Long Covid in Africa: ‘I Don’t Think Govts Are Taking It Seriously Enough’ – Prof Resia Pretorius

INTERVIEW | Juanita Williams from allAfrica interviews Professor Resia Pretorius from Stellenbosch University, Pretorius about her extensive research on Long Covid. A 2023 study published in Nature, involving over 29,000 patients, highlighted that nearly half exhibited Long Covid symptoms, with fatigue being the most debilitating. This finding underscores the ongoing burden of Covid-19, as millions continue to suffer from persistent symptoms, straining healthcare systems worldwide due to a lack of specific treatments, its complexity and variability.

Pretorius said Long Covid is a genuine and serious condition, often misunderstood or underestimated by some doctors. For individuals with pre-existing conditions like diabetes and high blood pressure, managing Long Covid symptoms can be particularly challenging as Long Covid involves over 200 different symptoms. It is essential to manage each symptom individually due to the lack of specific treatments for Long Covid. Pretorius focuses on diagnosing Long Covid, healthcare access and government responsibility on the ongoing threat of Covid-19.

Excerpts of interviews are edited for clarity

A friend tested positive for Covid a year ago but has been experiencing recurrent symptoms resembling stomach flu. Given his situation, living in an African country where healthcare is not accessible, what steps could he take to address these symptoms, especially considering the overlap with potential long-term effects of Covid?

Unfortunately, there is very little to do. You need to find a clinician who wants to listen to you and wants to look at the research, read more, and be informed. The only thing to do is find a condition that they can treat the symptoms and treat the person who experiences the various symptoms. Unfortunately, we don’t have any treatment regimes that have been clinically tested and trialed. It’s up to the clinician to do a clinician-initiated treatment.

What measures or strategies do you think African governments should adopt, given that a significant number of Covid cases on the continent were asymptomatic or went undiagnosed, to address the potential long-term health impacts and provide adequate support, especially for those with constrained healthcare access?

The problem is not an African problem. It’s a global problem, the things that you asked me now, you could just as well ask what can the U.S. or the UK or Europe do. It’s the same thing.

Governments need to fund more research, they need to be cognisant of the fact that researchers are saying there is Long Covid and then need to plan. They need to have Long Covid clinics where there are clinicians who can look after these patients and look at them in a holistic way, to treat them and the symptoms that arise. However, if the governments don’t do that, they will feel it two, three, or five years from now when the economy is suffering. Because if you think that if 10%, never mind 20, 30, or 40% of your population can’t function properly, how on earth are you going to get to keep your country economically stable? So globally, it’s a problem. It’s not an African problem, but probably more in Africa. People are putting their heads in the sand about the economic impact of this.

And the issue is Covid has not gone. It’s not patients who got Covid in 2020-21 that now are suffering from it. It means that we need to be aware that Covid is not gone, people still have new infections, and every single day new, Long Covid patients, hundreds of thousands worldwide, are reporting Long Covid.

It might be just as simple as I didn’t feel well for three, four, or six months, and then I recovered. But that’s still three or four, six months out of the economy. People have lost their houses, they’ve lost their jobs, and they are bedridden. Governments need to take into consideration that if we don’t fund research if we don’t look into clinical trials, we’re going to have a massive problem.

And the issue is our public sector hospitals cannot cope with the current load of patients. It’s all over the world that we have been saying and predicting and showing now that there is an increase in cancer. There is an increase in diabetes. There are increases in all inflammatory-type diseases. And there’s an excess death rate that we have. If we compare 2018, and 2019 levels of excess death rate to now. We do have a phenomenon of vaccine injury – we do have a phenomenon Long Covid. Sometimes they’re intertwined. There are so many more people dying for no reason. And it might be Covid-related symptoms that might have triggered cancer or a disease or the patient has just had a false track of symptoms.

I hate to ask this question, as I don’t align with the belief that vaccinations cause issues, and I want to make that clear. However, when individuals report post-Covid symptoms after being vaccinated, how does your research account for or consider the potential side effects of the vaccination in such cases?

I must unequivocally say I am pro-vaccination because it saves millions and millions of lives. However, there have been reports by clinicians and researchers that if you get some individuals, not many, in a very few percentage of individuals, you do get vaccine damage. That’s a fact. Vaccine damage can look very much the same as Long Covid because of the fact of spike protein. Spike protein has a role to play in Long Covid and it is inside some of the vaccines. Not all of them, but some of them. mRNA vaccinations make spike protein, so it triggers your immune system. So yes, there are vaccine injuries that we see.

However, vaccination still prevents death as a result of acute Covid. Therefore we need to promote vaccination. If you’re healthy, and you can have a vaccine, and you don’t have symptoms that the doctor might feel perhaps you shouldn’t get a vaccine because there are such cases, then I think still we need vaccination.

I’m sharing anecdotal observations, so my observations are not evidence-based. After recovering from her acute bout of Covid, my mother received her first vaccine after isolating, minimising the chance of being Covid-positive at that time. Surprisingly, she improved after the first dose. In their studies, have researchers observed similar instances of improvement following vaccination?

So some people who have Long Covid get a vaccination and get better because it’s another spike for your immune system to wake up, but some people don’t get better but will get worse. Then some people get the vaccination during Long Covid and don’t get worse or better. So yes, there are various scenarios, and it’s different for everyone.

I just want to clarify. So when I say side effects, and you say injuries, in terms of vaccines, is that the same?

I think side-effects or injuries of vaccine, or vaccine side-effects are the same thing.

As someone advocating for vaccination, would you recommend, on a general basis, that individuals without any current Long Covid symptoms still consider getting vaccinated?

I would not suggest anything because I’m not a clinician. However, the best would be to discuss with your clinician and look at your symptoms, because you don’t want to worsen your symptoms. Vaccination can cause more clotting. So if you are clottable, during your Long Covid journey, and you get vaccination, it might impact that.

You previously highlighted the existence of novel diagnostics for Long Covid. Could you provide more insight into what these novel diagnostic methods entail?

Yes, so it’s not diagnosing Long Covid per se. We’ve developed a method to diagnose clotting pathology in Long Covid and we discovered that people can have in the blood what we call micro clots. And these micro clots are found in platelet-poor plasma. Currently, it’s a novel method to look at platelet-poor plasma or plasma in which all the cells have been removed and respond down blood, so it’s the fluid part of the blood.

In that portion, we have these microclots and we’ve been studying it for a very long time, but in getting Long Covid there are many more of these microclots and novel methods aren’t microscopy or a method called Flow cytometry, which all pathology labs have. We are working on such methods to diagnose clotting pathology in Long Covid.