a very large subset of people who simply took several weeks or months from now a year to recover they still had for tea breathlessness and brain for problems with their movement and make outs and many others that the last it lasted. he had a goal could be of experiencing the the empire to the pandemic for the 1st time this was very much thought to be a chest infection that affected people's breathing but it seems to be a great deal more than not particularly for long covered sufferers i think one of the real confounders for a long coat it is how multisystem it is it moves around your body and that teaches us something about all the places the virus has been to do damage and it will only different organs it can affect so exists an example of a virus which almost attacks the weak parts in your system and that tax them specifically when called mysterious like that isn't it so i think most people you know it's been a year of steep learning curve for science and everybody has landlady roots and one thing they've learned is the receptive this virus is called a stew and a stool is in many parts of your body not just your lungs so there's many parts of fact that i listened to the tell him a long call that came from sufferers explaining the condition to each other they on lying on the on the on the internet yes i think that's really. very important to understand that the the understanding one crave of your gender has absolutely been led by the sufferers themselves recognizing it's the thing giving it a name and just flicking for some attention which they so so urgently need and it's a kind of phenomenon of the social media age that they've really made the running on this in a very intelligent way. and the how decide to leave yourself as a scientists and academics i mean all just and terms of understanding a condition which is very much dependent on human experience but is very multifaceted but it's it's when you experience for me in a way a very real rewarding experience because this is a chapter to textbooks that hasn't been written yet we don't know anything about it so you know how am i going to learn about it or know what to research it only by asking people who have got it and luckily the very network very articulate very well informed and they're telling us what perception that's a great story. the sometimes the compound us is being made with a me is that a useful comparison or cannot be misleading well i think it is and it isn't it would be useful if we understood more about any but all least years later we don't understand it very well so the use i get out of that is that they can feed off each other and influence and whatever we learn i think it'll be useful across the board a by definition we could only have heels experience of long covered suffer us but in terms of the cases that you've seen should people be hopeful that even those suffering from a long cold will gradually get better or is a situational for some people even more serious than not really really important question yeah because as you say we don't know where we're headed this is in uncharted territory and i wouldn't have known what to tell people if they saw a 6 month story a 2 year story and i feel a story and that has implications for them for their lives the health care provision for policymakers really hard to know i'd like to imagine it won't be too long from things i've seen in all of our infections and from the point that i've seen some people already recovering but he noticed. and in terms of the study of the condition any closer to understanding how the virus is and to that thing with the body as a result of of people beyond the observation and treatment. public of pete the phenomenon of this you know this crazy year we've been through in the last year is that we've become very impatient and all of medical research has been on fast food and everything is coming off so fast that if there is a brand new disease and you know some months into it we still can't explain it we feel impatient and said the answer your question is that we're kind of at the beginning of that story and have our tests to do and the hypothesis but it's early days. now understandably a great deal of the focus of the was suffering from covert has been on the acute condition the intensive care and some drugs which of approved the prospects of people going into intensive care has it been difficult to get the same focus on the long term effects of the long call that has a has been on the acute suffering of those in the intensive care was i was very important it's been very hard to get attention for long because you know you summed it up very well and there's a big difference between the e.q. to emergency or if somebody having to go to intensive care because they can't breathe and might die and somebody says well you know i used to cycle to work and now i can i can hold the world for now i can hardly get out of bed so it's a much more nuanced diagnosis much harder to count much harder to get attention not harder to get funding for research for science of course as give us great hopes for the vaccination program that will settle if not oh the woods yet but nonetheless hope is rising it's in the ascendancy it's of the same optimism for the prospects of people who are suffering from long covered up to a point i'd like to think so i think that the vaccine discussion was a different one because the next analogy a was so advanced ready for battle we knew what we had to do we need which facts teams were needed and we had a stupendous vaccine is that it needed preparation for 10 or 15 years that were ready to go as soon as we knew that we had to put this spike antigen into them and make them and they will have been actually wonderful for learning code good we don't quite yet know when the details we're dealing with but i think the 2nd we can get in there and do all the analysis i think things yes might might move quite fast . and our policy makers beginning to in the same way as they have the daily press called for sister to say how many infections of the death rate in casualty rate in the hospitals are the number of vaccinations are taking place are policymakers getting to grips with the long condition and all that that means for what place policy for general practice feel to dent defy the condition are we getting close to say we're going to have to do is look at this if we're going to help the people who are suffering i think it depends what you mean by the way getting to grips sarah think i think the u.k. has been better than sam in terms of realizing it's a thing and saying the right way and acknowledging that something has to give on the other hand it's not enough simply to take a clinic and you know nade up a signpost that says no one could have a clinic this way because you need to know which doctors have to sit in that clinic what their specialty should be what tests they're going to gave what treatments they came to give you know for a disease that could affect the lungs the kidneys the heart the brain you know this is many many doctors of many specialities he could team up to resolve this so the declaration of intent to step down but actually knowing how to do it is you know a long way to go. and you work you'll come across many patients when the sufferers of long call that inexperience what is it can be said to the people who are suffering from this new condition which is very difficult to explain because of this attack of the systems in multiple ways there is an aspect of hope and i think colors meant they can be given to those who are under the cost of long covert i think they're into the question at every desperate because many of these are young people family very active whose lives are transferred fuse jobs are correct some of them have lost their jobs their lives have been turned inside out and back to front like this thing and i think only of folks like me can try and do is use our knowledge of immunology and our of our infections to try and put forward the best possible hypothesis of what this is all about and get working on it and try and offer some solutions and this is i said this is a very infirm group who i think are quite receptive to that country. and there's a lesson for white or society from the last year that we're going to as a society have to mend our ways or because we might be seeing the the shape of things to come if we don't. on so many you could do a whole t.v. series on this. about the way we live on the planet and the fact that we we have one voice you know who sees you know a movement of farces new animal kingdom into our lives if you think about h.i.v. and get better and murders and sars and now this one because we encroach money. on other environments. and then i wouldn't be doing my profession a full justice and that's i said that we need to be prepared in terms of. capacity and medical research for these emergencies. you know the quote for me was if you think medical research is expensive try to look at the last you know and the cost of not doing enough of it professional them thank you so much for joining me on the elie saab and she'll. join us after the break well alex is in discussion with someone debilitated by this is a condition of local that we see the. lake taste on like site or and like hearing the brain doesn't have an organ for time right we have no organ for time nor could we because time is an immaterial physical substance like matter or like life so the brain has to create the perception of time. the. debate is is it fair for transforming our plates to compete and women scout of course in sports. as a society we have decided to categorize sports based on sex i definitely need to do not think that it's fair for athletes that when foreigners pile logical males to compete in the women's category. why do we have gender or do you have gender categories in sport because we do treat men and women differently. every single beat athletes will we all have biological advantages over each other. are the same use a lot of. friends are those of you here as a goal to. develop confidence and belief in myself and i've learned the value of hard work and dedication. no doubt. that these men say that they feel like to love it and they will not ever know what it's like to feel the loss of the baby her maybe biologically for you know that these that they will never do they really think this is fair. i just don't believe it. welcome back now the term long covert was born out of many online discussions at the start of this pandemic for many it's not a virtual reality but a real life disease that people are suffering from alex is that in conversation with dr natalie mcdermott to myself is trying to recover from the included. document thank you very much for joining us on the the hour examine show and thank you for having me. doc with them at the white but when did you 1st realize the infection you had was having a a long lasting impact where did that realisation 1st come and so i think i initially hands and caveats in march 20 twentieth's end of march but i made a full recovery from that and then in may time i think i rinse infected again and i had a home a starry identical illness you i had in the march time but i also developed nerve pain in my feet which i thought was a bit unusual but i seemed it would settle down and then after all my other symptoms settled down after about 2 weeks and the pain in my feet continued and i noticed that my legs weren't as strong as they had been and that just things didn't seem to be at quite right so it probably started very soon after my cute symptoms finished and and the student settled down. over the did the term local that seems to have a mad form groups of people suffering from the condition exchanging that experience across the internet but of course you are you're a physician so you would also have the the medical background but was it part of the the groups who experienced the condition the way just to believe that what was happening to you wasn't just to you but to a large number of people. yes so i suppose in in the summertime of 2020 i i actually hadn't really connected with any of the groups yet so i just realized that things were getting better and then things took a significant downturn in the september time but i really only became connected with the groups probably at about august 2020 and at that time then i realized that i wasn't alone in having ongoing problems but i think that the scale of the situation was still coming to coming to our knowledge so we realized there were quite a few doctors that we all said and gradually realized that when oprah of other people who were experiencing ongoing symptoms and how did that impact on your own work. the health service the what were you able to continue to work or was there can this just saw the billeted thing about wasn't possible and say for the test about 3 months after it happened i was off work largely because i couldn't walk far enough to actually get to work or walk around the wards so i didn't really feel i would be safe calling carrying on coldly or anything like that and then from the september time i returned to my academic research job for 6 months which i was able to do from home so i've been doing a slightly reduced number of hours but that working from home since then and i've returned to clinical work in march but i'm doing that virtually at the moment so doing clinics and things he's saying the more teams. a doctor and you've been one of the people who have been able to speak out about the condition and did you for dress the all party parliamentary group but westminster do you feel that the message is getting across to the policymakers that long over there is a real condition that many many thousands of people are suffering from and something else to be done to recognise the impact that that's having on a large section of the population and yes certainly since the end of last year and into the big beginning of this year there's been a lot more attention on the situation at hand i think people are taking it seriously now certainly n.h.s. england at tyson some money for clinics to support people with ongoing problems following caveats that nice guidance was published at the end of december time the initial sort of guidance on how to manage people with long caveats and then the all party parliamentary group they have many requests to karla meant about things that need to be in place and i don't think all of them have been taken on board yet but they've done a great job of lobbying for. a long crazy jewel case created problems to be recognised as an occupational diseases in trendline records plenty understand that with this overpowering threat to the health service from the acute condition and with the huge public health effort to try and control coronavirus lobs in the population that speedo quite easy for the people suffering from the long term impact almost fall through the cracks of that policy is that the the difficulty of getting people to the focus on the the longer term in part. yes certainly i think obviously and during the fast way we were aware that there might be a longer term impact although probably we should have been because with many viral infections there can be a long term sequentially that we see so we probably should have been aware of it so much at that point and then i think that the 2nd wave certainly impacted on people becoming increasingly aware of long cave it and then while people were becoming aware of it and recognizing that it was going to be a significant health burden within the population then we reached the n.h.s. being saturated during that 2nd wave and at the beginning of this year and so a lot of appointments in clinics that were supposed to be in place got put on hold to deal with the acute effects of that and i think that some the standard for you have to deal with the acute imagine but there is an imperative now that moving forward even if there are future waits if that pandemic we need to be able to maintain n.h.s. services and outpatient services and start to understand what's really happening with with long mate and this whole multitude of sit symptoms that different people experience. with them and tell us what about your order work as a physician and i know that you were involved in the containment of the ball outbreak in africa yes. pediatric infectious diseases doc temple i also do disaster response and and emergency medical response so i was involved in the very next demick in west africa i was in liberia for about 6 months and then i returned sierra leone at the end of the epidemic to undertake research into about as i have quite a lot of research experience in academic and pandemic diseases now. so you love very unusual position of physician who has studied and faces viruses and the impact of the mental nationally and you see the the impact of the pandemic a whole month of yourself suffering from this long term condition what message can you give to people in your position that science which is coming to the rescue for vaccination of the acute spread of the virus may also be able to hold the key to addressing the problems of long covert i think we need to recognize that long code it is a heterogenous group of of symptoms and possibly several different conditions within that and it is likely to be if you if you want the epidemic within the epidemic and as we come out of the it keep phase if this pandemic and we truly don't see featherweight still remain due to them vaccination now being in place we need to recognize the significant burden that long cave it is going to place on outpatient services simply for the access to therapies such as physio therapy and occupational therapy but also for the investigations that are involved and and the potential for some of these people to have long term organ damage especially if not managed it sort of promptly and the symptoms are allowed to sort of dwindle for quite a while so we need to be treating people but we also need to be investigating the underlying cause of what's going on and determining the classification of what long days and possibly trying some different therapies like we trial with educated in hospitals we need to start looking at clinical trials for things that might work for different groups of people within the. that presumably the suspect of the of the the level of suffering with some people might have long term but fairly mild symptoms for some that the symptoms are very serious indeed there's sort of a full spectrum of people who are suffering that after the fact so long kovar there's a continuing debilitating condition yes i believe so as we've seen from some of the survey data that's been published from some of the support groups there are vast numbers of different symptoms reported for different patients and some people are predominantly experiencing a fatigue like picture and possibly a pace viral fatigue which hopefully in time will get better and certainly with the right therapy support will get better but there's also a grief of people who are experiencing inflammation in the heart people experiencing problems with that nervous system in your illogical disorders so there's a huge huge spectrum and some people will have mild symptoms that might well result themselves within a few weeks after after their acute cavies or within the 12 week period we know from the office of national statistics data that we think about 20 percent of people might be at risk of lung cave it's following an acute case that illness but that by 12 weeks we're looking at about 10 percent of people still having ongoing symptoms so many people will will have their symptoms resolve in that 12 week period but there is also a good proportion of people who aren't and they are possibly the ones that need more intensive therapy and hurt and also investigation into what is going on and how we could better manage back their condition. and that way for people who are watching the program who cover the partly from culver but something's not quite right. paul with good advice be to the set so for the information and support groups to give them assistance and so there's several online support groups on on facebook that can be very easily found by just doing as sach but that is long hybrid s.o.s. and then there's the one caveat support group but i think initially if people have symptoms that they're concerned about the 1st port of call really should be speaking with their their g.p. and just seeing if they need to be referred to federal investigations or if they can be referred to a long havey clinic or a post cavan symptom clinic to see if they need any more investigations into possible organ damage or if they can access then fairly promptly some good advice from physio therapy or occupational therapy managing their symptoms and how best to come through this illness and finally doctor the damage in terms of your own condition the hope and progress that you're moving towards recovery. so i haven't seen any any significant improvement in my condition yet and lots i'm hyping that with some intense if it's yes there are p.r. i might start to see an improvement scene but at the moment i think it's still early days in the recovery process the automatic limit them up to you have our very best wishes and of thank you so much for joining us on the the alex salmon show thank you very much for most of us hope so for a lead into the pandemic trauma of no very real many of us of how divisive they still are those of expecting to get one very soon indeed across all 4 countries of the united kingdom the number of cases of cut all advisors of following a live course of deficit from a covert is falling as well. the chill wind of recession is still to blast across the population but nonetheless hope is in the ascendancy right no but for those who have been afflicted by a lone cove that the date may have continues and shows no sign of abating we can only believe that the science which has brought us vaccination will also biggest treatments to relieve that suffered so that if i'm to spin on myself and all of this sure is good bye for now i will see again that. americans love by and homed. this was a fundamental part of how our political leadership and our country of large understood the bargain you get a hoe and then you know rebel right as the things you don't revolt if you have a stake in the system. the really interesting sit down and think about the longer deeper history l.a. housings man in the united states not just the question of the american dream but the bigger question if you dream is for. as you read the stand in here from us and. our own move from what i saw. in our good armor on our show at the from there are rather democrats i thought before for america. i'm going to let him but i don't cut him then you cut and kick and. i don't lose a child with a truck full that it. doesn't make. me want to work then i'm modeling my michelle the times i know it does. and lot of the. members that i would hate for not doing. good for its whole food place choice i knew for years and payouts that time in theory has said. he she ought to have a. model for them after the couple fucks around mr hates it for jim and then oil for food are fairly mundane for. the money. the words dance off me and sticks to you. as part of a lot of my patients new response to joe biden labeling him a killer in a recent t.v. interview look at whether the american president's promise that diplomacy is back is in fact a stab in the back or try to come. we are in the crisis of the century. and i'm not ruling out anything anything for now european union threatens its allies with a covert vaccine export ban in a bid to fix its floundering job while other e.u. states call for russia's sputnik thing bags to be approved in the fall and the u.k. should strike trade deals with countries.