Long Covid, an enemy in hiding

KUALA LUMPUR: First, Larissa Lumandan left her cellphone in the freezer. Next, she could not remember what items she needed to bring along when moving to Kuala Lumpur from Sabah, or even how to arrange them in her luggage.

“It took me three days to pack a simple suitcase. It was, like, as though I didn’t know how to pack things. It’s never happened to me before, never,” the 32-year-old writer told Bernama.

It did not stop there. The Kota Kinabalu native said after moving to Kuala Lumpur last month, she would regularly do silly things like trying to find clothes she had chosen to wear while holding said clothes, and rewashing dishes over and over again because she kept forgetting she had washed them.

She described her mind as being “very blur”. In medical terminology, it is called brain fog, one of the most common symptoms of long Covid or post-Covid syndrome.

Larissa also suffered from fatigue, cough and hair loss, the latter appearing a few weeks after she recovered from Covid-19 in February.

Her case was considered mild, even though she described her symptoms as “terrible”. She has not sought treatment, saying her symptoms were improving.

She is one of the estimated tens of thousands of long Covid sufferers in Malaysia that health authorities do not know about, possibly to the detriment of the patients’ future health.

Experts are also concerned that this under-counting will result in a healthcare system unprepared to care for a large number of Covid-related medical conditions in the future.

According to the World Health Organisation (WHO), long Covid is the collection of symptoms that develop, return or remain weeks or months after patients recover from Covid-19, with most symptoms improving after three months, though they can also last for over a year.

WHO estimates between 10% and 20% of former Covid-19 patients have long Covid, though the definition varies from country to country, while the US Centers for Disease Control (CDC) estimates the rate to be higher at one out of five adults under the age of 65, and one in four among senior citizens.

The government reported that fewer than 20,000 people had long Covid by December 2021, and more than 9,000 have undergone rehabilitation at public facilities as at May 10.

“I suppose (the undercount is because) not all of the patients come for follow-up treatment or they suffer in silence, thinking the symptoms may be normal,” said Dr Sally Tee, consultant neurologist at Pantai Hospital Kuala Lumpur.

WHO lists common symptoms of long Covid as fatigue; shortness of breath or difficulty in breathing; memory, concentration or sleep problems; persistent cough; chest pain; trouble speaking; muscle ache; loss of smell or taste; depression or anxiety; and fever.

Infectious disease specialist Dr Bushra Megat Johari, who is doing a study on long Covid at Universiti Malaya Medical Centre, told Bernama the fact that long Covid could affect every patient regardless of severity was partly why there is undercounting of the condition.

“Most of the follow-up (cases are) those who were admitted to hospital – Categories 3 to 5 (moderate to severe) cases – so we might not pick up those in Categories 1 and 2 (asymptomatic and mild). It depends if they come in for medical attention,” she said.

Per current guidelines, asymptomatic and mild cases recover at home and are only known to Health Ministry officials if and when they report their infection status.

Data on long Covid depends on self-reporting as well, which leaves out those who sought treatment in places other than at a government facility.

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long Covid , post-Covid , health


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