A Generation of Health Damage

happened in virus news today. The US is watching New York closely, as it's the last large school district in the country to say it will send students back to school this fall. Today, Governor Andrew Cuomo confirmed that, based on infection rates around the state, every school district can reopen in September. Governor Cuomo said every region in the state falls below the three percent infection rate threshold that had been established. He also said school openings would be

revisited if infection rates spiked. Thailand will allow schools to fully reopen starting next Thursday. The Southeast Asian nation has not had a locally transmitted case for more than two months. All schools will be allowed to function without any capacity limits or social distancing rules. According to the Education Minister. Finally, in India, the country's all female army of contact tracers

is going on strike. Months of harassment, low pay, and lack of protection from infection has wish them to the breaking point. About six hundred thousand of the country's one million accredited social health activists will strike today and tomorrow. They want better and on time pay, as well as a legal status that ensures minimum wages. Losing the asha's would not only threaten India's virus containment effort, but also impact the other essential health services they provide, from child

vaccinations to tuberculosis control. The country's catastrophic coronavirus outbreak is now the third largest in the world. And now for today's main story. The coronavirus has been spreading worldwide for over seven months now, and more than eighteen million people are known to have been infected by it over that time. We've come to understand that in most people, the virus causes mild symptoms or none at all, at least at the time they have the virus, but even asymptomatic patients

may suffer lingering effects. It's yet another of the pandemics mysteries. Bloomberg Senior editor Jason Gale explains it may contribute to the pandemics significant long term social and economic costs. First was like typical flu, like syndrome, but no shortage or breath particularly it's with fever and extreme fatigue basically. Dr Peter Piot is one of our generation's most celebrated microbiologists.

In the mid ninet seventies, he was part of the team that isolated the bolivirus and to help control the first outbreak in what was then Zaire. Later he helped lead to fight against AIDS as President of International Aid Society and executive director of u n AS. For almost a decade it has been director of the London School of Hygiene and Tropical Medicine. So it was big news when he needed to be hospitalized for COVID nineteen almost five months ago. And that was ironically, after having spent

most of my professional life fighting viruses. It was the first time ever I not seriously ill because my situation deteriorated. I was admitted to the hospital with my oxygen saturation was like eighty three on admission and thanks to oxygen I made it through seven days there. Peter is speaking in an interview with the New England Journal of Medicine.

He told the journal last week that he developed pneumonia complicated by an aberrant hyper inflammatory response to this sas cove To virus, and it illustrated that COVID nineteen is far more than either you have a bit of the flu or you end up in intensive care and die.

And then they often say, oh, that's people who are over seventy and or pre existing conditions, as if we don't count, you know, there are lots of people in between with this chronic condition and this long tail of in my case, pneumonia, of mutual fibrillation, extreme tachycardia all the time. Peter had an irregular and often rapid heart right that persisted for months after his acute illness. He's seventy one and he managed a five kilometer job the

morning he was interviewed. Even still he gets fatigued. He says the ordeal changed his perspective. One viruses particularly sounds two. Well, first of all, it's something to avoid at all costs. I mean it's a bit of a lottery in a sense whether you'll develop an asymptomatic infection or serious illness like what I had. Of course there are risk factors being old, having diabetes hypertension, but I didn't have any of these underlying factors, and even young people today can

die from it. There are many more and more examples, and that's particularly important to realize now that a lot of the infections are happening in young people, and the scientific evidence suggests a proportion of these patients may endure decades of chronic diseases. Doctors refer to these conditions as sequel I. When they persist in younger patients, the impact on society is much larger because people have to live

longer with their disabling effects. The physician who treated UK Prime Minister Boris Johnson could COVID nineteen this generation's polio. Because of the physical, cognitive, and psychological disability, the illness

will lead requiring long term healthcare. I think we will be faced as a medical community also were probably soon hundreds of thousands, if not millions, of people ultimately with chronic conditions with long term sequality, and I think it's important that we are prepared for the fallout of chronic illness mental health issues, and of course, in my particular case,

I'm double motivated to defeat this epidemic. The coronavirus target cells line in the airway, sometimes triggering an overzealous immune response like what Peter Pond experienced that can weaken the muscles used for breathing and called scarring in the lungs of patients who experience even a mile about of COVID nineteen. The question is how will that affect lung capacity of the long term and what other lasting disabilities will COVID

nineteen survivor's face. Dr Thomas Filets, President of the Infectious Diseases Society of America. He says, we can look for clues among people who were sickened by severe acute respiratory syndrome or SARS almost twenty years ago. We do know from studies about that infection that people who have had particularly long scarring from a STARS, that they can have persistent symptoms for years. And we're of even one study that looked at fifteen years later and some of these

patients still had abnormalities of their lungs. And so this is something that we're going to have to whine closely, but I think we're already seeing it. We're seeing effects on the lungs We're seeing effects on the heart, on the neuro neurologic system, the emotional system, psychological system. So this is gonna have I think a significant burden on

our health care system for years to come. In Wuhan, the Chinese city where saskovit too emerged late last year, more than a third of severe COVID nineteen patients had complications such as stroke, acute kidney injury, and post traumatic stress disorder. As the pandemic spread across the world, doctors have reported similar problems. For example, one center in Italy found that almost nine out of ten patients reported the persistence of at least one symptom some sixty days later.

Where they looked at patients who had all been hospitalized, so these are all fairly sick patients, uh, And they found that literally eighties seven percent of these patients still had significant symptoms, multiple symptoms quite honestly, two months later after they're onset of symptoms, even after they were discharged from the hospital. Thomas's post traumatic stress disorder could be

another disturbing product of the pandemic. They're already beginning to see some patients who have been released from the hospital and some patients quite honestly, who never were sick enough to come in the hospital, but yet they're It really concerns them about what's happening with, you know, their long

term health status. We do know that it can affect the brain, for example, and it can have neurocognitive considerations, and so I think post traumatic stress disorder is going to be an issue that the psychologist psychologists are going to have to deal with. Thomas's heart problems may also manifest.

There was a recent study showing that there's this UH stress associated heart issue where patients coming in with looks like heart attacks, but when they do coronary artery um and geograms they really don't see particular coronary odor is, but yet they do have heart damage. And so there is this issue about the psychological issue and the stress mental stress that can be associated with the UH sort

of physical finding. The CDC two weeks ago published a survey of two hundred and seventy non hospitalized adults who tested positive for COVID. About a third of them said they hadn't returned to their normal health two to three weeks later. Among eighteen to thirty four year olds with no chronic medical conditions, one in five went back to normal. The authors of the report so that, in contrast, over our patients with influenza recovered within about two weeks of

testing positive for fluid. A COVID symptom study, which has gathered data from millions of people in the US, UK and Sweden, suggests ten percent of fift of people, including some mild cases, don't recover quickly. We're beginning to become aware of increasing percentage of patients who have had symptoms and even who are asymptomatic quite honestly, who may have long term health issues. And certainly this seems to be

much different than other respiratory viruses. The fact that people who have no apparent COVID nineteen symptoms can still have health problems highlights their insidious nature of sounds. Two. There's two studies now that have come out to show that patients who have had even asymptomatic infection, and these are patients who are identified either through contact tracings. And then the other group are patients who had come from cruise lines or cruise ships and we're quarantined for a while

and we're tested but never developed symptoms. And a group of them um did studies imaging studies of their lung and found scarring on their lungs. This could mean that they're going to have some decreased lung function, which may not be sort of physically evident now because they have good lung capacity, but as they get older, or if they have other conditions asthma or whatever, it could be a significant consequences down the line. So this is going

to be an issue. It's almost five months since the World Health Organization declared COVID nineteen the pandemic. We have no effective treatment, no vaccine, and we're still yet to fully understand the prognosis. The global contagions immediate threat is obvious, but the one we can't yet fathom might tenant to be just as catastrophe. That was Jason Gale and that's

it for our show today. For coverage of the outbreak from one and twenty bureaus around the world, visit Bloomberg dot com slash coronavirus and if you like the show, please leave us a review and a rating on Apple Podcasts or Spotify. It's the best way to help more or less nurs find our global reporting. The Prognosis Daily edition is produced by Topher foreheads Jordan Gospourey, Magnus Hendrickson and me Laura Carlson. Today's main story was reported by

Jason Gale. Special thanks to the New England Journal of Medicine. Original music by Leo sidran Our. Editors are Rick Shine and Francesca Levi. Francesca Levi is Bloomberg's head of podcasts. Thanks for listening.