Covid symptoms change

well you're most welcome to today's talk friday the 26th of august now we're going to be looking at the changing symptoms that we're seeing in covid19 at the moment and also the changes in long covered changes partly because of the change in variant but also because of the developing immunity so let's just jump straight into that with some zoe data here from tim specter now we're very much on the ba 5 wave at the moment we certainly know that ba 5 is by far the predominant variant just now and uh early data from tim spector's team is saying that the omicron ba5 is less likely to affect the brain and as we'll see in a minute the sort of neurological presentation of long-covered is the most common just now so hopefully with the omicron we're seeing early signs that there's um less long covered going to be developing now tim spector says the r value is one at the moment um i think he's being probably slightly pessimistic though i i agree it's probably greater than 0.9 but maybe not quite as high as one because if we look at his own data here we can see that the decline is leveling off but it's still going down so i'm still expecting to see some reduction which means that the r value is probably uh roughly uh 0.9 at the moment but you can uh take whose opinion you want on that but as far as i can see it's still going down slightly and as we noted yesterday the united states is just a little bit behind what's happening in the united kingdom now the new daily cases are still high we are in an endemic situation of course there's a lot of there's a lot of cases around um so new daily case is still a hundred thousand current prevalence 1.6 and this is symptomatic infection so there's actually probably about two million people with stars coronavirus ii infection in the uk today it's still very prevalent but so thankfully it's it's getting much much less serious which is why we're going on to endemicity and why i'm pleased that we're going back to living with covert for example we noticed that uk hospitals are not going to be testing asymptomatic emissions for covert as from next week which i think is a good idea what why why do we need to know if it's a mild if it's going to be mild for most people i mean the answer to that is for some people it can be more severe but it is a very small minority and that minority is getting smaller from the data that we have which is good infections less likely to cause um symptoms now this is the amount of symptoms presented so that's from early july up until now which is late august so we're talking about uh july august here fewer symptoms and milder presentation and part of this is ba 5 may have a lower viral load or people have got more immunity so they're able to lower their own viral load more quickly and this is why there seems to be an increasing proportion of uh we call them the lateral flow tests in the uk some people call them the rapid antigen tests but there's more of these tests coming back negative probably indicating that the infections that many people have are associated with the lower viral load and i actually suspect this is more due to developing immunity more so than the nature of ba5 itself so it's all it's all pretty good news really uh lateral flow is less likely positive now here's the change in the symptoms that the uh the the zoe team have identified uh again as we say basically in the last few weeks so cough um no phlegm about five percent less people getting that so that's the reduction of about five percent in that one fatigue well that's about five and a half percent uh dizzy lightheadedness less people getting that loss of smell less people getting that with ba5 chest pain and tightness less people getting that shortness of breath less people getting that and of course shortness of breath is a really important one because that's one of the most important one of the main reasons that people are being admitted to hospital so another reason why hospitalizations are going down um ultra altered sense of smell again going down down by about what 15 so shortness of breath there um probably about just over 12 percent of people less 12 less reports of that which is good now it just to balance the picture a bit the office for national statistics have actually noticed that a few symptoms have increased since june over the last three months so they think there's more abdominal pain fever sore throat and muscle ache according to the rns data so are we seeing a general reduction in the number of symptoms with milder symptoms yes we are but within that reduced amount are we seeing a change in symptom profile yes we are not surprising because of the ba5 variant and the developing immunity mostly due to the developing immunity i believe june 2022 asymptomatic this is office for national statistics data 61 reported any symptoms in other words 39 were asymptomatic while still testing positive and the office for national statistics is using the uh the pcr tests to see if people are positive or not so this is fairly uh fairly convincing data so good chunk about 40 nearly are asymptomatic now um moving on to long covered briefly um we have looked at this before but there's three distinct types of long covered uh identified now clusters of neurological symptoms so things that coming from the central nervous system basically so fatigue brain fog headache now these were most commonly after the alpha most common after the alpha and delta variant so people presenting with neurological type long coverage mostly had alpha and delta type virus second most common respiratory symptoms chest pain shortness of breath could point to lung damage the longer that these go on for the more likelihood it is this tissue damage now this was the largest cluster at the start of the pandemic now at the start of the pandemic of course this was the original wuhan virus so is it that the wuhan virus is more likely to cause the respiratory lung coverage or is it the fact that people weren't vaccinated uh in the early part of the pandemic i don't think we can differentiate from that from the data that we have but an interesting question and uh diverse range of symptoms is the third group so the third group is kind of everything else heart palpitations muscle aches and pains changes in skin and hair long covered cases in omicron no firm data but we do know it's less likely to occur 20 to 50 percent less likely to occur and the omicron variant this is this is claire steves who's done a lot of the research on um on this the omicron variant appears to be substantially less likely to cause long coffee than previous variants good news but still one in 25 who catch coffee go on to have symptoms for more than four weeks now this isn't surprising viral infections can give you symptoms for more than four weeks it's the one that's lasts for longer that we're more concerning now we do have the latest uh symptom list from um the copper symptom of data here uh this is this is current um and of course ba5 now with ba5 at the moment we don't we don't know for sure but i suspect we're dealing with a 90 plus of cases of ba five in the uk at the moment in the u in the united states we know it's about 88 89 percent because they're now casting is more up to date than the uk but uk data at the moment sore throat 63 percent get a sore throat now this is 63 percent of people that become symptomatic it's not 63 of cases because we know that 39 of cases were asymptomatic and now is probably getting nearer well over 40 i think we can safely say that patients are asymptomatic because we're getting more asymptomatic cases as time goes on so of those that develop symptoms 63 get a sore throat 51 get a headache blocked nose 48 cough with no phlegm 46 running those 45 cough with phlegm in other words what we call a productive cough where you're actually coughing something up 44 horse voice 44 sneezing 39 then fatigue muscle pains dizziness altered smell swollen neck glands the lymph adenopathy sore eyes chest pain and tightness 14 fee event down to 13 loss of smell down to thirteen percent shortness of breath as was said nicely down to twelve percent earache and hot flushes and uh that is the whole list of current symptoms uh and of course i'll put all of those in the uh all of that list i'll put them all in the description so you can see them in more detail now just to finish looking at long covered from the office for national statistics um data slightly well i don't know it's not different it's just um it's cumulative it adds together quite nicely to give us a fuller picture at the moment 1.8 million people in the uk reporting to have long covet at the moment that's the prevalence 2.8 of the population pretty high of course now the good thing about it is it's going down slightly but not a lot remember this is self-reported long coffee this is not based on any definitive medical diagnosis something nothing you can hang your hat on it's self-reported and here we see that the so this is um the the uh the prevalence here and we see it's kind of so what is that that that's uh that's the fourth of the fourth uh 2021 there so that's from uh april 2021 more up to up to date data and we see that the amount of long-covered went up quite consistently but now we do see the self-reported long-covered is starting to go down and from the data we have about omicron i think we can expect that to go down further but there is nuance to um the long copper let's just look at that as well of the 1.8 million people reporting long covered 81 symptoms lasts for at least 12 weeks 43 at last a year and now as time going on 21 lasts for two years now the longer people have long covered the more i'm concerned that some of the cases and i think it's going to be a big minority but some of them are caused by tissue damage which may not recover fully may not recover fully um if there's actual damage to the architecture of the lungs or damage to the myocardium of the heart unfortunately that's not going to fully uh regenerate so there could be some long-term consequences of long-covered indefinitely basically into the future uh symptoms adversely affected the day-to-day activity in 1.3 million people so 1.3 million people at the moment saying they are not able to carry on with their normal um day-to-day activities or at least the long-confidence is is um um affecting their day-to-day activities now long-covered symptoms fatigue shortness of breath loss of smell muscle ache are the ones that most people are complaining of so that would be in the neurological type wouldn't it whereas the shortness of breath is more in the respiratory type the loss of smells more in the in the neurological type whereas the muscle ache is kind of in the last section where it's sort of everything else is included now self-reported long-covered is more common in now this is quite interesting 35 to 69 year olds okay so it's not the old it's not the young well i suppose 69 is quite old but it's not the very old and very young more common in females more common in more deprived areas more common in people working in social care now that one's a bit of a mystery and more common in people with other self-limiting conditions other people with health limiting conditions or disabilities now this is the last bit here now this last bit here the office of national statistics wrap this up in in a double negative so you've got all of this information in the office for national statistics which is really easy to understand it really is superbly communicated and then you've got this bit about who's more or less likely to get it in double negatives and it took me ages to to work out what it means so why would they want to communicate so clearly for most of it and then so communicate so badly when they're communicating this so i've decoded what they've said so um self-reported long covered uh is less common so there's less self-reported long coverage in uh active students people that are retired and people looking for paid work now students of course want to get their qualifications the retired get the pension anyway hopefully uh people looking for paid work need the money so they're looking for work so long coverage less common in these people and of course these are the people that if you like can't afford to have long coverage so firstly why did the office of national autistics wrap this up i think i think the office for national statistics are reluctant to say that pump some people are probably using long covered as an excuse to avoid normal duties now i am not taking anything away from the huge number of people that are seriously suffering seriously suffering with long coverage but here the officer national statistics seem to be implying that there are some and they don't give a figure but there are some who um perhaps could be uh could be carrying out more normal duties than they are so um that's what they seem to be saying there pl please don't think i i'm demeaning people that are genuinely ill they're not we've interviewed them on this channel some people are genuinely suffering uh but it seems that other people uh maybe aren't suffering as much as they are intimating so there we are changing symptoms overall reduction in severity long covered whether it's genuine or not the genuine cases are enough to cause significant morbidity for some time to come worried that some of these aren't going to go on for long periods of time now so that's where we are at um basically people are getting less severe covered less symptoms less severe symptoms that's the general trend as immunity progresses and i'm still watching this closely but so far ba 5 hasn't been replaced that is there's no variant seems to be coming on to replace ba5 as ba5 replace ba4 and as that replaced ba2 and as that would please replace ba1 omicrons and has that replaced delta and his delta replaced alpha and his alpha replaced the original wuhan strain so i'm still quite optimistic that things are going to be pretty good this winter and cases are going to go down so um i'll just leave you with the best uh one of the best photos uh sent in so far into this channel that this one goes way back to 2020 but it's such a good one i think i'll show it so uh someone saw a similarity between one of my mannerisms and uh that's wallace isn't it grum it's the dog so that that one's uh that's pretty witty so that's good to finish on and uh on that optimistic note thank you for watching

Channel: Dr. John Campbell

Views: 728,423

Keywords: physiology, nursing, NCLEX, health, disease, biology, medicine, nurse education, medical education, pathophysiology, campbell, human biology, human body

Id: cGpnFFH3pnM

Length: 17min 21sec (1041 seconds)

Published: Fri Aug 26 2022