later.
Speaker 1: Where they looked at patients who had all been hospitalized,
Speaker 1: so these are all fairly sick patients, uh, And they
Speaker 1: found that literally eighties seven percent of these patients still
Speaker 1: had significant symptoms, multiple symptoms quite honestly, two months later
Speaker 1: after they're onset of symptoms, even after they were discharged
Speaker 1: from the hospital. Thomas's post traumatic stress disorder could be
Speaker 1: another disturbing product of the pandemic. They're already beginning to
Speaker 1: see some patients who have been released from the hospital
Speaker 1: and some patients quite honestly, who never were sick enough
Speaker 1: to come in the hospital, but yet they're It really
Speaker 1: concerns them about what's happening with, you know, their long
Speaker 1: term health status. We do know that it can affect
Speaker 1: the brain, for example, and it can have neurocognitive considerations,
Speaker 1: and so I think post traumatic stress disorder is going
Speaker 1: to be an issue that the psychologist psychologists are going
Speaker 1: to have to deal with. Thomas's heart problems may also manifest.
Speaker 1: There was a recent study showing that there's this UH
Speaker 1: stress associated heart issue where patients coming in with looks
Speaker 1: like heart attacks, but when they do coronary artery um
Speaker 1: and geograms they really don't see particular coronary odor is,
Speaker 1: but yet they do have heart damage. And so there
Speaker 1: is this issue about the psychological issue and the stress
Speaker 1: mental stress that can be associated with the UH sort
Speaker 1: of physical finding. The CDC two weeks ago published a
Speaker 1: survey of two hundred and seventy non hospitalized adults who
Speaker 1: tested positive for COVID. About a third of them said
Speaker 1: they hadn't returned to their normal health two to three
Speaker 1: weeks later. Among eighteen to thirty four year olds with
Speaker 1: no chronic medical conditions, one in five went back to normal.
Speaker 1: The authors of the report so that, in contrast, over
Speaker 1: our patients with influenza recovered within about two weeks of
Speaker 1: testing positive for fluid. A COVID symptom study, which has
Speaker 1: gathered data from millions of people in the US, UK
Speaker 1: and Sweden, suggests ten percent of fift of people, including
Speaker 1: some mild cases, don't recover quickly. We're beginning to become
Speaker 1: aware of increasing percentage of patients who have had symptoms
Speaker 1: and even who are asymptomatic quite honestly, who may have
Speaker 1: long term health issues. And certainly this seems to be
Speaker 1: much different than other respiratory viruses. The fact that people
Speaker 1: who have no apparent COVID nineteen symptoms can still have
Speaker 1: health problems highlights their insidious nature of sounds. Two. There's
Speaker 1: two studies now that have come out to show that
Speaker 1: patients who have had even asymptomatic infection, and these are
Speaker 1: patients who are identified either through contact tracings. And then
Speaker 1: the other group are patients who had come from cruise
Speaker 1: lines or cruise ships and we're quarantined for a while
Speaker 1: and we're tested but never developed symptoms. And a group
Speaker 1: of them um did studies imaging studies of their lung
Speaker 1: and found scarring on their lungs. This could mean that
Speaker 1: they're going to have some decreased lung function, which may
Speaker 1: not be sort of physically evident now because they have
Speaker 1: good lung capacity, but as they get older, or if
Speaker 1: they have other conditions asthma or whatever, it could be
Speaker 1: a significant consequences down the line. So this is going
Speaker 1: to be an issue. It's almost five months since the
Speaker 1: World Health Organization declared COVID nineteen the pandemic. We have
Speaker 1: no effective treatment, no vaccine, and we're still yet to
Speaker 1: fully understand the prognosis. The global contagions immediate threat is obvious,
Speaker 1: but the one we can't yet fathom might tenant to
Speaker 1: be just as catastrophe. That was Jason Gale and that's
Speaker 1: it for our show today. For coverage of the outbreak
Speaker 1: from one and twenty bureaus around the world, visit Bloomberg
Speaker 1: dot com slash coronavirus and if you like the show,
Speaker 1: please leave us a review and a rating on Apple
Speaker 1: Podcasts or Spotify. It's the best way to help more
Speaker 1: or less nurs find our global reporting. The Prognosis Daily
Speaker 1: edition is produced by Topher foreheads Jordan Gospourey, Magnus Hendrickson
Speaker 1: and me Laura Carlson. Today's main story was reported by
Speaker 1: Jason Gale. Special thanks to the New England Journal of Medicine.
Speaker 1: Original music by Leo sidran Our. Editors are Rick Shine
Speaker 1: and Francesca Levi. Francesca Levi is Bloomberg's head of podcasts.
Speaker 1: Thanks for listening.