MBBS iBSc DTM&H DMCC. Global. Junior anaesthetist. Inquisitive. Strive to always be open-minded. Clean air is a human right. I 😷
#LongCovid
#COVIDisAirborne
We need to embrace the uncertainty of the unknown, and show not only a clinical curiosity but compassion and understanding towards the
#LongCovid
experience. And demonstrate, in tangible ways, an appreciation of its potentially grave societal impact.
Don’t look up.
Over 144 million people long-term sick. Increases in stillbirths, preterm birth, and postpartum haemorrhage. Young people in numbers not seen before presenting to cardiologists.
The experts are screaming at the top of their lungs.
Arrhythmias. Myocarditis. Pericarditis. Sudden deaths in fit and healthy adults. Blood clots in lungs and brains. Bowel ischaemia. Damaged kidneys.
The experts are screaming at the top of their lungs.
Making others uncomfortable by taking airborne precautions…a short 🧵
I recently got disinvited to a close relative’s 60th birthday celebrations - mostly lunches and dinner events.
1/6
The issue isn’t with me. I’m not that bothered; quite like looking after my health and it’s the people and the experience I’m primarily there for, not the food. It’s others that are projecting theirs onto me. My guess is that my mere presence threatens their denialism.
6/6
Immunocompromised patient had covid for 613 days, which led to extensive viral evolution with over 50 mutations.
….yet oncology wards don’t see a need for HEPA filters, RPE (FFP3/N95), or ensuring staff stay at home if they’re unwell 🤔
The US economy is losing $2.6 trillion. The UK doesn’t have enough healthy people to employ and growth halts.
The experts are screaming at the top of their lungs.
Don’t look up.
#stuckinanalternateuniverse
#COVID19
#LongCovid
But this isn’t about me. This is about me going against social norms and making them too uncomfortable. Not eating when others are, and - most importantly - taking actions that others aren’t…
4/6
The others pats their friends with damaged bodies on their shoulders. Grieves the lost friend or relative. Reads the media’s headlines.
The experts are screaming at the top of their lungs.
“The idea that a child born today could contract COVID 40 times before college and live a normal, healthy lifespan, is completely unsupported by what we know about this disease.”
Great article. Proactive,tangible advice.
#CovidIsNotOver
@10DowningStreet
I’d explained that I wouldn’t eat due to the covid risk (but happy to drink with a SIP valve) but would love to see everyone and celebrate the birthday.
“Isn’t it best if you don’t come, it won’t be much fun for you, will it”.
Statement, not a question.
2/6
I recently visited Dublin with some friends. Had a blast. Very crowded Guinness museum with lots of people coughing. SIP valve did the job. They had an indoor pub lunch; I briefly left them and got my outdoor dose (my tent to bed ratio is always off) and found a lovely park.
5/6
Pretty much the same thing happened for a friend’s wedding a while back.
I’d already said that I’d love to be there. I have no doubt I’d have a wonderful time. Since when is great company, wonderful atmosphere, plus wine/champagne not?!
3/6
Developed runny nose, headache, sore throat, aching body. Treating myself as covid until proven otherwise. Shocked to realise that highly educated people around me “don’t think it’s covid so don’t think I need to isolate”…1yr+ into this and ppl still haven’t grasped the basic.
@CovidSolidarit1
Thank you, but they’re close family so it still hurts. Wanted to celebrate them. Practically, there are no obstacles. It’s their emotional reactions to our new, complex society that created them.
1/9 Thread on the narrative around
#longcovid
Commonly, the narrative around long covid is that we need to ‘understand how long the condition lasts’. I find that concerning.
1/3 Just had the result from a cardiac MRI as part of the
#coverscan
study.
Almost 13 months after contracting
#covid19
I’ve developed mild myocarditis.
Cognitive dissonance 🧵
Medically trained person asking my views on Eris being considered mild. Links to an article arguing it is, but which makes no comment on medium- to long-term risks of infection. 1/6
2/3 This is not a delayed finding - this is new. An MRI in Sept only showed pericarditis, no myocardial involvement. And clinically fits as I had new, angina-like pain in Jan-Feb.
Cannot stress enough how
#LongCovid
needs to be taken seriously and patients investigated properly
2/9 It implies that
#longcovid
is a condition that will self-resolve with time, i.e. medical intervention is not needed. But we do not know this, which makes it a dangerous assumption.
2yrs of gaslighting; dismissal; organ damage & subsequent chronic chest pain; the rare but amazing doctor who practices real medicine - listens, investigates & treats; my deep refusal to give up; and a very gradual and non-linear process of patching my life back together again.
Ending with a photo of my last hike. Not sure why. To show how I’d indeed patched myself back from 1yr’s bed-bound state, skin and bone at 48kg? To appeal to that empathy society tragically is proving to be lacking? To reminisce and give me the determination to recover? Probably.
Instead the world is turning unliveable for a large proportion of its population.
Humanity, empathy and compassion - traits that supposedly separates us from others in the animal kingdom - forced to step back while Darwinism takes over.
It’s simple. Practice
#airsafety
(filters,CO2 monitors; rewrite building regulations so new-builds accommodate a future with further pandemics (ie air filter systems..); FFP3 for all HCP; testing to know when to increase response by temporarily WFH, limiting indoor activity etc).
4/9 It perpetuates a view that
#pwLC
only need rest, rehab and time, and removes focus away from the urgent need for research into its pathophysiology and treatment development.
3/9 If anything,
@resiapretorius
’s work on microclots and platelet hyperactivation suggests otherwise. New organ damage, occurring at any point during the disease process - including many months down the line, also suggests otherwise.
A relentlessly careful life. Respirator at work. FFP2/3 everywhere else. Socialising outdoors. All it took was one evening. One single evening that could have been nothing other than a wonderful dinner. Had the venue just chosen to practice
#airsafety
by installing air filters.
9/9 The narrative around long covid needs to change. Sympathy and support is highly valued, but what every individual wants - and society needs - is to
#treatlongcovid
All
#pwLC
wants is their lives back. All a world battling a pandemic needs is manpower. Let’s achieve that.
I’ve done it once and I will do it again. But this further delays my recovery and return to work. At large costs to society. Politics is by its very nature incredibly short-sighted, and this time we’re paying an extortionately high price for that.
5/9 Also removing focus away from medical intervention, I believe the
#longcovid
narrative is too centred around the symptomatology rather than the diagnoses making up the umbrella term long covid.
Focus is on symptom support when it should be on diagnosis and treatment.
And I’d done it. I was hiking mountains, running 5Ks in 27mins, routinely cycling 10KM to work, and gradually but successfully increasing my workload (cognitive rehab was slower than physical - but equally working, especially after stellate ganglion blocks..).
8/9 POTS, IST, neuropathies, myopericarditis, MVA, mast cell dysfunction, OSA, V/Q mismatch etc…a myriad of diagnoses are being made in
#pwLC
- when appropriately looked for - allowing for treatments to be initiated. Not a cure, but often a big help.
Instead I’ve spent the last week soaking my bedsheets with sweat from my high fevers, establishing a 3AM warm milk with honey routine when my throat gets so sore just trying to swallow wakes me up, losing my voice, almost choking on thick secretions I’m struggling to cough up.
Preliminary results of Finnish study shows that air purifiers in Kindergartens reduced parental workplace absences by 30%‼️
Using this 30% across all kindergarten children can potentially save employers EUR 20 million annually in Helsinki alone.
Invest in HEPA filtration now 💨
Only took nearly 2 years, but the word is finally getting out:
#COVIDisAirborne
!
Prevention is always, always, always cheaper. Compared to the cost of staff sickness, the cost difference between FFP3 and FRSM is negligible.
#protectNHSstaff
#FFP3forall
6/9 I believe this needs to change. While
#pwLC
and the medical community impatiently awaits research into the underlying disease mechanism, each individual patient needs appropriate investigations into their clinical presentation.
I explain that focus need to not only be on the acute illness; it must consider medium- to long-term risks too to be a valid risk assessment. Also include a link to a paper on LC-risks. 3/6
One for
#MedTwitter
…
Part of a new
#LongCovid
endothelial function study. Distal UL occluded with tourniquet at 200mmHg for 5mins, plethysmograph on both fingers. Plus US images of brachial artery.
Showed that I have severe endothelial dysfunction.
Got covid 17 March 2020
Gets sent another article describing it as mild. Again only focuses on the acute illness.
I comment on the one-sided, and incomplete views in both those articles. Point out that HIV was also pretty mild initially. 4/6
I give multiple, clear examples of these risks. Sudden cardiac deaths, links to diabetes, miscarriages, pre-eclampsia, reduced sperm count, cognitive decline, leading cause of death in children, previous covid infection linked to last year’s RSV wave. 2/6
Example of how too many of England’s so called
#LongCovid
clinics lack diagnostic capabilities or access to multispecialty team. Pts bounced back to GPs due to untreated medical issues - a GP who referred in the first place as need specialist advice, yet have nowhere to send them
Direct quotes from Long Covid 'Hub' letter to my GP: "The HUBs objective is to assess the patients rehabilitation needs and make onward referrals to appropriate community based therapy teams"
#LongCovid
forums tell of diagnoses incl cerebral vein thrombosis, PE, myopericarditis, atrial flutter, microvascular angina, POTS, myelopathy, PUO (fever for 7+ months)..we need access to acute clinics for diagnosis and treatment. Rehab is secondary.
@fmwales
@vaughangething
This same person recurrently asks my advice for others with LC. Has tried incredibly hard over the years to help me however possible to recover from my severe LC. Has seen themselves how severely unwell I’ve been. Know my many diagnoses. 5/6
1/3 Very poorly constructed study by
@ONS
Not taking key symptoms like chest pain, palpitations, autonomic symptoms or brain fog into account. It’s hinting the true number of ppl with
#LongCovid
though - 1 in 9 says they have it!
@bbchealth
“the virus is now one of the top 10 causes of death for children ages 5 through 11 years”
#COVID19
. Top ten cause of death in children.
Yet this age group isn’t even OFFERED the vaccine in the UK!
Running out of words…the actions of this government is inhumane.
ABC7: Pediatric hospitalizations up 395% in NYC amid COVID surge: What to know about kids and omicron.
Experts say it is more critical than ever for children to get their COVID vaccine shots
I got covid after several on call shifts. I had only been at work and at home. I lived alone, drive to work.
I know I’m not alone in this - we were all in strict lockdown at the time..!
Airborne virus+pandemic+HCP…how much more is needed for it to be ‘reasonable evidence’?!
Just came across this Best resource on how to reduce the spread of
#COVID19
I've seen! Practical, simple, straightforward and scientifically accurate advice. Key point:
#COVIDisAirborne
This should land in everyone's inbox! Thank you
@jljcolorado
and team
I was a healthy cardiologist and marathon runner. Now, I have organ damage and I’m on two medications to thin my blood.
Let’s call
#LongCovid
like it is. A condition with potential to cause a vasculopathy and clotting state that will lead to unprecedented medical complications.
Thought it was just me but realising that lots of us long haulers who are starting to recover seem to be getting recurrent infections.
#LongCovid
/
#COVID19
directly impairing our immune system? Consequence of chronic illness and sickness-induced isolation? Presumably both.
1/4 The govt and the news are painting an image of an increasing number of
#longcovid
clinics which will provide desperately needed help for us. Yet the majority of these are not doctor-led;
1/2
#LongCovid
is a disease that’s all in the history. When I began recovering my family started asking when I was going back to work. Realising I give an appearance of being 100% well I began explaining the severe cluster of symptoms even shorter activities can cause,
Watched the panorama covid doc with my mum and dad today. my mum goes wow she's really got it bad that women compared to you, hard to hear knowing I think i am very similar or even worse at times. ppl close to you sometimes cant see it at all its disheartening.
#LongCovid
1/9 Interview worth watching.
#LongCovid
is an umbrella term for a severe, multi-system disorder. Or as
@resiapretorius
describes it in this interview, it’s a phenotype of acute covid.
#longcovid
is not a slow recovery.
It’s chronic endothelial inflammation caused by circulating microclots & hyperactive platelets- preventing O2 getting to tissue
Biomarkers will come.
Treatment will come.
Please watch & share
@resiapretorius
interview
Thread. 1/5 A very emotional morning, recalling just how sick I’ve been. I’m so grateful for having been given the opportunity to share my
#LongCovid
experience with
@AppgCoronavirus
.
“.. up to a million people needing treatment for long Covid [..] huge extra pressure on an already overstretched NHS”
“...shows the importance of vaccinating as much of the adult population as possible.”
#countlongcovid
#longcovid
#covidvaccine
@MLS_Dave
Same. The moral injury of witnessing superspreader events unfolding in front of my eyes, conversations around covid (or any disease prevention-starting to apply to measles too!) akin to hitting my head against a brick wall…it’s often feels too heavy to deal with.
A large number of anecdotal reports are telling of organ damage developing months into the illness - it risks patient safety not to investigate symptoms appropriately
#LongCovid
1/
Just watched
#Newsnight
report on
#LongCovid
. Key missing info:
1. ONS prevalence stats, including in kids (7-8%), released a week ago
2. Evidence of organ damage in non-ICU non-hospitalised LC patients & how this interacts with the discussed exercise therapy, e.g myocarditis
@SalamonSMD
What I’m realising too. It’s just often more complicated than that in practice, but there absolutely is a way to balance this. Adapting and growing.
“It seemed nobody had thought about the enormous implications of chronic disease as a result of letting SARS-CoV-2 spread[…], assuming it would all be fine for those classed as non-vulnerable.” Humble, honest, spot on - thank you
@Dr2NisreenAlwan
@LoneWolfMasker
I’m so sorry 😔 I’m trying to reframe it all, realising that people with these values are not those I want in my innermost circle. That’s reserved for those with the same ethics and values as me; those who make me heal, grow, develop. Chosen family. 1/2
“But COVID-19 does eliminate a significant number of T-cells, enough to make large numbers of sick people overwhelm emergency wards with RSV (respiratory syncytial virus), pneumonia, strep infections and other ailments.”
#CovidIsNotOver
#COVID19
#COVIDIsAirborne
@northernRG
Thank you. I honestly thought this infection wouldn’t be this bad given vaccines! No one should have to live in fear, but this shows that every precaution you take is worth it and those telling you otherwise are unfortunately giving bad advice. Stay safe and hope your LC improve
Pleased to see our letter, written by 39 doctors affected by
#LongCovid
, in
@bmj_latest
We call for
1. Research
2. Clinical Services
3. Patient involvement
4. Clinical diagnosis adequate to gain access to services
#countlongcovid
Briefly had to take the tube in London. Negative LFT. Somewhat short of breath in my FFP2 as I’m recovering from a respiratory tract infection. Surrounded by several people not wearing a mask at all.
Selfishness? Ignorance? Arrogance?
#COVID19
#COVIDisAirborne
#FFP2
#LongCovid
3/3 Side note - asking if ppl “think” they have an illness rather than if they have a diagnosis made by a medical professional indicates the continued gaslighting of this huge patient cohort. We need to properly and accurately
#countlongcovid
Terrible news of the death of a
#LongCovid
soul. Deepest condolences to his family 💐❤️
@david_rooksby
“Don’t be complacent and don’t be an idiot”
Imagine if
#ZeroCovid
had been our approach from the start. So much suffering that could’ve been avoided. But it’s never too late.
Ed Rooksby, a brilliant man who has just died, was 45, fit and healthy.
On the eve of the first lockdown, he contracted the virus, then developed Long COVID.
He wrote about the horrors of Long COVID weeks before he died. We should all read it.
Living cøvid-safe = giving up your social life? Not by my definition🧵
This weekend I:
…had a lovely dinner in the sun from
@busabaeathai
☀️
…followed by an EPIC gig
@foofighters
What a night!! 🤟🏼🎶🎸 Even had a cider or two thanks to my
#SIPvalve
🍻
1/2
@1goodtern
Another key aspect for me is EVERY shift. Shows the prevalence during our ongoing covid times…
Combined with that this means it’s not picked up in primary care (IMHO multifactorial, but lack of awareness and education is a major one).
@DRTomlinsonEP
Not only did they actively decide to make us cannon fodder - with complete confidence (arrogance) they made the assumption that immunity was prolonged. Not only was that wrong - many of us didn’t make any antibodies at all! Presumably no immunologist was consulted…
@Dr2NisreenAlwan
We already know kids may suffer of long covid, my 12y/o son is ill since march. It begun with a "mild covid" then we saw more than 30 simptoms, he is Still exhausted, POTS, too tired to go to school, brain abnormalities on pet scanner
#apresJ20
#LongCovidKids
8/9 Patients are recurrently told that their tests are “all” normal. I compare this to doing a pregnancy test and using the negative result to inform your patient that they’re not having a heart attack… We’re simply not running the right tests.
2/2 and even though I’m much improved compared to my bed/housebound state I still have some time left on my rehab journey.
LC patients need to be listened to. Truly listened to. Not judged by our appearance.
@DanWuori
Reminds me when I had a picnic with my cousin and little niece, who was super happily sat on my lap. Without thinking, I turned her around for us to look at the beautiful and exciting nature around us; she lost sight of mom and started crying! Aunt lesson right there 🙈
@ElizaEmTM
@FredTopel
Second this! And not just transmissible pathogens - would’ve loved one biking through clouds of pollution in London, or wearing one on the tube instead of blowing black out of my nose every evening..
Same. My moral injury runs so deep-how can people actively choose to breathe a blood vessel wrecking, immune system damaging,brain injuring virus on others when putting on an FFP3,getting a HEPA filter,&testing is SO easy?
Why do people actively want to harm others? I’m at loss
I don't want this "new normal". I don't want to "live with Covid". I'm tired of people dying and being disabled by a preventable disease. I'm tired of being unable to access healthcare. I'm tired of people minimizing SARS-CoV-2 and the suffering of those injured by this virus
@doctor_oxford
@bowditch71
@LibDemPatrick
@PeterStefanovi2
@JoFroggatt
@ITV
It’s not about a dichotomy between an authoritarian state of imposed mask mandates and individual choice. It’s about setting an example as a healthcare professional, about communicating through action that you are aware that the pandemic is still ongoing, that it’s airborne,
1/4
@DrKerrySmith
Kerry I’m at loss for words! How can this go ignored, especially with known clinical consequences.. This truly is the start of the HIV epidemic all over again (and I wasn’t even around to see that; have just read enough history to realise..). Nothing learnt. Beyond disheartening.
@alitwy
Lots of us have been saying the same thing lately..stay strong - our future bodies will thank us! Just remember that there’s many of us in this wise virtual boat together, we’re just geographically apart
#Solidarity
#CovidIsNotOver
GP Amy Small says she lost her job after experiencing so-called long Covid. She is calling for a "one-stop shop" that offers specialist support and treatment.
Read more ➡️
@YouAreLobbyLud
Well said. I’ve done some fairly high risk travelling but always done extensive risk assessments before-knew exactly what I was doing, how to mitigate the risks, and what risks I could not mitigate against ie an informed decision to accept them. I don’t accept the risk of covid..
Another excellent thread from
@elisaperego78
So much has come out of this last ~1.5yrs (especially friendships, wisdoms and connections!) I wish to believe that we have an inspiring and proactive time ahead of us, leading to a positive cultural shift
This is one reason why the patient-made term
#LongCovid
and advocacy movement are needed
Long Covid is a disease identified, named and defined by those experiencing it
It gained recognition at the speed of light despite all the structural injustices in medicine and policy making
1/3 Feels like a key paper moving forward with
#longcovid
. This says it all really:
“beyond the first 30 days of illness, people with COVID-19 exhibit higher risk of death and health resource utilization”. Horrific.
Thank you
@zalaly
et al!
“Testimonies [...] illustrate profound stigmatisation. Many of them have been disbelieved and their ill health was not recognised for months.”
Invaluable article highlighting an experience sadly shared by the vast majority of
#pwLC
#LongCovid
3/4 Meanwhile many of us remain medically too complex for our local hospital consultants to manage, with them attempting to turn to
#LongCovid
clinics for what they assume will be expert medical management..