Note – this was published on July 13th, 2022 and updated on July 22, 2022. I will try to update this page with new information as I come across it. Image of SARS-Cov-2 virus from Wikimedia.
I can think of several jiu-jitsu training partners and several firefighters I’ve worked with who have been crippled by Long Covid. And I’m not unique; by now most people know someone who has been affected by Long Covid.
In the article and video below I go through some of the science of Long Covid, and then present a fairly simple, minimally disruptive method to reduce transmission rates in public spaces like gyms that’ll minimise the chances of your students and training partners from getting this debilitating condition.
I first published a very rudimentary form of this as a story on my Instagram (@stephan_kesting) and then as a video on my Youtube channel.
The video above is fairly short but covers my main points
Below I’ve elaborated on those main points with a ton of references including to many peer-review articles published in some of the top scientific publications in the world.
LONG COVID IS COMMON AND WE NEED TO TAKE IT SERIOUSY
1, Vaccination is still very effective at reducing death & hospitalisations but now that Omicron and the children of Omicron (BA.2, BA.4, BA.5, etc) are in circulation it’s now less effective at preventing the initial infection (The Lancet).
2, About 20% of all people who catch Covid (including mild cases) develop Long Covid (The CDC). Many other studies suggest that the incidence of Long Covid is higher; analyzing data from 31 different international studies found that 49% of Covid survivors had Long Covid Symptoms (The Journal of Infectious Diseases).
3, Vaccination doesn’t too much if you get infected. A huge study published in Nature, one of the most prestigious journals in the world, found that it only reduced the incidence of Long Covid by 15% (Nature).
4, Long Covid symptoms can be very severe go past the lungs. The virus is neuroinvasive & can affect most organ systems of the body.
- Cardiovascular damage: 5% of all people who had Covid end up with cardiovascular issues within 12 months including atrial fibrillation, myocarditis, stroke,, coronary disease & heart failure (Nature)
- Inability to Work: a study on 4,000 people in 56 countries found that 1 in 5 people are unable to work at the 6 month mark (The Lancet & Forbes).
- Diabetes: A massive study on 200,000 people published in The Lancet found that people who had had Covid were 40% more likely to develop diabetes within a year than people who had not (Nature & The Lancet).
- Suicide: A study in the British Medical Journal of 150,000 COVID survivors (hospitalized & not) found that had 10-15x higher risk of considering suicide after 1 year (British Medical Journal)
- Brain Damage: A study published in Nature found Covid infection is associated with reduction in gray matter & and brain size (Nature).
- More Brain Damage: A study published in Cell found mild respiratory Covid infection caused brain inflammation in both humans and mice (Cell)
- Blood Clots: A study of more than a million people found a fivefold increase of deep vein thrombosis, a 33-fold increase pulmonary embolism, and an almost twofold increase of bleeding in the 30 days after infection (British Medical Journal).
- Memory problems, depression, & anxiety are frequently seen in Long Covid (Experimental and Therapeutic Medicine & European Journal of Nuclear Medicine and Molecular Imaging).
5, The risk of Long Covid goes up with repeated infections. We do not yet know how much that risk increases each time but researchers are working on this (as this pre-print article indicates). The intelligent thing to do right now is to try and limit the number of times you get infected.
COVID IS AIRBORNE AND PRIMARILY TRANSMITTED THROUGH AEROSOLS
6, We now know that Covid is primarily spread through the air through virus particles, aerosols, & droplets exhaled while breathing, talking or yelling. The best resource here is this highly researched FAQ on Protecting Yourself from COVID-19 Aerosol Transmission written by 5 PhDs.
More research on airborne transmission is available from the CDC & Nature.
7, The easy way to visualise this is imagining that everyone around you is smoking a cigarette and that aerosols behave like cigarette smoke, remaining in the air for a long time. This makes air mitigation super-important; we need to move fresh air into our indoor spaces.
COVID MITIGATION: VENTILATION, CARBON DIOXIDE MONITORING, AND HEPA FILTRATION
Fortunately there are relatively unobtrusive & inexpensive measures that can be implemented.
8, How much ventilation is enough? We can quantify this by using Carbon Dioxide as a proxy variable.
CO2 isn’t harmful in itself, but humans exhale both CO2 & aerosols at the same time so if CO2 levels are high then aerosol levels will be high as well. Monitor CO2 levels with inexpensive, low maintenance detectors to determine whether ventilation needs to be improved.
I have tried different CO2 detectors and currently use the Aranet 4 CO2 detector which is easy to use, seems to be reliable and has the longest battery life.. I have no financial interests in that company.
9, Monitoring CO2 levels & then improving ventilation to lower those levels when needed is not a radical approach. For example, the school system in the UK currently equipping all classrooms with CO2 detectors.
- Gov.uk Press release: All schools to receive carbon dioxide monitors
- Curbing COVID-19 in schools (Imperial College)
- Teacher’s union guidelines for using CO2 detectors in classrooms
Guidelines from the National Education Union ofor ventilation and CO2 monitoring
10, Indoor spaces can often reach 1,500-2000+ ppm or if there are multiple people in a room. Several different targets for maximum CO2 levels have been proposed.
- U of T Epidemiologist Colin Furness recommends keeping indoor spaces at less than 600 ppm.
- In UK classrooms the target concentration is 800 ppm or less.
11, Ventilation can easily be improved in most situations by opening windows &/or increasing fresh air intake in the HVAC system
12, The inclusion of HEPA filters (which remove aerosols from the air) add an added layer of safety. Building a Corsi-Rosenthal box to filter air is even more effective.
A 3 STEP PLAN
1, Measure CO2 concentrations in common areas by installing CO2 detectors. These sensors typically last years & have very low maintenance costs.
2, If CO2 concentrations are more than 800 ppm improve ventilation by opening a window, doors, or changing HVAC settings
3, Use HEPA filters to filter aerosols out of the air for added safety
POST SCRIPTUM 1
Why do I do this? Why do I keep on drawing attention to myself and opening myself up to attacks by trolls?
I think this tweet of mine sums it up…
My response to the people who tell me I’d get more followers by taking a less controversial position… pic.twitter.com/K0XQzJ76ob
— StephanKesting (@StephanKesting) July 10, 2022
POST SCRIPTUM 2
My interview with U of T Epidemiologist Colin Furness covers many of these topics in detail and is available in audio format on my podcast here and/or in Youtube format in the video below:
POST SCRIPTUM 3
For activities that involve heavy breathing and close physical proximity (i.e. BJJ) I don’t think that ventilation is enough, especially during Covid waves.
As I write this (July 2022) the region in which I live is clearly in a wave if you look at the waterwater testing (what is watewater testing). Until those numbers subside I am using covid rapid tests before my training sessions and insist that my training partners do the same.
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