Wanita

There was no mention of long COVID and statistics on its prevalence on the Ministry of Health Malaysia (Kementerian Kesihatan Malaysia, 2021) website and according to Dr Christopher Lee, infectious disease advisor of the Ministry of Health Malaysia, “There’s very little data on long Covid in Malaysia. But some of these patients are being followed up by the relevant medical subspecialties such as respiratory physicians, neurologists, etc.” (Batumalai, 2021). The haphazard nature of how both countries had implemented condor sanitaire is not unique to both countries (ah, politicians!), but both countries, especially Malaysia, have failed to consider the detrimental impact of long COVID, not just on the disease burden and livelihoods of individual patients and their families, but to the country’s economy. According to the WHO, long COVID are persistent symptoms of COVID-19. A quarter of COVID-19 survivors will continue to have persistent symptoms for a month, with 1 in 10 suffering these symptoms of more than 12 weeks. Symptoms of long COVID can be extremely debilitating; the symptoms include, fatigue, muscle pain, shortness of breath, ‘brain fog’ (cognitive dysfunction), and autonomic dysfunction. Women and healthcare workers are at risk. The odds of how you can progress to getting long COVID does not depend on the severity of the COVID-19 infection (Davis et al., 2021; WHO Europe, 2021). Yet, we are not doing enough to warn the public about long COVID. We are still focussing on the mortality rates of COVID-19 but dismissing the long-term disability associated with poorer quality of life due to long COVID.

The overlapping similarities between long COVID and myalgic encephalomyelitis (ME) cannot be dismissed (Amitay & Komaroff, 2020; Geddes, 2020; Smyth, 2021). ME is a complex, chronic multi-systemic disease. A characteristic feature that may be present in both diseases is post-exertional malaise (PEM) where minimal physical or mental exertion (e.g., brushing your teeth, replying an email) can cause serious health paybacks to the patient at 24 to 72 hours later, in the form of increasing of levels of fatigue and other symptoms, such as cognitive dysfunction, lasting from days, weeks to months (Davis et al., 2021; Décary et al., 2021). According to Dr Charles Shepherd, the ME Association UK advisor, about 10% of long COVID patients could develop an ME-fatigue like condition from our understanding of previous outbreaks such as the SARS outbreak in 2002 (Smyth, 2021). ME affects women 1.5-2 times more than men (Lim et al., 2020). We still do not understand why some patients and not all patients, develop long COVID after a COVID-19 infection, in the same way, we do not understand why only some patients develop ME post infection.

Perceptions of ME differ across the Atlantic. Harvard and Stanford are just the few top universities of the world focussing their efforts on finding the biological causes of ME in collaboration with The Open Medicine Foundation. In the UK, it is a constant battle between ME patient groups, ME biological researchers such as The Morten Group Oxford, and the medical establishment, for ME to be taken as a serious multi-systemic disease in the last 30 years. The burden to improve from ME is placed on the patient – apparently, certain illness beliefs and membership of patient groups hamper progress (White et al., 2007; De Gucht, Garcia, den Engelsman, & Maes, 2017). Already, a UK journalist, George Monbiot, had been blamed for spreading long COVID, “for just talking about it” (Monbiot, 2021). My fear is that the symptoms experienced by long COVID patients will be psychologised in the same way ME is psychologised i.e., to originate from the mind, and the majority of patients who will be dismissed and have their symptoms belittled, will be women. It is estimated that “1.1 million people in private households in the UK reported experiencing long COVID.” Over the four week period ending on 6th March 2021, females had a higher prevalence of persisting COVID-19 symptoms at 12 weeks. Prevalence was also highest among the 25 to 34 age group (Office for the National Statistics, 2021). These were young and healthy people who did not die from COVID-19 but are left disabled from the condition.