The long Covid, "a parallel epidemic": what the scientists say

“I can not anymore.” At 35, that’s how many of Pierre*’s sentences begin. A physiotherapist by profession and a great lover of high mountain sports, the young father of a family has recently given up a good part of his working life. “I went from hyperactive to an almost vegetative state,” he says in a quavering voice. On sick leave for two months, Pierre struggles to walk, and talking too long can be a test. “When I just go for a walk with my three-year-old son, I come back exhausted,” he says.

At the beginning of 2022, Pierre was infected with Sars-Cov-2, without however developing a severe form. “I coughed for a week,” reports the man who, after ten days in solitary confinement, resumes his work and sports habits. “Gradually, I began to have discomfort, drops in blood pressure and was constantly vomiting.” Diagnosed with Covid long several weeks later, Pierre then sees his life shift into another dimension which petrifies him, “more than the idea of dying”. “I can’t work or anything anymore. My life is now just about suffering. It’s as if I had been buried alive.”

Like Pierre, there would be millions to suffer from a long Covid. That is, persistent symptoms of Covid more than two months after infection, which cannot be explained by other diagnoses and which have an impact on daily life, according to the WHO definition .

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“Considerable and significant figures”

In the United Kingdom, a new study, published on October 3 by the National Statistics Office, reveals that around 2.3 million people, or 3.5% of the population, have suffered from a long Covid, of which 1 million still have persistent symptoms more than a year after infection. On a European scale, a model, published in mid-September and carried out for WHO Europe, shows that during the first two years of the pandemic, at least 17 million people on the European continent (53 States taken into account) have experienced a long Covid. Asked by the Washington Post This Wednesday, October 12, WHO Director General Tedros Adhanom Ghebreyesus calls for “sustained” efforts to help people who are still experiencing “prolonged suffering”. “While the pandemic has changed drastically due to the introduction of many lifesaving tools and there is light at the end of the tunnel, the impact of a long Covid for all countries is very serious and requires immediate and sustained action commensurate with its magnitude,” he said.

Across the Atlantic, many scientists are worried about this mass of people affected by persistent symptoms of Covid. Some even go so far as to speak of the long Covid as a “new epidemic”, or “a parallel epidemic” to that of acute Covid-19 cases.

“Indeed, the figures for the long Covid challenge and are not negligible, opines Jérôme Larché, referent doctor for the long Covid course for the Regional Health Agency in Occitanie. The long Covid is an integral part of the Covid-19 pandemic, but its proportion is such that it can be called an epidemic too.” A finding shared by Professor Dominique Salmon-Ceron, infectious disease specialist at the University of Paris. “We can qualify the long Covid as a pandemic within the pandemic. With the difference that this pandemic will last in the longer term, because some patients are still suffering from the long Covid three years later.”

Direct consequences on society and the economy

In France, the latest study on the subject published in July by Public Health France suggests that 30% of people who contracted Covid-19 developed long-term symptoms. That’s 2 million people. But over time, the prevalence decreases. Among patients diagnosed with long Covid, between 10% and 15% of patients would keep severe symptoms, while for the others the disease resolves. “This means that there are at least 100,000 people who would suffer from a severe form, some of whom are disabled in their everyday life”, underlines Professor Salmon-Ceron, among the pioneers in France in terms of taking in charge of Covid long patients.

“You realize if there are so many people in my condition, laments Pierre on the other end of the line, whose flow accelerates, then runs out of steam. If we integrate the relatives of the sick in the equation is double or even triple ruined lives.” For Dr Larché, there is no doubt, “the Covid long epidemic is much more than a disease; it is a societal pathology which disrupts both the healthcare system, people’s lives and the economy”. In the United States, an analysis by the Brookings Institution, published at the end of August, revealed that up to 4 million Americans could be out of work as a direct result of their long Covid. In terms of lost wages, that could amount to at least $170 billion a year, the report said. In 2021, a survey by the Union of British Trade Unions had already pointed out that 16% of people with long Covid had reduced hours at work and that 20% were on sick leave between April and May 2021. “Psychosocial impacts and economic of the long Covid are major, comments Professor Dominique Salmon-Ceron. Some people, a minority fortunately, will remain disabled and they will have to be supported. The State must realize this. ”

Especially since French researchers are studying the possibility that the cognitive disorders observed in many Covid long patients are the sign of a cerebral vulnerability which could last. This is what Vincent Prévot, research director at Inserm, at the Lille Neurosciences and cognition laboratory, began to observe. “It was discovered quite early on that the virus expressed a protein that it uses to feed the genetic material it produces. It uses this same protein to induce the death of endothelial cells, which form the blood vessels of the brain. By doing this, it risks creating micro-hemorrhages, explains the researcher. If these micro-hemorrhages are confirmed, then this weakens regions of the brain and perhaps they will age less well over time, which can induce loss of cognition and predispositions to the development of neurodegenerative diseases. A phenomenon already observed after the Spanish flu epidemic, which had given rise to predispositions for Parkinson’s disease.

Barrier gestures and vaccination to protect against it

Until now, scientists and patient associations have pointed to a broad lack of interest on the part of the public authorities with regard to the long Covid. “I think that in France, this lack of interest stems from the fact that the scientific debate is not resolved, explains Dominique Salmon-Ceron. There are always on the one hand those who think that long Covid is a new organic disease, and those who argue that it is psychosomatic and that the patients maintain their symptoms.” A vagueness which feeds, according to her, a kind of status quo on the care and recognition of long Covid patients.

Nevertheless, the best ways to avoid the long Covid remain not to catch the Covid, and therefore to protect yourself by barrier gestures and vaccination. “We are not yet certain that multiplying infections is a factor in itself which can give rise to a long Covid”, explains infectious disease specialist Jérôme Larché. Over the last waves of the epidemic, scientists are seeing a drop in long Covid cases. “We do not yet have fully consolidated data, but it seems that this risk mainly concerns primary infections”, assured L’Express Professor Alain Fischer. This “parallel epidemic” has not yet revealed all its secrets.

* The first name has been changed.