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Ball and run to to get

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the well welcome show where we

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bring science that was and he

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means is discovering his goals at

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least at technology and leave without

0:47

admitting this is the naked Scientists.

0:50

Hello welcome to this week's Naked

0:52

Scientists! This is the program that

0:54

brings you the latest breakthroughs in

0:56

science, technology, and medicine. And I'm

0:58

Chris Smith and today we're revisiting

1:00

Long Cove. It almost two million

1:02

people in the Uk are estimated

1:04

to be living with the condition,

1:06

so all we any closer to

1:08

finding out what is causing their

1:10

debilitating symptoms from Cambridge University's Institute

1:12

of Continuing Education. This is the

1:14

Naked Scientists. Four

1:24

years ago, the World Health Organization

1:26

officially recognized Cove It Nineteen as

1:28

a pandemic. Since. Then we've

1:30

seen the development of effective tests

1:32

and treatments a billions of vaccinations

1:34

administered which have reigned in the

1:37

disease and turned what was formerly

1:39

a death sentence for some into

1:41

a mild infection for the vast

1:43

majority. But while the global health

1:45

emergency acutely is over, the aftershocks

1:47

of the infections are still very

1:49

much reverberating around us and societal

1:52

and economic terms and also imposed

1:54

infection syndromes that a hitting some

1:56

people. In the Uk load

1:58

an estimated two million people are some

2:00

how long term symptoms that last least

2:02

four weeks after their first infection with

2:04

salt curvy to because of cove it

2:07

and some have now been living with

2:09

these problems for years. This

2:11

is known as Long Cove It

2:13

and today we're bringing you the

2:15

latest developments in our understanding of

2:18

it's pernicious and puzzling presentations. Sarah.

2:20

Taylor is university lecturer who first call

2:22

cove it in early twenty twenty two

2:24

when the I'm A Chrome wave of

2:26

the virus was at it's peak. The

2:30

headache. Lasted for

2:32

months. And

2:34

then other symptoms.

2:37

Appeared. Stiffness,

2:39

Getting. Up and down a. Staircase.

2:42

Was a share active well

2:44

as a lot. The Tin

2:46

Man. Just couldn't Really

2:48

thin likes. The. Figures issue

2:50

though was cognition. Spatial

2:53

reasoning is particularly. Problematic.

2:57

I go to chair base yo this.

2:59

I know I can only do half

3:01

the session. Because. Of just

3:03

so exhausted. But I'm not

3:05

just getting physically exhausted. The

3:08

ladies tell me where to put my

3:10

hands. And. As

3:12

time progresses, I'll get more and

3:15

more confused and unless the ability

3:17

to set of coordinates. My.

3:19

Hands and the Brain Fog. Starts.

3:22

Kicking in the So is actually

3:24

the brain fog more than the

3:26

physical. That is why I only

3:28

do half the session. The.

3:31

Ability to think is part and

3:33

parcel of my job. And.

3:37

In the face the months after getting cove it.

3:40

I couldn't think of couldn't

3:42

process. Information. Way.

3:46

I was on sick. Leave for

3:48

a year. Some. Days a

3:51

text message would be a

3:53

few words. I couldn't.

3:55

Write anything that makes sense.

3:58

And. Couldn't speak

4:00

to make sense either. When.

4:03

I got referred to the Long Povich

4:05

Clinic. I. Got

4:08

a swallow test and all that

4:10

kind of thing. Which

4:12

was very useful because swallowing was an

4:14

issue that has now. Been.

4:17

Largely resolved. But.

4:19

No one really worked with me on my.

4:21

Cognition. And the

4:24

sort of speech issues. So.

4:26

Retailer whose experience may well be

4:28

familiar to many. A

4:31

While many with long Cove like

4:33

Sarah have reported neurological symptoms including

4:35

brain fog, the has until recently

4:37

been no objective measurement of how

4:39

severely people are really affected. That

4:41

was until a new study from

4:43

Improve College London recently published in

4:45

the New England Journal of Medicine

4:47

found that people experiencing on cove

4:49

it so cognitive deficits equivalent to

4:51

a loss of six points of

4:53

I q. I've been speaking to

4:55

the lead author on the study, Adam Hampshire.

4:58

We. Bill on the back have

5:01

one of the largest epidemiological studies

5:03

that was running the Uk during

5:05

the Pandemic game's called React which

5:08

is the real time assessment of

5:10

community in transmission and that was

5:12

a project where they sampled someone

5:15

you'd have about three and half

5:17

million people. Randomly.

5:19

Within the general population to see

5:21

a different points in a pandemic.

5:24

Whether they had been infected with

5:26

the virus and where the had

5:29

peridot. So. Because of his

5:31

background on people's history of covert

5:33

If you like. And

5:35

what we did we we contacted

5:37

a hundred thousand of them and

5:40

often take part in an online

5:42

com with on a platform it's

5:44

called computer on. That. can

5:46

measure different aspects of cognitive

5:49

in memory ability through people's

5:51

laptops as smartphones an hour

5:54

of those people we contacted

5:56

as bad a hundred and

5:59

forty did at

6:01

least one of our tests and

6:03

about 112,000 completed the entire assessment. How

6:09

big are the differences that you're detecting? So if

6:11

I took an IQ test for example and I

6:13

was affected in the way that some of the

6:15

people you registered in the study were affected, how

6:18

many IQ points down would I

6:20

effectively be if I were affected

6:22

in that way? If we

6:24

treat the global score from

6:27

this assessment like an IQ

6:29

test then the

6:31

group with the largest cognitive

6:33

deficit is on average people

6:35

who were in intensive care

6:38

and so they showed difference of

6:41

around about minus 9 IQ

6:44

points. People who have

6:46

ongoing persistent symptoms that is the

6:48

ones who may have long COVID,

6:51

they perform at about minus 6 IQ

6:54

points and that's

6:56

enough that it could affect your

6:58

daily function. You're very

7:00

likely to be aware and

7:02

notice that change. The

7:05

larger number of people sitting in the

7:07

short-term symptom group and they

7:09

show a difference on average of about minus 3

7:11

IQ points and that's very small but

7:14

we are powered, we're able to detect

7:16

that because we measured so many people.

7:20

Were there any things that lept out in

7:22

people who got SARS-CoV-2 infection where

7:25

certain elements of cognition were consistently

7:27

impacted or is it just an

7:29

across-the-board reduction for at least a

7:31

period of time in everybody? In

7:34

terms of aspects of cognitive

7:37

ability we saw

7:39

the strongest relationships with having

7:41

had COVID-19 in

7:44

memory function, reasoning and

7:46

what we call executive function, things

7:48

like planning. That's the case if

7:51

we were looking at for example people who

7:53

had longer term sort

7:55

of ongoing persistent symptoms so what

7:57

some people would refer to as

7:59

long COVID. And

8:02

critically, when a person says

8:04

they get better, because we know that a

8:06

proportion of people have symptoms for a certain

8:08

period of time and then they get better,

8:11

when they get better, does their cognition

8:13

go back to normal, do you think?

8:15

We have to be very careful here in

8:18

terms of the inferences that we draw.

8:20

What we're looking at are essentially associations.

8:22

We're not looking at change because we

8:24

have only measured one time point. Nonetheless,

8:28

the pattern of results that we see shows

8:30

that people who have ongoing persistent symptoms,

8:33

they perform worse than

8:35

people who had shorter

8:38

duration symptoms. Whilst that's the

8:40

case, even people who had short duration

8:42

symptoms, on average, showed

8:45

slightly worse cognitive performance compared to

8:47

people who had not had COVID

8:49

at all. The really

8:52

interesting group are people who've had ongoing

8:54

persistent symptoms, but by the time we

8:56

cognitively tested them, those had

8:59

resolved. That set

9:01

of participants performed at the same

9:03

level as people who

9:05

had only short term symptoms.

9:08

That is only a small

9:10

cognitive deficit with still

9:12

evidence. Well,

9:14

that's slightly encouraging, isn't it? Because notwithstanding

9:17

the fact that this is an

9:19

association, would argue that there should

9:21

be an improvement in someone when

9:23

their symptoms overall subside.

9:26

Exactly. I think

9:28

on the face of it, our study has

9:31

some results that were quite

9:33

negative and not really what

9:35

we hope to see. For example, that

9:37

we see any association between

9:40

shorter duration COVID and

9:42

cognition. That's

9:44

somewhat worrisome. It's not what

9:46

we were looking for. We didn't predict that.

9:49

On the other hand, it does

9:51

appear to be the case that people

9:53

who have long term persistent symptoms, when

9:55

those symptoms eventually subside, they may

9:58

well have some degree of of

10:00

recovery in their cognitive and memory

10:02

abilities. Another really

10:05

quite promising result that we had is

10:08

that actually several of the results

10:10

in the study converge towards indicating

10:13

that this association between COVID

10:16

and cognition has reduced

10:20

throughout the pandemic. So the

10:22

association was larger for the

10:25

original virus and for

10:27

the alpha variant, but by

10:29

the time we get to Omicron, it seems to

10:31

have been diminished. So what do

10:33

you attribute that? Do you think that's because

10:35

by that time it's hitting people who've been

10:37

either infected before and

10:39

recovered or vaccinated before and are

10:42

therefore subject to a less severe

10:44

infection? Well, our

10:46

model takes all of these things into

10:48

account, but they're quite hard to disentangle

10:50

because they correlate across time. So

10:52

of course, if you think through the

10:55

course pandemic, different

10:57

virus variants were dominant,

10:59

right? And then in addition to

11:01

that, partway through, they started to

11:04

roll out vaccinations and

11:07

approaches to treatments probably

11:09

improved somewhat as well. Within the

11:11

model, it would appear to be the case

11:14

that if a person was vaccinated

11:16

at least twice prior

11:19

to their infection, they

11:21

have a small cognitive advantage

11:24

relative to people who had not

11:26

yet been vaccinated. So I think

11:28

that's one aspect that's probably coming into

11:30

play. And it's very likely that later

11:32

variants had a lesser impact

11:34

on cognition as well. So these

11:37

things aren't mutually exclusive. Imperial

11:40

College's Adam Hempshire. You're

11:48

Listening to The Naked Scientists with me, Chris

11:51

Smith. And This week we're looking at Long

11:53

COVID. Shortly, we'll hear how the immune system

11:55

might be driving some of the most common

11:57

signs and symptoms of this illness among those

11:59

who.. Have the condition. The. First, while

12:01

the robust evidence that infection with Cove

12:04

it can As and I'm Hampshire was

12:06

just telling us lead to a significant

12:08

reduction in cognitive ability, it's still just

12:10

a part of the overall picture when

12:12

it comes to what we come to

12:15

term Loan Cove It naturally midterm. It

12:17

is a pediatric Infectious diseases doctor from

12:19

King's College London. For her the

12:21

aftermath of what was at the time put

12:23

a mild case of cove it has been

12:26

significant. Disabling. And. Quite

12:28

different from some of the other things with heard

12:30

about so far. I. Was

12:32

working on the front lines during the

12:34

pandemic I started at Geico Mystery in

12:36

March has Twenty Twenty and I contracted

12:39

Cave it probably be A by the

12:41

end of March, Twenty Twenty fully recovered

12:43

from that, went back to work and

12:45

then at the end of May Twenty

12:48

Twenty. I seem to get an almost

12:50

identical illness again and following on from

12:52

that illness, I developed nerve pain in

12:55

my seat and then that seem. To

12:57

progress takes other neurological symptoms

12:59

and problems Walking. I

13:02

knew you straight away because I was watching you

13:04

on the television at the start of the pandemic.

13:06

You were a fit, healthy young woman by the

13:08

look of it. Is that true? Yes,

13:11

that's true. In fact, I think not. Even

13:13

two years before I just returned from a

13:15

massive fieldwork study in Sierra Leone, I used

13:17

to walk four miles a day. I would

13:19

run regularly. And. We.

13:22

Just walked into this office together and

13:24

you're using crutches and it's four years

13:26

since you contract it covered. You think?

13:29

Yes, so I've been using the Coaches Fair

13:32

probably about the little over three and half

13:34

years now, and I wouldn't say that my

13:36

sentences. Really improved during. That time

13:38

I think my ability to manage them deal

13:40

with them has improved, but the symptoms themselves

13:42

up pretty much the same. You

13:45

say you get some nerve pain and some

13:47

other neurological symptoms. So tell us what. Your.

13:49

Life is like than that, what's actually happening to.

13:52

I find it difficult. To walk listing my see off

13:54

the ground is what challenge certainly catches. I can

13:57

can I use my arms to propel my legs

13:59

of it? But I need crutches.

14:01

Her guys, you know, a few hundred

14:03

meters and anything beyond that. I generally

14:05

use him ability Skeeter to get around,

14:07

but it also affects my bladder and

14:09

my bow and leaves me with constant

14:11

pain in my legs and my faith.

14:14

Is he getting worse? Getting better?

14:16

Well, It's not. Clear.

14:19

At the moment it's not getting better. the

14:21

I can tell and I had some investigations

14:23

recently. You suggest maybe that's been a slight

14:25

listening, but I'm not sure yet. One

14:28

thing that people often say to me is that

14:30

it's really hard to get support. To.

14:33

See somebody who can listen to them?

14:35

To. Find out about this symptoms, offer

14:37

solutions to manage their problems that having

14:39

better is that improving? Or or is

14:42

this still a black hole for people

14:44

who find themselves in a bad state?

14:46

Posts Cove it. I

14:49

think there's some. Improvement in

14:51

people being more understanding of the

14:53

condition and trying to support people

14:55

in their recovery. But the problem

14:57

is, I think we don't. Have

14:59

any solutions. So while they might be

15:02

people to see in a clinic environments

15:04

I Health Care act has set my

15:06

assess you. I think the still long

15:08

waits that up but. There

15:10

are people who will assess you and

15:13

have a bit better understanding of the

15:15

the symptoms. We don't have any answers

15:17

as to how to manage that other

15:19

than take things easy and pacing and

15:22

so on. And another see that does

15:24

work to some people, some people have

15:26

fully recovered. But. We

15:28

tend to see that and people who

15:31

got kebede later on and they tend

15:33

to. Show signs of recovery within

15:35

the first year, and more or less a

15:37

complete recovery within the first twelve to eighteen

15:40

months. So those of us he's had kv

15:42

that the very beginning. And

15:44

have not really shown any signs of recovery.

15:46

Three and half he is it. And we

15:48

just don't know what the outcome is to

15:50

that. Because if you haven't improved and three

15:52

and a half years is something magically going

15:55

to change overnight, that's your body. Just seventy

15:57

says oh now I'll recover. I think we

15:59

want to believe. but I

16:01

can understand the desperation for various

16:04

treatments and people trying

16:06

different things even though there's no good evidence

16:08

to suggest they work. A powerful

16:11

story isn't it? Natalie McDermott there, we'll hear

16:13

more from Natalie a bit later on in

16:15

the programme. So the question

16:17

is why has this happened to some

16:19

people? Given the broad range of symptoms

16:21

from brain fog to fatigue, muscle pains

16:23

and signs of nerve damage it's

16:25

likely that long Covid is not

16:27

one single condition but an umbrella

16:29

term that unites a host of

16:31

different syndromes, all with different mechanisms,

16:33

outcomes and best treatments. I

16:36

went to see Cambridge University virologist Ben Krishna

16:38

who branched out into working on long Covid

16:41

during the pandemic. He agrees that

16:43

long Covid can be an unhelpful

16:45

term. So the problem with the

16:47

terminology of long Covid is just that it's

16:50

a very broad and umbrella term. You can

16:52

imagine three different people. You've had one person

16:54

who was very very sick with Covid-19 in

16:56

2020. They went into hospital,

16:59

they were put on oxygen, they were given

17:01

what we call mechanical ventilation. So they essentially

17:03

had a tube put into their lungs and then

17:06

their lungs were inflated artificially for a

17:08

certain amount of time and then eventually they've

17:10

recovered and they've been discharged from the hospital

17:12

and you're thinking six months later are they

17:14

feeding back to where they were

17:16

before Covid-19? The answer is probably no

17:19

but is that really long Covid or

17:21

is that really just them slowly recovering

17:23

from the initial infection? You

17:26

then have person two, they lost their taste and

17:28

smell, that hasn't come back for whatever reason. I

17:30

don't think we exactly know what causes that yet

17:32

but for whatever reason they can't go to restaurants

17:34

but at the same time they can go into

17:36

work and they do everything they normally

17:38

do is just the taste and smell that's gone. And

17:41

the third case, and these are perhaps in my

17:43

opinion the strangest cases where somebody got

17:45

sick with Covid-19, they had the similar symptoms

17:48

that a lot of people are familiar with so they were

17:50

in bed and feeling fatigued and

17:53

Most people got better and they went back to

17:55

their normal lives. And for these people, they just

17:57

didn't get better. And in some cases it's been.

18:00

A. Year been sometimes two years and these

18:02

people still feel like the first early days

18:04

of viral infection Alleges never covered. What?

18:08

Do we think the underlying mechanisms

18:10

of cases like that latter one

18:12

might be? So it's still quite

18:14

controversial what might be causing It's

18:16

there is a growing body of

18:18

evidence that the mean systems which

18:20

is on and then failed to

18:22

switch off what exactly is causing

18:24

That is not entirely clear. It

18:26

could be for example that people

18:29

got infected with the virus, the

18:31

virus has infected some pass their

18:33

body and is there with their

18:35

a very low level and it's

18:37

just. Continually making small about the virus and

18:39

as a result of this, their immune system

18:41

is still on and still fighting the virus.

18:43

And that's what's making them feel sick. Because

18:45

we know that a lot of what really

18:47

makes you feel sick when you've got a

18:50

virus is actually the mean systems response fight

18:52

the virus, not the virus itself. Alternatively that

18:54

could be something auto immune. so could be

18:56

that the mean system started are fighting. The

18:58

virus and now it's. Mistakenly

19:00

started attacking a part of the body the

19:02

it's not supposed to and actually a lot

19:04

of long time it does look a bit

19:07

like also mean it's a particularly many patients

19:09

say they have cycles of symptoms that they

19:11

get better than they had. Get worse than

19:13

they get better again. Oh finally it can be something

19:15

that which is. Not aware of like now. I

19:17

could be that the mean system is switched on,

19:19

it's not switching off and it for some reason

19:21

that we just don't know about yet. How

19:24

are you. Trying to get underneath that and

19:26

find out which of those or. Whether.

19:29

It's all of them are behind this. Of

19:31

research suggested that the immune system had switched

19:34

on and people who had type of nineteen

19:36

and the most people would switch off by

19:38

in this small group of patients with Long

19:41

Cove it it just was still with switched

19:43

on and a was thickly switched on it

19:45

was making one particular protein. this protein is

19:47

cool interferon. Gamma and If is known

19:50

to make you feel quite sick.

19:52

We tried. Looking for virus in these patients.

19:54

So what we did was we took blood samples

19:56

on these patients and that we just look for

19:58

signs that the vibes Still that's. The To

20:00

find anything in the patient's blood. We

20:02

were particularly interested in their intestines, so

20:04

there's some data out there showing that

20:06

patients continue hobbling the virus in their

20:09

intestines and it comes out and that

20:11

pay? that is that. See where we're

20:13

moving at the moment is trying to

20:15

understand that. Side effects. If

20:17

that is the case, the east of

20:20

the viruses tickled the immune system and

20:22

he stayed locked on in some way.

20:24

Or the viruses hiding somewhere and tickling

20:27

the mean system from a covert hiding

20:29

place possibly the got any. this nora.

20:31

the immune systems overactive. What can we

20:34

do? To. Turn it off. The

20:36

same is why the mechanism is so important

20:38

because he my approach those and completely different.

20:40

Nice if you're having a small about virus

20:42

somewhere in your body he might actually be

20:44

able to treat long favored by giving people

20:47

antivirals. Alternatively if it's auto meeting and I'm

20:49

people I was going. To do absolutely nothing and

20:51

watching what you want to do is sick. If. I

20:55

have heard that there were clinical studies looking at

20:57

both of those. I have seen any convincing results

20:59

on where the other yet, but that isn't. With.

21:02

The comic that people are very excited by. Do

21:04

you think this phenomenon is unique? A

21:07

two songs go be to the current

21:09

virus that causes Cozad. Would.

21:11

Have a friend of ours is do

21:13

this all mobile. They might or viruses

21:15

be capable of doing this. So if

21:18

we had a bad dose of flu

21:20

this could happen and. Is

21:22

it just that we got so many

21:24

people all at once catching source code?

21:26

Be to that it disclosed this phenomenon

21:28

and it's always been there. We.

21:30

Just didn't see it. Eve. But and

21:32

better. what? And I could have like that.

21:35

So yes, it's probably the case that you

21:37

had this new virus. It's hands up no

21:39

one has any immunity to it. Everybody gets

21:42

sick all at once and seen at this

21:44

big wave of people with what we call

21:46

like post survival syndrome instead just sick and

21:48

for long periods of time off the virus.

21:51

There is evidence from South Code one company

21:53

called Sars that was an outbreak. The happened

21:55

in East Asia sickly South Korea and Japan

21:57

and China back in two thousand three that

22:00

will patients there who got sick at the

22:02

time and they were reporting years later that

22:04

they still didn't feel better. I have seen

22:06

some evidence that Fleece can do this. They

22:09

had a patient you. Got Spanish flu and

22:11

nineteen nineteen and we're still seconds and twenty

22:13

and latest they want to do with this

22:15

person. So yeah there's this view now that

22:18

may be all viruses cause this and if

22:20

you have a brand new virus that springs

22:22

across from animal with and and course the

22:24

pandemic, you're gonna get a big wave of

22:26

posts viral illness. And of course that's very

22:28

worrying because we expect that will. Eventually. Be

22:31

another pandemic. And so trying to understand long

22:33

play with now might help prepare us for the

22:35

next one. Thing. Krishna.

22:37

They're. Not withstanding

22:39

some of these positive developments in our understanding

22:41

of long cope with a one size fits

22:43

all treatments for the verse ways it manifests

22:46

and people is therefore unlikely to materialize. and

22:48

it's a problem that could be with us

22:50

for many years to come. In the meantime

22:52

though some of those living with long covert

22:54

fill forgotten among the medical professionals who were

22:57

on the front line of the pandemic response.

22:59

Doctors. Like Nutley Mcdermott, whom we heard

23:01

from earlier feel that they were offered

23:03

insufficient protection for the danger they're exposed

23:05

to, and some like her are now

23:07

living with debilitating, long term health problems.

23:09

the impact on their ability to do

23:11

the job they originally trained for. Can.

23:14

You do your job, still you up on

23:16

the boards looking after little kids can use

23:18

to do that. Not

23:21

really are not in the way I

23:23

did before. I would like to keep

23:25

doing that. that even just to complete

23:27

my training which I just finished has

23:29

really cost me. From a health perspective.

23:32

Say I might be able to the

23:34

reset side of my job provided I

23:36

can get more funding, but the actual

23:38

full time clinical component is very difficult

23:40

for me. I'm. Looking. At

23:42

may be. Moderated. Still plans

23:44

but I can't be the doctor I

23:47

was hoping today and I also am

23:49

very passionate out disaster, an epidemic response,

23:51

and a well. I'm just not convinced

23:54

that many organizations would want to send

23:56

me out to disaster zone right now.

23:59

If you. You can't do your job

24:01

that you've been training to do, you're aspiring to

24:03

do, and you were good at it. Does

24:05

this mean that you basically

24:07

can't practice? How

24:09

is the NHS or your employer looking

24:11

after you because you were

24:13

effectively being exposed to a threat? You've

24:16

ended up with this problem almost certainly

24:18

because of that threat and

24:21

succumbed to damage because of it. What

24:23

do they say? Well,

24:25

unfortunately not a lot really. The

24:28

problem is that because I've come to the end

24:30

of my training, whilst I was in training, obviously

24:32

there was some degree of protection to help me

24:35

get to the end of my training. But

24:37

as with any doctor, when they finish their training,

24:39

they then need to apply for consultant posts. And

24:43

it's very difficult for me to apply for

24:45

a consultant post because I need modifications in

24:48

place to do that. So essentially I'm

24:50

applying for a job that I know

24:52

I can't do without adaptations and modifications

24:54

to the job plan. And that's

24:57

a very difficult thing to do. Otherwise

24:59

I can continue in research and I can

25:01

apply for research funding. But so far I

25:03

haven't been very successful at that either. But

25:06

is there nothing occupationally that you can do?

25:09

Because if I succumb to an injury at

25:11

work, then I have a reasonable

25:14

expectation that someone will make good on that. Well,

25:17

I think that the problem is that at the moment

25:20

there's a lot of toing and

25:22

froing between who made the decisions

25:25

about the personal protective equipment we were provided

25:27

with. I think a lot of

25:29

people don't realise that many of us were working

25:31

on COVID wards with nothing but a surgical mask.

25:34

I found it ironic that there would be people on

25:37

the underground who had better PPE on

25:39

than we were given working with known

25:41

cases of COVID. But no

25:44

one will quite acknowledge the decision

25:46

making chain that brought about

25:49

the blanket policy on PPE. And

25:52

I believe that our employer had a

25:54

duty of care to protect us as

25:56

best they could. I mean, nothing is

25:59

100% fair. but as

26:01

best they could and that they failed in

26:03

that regard. But unfortunately,

26:05

until we get a clear

26:07

understanding of the

26:09

pathway of decision making and

26:12

why those decisions were made, it's

26:14

very difficult to challenge. But

26:16

we are now trying to take legal

26:19

action on behalf of all healthcare workers

26:21

who may have been very negatively affected

26:23

by this virus to try

26:25

and get those answers, as well

26:27

as for some of my colleagues who are unable to

26:29

work at all to find some

26:32

kind of compensation for them because they've lost their

26:34

careers and their livelihoods. So

26:36

there's a bigger cost to living with long COVID

26:38

than just the direct health impacts, as is clear

26:40

there. Thanks again to Natalie McDermott.

26:42

And we approached NHS England to see if

26:44

someone was available to speak to us. They

26:46

told us long COVID remains

26:48

a new and complex condition and it

26:51

is important we continue to build an

26:53

evidence base of proven interventions that can

26:55

support people to manage their symptoms and

26:57

aid recovery. They go on to say

26:59

the NHS has established over 100 specialist

27:01

post COVID services across England which

27:03

offer a range of specialist multidisciplinary

27:06

support in managing and treating the

27:08

physical and psychological impacts of long

27:10

COVID. If you're concerned about ongoing

27:12

symptoms following COVID-19, please speak to

27:15

your GP team.

27:17

Meanwhile, might yoga have a therapeutic role

27:19

to play in helping to rehabilitate people

27:21

with long COVID? Nick stole the virtues

27:23

so we sent along James Titko to

27:26

the Yoga For Life Project's Claire Woolley

27:28

for some tips on his breathing. In

27:31

March 2020, my

27:33

husband got COVID and

27:36

it became apparent that he wasn't

27:39

getting better from it and it

27:41

was so early that the

27:43

word long COVID had been coined at

27:46

that stage. One thing he

27:48

really was struggling with was chest pain and

27:50

his breathing. And so I

27:52

decided to set up a breathing class

27:55

and we quite quickly got a

27:58

lot of people joining this. initially

28:00

through word of mouth and

28:03

it was on Zoom. And I

28:06

was teaching really people how to

28:08

breathe properly, possibly for the first

28:11

time in that we're never taught

28:13

that. And it's very

28:15

common for people who have had

28:18

COVID to get something

28:20

called breathing pass-in disorder,

28:22

where you breathe using

28:24

your upper respiratory muscle, so the

28:26

upper part of the chest, and out

28:29

through your mouth rather than breathing in

28:31

and out of your nose and into

28:33

your belly. And in correcting that, you

28:37

switch on your vagus nerve, which

28:39

in turn switches on your parasympathetic

28:41

nervous system, your system of rest

28:44

and digest. It's

28:46

a very interesting thought, teaching

28:48

people to breathe properly, something

28:51

we obviously all do unconsciously in order to

28:53

stay alive. I'm intrigued, Claire. Can you give

28:55

me a taste? Okay.

28:58

So you can do this practice lying

29:00

down, seated or standing, but

29:03

if you're doing it seated, if you

29:05

bring your feet underneath your knees, your

29:07

knees are hit with the part and

29:09

you just feel down into

29:11

the four corners of your feet. And

29:14

so that you start to feel really

29:16

centered and stable, you should very gently

29:18

inhale, draw the shoulders up to your

29:20

ears, and then as

29:22

you exhale, dropping your shoulders down your back, root

29:26

down through the four

29:28

corners of your feet, the sitting bones, and

29:30

reach up tall through the crown of your

29:32

head, and just start to feel

29:34

this sensation of space

29:37

in the front body. And

29:40

then very gently place

29:42

one hand on your belly, the other hand onto

29:44

your chest, and perhaps close

29:47

your eyes or take a soft

29:49

gaze, start

29:51

to come into your feeling body and

29:53

observe where you're feeling the breath in

29:55

your body. And

29:58

if you're feeling the breath, in

30:00

the upper hand, you're breathing using

30:03

the upper respiratory muscles. And

30:06

we want to descend the breath now down into

30:08

the lower hand. So

30:10

very gently start to breathe

30:13

into the lower hand, feeling the breath

30:15

expand with the belly, and as you

30:17

exhale, feel the navel drink back towards

30:19

your spine. And

30:22

then inhaling, belly

30:24

rising, exhaling, belly falling.

30:29

And keep going with this breathing

30:32

practice. And when you start

30:34

to observe some

30:37

stillness in the upper hand, drop

30:39

that hand down onto the lower

30:41

hand, keep focusing on

30:44

that breath, feeling the breath flowing in

30:46

and out of the nose and

30:50

in the belly. And return

30:52

to your gentle smile and

30:55

perhaps just take a moment to observe whether you

30:58

feel different how you did at the

31:01

start of the practice. Oh

31:04

Claire, that was wonderful. And I was able

31:06

to take part in

31:08

that brief exercise while sitting

31:10

down. I presume while yoga

31:12

is not an extremely

31:14

vigorous exercise, it still

31:17

takes some aerobic strength.

31:19

Is that an accommodation therefore that

31:22

you've made to bring this to

31:24

people with all sorts of presentations?

31:27

Yes, yes. So it's important that

31:29

what we teach people can do

31:31

also lying down and from a

31:34

bed. So the yoga

31:36

we teach, aside from the breath,

31:38

it's very, very calm and

31:40

restful. There are lots of pauses.

31:43

And we also encourage people

31:45

if they're really fatigued or it's difficult

31:47

for them to do is

31:49

instead of doing it, visualize themselves

31:52

doing it because there's a certain

31:54

amount of research to show that

31:56

this also can have physiological benefits.

31:59

The calming voice. of Claire Wally there

32:01

from the Yoga for Life project. Despite

32:04

all you've heard today about the

32:06

extremely serious illnesses that some people

32:08

living with long COVID experience after

32:10

infection missiles COV2 there is still

32:12

nevertheless a stigma around it and

32:14

perhaps that's because as we've heard

32:17

it's such a difficult thing to define

32:19

but scientists are tirelessly probing the pathology

32:21

of long COVID and there are thankfully

32:23

some green shoots beginning to emerge. We

32:26

encourage you to get in touch with us

32:28

to describe your experiences and please do keep

32:30

the conversation going. Our email address chris

32:33

at thenakedscientist.com. That's

32:36

it for this week. Do stay tuned for

32:38

our weekly roundup of science news this Friday

32:40

and be sure to join us next Tuesday

32:42

when we're going to talk ticks searching for

32:45

the source of the rise in tick related

32:47

diseases to be precise. We hope you'll join

32:49

us then. The Naked Scientist

32:51

comes to you from the University of

32:54

Cambridge's Institute of Continuing Education. It is

32:56

supported by Rolls-Royce. I'm Chris Smith and

32:58

from everyone here at the Naked Scientist

33:00

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