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Understanding Long COVID


In the latest issue of our magazine, Meghan O’Rourke surveys what doctors know so far about treating this scary illness—and how these studies could transform medicine.

For an estimated 10 to 30 percent of COVID-19 patients, recovery can take months. Known as COVID long-haulers, these patients suffer from symptoms such as severe fatigue and brain fog long after their initial infection.

In the latest issue of our magazine, the writer Meghan O’Rourke surveys what doctors know so far about treating this scary illness—and explains why long COVID “may change our medical system, our ideas about infectious disease—and the future of millions of Americans.”

1. The condition resembles a variety of known ailments.

It shares similarities with autoimmune disorders, dysautonomia, and more—“all poorly understood conditions that, evidence suggests, can be triggered by the body’s response to infections,” Meghan reports.

2. Breathwork looks like a promising part of treatment.

Long-COVID patients appear to breathe “shallowly through their mouths and into their upper chest.” When Mount Sinai introduced a breathwork program, “everyone in the pilot program reported improvement in symptoms like shortness of breath and fatigue” after a week, Meghan reports.

3. This story might be bigger than COVID-19.

“I wouldn’t be surprised if people are walking about with long Epstein-Barr virus, or long influenza,” one expert told her.

“Many researchers I spoke with believe that the race to understand long COVID will advance our understanding of chronic conditions that follow infection, transforming medicine in the process,” Meghan explains.

The British flag and Meghan Markle

What to read if … you’re still processing that interview:

“Meghan embodies all the negative stereotypes Britons have about our distant cousins across the Atlantic: too loud, too brash, too much,” our staff writer Helen Lewis argues from London. “It will be beautifully ironic if this American can, by speaking out, change the tone of royal coverage in Britain.”

One question, answered: If my parents are vaccinated, can my kids go maskless with them?

The CDC today released guidelines that suggested a vaccinated household could spend time indoors, without masks, with one other unvaccinated household. Our assistant editor Lora Strum explains what risks to consider:

Say your children are carrying an asymptomatic infection, not wearing a mask, and interacting with their vaccinated grandparents. People who are vaccinated and exposed to the coronavirus are unlikely to experience severe symptoms, require hospitalization, or die from COVID-19, experts told me. So the risk to your parents is lower than it has been.

Now let’s reverse that: This time, your parents are carrying an asymptomatic infection and interacting with your children, who are not wearing masks. It’s possible that your children could contract the virus. The coronavirus vaccines are very good at protecting against severe disease, but they do not eliminate the risk of catching or carrying the virus.

The risk that your parents would transmit the virus is lower than it would have been pre-vaccination, although we don’t know how much lower. Emerging data suggest that “even if a vaccinated person is asymptomatically infected with the coronavirus, they are less likely to transmit it to someone else than someone who is unvaccinated with asymptomatic infection,” Joshua Barocas, an infectious-diseases physician at Boston Medical Center, tells me. (That also means that your vaccinated parents are less likely to become super-spreaders if they catch an asymptomatic infection from your kids.) Wearing a mask, however, would further reduce the risk of transmission.

Children under 18 are less likely to suffer severe infection, experts say, but they can still spread the disease. If they caught SARS-CoV-2 from your parents, your children could potentially carry an asymptomatic infection to anyone in their bubble—you, their friends, or other caregivers. So if you do decide to accept the risk of going mask-free, make sure your kids still mask up afterward, to protect others.

For the latest on life after vaccination, read Rachel Gutman’s story on how to navigate America’s awkward, semi-vaccinated months.

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