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Prepare for a 'more contagious' virus, says Vanderbilt University doctor

Dr. Wes Ely, Vanderbilt University Co-Director of the Critical Illness, Brain Dysfunction and Survivorship Center, talks about the effects of 'long-COVID' and assesses what the Omicron variant's impact might be.

Video transcript

- We're keeping an eye on the markets right now for you. I want to show you as we head toward the closing bell where we stand. The Dow is off 144 points. NASDAQ is off 163 points. The S&P 500 is down 11 points. This, of course, after the news that the United States, the CDC, has identified the first case of COVID-19 that is caused by the omicron variant. We're going to talk about this with Dr. Wes Ely, Vanderbilt University's co-director of the Critical Illness, Brain Dysfunction, and Survivorship Center.

Also want to bring in our correspondent Adriana Belmonte. Good to have you both here. Doctor, before I turn it over to Adriana, because we had originally wanted to talk with you about these long haul symptoms that COVID-19 patients who have beat the disease are experiencing, but I've got to ask you, you hear about omicron now in the United States, what are you expecting? What are you thinking?

WES ELY: I think we're going to see a virus that is more contagious than delta was. I don't know if it's going to be more severe of illness. But I think we're going to see our numbers in critical care units like where I work at Vanderbilt University go up. And I'm worried about bed control and the ability of us capacity-wise to care for the patients that are likely going to be infected by omicron.

ADRIANA BELMONTE: So Dr. Ely, I know that you see COVID patients firsthand. I'm wondering what kind of symptoms that you've been seeing lately and as well as your long haul COVID patients, which I know that you work closely with them as well.

WES ELY: Sure. You know, the patients who end up getting COVID and sick, they have two prongs of problems. One are the immediate problems of the illness after they were critically ill in my ICU. We call this the post intensive care syndrome, or PICS. And it's dementia. It's depression. It's PTSD. It's muscle and nerve problems. And then 100 days later, they develop this problem called long COVID. And it hits them with a complete barrage of problems in their GI tract, their heart rate going crazy, their ongoing shortness of breath, and a tremendous amount of brain fog. And these things, Adriana, really disable them, take them out of the workforce, and make them feel very confused about the direction of their life.

ADRIANA BELMONTE: So you've mentioned quite a variety of symptoms here. Have you ever seen anything like this where there's been such long term, I guess, after effects of an illness at this magnitude?

WES ELY: We know that after other viral illnesses people can have a post-viral constellation of symptoms like this. It can happen from the flu. You might remember H1N1 years ago when you were a young girl. I think that we haven't seen this magnitude of problems, Adriana. So we've had it before, but never to the point where it's been an absolute public health crisis where 10 to 20 million people in the United States are going to be suffering from this for months and years. And it's something that our medical community and society at large really were not prepared to handle this issue of long COVID.

ADRIANA BELMONTE: So I want to get your take on something. I've spoken to a few people who are dealing with long haul COVID. They've had it for over a year now. And there's two key quotes here that I thought were really, I guess, fascinating. One woman said it's like I'm trapped in a body that won't function properly and the life that I had pre-COVID is gone. Have you been seeing this, I guess, anecdotally in some of your other patients as well where it's like they're just not the same as they were pre-COVID?

WES ELY: Absolutely. One patient told me, Dr. Ely, I wish that my hand was cut off so that people could see that something was wrong with me. But as it is when they look at me, they think I'm fine. And I'm completely diseased and burdened by these problems of long COVID. And everybody thinks I'm OK. And it makes it worse for me. And so they feel silenced. And I think that when they are silenced or feeling silenced, it causes additional pain and additional mental health problems already on top of the physical suffering.

- Doctor, I'm going to jump in here. I wanted to ask you a quick question. We heard Anthony Fauci, Dr. Fauci, talk about the fact that if you are vaccinated and you have a booster that even if it's not designed for things like omicron, it can help prevent severity. Would that have an impact if you should have a breakthrough case in controlling these long haul symptoms? Do we know enough about that?

WES ELY: There's no doubt that vaccinated patients get much less severe illness. And I don't see them in my intensive care unit to the degree that I would if they had not been vaccinated. So there's a tremendous double digit improvement in your likelihood of getting COVID but staying fairly mild. We think that there probably is a relationship between how sick you get with COVID and the likelihood of the long term problems for long COVID. No doubt the sicker you get initially the worse your long term problems are going to be.

So it makes absolute logical sense that vaccination reduces severity and therefore prevents the dramatic nature of the long COVID better than it would be if you were unvaccinated. It should not be concluded though that people who were vaccinated won't have any long COVID because, if they get breakthrough infections, they still can't have this problem. And I don't want them to be unbelieved or disbelieved. And so I just wanted to make that last comment.

ADRIANA BELMONTE: And Dr. Ely, I want to ask you, some of the other long haul COVID patients that I've spoken with as well, they've talked about how they've been denied unemployment because they can't go back to work. They can't function properly, as previously mentioned. But unemployment sees them as being physically capable. Have you been seeing this as well? And how can this be, I guess, remedied?

WES ELY: The disability that occurs after long COVID, as I said, sometimes doesn't meet the criteria from the medical testing perspective to qualify for things like POTS, which is an acronym for a heart disease and a nervous problem that people get after COVID. And so when they don't meet these medical criteria, on paper it looks like they don't actually have a disease. And these are the patients that are telling you that they're being denied disability.

It's a real problem in our country right now. And we need to understand that the patient is the expert in their own illness, not deny them the truth of the fact that they have an ongoing disability, and somehow make an accommodation for them to qualify for disability. Patients are having a hard time getting around that right now. And in our medical center, the research center which I lead called the CUBS Center, C-I-B-S, or Critical Illness, Brain Dysfunction, and Survivorship Center, we are creating a host of support groups to have people come in on Zoom. They're all free.

People can find me on Twitter @WesElyMD. And we can help these people find a way forward that they can maybe get around some of these games that they're being made to play because we weren't ready as a society to have them check all the boxes, if that makes sense.

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