COVID, Quickly, Episode 10: Long Haulers, Delta Woes and Barbershop Shots

Tanya Lewis: Hi, and welcome to COVID, Quickly, a Scientific American podcast series!

Josh Fischman: This is your fast-track update on the COVID pandemic. We bring you up to speed on the science behind the most urgent questions about the virus and the disease. We demystify the research and help you understand what it really means.

Lewis: I’m Tanya Lewis.

Fischman: I’m Josh Fischman.

Lewis: And we’re Scientific American’s senior health editors. Today, we’ll talk about clinics for long-haul COVID patients …

Fischman: The rise of the Delta variant and what you can do about it …

Lewis: And using barber shops to get vaccines to communities that need them most.

Lewis: Early in the pandemic, there were some reports of people with odd symptoms such as fatigue and memory issues that continued long after their acute infection. Now these “long haulers” are getting some specialized help.

Fischman: More and more data is coming out about long COVID: serious physical and mental effects that can last half a year after people first get infected. The latest study came out last week in the journal Nature Medicine. Researchers looked at health records for a few hundred people in Bergen, Norway. That was almost everyone in the city diagnosed with COVID during several months in 2020. Overall, 61 percent of the group had symptoms six months after they were first infected.

Their most common problem was fatigue, followed by difficulty concentrating, disturbed smell or taste, memory trouble, and a hard time breathing. Two striking things about these patients. One was that many had just a mild or moderate case of COVID at the start. The other was that a lot were young, aged 16 to 30. Other studies have reported a similar symptom cluster, such as one by University of Washington researchers that found about 30 percent of people with COVID had these lingering troubles. 

Lewis: Do doctors know the cause of these problems?

Fischman: That’s still a mystery. Some people have organ damage related to the virus infection but some do not. Doctors are trying to figure out how to treat them. SciAm contributor Melba Newsome wrote this week about new COVID recovery clinics that treat the whole patient, rather than making people run from a lung doctor to a neurologist to an immunologist. Patients say the coordinated care helps, and they feel more hopeful since they’re being taken seriously and not dismissed as crank cases. The NIH also is taking it seriously, spending about a billion dollars to study the disease. It now has an official jawbreaker of a name:  Post Acute Sequelae of SARS-CoV-2 Infection.

Melba notes, however, that there is a racial imbalance showing up at these clinics. Overwhelmingly, the people referred there are white. But people of color are more likely to get COVID. So access barriers, such as lack of health insurance, are likely keeping care away from many people who need it. It’s yet another burden added to the health inequality already hurting people in the pandemic.

Fischman: Let’s talk about the Delta variant. It’s spread to more than 70 countries, and is now the dominant variant in the U.S. How worried should we be?

Lewis: The Delta variant is definitely concerning—particularly for unvaccinated people. It’s already causing another surge in the U.K., where it makes up the vast majority of cases. And a company that’s been tracking virus sequences in the U.S. estimates this variant now accounts for about 40% of cases here—making it more than twice as prevalent as the Alpha variant that was previously the most common.

As you’ve noted before, research from the U.K. suggests Delta is at least 40 percent more transmissible than Alpha, and almost twice as likely to result in hospitalization. The data are a bit murky on whether it actually causes more severe disease or not, though—so far, it hasn’t caused a huge uptick in hospitalizations or deaths in the U.K.

Still, it’s spreading widely in the U.S., where only about half the population is vaccinated (far less in some areas). Experts say it’s not likely to cause another devastating nationwide surge like the one last winter, but it will probably lead to flare-ups in states where fewer people have been vaccinated, such as Alabama or Mississippi. And the risk could increase in places where hotter temperatures force people to spend time in air-conditioned indoor settings where the coronavirus can easily spread.

Fischman: This sounds pretty grim. What can we do about it?

Lewis: The good news is that the vaccines work. More data from the U.K. show that two doses of the Pfizer vaccine were 96 percent effective at preventing hospitalization, and two doses of the AstraZeneca vaccine were 92 percent effective. But you need both shots—a single dose of AstraZeneca was only 71 percent effective at preventing hospitalization, and one dose of both vaccines was only around 34 percent effective at preventing infection. We don’t yet know how well the Johnson & Johnson vaccine works against the Delta variant, but it’s likely to provide some protection.

Meanwhile, the World Health Organization is urging even vaccinated people to keep wearing masks and practicing social distancing, just to be on the safe side given how much virus is still circulating. The CDC has not changed its guidance, though – it still says vaccinated people don’t need to mask up unless they want to. But with Delta being so transmissible, it couldn’t hurt to err on the side of caution.

Lewis: There are still plenty of people who are skeptical about getting vaccinated—sometimes for valid reasons. Now, some efforts are trying to build trust by reaching people in their neighborhoods.

Fischman: The rate of COVID vaccinations among people of color lags behind that of white people. Access barriers are one reason, and so are negative experiences with the medical profession that breed distrust. Black-run barbershops and hair salons may be able to counter some of this, says Stephen Thomas, who directs the University of Maryland’s Center for Health Equity. For the last 15 years, Thomas has been researching the trust placed in barbers and stylists by their communities, and says its a powerful thing. He’s been training these people to help educate their clients about ways to prevent diseases such as diabetes.

Now this expertise is helping with COVID vaccines. Thomas’s group is part of a White House “Shots At The Shop” campaign. Barbers and stylists are getting trained to talk to people about the benefits of vaccines versus the risks, building on long relationships. These conversations, which can happen while snipping and combing, are not lectures. And they’re not magic and don’t convince all doubters. But they do have an effect on many people.

Some shops become pop-up vaccination sites staffed by local health clinics, solving access problems by bringing free vaccines into the neighborhood. Thomas’s project is called The Health Advocates In-Reach and Research. That abbreviates, naturally, to HAIR.

Lewis: Now you’re up to speed. Thanks for joining us.

Fischman: Come back in two weeks for the next episode of COVID, Quickly! And check out SciAm.com for updated and in-depth COVID news.

[The above text is a transcript of this podcast.]



Source link