One of the factors that determines how vigorously we respond to COVID is the seriousness of the disease. This has been a contentious point from the very beginning of the pandemic. First the COVID minimizers insisted that it was like the flu, which would only have been true if the flu were twice as transmissible and ten times as deadly. Now they're saying that the omicron strain is pretty much a cold.
If COVID were always a short-term respiratory illness, then it would be silly to make a big fuss about it. But I am still going to attempt to avoid COVID. I'm not especially worried that it's going to kill me at this point, but I am concerned about the degree and the duration of COVID-associated morbidity. Even if I were to develop a mild case myself, I hate the idea that I could spread a disease with the potential to cause significant disruption to someone else's life.
For a subset of patients -- most often but not always those with risk factors -- COVID is associated with significant morbidity. Let me tell you a story to show you what I mean. I know a woman whose case of COVID landed her in the hospital. Although she was my age, healthy and active prior to her COVID diagnosis, the virus attacked her heart and left her with atrial fibrillation.
Atrial fibrillation is one of the serious arrhythmias. It disrupts the steady, strong coordinated contraction of the heart and allows blood to pool in the atria. When blood isn't moving steadily, it clots. If you spin up a blood clot in your heart and push it out into your blood vessels, bad things will happen. Atrial fibrillation significantly increases your risk of a cardiac event and it quintuples your risk of a stroke. If you say "untreated atrial fibrillation" to a doctor, the doctor will grimace and wince.
So they impressed upon her the urgency of treating the arrhythmia. They tried to fix the problem with a cardioversion; the process of administering electrical shocks to her heart was unsuccessful as well as much more unpleasant than advertised. Next they did an ablation, running a catheter up from her groin to her heart and burning out the problematic wiring. I doubt that any of these healthcare expenses are tallied up anywhere as COVID-related costs, but they were the direct result of her COVID infection.
She was on blood thinners all through the attempt to get the arrhythmia under control, because nobody wanted this 51-year-old woman to throw a clot. When you get a prescription for blood thinners, the pharmacist warns you about the potential side effects, but the events that ensued still took her by surprise. At age 51, she thought her ovaries had closed up shop. It had been six months since they had last alerted her to their activities, but suddenly they were back in action with a torrential vengeance. We're talking go-build-yourself-an-ark levels of nonsense.
Because? Blood thinners. Because? Atrial fibrillation. Because? COVID. If you're telling your blood to clot less effectively, torrents may result.
She got home and tried to run upstairs to grab some Advil and start a load of torrent laundry. But the situation was bad enough that instead she blacked out on the stairs, and hit her face as she fell.
Guess what happens if you fall and hit your face while on blood thinners? Massive facial bruising, that's what. Appalling facial bruising, of the sort that makes everyone who interacts with you for the next two weeks say, "Are you...safe...at home?" to which you reply, "Oh, I'm fine; I just fell down." ...Sure you did, they think to themselves, because no one bruises like that from a simple fall.
Unless they're on blood thinners, because atrial fibrillation, because COVID.
In the big picture she has had a good outcome. The doctors did eventually get the atrial fibrillation sorted out. The COVID fatigue did eventually abate. The bruises did eventually recede. But also...dang. That was a lot of hassle and expense and medication and time off work and worry and intrusive questions and avoidable suffering.
That doesn't sound very much like a cold to me.
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