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Covid-19's long-term effects: 'You just don't want to get this virus if you don't have to'

It can be tempting to think of Covid-19 patients as falling into one of two categories. Covid-19 patients have reported 'brain fog' months after being infected Photo: 123RF / Olga Yastremska and Leonid Yastremskiy Category 1: young, otherwise healthy individuals who experience mild symptoms and recover at home. Category 2: older people and people with pre-existing health conditions who become seriously ill and go to hospital. While it's true that there is a spectrum of risk when it comes to severity of disease, it's become increasingly clear that not everyone fits neatly into one of these categories. For many people, the labels of "mild" or "severe", "sick" or "recovered" are blurred by their experience of ongoing, sometimes debilitating symptoms weeks or months after they first were infected. Both anecdotal reports and a growing body of research suggest persistent fatigue, breathlessness, "brain fog" and muscle aches, among other symptoms, are plaguing people some time after their infection has cleared. So what do we know about the lingering health effects of coronavirus, and how concerned should we be? Health effects can linger for months It's difficult to say what proportion of people with Covid-19 face medium- to long-term health impacts given how new the virus still is, said Dr Kirsty Short, a virologist at the University of Queensland. "It's definitely happening, I just don't think we have a grip on how common it is," Short said. In July, researchers in Italy found almost 90 per cent of patients with acute infections were still experiencing symptoms two months later. Research from the US and UK, following a much broader group of people affected by Covid-19, suggests symptoms persist in about 10 to 15 per cent of cases. In the same way the virus can sometimes cause serious illness in young, otherwise healthy individuals, lingering symptoms appear to affect people of all ages, including those with no underlying health conditions. Lasting effects are also not restricted to those who experience severe illness when they're first infected. People who are asymptomatic or have a mild case of Covid-19 can also face prolonged illness. Sometimes, these symptoms take weeks or months to appear. The virus affects multiple organs SARS-CoV-2 is primarily thought of as a respiratory virus, but the damage caused by Covid-19 is not always restricted to the lungs. The virus binds to the body's ACE2 receptors, which are found in large numbers in the respiratory tract, but also in the heart, blood vessels, kidneys, liver and gastrointestinal tract. In some cases, it may be that the virus itself is causing damage to the body's organs. But researchers suspect it's high levels of inflammation in the body - triggered by the immune system trying to get rid of the virus - that's wreaking havoc, even after the infection has cleared. "Most likely, they've had this overwhelming inflammatory response - which we know happens in COVID-19 patients - and then that's had knock-on effects." Covid-19 can damage multiple organ systems, including: Lungs: Lungs can be damaged when the virus enters the cells of the airways. It can cause scarred, stiff tissue that makes it difficult for the lungs to do their job of oxygenating the blood - leaving people breathless. Heart: The virus can cause inflammation of the heart muscle or heart failure when the organ doesn't pump blood as well as it should. The heart can also fail from lack of oxygen. Brain: If the virus enters the brain, it can cause a sudden and severe infection. Neurological symptoms may also be a result of inflammation in the brain or strokes caused by blood clots. Covid-19 coronavirus particles. Photo: AFP Symptoms seen in other infections Self-described as Covid-19 "long haulers", some patients describe debilitating fatigue, difficulty exercising, and general "brain fog" months after their infection has cleared. Short said post-viral fatigue is seen in other viral infections too. "We know that Epstein-Barr virus, which causes glandular fever, has also been linked to chronic fatigue syndrome," she said. Similarly, there is evidence to suggest Covid-19 can cause heart damage, which is not unusual for a virus, said Dr Linda Gallo of the University of Queensland. "We know from SARS that there was evidence of cardiovascular involvement," said Gallo, who is researching how coronavirus affects the heart. "However it was generally considered to be pretty self-limiting, and not persisting beyond the period of recovery. While research on long-term cardiovascular effects is limited, Gallo said some of the preliminary evidence is concerning. "The fact there are people who [have] recovered at home and had fairly mild symptoms are now showing evidence of heart damage is problematic, and surprising." Gallo is part of a study investigating the longer-term effects of Covid-19, especially on people with diabetes, and is currently looking for people who have had coronavirus to participate in a study. Although it's too early to say what the impact is on people with existing diabetes, she said there is a possibility Covid-19 might be linked to the onset of diabetes. "The thought is that the virus directly attacks the pancreas. That's just a hypothesis - there's not direct evidence of that at this point," she said. "It could be multifactorial, so a combination of direct virus effects as well as an overall hyperinflammatory response." A timely reminder There are multiple studies now underway to investigate whether Covid-19 leaves a lasting health impact, and if so, to what extent. Short said without long-term studies, it's difficult to know how concerned we should be about Covid-19 in contrast to other existing viral infections. "The question is: If you took a virus of similar severity and similar duration, would you also see long-term complications?" she said. "It's very possible that we're just seeing this with SARS-COV-2 because of the sheer numbers of people being infected." Even still, the emergence of symptoms down the track is a reminder of why it's important to take precautions. "I think it's just another reason as to why we're taking all these measures ... because you just don't want to get this virus if you don't have to." - ABC
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Trump plans to pick Judge Amy Coney Barrett for Supreme Court – sources

US President Donald Trump has revealed his nomination to fill the vacancy on the US Supreme Court left by the death of Ruth Bader Ginsburg. Amy Coney Barrett Photo: AFP / University of Notre Dame / Julian Velasco His choice federal appeals court judge Amy Coney Barrett, 48, is known for her conservative religious views. Trump has said he will formally announce on Saturday his choice to replace Ginsburg, the liberal icon who died on 18 September at age 87. The Republican president had multiple times this week mentioned Barrett as under consideration. Two sources confirmed on Friday that Trump plans to nominate Barrett, but warned that Trump could change his mind. Trump himself told reporters on Friday that he had made his decision, but declined to say who his pick was. Barrett was appointed by Trump to the Chicago-based 7th US Circuit Court of Appeals in 2017 and is known for her conservative religious views. Supreme Court justices are given lifetime appointments. If confirmed, Trump's nominee would give conservatives a commanding 6-3 majority on the court at a time of intense political divisions in the United States. Barrett has been viewed as a frontrunner throughout, along with fellow federal appeals court judge Barbara Lagoa. Barrett previously served as a clerk to conservative Supreme Court Justice Antonin Scalia, who died in 2016. Trump said he did not meet with Lagoa during a campaign trip to Florida. Trump's nominee has what appears to be a clear path to Senate confirmation before the 3 November presidential election, with Republicans holding a 53-47 majority in the chamber and only two senators in his party indicating opposition to moving forward with the process. Democrats have objected to the Senate acting on Trump's nominee in light of the decision by Republicans in the chamber in 2016 to refuse to consider Democratic President Barack Obama's nominee to replace Scalia after he died during a presidential election year. Trump has made two previous Supreme Court appointments: Neil Gorsuch in 2017 and Brett Kavanaugh in 2018. Ginsburg, a champion of gender equality and various liberal causes, made history again on Friday as the first woman and first Jewish person to lie in state in the US Capitol. Democratic presidential candidate Joe Biden attended the ceremony a day after Trump was greeted with jeers and boos by a nearby crowd as he visited Ginsburg's flag-draped coffin outside the Supreme Court building. - Reuters
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Two hurt in stabbing near Paris Charlie Hebdo office

Two people have been stabbed and seriously hurt in Paris near the former offices of the satirical magazine Charlie Hebdo. Military and police deployed on Boulevard Richard-Lenoir, near where the attack took place. Photo: AFP / Marie Magnin / Hans Lucas Two suspects have been arrested. One of them was seized in the nearby Bastille area with blood on his clothing, police told the BBC. Anti-terrorism police have taken over the investigation. A security cordon has been set up in the 11th arrondissement in eastern Paris. Nearby metro stations were closed and five schools in the area immediately went into lockdown. The schools were allowed to reopen some hours later. A blade - described as a machete or a meat cleaver - was recovered at the scene of the attack near the Boulevard Richard-Lenoir. Police quoted by French media said the "main suspect" was from Pakistan and the second person arrested was from Algeria. They have not yet been named and any connection between them has not been disclosed. The conditions of the victims have not been made public although French Prime Minister Jean Castex told reporters at the scene that their lives were not in danger. The attack comes as a high-profile trial is under way in Paris of 14 people accused of helping two jihadists carry out the 2015 attack on Charlie Hebdo, in which 12 people were killed. The two people wounded were staff at a TV production company, one of their colleagues told AFP news agency. "Two colleagues were smoking a cigarette outside the building, in the street. I heard shouting. I went to the window and saw one of my colleagues, covered in blood, being chased by a man with a machete in the street," another member of staff at the Premières Lignes production firm said. The firm has offices in the Rue Nicolas Appert, a side street off Boulevard Richard Lenoir where the former Charlie Hebdo offices are located. A mural to the 12 people killed in the Charlie Hebdo attack is nearby. The satirical magazine has since moved to a secret location. Castex visited the scene accompanied by Interior Minister Gérald Darmanin and Paris Mayor Anne Hidalgo. The prime minister reiterated the government's "firm commitment to combat terrorism by all possible means". At a news conference, anti-terrorism prosecutor Jean-François Ricard confirmed that the "main perpetrator" had been arrested and said a "second individual" was also in custody. "The investigation will continue," he said. Charles Michel, President of the European Council and former Belgian PM, expressed his "full solidarity with the French people". "All my thoughts are with the victims of this cowardly act of violence. Terror has no place on European territory," he tweeted. In a tweet, Charlie Hebdo expressed its "support and solidarity with its former neighbours... and the people affected by this odious attack". Charlie Hebdo has marked the start of the trial by reprinting controversial cartoons of the Prophet Muhammad that sparked protests in several Muslim countries. In response, the militant group al-Qaeda renewed its threat to the magazine. The magazine's head of human resources said earlier this week that she had moved out of her home after receiving death threats. The defendants in the trial are also accused of helping another jihadist carry out a related attack in which he shot dead a policewoman, then attacked a Jewish store, killing four people. The 17 victims were killed over a period of three days. All three attackers were killed by police. The killings marked the beginning of a wave of jihadist attacks across France that left more than 250 people dead. - BBC
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Britain's Princess Eugenie is pregnant – Buckingham Palace

Princess Eugenie is pregnant and expecting to give birth in early 2021, Buckingham Palace says. Princess Eugenie of York and her husband Jack Brooksbank arrive for the Royal Family's traditional Christmas Day service in eastern England, on December 25, 2018. Photo: AFP / Paul Ellis Queen Elizabeth's granddaughter, who is the 10th in line to the British throne, is the younger daughter of Prince Andrew and his ex-wife Sarah Ferguson, the Duchess of York. She married Jack Brooksbank at Windsor Castle in 2018. "Her Royal Highness Princess Eugenie and Mr Jack Brooksbank are very pleased to announce that they are expecting a baby in early 2021," Buckingham Palace said in a statement. "The Duke of York and Sarah, Duchess of York, Mr and Mrs George Brooksbank, The Queen and The Duke of Edinburgh are delighted with the news." Her Royal Highness Princess Eugenie and Mr Jack Brooksbank are very pleased to announce that they are expecting a baby in early 2021..The Duke of York and Sarah, Duchess of York, Mr and Mrs George Brooksbank, The Queen and The Duke of Edinburgh are delighted with the news. pic.twitter.com/nLrzkwHMGC — The Royal Family (@RoyalFamily) September 25, 2020 On her Instagram account, Eugenie posted a picture of a pair of baby slippers and wrote: "Jack and I are so excited for early 2021", adding a baby emoji. Her child will be the ninth great-grandchild for the 94-year-old queen. -Reuters
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North Korea's Kim Jong Un 'sorry' over killing of South Korean to control coronavirus

North Korea has expressed regret that it shot dead a missing South Korean to prevent the spread of coronavirus, says the South's national security adviser. North Korean leader Kim Jong Un speaks during a meeting in Pyongyang on August 25, 2020. Photo: STR / KCNA via KNS / AFP North Korea's United Front Department, in charge of cross-border ties, sent a letter to South Korean President Moon Jae-in's office a day after Seoul officials said North Korean soldiers killed a South Korean before dousing his body in oil and setting it on fire. The rare message came as Moon faced intense political fallout over the incident, which coincided with a renewed push for policy to engage Pyongyang. The letter cited North Korean leader Kim Jong Un as saying he was "sorry" that the incident disappointed the South Korean public and should not have happened, Moon's security adviser Suh Hoon said. The soldiers fired more than 10 shots at the man, a South Korean fisheries official who went missing this week, after he did not reveal his identity and tried to flee, Suh said, citing the letter. But the letter said they burned a floatation device he was using, according to their anti-virus manuals, and not his body. "The troops could not locate the unidentified trespasser during a search after firing the shots, and burned the device under national emergency disease prevention measures," Suh told a briefing, referring to the letter. The shooting shocked many South Koreans and triggered a fierce backlash from opposition lawmakers, prompting Moon to issue an unusually stringent response calling it "unpardonable." In 2008, North Korean troops shot to death a South Korean tourist who strolled into an off-limits area while staying at a North Korean resort complex, resulting in a halt of inter-Korean tourism projects. Moon has pledged to reopen the tour programmes. The military announced the fishery official's death a day after Moon proposed a new regional disease control and health initiative including North Korea to cope with crises like the coronavirus and strained ties with Pyongyang. Moon and Kim have recently exchanged letters to share hopes to rebuild relations after tackling the coronavirus, Suh said. -Reuters
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