In the early days of 2020 and through 2021, the SARS-CoV-2 virus and COVID-19 were constantly on the lips of everyone and with constant coverage across various media platforms around the world. Therefore, it may be assumed that many persons understand a thing or two about the virus and the COVID-19 pandemic. And due to the novelty of the virus at the time, several people did not know what to expect. However, based on the commitment of governments around the world to providing the needed resources and funding, scientists were able to develop a COVID-19 vaccine in record time. The unprecedented development of the COVID-19 vaccines and other non-pharmaceutical interventions helped mitigate the possible overall effect of the virus. The metrics for this overall effect are hinged on three factors: severity, hospitalisation and death. These three factors seem to have formed the basis for the most recent government policies on COVID-19 restrictions. There is Long COVID, which is a lingering issue after recovering from the disease and this forms the basis for this article.
Long COVID may be defined as symptoms that last longer than four weeks after testing negative from an initial SARS-CoV-2 infection. It can also be described as the residual leftovers after recovering from the COVID-19 disease or the SARS-CoV-2 infection. These residual effects include but are not limited to constant migraines, brain fog, a disruption in the brain olfactory system resulting in continuous loss of smell and taste, persistent SARS-CoV-2 virus remnants in the oesophagus, shortness of breath, fatigue, loss of concentration and other neurological and gastrointestinal problems. These symptoms are equally seen among people with mild SARS-CoV-2 infections and it cuts across all age brackets, ethnicity and gender, and is very common among the unvaccinated population.
In recent data released by the Office for National Statistics in the United Kingdom, 1.7 million people in the UK are living with Long COVID, which is 2.7 per cent of the population. Also, of people with Long COVID, 784,000 people first had COVID-19 at least one year previously and 334,000 first had the disease when Omicron was the main variant.
It is imperative to mention these data are self-reported Long COVID before Alpha was declared a variant of concern to the week ending March 5, 2022. It is well established that the transmissibility and infectivity of Omicron BA.2 are much higher compared with the BA.1 — the first Omicron variant. Based on BA.2 transmissibility and ease restrictions around the world, there is a possibility of BA.2 doubling the number of people with Long COVID from the previous BA.1 period.
Further, there is a potential for several morbidities that may arise from SARS-CoV-2 infection, hence the new metric for quantifying the success of the pandemic or developing government policies should shift from the three initial metrics (death, severity and hospitalisation) to include Long COVID. And this should form the centre of our public health messaging in Nigeria. It is well documented that the current vaccines hold against death, severity and hospitalisation. However, in a population where the official death rate from COVID-19 are low (which may be attributed to several factors), convincing the said population to get the COVID-19 vaccines will be difficult; specifically, if the public health messaging is heavily centred on the first three metrics. But with the fourth metric, Long COVID, individuals will easily identify the benefit of a COVID-19 vaccine shot. At present, there seems to be no study or survey in Nigeria looking into Long COVID.
It is imperative we pay attention to the aftermath of COVID-19 disease in a Nigerian population and this will help contextualise the public health messaging in the country. Without this sort of study or survey, it will be difficult to address the pandemic in Nigeria through vaccination. Studies have shown that vaccinated individuals are less likely to come down with Long COVID compared to unvaccinated individuals. We know the challenges with the Nigerian healthcare system, compounding this with a sickening future society due to the SARS-CoV-2 virus is a cost too high to bear as a nation or people. Since the COVID-19 burden in Nigeria is far from hospitalisation, severity and death, the possibility of Long COVID in the population cannot be underestimated.
- Dr Peter Imoesi, a Research Fellow at the University of Aberdeen, Scotland, United Kingdom, holds an MSc degree in Molecular Biology (England) and a PhD in Translational Neuroscience with a speciality in Molecular Neuroscience (Scotland)
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