Corona Daily 005: Flashback: Part Two

Humans are capable of absorbing catastrophic news from abroad with tranquility. We placidly read about wildfires in Greece or Turkey. The agitation usually begins when the disaster reaches our own city.

*****

News reports on 21 January identify the first case in the USA. A single unnamed male in his 30s, residing in Snohomish County was America’s first patient. He was travelling solo since November in Wuhan. He landed in Seattle on 15 Jan. with a fever and cough, and in hospital four days later.

On 22 January, CNBC interviewed Donald Trump. An extract:

Interviewer: The CDC has identified a case of coronavirus, in Washington State. The Wuhan strain. If you remember SARS, that affected GDP. Travel-related effects. Have you been briefed by the CDC? Are there worries about a pandemic at this point?

Trump: No. Not at all. We have it totally under control. It’s one person coming from China, and we have it under control. It’s going to be just fine. I trust China. I have a great relationship with President Xi. We just signed probably the biggest deal ever made.

*****

On 30 January, the Hindu reported India’s first positive case, a 20-year old girl from Kerala studying in Wuhan University. On 23 January, she flew back from Wuhan, and four days later had a sore throat and dry cough. She had not been to the Huanan Seafood wholesale market. On a train from Wuhan to Kunming, she had noticed several people with respiratory symptoms. She was discharged from the hospital on 20 Feb 2020. (She stayed in India until July 2021 due to travel restrictions. Ironically, in July, she gave a test before leaving for Wuhan, and tested positive. She was re-infected after 18 months).

*****

On 1 February, BBC and other media reported the first two patients in the UK. On 29 January, a 23-year Chinese national called the NHS 111 phone line from his hotel room in York. Known in medical journals as “B”, this University of York student had fever, dry cough and muscle pain. His 50 year old mother “A” who flew from Wuhan a week earlier had fever, cough and sore throat. The pair was discharged on 17 February.

By January end, coronavirus had spread to 25 countries, with 7,818 confirmed cases and over 400 dead.

*****

On 22 January, WHO postponed a decision on whether to declare the outbreak a “public health emergency of international concern.” WHO Chief Tedros Adhanom said “this is an evolving and complex situation.”

Wuhan was closed off from the following day.

“At this time there is no evidence of human-to-human transmission outside China”. Said Adhanom. “That doesn’t mean it won’t happen.” He added.

On 28 January, it did happen. A German man was infected by a colleague who had returned from Wuhan. In Vietnam and Japan, the virus was transmitted from one person to another. On 30 January, a woman in Illinois back from Wuhan passed the virus to her husband.

 On 30 January, WHO declared the outbreak a global health emergency.

*****

WHO spent the first few weeks of February debating new virus names. On 11 February, the viral disease was baptized as Covid-19.

On 24 February, WHO confirmed at a press briefing that the coronavirus outbreak does not yet amount to a pandemic. “Using the word pandemic does not fit the facts, but may cause fear.” Said Tedros Adhanom. “For the moment, we are not witnessing uncontained global spread, and we are not witnessing large-scale severe disease or death.” He added.

By 2 March, the virus had spread to over 60 countries. Adhanom said most cases were linked and could be traced to known contacts, with no evidence of the virus spreading freely in communities. “As long as that is the case, we still have a chance of containing the virus.” He added.

*****

Before the end of January 2020, USA, India, UK and many other countries had had their first infections. On 24/25 February, Donald Trump, his family and entourage were visiting India. As part of the Namaste Trump tour, more than 100,000 Indians were cheering Trump in India’s largest stadium (now renamed Narendra Modi stadium).

On 11 March, WHO declared this was a pandemic. In the previous two weeks, cases in China had grown 13 times. “Describing the situation as a pandemic does not change WHO’s assessment of the threat posed by this coronavirus.” Said Tedros Adhanom. “Pandemic is a word that, if misused, can cause unreasonable fear, or unjustified acceptance that the fight is over, leading to unnecessary suffering and death.” He added.

*****

(Continued)

Ravi 

Corona Daily 006: Flashback: Part One

January 2020 was dominated by news about the US senate’s impeachment trial of President Trump, bushfires raging in Australia, the Brexit drama finally ending with the EU-Britain divorce on 31 January, and Muslim women occupying a road in central Delhi to protest against India’s proposed discriminatory law. Only cover-to-cover readers came across a small news item talking about a mysterious flu in China turning parts of urban China into empty places.

*****

Now, nineteen months later, I tried to find the first mention of the coronavirus in any major international newspaper. It is perhaps a 6 January report by Sui-Lee Wee and Vivian Wang in New York Times. It quotes Lee Poon, a public health expert at the University of Hong Kong. “I hope this pathogen is a less harmful one so it would not cause a major epidemic similar to SARS.” He said. “It would be a nightmare for all of us.”

“The (Chinese) authorities have acted swiftly to clamp down on discussion about the outbreak. Censors blocked the hashtag #WuhanSARS. The police said they were investigating eight people in Wuhan for “spreading rumours” online about the disease.” NYT reported.

*****

On the following day, 7 January, the US embassy in China issued a health alert. It said: “Travelers to Wuhan should avoid animals (alive or dead), animal markets and products that come from animals (such as uncooked meat). They should avoid contact with sick people, and wash hands often with soap and water.”

A longer article appeared in NYT on 8 January. It boldly, but not prophetically said, “There is no evidence that the new virus is readily spread by humans, which would make it particularly dangerous, and it has not been tied to any deaths.”  

“The initial cases were linked to workers at a market that sold live fish, animals and birds. Workers disinfected and shut down the market after the city health department said many of the cases had been traced to it.”

It is strange, if not suggestive, that the Chinese articles hyperlinked in the NYT have disappeared. You only see “404 not found”.

*****

On the same day, 8 January, a Hong Kong newspaper reported about a 36 year old woman returning to Korea from her business trip in China. She was diagnosed with pneumonia and was isolated.

The Washington Post dated 8 January also confirms “there is no clear evidence the unidentified disease can be transmitted between humans.”

The post is more graphic in describing the Wuhan market. “The 1000-stall bazaar sold not only seafood but marmots, spotted deer and venomous snakes, according to state media reports that described the market as filthy and messy.”

The article has an ominous sentence: “If the Wuhan pneumonia were found to be contagious, it could pose a major public health challenge coming just before the Lunar New Year Holiday, when more than 400 million Chinese are expected to travel, including 7 million who vacation overseas.”

Thankfully, the report ends on a comforting note. “Xu Jianguo, a former top Chinese public health official, struck an assuring note and said the government’s disease control capabilities today are much stronger than they were in the early 2000s. More than a decade has passed. It’s impossible for something like SARS to happen again.”

*****

Though I mentioned 6 January NYT article as the earliest, articles in local newspapers precede it. On 5 January, the Bangkok post talks about Thailand officials running thermal scans on passengers arriving from Wuhan. Every week, 24 flights arrived from Wuhan to Thailand. “China Southern Airlines will operate additional flights to Phuket from Jan 10 to Feb 3 to cater to the Chinese New Year festival” the report adds.

Now we know that the special flights went ahead, and Wuhan passengers in thousands landed in Phuket to celebrate the New Year.

*****

Judging by the newspapers in January, those in and around China who had experienced SARS were terrified the mysterious pneumonia may cause a SARS-like toll. That was the imagined limit. (By the way, SARS globally caused 8,098 cases and 774 deaths.)

During SARS, the doctors and nurses were ill at the start of the outbreak. This time, that was not the case. That misled the Chinese officials to believe human-to-human transmission was not possible.

*****

(Continued tomorrow)

Ravi 

Corona Daily 007: Unfinished Learning

Two months ago, I wrote about our fitness going down as a result of the shut gyms and swimming pools, as well as general reduction in exercise. In June, I rejoined the gym after a fifteen month gap. I am still unable to lift more than 75% of weights I could effortlessly lift before the pandemic.

Something similar has happened with the school students. Two USA reports published last week, one by McKinsey and another by an organization called NWEA show that the steepest drops have been in two subjects: Mathematics and reading.

On average, students fell five months behind in mathematics, and four months behind in reading by the end of the school year. Historically disadvantaged students lost even more. Students in America’s black-majority schools ended six months behind in Mathematics, low-income school students seven months.

McKenzie uses the term ‘unfinished learning’ to capture the pandemic fact that students didn’t get the opportunity to finish the learning they would have in a typical year. In many countries, students are promoted to the next grade with or without a reliable way of assessments. However, even imperfect education systems use building blocks, particularly for Mathematics and reading. How to continue with the construction of a skyscraper when two floors are missing in between? If younger students don’t spend enough time learning the alphabet and basic texts, can they start reading books just because they are promoted?

Other than the academic knowledge, children are at risk of finishing school without the skills, behaviours and mindsets to succeed in college or in the workforce.

*****

In the survey of 16,370 parents from across all the US states, 35% of parents said they were extremely anxious about their child’s mental health, and social and emotional well-being. Parents reported increases in clinical mental health conditions. There is a 5 percentage point increase in anxiety among children, and 6 percentage point increase in behaviors such as social withdrawal, self-isolation, lethargy and irrational fears.

Chronic absenteeism from grade 8 to 12 has gone up by 12 percentage points. 42% of students are not attending schools at all (when they should), according to their parents. In the US, before the pandemic, 3.1 million children were chronically absent from school. That number has now more than doubled.

Chronic absenteeism is the first step to dropping out of school. As per the McKenzie report, up to 1.2 million children could drop out altogether because of the pandemic. The report calculates the loss to them, and to American society. White students are likely to see their lifetime earnings reduced by 1.4%, the reduction for Black students could be 2.4% and for the Hispanic students 2.1%.

Lower earnings, lower level of education and the consequent reduction in innovation lead to decreased economic productivity. By 2040, all the school students of today, (kindergarten to grade 12) will be part of the workforce. The report expects the potential GDP loss of around $160 billion from pandemic related unfinished learning.

*****

At the bottom end, more than 1 million American children simply were not enrolled in local schools. They didn’t show up in person or online. Educators realized there is no substitute for quality, in-person kindergarten. Children begin to identify numbers and letters, the first building blocks. Kindergarten is a place where teachers can generally diagnose dyslexia, autism or the need for a child to wear glasses.

Both in the USA and UK, registrations for home education went up. In the UK, they rose by 75% in the eight months of the academic year. Covid anxiety has made parents remove children from the school register and switch to home-education officially. Not just kindergarten children, but older ones as well. Between September 2020 and April 2021, over 40,000 pupils were taken out of UK schools. Many parents admit they are “reluctant home educators”.

*****

Though this article gives a glimpse of the state of education in the USA and UK, the problems are universal. Predictably, they are more acute in Asia and Africa.

School re-opening for in-person learning is a critical potential action. When schools re-open, the teachers should focus on building the missing blocks, finish the unfinished learning.

Ravi 

Corona Daily 008: Want a Job in Ibiza?

Candidate and job description: A foreigner (from outside Spain), age 30-40. Should look like and dress like an obvious foreign tourist. Fond of disco music and dancing. Hang out in the island’s bars till 1 am when the curfew begins. (Drinks and food will be paid for).  

*****

For those who don’t know, Ibiza Island is Spain’s summer playground, famous for its night-clubbing. Like going to Las Vegas to visit casinos, foreign tourists arrive at Ibiza to spend nights in its clubs. In normal times, mega clubs such as Pacha or Hi Ibiza are visited nightly by thousands. Clubbers in Ibiza wake up at noon or later, again take an early evening nap; spend the night clubbing, followed by “disco sunrises”. For years, the local authorities have been trying unsuccessfully to introduce a law that will shut the clubs at 6 am, yes, six in the morning.

*****

Why are the Ibiza authorities desperately looking to recruit foreigners? The Delta variant has upset summer plans. Cases are rising, and Ibiza has imposed a strict curfew at 1.00 in the night. Most nightclubs are ordered shut. Some outdoor events are possible, but patrons are not allowed to leave their chairs, absolutely no dancing. Gatherings in restaurants and bars are limited to small numbers.

As a result of the covid restrictions, parties now happen illegally. Most parties happen in private homes, promoted through messages on social media. The fines for those organizing illegal parties are high - $700,000, but the parties haven’t stopped.

The 30-40 year old foreigners’ squad will be expected to keep their eyes and ears open. When they are in bars, innocently they will try to solicit invitations to those private parties. Bars and taxi stands are the two places where people gossip about the gatherings. It has become big business; some charge $60 as entrance fee.

Why can’t Ibiza’s own detectives or health inspectors do this job? Because their faces are known. The locals will view a known policeman dancing at an illegal party with suspicion. Ibiza officials have decided that the recruited foreign undercover agents will solicit invitations. Inform the police the details of the party, and then wait until the police arrive.

*****

Spain is a democratic country. The police don’t have the authority to enter a private home (even if the music is blasting) without a warrant. However, they are now trying to do it under the pandemic health regulations. Without private detectives, it is not easy to find those venues. Many of them are in secluded residences, away from main roads. If the police were to enter a house wrongly, it would result in bad media publicity as well as possible court cases.

Once the detectives alert the authorities, police will place themselves outside the planned house (this is lawful), and prevent people from joining the party.

The “party tracking project” includes getting the right information. The undercover agents will go to the parties to collect evidence (sale of tickets, alcohol, take photos of unmasked people, see if social distancing is observed). Ibiza police suspect some parties are organised by foreign business groups with great capacity for logistics.

*****

Ibiza law allows cutting power supply of a place. But it requires a notice of 48 hours. (By which time the illegal party is over). It is also considered a safety hazard. There may a stampede of people not very sober. Moreover, the Ibiza law enforcement has learnt there is nobody to talk to at 4 am to have the electricity supply cut off. Done without proper security or valid reason, cutting off power is considered a crime of coercion.

Local officials have concluded their best bet is the foreign detectives. The objective is to learn where the illegal parties are happening, place police outside, and prevent people from going in.

*****

If your age and spirit permit it, why not apply for the job? Ibiza is one of the paradises on earth.

Ravi          

Corona Daily 009: Romeo Budhoo’s Story: Part Final

In February 2021, Budhoo had attended a landlord rally in front of the official residence of Governor Cuomo. The rally leader said the moratorium was not fair for landlords, because they were not super-rich landlords like Donald Trump. For landlords to get any funds from the state, the tenant must do much paperwork. There is no incentive for the tenants to do it.

“They are telling themselves - Why should we go and do all these things and hustle to apply when nobody can put us out of the apartment?” Budhoo said. Alfonzo Hill, his tenant had not participated in the summer 2020 relief program. Even when the renters signed up for relief, many landlords were scared, because for a year since signing they lost the right to evict a tenant. Budhoo didn’t belong to that camp. He was willing to try and co-operate with Hill to push forward the paperwork.

*****

He kept returning to his house at 1042 Cutler. One morning he parked his car and watched the front door for any sign of Alfonzo Hill. In his imagination, he often pictured Hill coming out with a monthly check or even the entire $12,000 he owed. He counted the empty cans on the porch. He sent a text message to his wife, “nothing yet.” Budhoo listened to music and played a video game on his phone, before realizing he had wasted too much time.

He was not authorized to enter the house, or demand payment, or evict the tenant.

Budhoo saw some movement further down the road. A woman was throwing clothes from inside the house on the lawn. It looked like an eviction. Curious, Budhoo drove close to the house.

“Are you the landlord?” He asked the woman. She said yes.

“Wow. Congratulations.” He said, pointing to all the trash thrown out on the lawn. “I have been trying to get back my house for over a year. How did you do it?”

“It’s not what you think.” The lady said. “I didn’t evict. They just left.”

“Hey, come on.” Said Budhoo.

The landlady laughed and explained how she had systematically applied pressure the whole year.  She had bombarded the tenant with eviction paperwork and notices, though she knew eviction was not possible. She stopped repairing anything, filed a case in small claims court. She served notice on her debtors to legally seize their wages or savings. Eventually, they got sick and decided to vacate on their own.

“I like to be reasonable, but it’s either my house or theirs.” She said. Her victory was visually spread in front of Budhoo. An empty house, and in front of it 28 garbage bags piled high on the sidewalk, an overturned chest of drawers, a child’s mattress soaked through by rain and thousands of grains of rice scattered all across the street.

“I have been lucky.” She said. “I only rent good people, and most have paid. It seems like other landlords are going under, but I am actually trying to invest. I am looking to buy.”

Budhoo helped her pick up the garbage bags and threw them in the industrial dumpster.

“I might have an opportunity for you.” He said. “You know that house 1042 Cutler? It’s a good house. I can give you a good price.”

*****

The true story written by Eli Saslow ends at this point. He doesn’t tell us whether Romeo Budhoo succeeded in selling the house to the lady. He probably didn’t. But that’s not the point.

The story is about the human crisis for tenants as well as small landlords. On the 31 July midnight, America’s ban on evictions expired, putting millions of American renters at the risk of being evicted from their homes. More than 15 million people in 6.5 million homes have defaulted on rents over $20 billion to landlords.

On 3 August, the Biden administration imposed a new 60-day moratorium in parts of the USA, citing the spread of the delta variant. The can has been kicked one more time down the road. Romeo Budhoo’s wait to get his house back continues.

*****

Ravi 

Corona Daily 010: Romeo Budhoo’s Story: Part Two

The unemployed Alfonzo Hill, Budhoo’s tenant, browsed the internet for days to learn about tenant rights, New York’s rent strikes, and the eviction moratorium. In the pandemic economy, the US government had banned all evictions until the end of July 2021 to avoid, or rather postpone, a historic housing crisis. Officially, more than 8 million American rental properties were behind on payments on average by six months. Most were owned not by big companies or banks, but by small landlords like Budhoo.

On TV, Alfonzo Hill watched Governor Cuomo say that inability to pay rent was the state’s number one issue, and the moratorium had taken it off the table. In the presidential campaign, Joe Biden said rents should be forgiven. Not delayed but forgiven. Hill made it a point to vote for Biden. After listening to the leaders, Hill’s conscience was clear. He spent the unemployment allowance and the four-figure stimulus checks to fix the broken engine in his minivan, buy some furniture, pay off the credit card debt, and gave his daughter a laptop for her virtual lessons. Why pay to Budhoo what may be forgiven by the new president?

*****

Budhoo dialed a number saved as “Julie eviction” on his cell phone. Her real name was Julie Horn. She owned a few properties herself, and specialized in the eviction business. This entailed helping landlords file court cases, notarize documents, serve eviction paperwork to tenants. Schenectady, with more than half its population renting, and about 1,000 tenants getting evicted each year, provided Julie with a decent amount of business. Julie’s card said “the Hit Lady”. She had met all kinds; tenants crying, begging, threatening or running away. In the pandemic, though, what she experienced was indifference.

Budhoo had sought her help in the past. Julie’s fees and eviction expenses were labeled as “routine turnover” in his books.

This year, Julie’s work had become difficult. The courts still heard eviction cases. But they asked for far more documents. A tenant who was a veteran couldn’t be evicted under any circumstances. Even if the court were to pass an eviction order, it couldn’t be served until the federal moratorium was lifted at the end of July 2021.

*****

Julie talked about the general perception. Budhoo was the landlord, the acknowledged villain. He was the greedy man trying to throw people on the streets.

Budhoo was trapped between non-paying tenants and the government demanding insurance, mortgage payments and property tax. One third of the American small landlords were about to go bankrupt.

“Have you thought of trading cash for keys?” Julie asked him. This was a new strategy in Schenectady. The landlord should pay $500 to the tenant; and forgive all overdue rent if the tenant moved out.  

“That’s crazy” said Budhoo. He didn’t have money to give to his tenants. He would rather commit suicide. Seriously, he told Julie.

“Have you thought about selling it?” Julie asked.

Budhoo doubted he would find a buyer willing to take the house along with its non-paying occupant. If he was lucky in finding a buyer, it would be to minimize his losses. He had put his entire life in the tenancy business. The work of twenty years was being erased in a single year.

*****

In the following month, Budhoo attended a meeting of the distressed landlords. Each of them was a rent creditor for more than $10,000. Most were immigrants who had saved the city twenty years ago. Now the city was trying to survive the pandemic by raising the trash fees and property taxes.

They shared their stories. Some were trading cash for keys as Julie had suggested. Others were cutting off heat in the houses, trying to force the tenants out. For fear of not getting rent, vacant properties were not rented out any more. One person told the story of an Albany landlord who had broken into his own apartment on a Sunday morning. At gunpoint, he had tied the tenants, and then dropped them at a cemetery 30 miles from the property.

Budhoo didn’t think that was a real solution.

*****

(The third and final part tomorrow.)

Ravi 

Corona Daily 011: Romeo Budhoo’s Story: Part One

Romeo Budhoo had looked forward to 1 August, 2021.

Budhoo is an immigrant from Guyana who lives in New York’s Schenectady. In the early 2000s, in another recession, his family had arrived in Schenectady which had lost half the factory jobs. One third of the residents had left town. The city had thousands of vacant homes. $18,000 per house was needed to demolish them. The mayor had a bright idea. He knew the resourcefulness of the Guyanese immigrants. The hard-working Guyanese were known for their ability to repair dilapidated houses. The mayor offered to sell the houses at peanut prices, some of them going for a token $1. In all, 5000 Guyanese bought them, repaired them, rented them out, and started paying property taxes to resurrect the city. Romeo Budhoo was one of them.

*****

For the past fifteen months, on every first of the month, which Budhoo called “pay day”, he took his booklet of receipts and drove to his tenants. A hairdresser, a true gentleman, who owed Budhoo $7,000, gave $75 in cash to comfort him. On the receipt Budhoo wrote: “Thanks for at least trying to work with me.”

He then moved to his main source of income, a 1901 three story house at 1042 Cutler St. that was confiscated, condemned and about to be demolished when Budhoo bought it for $79,000, his life-long savings. He had personally worked on the wiring, plumbing, installed granite tops, and was renting it out for $950 a month. The house rent had paid for his daughter’s college degree. For the last twenty years, he had collected the rent on the first of the month. That process had come to a sudden halt in March 2020.

On 1 April, after missing the payment, he wrote to the tenant, “Just a friendly reminder.” A month later: “Good morning. Are you able to pay the rent?” In September, when he still hadn’t received a cent, the US government announced a national eviction moratorium. The first of several. “Please, I am willing to work with you” he wrote to the tenant, but didn’t receive an answer.

In May 2021, over a full year without payment, Budhoo was unable to use any of his credit cards, had applied for a secondary loan on his car, defaulted on $13,000 in property taxes and was taking medicines for panic attacks and stomach ulcers. He had started mowing people’s lawns for pocket money.

“This is robbery.” He wrote to his tenant. “You are stealing from me.”

*****

He got out of the car, and walked around the house soft-footed like a burglar. He didn’t knock, because the tenant had accused him of harassment, and police had read to him tenants’ rights. The police warned he would be charged for trespassing (though he was the owner of the house).

Inside he could see a TV and two heaters. The yard was dirtied with empty cigarette packs, wrappers and beer cans. The tenant was living free and damaging his home. Budhoo took a garbage bag out of his car, and began collecting the trash. Though he didn’t control the property, he was legally responsible for its maintenance. He had been fined four times for his tenant’s trash violations.

*****

Alfonzo Hill, 38, the tenant, watched Budhoo from inside. He made sure Budhoo’s car left before coming outside and smoking on the porch. Before the pandemic, he lived with his girlfriend and 13-year old daughter. Working as a cook at a local tavern, he was earning $700 a week until governor Cuomo banned indoor dining. He lost the job, and weeks later his girlfriend left him because he couldn’t pay the bills. After a year of surviving the pandemic, he was unemployed and broke. His daughter attended sixth grade virtually. They had a few dollars left. Poor and black, they were vulnerable to Covid.

“He is the exterminator and we are the rats.” He told her about Budhoo. “We’re not human to him. We’re money. It’s all a big game.”

*****

(Continued tomorrow. Source: Eli Saslow in Washington Post.)

Ravi 

Corona Daily 012: Long Covid and Children

The coronavirus naturally keeps looking for new victims to attack.

Israel, one of the top vaccinated countries (85%+ adults fully vaccinated), saw the number of cases become negligible at the beginning of June. Later in the month, cases rose to more than 100 a day, most of them children under 16. Hurriedly, Israel’s Ministry of Health recommended all 12-15 year olds get vaccinated.

In the USA and UK, covid is becoming a disease of the unvaccinated. That often creates an image of those refusing to take vaccines. But the unvaccinated population also includes children for whom no vaccines are available.

*****

An Italian pediatrician, Danilo Buonsenso, first tried to quantify Long Covid in children. His team interviewed 129 children diagnosed with Covid-19 last year, and found that more than half of them still had lingering symptoms four months after the infection. Insomnia, fatigue, muscle pain and a persistent cold were the common symptoms.

Surprisingly some children, who were asymptomatic or had a mild covid infection, had developed Long Covid. This finding is common to studies from most countries. The original infection doesn’t need to be severe for a child to experience Long Covid.

*****

The data from the UK office of national statistics (ONS) updated in April 2021 showed that 9.8% of children aged 2-11 and 13% aged 12-16 reported at least one lingering symptom five weeks after infection. Another report released in April found that 25% of children discharged from hospitals in Russia had symptoms more than five months later.

Everywhere, the numbers are lower than those reported for adults. However, the numbers still worry parents, because the initial assumption was that Covid-19 didn’t pose risks to children. If 10-15% of the children, asymptomatic or with mild infection do have long-term symptoms; that is a puzzle scientists would like to study.

Jakob Armann, a German pediatrician, offers some positive news if his hypothesis is correct. Long Covid symptoms include fatigue, headache, difficulty concentrating and insomnia. Dr Armann says that other pandemic-related phenomena; school closures, isolation, no interaction with friends, in some cases family members falling ill or dying; could all produce the same symptoms. That would inflate the Long Covid stats artificially. To scientifically determine this, you need a control group, a group of non-infected children with similar symptoms.

Since May 2020, Dr Armann’s team has been taking blood samples from secondary-school children in Dresden to track rates of infection. In April and May 2021, over 1,500 German children were surveyed. Nearly 200 of them had antibodies suggesting prior infection. All children were asked questions to determine the proportion of Long Covid.

In May, Dr Armann reported the team found no difference in rates of symptoms between the two groups. (With and without prior covid-19 infection). This makes him believe Long Covid in children is probably much lower than suggested by many studies. It does exist, but the true figure is perhaps 1% rather than 10%, he says.

What is more important is to see how long the symptoms would last. If they were to last all their life, even 1% of children getting Long Covid is a serious issue, he adds.

*****

Most scientists are demanding a proper definition of Long Covid so that studies can decide how serious the problem is among children, and which children are at risk. Pediatricians know a great deal about chickenpox, because it has been around for seventy years, Covid only a little longer than a year.

Two weeks ago, a $40 million study was launched to examine Long Covid and MIS-C (multi-system inflammatory syndrome in children). In the USA, more than 3.6 million children have tested positive for covid-19 and more than 2800 cases of MIS-C, a serious condition possibly associated with the virus. MIS-C symptoms include fever, abdominal pain, bloodshot eyes, breathing trouble, rash, vomiting, diarrhea and neck pain. This can affect the heart function and blood pressure.

The study will enroll over 1,000 children (under 21) with confirmed history of covid infection. Another 1,000 children with no infection history will be enrolled as the control group.

Hopefully, the detailed study will produce results that are reassuring for parents the world over.

*****

Ravi 

Corona Daily 013: Long Covid: Part Two

In 2004, SARS had posed a similar riddle. Twelve months after contracting it, some patients continued to be unwell. There was no evidence of any lingering lung infection or the presence of the SARS virus. Still the patients were weak, extremely fatigued, with a constant body-ache, unable to work. Rather than long SARS, it was called the “post-SARS syndrome”. Harvey Moldofsky, a fatigue researcher from Toronto, found out that most of these patients were sleeping badly. He suspected it meant inflammation in the brain. However, he had no funds to investigate further.

A breakthrough came from China. Chinese scientists discovered SARS virus’s genetic material in the patients’ brain cells. The olfactory nerve connects our nose to the brain. Dr Moldofsky felt this was the route the virus had taken to reach the brain. The viral fragments interfering with the brain functioning probably caused sleep disruption and other issues.

Amy Proal, a microbiologist, believes viruses linger in the remote pockets of our bodies that are beyond the reach of the immune system. They cause several post infectious syndromes including CFS (Chronic Fatigue Syndrome) and long covid. Dr Proal says every major pathogen results in chronic cases. A huge number of studies show infectious organisms can persist in tissue, and contribute to diseases. Some viruses are highly “neurotrophic”, meaning they invade the nerves and hide out there. There is evidence the covid-19 virus is capable of this.

In the past, Dr Proal adds, many doctors thought those symptoms to be psychological. In the last ten years, though, survivors of Ebola, Zika and Covid-19 have suffered long-term illnesses that were real and not psychological.

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Scientists found that the Ebola virus can linger in the body for months or years. Dr Georgios Pollakis, a British microbiologist works with hospitals in Africa to monitor Long Ebola. One study found the antibody levels in Ebola survivors rising after a year. Dr Pollakis and others discovered the virus hidden in the body’s reservoirs, from the eye to the lymph nodes, and even in body fluids like breast milk and semen.

A paper this year suggested that an Ebola survivor recently caused an outbreak in Guinea. He had contracted the infection around 2015. The Ebola virus was dormant in his testes for over five years. The man infected his sexual partner with that hidden virus.

Dr Pollakis believes Long Covid just like Long Ebola happens because the body is unable to eradicate the virus within. The remaining hidden fragments of the virus periodically get back into the bloodstream, causing an immune reaction and other symptoms. Covid-19 virus is shown to be capable of infecting a wide range of tissues, from the brain to the testes. The virus can reside in the semen for a long time.

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Dr Heightman thinks that in some patients Covid provokes the immune system to attack the body’s own tissue. This is similar to autoimmune diseases like rheumatoid arthritis or multiple sclerosis. This theory may explain the higher proportion of women suffering from Long Covid. (Though more men are infected and die of covid itself). In Heightman’s clinic, 66% of the long covid patients are women.

Another hypothesis is Covid-19 triggering re-activation of other viruses hidden in our bodies. Viruses causing Chickenpox or the EBV from the Herpes family are known to lie dormant in human bodies for years or decades. A group of scientists speculates that covid may re-activate such viruses that result in the new chronic symptoms.

Currently, there are no approved medicines for long covid.

The good news is that many long Covid patients simply get better through natural recovery. Since covid-19 is only 18 months old, we don’t yet know how long the Long Covid can be. Despite death rates falling, the risk of Long Covid remains alive. UK has so far awarded scientists at the University of Birmingham £2.2 million to study Long Covid. Far more has been requested in the USA and Europe. A significant number of Long Covid patients are health care workers. It is in societies’ interest to make them healthy and productive faster.

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(Continued tomorrow)

Ravi 

Corona Daily 014: Long Covid: Part One

The pandemic is now over 18 months old. Out of the nearly 200 million coronavirus cases, 15 million are currently active, either isolated, or in hospitals; asymptomatic, mild or serious. Out of the remaining 185 million cases, called closed cases, over 4 million have died. The surviving 180 million+ are classified as recovered. 2% of the closed cases have died. 98% have recovered.

Sequela is a medical term that describes a condition resulting from a disease, injury or other trauma. The disease or trauma is over, but a chronic condition follows as its consequence. A rape victim may feel a post-traumatic stress disorder for years. That disorder is a psychological sequela of rape.

Long Covid is a long term sequela of Covid-19. No pandemic dashboard gives you the “Long Covid” patient numbers. If not dead, patients are classified as recovered.

Not all of them have recovered.

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In July 2021, there was a flood of articles on Long Covid. Enough time has passed to understand covid’s “longness”. When the pandemic started, many thought covid would be similar to flu – once over, everything would be fine.

In May 2020, Melissa Heightman started the UK’s first post-Covid clinic. BBC’s David Cox talked to her at length. More than a year after setting up the clinic, one third of the clinic’s patients are still unwell, and mostly unable to work. More than half the clinic’s patients were never hospitalized for covid-19.

The clinic regularly gets patients, relatively young, without comorbidities or health conditions. Most of them had a mild covid infection. However, after the virus supposedly leaving their bodies, their new ailments continue for weeks or months.

The most common long covid symptom, experienced by 80% of Heightman’s patients, is a crippling fatigue, making even the simplest tasks difficult to execute. Research studies elsewhere find persistent fatigue in 62% of long covid patients.  Scientists now estimate that one in every 10 covid patients will still have symptoms 12 weeks later. (Despite testing negative).

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The medical fraternity classifies the long covid patients into two groups: those who were admitted to a hospital and those who weren’t. Ironically, doctors find it easier to manage the patients who were hospitalized. As a rule, their lungs or heart were damaged by an acute viral infection, or the damage was caused by cytokine storm, where an overreacting immune response attacks the patient’s own tissues. CT (computerized tomography) and MRI (magnetic resonance imaging) scans clearly show the extent of the damage. Drugs such as colchicine are used to treat the lingering inflammation. It takes up to six months to see improvements in the scans. Except those who were in the ICU for a long time, all are expected to have no permanent abnormality.

The non-hospital patients display a puzzling variety of symptoms. Dr Heightman says the peak age for this group is 35-49, and some surveys have identified 98 different symptoms. The top ones are fatigue, brain fog, muscle and joint pain, sleep disturbances, migraines, chest pain, skin rashes, sensitivities to smells and tastes, and dys-autonomia, a rare condition causing rapid, uncomfortable increase in heartbeat during any activity.

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Globally, there are still very few clinics like Heightman’s. PLRC (Patient-Led Research Collaborative) is a self-orgnised group of “Long Covid” patients who share their symptoms and experiences. They published two papers last year. Anyone suffering from long covid is welcome to join the group.

Their recent survey presents a depressing picture. Out of 3,762 long covid patients, 77% still experienced fatigue after six months, 72% struggled with post-exertion discomfort and pain, 55% suffered from cognitive dysfunction and 36% of female patients experienced issues with their menstrual cycles. Hannah Wei, one of the PLRC leaders, said her own cycle disappeared for three months.

For many non-hospital long covid patients, symptoms came and went in three different waves. (Wave 1): dry cough and fever. (Wave 2): dysautonomia for about two months. (Wave 3): skin rashes, muscle pain, new allergies and brain fog. Usually happening four months after the initial infection, this wave just keeps going.

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Tomorrow, I will write about the different theories around this mystery. What may be causing Long Covid?

Ravi