What we know about Covid-19 is changing – including new symptoms and how it spreads

South Africa’s Covid-19 ministerial advisory committee head, professor Salim Abdool Karim, says that health experts and scientists are learning new things about the virus on a daily basis – and while some revelations are alarming, others require more research.

Speaking to 702 on Friday (10 July) professor Karim said that if you had asked him two weeks ago whether the coronavirus could cause diabetes, he would have said absolutely not.

However, at least three papers show that this has happened in some patients where the virus has spread to attack the insulin-producing cells in the pancreas.

“It’s rare, but the virus is able to attack those cells and kill them, causing diabetes. It’s not related to whether you have any pre-existing diabetes, or you’re pre-diabetic: this happens in individuals where the virus has been able to spread through the entire body,” Karim said.

“This only happens in a very small fraction (of patients) – but when it does, we are only now learning of the full spectrum of disease it causes.”

Other new symptoms of the virus that are coming to light include long-term sequelae – which is chronic residual illness suffered after trauma, like difficulty breathing, and general fatigue.

Karim said that some people who have recovered from the virus are facing prolonged recovery periods littered with further complications.

Meanwhile, new studies out of University College London have suggested that some severe problems could occur in even ‘mild’ cases of infection, including brain damage and other neurological issues.

Researchers from the university assessed the neurological symptoms of 43 patients hospitalised in the UK with either confirmed or suspected Covid-19 infection. They found 10 cases of temporary brain dysfunction, 12 cases of brain inflammation, eight strokes and eight cases of nerve damage.

Is it airborne?

Karim’s comments come amid growing concern around a surge in cases in South Africa – in areas like Gauteng and the Eastern Cape, in particular – as global experts debate over whether our understanding of the disease, and how it is spread, is complete enough.

Of particular worry is a debate around whether the virus is airborne, existing in finer air particles expelled from our mouths which can transfer the virus far beyond 2 metres, and linger in the air for hours.

A group of 239 scientists from around the world have penned an open letter to the World Health Organisation, asking the global health body to acknowledge that this is the case, and to encourage countries globally to adjust their Covid-19 response policies accordingly.

The WHO said it was in the process of compiling a body of evidence around this, but maintained that social distancing and wearing face masks is still the correct position to take.

The health body also noted that while it appears as if while global deaths have levelled off, the spread of the virus is actually accelerating in many regions, and the world is still some way off from the peak.

According to Karim, the idea that the virus exists in finer air particles is not new, and has been known for some time – but he said the real question is whether or not these particles linger in the air for a long time, and are sufficient enough to cause infection.

This needs to be tested further, he said.

“The evidence that the virus is in little droplets, is something we have known for a long time. It’s not new. That it can be spread by aerosols, it is known,” he said.

“What is an issue is whether these little droplets that float stay in the air for a long time? And do they actually cause infection? That is an unanswered question.”

He said South Africa already works on the basis that the virus can be spread by aerosols, but he wouldn’t describe the virus as ‘airborne’ at this stage, saying he would want more information.

“It seems likely, but there’s a difference between likely and whether it is,” he said.

Since 31 December 2019 and as of 10 July 2020, 12,245,417 cases of Covid-19 have been reported, including 554,721 deaths.

Read: This is when we could get the first Covid-19 vaccine

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What we know about Covid-19 is changing – including new symptoms and how it spreads