Science Friday - Mask Mandates Drop, International Salmon Survey, Long COVID Answers And Questions. March 11, 2022, Part 1

Episode Date: March 11, 2022

As Mask Mandates Drop, COVID Cases Increase In Some Parts Of World Later this month, Hawai’i will become the 50th and final state in the U.S. to drop its indoor mask mandate, as those and other COVID-19 protections tumble down nationwide and in places like the United Kingdom and Austria. But as the winter omicron surge eases in some places, an omicron subvariant called Ba.2 is joining the viral mix. And the pandemic is far from over elsewhere. Science journalist Roxanne Khamsi reports on rising case counts in Hong Kong—a country with previously low numbers. A year ago, it reported only 17 total cases per day, but recorded more than 56,000 this past week. Plus, why war in Ukraine may threaten the effort to eliminate polio globally, the death of the recipient of a genetically modified pig heart, and other science stories.   U.S., Russia, and Canada Continue Collaboration On Wild Salmon Survey Tensions continue to simmer between Moscow and Washington in the wake of Russia’s invasion of Ukraine. In many respects, the divide between East and West is deepening: Oil companies are canceling partnerships with Russian firms. State legislators are calling for the state’s sovereign wealth fund to dump Russian investments. President Joe Biden announced Tuesday the U.S. would close its airspace to Russian aircraft. But the United States and Russia are continuing to work together on at least one issue: salmon. There’s a map scattered with orange, green, blue and red dots spanning most of the North Pacific above 46 degrees latitude. On the map are three flags of Arctic nations: the U.S., Canada and the Russian Federation. “This interaction between the countries in this is really something that has never happened to this scale before,” said Mark Saunders, the executive director of the five-country North Pacific Anadromous Fish Commission. He’s talking about the 2022 Pan-Pacific Winter High Seas Expedition. Vessels from both sides of the Pacific are braving gale-force winds and 13-foot seas as they crisscross the ocean from the edge of the Aleutian Chain to the Strait of Juan de Fuca. All in the name of research on challenges to wild salmon runs that are important to people on all sides of the north Pacific Rim. Read the rest on sciencefriday.com.   While Long COVID Treatments Improve, Big Questions Remain Over the two years of the COVID-19 pandemic, one topic has been on many people’s minds: long COVID. Some people with COVID-19 have symptoms that last for weeks, months, and sometimes even years after their initial infection. Long COVID affects people in different ways. Some report debilitating fatigue or a persistent brain fog that makes it hard to concentrate. And for many long haulers, their ability to exercise and or perform simple daily tasks remains severely limited. There’s still a lot that we don’t understand about the underlying causes of these symptoms. No one knows why some people develop long COVID, while others don’t. But over the last two years, researchers have slowly accumulated more knowledge about the drivers of long COVID, and how to best treat it. Ira speaks with two people intimately familiar with long COVID: Dr. David Putrino, director of rehabilitation innovation at Mount Sinai Health System in New York, New York, and Hannah Davis, co-founder of the Patient-Led Research Collaborative based in Brooklyn, New York. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

This is Science Friday. I'm Ira Flito. Later in the hour, we'll discuss what we're starting to learn about long COVID. And we want your calls and questions. Our number 844-8255, that's 844-Sy-Talk, if you have questions about long COVID, or you want to share your own information. But first, you know, it either seems like yesterday or a very long time ago, but it was actually two years ago today that the WHO declared COVID-19. a pandemic. Later this month, Hawaii will become the 50th and final U.S. state to drop indoor mask requirements. Those and other COVID-19 protections have been tumbling down nationwide as the winter omicron surge has eased. But case numbers are still going up elsewhere in the world and signal a

virus that is far from finished. Here with more on this and other recent stories is science journalist Roxanne Comsi. She joins us from Montreal, Quebec. Welcome back, Roxanne. Hi, Ira. It's great to be back. Nice to have you. Okay, let's get right into this. We really have seen a lot of COVID-19 protections taken down in the U.S. in the last couple of weeks. What reasons have been given for this? Well, yeah, it's true. So recently the CDC said that 98% of Americans live in locations where you don't have to wear a mask indoors if you don't have any predisposing conditions that would put you at extra risk. And part of that's because they have determined that enough people have immunity. And they've also kind of changed the calculus in terms of what is a high

risk environment. So they've kind of hired the threshold of the number of cases that makes a place a high risk location. Yeah. It's not just the U.S. dropping protections either, right? Other countries have. No, a whole bunch of countries that the UK has. And, you know, Austria recently backtracked. There was a mandate that there was about to go in effect

for people to be mandated to be vaccinated. And recently lawmakers took a step back and said, actually, we're not going to enforce that. So there's definitely a walking back of restrictions and things like that in a lot of places, not just the U.S. And the other hand, there are places where case numbers are

definitely not going down or watching the numbers go up. So absolutely. And this is happening at a lot of places where they had a COVID zero policy. So they'd really been successful in keeping the virus at bay for for months and months and months. Someplace like Hong Kong, the highest number of cases of COVID that they had in a day last year was 60. And now they have tens of thousands of cases a day and I think around 250 people a day dying, which for a place with not a huge population is an extremely high number, and China seems to also be perhaps heading in that direction to you. We'll have to look into that in great detail as we go on in the months. There's also a sub-variant of Omicron beginning to circulate

more widely, right? Right, exactly. B-A-2. And I think what's interesting is there's been a huge consensus that it's more transmissible than the original Omicron variant. What seems to be still in debate is whether it's more dangerous. A lot of people say no. Some people say yes. But yeah, so we're not done with variants by any means. The story is not over at all. Yeah, we're not done with the virus.

We'll get into that a little bit later also. But let's move on to other infectious disease news, especially polio. Polio has been close to eradication for years now, but we're still not there, right? A few weeks ago, we talked about its reemergence in Mowali, Malami, Malawi, and now the Russian invasion of Ukraine may be further jeopardizing the end of this virus. Why is that? Well, I think this is a really interesting and somewhat, in a way, sad story. So the polio eradication campaign launched in 1988, and it's possible because polio doesn't have an animal reservoir.

Unlike SARS-CoB-2, it really just happens in humans, and, of course, can cause. paralysis and really horrible effects. But by 2017, there were only 17 cases of polio in the world, which was great achievement. And then in recent years, in places particularly worn-torn places like Afghanistan and other regions like that, it's been creeping up. And as you mentioned in Ukraine, there was an uptick in polio where there were two kids that got paralyzed with polio not that long ago, the last case being in January. And it indicates that the virus is still circulating there and that, you know, with only 50% of kids under one vaccinated

against polio there, and the war now happening, just totally disrupting vaccination campaigns, there's a huge worry that this is going to set back this campaign to eradicate polio, which has, until recent years, been such a success story. Yeah, because we do have very effective vaccines for it. Absolutely. I mean, there's two different kinds of vaccines. One is given orally. It's like a drop in the mouth.

And then the other one is a shot. And there's different strategies. The one that's given as drops in the mouth is more feasible to be given in conflict regions. Of course, the downside is it's not quite as effective as the shot. Right, right. Yeah. We're actually going to go back to a story now that you brought us two months ago when it was reported that a man had received a heart transplant using the heart of a genetically

modified pig, but the update is a sad one, is it not? It is a sad one, and I'm really sorry to bring this news, but the patient, David Bennett, who received the pig from a, sorry, received the heart from a pig, unfortunately passed away this past week, and the doctors who did the transplant aren't quite sure what happened. They don't know if his body rejected this heart. that had been so specially tailored to not be rejected by his body, by these genetic modifications in the pig that it came from. They're putting together a report,

but for him it was really like a last resort option. He was too sick to receive a human heart, so to be in a place on the wait list where he would receive a human heart. So this for him was kind of the last opportunity, and unfortunately it didn't work out. We'll have to wait and see what. They haven't published their findings, but we'll have to wait and see for that. Yes, absolutely.

To something a little bit different. History nerds, we are excited this week at the announcement that the ship of explorer Ernest Shackleton has been discovered more than a century after it was lost to crushing Antarctic ice. I mean, someone who's been to Antarctica, that's all they talk about when I was there. It's how brave and smart he was. This is thrilling to see. And, you know, there were video, there was video of this. Yes.

It's also, it seems surreal in some ways. I know we're on the radio, so people can't see what we're talking about, but it looks like somebody just dropped it there yesterday when in fact it's been there for 107 years. Part of me wonders if it's so well preserved because it's in this cold area, which is, of course, also why it was so hard to find. If you listen to the researchers who found it talking about the journey to like uncover where it actually was, they talk about, you know, snobes. storms, ice storms, all sorts of elements that kept them from, you know, being in the right place to drop this

device, this robotic device under the ocean to search. So, but yeah, so they've uncovered the endurance which Shackleton had been set out with to try to traverse Antarctica after kind of missing out on being the first person to get to the South Pole. And three thousand meters under the ocean, And the sea there, it sat for 107 years until today they found it. It's only fitting that it took so much effort to get it because he took so much effort to save all of his crew. No one died in that rescue. It's an amazing story, but it's too long for us to tell. Go Google it.

It's unbelievable. One last story. Yeah, I was just going to say they kind of camped out on the ice for months before they could get to safer ground with lifeboats. And then there was this 800 miles trip in a lifeboat that went to an island where they could try to bring back some rescue people. And they did. It's an incredible, incredible feat. One last story, just in time for daylight savings. Because that's happening this weekend.

Who knew so quickly? You've got a story about Stonehenge. Who doesn't love Stonehenge? We all do, right? It's mysterious. We think it might have told time somehow. And now someone thinks they figured out exactly. exactly how? What's the deal here? Right. And you're totally right. This is just perfect timing because we're all going to set our clocks back an hour. Sorry, skip ahead an hour. I can never keep track of that. And so Stonehenge used to be thought of as kind of built around the solstices, you know, winter and summer. But a reanalysis has looked at the stones and said, actually, this might be a solar calendar, kind of not too dissimilar from what we have today with three, we have 360.

days and then a leap day every four years. This was 365.25 days, similar to what the Egyptians had figured out a couple centuries before. Wow. I want to throw in a bonus story that you have for us today. That's something about researchers finally talking about sharks sleeping. The only kind of shark I ever want to encounter is a sleeping shark. Well, you know, because I remember being a scuba diver that they said the sharks are sleeping, they're not moving, but they have to keep the water moving past their gills so that they can still breathe. But they

do sleep? Is that what we're finding here? Yeah, so this is a study that was done on a particular kind of shark known as a draftsboard shark, which gets its name from its checkered like external, I guess skin is what you'd call it. And scientists kind of had an idea that sharks

slept, but they weren't really sure. No one had to like put them in a tank to observe and find out. So they did this and using certain physiological measures, like how much oxygen they were consuming, and also interestingly, like, their eye movements, they appeared to be, so they determined that when they were sleeping, they were using like half as much energy as when they were resting, and also that they had as different positions. So they were flatter when they were sleeping, as opposed to a little bit more upright. So they kind of had their, like, torsos perked up

when they were resting a little bit more, like one of these yoga positions. Now I've heard it. I can't get it out of my mind. I'm going to think shark yoga next time I'm on my mat. And especially with breathing, right? That's what yoga is all about. We know the charts. Yes, and resting.

And resting. And restortiveness, yes. Terrific, Roxanne. Thank you for taking time to be with us today. Great stuff. Great. Talk to you later. Thanks, Ira.

Roxanne Comsi is a science journalist based in Montreal. We have to take a quick break. And when we come back, how Russia's invasion of Ukraine, Ukraine has disrupted a multinational survey of wild salmon. And the scientists are trying to figure out how they can continue this without, you know, without all the implications that it has working with Russia. We want also your calls about long COVID. We're going to be talking about it. Give us a call.

Our number 844-724-8255. That's 844-Sight-Talk. Do you have long COVID? Do you have people you know? we're going to have a couple of experts talking about it. So stay with us. We'll be right back after this break. This is Science Friday. I'm Ira Flato. Now it's time to check in on the state of science. This is KERNO. St. Louis Public Radio News. Iowa Public Radio News. Local science stories of national significance. A little over a month ago, scientists from the U.S., Russia, Canada, Japan, and South Korea

embarked on a collaborative scientific survey to track wild salmon in the North Pacific Ocean. Then Russia invaded Ukraine, setting in motion, as you can imagine, a substantially more tense political situation to navigate. Yet despite the tension, scientists have opted to continue to collaborate in pursuit of understanding the recent fluctuations in the wild salmon population. Joining me now to talk about his reporting on the topic is Eric Stone, news director of KRBD, based in Ketakan, Alaska. Eric, welcome to Science Friday. Hi, thank you for having me. You're welcome.

Before we get into the details of this research project, let's start with some basics of a salmon's life cycle, okay, for those of us who might need a refresher. What is the salmon run? Okay, so salmon spend part of their lives in freshwater and part of their lives in saltwater. They're what's called an anadromous fish. And basically what happens is they hatch from eggs in these rivers, and then they swim out to sea after fattening up just a little bit. And they spend a little while out there generally two to five years, depending on the species, eating things like herring and squid and all kinds of stuff. And then towards the end of their lives, they swim back up the river to deposit eggs and fertilize the eggs and start the cycle over. And they can swim sometimes more than 2,000 miles in at least one river in Alaska.

Wow. And as they swim up, the river, they don't eat. It's remarkable. And in Western Alaska in particular, and you know, frankly, all over Alaska, the salmon are vital sources of food for indigenous people. People catch them in nets and fish wheels and people catch them with rods and reels as well. It's an important cultural phenomenon. People construct these things called fish camps where they go and gather, you know, their food source for the winter and catch all these salmon. And, you know, not to mention, commercial salmon fishing is a huge industry here in Alaska. It employs lots of people. It also feeds people all over the United States and all over the world. And so there are lots of rivers in Alaska where the salmon are running, and maybe they fluctuate about the number of salmon that are migrating. That's right. Yeah. So the salmon runs on these various rivers.

They fluctuate in weird ways, and we don't totally know why. So I'll give you a few examples. Pink salmon harvests here in Southeast Alaska were among the lowest in decades in 2020. And then in 2021, pink salmon beat the forecast by a good bit. Wow. King salmon stocks all over Southeast Alaska are also in trouble. Like fishing for any salmon near the mouth of a major river here in Ketchikan has been banned outright for years. But it's really in western Alaska where the salmon runs have been in crisis most recently.

So in 2020, the Yukon River chum salmon run faltered. Chum salmon is a species of salmon, one of the five Pacific salmon species. And then in 2021, the run totally collapsed. There were so few fish that people were not allowed to fish. and that's, you know, a large component of how people feed themselves. Authorities had to ban fishing up and down the river to preserve what little of the run remained. And it was a massive shock to people who depend on salmon, go to great lengths to replace it. One resident told Olivia Eberts of radio station KYUK in that area that he took his river-going skiff into the dangerous waves of the Bering Sea.

But runs on the Cuscaquim River that have also been faltering. Mike Williams, Sr. of the Cuscaquim Intertribal Fish Commission, that's an organization that manages and researches salmon in the area, told me that he's worried about runs all over the region. We depend on the salmon to sustain us and we're about the returns of our salmon in all of the rivers in western Alaska. And while the salmon run collapsed in that area on the Yukon River and is trending down on the Cuscoquim River, that same year in 2021, the Sock-I salmon run in Bristol Bay, which is a

giant commercial fishery that set a new record. That's amazing. So what you want to know and what the scientists want to know is why this wild fluctuation is going on. Yeah, that's right. And the problem is we don't know. Most of the effort that's gone into studying salmon has been focused on what happens in freshwater, you know, where they reproduce. Right. Scientists think that issues happen in the open ocean while they're out fattening up. There has been some research and there are a few theories. I'll run through a couple of those. One is bycatch, the idea that salmon at sea, are getting scooped up in the nets for soul and flounder or pollock accidentally caught more or less.

Another is that hatcheries, basically there are these facilities where salmon are raised from eggs into, you know, juvenile salmon and they're artificially enhancing wild populations. And one of the theories is that those artificially enhanced populations are out-competing wild salmon. And then the third theory is that climate change is messing with the food web. That's, you know, warmer ocean, more acidic. So we know the ocean is changing, but not as much how the sand. are reacting to the condition, it's kind of a big black box. What is the 2022 Pan Pacific Winter High Seas Expedition?

And how will it help test some of these theories? So basically, it's a giant effort to study what happens in the black box of the open ocean during the winter. So vessels from three of the five countries you said at the top, the U.S., Canada, and Russia, they're out canvassing the North Pacific as we speak right now. They're putting a net down to see what kind of salmon there are. and the reason they're doing it during the winter is that winter is an especially tough time for salmon.

There's not as much food, and this is where it's hypothesized that most of them die. So this is a good time to figure out what's going on with the population. So the idea is to give a better idea of how salmon are reacting with predators, with each other, with ocean conditions, kind of shine some light in that black box. Yeah, given the current political situation, is the survey going on as planned?

Has there been any talk about, not cooperating or eliminating Russia from this survey? So I haven't heard any talk about, you know, cutting Russia out or doing a massive amount of work on this subject. And the survey is still going ahead. There have been some modifications. One, you know, an interesting thing is that one of the survey vessels from Russia, the one that's covering an area that goes from about the middle of the Alaska Peninsula,

so it's kind of even with the west coast of Alaska, all the way out to the almost the end of the, Eolution chains. They actually tied up in Dutch Harbor, that's the deadliest catchport, a day after Russians invaded Ukraine and started their assault on Kiev. And now what happened is that a U.S.-based scientist was not allowed to board. So what happens now is that Russians are not allowed to survey within the 230-mile exclusive economic zone of the United States, basically, you know, waters close to the United

States. And that is going to have impacts on the results of the study. It doesn't mean the mission is a failure. according to one of the scientists I talked to, but it means that salmon activity within that area near the Aleutian chain is going to remain a mystery for now. So I spoke with Bill Templin. He's Alaska's chief salmon scientist,

and he told me the five-country commission has worked together in times of tension before. He said some Russian scientists actually included disputed islands in some salmon stock maps, and the Japanese had to politely ask him to change the maps. So he said that was all in good fun, but this is quite a bit more tension than usual. Even so, Templin told me that the salmon scientists are used to putting their work first and their political leaders' policies second. All of us to work together to understand what's happening out there and the way it affects our nation. I think it's a pretty huge deal, and I'd hate to see it to go away.

And you can actually track all of these vessels. There are four of them from the U.S. Canada and Russia. They're all on a map at yearofthesammon.org. Wow, I think I'm going to do that. Thank you, Eric. Great report. Oh, thank you very much for having me. It was really a pleasure to be on.

Eric Stone, news director of KRBD, based in Ketakan, Alaska. For the rest of the hour, we're going to talk about a topic that should be on a lot of people's minds, but likely isn't. I'm talking about long COVID. This is where folks who get COVID have symptoms that last for weeks, months, sometimes even years after their initial infection. Much of the country has rolled back mask mandates thinking we've moved on from COVID. but there is a group of people who may have to live with it indefinitely. It's not over for them. Long COVID affects people in different ways.

Some report debilitating fatigue or a persistent brain fog that makes it hard to concentrate. And for many long haulers, exercise and basic movement is not the same as it was pre-infection. There's still a lot we don't understand about the underlying causes of these symptoms, or why some people develop long COVID while. others don't. Or could even a mild case or a symptom-free case of COVID lead to more debilitating illness later in life? Over the last two years, researchers have slowly accumulated more knowledge about the drivers of long COVID and how best to treat it. And that's what we're going to be talking about now. Joining me today are two people intimately familiar with long COVID. Let me

introduce them. Dr. David Petrino, Director of Rehabilitation Innovation at Mount Sinai, system in New York, New York. Welcome to Science Friday. Thank you for having me. And Hannah Davis, co-founder of the patient-led research collaborative. She's based in Brooklyn. Hannah, welcome to Science Friday. Thanks. It's great to be here. Nice to have you. Dr. Petrino, are you seeing a surge of new long COVID cases as a result of the Omicron surge? Absolutely. I think we're certainly seeing more cases coming through as a result of the Omicron surge. But I would also point out that many individuals are only just starting to get care now from some of the initial waves of COVID-19. So it often takes a little while for patients to get to us once they've been ill.

And have you been able to track it outside of the U.S. and in other countries? Absolutely. I mean, I think that. Hannah Hannah's work and the work of the patient-led collaborative has been phenomenal at this but certainly we've been tracking the literature and that has been published in other countries and countries that have been

putting out more work than the United States in actually trying to track across the entire country and the numbers are concerning. The most recent ONC report from the UK showed that 2% and estimated 2% of the UK population has long COVID. That's amazing. How likely are vaccinated and boosted people to get long COVID versus those who are not? This is a tough question to answer.

We certainly know that there is emerging literature to suggest that perhaps your probability of going on to develop long COVID is reduced post-vaccine. but the most up-to-date data that has been published on this matter still places it at a pretty high percentage. So the most recent estimates would suggest that in breakthrough COVID infections, that is COVID infections that are occurring in people who are fully vaccinated, there still appears to be around a 10% chance of going on to develop long COVID symptoms, which is very, very high. Wow, yeah. Wow. Let's take a question from a listener who sent us one through our Voxpop app. I'm Deb in Portland, Oregon. I'm curious about whether the rumors that I've heard about sometimes vaccinations,

helping people who have long COVID to kind of reboot their systems and have their symptoms improve, whether that's true or not. What do you say? I think that's a great question. The way that we're currently viewing vaccinations and their role in long-cocturbed symptoms is I view a vaccination as a symptom modifier. So some people are experiencing worsening symptoms. Other people are experiencing improvement in symptoms. And a larger majority of individuals don't really see a change in their symptoms post-vaccinations.

So this is interesting because it gives us some clue as to how some people with long COVID may have some immune underpinnings that are influencing their symptoms. And there's some phenomenal work happening under the leadership of Akiko Iwasaki out at Yale University looking into this exact question. But right now, I would not say that you can rely on a vaccine to improve your long COVID symptoms. This is Science Friday from WNYC Studios. Talking about long COVID with Hannah Davis and Dr. David Petrino. And Hannah, let me go to you.

Why did you decide to start the patient-led research collaborative? So I'm a co-founder of it with four other patients who are in some context or researcher or data scientist or policymaker before getting sick. For us, we all got sick in March 2020 in the first wave. And at the time, there were no answers for us. You know, the CDC was still talking about this as something that didn't affect younger people, that everyone would recover from in two weeks if they weren't hospitalized. And we had all gotten sick and we're still sick.

And in April 2020, we're still sick and really had no clue what was happening. There was no public communication. And so we all joined the Body Politics Support Group. And it's on Slack. So there was a data nerds channel. So that's that really selected for people who were very curious and kind of looking for any data or any answer to explain what was happening to us. And one woman, Gina Asaf, decided to make a survey of all of the patients at that time, several thousand patients who were experiencing these symptoms. And I joined right when they had collected the data.

So I offered my skills. My background was in machine learning. and, you know, we just wanted to get answers for ourselves at first, but at the time that was the only data available, so we started getting calls from the CDC, et cetera, and then, you know, decided to keep continuing the research. Why is it so important to have patients driving the research conversation? I think especially for under-researched and poorly understood illnesses, doctors' hypotheses might not necessarily be the most accurate. Patients have the strongest understanding of the illness because they've had, they have lived experience of it. And this leads to knowing the right questions to ask in research. And so listening to patients and engaging in patient-led research helps speed research up overall because you can kind of focus on the areas that seem to be the biggest clues.

Do you think that health care officials were sort of ignoring long COVID patients, long haulers from the beginning? Yes, definitely. I think one of the things that bothers me the most is that we actually have so much evidence, including in the last SARS, including other viruses like EBV, that many, many viruses lead to long-term effects. You know, myalgic encephalomyelitis, disautonomia are really common post-viral conditions. And this should have been integrated into the pandemic response from the start. And that just didn't happen. All right, we're going to take a break. We want to hear more of comments that you have to make. We have a lot of people coming in on Twitter and on the phones.

Our number 844-724-8255-8-4-4-Sight-Tock. If you want to talk to our guest, Dr. David Petrino, Director of Rehabilitation Innovation at Mount Sinai Health System based here in New York, and Hannah Davis, co-founder of the Patient-led Research Collaborative based in Brooklyn. 844-7-24-8-255. So many questions. We'll see if we can get to as many of them as we can because this is a topic we have to talk about. Stay with us. We'll be right back after this break. This is Science Friday. I'm Ira Flato. If you're just joining us, we're talking about the phenomenon of long COVID with my guest, Dr. David Petrino, Director of Rehabilitation Innovation at Mount Sinai Health System here in New York. Hannah Davis, co-founder of the Patient-led Research Collaborative. She's based in. in Brooklyn, New York. And I'm going to go to the phones. Before I do, I want to bring up an

interesting point, I think, that's central to the issue here. And that is that the CDC recently relaxed mass guidelines and many states across the country have followed suit. They've reverted back to pre-pandemic precautions as COVID seems to be going away. Dr. Petrino, should public health messaging and policies be more focused on long COVID? Yes. I mean, in the strongest possible terms, yes. I think that from the outset, long COVID has been treated more like a shadow pandemic and less like an actual pandemic. People have not been giving it the level of attention it deserves as a mass disabling event in the United States. And the current sort of switch away from safe practice across the nation should be cause for alarm for everybody.

long COVID is very much a continuing issue that we need to be strongly concerned about and we still need to strongly get out the message that death is not the only serious outcome of COVID, especially non-hospitalized COVID cases, these so-called mild cases of COVID. There's nothing mild about an acute case of COVID right now. Hannah? I completely agree. I feel like the

change to deprioritized masks just says that long COVID doesn't matter. And it's going to put so many people at risk who don't even realize that they are at risk, honestly, in many cases, because there's been such a lack of prioritizing and communicating about how serious long COVID is and how anyone, it can happen to anyone and completely, you know, change your life, possibly permanently. Let's go to the phones to Connor in Harrisburg, Pennsylvania. Connor. Are you there? Oh, who's on the phone? All right. Let's see. Let's hope we're working the phones here and that they're working. Let me go to, let's see who else we can go to. Let's go to.

Let's go to Audrey and Fairfield. Hi, Audrey. Are you there? Audrey, are you there? Audrey, are you there? Hi, Audrey. I'm here. I'm here, yes. Hi, go ahead. Hi, I have a unique situation. I, have what's called a prolonged concussion, which means I had two head injuries within six weeks. And I had COVID. My whole family had it the first week of September or the two weeks. I had all the symptoms of my concussion, which were migraines. I couldn't remember things. it messes with your whole vestibular system. So I'm still have those side effects. Does your physician take these things seriously?

Yes. What ended up happening is come the middle of October, November, I was losing memory. I was getting lost. my eyes were getting weak again. My migraines were unbearable. So I see two neurologists, and I also am in cognitive therapy as well as eye therapy, which I had graduated from, but now I'm back in it.

And my neurologist, as well as my eye doctor, have said there's no research about this, and they don't know the long-term effects. And that is very scary to me. And I don't know if you know anything about that or have you seen anything regarding concussion. Let me ask my guests, Hannah, Dr. Petrino. I would say that I'm not sure what the impact of COVID is, particularly on post-concussion syndrome, but long COVID is definitely very similar to post-concussion syndrome in that it causes many of the same symptoms that you just mentioned. I'm not sure if Dr. Petino knows more than that.

Yeah, thanks, Hannah. I would tend to agree. And first of all, I'm just so sorry for what you're going through that it does sound very uncertain and quite frightening. What I would say is that many of the symptoms that we see with long COVID can be often associated with what we call disordinomia, which is a part of the nervous system called the autonomic nervous system, which controls a lot of things that are ordinarily under automatic control in the body, getting knocked out of balance. And we know that post-concussion syndrome often is also explainable by disorderanomia as well. And so it is very possible that you've experienced a flare

of your existing disordernomea as a result of your long COVID infection. Your physicians are correct in that we currently don't have a lot of research in people who had post-concussion syndrome and then got COVID to say that this is precisely, certainly what is happening. But it does sound like you're getting good care and there's a good chance that what we're looking at is a worsening of your disordernome. Is it possible that you can develop long COVID symptoms without even knowing you have contracted COVID in the first place? Dr. Patrino?

Absolutely. We know for a fact that your chance of contracting long COVID is not correlated with the initial severity of your symptoms. So we have certainly seen many individuals who had an asymptomatic course of COVID-19 infection go on. to develop long COVID symptoms, which is incredibly alarming when we consider the fact that it's hard enough right now to get insurers and other care providers to take long COVID seriously when you have a known case of COVID. But if you were an unfortunate individual who had an asymptomatic case of COVID and was unable to test positive or develop antibodies, as we know that many people with COVID do not seroconvert, you may find yourself in a really tough situation.

We have some tweets that are coming in. Shannon on Twitter asks, if you're not vaccinated, can long COVID effects be more serious or more likely? Certainly more likely. We still don't know all of the factors that contribute to severity of long COVID symptoms, but we certainly know enough now that you know, if you're unvaccinated, your chances of developing long COVID-like symptoms are more like 30%. That's, that's, wow. Let's go to the phones because we have lots of people who have questions. Let's see if I go back to Connor and Harrisburg. Are you there, Connor?

Oh, hey, how you doing? Hey there. Go ahead. Oh, sorry. Long-time listener. I always enjoy listening to your show while it works. I have an interesting story. I'll keep it short.

But I had COVID when it first came out. My mother went on a business trip, and she came back sick, and she didn't tell anybody. And I got it, and it hit me a lot harder than it hit her. And I was under the undercover for two weeks, all the symptoms, complete nightmare. And as I was recovering, it was very, very slow process. I was on a hike, and I got bit on my arm by a tick. And I didn't think twice about it. And, you know, I've probably been bitten by a tick many times before,

but instead of my health slowly going towards normal is going the opposite direction. I'm just wondering, like, could there be a relation? Do you think you got Lyme disease? what you're saying. Oh, no, I definitely have it. Did it affect COVID? Did it affect your long hauling? Yeah, yeah. Let me ask the doctors. Dr. Petrino, what do you think? You know, we think about long COVID as an infection associated illness, and some of the initial work that we're seeing coming out of some phenomenal immunology research labs and in fact some of the work that we're doing ourselves is really pointing us toward the idea that many

people with long COVID have changes to their immune system occurring and one of those changes can be that some of our immune system that deals with making sure that we generate antibodies to fight off dormant infections that we have in our body, as well as fighting off new infections, can be impaired. And so we often see reactivation of old infection-associated illnesses. So many people who previously had Lyme disease, but it's been quite dormant for some time, can experience worsening of Lyme symptoms. Epstein-Barr virus is another very common virus that people are experiencing reactivations of. And the list goes on. There are many, many previous viruses that can be reactivated by the immune sequelae of long COVID. That's really interesting.

That's something no one talks about. Something like herpes, things like that, cause a recurrent? Absolutely. Absolutely. Anything that was laying dormant can often be reactivated. And we, I'm sure, I'd love to hear from Hannah because she has way more data than we do. Well, I'm going to go to Hannah. Let me just give us a break. This is Science Friday from WNYC Studios. Okay, Hannah, you've published two research papers tracking long COVID symptoms. What are the biggest takeaways here?

So for us, I think that in the beginning, we kind of helped show that long COVID wasn't just respiratory symptoms, that it was kind of cognitive, neurological, systemic, immunological. the reinfections like Dr. Petrino was just talking about. Our recent paper, one of the biggest findings for me, was actually that cognitive dysfunction and memory loss are in the top three frequent symptoms and happen as equally in 18 to 29-year-olds as in people over 60.

Wow. And so, you know, in the beginning we heard a lot about brain fog, but we really showed that it impacts the ability to drive, to take care of your children, to communicate, and especially to work, we found that two-thirds of people had to either reduce their hours or quit completely, and that didn't even include people who took early retirement because of COVID. And then another really big thing we found was that, as Dr. Petrino mentioned, we have a very big issue with people who weren't able to get tests in the first wave,

and even in recent waves. You know, Omacron had a lot of testing and accessibility. The CDC estimates that only one in four COVID cases have confirmation. So we actually accepted people that were symptomatic positive and symptomatic negative and then compared them. And we found that the major difference between the two cohorts was not actually in the symptoms. And this was looking at, you know, dozens of symptoms over time. But the date that they got tested after onset. So the positive cohort got tested at an average of day six.

The negative cohort got tested at an average of day 43. And so we try to communicate to people that having a negative. test doesn't always mean they didn't have COVID. It often means they weren't able to access a test. This is Science Friday from WNYC Studios. Talking with Hannah Davis and Dr. David Petrino, a tweet. This is a really interesting tweet from Maelstrom who asks, are we going to have a huge population of people suffering debilitating symptoms?

I think so, definitely. I mean, from my perspective, you know, there's only a couple of places in the world that are tracking long COVID, you know, at the population level. And one of them is the UK. And they have found right now 2.4% of the entire population has long COVID, and that includes 4% of teachers and healthcare workers. And that's after two years of the pandemic. And we know that, you know, recovery can happen in the first three months,

and after that, it's less likely. And if you get diagnosed with something like myelgic encephalomyelitis or dysodonomia or a lot of these other kind of clotting conditions, There's no evidence to show that, you know, that it's not lifelong. It's likely lifelong in many of these cases. And every year, if we're disabling, you know, one and a half extra percent of our population, you know, which gets vulnerable every year, more vulnerable every year because having a COVID infection in itself is a preexisting condition, it looks, from my perspective, it looks pretty dismal. Wow. Let me get one last question for time.

Beth in Neptune, New Jersey. Hi, Beth. Oh, hi. I'm sorry. I've lost you for a minute. So I have a sort of a complicated case, which I will really try to be succinct about. I have had an, I am hypothyroid since I'm two years old. I'm in my 60s now. And a lot of these symptoms mimic an underactive thyroid. And of course I'm medicated and under the care of an endocrinologist. but I was in California President's weekend when COVID was first starting with my daughter and she came back and was diagnosed with COVID and I never was diagnosed with it.

I never had specific symptoms and I didn't test for antibodies when I found out she had it. However, I can honestly say, and I'm a teacher and my school started right back that September. So I've been in school for a long time with... Beth, I have to ask you to say, to sum up what your question is. So my question is, how do I know? Is there any way to know if it's my thyroid or COVID or long-term because all I have symptoms of brain fog? I've had palpitations.

I got you. Dr. Petrino, any answer to that? Thank you for sharing that story. I think you've raised a very important point, which is at present, we do not have a good answer for you. It could be worsening of your thyroid condition or it could be the case, as we were discussing earlier in the segment that you had an asymptomatic case of COVID that has led into long COVID. What I can say is that we are working around the clock to try to come up with meaningful concrete biomarkers of long COVID that can allow us to diagnose long COVID beyond a clinical diagnosis based on symptoms, but we're not quite there yet. All right.

We have run out of time so many questions, so a little time to answer them. Dr. David Petrino, Director of Rehabilitation Innovation, Mount Sinai School of Medicine here in New York. Hannah Davis, co-founder of the Patient-led Research Collaborative, she's based in Brooklyn, New York. Thank you both for this valuable information today. Thank you so much for having us. You're welcome.

And if you want to find out how to join the Long COVID Support, groups we've talked about or participate in the patient-led research collaborative survey, go to ScienceFriday.com slash long COVID. That's ScienceFriday.com slash long COVID. Here's Kyle Marion Verterbo with some of the folks who helped make this show happen. Thanks, Ira. Annie Niro is our individual giving manager. John Dan Koski is our director of news and audio. Daniel Peter Schmidt is our digital producer, and I'm community manager, Kyle Marion Viterbo. Thanks for listening. Thanks, Kyle.

B.J. Leidman composed our few music. Thank you, well, for listening. I'm Irafledo in New York.