‘Long covid’ and universities

When covid first emerged as a public health emergency, there was an appropriate focus on avoiding hospitalisations and reducing mortality. It was assumed that for most people covid would lead to a brief period of ill-health with a swift recovery. As the pandemic progressed, it became apparent that many people, including those who get over the initial infection easily, ended up with symptoms lasting months. There is no treatment available and many have not yet recovered after more than 6 months. As will be set out below, the reality of ‘long covid’ is now acknowledged in the UK political establishment, the global scientific community, and among global policy actors. This renders a failure to take the risk of ‘long covid’ into account when making decisions about return to university as negligent. In the absence of an effective test and trace system, while the virus is still out of control, it is putting students, staff, and local communities at unknown risk of currently untreatable chronic illness. This risks creating a generation of British young professionals that are unable to compete internationally and it risks leaving university staff unable to work.

Risk of ‘long covid’ is real

In a presentation made to the Health and Social Care Committee on the 8th September 2020, Health Secretary Matt Hancock acknowledged the reality of ‘long covid’. As part of a longer statement on this, he observed: ‘It doesn’t matter how serious your infection was initially, the impact of long covid can be really debilitating for a long period of time.’ The American infectious disease expert Anthony Fauci has been acknowledging the reality of ‘long covid’ since July, but in a recent interview for the British Medical Journal, he observes: ‘there have been some studies, one from Germany and now a more recent one from the US, on cardiovascular effects, even on people without symptoms who’ve recovered biologically’.

Research into ‘long-covid’ was partly driven by the personal account of Paul Garner, professor of epidemiology at Liverpool School of Tropical Medicine. Ninety-five days after the onset of symptoms, he wrote ‘I am unable to be out of bed for more than three hours at a stretch, my arms and legs are permanently fixing as if injected with Szechuan peppercorns, I have ringing in the ears, intermittent brain fog, palpitations, and dramatic mood swings.’ There have now been many scientific papers published on the reality of ‘long covid’. In the UK, Trisha Greenhalgh has been at the forefront of this. In early August, she was the lead author on a paper which presented the results of one of the first large studies on long covid. It observes that approximately 10% of those who contract the virus may be let with symptoms months afterwards. The paper describes a ‘multisystem disease, sometimes occurring after a relatively mild acute illness’.

In August, the Director General of WHO, Tedros Adhanom Ghebreyesus, had a public hearing with people affected by ‘long covid’. He responded: ‘we hear you loud and clear, and we are committed to working with countries to ensure you receive the services you need, and to advancing research to serve you better.’ The WHO regional director for Europe stated: ‘While young people are less likely to die than older people, they can still be very seriously affected, this virus affects organs throughout the body’.

As set out above, the political community in the UK, the scientific community, and the global health policy community, now acknowledge the reality of ‘long covid’. In patient testimonies, we can see that it affects people that are otherwise young and healthy. There are countless testimonies from people who are the same age as university students, who report that after being healthy and sporty prior to infection, they are now still unrecovered six months after initial infection (e.g. here, here, here). University teaching can, for the most part, be delivered successfully online. Putting students, staff, and communities at unnecessary risk of contracting covid in this context is negligent.

Plans to support those with ‘long covid’

In a context where students have been encouraged onto campus, in-person teaching is being required, and outbreaks of the illness are likely, it becomes even more essential to put plans in place for supporting those who end up with long-lasting effects of covid. This includes supporting access to health care, putting mechanisms in place to allow for long-term absences from work, and examining obligations in terms of compensation. Rest is identified as a key treatment for ‘long covid’. This means that messaging to staff and to students must emphasise that if they contract covid, they should pause their work and studies and rest as much as possible, with the reassurance that this will be supported by the university.

The only safe, effective, and therefore reasonable way to reduce the risk of long covid in the present is for the University to move all teaching and working to online as the default option.