Nearly Half of Covid Patients Haven’t Fully Recovered Months Later, Study Finds

 

"The findings strengthened calls from scientists for more expansive care options for long Covid patients.

A study of tens of thousands of people in Scotland found that one in 20 people who had been sick with Covid reported not recovering at all, and another four in 10 said they had not fully recovered from their infections many months later.

The authors of the study, published on Wednesday in the journal Nature Communications, tried to home in on the long-term risks of Covid by comparing the frequency of symptoms in people with and without previous Covid diagnoses.

People with previous symptomatic Covid infections reported certain persistent symptoms, such as breathlessness, palpitations and confusion or difficulty concentrating, at a rate roughly three times as high as uninfected people in surveys from six to 18 months later, the study found. Those patients also experienced elevated risks of more than 20 other symptoms relating to the heart, respiratory health, muscle aches, mental health and the sensory system.

The findings strengthened calls from scientists for more expansive care options for long Covid patients in the United States and elsewhere, while also offering some good news.

The study did not identify greater risks of long-term problems in people with asymptomatic coronavirus infections. It also found, in a much more limited subset of participants who had been given at least one dose of Covid vaccine before their infections, that vaccination appeared to help reduce if not eliminate the risk of some long Covid symptoms.

People with severe initial Covid cases were at higher risk of long-term problems, the study found.

“The beauty of this study is they have a control group, and they can isolate the proportion of symptomatology that is attributable to Covid infection,” said Dr. Ziyad Al-Aly, chief of research at the V.A. St. Louis Health Care System and a clinical epidemiologist at Washington University in St. Louis, who was not involved in the research.

“It also tracks with the broader idea that long Covid is truly a multisystem disorder,” Dr. Al-Aly said, one that resides “not only in the brain, not only in the heart — it’s all of the above.”

Jill Pell, a professor of public health at the University of Glasgow who led the research, said the findings reinforced the importance of long Covid patients being offered support that extends beyond health care and also addresses needs related to jobs, education, poverty and disability.

“It told us that Covid can appear differently in different individuals, and it can have more than one impact on your life,” Dr. Pell said. “Any approach to supporting people has to be, firstly, personalized and also holistic. The answer doesn’t just lie within the health care sector.”

Long Covid refers to a constellation of problems that can plague patients for months or longer after an infection. Over the last year, researchers have given more attention to understanding the daunting aftereffects as the number of Covid cases exploded and health systems learned to better manage the initial stages of an infection.

U.S. government estimates have indicated that between 7.7 million and 23 million people in the United States could have long Covid.

Globally, “the condition is devastating people’s lives and livelihoods,” Tedros Adhanom Ghebreyesus, the director general of the World Health Organization, wrote in an article on Wednesday for The Guardian. He called on all countries to devote “immediate and sustained action equivalent to its scale.”

The authors of the study in Scotland tracked 33,000 people who had tested positive for the virus starting in April 2020 and 63,000 who had never been diagnosed with Covid. In six-month intervals, those people were asked about any symptoms they had, including tiredness, muscle aches, chest pain and neurological problems, and about any difficulties with daily life.

By comparing the frequency of those problems with infected and uninfected people, the researchers tried to overcome a challenge that many other long Covid researchers have confronted: how to ascribe less specific symptoms to Covid when those problems are also common in the general population and may be prevalent in the midst of a pandemic.

Several of the most common long Covid symptoms identified in the study were also reported by one-fifth to one-third of participants who had never been infected, the study found. But symptoms were significantly more common in people who had previously had Covid: Those participants were more likely to report 24 of the 26 symptoms tracked by the study.

Of those with previous Covid cases, 6 percent said on their most recent follow-up survey that they had not recovered at all and 42 percent said that they had only partly recovered.

Dr. Pell said that she was still studying the trajectory of long Covid symptoms over the months and years since an infection. But the new study opened a small window onto that question.

In one group of previously infected patients, about 13 percent of people said that their symptoms had improved over time, while about 11 percent said they had deteriorated.

“Some do resolve over time,” Dr. Al-Aly said, “but also there’s a good number of people who remain symptomatic with a bunch of manifestations over longer time periods.”

Only a small portion of the study participants — about 4 percent — had been vaccinated before their infections, and many of those with only a single dose.

“We’re now really heavily reliant upon vaccination,” Dr. Pell said, “which does confer some protection, but it’s not absolute.”

Women, older people and those living in poorer areas also faced more serious aftereffects from an infection. So, too, did those with pre-existing health problems, including respiratory disease and depression.

About nine out of 10 study participants were white, making it more difficult to determine how and why long Covid risks may have differed among racial and ethnic groups.

For health systems still working to recover from recent Covid surges while facing an onslaught of patients with the flu and other respiratory illnesses, considerably more resources were needed to treat patients suffering from an earlier coronavirus infection, scientists said.

“Our systems are not prepared,” Dr. Al-Aly said.”

Gaminimas Amerikoje

„Titano ekonomika

    Autoriai: Asutosh Padhi, Gaurav Batra ir Nick Santhanam

    (Public Affairs, 240 puslapių, 29 doleriai)

 

    Po daugybės alinančių naktų, projektuojant ir konstruojant automobilį „palapinėse“, Elonas Muskas pasirodė su įžvalgia pamoka Teslai. „Klausimas nėra susijęs su automobilio dizaino kūrimu – tai absoliučiai susijęs su gamybos sistema“, – sakė P. Muskas 2019 m., kai buvo pristatytas automobilių gamintojo visureigis „Model Y“. „Norite turėti gero produkto padarymą, bet iš esmės tai yra lengviausia dalis. Gamyklos yra sunkiausia dalis."

 

    P. Muskas norėjo pakelti vertikalią integraciją – arba tiekimo grandinės kontrolę – iki to aukštumos, kurią jis vadina „absurdiška“. Jo verslo filosofija buvo lemiama.

 

    2022 m. vasario mėn. federalinė vyriausybė paskelbė, kad tiekimo grandinės problemos reiškia, kad Amerikos gamintojai savo atsargose turėjo penkių dienų lustų, o tai yra avarinis trūkumas, palyginti su 40 dienų tiekimu prieš trejus metus.

 

    Nelaimė kalba apie būtinybę atkurti gamybą namuose, teigia bendraautoriai Asutosh Padhi, Gaurav Batra ir Nick Santhanam savo sklandžioje, lengvai virškinamoje ir savalaikėje knygoje „Titano ekonomika: kaip pramonės technologijos gali sukurti geresnę, greitesnę ir stipresnę Ameriką“. “. Knygos prielaida yra ta, kad „mes galime sukurti tūkstantį įmonių, panašių į Tesla kiekvienoje pramonės šakoje“.

 

    Autoriai rašo: „Iš dalies to, ką Muskas suprato – ką taip pat priėmė ir kiti pramonės lyderiai – yra ta, kad Amerikos dvasios esmė yra valdyti savo likimą“.

 

    Ponai Padhi, Batra ir Santhanam, visi dabartiniai arba buvę McKinsey vadovai, yra kilę iš inžinierių ir vadybos sričių, suteikiančių jiems autoritetą „pramoninių technologijų“ srityje – bendras gamybos, robotikos ir techninės įrangos gamybos terminas. Nepaisant to, kad jie yra baltieji konsultantai, jie padėjo tvarkyti gamyklos grindis – sričiai, kuri paprastai nėra susijusi su McKinsey. Chemijos inžinierius P. Santhanamas tapo profesionalu per dot-com bumą, tačiau mieliau dirbo su technine įranga, kurią galėjo paliesti, vėliau konsultavo puslaidininkių gamintojus, kaip McKinsey konsultantas. Ponas Batra kažkada dirbo plataus vartojimo prekių gamykloje Indijoje, kur 20 000 gyventojų turintis kaimo miestelis „palaikomas gamyklos“. P. Padhi dirbo pramonės įmonėse Klivlande, kur stoikiški darbuotojai kūrė naujoves apie tai nekalbėdami, kitaip, nei Silicio slėnyje, kurį jis matė, kaip kraštą, pilną kalbų.

 

    Kai daugiau įmonių perkelia savo gamyklas iš Kinijos ir kitur, autoriai teigia, kad Amerikos gamyba skatina socialinę ir ekonominę jėgą, kurią jie vadina Didžiuoju stiprinimo ciklu. Gamyklos įkuria filialą mažuose Amerikos miesteliuose, darbuotojai įgyja naujų įgūdžių ir parsineša namo geresnius atlyginimus, perka namus ir pagerina savo gyvenimą. Laikui bėgant, atsiranda daugiau talentingų žmonių, kurie ieško geresnės gyvenimo kokybės, atidaro verslą, investuoja kapitalą ir prisideda prie vietos kultūros.

 

    Autoriai slenka per daugybę anekdotų apie 3-D spausdinimą, pažangias medžiagas ir dirbtinį intelektą, taikomą gamyboje, ir pabrėžia, kad kai kurios pramoninių technologijų įmonės konkuruoja su Facebook ir Amazon grąža. Tačiau šis sektorius pritraukia mažiau, nei 1% rizikos kapitalo. Virdžinijoje įsikūrusios bendrovės „Trex“, kuri naudoja pažangią robotiką plastikiniams maišeliams perdirbti į statybines medžiagas, akcijų kaina per pastarąjį dešimtmetį padidėjo beveik 5000 %. Dvi gamyklos sujungtos, naudojant pažangią programinę įrangą, „Trex“ yra sėkmingos įmonės, pakeičiančios senesnį, statinį centrinės gamyklos modelį, pavyzdys.

 

    „Titano ekonomika“ yra geriausia, kai ji atveda mus už superžvaigždžių miestų Silicio slėnio ir Niujorko ir į klestinčius gamybos centrus Pietų Karolinoje, Teksase ir Indianoje. 

 

Autoriai rašo, kad „kiekvienam Flintui, Mičigano valstijoje, liūdnai nusiaubtam dėl prarastų darbo vietų automobilių pramonėje, yra Simpsonvilis, Pietų Karolina“. Aštuntajame dešimtmetyje „Michelin“ atidarė padangų gamyklą Simpsonvilyje, kurioje dirba 25 000 žmonių, ir padėjo apmokyti darbuotojus. Nuo devintojo dešimtmečio automobilių gamintojas BMW, aviacijos ir kosmoso įmonė „Collins“ ir daugybė kitų firmų pasirodė ir pasamdė kvalifikuotą šios srities darbo jėgą.

 

    „Titano ekonomika“ kartais skamba per gerai, kad būtų tiesa, kaip „McKinsey“ brošiūra klientams ir investuotojams. Iš tiesų, kartais atrodo, kad autorių ryšys su „McKinsey“ susilpnina jų galimybes kvestionuoti įmones, kurias jie apima. „Kalbant apie valdymą, įvairios valdybos sudėtys, didesnė analitikų aprėptis ir kintančios mažos apyvartos investuotojų profilių dalys prisideda prie daugialypės plėtros“, – paslaptingoje ištraukoje rašo autoriai. Tuo tarpu galimybė paaiškinti rinką investuotojams, priduria jie, yra „sritis, kurioje daugelis pramonės įmonių vis dar nepasitenkina“.

 

    Nenoras kritikuoti apima šalis, kuriose McKinsey aktyviai veikia. Autoriai rašo, kad Kinijos vyriausybė yra „nusiteikusi pirmauti“, teikdama valstybės lėšas svarbioms pramonės šakoms. Tačiau jie niekada neužsimena, kad šalis, importuojanti daugiau lustų, nei bet kada anksčiau, kartomis atsilieka nuo Amerikos puslaidininkių pramonės ir toli nuo savo apsirūpinimo vizijos.

 

    Autoriai teigia, kad JAV vyriausybė turėtų labiau įsitraukti į nacionalinę pramonės strategiją. Tačiau jie užgožia jau vykstančias transformacijas. Jie niekada nemini rugpjūtį pasirašyto CHIPS ir mokslo akto, į kurį įeina 52,7 mlrd. dolerių subsidijos JAV puslaidininkių gamybai. „Intel“ generalinis direktorius Patas Gelsingeris pavadino tai potencialiai „svarbiausia pramonės politikos dalimi“ nuo Antrojo pasaulinio karo.

 

    Tai tik vienas pokytis, kaip Amerikos verslo lyderiai žiūri į namų pramonę. Nepaisant to, „Titano ekonomika“ yra malonus skaitymas apie nepastebėtą ir neįvertintą sritį bei sėkmingiausias jos įmones. Laikas tinkamas. Amerikiečiai suvokia, kaip svarbu stiprinti atsparumą namuose, o ne pasitelkti išorės paslaugas, kad būtų truputį sumažinti kainą.

    ---

    P. Cainas yra Linkolno tinklo vyresnysis bendradarbis ir dviejų knygų apie technologijas ir pramonė autorius.“ [1]

1. Making It In America
Cain, Geoffrey. 
Wall Street Journal, Eastern edition; New York, N.Y. [New York, N.Y]. 13 Oct 2022: A.17.

Making It In America

"The Titanium Economy

By Asutosh Padhi, Gaurav Batra and Nick Santhanam

(PublicAffairs, 240 pages, $29)

After many grueling nights designing and building a car in "makeshift tents," Elon Musk emerged with a prescient lesson for Tesla. "The issue is not about coming up with a car design -- it's absolutely about the production system," Mr. Musk said in 2019, during the unveiling of the car maker's SUV, the Model Y. "You want to have a good product to build, but that's basically the easy part. The factory is the hard part."

Mr. Musk wanted to take vertical integration -- or control over the supply chain -- to what he's since called "absurd" heights. His business philosophy was decisive.

In February 2022, the federal government announced that supply-chain issues meant that American manufacturers had five days' worth of chips in their inventories -- an emergency shortage compared to their 40-day supplies three years earlier.

The disaster speaks to the need to rebuild manufacturing at home, argue co-authors Asutosh Padhi, Gaurav Batra and Nick Santhanam in their fluid, digestible and timely book, "The Titanium Economy: How Industrial Technology Can Create a Better, Faster, Stronger America." The book's premise is that "we are capable of producing a thousand companies akin to Tesla in every industry."

The authors write: "Part of what Musk understood -- something that has also been embraced by other industrial leaders -- is that the core of the American spirit is about controlling one's destiny."

Messrs. Padhi, Batra and Santhanam, all current or former McKinsey executives, come from engineering and management backgrounds that give them authority in the field of "industrial technology" -- the catchall term for manufacturing, robotics and hardware production. Despite being white-collar consultants, they've helped run factory floors, an area not normally associated with McKinsey. Mr. Santhanam, a chemical engineer, came of age as a professional during the dot-com boom, but preferred working with hardware he could touch, later advising semiconductor manufacturers as a McKinsey consultant. Mr. Batra once worked at a consumer-goods plant in India, where a rural town of 20,000 "was supported by the plant." Mr. Padhi worked for industrial companies in Cleveland, where stoic workers innovated without talking about it, unlike in Silicon Valley, which he saw as a land full of talk.

With more companies reshoring their factories from China and elsewhere, the authors argue that American manufacturing is propelling a social and economic force they call the Great Amplification Cycle. Factories set up shop in small American towns, workers learn new skills and take home better paychecks, buying homes and upgrading their lives. Over time, more talented people show up looking for a better quality of life, opening businesses, injecting capital and contributing to local culture.

The authors glide through a succession of breezy anecdotes about 3-D printing, advanced materials and artificial intelligence as applied to manufacturing, and point out that some industrial-technology firms rival the returns of Facebook and Amazon. Yet the sector attracts less than 1% of venture capital. Trex, a Virginia-based company that uses advanced robotics to recycle plastic bags into construction material, has seen its share price increase by nearly 5,000% in the past decade. With its two factories connected through advanced software, Trex is an example of a successful company replacing the older, static model of the central factory.

"The Titanium Economy" is best when it brings us outside the superstar cities of Silicon Valley and New York and into prosperous manufacturing hubs in South Carolina, Texas and Indiana. The authors write that "for every Flint, Michigan, that has been infamously devastated by the loss of jobs in the automotive industry, there's a Simpsonville, South Carolina." In the 1970s, Michelin opened a tire plant in Simpsonville, home to 25,000 people, and helped train workers. Since the 1980s, the auto maker BMW, the aerospace firm Collins and numerous other firms have showed up and hired the area's skilled workforce.

Replete with stories of bonanza and fortune, "The Titanium Economy" at times sounds too good to be true, like a McKinsey brochure for clients and investors. Indeed, the authors' McKinsey affiliations sometimes seem to dampen their ability to question the companies they cover. "In terms of governance, diverse board compositions, higher analyst coverage, and changing shares of low-turnover investor profiles all contribute to multiple expansion," the authors write in a cryptic passage. Meanwhile, the ability to explain the market to investors, they add, is "an area where many industrial companies still fall short."

The reluctance to criticize extends to countries where McKinsey has a strong presence. The authors write that the Chinese government is "dedicated to taking the lead" by providing state funds for critical industries. But they never mention that the country, which imports more chips than ever, remains generations behind the American semiconductor industry and is far from its vision of self-sufficiency.

The U.S. government should be more involved with a national industrial strategy, the authors argue. But they gloss over the transformations already under way. They never mention the CHIPS and Science Act, signed into law in August, which includes $52.7 billion in subsidies to U.S. semiconductor production. Intel CEO Pat Gelsinger called it potentially "the most important piece of industrial policy" since World War II.

This is merely one shift in how American business leaders view homegrown industry. Nevertheless, "The Titanium Economy" is an enjoyable read about an overlooked and underappreciated field and its most successful companies. The timing is right. Americans are waking up to the importance of building resilience at home, rather than outsourcing for an easy price cut.

---

Mr. Cain is a senior fellow at the Lincoln Network and the author of two books on technology and industry." [1]

1. Making It In America
Cain, Geoffrey. 
Wall Street Journal, Eastern edition; New York, N.Y. [New York, N.Y]. 13 Oct 2022: A.17.