COVID has become a silent killer

Taking the disease for granted could be dangerous or even deadly

This is a reprint of my bi-weekly Salon column.

I don’t know what it’s like in your neck of the woods, but here in our small town on the edge of the Poconos, fall is finally here. It’s nippy in the mornings and doesn’t get above 60 on some days, and only rarely brushes against 70. The sun is a little lower in the sky every day; people are wearing their quilted Carhartts and fleece Patagonias, and lined boots can’t be far away.

Everyone is still going maskless inside and out. It’s been this way all summer. You go into the Turkey Hill quick-stop, or the Key Food, or even to one of the small shops on Main Street, and nobody is wearing a mask. I did see one at an art opening last week for “Andy in Nature,” an exhibit of photographs of Andy Warhol by Christopher Makos and ethereal flowers by Paul Solberg. There were probably 200 people packed into the soaring space atop Forest Hall, built in 1904 to house the Yale University Forestry School summer program. (The American conservation movement was born in this town, incidentally.) The mask at the opening wasn’t worn by yours truly;  I’have been as accepting as everyone else of the fiction that the COVID pandemic is over. 

It only seems that way. The average weekly case count here in Pennsylvania is about 2,500; that number has hovered between 2,500 and 3,500 daily since early in the summer. On Thursday, the number of new cases nationally was 100,524, with a weekly average of 50,000, down from a high of about 126,000 at mid-summer. While the case count has gone down since spring, the national death count has stayed more or less steady, at about 400 a day.

You have to Google to find those number, because deaths from COVID have gone the same way news about Hurricane Ian will go when all the hoopla is over and shots of splintered homes and flipped-over cars and pleasure boats perched on people’s front porches have left our TV screens.

COVID numbers are as hard to find as people wearing masks in the supermarket, even though health care experts say the current statistics are likely a “massive underestimate,” according to U.S. News, “as many relied on at-home tests that aren’t reported to health departments.”

The White House and the Centers for Disease Control are on the case, however. They predicted in the Spring that as many as 100 million American citizens could become infected with COVID over the fall and winter. That is nearly one-third of our population, folks, a whole lot of people by anyone’s count. John Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, was recently interviewed by U.S. News and said the 100 million new infections predicted by the CDC are possible because hundreds of thousands of cases are never reported to local health departments, meaning the CDC never gets the full picture.

“I don't think it's unreasonable to think that we've had about 100 million infections the past three months, so why couldn't that happen again in winter?” Dowdy said. If the death count stays at 400 a day — and it’s likely to get much higher given the predictions of a new surge in infections — more than 145,000 of our fellow citizens will die from COVID this year. That’s well below the 2021 total of 415,000, but it’s still a lot higher than the number of deaths from influenza every year. 

So, is COVID turning into just another form of the flu? You get a booster shot every fall and go about your life as usual? Not really, especially when you consider the effects of what has become known, for want of a better term, as “long COVID.” The stats on this mysterious chronic form of the disease are eye-popping. According to information gathered by the Census Bureau from adding new questions about COVID to its Household Pulse Survey, about 16 million Americans suffer from long COVID today, with as many as 4 million out of the workforce due to the long-term disease. 

A study by the Minneapolis Federal Reserve Bank backed up the findings of the Census Bureau. They determined that 21 percent of people who have contracted COVID still suffer from symptoms three months later, which the Minneapolis Fed defined as long COVID. About 70 percent of Americans have come down with the disease. Taking 21 percent of that figure yields a total of 34 million people of working-age who have or have had long COVID. The Fed survey found that 50 percent of people with long COVID eventually beat the disease, yielding a figure of 17 million, unnervingly close to the Census estimate of 16 million.

What does all this mean? Well, the Census Bureau survey estimated that lost wages from long COVID could be as high as $230 million. If you look at that very dry statistic more closely, you find that hundreds of thousands of mothers and fathers are out of work, suffering from what the New York Times recently described as “a constellation of debilitating fatigue, shortness of breath, neurologic symptoms and more that can occur even after mild infection…[and] racing hearts and brain fog so devastating that they were unable to work.” Those mothers and fathers are probably passing the disease along to their kids, and at the least aren’t there for them in the same way they were when they were healthy. The effects of the disease creep through the population in all kinds of ways and end up affecting us all, young and old.

Many long COVID patients seeking help at a recovery clinic in Boston, according to the Times, “were white and just over 70 percent were female.” But the disproportionate number of white female patients in the Boston clinic may be an anomaly caused by the economic status of those who got it together to present themselves for follow-up care. A study done in Los Angeles found that many of the patients who were infected with COVID and hospitalized “in the first pandemic wave, were disproportionately Black and Hispanic men…[and] Black and Hispanic patients had lingering symptoms such as fatigue and shortness of breath at similar rates as their white peers.”

Although long COVID doesn’t appear to discriminate, the Times reported that “at every turn, Covid-19 has revealed the fault lines in our health care system and society. It should come as little surprise that the care delivered in the wake of this virus threatens to further entrench pre-existing disparities.” That means people who can’t afford medical care, or those who can’t access it because they live in rural communities distant from clinics and hospitals, are not receiving adequate care to treat the symptoms of long COVID. They fall between the cracks in the health care system and end up as one of the 4 million people out of work due to the long-term effects of the disease.

It gets worse: CNN reported this week that Britain confirms the CDC estimates of a steep increase in COVID over the fall and winter. The study found that the U.K. “could be heading into a fall Covid-19 wave, and experts say the United States may not be far behind.” The Zoe Health Study, by following COVID since the earliest days of the pandemic in 2020, “has accurately captured the start of each wave, and its numbers run about one to two weeks ahead of official government statistics,” according to CNN. About 500,000 people use an app on their phones to report their daily symptoms and the results of home COVID tests. “After seeing a downward trend for the past few weeks, the Zoe study saw a 30% increase in reported Covid-19 cases within the past week,” CNN reported. “Our current data is definitely showing this is the beginning of the next wave,” Dr. Tim Spector told the network. He is a professor of genetic epidemiology at Kings College London.

On the home front, “We are seeing the increase in many respiratory viruses right now in the US, so it’s not a stretch to think that a new COVID wave (or ripple) will be coming soon,” Nathan Grubaugh, who studies the epidemiology of microbial diseases at the Yale School of Public Health, said in an email to CNN.

We got our boosters earlier in the week, and researching this piece has made me think again about following the crowd and going about life as usual when it comes to COVID. So, starting this weekend, when we grab our jackets and scarves to walk up the street to our local deli or stop by Lowe’s to pick up some mums and potting soil, I think we’ll be grabbing our KN-95 face masks, too. 

Who wants to be a silent statistic,  either in the hospital or the grave?