11/28/20: COVID-19 PATIENTS WHO INITIALLY HAD MILD SYMPTOMS ARE SEEKING MEDICAL HELP LATER FOR ‘RESURGENCE’ OF SYMPTOMS, DCDHHS REPORTS.

Eleven people who initially experienced only mild symptoms of COVID-19 sought treatment the week of Nov. 15-21 at the Outer Banks Hospital Emergency Department for a “resurgence of symptoms,” the Dare County Dept. of Health and Human Services reported yesterday in its first-ever followup of any of the 1,035 people who have tested positive locally for the disease.

These 11 people are among what Dr. Sheila Davies, Director of the DCDHHS, characterized in her Friday COVID-19 update, as a “concerning increase” in the number of people who are experiencing such a resurgence.

Dr. Davies, who is the county’s Public-Health Director, also reported that nearly one-third of the 1,035 COVID-19 cases that have been diagnosed in Dare County since March—332 of them—were diagnosed in November, as people “let down their guard” in observing safety protocols.

“Concerning” is a newly fabricated, and seemingly ubiquitous, adjective that we strongly dislike. It says nothing in this instance except that Dr. Davies is concerned.

Unfortunately, physicians and scientists, such as Dr. Mandy Cohen, Secretary of the N.C. Dept. of Health and Human Services, who describes COVID-19 metrics in North Carolina as “concerning,” have embraced this new word and its meaninglessness.

We would like to know from Dr. Davies: How many people infected with COVID-19 are seeking treatment in the ED for resurgent or lingering symptoms that are more severe? What symptoms are they experiencing? Are they people who were considered to have recovered because they tested negative twice for COVID-19? What is the average time gap between their initial symptoms and the current symptoms about which they are complaining? What do you make of this?

The next time Dr. Davies speaks to the symptomatic history of people infected with COVID-19, we trust the scientist who is entrusted with mitigating the damage caused to Dare Countians by the SARS CoV-2, will be more specific—starting with a profile of who these people are, vis-à-vis the disease.

We do not need their names or their places of residence, but we do need to be informed about the course of their illness.

As Beacon readers know, we have been writing lately about post-COVID-19 syndrome, which occurs after the acute phase of the illness has passed, and patients are considered to have recovered. It is also known as long COVID, and those who suffer from it are called long-haulers. (See The Beacon, 11/22/20, 11/24/20.)

There is no definitive set of symptoms to define post-COVID-19 syndrome, nor is there yet a defined duration, although symptoms are generally not considered lingering until three months after a patient’s diagnosis.

Post-viral syndromes, such as those that occur in patients who formerly had the Epstein-Barr or Ebola virus, are a well-known phenomenon. One condition manifested by these patients is myalgic encephalomyelitis, sometimes called chronic fatigue syndrome, ME or ME/CFS. As one sufferer described it, it is a I-can’t-get-off-the-couch fatigue because any exertion is exhausting.

The most common symptoms suffered by COVID-19 long haulers are profound fatigue, body aches, shortness of breath, and difficulty concentrating (“brain fog”), according to our medical-research sources. Other symptoms include chills, sweats, pain, fever, and difficulty regulating blood pressure and heart rate.

Post-COVID syndrome is a morbidity of COVID-19. A morbidity is simply a diseased state. It cannot be known yet if this morbidity is permanent.

Since the coronavirus pandemic began, the focus by public-health officials, governments, and the media has been on the mortality caused by the virus, not on possible morbidities. This was as it should be, with so many people stricken, tethered to ventilators, and dying, and with hospitals’ capacity to treat them all strained and exceeded. But we believe it is time now to enlighten the public about other potential harms that the virus may cause.

As we have said previously, this is a new virus that is causing what scientists call an emerging infectious disease. With emergence come uncertainty and a certain amount of scientific guesswork based on analogy to other respiratory viruses. But all analogies are, by their nature, flawed. (Hence, the early belief that wearing a mask would not be beneficial to the wearer.)

SARS-CoV-2, which causes the disease dubbed COVID-19, is unique. It is not the same as a strain of the influenza virus, SARS-CoV-1, which causes what is referred to as severe acute respiratory syndrome, or any other virus that has a known clinical history. It is not possible yet to know how this virus, which invades so many organ systems, may affect people who contract it and then recover. That scientific truth alone should make everyone cautious.

We look forward to receiving more information from Dr. Davies about patient followup.

BACK TO THE NUMBERS: 20 NEW CASES REPORTED LOCALLY ON THANKSGIVING

We were wrong in anticipating that the DCDHHS would take a break on Thanksgiving. Instead, it reported 20 new COVID-19 cases on its dashboard that day and seven more yesterday.

Eleven of the 20 people whose positive COVID-19 test results were in the Thanksgiving count are Dare County residents, and nine are nonresidents, according to the DCDHHS dashboard.

Five of the 11 new Dare County cases are in the 25-to-49 age group; three are in the 50-to-64 age group; two are age 65 or older; and one is a juvenile, age 17 or younger.

Five of the nine non-resident cases are also in the 25-to-49 age group, along with two in the 18-to-24 age group; one, age 50 to 64; and one age 65 or older.

Yesterday’s seven cases were concentrated in the 50-to-64 age group: Five people in that age group, of whom four were Dare County residents, tested positive for COVID-9. The remaining two cases were a local man, age 18 to 24, and a non-resident man, age 65 or older.

All 27 of the newly diagnosed people are in isolation.

Dr. Davies’s analysis yesterday of the means of contagion of the most recent COVID-19 cases continued to show that direct contact with an infected person predominates.

ON THE STATE LEVEL: The NCDHHS has reported 7,278 new COVID-19 cases during the past two days after taking a break for Thanksgiving. Yesterday’s total was 3,834, and today’s total is 3,444.

After COVID-19-related hospitalizations statewide dipped slightly yesterday, they climbed back up today and now number 1,840–a record high–according to the NCDHHS dashboard.

Eighty-one more North Carolinians have died of COVID-19 in the past two days, bringing the total number of COVID-19 deaths in the state since tracking began in mid-March to 5,219.

The NCDHHS reported a positivity rate of 7.3 percent yesterday and a positivity rate of 7.8 percent today.

New COVID-19 infections acquired over the Thanksgiving weekend will not be reported until the middle of next week, at the earliest.

Ann G. Sjoerdsma, 11/28/20

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