Sick of COVID: The Long Haulers

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On wireless EAR BUDS BY RAKE ON DOT com slash naked scientist. Have you loud and clear. Hello Signed that is to say physics. Medicine. Nature. Brain. Universities. Hello welcome to the naked scientists the show where we bring you the latest breakthroughs in science technology and medicine with me Phil Sansom and with me Chris Smith and this week we meet the people still suffering the after effects of covid nineteen months after catching the virus these patients weren't enough to be hospitalized I thought they were going to recover just a week or two now that on a rollercoaster of bizarre symptoms a cooling, it long cove it but what is it plus in the News Ken Children Harbor more coronavirus than adults and a new space mission to Mars gets underway. The naked scientists podcast is powered by UK false dot coach Uk. Now I up previous studies have suggested that children may be poor spreaders at the coronavirus and may even be less susceptible to catching it and this regard the UK chief medical officer Chris Witty has cold reopening schools are priority and in weighing the risks and benefits described how children are much less likely to come down with Sirius cove in nineteen but a new study out of the laundry children's hospital, of Chicago suggests. That kids may actually play host to two significant amounts of the virus tightly healed sergeant and our colleagues were looking at corona virus, genetic material, the so called viral nucleic acid inside the noses and throats of their patients and she told Phil what they found older children had similar amounts of the pieces of virus viral, nucleic acid to adults and younger children actually had a bit more than the older children and the adults. That's surprising. Right because kids to get sick really with covid. So people I thought had thought that they didn't get infected. So actually, and I find this quite interesting in general is why aren't kids getting sick as adults and one of the possibilities was that kids just weren't able to get infected or if they got infected, they weren't going to be able to sustain replication and this data argues that that's not the case kids are able to get infected and have replication of the virus. Okay. How did you do this? How many kids did you look at? Actually. This was a clinical observation. We noticed that a few of our young kids that had recently been screened just for clinical symptoms had very high amounts of viral nucleic acid and when we went back and we looked at all the tests that we had done, we found this pattern. So after we controlled for duration and severity of infection, we were left with one hundred and forty five patients. We had younger children less than five years old. We had children aged five to seventeen years old and then adults over eighteen. So you're comparing young kids, older kids and adults who have had the disease for the same amount of time and are physically the same amount of sick cracked. How much more virus did the younger kids have than the older kids? So. It's hard to measure directly how much more virus the children had been the adults because what we looked at was just a nucleic acid children have about ten to a hundred fold more nucleic acid compared to the older children than adults and other previously published work by other groups have found that about that much nucleic acid correlates to having more infectious particles. Which is quite a? Shock when people thought Oh these kids aren't GonNa Spread Corona viruses. Okay. To Send them back to school the people who were saying, no, this isn't safe. This is a lot of support in their corner. Isn't it? It's an early piece of data that's needed to stand if kids have infectious virus, but we didn't look at actual infectious virus as a scientist. I always want to be as precise as possible when I'm talking about my dad so I can't say for sure that kids have more infectious virus. But this does argue that it's possible. The big questions well is aren't these kids as sick as adults? I find that fascinating what our kids doing, what's different about their bodies that allow them to be somewhat protected compared to adults I wonder if studying children will help us figure out how to treat adults. There are several different possibilities. One of the ideas is that it has to do with the receptor for the virus and actually where it's located in children and how much of it there is. Another possibility is the virus just isn't able to get down into the lungs as well, and that could be related to virus or it could be related to the immune system because that's the third possibility is that the immune system and children is able to protect against viral infection whereas an adults the immune system somewhat overreacts and actually causes damage itself. I think that it's probably the immune system, but that's a hypothesis still. A fascinating result there Taylor healed sergeant and that study has just come out in Jama pediatrics? This week the program is sponsored by ripple energy. They're doing something that's unusual and also a I, and they want to share the opportunity with you and we twenty years experience in the. Wind. Power. Industry Sarah Merrick is their founder and CEO. Ripple does is we enable individual households to own a bit of a wind farm and have the low cost clean electricity generates supply to their hope I project is now open. It's great rather in south Wales. So have really keen for people to be able to join the project and. Be Part of what does the UK's very first consumer owned windfarm can you tell us a bit about how this business will work? Sarah 'cause must become a member of a cult which owns the wind farm and it's all very democratic one member one vote. So you simply decide how much of the wind farm you want to own depending on how much electricity you use, when you can just sign up and in actually a couple of minutes on our website and you become. A member, the co-op I knew own your bit if they're in farm and then we go a build it, and then once its operational, you get your share of the actress that the wind farm generates supply to your home by the grid, and then the savings the are associated with your ownership are applied your bill automatically each month basically take care of everything right from gathering the thousands of people together managing the build of the wind farm and then managing the relationship with. Supply partners so that everyone gets savings that you try to their bill straightaway. How much is this gonNA cost to build the cost of building the whole turbine is just over four million pounds and then an individual households sheriff that if they wanted the wind farm to generate as much electricity as they use each year, the upfront cost is around eight, thousand, nine, thousand, nine, hundred pounds, and for that, they would gets savings of around twenty five percent on their electric bill because. The electricity is coming from the grids. You still need to pay all the grid charges. There's lots of taxes and levies part of your electricity bill you wanted to pay all those bits. It's the electricity part of your actress. Saving on. So over the twenty five year lifetime if the wind farm we estimate it's around a twenty five percent reduction on your electricity bill each year for the two, thousand, five year lifetime and therefore how many years after I've invested? Is it before? I. Got My money back in saved electricity we're expecting it to be around fourteen years based on the government's electricity price assumptions. If Electric prices are higher than those assumptions, the payback is shorter because your savings would increase if the price of electricity goes down your savings which uses well. What abso- move house though because it's attached to you and not your home. If you move you just up your supplier light, you would if you moved home and say, Hey, I've moved and they then supply it to your new hope it's really portable it goes wherever you go essentially. You said that the average household investment will be about two thousand pounds. So you must be if you want to raise four million quid, you must be looking for about two thousand subscribers. Yes. Assets just over two thousand six with because is limited. We're expecting it to fill up by the end of August. Is Not the point of no return where you got to be in the door by the end of August or the opportunity is is going to pass. Exactly yes once wind farms full there's no more of it to be what he wants to people need to get in in the next three or four weeks in order to be able to benefit and be part of the case I, consumer owns windfarm and when will it actually become operational? When would I start to see money flowing into discount off my bill? We're expect it to be spring necks jest of Time Sleep easy billed as a single turbines. It shouldn't take very long to construct people would see savings on their bill from around April twenty, twenty one onwards, and this is a I. Don't think anyone has actually tried to do this with a wind turbine not this before why did you decide to go down this path? It's always the world I have you worked at the wind industry for so long I saw that it was possible for big companies like Google and facebook they could bits of a whole inform themselves but it it seems really unfair that me as an individual consumer I wasn't able to. Own. What is now the UK's cheaper source of power direct people want to act on climate change and they one low cost electricity as well. So that's why I set up ripple to solve that for people and what safeguards are there. So that people who who did decide to invest know that their money is is secure on the company for twenty five years. He's going to be there and they're going to get the money back. So the cope owns the wind farm and they will do I twenty five years. Ripple doesn't own the wind farm with the Managing Agency we just bring everything together and make it happen and if I decide, I want to invest more than two thousand pounds you taking bigger subscription. So a person could therefore discount proportionately more of that L. Interest Seacoast. The most that you can invest would be the equivalent amount of the wind farm that which generate your consumption plus twenty percent. You're owning a bit of a windfarm to get low cost clean electricity that you use yourself. So if you have now convinced listeners to the naked scientists that this is a good idea. What should they do? So they can join ripple disco to ripple energy. Dot. COM, and you can sign up there. We're expecting it to close by the end of August. So people need acts pretty quick if they want to be part of this project Sir Americ-, CEO of ripple, energy, who is sponsoring our program this week. Now it's been a big week for space, exploration SPACEX Dragon Endeavor craft safely returned crew members from the International Space Station culminating in the first splashdown ocean is seen in forty five years and as Ben mcallister reports a key Mars mission. We actually featured here on the program a couple of weeks ago got underway. On the thirtieth of July twenty, twenty, a rocket launched from Cape Canaveral Air Force Station in Florida USA to begin a seven month four, hundred, eighty, million kilometer journey to Mars. Aboard is the perseverance Mars rover. The river was launched now as bearing a window known as the closest approach between the earth and Mars. Because mazas further from the sun, it takes about twice as long as earth does to complete a lap of the solar system. This means that the two planets that closest to one another only about once every two years, which is why it's now or twenty, twenty two. In some ways, perseverance like a slightly more developed big brother to curiosity the most recent previous malls Robo. In fact, many of its design launch and landing features a based on curiosity with a few extra new bells and whistles added. The landing process will also be similar. The robot will reach the Martian atmosphere and then have to complete the terrifying seven-minute descent to the surface without any help from NASA. The rover will intimate atmosphere traveling at about nine thousand, nine, hundred, thousand kilometers an hour and descend in three stages. First, it will deploy an incredibly strong parachute to do the brunt of the work. Then it will detach from the parachute and employ rocket boosters pointed downwards to counteract the rovers velocity. Finally, the robot itself will be lowered gently to the ground from the platform holding their boosters, using what NASA calls the Sky Crane. In contrast to the car is curiosity perseverance is even bigger has better wheels and equipped with new technology including a fancy rock-drill taking samples of the rocky Martian surface and its own helicopter drone cold ingenuity. If it's successful, it will perform the first powered flight on the Martian surface Mars own riper moment it will then be used to help scout locations. So perseverance to visit. But it isn't just the kit which is different perseverance. Brand new exciting mission a mission. All about life on Mars one major goal is to search Mas for evidence of ancient microbial life that is looking for remnants and traces left behind by any small organisms which may have been present billions of years ago when Mazda's less dry and more supportive of life. The second major goal is to test a bunch of different equipment and systems possible future human habitation on the Red Planet for example, testing a process converting MAS carbon dioxide, rich atmosphere into oxygen, and testing the suitability of a range of materials for use in future space suits intended to support humans living in working on the Hash inhospitable Martian surface for the temperature rarely gets above zero abrasive dust domes can be frequent and the incoming radiation levels with no ozone. All magnetosphere to block them can be lethal. For now, as far as we know, Mars is the only planet in our solar system populated entirely by robots. However, if perseverance is successful in paving the way for the future human habitation of Mars, it may not belong to the robot overlords for long. Then mcallister there he's University of Western Australia. We will indeed very much looking forward to catching up with perseverance when it reaches malls in twenty twenty one. For Mars now to moos before social distancing when we saw our friends, we might have shook their hand slap them on the back maybe even give them a hug cows though choose a more intimate route unlike us they lick each other on the face and neck to say hello at least unlike most of us now new research from the Universidad. Australia Chile has used this licking behavior to assess the hierarchical relationships between cows in a herd as lead researcher Gustavo Monte told Eva Higginbotham. To be completely honest in these trying times, I can't really think of anything more relaxing than sitting in a field and watching of cows lick each other and that's exactly what members of the research team did every day several hours a day for a month noting down who leaked, who who got the most licks who got the least legs and how this changed over time. But the question remains why one of the motivations of this study has to do with one consequence, which is Rico for on the Way that we are managing cows. Let's say in the Western type of production spatially. So our systems are very intensive nowadays and part of management animals are group on regrouped very often for different purposes. So this is a problem in the way that because to establish this here, key on this relationships for a group of cows, you take some time. The problem is once they reached Kelly Renault's status of recognition than because of the management, some of the causal or even the leader is removed from. The group on then you cows when you animals came to this group, afford had to reestablish all the process all over again, and this has happened several chimes within a year within a group and within the life of the cows previous studies have shown that the constant reshuffling of animals can make them stressed out and farmers have known for a long time that stress can have a big effect on milk production. The researchers wanted to understand the effects of this reshuffling on the social dynamics of the heard. And realized that they could use looking events as a window into the social dynamics. So they observed the cows without interfering your some sort of big brother and plugged the data into a computer to perform a modern technique called social network analysis where each cow is represented by a node, and they could scrutinize the complex web of relationships over time kind of like facebook for cows is the nick that is used nowadays with big data. No. So when facebook goal, whatever company wants to a WHO are your relationships? With whom you are working with So it's the same sort of thing, knicks the where us for our situation. One of the bottom findings of this study was that unexpectedly dominant cows leaked to more than the younger cows into the group and that this could be blend the delivery in some way is. This sort of action to reward the low level unable to keep the say cohesion I. Think One important finding the these social grooming in both ways. They can establish Diogo bonds between members of the group on this also in. The version of the hurt. They also found that cows that were new additions to ahead were looking more often and hypothesized that maybe they were doing favors and trying to be friendly to get down with the new group. Interestingly though the cows that the most looking received the least licks in return, this might be because licking another cow is something of an investment, and if you go around licking everybody in might suggest that you're not going to invest in specific relationships and so the all the cow, my not bother investing in you either. Overall Gustavo in the rest of the team suggest that licking can be used as a positive marker for wellness within a heard if there's lots of looking things stable and everyone is content with their friends. If there isn't things going wrong in the complex social emotional relationships of the head and Gestapo argues that farmers should be mindful of this important aspect of cows welfare when reshuffling the groups. Or is important I wa- mood your cows in that was Kostov Monty and the work that his team have just published is out in frontiers inventory science. Chris Barrow bringing you a brand new podcast called naked gaming. This is where we look at Gaming News. Hideo Kojima creator of the metal gear franchise was honored with the b-actor fellowship the highest accolade the organization can give reviews. Why are you cutting everything all that's not how it's supposed to be. Sure Hey. Me Go back in time. With. Retro Revival. Yes Mom just ready. Naked Gaming download it now wherever you get your podcasts. For the rest of this program, we're going to be investigating the phenomenon of loan cove. It also known as long tail or long hole cove it. It's one of the stranger features of the virus that number of people who've gotten. It still haven't gotten over their illness even months down the line. Patients with severe covid nineteen usually end up in hospital often in intensive care many. Sadly, make it. It's no surprise then that those who do pull through my need months of rehabilitation afterwards but we're talking about this week those people who haven't been to it you and we're told their cases were just mild if they were told the tool and these people had expected to recover in just a couple of weeks but that doesn't seem to have happened. Pull Garner is one such person. He is an infectious diseases doctor at the University of Liverpool and he's been vocal about his experience one which started about five days after he first felt symptoms. Heart was racing felt really halt felt absolute exhaustion I. felt as I'll I was about to pass out. I actually thought I was dying I thought Oh my God pull this disease is really bad and this is it That was the the star of this twelve weeks cycle of abuse from this virus. You just didn't know when he woke up in the morning and might then have renewal is where you have a blinding headache we a pain in your cough or won't of. A. Full you diarrhea one morning or you might just have a Mug us in your head not be able to understand what's going on around. You is really really horrible. Really. This has been twelve weeks of this. Yes. But the thing about the disease it changes. After about five Oh six weeks I started getting these highs you actually sleep and when you wake up from the sleep, you feel incredibly refreshed. Got Out and produce walk a little bit too far but. It comes back and Sauk she between the is. Is Not just walking physical exercise. It's also mental and is also emotional. So if you have emotional events that consumes your energy, a makes you on well. It. Changes Your Life. Have you had the any of the coronavirus tests I had. The antibody tests done not came out positive. and. How Dr is generally responded to you with all these symptoms and this illness that just keeps going on. Other people have suffered a little more than than I have a white male doctor. Other. People have had some of their symptoms somewhat dismissed. An part of the reason is the symptoms are really so strange. I actually think the people sometimes don't believe the symptoms that they're getting because it does mess around with your head it messes around with your mood, and then if they have a doctor, the is relatively unsympathetic doesn't know about long cove it they get dismissed. On there, other people in the same boat. The thousands? Most of these people up people, the not officially recorded in the system. Pull Garner now given as he said that the HFS doesn't have good records on these people. How did you find out the scale of the problem? One way is using the UK's Kovic symptom tracker APP, which is got millions of willing participants logging the symptoms they're experiencing every day. Tim Spector. From King's College London leads the team that's been looking through the data. We know just after about the first month of collecting symptoms and we found those group of you will just kept logging. The average duration of symptoms was between ten and twelve days. But around ten percent of them had symptoms that lasted for over a month at one in twenty still have symptoms tremont song. One in twenty people when you think of APPs three million people infected in the UK is a lot of able with debilitating symptoms yet that that's a huge proportion. What kind of symptoms were these people getting? Will we ask in the about nineteen symptoms and the ones that seem to be coming up strongest were fatigue array, severe fatigue, but initially? Really could hardly get out of bed. And that would often cycle as well. So it would improve and then get worse. Muscle aches was another common thing is assisted. And shortness of breath the other one which is rather strange which occurred in about a fifth of these people was loss of smell and this seems to be lasting Munson. Some people which doesn't sound very important city stop thinking about how that really affects your ability to appreciate food and drink and. Can make you very crest if you lose it. People representing with a whole range of different symptoms on top of that. We actually had three people that after three months was still having intimated favors. Wow. Is really strange and we have about eight percent of people that had rashes that would appear on fingers and toes. This witness symptoms varieties now starting to be understood because it looks like different antibody responses and all these different subgroups. And I think as time goes on, we'll see and it's not necessarily one disease but as perhaps six or ten sub disease or sub responses to this I, tend to avars. Tim Spector. SA- bizarre ruinous indeed, isn't it with us is Oxford Base GP Helen Soul Spray. She's been seeing patients with the scientists. Is that a pretty fair summary. Helen you're. You're seeing people with those sorts of symptoms absolutely, and I would say the most common symptom is the fatigue to just not being able to do stuff. Patients who previously that being really fit. That'd be sort of people who'd go running several times a week, and so actually they weathered the initial illness not so badly suddenly they didn't need to go and get oxygen hospital or anything like that. And as a consequence, they never had a a swap so that never got a proper diagnosis but now. Months down the line they still get obsolete. So extent if they walk culture of Malta, the local shock and then have to rest got patients who say I was okay this morning but also shower had to sit down for an house. That's no way of getting back to life. And how quickly off the people are the ones say recover because they haven't. But how quickly after the acute symptoms do people notice that they're getting these bizarre constellations of symptoms and I'm particularly this fatigue? I think it's a little bit difficult to know because for many of my patients, they didn't have a contact me particularly the people who were in April, the big message going out which was saying don't call anyone less. You're really really really sick is a different partner for each patient I think the each have a different set of symptoms. So some the thing that's really bothering them still is being out of breath I've got one patient twos having fevers, persistent fevers all the time, which is really difficult because everyone thinks she still infectious which she isn't. But just still really affected by those favors and stopping at things when you say that you know she's not still infected. How do you know that? Because we've the reason Roskin this question the reason for us in this question is poor Ghana who we were hearing from just now infectious diseases Dr, who described his experience. He said he had an antibody test and it was positive but he was interested in whether or not. He still had virus in him. It's really difficult to tell this particular person I think has had swap tests the proof she's not carrying the viral Rene and more, and some of the patients have posted antibody tests but not all of them and that's also really difficult things for people because if they didn't have a swab in the first place although they had symptoms that they came on the right time had a really convincing set of symptoms. You think Yep that's definitely covert, they don't now have any antibodies. because. We know that some people's antibodies Wayne quickly. So it's it's actually really difficult to tell. Am I think somebody else was talking about how difficult it is. If GP's don't understand what's going on and if you have no swap to start with I'm no antibodies now on a collection of really really wit symptoms it's unfortunate quite a few patients are not getting a fully sympathetic or empathetic response from that. Will. Dwell a little bit more on testing a bit later in the program to explore some of those deficiences that you've highlighted Helen have. You noticed though in the patients that come to see you with the symptoms are there any general trends of the kinds of people who presenting like this and you can say they fit a particular group or is it just all and sundry all ages both sexes young old? No different sundry I've probably got more slightly younger patients actually not so many patients in the sixties and seventies but more patients in the thirties and forties I would say, I mean that may just be good for patients I'm seeing. One of the good things are just beginning to see some of these patients. You know what? I feel that what? It's not just for day or two I've actually felt better for holy. Hell and thank you for ending on that very optimistic note that's GP Helen source break with her account of the patient. She's been seeing with the long tail of coronavirus infection. The naked scientists podcast is produced in association with Spitfire Cost Effective Voice Internet, and Ip Engineering Services. The UK businesses find out how Spitfire can impel your company had Spitfire Coach UK. Music in the program is sponsored by epidemic, sound perfect music for audio and video productions. Miss, we will learning about long covert the condition where corona virus sufferers recover from the acute infection. But thank God wants to develop a teague another very bizarre symptoms. The Ken lost months and hints are starting to emerge about the damage or complications that are going on in multiple different or in these patients and a group of medical scientists in Germany have recently discovered ongoing heart issues in a significant proportion of people that only ever had this mild covert cardiologists. Valentina Portman explains we investigated patients that recently recovered from covid nineteen illness. So we have the very, very deep look at their hearts. And in these patients, we found that many many of them even if they didn't really have a rough course of the original illness, they still had persist and ongoing cardiac inflammation a little bit like a flu of the heart. How many of them had this kind of inflammation? We scan total of hundred patients seventy eight off. Those have had some findings in the heart. Of these sixty had very active inflammation. Inflammation within the heart muscle something that we call myocarditis as well as inflammation of the lining of the heart pericarditis. How long is this after they were originally sick? The average time from their original causative task was seventy one days. Wow that's a long time since they had this, you know positive test what's going on? This is the question that obviously I can only speculate on and it is not due to an ongoing infection of the heart muscle. So it is not the virus remains within a heart cells. The body itself is understanding the inflammation of the heart is something that it has to fight against or tries to control it but this is obviously at this present point hypotheses. Juno whether this kind of heart inflammation might linked to any specific symptoms that people are feeling months after they were supposed to go better from covert. That is very difficult to say because Hark inflammation does not present with specific symptoms being knocked feet especially young patients. This is one of those symptoms definitely can make aware of it. However inflammation takes a long time to present itself with what we call text book symptoms, chest pain shortness of breath swelling of the legs. But in general, then this might be kind of a hint as to why these people are still unwell. Absolutely this is definitely one of the things that we should look for very early and very fast if possible. In konic inflammation trying to be very sporty very fast is probably not the right thing and I think if any message can be given the present point is that we just need to give the heart as well as the rest of the body time to heal. Balancing appointment from the University of Frankfurt explaining her study from the Journal of Cardiology. Now, this sort of inflammation is a strong hint. The body's own immune system may be a key player in this long tail post, Covid Syndrome and with us to discuss it is University of Cambridge's. Clare. Bryant, so clear what do you think's going on? Yeah, that's a great question Chris and somewhat complicated by the fact that. We're really just beginning to understand what's happening with the immune response per se. But basically, inflammation is the way in which the body tries to control infections, and therefore the production of information should be protective response against the virus. But what seems to be happening with this infection is that the body is mounting an excessive response and then the longer tale presumably, you'll guessing some long term inflammatory response that somehow is not switching off in the way you would normally expect it to after an infection. So, we're getting effects, which is short term. The virus goes in it does some damage you get inflammation because it's there that successful and gets rid of the virus, but it's almost like the vestiges of the inflammatory response just remain grumbling on indefinitely and damaged tissues. That seems to be was happening and that's really quite concerning because. One of the things we noticed that the has is able to attack feel sells sells line in the lung, the plug vessels. This evidence suggesting that infected cells of the loin vessels is communicating with immune cells, and this then is causing and triggering information in this can actually cause reprogramming of different immune cells and presumably there's a reprogramming going on which is leading to the unbalanced immune response that we're saying. Why is it so pronounced in some people and other people don't even know they were even infected. Think we really know tool. It's really not clear toll why some people get nothing other people get this kind of long effect. Do you think is the virus or do you think it's the individual? I guess it's more likely to be an individual response in that the virus is going to have pretty similar effects wherever it goes. It just depends how you as an individual respond to that virus. And potentially a host genetic factors that we just don't know about. In Cambridge, the Department of Medicine. Adam Brooks Hospital have been running a very important study where they've been collecting samples from extremely large numbers of patients who have corona vars of a range of different varieties, and they're following through those patients and looking actually at the aftermath as well as when they're acutely unwell. I wrote to Professor Ken Smith Today he's on holiday so he was unable to join us on the program but I asked him could you tell us a bit about the findings and he said that one new observation they've made is that about twenty eight to fifty days after the first symptoms with Corona virus people with even moderate disease who have recovered and gone home have changes to the levels of white blood cells in the blood. And those changes. Don't seem to be resolving. They've got some cells which are higher many cells which are much lower and he said to me that this raises the possibility that there could be some kind of ongoing immune abnormality after covid nineteen that's driving some of the symptoms including the long-term symptoms seeing, and the fact that some of the the cell levels are very low. He said to me is there a possibility of post covid Immune Deficiency Syndrome and actually it wouldn't be so unusual for that day and would it because in the last year we've seen paper published where when people catch measles virus? Measles goes through the immune slate clean people lose all of their immune memory and their immune to measles, but then they're not immune to anything else. Yeah I mean I think that's extremely interesting and if this is true in covert as well and this data would support that as a possibility, a sort of immune Nisar. The Not. That's extremely interesting and really speaks to us as thinking really carefully you take a post covy patient. fave also had their immune slate wiped clean. Then we need to think about boosting them for vaccines against other infectious diseases to protect against secondary infections, tertia infections. But to one side for second why do you think that people are presenting with the symptoms that they are Helen. I'm Paul who we heard from earlier in the program. But both describing this profound fatigue and fatigue that you don't know is there and to do something, and then it kicks in why would the immune system produce symptoms like that? If you have a generalized inflammation. Information your heart or you got information in your lungs. You. Probably will feel fatigue because what happens is the function of those tissues is compromised. You get a less efficient cardiac function you're guessing less optionally ritual brain and your your muscles. So therefore, you will be tired if you're getting less efficient spirit, she system function because you lung damage or long information than you'll get less oxygen delivery in that will make you fatigued. Information in a nervous thousand south of the brain will lead you potentially feeling fatigued. So there's a whole host of factors here where information on the hall, where if you've got unregulated information, which is no longer fighting the infection. It will make you feel bad information makes you feel bad. With that mind ep what's going on with the next person we're going to hear from this is Barbara Melville. Had Corona virus and has subsequently had long tail symptoms very similar to poor but many of them mirroring some of the points that took place been making. It's been a roller coaster. I've had symptoms since the middle of March. Start with coffin congestion nothing to concerning. Fast forward a couple of weeks later on I can't breathe properly at one point I was unable to walk. A cold one, one on the Tim Sunshine's it. Few minutes later, I collapsed rating with heats Antarctica an ambulance. Wet. Tolls Patil at that point diagnosed with COQ nineteen. Able to test me for the next ten weeks. So obvious bad boned with breathing difficulties low oxygen saturation's Tennessee Star Rio, dizziness nausea you name a harder but the main problems which continue to this day are breathing difficulties. So I can actually walk more than a couple of minutes. Sny I used to be an avid hell walk her martial artist am cut get to the end of my street. And you're talking to me now is this an effort as well that it's going to take it out of you and maybe come back to hit you tomorrow I haven't really had that kind of post viral fatigue people talk Abo- for a while. So I'm lucky but I am the APP MINIMA support. Group and they are definitely seeing this pattern of what we call boom and bust whereby do something and then there's immediate effect. Personally that's not why I'm seeing what is wire malone nervous about the blanket label of push viral cheek for everybody I sent not maybe the case for some people haven't been the case for me. Have you had the antibody test When I was in hospital, they were unable to do it. They said, they get into trouble and I've decided not to have an antibody test present. My feeling is they're not robust enough. I'm concerned that if I worked to have a positive test that may have stigma attached to it to rather lake HIV did back in the ninety S. Of heard from a few different people that some of their symptoms are like weirdly brain related. Yes. This is an interesting one. People talk about brain fog not a collective way of describing memory loss are that thing where you put your laundry in the toilet instead of the laundry basket? That sort of thing that d really get to get some. Clarity on urological, site. Bobber Melville. Clare. Many of the symptoms that Barbour describes quite acute symptoms. Do you think that she's got sort of injury to various tissues caused by the virus directly and she suffering the effects of that or do you think she's got these subsequent immunological effects going on? What do you think it could be both? A combination of both but my slightly immunological because information leased average long-term damages is exactly the kind of symptoms. She's the reasons for the symptoms that she's describing. And what about the prognosis in people who have this Helen did say earlier that some of our patients saying I'm beginning to turn the corner but once you've got these footprints in your immune system caused by affection light covert. They. Therefore keeps or will this eventually sort of put himself? Right. We have to hope that it will eventually solve itself Crisp. But at the moment, that's a big unknown heavens giving us some hope but really we just don't. Play thank you clip Bryant from the University of Cambridge Clare Staying with us through the program will be talking to a bit later on about getting a test for covid. So far in the program, we've learned about the condition of long cove it and we've heard some possible explanations for what might be underlying them. But now we're GONNA turn our attention to the more unusual symptoms as well as taking a look at some options testing and Treatment Barbara. Melville asked us to provide some clarity on the neurological sight of this disorder and humanity that is University of Cambridge neuropathologist Kieran Allinson Kieran, how can the current virus affect your brain? Will think. Brian can potentially do that by a variety of different mechanisms. Potentially the current of ours could actually infect the brain tissue itself and cause inflammation. In the brain tissue. May might be that the immune system causes excessive inflammation generally throughout the body including the brain and maybe the virus doesn't actually end the brain at self, but it sets up. An Immune response that causes inflammation in the brain. Now it's it's quite hard it for viruses and other stuff to get into your brain because obviously that something that the body desperately doesn't want if if that's actually what was going on, how would that be happening? Is Variety of possible roots into the brain. The vars do take. For example, the factory nerve is where the herpes virus simply virus infects Brian Vaa. It may cross from the Blood Savar in the bloodstream can cross across the blood brain barrier, which is the largest barrier in body. It's bar deliberate doesn't let much across Ernie selectively let certain things across. And it might be the versed get into the nerves. Come off the spinal to come of the brain stem. Trouble Buck in the nose and get into the brain that way. Do you have any evidence either way I mean you're in Europe pathologist what have you seen? Of examined. The brains from a few people who them Cevik covid nineteen. I've seen a variety of different changes of certainly seen what we call encephalitis, which is inflammation of the brain. So that's some wanted cells of the immune cells in the brain tissue causing inflammation and damage. But I didn't actually detect the vars in the brain tissue. So, I don't know where the virus was that an sets up the inflammation. Or wherever never that but sets inflammation in the body. And that can cause damage the brain we've vars ever been directly in the brain tissue. There is no good evidence yet the covid nineteen bars can directly infect neurons and other brain cells, but it certainly as possible. The other way I've seen the virus. In fact, the brain is strokes and might damage the cells that line blood vessels. And the brains full blood vessels, little tiny blood vessels, and it can cause them to close off form strokes of you that die and that might relate to the fact that the virus causes. This hypoc regulation always makes you more sticky more liable to clots. So I've certainly seen both forms of brain damage in. Nineteen. If you had to put money down anything what would be your bet because people like Pau have talked about he actually asked us to ask someone like you. He says, I've had things like wild swings and mood sometimes I wake in tears feel absolutely side by the afternoon I'm almost high ready to conquer the world. No history of mental illness if you had to put down, what do you think is going on is the virus you know getting into his brain or or what? Will. So it's been increasing recognize. It definitely does the Brian caused brain symptoms, neurological symptoms, und-? Some equal encephalopathy whether brain isn't generally isn't working very well. I think. That when they've tested the set from patients with North Sue. What's what's CSF? Spinal Fluid Paves the brain spawn Gordon's or provide it nutrients, etc.. We can test for the virus on on patients where they've done that doesn't mean very many where they've actually detected the nucleic acid of the virus in the several spinal fluid. My guess is more that it's A. What we call a power infectious process. So the IT Jus, the infection, but not directly to the of the virus. So think the virus causes the scientists storm, which is massive overreaction of our immune system. In susceptible people and not can damage blood vessels throughout the body that can cause the blood brain barrier. It's become more leaky. So inflammation that normally wouldn't get into the brain what would know may not pass into the rain Might be able to across Lebron Beria. Interesting. Maybe, the brain itself in terms of other neurological stuff poll and lots of other people that I've spoken to talk about this fizzing feeling Paul says it's in his arms and legs other people states in their skin. Some buzzing and call it pepper corn feeling. What do you think might be going on there? Was surprised things out about covid nineteen as it can damage the peripheral nervous system, which is all tunnel nerves start your skin provider sensation. This is a real feature post covert of dumbest to perform nerves causing changes in the sensation of the skin. So mobile loss of failing what we call anesthesia, but also just changes in feeling so unusual or maybe painful feelings were just from light-touch Cetera. Karen. Thank you so much that Karen Allinson and a paper by Kieran as well as our very own Chris Smith, which is on the possibility of the coronavirus using this vegas nerve a nerve that goes into the brain to infect the brain that's recently been accepted by a journal called neuro pathology and applied neurobiology, and that paper should be out soon. Well let's go back to the immunology of all of this with us is a class Bryant who is an immunologist at the University of Cambridge and Clare One of the things which has been at the heart of of many of the debates, discussions and arguments all the way through the coronavirus pandemic is testing. Initially everyone said, we need an antibody test because then we can work out who's really had it. Now, we've got antibody test and people still confused not least scientists. So what's going on? Yeah it's It's a bit of a disappointment isn't it? Antibodies made. Over a period of time joined time Colston when infection. So timing of the antibody test is absolutely critical. So it appears that in the first week of infection using antibody test, you only pick up about thirty percent of the people this because you're antibodies are just beginning to be generated. than by but weeks two to three with antibody levels of peaking, and at that point about seventy percent paper will positive. After that? We were a little unclear because it depends how long antibodies last four and how sensitive antibody test is is a little bit disappointing because one hoped it would be a little bit more clear cut than that. But it it's beginning to appear that the antibody test is not going to be the magic silver bullet that. Prime Minister. hoped it would be. Researchers in Sweden recently said, we'll antibodies not necessarily the bill, an endle- and actually white blood cells t cells, which also helped to fight off infection play a massively important role and some people might have no antibodies but lots of t cells, what are they getting at and would you agree with them? Yeah. Yeah. Definitely. I mean. There's this two sides to every story with immune system. So what the T. cells do say they detect pickup and destroy infected cells. T cells also inform the B. Cells B cells, the cells generate the antibodies. So also help pile out more antibodies to attack the virus as well. So anything that stimulates cell responsible help with generating protective immunity against virus. So antibodies on the T. cells are actually critical to generating a potentially protective immune response. But again, I say that with the caveat that we hope that this is what's going to happen and we hope that the this is what a vaccine should do is stimulate and sponsors and t cell responses but as yet we don't actually know because we haven't got that data yet. If we look it of a corona viruses because there are four common human krona viruses that come every winter nichols common cold type symptoms. One of them infect cells are exactly the same route as this new corona. Navarre's so can we get some clues from how the immune system responds to that to inform what the likely long-term response to this new one will be? You can get what against that particular corona virus and that will help you against calls for the wall. Trouble is the protection doesn't seem to last very long. And so there's a lot of discussion about willing. If you use a vaccine, we need to be regularly boosted if so frequently because the protection you get against the Cocos and corona virus doesn't seem to last for tremendously longtime. Clear thank you and I suppose one piece of good news is that the data we have so far from some of the vaccine that have been tested, they do suggest that both t cells and antibodies produced in response to those vaccines, which is encouraging because it sounds like from what Clare saying that's what we need. Clermont thanks to our guests. Helen. And Karen, Allinson, as well as poor Ghana Tim Spector. Valentine appointment and Barbara Melville and let's hope that there is both more research to understand the condition and opportunities soon to support these patients at the same time as those who are coming out of critical care. Finally now, we've just got time for question of the week and this week at a Murphy has been searching the files for an answer to this question from Johnny does bearing paper in a landfill sequester carbon. Accents in a way trees are in the grounds trees make paper. If you put that paper buck in the ground you're helping out. Right. Well. Sean Fitzgerald from the Royal Academy of Engineering and visiting Professor at the University of Cambridge might stop us from barking up the wrong tree. Carbon sequestration is the process by which carbon dioxide is removed from the atmosphere and locked away in various forms such as being buried, underground, converted to minerals such as carbonates us to raise the carbon content of soils or stores would for future generations. It is very natural to pose the question does burying paper in landfill. Sequester. Carbon. When my I thing that given that trees contain carbon and trees were fell to make the paper if we could keep it landfill that might be a solution however, there is more to it than that. We need to consider two things the results of making paper in the first place, and then what happens if we put it in landfilled of course as with many things signs, the truth is quite simple. The tree loss caused by the manufacture of paper is staggering. About thirty, five percent of trees felled worldwide a used to feed the paper industry. We're not replacing these the rate we're failing them. So I use paper isn't helping here. About landfill once we have used the paper. Well paper doesn't stay the same condition overtime it will decompose and release methane and carbon dioxide. Both gases are a real problem. Methane is more potent as a greenhouse gas although it doesn't last as long in the atmosphere. But nevertheless, it lasts for years. So was a real problem. The simple answer is to use less paper. Thank you sean for digging open answer to that one for us next week, we're looking out for an answer to this question from Lionel. I'm still descent switches on a light when it takes a sound how? My hands the come on fractions of a second before the sound does he take my brain long process assign than the light? What do you think email Chris at the naked scientists dot com or come join in the debate on our forum naked scientists, dot com slash forum, and if you have a question of your own, we love getting them send them in by email or there's a simple web form on our site naked scientists, dot com slash question, and that is it for this week on the naked scientists as always if you're looking for papers that we have talked about, you can find them on our website along with. Transcripts for the interviews that we've done and next time. How well can you understand the people around you? We look at everything that goes into communication from your words, Your Voice, and some things you might not be thinking about plus town Mike. COVID. Nineteen, get in the way the naked scientists is brought to you by the Institute for Continuing Education at the University of Cambridge and is supported by Rolls Royce? I've been filled. Sanson. And from all of us here at the naked scientists team take care goodbye.

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