Nevertheless, six months ago the presidents of the colleges and universities in the Washington, D.C. region charged our organization, the Consortium of Universities of the Washington Metropolitan Area, with bringing together the best and brightest researchers across our institutions.  We came together for months of meetings and workings groups seeking to identify the potential solutions to reducing gun violence that showed the most promise.  To my surprise, we were able to find a great deal of common ground – although not without continuing areas of reasonable debate.

Gun violence itself is often misunderstood as focusing on mass shooting events, which themselves can be defined in different ways.  While those events are terrifying and receive tremendous coverage, far more people in our country die from suicide or homicide by gun than in mass shootings. 

Solutions have to start with understanding the causes of that violence, and we know that far more research is needed.  It seems evident to suggest that less ready access to guns would reduce suicide by gun, and likely homicides as well – yet according to our experts, gun buyback programs, which are often very comforting to a community, have had little impact on gun violence.

Community intervention programs were the single solution that found the most common ground in our discussions.  These programs engage local communities, sometimes through community-based organizations, schools, places of worship, or hospitals, in interrupting patterns of violence. 

They are very promising – and best of all, compared to most solutions, they are very inexpensive.  It is an area where far more investments should be made both in expanding and piloting programs, and in long term research in their outcomes.

Our experts also had many ideas for communication and education campaigns.  Of course, past public health campaigns have mixed results.  From encouraging use of seat belts to discouraging illegal drug abuse to COVID vaccinations, we can all readily remember campaigns that seem to have worked, and just as many that did not. 

Nevertheless, our experts highlighted a number of very targeted campaigns that were likely to generate success, including anti violence campaigns and conflict resolution training in schools, but only if they can be done without vilifying gun ownership.  Additionally, there was admiration for the very promising field of pushing back against online efforts by extremist groups to incite violence.

There seemed to be little or no downside to ideas surrounding increased safety and training.  Many of our most ardent gun rights supporters felt most passionately that providing easier access to safer gun storage and better training would make everyone safer. 

I was fortunate to be in the room for discussions with so many amazing experts giving their time and talent to respond to this crisis.  From them, I learned that all of these proposals will work best if aligned with wise legislation and policy, and that it is likely the best ways to reduce overall violence is to address root causes of economic equity and marginalization. 

It was shocking to me that the primary cause of death in children in our country has relatively little funding for research.  Most of all, it was hopeful to find that by collaborating across diverse thinkers from many disciplines, we were able to find that elusive common ground.  It made me believe, more than ever, that even on subjects where we have such deep divides, we can come together to find ways to make our children safer.

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Washington University School of Medicine announced a new clinic specifically targeting patients who recovered from Covid-19 but continue to suffer from a wide range of symptoms. Covid Long Haulers in St. Louis and the surrounding area will have access to top-notch care in this multispecialty service line.

The Care and Recovery After COVID-19 (CARE) Clinic recognize people with long Covid presents with diverse issues and complications. Patients often complain about problems in the heart, lungs, kidneys, brain, blood, insomnia, sleep, and mood disorders. To facilitate care coordination, the CARE clinic has access to specialists in Cardiology, Endocrinology, Gastroenterology, Hematology, Infectious Disease, Nephrology, Neurology, Occupational Therapy, Physical Therapy, and Pulmonology.

The team of specialists addresses each patient’s needs by providing a comprehensive individual assessment. Referrals, testing, and recommendations are coordinate from the central hub of the CARE Clinic.

The St. Louis Washington University CARE Clinic will schedule patients with Long Covid symptoms who have had a confirmed positive case of COVID-19 by a nasal swab test, a saliva test, or a blood antibody test.

Washington University is not the only institute launching post-Covid care clinics. The National Institute of Health (NIH) announced a new initiative to study the causes of the post-Covid condition. The influx of a $1.15 billion investment in new medical research funding will hopefully open the doors to preventative steps and, ultimately, treatment options.

Scientists continue to learn more about persistent symptoms after a Covid-19 infection. Popular terms for the condition include “long Covid” or “Covid long haulers.” The CDC uses the more descriptive term post-COVID condition to cover the set of post-infection signs and symptoms experienced more than four weeks after infection with SARS-CoV-2.

We know that SARS-CoV-2 enters the brain and causes inflammation. Scientists in Bethesda, Maryland, published a paper in the New England Journal of Medicine evaluating the brains of people who died from Covid-19. They noted inflammation and evidence of leaky blood vessels in the postmortem brain tissue.

Despite these findings, we do not know the specific reasons the virus causes persistent symptoms in some patients. Long Covid symptoms appear in some patients with severe Covid disease and those with mild or asymptomatic infections.

The CDC lists common symptoms of post-Covid complaints.

• Tiredness or fatigue
• Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
• Headache
• Loss of smell or taste
• Dizziness on standing
• Fast-beating or pounding heart (also known as heart palpitations)
• Chest pain
• Difficulty breathing or shortness of breath
• Cough
• Joint or muscle pain
• Depression or anxiety
• Fever
• Symptoms that get worse after physical or mental activities

FIGURE. Self-reported symptoms at the time of positive SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) testing results and unresolved symptoms 14–21 days later among outpatients (N = 274)* — 14 academic health care systems,† United States, March–June 2020

A recent study published in the Lancet evaluated patients six months after hospital discharge. Approximately 75% of the 1,655 hospitalized COVID-19 patients in Wuhan, China, continued to have at least one symptom six months after discharge.

Another Lancet study evaluated the neurolgic and psychiatric outcomes in 236 379 Covid-19 survivors six months after infection. One third met criteria for a neurological or psychiatric diagnosis within six months of infection. Anxiety, depression, muscle pain, substance abuse and insomnia were the most common reported conditions.

Patients in St. Louis and the surrounding area with post-Covid condition symptoms can find more information here.

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