An informed guide to the pandemic, with the latest developments and expert advice about prevention and treatment. |
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 | | The New York Times |
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Before we dive in today, I want to take a moment to mention some upcoming changes to the Coronavirus Briefing newsletter. |
The story of the pandemic is shifting, again. Even as more contagious variants circulate, the United States, and much of the world, is trying more than ever to accept that the virus is "here to stay," as the C.D.C. described it this week. |
The aftereffects of the coronavirus on the economy, education and work are also coming into sharper relief, and scientists are making progress in better understanding Covid and its effects on our bodies. |
To reflect these story lines, next week we will broaden the focus of this newsletter under a new name: the Virus Briefing. We will continue our expansive coverage of the coronavirus, but will also keep close tabs on other viral threats and health news. |
On Mondays and Fridays, we'll send you a short breakdown of news you need to know. On Wednesdays, I'll bring you in-depth coverage of the latest developments, including interviews with experts and Times reporters to help make sense of the week's news. |
We'll also be continuing the conversation with you, regularly asking for you to weigh in on the news and tell us your stories. Your thoughts over these last two and a half years have been an invaluable window into the wide-ranging effects of the virus, and I look forward to hearing more from you as we expand our focus and move through the next phase of the pandemic. |
 | | People who are exposed to the virus no longer need to quarantine at home, regardless of their vaccination status.Jim Wilson/The New York Times |
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"We know that Covid-19 is here to stay," Greta Massetti, a C.D.C. epidemiologist, said at a news briefing. "High levels of population immunity due to vaccination and previous infection, and the many tools that we have available to protect people from severe illness and death, have put us in a different place." |
Here's what to know about the changes. |
- People who are exposed to the virus no longer need to quarantine at home, regardless of their vaccination status, although they should wear a mask for 10 days and get tested for the virus on Day 5.
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- People who test positive for the virus should still isolate at home for at least five days. Those who had moderate or severe illness, or are immunocompromised, should isolate through Day 10.
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- Unvaccinated students who are exposed to the virus will no longer need to test frequently in order to remain in the classroom, an approach known as "test to stay."
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- The C.D.C. no longer recommends that people stay six feet from others. Instead, it notes that avoiding crowded areas and maintaining a distance from others are strategies that people may want to consider in order to reduce their risk.
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- Contact tracing and routine surveillance testing of people without symptoms are no longer recommended in most settings.
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- The guidelines around masks — which recommend that people wear them indoors in places where community Covid levels are high — have not changed.
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Many health experts praised the new guidelines as representing a pragmatic approach to living with the virus in the longer term. But the pandemic has not ended, experts noted, and newly stringent measures may be needed in the event of new variants or future surges. |
 | | Derek Abella |
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Long Covid and mental health |
A few days ago, we came across a recent piece of journalism that gave us pause. |
Anne Helen Petersen, in her Culture Study newsletter, spoke to a communications professor who noticed a startling trend of solace and despair in conversations among long Covid sufferers in internet communities. While many of the symptoms of long Covid are well known at this point — exhaustion, shortness of breath, mental fog — Anne's conversation got us thinking about the hidden effects that long Covid can have on our mental well-being. |
To learn more, I turned to my colleague Pam Belluck, who covers long Covid. |
What do we know about mental health and long Covid? |
There are two correlations that people are seeing. Long Covid is a very complex constellation of as many as 200 symptoms, and among those, depression and anxiety tend to be reported fairly often. |
One large study analyzed electronic records of more than 150,000 Covid patients and compared them with people who had not gotten Covid. None of the Covid patients in the study had been treated for mental health conditions in the two years before getting the coronavirus, which allowed the researchers to focus on issues the patients developed after getting Covid. |
They found that people who had Covid were 39 percent more likely to be diagnosed with depression and 35 percent more likely to be diagnosed with anxiety in the year after they had recovered from their initial Covid infection than people who didn't have Covid in that same period. |
What's the other correlation? |
The other thing being reported is that people who have previously been diagnosed with depression or anxiety seem to be at somewhat greater risk for developing long Covid. Post-Covid clinics are finding that when they ask patients about their previous medical history, a number of those patients report having experienced depression or anxiety in the past. |
For example, a study of the first 100 patients that showed up at a Covid neurological clinic run by Northwestern Memorial Hospital in Chicago found that 42 percent of those people reported that they previously had depression or anxiety. Depression and anxiety are very common in American society, so that's not necessarily surprising, but it does seem to be a bit more common in people who develop long Covid, and doctors don't really know why. |
Also, for people who already had depression or anxiety, developing long Covid can make their mental health symptoms worse, according to therapists and others who are treating those patients. |
Why are people with long Covid experiencing mental health issues? |
Nobody knows for sure. The best insights suggest that there are probably a number of factors contributing to this. |
There have been several studies looking at the possible effects of Covid on the brain. Researchers still have a lot more questions there than answers, but there's some work that has suggested that the same inflammatory reaction and immune response that Covid causes in the rest of the body can also affect the brain. |
The evidence doesn't really show that the virus itself often penetrates the brain, but studies have found that the inflammatory reaction that Covid causes throughout the body also causes inflammation in the brain. That could be contributing to brain fog and cognitive issues, which we've heard a lot about, and it could also be contributing to mood issues and mental health issues. For example, one expert I've talked with said that inflammation in the brain can disrupt the ability to make serotonin, which plays a role in mood regulation and in sleep. |
What are other factors that could explain this? |
Separate from the brain changes that might be occurring, just being ill may be having an effect. If you have long Covid symptoms, like fatigue or brain fog or respiratory difficulties, it's not surprising that those issues are going to affect your mental health as well. If you're not able to function the way that you used to function — you're not able to get back to work, to exercise, to be active and engaged with your family and friends — it makes sense that those struggles can make people anxious and depressed. |
And it becomes kind of a vicious circle. You're feeling fatigued. That's fueling depression. You might be feeling stressed about your depression. That stress may fuel some anxiety. So it's a very integrated picture with various symptoms overlapping and connecting. I think it's helpful for people, and society at large, to try to understand how the physical and brain-related symptoms can occur together and to recognize that people should not be stigmatized for having Covid-related mental health issues. |
How can people help themselves? |
Mental health issues in long Covid are increasingly being recognized, and a lot of the medical recommendations are the same for long Covid in general. Reach out for help. You may want to seek the same types of counseling or therapy or treatment that is provided to people experiencing non-Covid-related mental health issues. You may want to seek recommendations from providers who are specifically treating long Covid patients. Some people may find support groups helpful. There are several patient-led organizations that provide great lists of resources, some of them drawing on the experience of patients who have other similar postviral illnesses like myalgic encephalomyelitis/chronic fatigue syndrome. |
And some people find that their mental health symptoms and other long Covid issues ease over time. For example, if you're getting some of your energy back, you're able to go back to work, you're able to exercise, if you're able to get some of your life back, then it stands to reason that your mental health might improve too. |
What else we're following |
| Thanks for reading. I'll be back Wednesday — Jonathan |
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