Santa Clara County holds hearing on long COVID

Santa Clara County has led the way when it comes to managing COVID-19 infection. But now officials are grappling with a growing concern: long COVID.

Long COVID is when symptoms continue for more than 12 weeks after infection. A recently published study by the Centers for Disease Control and Prevention found that one third of participants reported long COVID after recovering from the initial phase of illness.

On Tuesday, Santa Clara County Supervisors Joe Simitian and Otto Lee held a hearing on long COVID with a panel of health experts who spoke about challenges with the lingering illness.

“Some patients are very incapacitated,” said Dr. Hector Bonilla, co-director of the post-acute COVID-19 syndrome clinic and clinical associate professor of medicine-infectious diseases at Stanford University School of Medicine. “Many people have to stop working, (there’s an) impact to motor functions.”

The most common symptoms of long COVID include fatigue, difficult or labored breathing, distorted sense of smell or taste and muscle or joint pain. Symptoms can also include cognitive impairment. Long COVID can occur even in people with mild illness.

“If we’re talking about a condition that’s going to affect 10-20% of those who survive COVID, we’re talking about 25 million people in the United States,” said Dr. Brian Block, the associate director of the medical ICU and the associate director of critical care ultrasound at UC San Francisco. “Whereas mortality has been in older adults, the group that seems most at risk to have the long-haul symptoms of COVID are younger, working age adults.”

Block said UCSF set up a multidisciplinary COVID clinic expecting to take care of people who had severe COVID such as older adults and those with preexisting conditions such as obesity and diabetes. But he was surprised by the number of young people coming in without those risks.

One tip health experts offered to help prevent long COVID is to get vaccinated.

“In the clinics, some of the patients we’re seeing who are not vaccinated are younger,” said Dr. Angela Suarez, medical director of primary care at Santa Clara Valley Medical Center. “Making them aware that they’re at risk for long COVID is a good way to possibly convince them to be vaccinated.”

As of Tuesday, approximately 85.2% of Santa Clara County residents age 12 and up are fully vaccinated against COVID-19.

An FDA panel is recommending the Pfizer vaccine for children ages 5-11, who are currently ineligible for vaccination. The CDC still needs to sign off on the vaccine before it can be administered to that age group.

Dr. Supriya Narasimhan, chief of the infectious diseases division and hospital epidemiologist at Santa Clara Valley Medical Center, said in order to prevent long COVID, you have to prevent all forms of the virus.

“Prevention of COVID starts with masking, starts with vaccination,” she said. “Vaccination prevents long COVID by about 50% even if there is a breakthrough in vaccinated persons.”

Few breakthrough cases have occurred locally, but there is data that shows the vaccines’ effectiveness declines over time. The approved COVID-19 vaccines remain highly effective at preventing serious illness, hospitalizations and deaths, health experts say.

Following the Q&A with the health experts, Simitian asked County Executive Jeff Smith and Valley Medical Center CEO Paul Lorenz to weigh in on different approaches to an integrated clinic with multidisciplinary teams likes those that exist at UCSF and Stanford. Smith said the main issue has to do with the number of cases being identified locally.

“In the long run it will certainly be more advantageous to have a multi-specialty focused clinic for long COVID patients,” Smith said. “At this point I think our numbers are sufficiently small and morbidity is sufficiently small that it really doesn’t make sense to have its own clinic. But it soon will be I think, so we’re prepped for that when the time is right.”

Lorenz agreed and said any plans to open a multidisciplinary clinic will be based on input from the county’s medical staff.

“As we evolve in terms of understanding long COVID… we will continue to confer with our medical staff and make any further recommendations to your board through the county executive office,” he said.

Contact Nick Preciado at [email protected]