Do you remember what you were doing on Jan. 25? That was the day the first case of a novel coronavirus was reported in Canada. On Jan. 22, a man returned from Wuhan to Toronto and felt fine with no symptoms. The next day, he became sick enough to need hospitalization.
As with all new infectious agents, the public health system responded quickly, isolating the patient in a negative pressure room. Contact tracing began and fortunately, only one other person turned out to have the virus. But on Jan. 25, Health Canada declared Canada now had COVID-19.
It was just over six months ago. It has been almost eight months since the first cases of a mysterious pneumonia were reported to WHO by China. And possibly nine months since the first cases of the illness were possibly detected.
Yet in that short period of time so much has changed. Worldwide, according to the John Hopkins University COVID-19 dashboard, over 21 million cases of the disease have been reported with 761,393 people having died because of the virus. In Canada, those numbers are 123,318 cases and 9,067 deaths. In British Columbia, 4,274 cases and 196 deaths. We presently have 578 active cases and 3,500 people listed as recovered.
Of course, I am writing this on Aug. 13 and all of those numbers will be out of date within hours. The number of daily new cases is increasing as the virus spreads around the world and throughout our communities. Further, these are the cases where the patient has sought out a test. Epidemiologists estimate for every case tested, there are another 10 who do not get tested either because their symptoms are so mild they don’t think they have the disease or because they are actually asymptomatic and feel fine.
On top of this is the latency period between the time when a person comes in contact with the virus and the time when their viral load is enough to cause symptoms and they become infectious.
All of this is to say we are well and truly in the thick of this pandemic right now and it is not going to disappear any time soon despite what naysayers may think. There is so much more that we need to learn about the disease and its effects. Why is it so virulent? What exactly is it doing in our bodies? Is it mutating?
It has been estimated well over 60,000 academic papers on COVID-19 have been published since the outbreak began. Biochemists, microbiologist, genetic researchers, medical doctors, and health professionals of all stripes are trying to come to grips with the virus.
One thing that is becoming clear is that recovery from the virus is not going to be simple. Most of us have had the flu. You feel lousy for a few days, maybe a fever or chills, and maybe vomiting or diarrhea, but they you recover and get on with your life. Within a week or so, it is like the flu never happened.
Not so for many patients with COVID-19. In a recent article in Science, neuroscientist Athena Akrami discusses her recovery. “I used to go to the gym three times a week” she says but now “my physical activity is bed to couch, maybe couch to kitchen.”
She had textbook COVID-19 symptoms – a fever, cough, shortness of breath, chest pain, and extreme fatigue. But despite being considered recovered, her symptoms have persisted. Since March, she has had only three weeks when her body temperature was normal.
And she is not alone. Thousands of post-COVID-19 patients – considered recovered by a strict medical definition – have lingering symptoms, including fatigue, racing heartbeat, shortness of breath, achy joints, persistent loss of their sense of smell, brain fog, and permanent damage to the heart, lungs, kidneys, and brain.
The likelihood of any particular patient developing persistent symptoms is still one of the unknowns. It does not seem to track with the severity of the initial illness. For example, in one case a man had a mild infection while an elderly woman ended up in the hospital on a ventilator. Yet, he has been suffering from fatigue, falling asleep all day long and cannot work, while she has no symptoms except minimal lung damage.
It is clear that in the wake of the pandemic there will be an epidemic of chronic illness to follow. Many research groups are already setting up to follow patients for at least the next year and possibly for the next 25 years to assess the long term impact of the disease and its effects on the health of these patients.
Jan. 25 may have been the day the first case was reported in Canada but it is also likely to be the starting point of a very long battle for many patients.
