The Scottish COVID-19 Inquiry continues its valuable evidence gathering into the response and aftermath of the pandemic in Scotland.
It has published a report commissioned from independent experts on post-viral and other post-acute infection syndromes, including long COVID. The report examines what was known about long-term health consequences of infectious diseases before COVID-19, and their implications for pandemic preparedness.
The report was authored by Professors Chris Brightling and Rachael Evans, academics at the University of Leicester. The authors draw on decades of clinical research and their leadership of the UK’s largest long COVID and post-hospitalisation COVID-19 studies.
At the end of this article are included both the full report, and the summary of the report.
Definition of Long COVID.
Long COVID was initially described in spring 2020 by people with lived experience and rapidly formed patient support groups: Long Covid SOS, Long Covid Support and Long Covid Kids. People were reporting ongoing challenging symptoms commonly fatigue, breathlessness, brain fog, headaches with reduced physical function after COVID-19.
Important for all of us is – have lessons have been learned from the response to the COVID-19 pandemic? In the 21st Century the warning signs were there :
The SARS-CoV-1 virus, a global epidemic thought to originate in China in November 2002, involving 29 countries across Asia, North America and Europe.
The Middle Eastern Respiratory Syndrome (MERS), first identified in Saudia Arabia in 2012 and subsequently known to be caused by a coronavirus (MERS-CoV), transmitted from animals to humans. MERS has a low human to human transmission rate but a high fatality rate of approximately one third of cases. MERS has never become a global pandemic but there are ongoing outbreak and sporadic clusters particularly in the Middle East. Cases of MERS have been reported in 27 countries and by early 2024 approximately 2600 cases were reported with 940 deaths.
As there were few long-term (even one-year post-infection) studies for SARS-CoV-1 or MERS, unsurprisingly there were even fewer mechanistic studies investigating the cause of any longer-term sequelae.
From other studies and the experience of these and other respiratory viruses, “there should have been an expectation that SARS-CoV-2 would involve longer term sequelae but the scale and severity would have been unknown.”
What should we have learned from the SARS-CoV-1 and SARSCoV-2 pandemics, and from MERS outbreaks of the 21st century?
- Planning for long term health care.
- Supporting people who are returning to work.
- Research and clinical care for post infections should be person centred and involve different agencies working together.
- Expansion of ME/CFS recovery and rehabilitation programmes.
Rather than waiting for the ‘next pandemic’, research and clinical care should be co-ordinated and researching the underlying mechanisms of these phenomena to enable better treatment for current and future patients.
The Summary and Conclusions from the Report should be required reading for not just our next Scottish Government, but for all newly elected MSPs after the election to the Scottish Parliament on 7 May. They need to ask the questions of our health and social care sectors on their preparedness for a future pandemic, and put in the funding required to limit the devastating impact it can have on both our health, mental well being, economy, and society.
Summary and Conclusions:
Copies of the reports to download can be accessed here:
Fiona Grahame