A Conversation About Long COVID
PROF CHANG: Hello, I'm Curtis Chang, I'm a Theologian and former Pastor. And we here at Redeeming Babel have produced a series of videos to help Christians think about the vaccine. And one of the ways that God helps Christians think, is through trusted leaders and our faith and medical community. And one such leader is Dr. Steven Finkbeiner. Dr. Finkbeiner is the Director of the Gladstone Institutes, a leading research center, and a professor at the University of California, San Francisco. He's also a committed Christian, having attended Wheaton College as an undergraduate, and as a leader at Evangelical Covenant Church. Dr. Finkbeiner's laboratory has investigated COVID-19's effects on the brain, and especially this phenomenon known as long COVID. Dr. Finkbeiner welcome so much, thanks for joining us.
DR. FINKBEINER: Thank you Curtis, it's a pleasure to be here.
PROF CHANG: Dr. Finkbeiner, we ask all of our guests the same opening question, which is, have you gotten vaccinated yourself? I think I know the answer to this.
DR. FINKBEINER: Yes, my wife and children and I have been fully vaccinated. We experienced some of the temporary common side effects including soreness at the injection site, muscle aches and pains and fever. What I tell people is that although we call these side effects and nobody enjoys them, they really are good signs that the vaccination is working the way it was supposed to work. There are signs that the immune system is responding and learning, so it will be ready if it encounters the actual SARS-CoV-2 virus, and able to prevent it from causing severe COVID disease.
PROF CHANG: That's a super helpful explanation and advanced kind of explanation of what people are gonna experience. So you've studied this phenomenon called long COVID, explain for us what exactly is long COVID?
DR. FINKBEINER: Yeah, so long COVID refers to symptoms experienced by those who've been infected by the SARS-CoV-2 virus, which persists long after the initial illness. The initial illness lasts days to weeks, but symptoms of long COVID can last much, much longer.
PROF CHANG: And how serious is it? I mean, how long does it last? And also, how widespread is long COVID?
DR. FINKBEINER: Yeah, long COVID is actively being studied, so we don't have final answers yet, but we've learned a number of things about it. Some of the symptoms are similar to those that are common during the initial infection, and those include tiredness, fatigue, headache, loss of smell or taste, cough, difficulty breathing shortness of breath, joint and muscle pain and fever. But other symptoms are more alarming and debilitating including chest pain and heart palpitations. The neurological symptoms concern me and include depression, anxiety, difficulty concentrating and thinking. These symptoms can at first appear weeks after infection and last at least weeks or months. We don't have accurate information yet on how widespread long COVID is, and the estimates range widely, probably somewhere between two and 20% of people with COVID-19 will develop it. But some have reported that up to 30% of patients may develop the neurological symptoms of long COVID.
PROF CHANG: Wow, so those are really high numbers. And I know that many people have already, millions of people have contracted COVID, and experienced it as no big deal. And they may also think that they're already protected, because they've been infected in the past. What is the risk of long COVID for these people, for people who in the past already got COVID?
DR. FINKBEINER: Yeah, remarkably, long COVID can happen to anyone who has had COVID-19, even if they have had mild symptoms or no symptoms at all during the initial illness. The demographics of long COVID are not well-established, but there's some evidence that it tends to affect folks who are teenagers up to their fifties with it being less common for much older people. But remember, older people are also at increased risk of dying from COVID. So there may be fewer who survive to develop long COVID.
PROF CHANG: Well, those sound like really serious conditions that raises the next question, does getting vaccinated protect you from long COVID?
DR. FINKBEINER: Yeah, Curtis, well, there's good news there. Vaccination is highly effective. The best estimates are that the vaccines are 95% effective for preventing people who are infected by SARS-CoV-2 Virus from developing severe symptoms of COVID-19 disease and would be expected to prevent long COVID. Also, we normally think about vaccination in people who have never been infected, but interestingly, about a third of patients who were infected and developed long COVID reported improvement in their symptoms after vaccination. So it may not only protect you from long COVID but vaccination may also prove to be a treatment for some.
PROF CHANG: Dr. Finkbeiner, I want you to help us think about risk, because some people are concerned about the risk of potential side effects from the vaccine, and that's why they're hesitant about taking the vaccine. So how should somebody weigh the risk of potential vaccine side effects down the road, against the risks of remaining unvaccinated?
DR. FINKBEINER: Yeah, that's a great question, Curtis, and it's an important one. At this time, the most common side effects from vaccination are relatively minor, and are common side effects associated with immunization. As I mentioned earlier, these symptoms are an indication that the immune system of the person getting vaccinated is functioning well. In fact, a lot of people don't realize that when you get a cold or the flu, a good deal of the unpleasant symptoms that they experience actually come from the reaction of their own immune system, as it fights viral infection rather than the direct damage by whatever virus is causing the infection. So experiencing these symptoms after vaccination is a sign the immune system is learning to recognize SARS-CoV-2, like it should, and developing protection against COVID. That said, rare but potentially serious side effects of abnormal blood clotting have been reported for the AstraZeneca and Johnson & Johnson vaccines. But I think it's important to put this in perspective. These side effects are rare and treatable, and it's considerably more common to develop abnormal blood clotting from COVID infection, than from vaccination. For almost everyone, the risk of death and disability of COVID infection will be much, much greater, than the risk of serious side effects of vaccination, given the safety and efficacy profiles of the vaccines. I think it's sometimes hard for our brains to understand and compare risks, especially if the events are uncommon, but unless people get vaccinated, they will remain at risk for COVID infection. And the SARS-CoV-2 virus is not going to disappear. If SARS-CoV-2 becomes endemic as some have suggested, then the risk of serious infection will always be present for people who aren't vaccinated. And if anything, some of the new generic variants of COVID that have emerged have made the virus easier to transmit and even more lethal. Also, there have been multiple reports of people who've been infected more than once. This suggests that having a previous infection does not necessarily protect everyone from another infection in the future. And so vaccination is recommended for people, even if they've already had COVID.
PROF CHANG: So, bottom line and for us as a Christian and as a doctor, what is your message to Christians who are still hesitant about getting vaccinated?
DR. FINKBEINER: Yeah, absolutely. Everyone listening should discuss the matter with their primary care physician first in case there are any special circumstances that need to be addressed. But for the vast majority of people, it's my professional opinion that they become vaccinated. In addition to the personal benefits, they will help to love and protect those around them which is something all believers can be excited about.
PROF CHANG: Dr. Finkbeiner, thank you so much for coming here and sharing your expertise, as well as your faith perspective. We're really, really privileged to have your expertise. Thank you.
DR. FINKBEINER: It’s been my pleasure, thank you.