Local doctors and public health workers gathered last week to learn about the latest research into Long COVID.
Dr. David Putrino of Mount Sinai, an expert on Long COVID and other post-acute infection syndromes, visited Santa Barbara for a dinner lecture hosted by the Santa Barbara County Public Health Department and nonprofit The Chesley Initiative.
Long COVID is broadly defined as surviving an acute COVID infection and still having symptoms three months later – failing to fully recover, Putrino said.
There are more than 200 presenting symptoms, affecting 10 organ systems. “It presents in any way you can imagine,” he said.
This week marked the four-year anniversary of Santa Barbara County declaring a public health emergency for the COVID-19 pandemic, noted Dr. Mouhanad Hammami, the county’s public health director.
“I’m seeing some of you for the first time in three dimensions,” said Dr. Lynn Fitzgibbons, an infectious disease physician at Cottage Health, during her remarks. She reflected on the pandemic and the medical research being done now.
“We’re talking about science that was not even imaginable 10 years ago,” she said.
Hundreds of millions of people around the world have post-acute infection syndromes, including Long COVID, Putrino said.
“For a long time, these diagnoses were met with gaslighting,” Putrino said.
When patients said, “I know most people recover, but I’m not,” physicians didn’t always listen.
He also said Long COVID and other post-acute infection syndromes are more common in women than men, about a 70:30 ratio.
How Common is Long COVID?
About 6.8% of adults in the United States have Long COVID as of March, according to a Centers for Disease Control and Prevention survey. That’s a scary statistic because the last survey in October showed the number at 5.3%, Putrino said.
About 30% of people who ever had COVID have experienced Long COVID, according to that same survey.
Putrino said his staff warned against having too many “scary slides” in his presentation, but he presented them anyway, including this one: For each acute COVID infection you survive, the risk of Long COVID increases.
He also said that even a mild acute illness can lead to brain damage.
“There’s no such thing as a harmless infection now that COVID’s on the block.”
The most common symptom of Long COVID, in over 90% of people, is post-exertional malaise – patients report being completely wiped out, or unable to get out of bed, he said.
“Their muscles are not working,” he said. “Their energy systems are broken. We have to fix it if we want them to be able to exert themselves again.”
About 25% of people have Long COVID so severely that they can’t work anymore, Putrino said. That’s estimated to have a $3.7 trillion economic impact, not to mention the effect on patients’ lives, he said.
Teams at Mount Sinai have been studying the cortisol and sex hormone levels in Long COVID patients, he shared.
They’re also working on a Long COVID test using blood biomarkers, which have successfully identified Long COVID patients over healthy patients.
How to Help Long COVID Patients
Putrino also shared guidance for how to diagnose and treat Long COVID patients.
There were many clinicians in the room from Cottage Health, Sansum Clinic, Santa Barbara Neighborhood Clinics, Public Health and other local medical institutions.
There are no approved treatments, but there are a lot of ways to stabilize patients, Putrino said.
“Listen to your patients and their needs,” he said. “People with Long COVID are the experts on Long COVID.”
He suggested pacing and lifestyle management (how to spend their finite amount of energy, hydration, avoiding things that make them feel worse); breath work; and autonomic rehabilitation.
One Long COVID patient attending the event said her doctor sent her to different specialists for each symptom, and Putrino said that fragmentation happens a lot.
Primary care physicians need to become more specialized in diagnosing and treating Long COVID since it’s so common, Putrino said.
Local Health Leaders Reflect on Pandemic
Before Putrino’s presentation, local health leaders reflected on their work and the community impact of the pandemic.
As of December, 840 Santa Barbara County residents have died from COVID-19-related causes.
