Even as Covid cases continue to climb, the Government’s plan to lift all remaining restrictions in a matter of days is still on track for a single reason: the vaccine has severely weakened the link between infections, hospitalisations and deaths.
Yet, amid the optimism, another concern has cast a shadow – the rising diagnoses of long Covid, the debilitating condition that leaves sufferers battling symptoms for months after being infected.
More than a million Britons are said to be living with lingering problems, from breathlessness to brain fog, and that figure could double by the end of the summer, say experts.
With no effective drug treatments yet discovered, there has been little hope for those living with the worst difficulties – until now.
In a world first, British scientists are set to explore giving long Covid patients monthly doses of the Covid vaccine, in an effort to combat the chronic condition.
In a world first, British scientists are set to explore giving long Covid patients monthly doses of the Covid vaccine, in an effort to combat the chronic condition. (Stock image)
The first stage of the study was given the green light on Friday: later this year, 40 long Covid sufferers will be offered at least two extra jabs.
Funding has been offered by several of the major vaccine developers, and if the pilot is successful the scientists involved have been told they can recruit thousands more patients.
Speaking exclusively to The Mail on Sunday, Dr David Strain, senior clinical lecturer at the University of Exeter Medical School, who will lead the trial, says the manufacturers are interested in funding the study after early research showed that long Covid symptoms were significantly reduced after patients had a jab.
Dr Strain said: ‘Many saw a dramatic improvement within days of their jab. Their fatigue disappeared, they were able to walk further without feeling breathless.
‘Some said it was the closest to normal they’d felt since they first caught Covid.
‘In an earlier study we saw this lasted for about a month after the first dose, but then symptoms return.
‘The same pattern was seen when people went for their second jab. We want to find out whether, over time, offering regular doses can make this change permanent.’
Scientists believe roughly one in ten people who catch Covid will suffer from prolonged symptoms.
These vary, but the most common include shortness of breath, muscle aches and problems with thinking and concentration – dubbed brain fog.
For many, their symptoms are yet to subside and, according to the Office for National Statistics, nearly 400,000 Britons say they have been experiencing symptoms since contracting the virus towards the start of the pandemic.
Doctors have struggled to treat the condition, despite the fact that in the past year the NHS has opened more than 80 specialist clinics to treat the rising number of patients.
The exact causes and processes that result in the majority recovering from Covid infection fully, while others do not, are still unknown.
Liliana Jackson (above), 16, from Sleaford, Lincolnshire, has suffered from long Covid since September 2020, when she tested positive for the virus
Many even argue it is a ‘collection of syndromes’ rather than one disease.
But recent research has suggested that Covid vaccines may be a highly effective treatment.
A paper published in the Lancet medical journal in May, authored by Dr Strain, which surveyed more than 900 long Covid patients, reported that more than half saw their symptoms improve after they received their first vaccine dose, and there was a particularly strong response in patients who received the Pfizer or Moderna jabs.
However, patients noted the positive change was temporary, lasting only a few weeks.
Dr Stain said: ‘The plan would be to recruit patients whose symptoms are so severe their lives are severely limited by the condition. Those, for example, who can’t go to work or pack their child’s lunch in the morning because they feel so fatigued.
‘We would offer them the jab at a long Covid clinic and they’d return for another the following month.
‘The jabs cost roughly £15 a dose, and if it can get hundreds of thousands of Britons back to normality then it would be a very cost-effective treatment.’
The trial will be the first time in the world a Covid-19 vaccine will be used for any purpose other than protecting people against the virus itself.
At a time when vaccines are in short supply, it is expected to raise ethical questions.
But Dr Strain is clear the vaccines being used will not have been taken out of the supply chain. Instead, manufacturers have offered to provide ‘outdated’ jabs.
He said: ‘Right now all the manufacturers are designing their second-generation vaccine. These will be designed to combat the Delta [Indian] variant, as well as the South Africa variant, which many worry is highly resistant to current jabs.
Liliana had her first vaccine dose in March, and after five days of feeling unwell with the typical side effects of nausea and aches, her symptoms suddenly improved
‘Once new vaccines have been created, there’ll be no need for the original vaccines, which were designed with the initial Covid variant in mind. These will be the vaccines we use in the trials.’
Long Covid patients can be roughly split into two groups.
The first comprises those who were hospitalised with serious Covid symptoms. These patients may have suffered serious damage to vital organs such as the lungs or heart. As a result, it can take months for them to recover.
This is, to a large extent, expected after severe illness.
However, doctors are more confounded by the other group of sufferers – those whose illness was initially mild but then lingered or even worsened.
These patients make up the majority of the UK’s one million long Covid sufferers.
Professor Danny Altmann, an immunologist at Imperial College London, said: ‘There is no real consensus yet on what is behind long Covid, though there are several theories.’
One is that symptoms are brought on by reservoirs of the virus which remain in certain areas of the body after infection.
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A similar condition was seen during the 2014 Ebola outbreak in West Africa, where many who survived the deadly disease continued to experience illness for months. Scientists believe this was due to persisting low-level infections.
Recent studies in the US have found Covid cells in the gut months after infection.
Prof Altmann believes this may explain why vaccines can reduce long Covid symptoms.
He said: ‘What we may be seeing is the jabs are giving the immune system an added boost, which allows it to reach the pockets of the body where the virus has been hiding.’
Another popular theory is that the virus destabilises the immune system – some studies suggest that Covid can affect the mitochondria, the power-house within cells which supplies them with energy.
Experts say this can cause the immune system to malfunction and attack healthy cells.
Similar mitochondrial dysfunction has been observed in patients with chronic fatigue syndrome, which shares many symptoms with long Covid.
Dr Strain believes this is the most likely theory, and argues the vaccines are, even temporarily, shutting off this overactive immune response.
He said: ‘It’s possible that, by focusing the immune system on the act of developing Covid antibodies, it can reset the cells which are misfiring. It’s akin to turning a faulty computer off at the plug and restarting it.’
Whatever the cause, many long Covid sufferers across the UK who for months have been severely debilitated by the condition say their symptoms were markedly improved after vaccination.
Liliana Jackson, 16, from Sleaford, Lincolnshire, has suffered from long Covid since September 2020, when she tested positive for the virus.
Since then she has suffered from nausea, migraines, rashes and fatigue. Liliana missed the majority of the last school year due to her ill health.
Her mother, Gail, said: ‘She used to be so active. She loved swimming, but now some days she can’t even get out of bed.’
Current Government guidelines say the vaccines are available only for over-18s and 16 and 17-year-olds with underlying health conditions.
Due to the extent of Liliana’s symptoms, her GP placed her on the clinically vulnerable list, which meant she was eligible for a jab.
Liliana had her first dose in March, and after five days of feeling unwell with the typical side effects of nausea and aches, her symptoms suddenly improved.
Gail, 50, a charity worker, said: ‘The change was really significant. Liliana felt completely over it. She had her energy back and, four weeks after her jab, she was well enough to go to school for the whole week.
‘It was the first time she’d done that since she caught Covid. She even started doing some evening activities with friends again. Things seemed great.’
Unfortunately, the changes were short-lived.
A week later, Liliana’s symptoms returned in full, and her second vaccine dose, which she had in May, failed to have the same positive effect.
Gail says the family would jump at the chance for Liliana to take part in the trial.
Covid Q&A: Is shielding on the cards, and has a surge been triggered by the Euros?
Could vulnerable people be asked to shield again?
The Department of Health warned last week that Britons with serious underlying health conditions that could make Covid vaccines less effective ‘may want to take extra precautions’ when restrictions are lifted on July 19.
Meanwhile, Health Secretary Sajid Javid said that cases could rise to up to 100,000 per day in the coming weeks – a rate higher than the winter peak.
Charities have urged Ministers to issue guidance to those who previously shielded after a ‘deluge’ of emails from anxious people asking what to do to protect themselves. According to reports, the clinically vulnerable will not be told to stay at home but should make themselves fully aware of the risks in certain situations.
However, data released on Friday by Public Health England (PHE) suggests the effect of the vaccines on this group may be more robust than first thought.
A study of more than one million at-risk people, including those with blood cancer, severe asthma and conditions that weaken the immune system, found two doses of the AstraZeneca or Pfizer jab to be at least 74 per cent effective against symptomatic infection.
They are believed to be even more effective in preventing hospitalisation and death.
Dr Mary Ramsay, head of immunisation at PHE, said: ‘This real-world data shows most people who are clinically vulnerable still receive high levels of protection after two doses of vaccine.’
Is England’s success in the Euros driving up the rate of Covid infections?
According to data from Imperial College London’s REACT study, published on Friday, men are currently 30 per cent more likely than women to test positive for Covid. Experts believe this is due to men crowding into pubs and friends’ homes to watch England play in the Euro 2020 tournament.
A similar pattern has been observed in Scotland. Following the match against England in mid-June, Public Health England said nearly 1,200 Covid cases in Scotland had been linked to football fans travelling to London – 397 of those attended the game at Wembley Stadium.
At the end of June, Scotland recorded 4,000 cases in a day – its highest since the beginning of the pandemic. However, in the past week, cases have begun to fall.
Paul Hunter, professor of medicine at the University of East Anglia, credits Scotland’s exit from the tournament on June 22 for this decline.
She said: ‘I would absolutely put her forwards for it. Liliana is about to start her A-levels in September and I don’t know how she is going to do it. We’ll try anything, at this point.’
Dr Strain said the plan for the trial was safe: ‘Vaccines create a very specific immune response, and this has limited effect on the body as a whole. We experience these kinds of immune responses on a daily basis.
‘There are other drugs that have a similar effect on the immune system, such as monoclonal antibody treatments which are used to treat cancer and arthritis, and which are given on a regular basis.
‘There’s no reason to believe that having one of these vaccines every month would be unsafe, but safety will obviously be something we will pay close attention to.’
Dr Jeremy Rossman, a virologist at the University of Kent who was involved in the original Lancet study, said: ‘If giving the vaccine to protect against Covid, two doses are needed to create an adequate immune response.
‘It might be the same principle at play when using it as a treatment – patients will need a number of jabs to have a lasting effect. The next step is to find out how many are needed.’
He added: ‘It’s important to note that not all patients responded to the vaccine. So one of the key takeaways from the study should be working out why this is the case.
‘Perhaps it is because these patients have a specific type of long Covid, which is responsive to the vaccines. It will be interesting to find out.’
However, not all experts are convinced. Dr Rehan Mustafa, a respiratory medicine consultant who runs a long Covid clinic at the James Cook University Hospital in Middlesbrough, says there is unlikely to be a simple answer to the condition.
‘Long Covid is such a wide range of symptoms and we believe it could have a number of different causes, so it’s hard to imagine how one medicine could combat all of them,’ he said.
‘For example, some patients suffer from swollen joints, and you can treat that with anti-inflammatory drugs. But other patients suffer from brain fog, which may need a psychiatrist.’
Dr Mustafa claims the approach used in long Covid clinics is already having a positive impact. ‘Clinics offer patients a range of services, including physiotherapy, breathing exercises and psychiatric support. The combined approach we are taking in our clinic appears to be working.
‘Treating long Covid is about holding the patient’s hand as they slowly move back towards full health.’
But others claim these clinics are having little effect.
Ondine Sherwood, from LongCovidSOS, a campaign group for sufferers, said: ‘The clinics are assessment centres, not treatment centres.
‘While there are tests now that can confirm you are suffering from long Covid, there’s nothing these clinics can actually give you which will solve the problem.
‘Whether it’s the vaccines or other drugs, we need to focus on finding something which will help the hundreds of thousands of Britons suffering.’
Another, long Covid sufferer who saw improvement after their jab is Garry Loftus, 51, from Stoke.
Garry tested positive for Covid in December and says he has since suffered from fatigue and breathlessness so serious he has had to quit his job as a hospital porter.
‘In January it got so bad I had to start sleeping on the ground floor because I couldn’t make it up the stairs. It feels like I have sand in my lungs at all times.
‘I was in the Army for 26 years, and what I have been through in the past six months has been far harder than any tour I served.’
Garry had his second dose of Pfizer in April and says, while the changes weren’t instantaneous, he has felt a gradual improvement.
‘My fatigue levels have really reduced. I used to get these bouts where I was out for the count for five days – now these last only two days.
‘I’d jump at the chance to have another jab to see if that helped.’