By Troy Farah, Salon's science and health editor specializing in drug policy and pandemics, 8/10/24
"The 2024 Olympic Games are serving up some less-than-subtle metaphors for how poorly we handle public health. Just after winning a bronze medal in the much-anticipated men's 200-meter race, U.S. sprinter Noah Lyles collapsed on the track in exhaustion — not just because he’d completed a brutal run in just 19.7 seconds, finishing third, but also because he was sick with COVID-19, a diagnosis that he’d concealed from others. He had been favored to take home gold, as he did in the 100-meter race a few days earlier.
"But seeing an American Olympic star sprawled out and gasping on the track, and then taken away in a wheelchair, was more than a shocking image. It also represented the general “mission accomplished” attitude toward SARS-CoV-2: We think we’ve won against this virus and we haven’t.
"COVID isn’t just spreading like wildfire through the Olympic Village in Paris — we are undergoing surges across the globe, with the World Health Organization tracking steep rises in infections in 84 countries. After more than four years fighting this thing, it is still knocking us out.
"In some parts of the U.S., the amount of COVID is so high that experts are claiming this summer surge is on par with winter waves of the virus. But none of this should be unexpected at this point. This is no longer the “novel” coronavirus that once terrified people with its unpredictability. We know how it behaves, with surges in both summer and winter, and we know how to fight against it — yet our apparent strategy at the moment is to pretend it doesn’t exist at all, even when it swipes us off our feet.
"It’s true that the pandemic is much different than it was in 2020. For one thing, in spite of this surge, deaths are relatively low, following trends since vaccines became available. In 2023, COVID dropped from the fourth leading cause of death in the U.S. to the 10th, according to recent provisional data from the Centers for Disease Control and Prevention. That's not great, but it does indicate that widespread immunity (from vaccines, previous infections or both) is giving us some level of protection. Though let’s not forget that at least 1.2 million Americans have died to date from COVID. It’s nothing to sneeze at.
"Deaths aren’t the only concerning metric, of course. Sometimes a COVID infection is asymptomatic, while at other times, the symptoms last for months or years or never fully go away. Patients call this long COVID and public health experts have described it as a mass disabling event. Lyles isn’t just lucky he won a bronze medal — he’ll be lucky if he doesn’t experience months of headaches, lung issues or extreme fatigue that never goes away.
"Yet long COVID is rarely factored into discussions about this pandemic, even when kids get it. Instead, it’s treated as if infections are merely a mild cold at this point. Just shake it off, as Taylor Swift might say, while her summer tour dates become superspreading events.
"Millions of patients can attest that COVID is anything but mild — and it's definitely not the flu. The SARS-CoV-2 virus can worm its way into nearly every part of our bodies, trashing our immune system and damaging our organs. We tend to think of the disease as a respiratory problem, given all the coughs and sniffles it produces, but it’s really more of a vascular disease, impacting any system that relies on blood vessels. That can include damage to the brain, which can manifest in symptoms like long-term cognitive impairment and Parkinson’s disease.
"Yes, a virus that can literally cause brain damage is spreading at record levels and most people are acting like it’s just another wave. Just keep running.
"But we’re not just paying the price with our bodies. The economy is also getting smacked by long COVID. A recent comprehensive review in the journal Nature Medicine found that the “cumulative global incidence of long COVID is around 400 million individuals, which is estimated to have an annual economic impact of approximately $1 trillion.” That's ignoring the long list of ways that long COVID wreaks havoc on the body, including, as the study notes, "viral persistence, immune dysregulation, mitochondrial dysfunction, complement dysregulation, endothelial inflammation and microbiome dysbiosis."
"The fact that we are ignoring this extreme issue, at one of the most intense moments in the pandemic so far, is killing us, disabling us and costing us greatly.
"So what can be done? We don’t need to fear the virus anymore, but we need to be conscious of the risks. We know how it works and how to protect ourselves. Taking precautions that will stop the virus from spreading will also give it fewer opportunities to mutate and evolve new ways of getting around our immunity.
"We can surveil the virus better using regular testing, but the CDC stopped tracking cases last year (it still tracks hospitalizations, deaths and ER visits) and the Biden administration stopped mailing free tests months ago. Requirements for hospitals to report COVID data were also lifted in May, though that policy will be reversed later this month and will become mandatory come November. Still, that's a good chunk of time with incomplete or inadequate hospital data, and lacking that, it's hard to know what the pandemic really looks like.
"Although it's not a perfect gauge, wastewater data remains one of the only consistent metrics throughout the pandemic, which is how we knew this surge was coming more
than a month ago. That didn't translate into action at the federal
level, and COVID is barely visible as an issue, if at all, in this
year's presidential campaign.
"We can mask in public, especially in crowds. It's never been fun to wear one, but masks really do work — though they’re a bit like condoms in the sense that their efficacy relies on being used correctly. A KN95 or N95 mask is best, and it needs to cover one's nose.
"We can keep up-to-date with vaccinations, which prevent infections from becoming severe or deadly and lower the chances of developing long COVID, even with just a single dose. Yet only about 28% of Americans received the latest shots, a decline from 69% when the first round of vaccines were released. (The reasons why immunization wanes from certain vaccines are complicated, but COVID is far from the only disease that requires boosters.)
"We're all suffering from pandemic fatigue after being put through the wringer over the past four years. But COVID doesn’t care how long we’ve been dealing with this crap. It doesn’t care if we’re bored or want to go to sports events or political rallies. It’s a virus, meaning it has no desires, no consciousness, no autonomy. It’s just a bunch of proteins that have been randomly selected through nature to easily and effectively hijack our immune systems.
"We have plenty of tools to protect ourselves, but our strategy is
instead denial, and it isn't working. The virus doesn't just take
advantage of the ACE2 receptors in our bodies, it takes advantage of us,
less directly, through conspiracy theories, misinformation, vaccine
skepticism and regular old negligence and apathy. We all want to stop
running this race against COVID. But to do that, we have to turn around
and face it."
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