Taking pandemic sequelae seriously: from the Russian influenza to COVID-19 long-haulers

• Published in: The Lancet 2020-10, Vol.396 (10260), p.1389-1391
• Main Authors: Honigsbaum, Mark, Krishnan, Lakshmi
• Format: Article
• Language: English
• Subjects: Betacoronavirus; Causation; Chronic illnesses; Complications; Coronavirus Infections - complications; Coronaviruses; COVID-19; Critical care; Disease; Epidemiology; Fatigue; Haulers; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Illnesses; Infectious diseases; Influenza; Influenza, Human - complications; Influenza, Human - history; Long COVID; Medical research; Pandemics; Pandemics - history; Patients; Physicians; Pneumonia, Viral - complications; Respiratory diseases; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Signs and symptoms; Social networks; Suicide; Suicides & suicide attempts; Victorian period; Viral diseases
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(20)32134-6

The result was that by the middle 1890s Russian influenza was being blamed in England for everything from the suicide rate to the general sense of malaise that marked the fin de siècle, and the image of a nation of convalescents, too debilitated to work or return to daily routines, and plagued with mysterious and erratic symptoms and chronic illnesses, had become central to the period's medical and cultural iconography. Some 10 months into the pandemic sparked by the emergence of severe acute respiratory syndrome coronavirus 2, COVID-19 is revealing itself to be similarly protean, comprehensive, and persistent, and a new category of patients is emerging, colloquially known as COVID-19 “long-haulers”. [...]as mitigation strategies have provided some respite for critical care physicians ahead of a resurgence in infections, it appears that COVID-19 is a disease with a bewildering array of complications. [...]the designation of mild disease in some patients risks conflating self-resolving illnesses of short duration with persistent and, according to some long-hauler accounts, emotionally and psychologically debilitating morbid responses. Furthermore, in the late Victorian period ideas of infectious disease causation were in a state of flux and laboratory medicine had yet to supplant older environmental and epidemiological understandings of disease and the close observation of patients' symptoms, particularly in the UK where physicians and medical researchers were suspicious of the “new” German bacteriological methods.