Short-term thinking threatening to extend long tail of COVID-19

Studies on the “long tail” of COVID-19 are emerging. They make you wonder if the pandemic’s effects will ever end. They feed into the view that our public health crisis will punch a permanent hole in the economy.

This poses critical challenges well beyond typical social, medical and economic implications. It stands to be a long-range test for the structure and financing of the health-care system and for public policies and expenditure strategies. If decision-makers are even thinking about this, they certainly aren’t talking about it yet.

At a personal level, these American studies suggest that new medical conditions, higher rates of outpatient medical care and a higher incidence of deaths surface months after infections in non-hospitalized patients. These are complications the health system did not anticipate.

One study, published in recent weeks in the journal Nature, found an alarming death rate – 60% higher – one to six months post-infection among COVID-19 patients who initially didn’t even require hospitalization.

Another study, published last week by the U.S. Centers for Disease Control and Prevention, found that more than two-thirds of non-hospitalized patients required outpatient visits one to six months post-infection. Of those, two-thirds received a new primary diagnosis – a matter that the study’s authors said we had better start understanding and preparing for.

These studies followed a U.S. National Institutes of Health report in January noting that even in asymptomatic or moderately affected patients, the body’s pathways remain “perturbed” well after infection has subsided.

We don’t know enough about why there are “long-haul” patients that remain sick for weeks and months. Nor do we know enough about the “long-tail” consequences of infection or how the coronavirus activates unrecognized syndromes.

The emerging data appears most troublesome for older patients. With the American studies, the patients were disproportionately women, or Black, or with underlying health conditions.

In contemplating the significance of these early findings, though, I couldn’t help but apply the message of long-term health uncertainty to the cruel local absurdity of the current spectacle of the NHL’s Vancouver Canucks. They may seem at a remove from the subjects of the studies, but it is impossible to dispute that in placing them back on the ice days after their rampant infections, we have sentenced them to more insecurity than necessary.

If we have learned anything in the pandemic, it’s that we know next to nothing until after the fact. A year ago, we were elbowing people at Costco for access to hand sanitizer and ordering wipes online from black marketeers. Newspaper subscribers were declining their papers for fear of contaminated surfaces. We were taking tutorials on how to wash our hands. We were being scolded for touching our faces. Masks were considered irrelevant.

Vaccines were developed with historic speed, but we did not have time to measure the duration of their effectiveness, so we had to improvise as we went on how long we could wait until a second dose in order to deliver a first dose to more people. Great that we did, but it should tell us we are amid on-the-job learning and should be judicious in letting economic impulse or avarice guide public health discipline – even when it comes to young hockey millionaires. The sports business is increasingly thinking the virus is all over.

The Canucks are much more than athletes with grand paycheques every two weeks. They, like all major sports franchises, contribute enormously to the formation of our socio-cultural identity. When we complicitly sanction their harm, we violate a community covenant. In their case, we are strangely expedient and dismissive in flouting risk based on relative guesswork that study upon study is by the day laying open to question.

A few weeks back I suggested the illness-wracked team simply shut for the season. If it mattered at all, its playoff chances were slim and chances of advancing within them toward the Stanley Cup slimmer. The late-season infection gave insufficient recovery time to resume competition with teams that for three-plus weeks in their absence had been intensifying their play.

To watch them take the ice initially and win twice was in hindsight unsurprising – adrenaline mixed with ambition will do that for you, but only briefly. Nor was what followed surprising: a physically and mentally flattened squad, with more risk of injury and long-term harm to come in the dense, draining schedule ahead. The pessimistic mathematical models of the coronavirus have been thankfully wrong, but the pessimistic mathematical models of the Canucks’ playoff hopes will not be.

Their plight is an object lesson in our blind determination to pretend there are exemptions to the biological rules the pandemic is rewriting. It is an affront to all of us when the league, the owners, the rights holders, even the players’ association, are cavalier with the communities that support them.

Even with excellent intentions, serious mistakes have been made in the pandemic about how lenient or restrictive our activities have been regulated. We can’t watch our children play outdoors but we permit professionals to collide with each other indoors. Without a longer-term understanding of the virus, we are flagrant gamblers with their health. This is one gamble that could be taken off the table to cut the losses. •

Kirk LaPointe is publisher and editor-in-chief of BIV and vice-president, editorial, of Glacier Media.