Omicron spread in Spain raises fears of deluge of long Covid cases

Aránzazu Abión’s life has been torment since she was diagnosed with Covid-19 on February 29, 2020. It took the health worker from Barcelona eight months to prove she had long Covid, and that her chronic fatigue and loss of vision and hearing were not due to anxiety, as the first medical specialists had told her. Her symptoms flared up again in July 2021, when she caught the delta variant of the coronavirus, and again in November, when she was infected for a third time, on this occasion with the more-contagious omicron strain.

Her case may seem exceptional, but many other long Covid sufferers have also been reinfected with omicron in Spain’s ongoing sixth wave, and like Abión, they too have seen their long Covid symptoms come back or have started to develop new ones. But the collective Long Covid Acts, which represents people with the condition in Spain, and the Spanish Society of Family and General Practitioners (SEMG) – which has developed a clinical guide for long Covid – say it is too soon to reach conclusions on the consequences of reinfection on long Covid sufferers. These groups, however, do warn that the rapid spread of the virus due to omicron will multiply the number of long Covid cases and quickly turn the condition into a major public health problem.

“We are at a stage of uncertainty and concern over the potential consequences of the omicron variant, but since a short amount of time has passed since its appearance, we don’t have the data to confirm whether it is worsening cases of long Covid,” says doctor Lorenzo Armenteros, the spokesperson on Covid-19 for SEMG. The health expert is, however, very worried about the record-high numbers of coronavirus cases in Spain due to omicron and the possibility that this sixth wave of infections will cause more long Covid cases. “If the trend that 15% of those infected develop long Covid continues, the volume could be enormous, the figures may be tremendously high with respect to what we have seen so far,” he warns.

It seems like Covid is just like a minor case of the flu, but this disease can harm you for the rest of your life

Mely Rodríguez, long Covid sufferer in Gijón

Joan Soriano, an epidemiologist in the pulmonology department of Madrid’s La Princesa University Hospital who was part of the group of international experts which set the first definition of long Covid released by the World Health Organization (WHO) at the end of 2021, estimates that between 400,000 and 800,000 people in Spain suffer from long Covid. “The last estimation that we did with Washington University found that one in six coronavirus cases develops long Covid. This already makes it a public health problem, it would be one even if the figure was just 1%,” he warns. “With the new variants, the problem is we still don’t have enough information on the acute illness caused by SARS-CoV-2, and even less so on the relationship to chronic illnesses such as long Covid.”

Aránzazu Abión tries to speak optimistically about the last two years of chronic pain, fatigue, general discomfort, tachycardia (rapid heartbeat) and memory loss. But she breaks down when she talks about the lack of understanding from doctors she initially approached, her endless trips from one specialist to another and the flare-up of her symptoms when she was reinfected in July. That time around, she tested positive for 49 days and was forced to spend two months confined to her home in the middle of summer. Then in November, just a few months later, she came down with a high fever. “It’s very strange for me to have a fever so I guessed that I had it [Covid-19] again,” she says. Her fears were confirmed when she took a home antigen test ahead of her family’s Christmas Eve dinner. But she was unable to take a PCR test until January 4 – nearly two months after the onset of her symptoms – due to the overload in primary healthcare systems, which have been struggling to cope with the sixth wave.

“I am going to turn 40 and my life is on hold,” says Abión, her voice breaking. She has gone from taking part in triathlons and running a half-marathon in Barcelona in February 2020 to barely being able to get up the stairs. She is aware that getting care in one of the many long Covid units in Catalonia’s hospitals could help her with everyday living, but after two years of being passed from one medical specialist to another, she says she no longer has the energy to fight. “I have asked my family doctor to refer me to one of these units, but they are full,” says Abión. What she is calling for is psychological support. “I feel like my life is at risk. I have mood swings, right now I am overwhelmed, it’s horrible, truly horrible.”

Reinfection vs fluctuating symptoms

Sandra González has been waiting since the end of December to be seen by a long Covid unit in Granada in Spain’s southern Andalusia region. She caught Covid-19 for the first time in October 2020 and tested positive again on December 28, which brought back her respiratory problems. “When I caught it the first time, I had a lung disease and they had to give me corticosteroids [an anti-inflammatory medicine],” she says. “We had it under control, but they have had to strengthen [the treatment] because this symptom has come back stronger than it was.” Her headaches have also returned, as has the buzzing sound in her ears, which before, with medication, only happened sporadically. “Right now, I don’t know what it’s like to be in silence and not hear sounds constantly in my head.”

Armenteros from SEMP prefers to be cautious and not make conclusions yet about how reinfection affects long Covid patients. “We have to leave a margin of two to three months in order to know what effect the sixth wave could have had, because in many cases, reinfection has become mixed up with the very symptoms that they [long Covid patients] already had,” he explains. “If someone had chronic symptoms, suffering from Covid could appear to be what we call a fluctuation in symptoms, meaning they are sometimes worse and sometimes better. In some cases, what could have been a long Covid crisis was, in the end, a reinfection.”

Mely Rodríguez lives in Gijón in the northern Asturias region and caught the coronavirus on March 18, 2020. In November of that same year, after listening for eight months to primary healthcare doctors dismiss her problems with dizziness, constant nausea, fatigue, respiratory problems, memory loss and loss of vision in one eye as “anxiety and a call for attention” following the birth of her child and falling pregnant again, a professional from her private medical insurance urged her to get tested for long Covid in Barcelona.

Rodríguez caught the virus again over Christmas. She is not the only one in her large family to suffer from long Covid. Her six-year-old son Sergio, who is one of her six children, tested positive in July, and since then has been suffering from fatigue and diarrhea: his life has not gone back to normal. Rodríguez is calling for more research into long Covid and more visibility. “It seems like Covid is just a matter of being confined for 10 days, that it’s like a minor case of the flu and that’s it. This disease can harm you for the rest of your life. If the many of us in this position explained it like this, perhaps people would be more aware,” she says.

The coronavirus pandemic has turned the lives of Abión, González and Rodríguez, and all long Covid patients in Spain, upside down. Not only do they fear their symptoms will last longer, they also fear that they will worsen. All three women warn against downplaying the risk of coronavirus contagion – a warning that is repeated by the epidemiologist Soriano: “This new variant is spreading in a way that hasn’t been seen before until now. We have to be cautious, because we are learning practically every day and we don’t know yet what is going to happen with each of the most worrying variants, nor how they will affect long Covid.”