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CDC to Issue Guidelines As Long-Haul COVID Numbers Rise

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April 28, 2021 — The CDC is finalizing new guidelines for doctors on long-haul COVID-19.

In a daylong congressional hearing Thursday, John Brooks, MD, a medical epidemiologist in the CDC’s Division of HIV/AIDS Prevention, testified that the guidelines were going through the clearance process at the agency.

“They should be coming out very shortly,” Brooks said.

The guidelines, which were developed in collaboration with newly established long-haul COVID-19 clinics and with patient advocacy groups, will “illustrate how to diagnose and begin to pull together what we know about management,” of the complex condition, Brooks said.

For many doctors and patients who are struggling to understand symptoms that persist for months after getting infected, the guidelines can’t come soon enough.

National Institutes of Health Director Francis Collins, MD, who also testified at the hearing, estimated as many as 3 million people could be left with chronic health problems after even mild COVID infections.

“I can't overstate how serious this issue is for the health of our nation," he said.

Collins said his estimate was based on studies showing that roughly 10% of people who get COVID could have long-haul COVID-19 and whose “long-term course is uncertain,” he said. So far, more than 32 million Americans are known to have been infected with the new coronavirus.

“We need to make sure we put our arms around them and bring answers and care to them,” said Rep. Anna Eshoo, a Democrat from California who is chairwoman of the Subcommittee on Health.

Jennifer Possick, MD, who directs the post-COVID recovery program at Yale-New Haven Hospital, testified that the tidal wave of patients she and her colleagues were seeing was overwhelming.

“We are a well-resourced program at an academic medical center, but we are swamped by the need in our community. This year, we have seen more patients with post covid-19 conditions in our clinic alone than we have new cases of asthma and COPD combined,” she said. “The magnitude of the challenge is daunting.”

Possick estimated that there are “over 60” clinics in the U.S. that have started to treat Long COVID patients, but said they are grassroots efforts and all very different from each other.

“Whoever had the resources, had the time was able to take the initiative and forge to the relationships because most of them are multidisciplinary, did so," she said.

Several members of Congress shared moving personal stories of loved ones or staffers who remained ill months after a COVID diagnosis.

Rep. Ann Kuster, a Democrat from New Hampshire, talked about her 34-year-old niece, a member of the U.S. Ski Team, who had COVID just over a year ago and “continues to struggle with everything, even the simplest activities of daily living” she said. “She has to choose between taking a shower or making dinner,” Kuster said. “I’m so proud of her for hanging in there.”

Long-haul COVID-19 patients testified and described months of disability that left them with soaring medical bills and no ability to work to pay them.

“I am now a poor, black disabled woman, living with long COVID,” said Chimere Smith, who said she had been school teacher in Baltimore, MD, “saying it aloud makes it no more easier to accept.”

Smith said COVID-19 had affected her ability to think clearly and caused debilitating fatigue, which prevented her from working. Smith said she lost her vision for almost 5 months because doctors misdiagnosed a cataract caused by long COVID as dry eye.

“If I did not have a loving family, I will be speaking to you today from my car, the only property I now own,” Smith said.

Smith said that long-haul COVID-19 clinics, which are mostly housed within academic medical centers, were not going to be accessible for all long haulers, who are disproportionately women of color. She said he had started a clinic, based out of her church, to help other patients from her community.

“No one wants to hear that long COVID has decimated my life or the lives of other black women in less than a year,” Smith said. “We've just been waiting and hoping for compassionate doctors and politicians who would acknowledge us.”

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