The world is changing fast and to keep up you need local knowledge with global context.
Until now, the medical prospects for persons suffering from long Covid have been very bleak. As recently as three weeks ago, BizNews republished an article by our partners at The Wall Street Journal covering long Covid. The central message and, essentially, advice to patients struggling with long Covid symptoms was to pace themselves. Neither heartening nor motivational advice for those who find themselves incapable of functioning as a consequence of debilitating fatigue and cognitive dysfunction. However, there is hope. Dr Ashleigh Bhanjan, a specialist neurologist and bioflex practitioner working at Life Entabeni Hospital in Durban, has been treating long Covid with photobiomodulation therapy, with highly encouraging results. BizNews spoke to Dr Bhanjan who provided great insight on long Covid, including those who are at risk, the correlation between persons with severe Covid-19 infections and those who are likely to develop long Covid (spoiler alert – no correlation) and photobiomodulation therapy. – Nadya Swart
Dr Ashleigh Bhanjan on the most prevalent symptoms of long Covid
From what we have extrapolated from the clinical data and all the research that’s been going on since Covid-19 started for almost two and a quarter years now, I would say that, firstly, the symptoms of long Covid have to be present for a certain duration after you have the infection. So most patients don’t really have the ongoing symptoms.
So I would say usually within four weeks, most patients have the symptoms and have actually improved. There’s no further progression or persistence through either of the symptoms. And the symptoms we are talking about are shortness of breath, chronic fatigue, pain that can be from hip pain, headaches and pelvic pain to arthritic pain and neuropathy-type pain.
On whether long Covid develops immediately subsequent to Covid-19 infections
From the cohorts of patients they’ve looked at internationally in China – [a study] which has been published in Lancet 2021 – they looked at a six-month duration and followed up these patients after being diagnosed with Covid-19. There was no real break between clinical diagnosis and symptom re-onset. So, symptoms are usually persistent. They just don’t get better. That is what they’re describing.
A variety of patients will present with a different symptom complex. Certain patients might just have ongoing headaches. Certain patients have difficulties in breathing [and say]: “My chest specialists can’t find a cause, the X-rays are normal. My chest just isn’t better.” So there’s not really a stop in symptom duration. There’s actually more of a continuation.
On photobiomodulation therapy being used to treat patients suffering from long Covid
It sounds like a very complex form of modality, but let’s just break it up simply. Right. ‘Photo’ meaning light, ‘bio’ meaning life, ‘modulation’ [meaning] change. So changing life using light therapy. This has been out for about 60-odd years and obviously in a different clinical context. I am a neurologist, so I am more into the research in neurological disorders. I’m seeing all these patients who are presenting with a lot of brain fog and chronic headaches in the post-Covid-19 sort of spectrum. But yeah, the therapy has really taken off in the last decade, I would say. And a lot of research has gone into neurological conditions, neurodegenerative disorders, chronic pain syndromes. We are just applying that knowledge now into applications in [the] clinical diagnosis of neurological conditions and the results seem to be quite outstanding.
On the results of photobiomodulation therapy
From experience and seeing these patients, I think each patient is different. Those patients who do have complex pathologies like type two diabetes, kidney failure, previous stroke or rheumatoid arthritis, they do take a little bit longer. But because we modulate the underlying pathological mechanism – which in our case, what we think is predominantly inflammatory-based and neuro-inflammatory-based, so inflammation in the brain – we see patients getting better over two weeks and, in fact, not even after a lot of treatment.
In fact, we don’t even advocate treatment every single day. We do treatments for these patients sometimes twice or even three times a week. And within two weeks, all of a sudden, they can breathe again, they can walk up stairs. They don’t feel that fatigue and exertional dyspnea that they had. Usually the brain fog starts to settle. After time, they start sleeping better and overall they feel more alive.
On whether women are twice as likely to develop long Covid (as reported in the Financial Times)
That’s correct. We are still trying to elucidate why that is. Perhaps, there are more patients who have, for example, chronic pain syndromes and chronic inflammation in female patients who perhaps have rheumatoid arthritis, osteoarthritis or hip conditions. That peripheral inflammation might be a contributory cause in that cohort of patients. So perhaps that is the reason why.
On the availability of treatment nationwide and the scepticism of the diagnosis
There are not many photobiomodulation clinics in the country. I am based in Durban at Entabeni Hospital and the Durban Neuro Laser Clinic and we have obviously put it out there
on social media platforms as well informing patients about these types of conditions. Because, as you mentioned, initially there was a lot of scepticism about the diagnosis. Is it really a condition?
You should try to locate if you have no photobiomodulation clinic near you, there are some in Durban, Cape Town and Johannesburg. I guess that is all dependent on the treating doctors or therapists there if they are comfortable treating Covid-19and post-Covid-19 syndromes, knowing what they are actually targeting. That is also very important, knowing the underlying treatment mechanisms and how you would go about administering the treatment and how often for each individual patient.
On what the treatment looks like and entails
So we have treatment arrays, which is basically a little instrument that is contoured. We can contour it on your brain, over your neck, over your shoulder region, for example, for a patient who has got a painful arthritis or so forth. It consists of a lot of LED lights. We use red light as well as near-infrared light therapy, which has a very potent anti-inflammatory effect. And that is what we are targeting.
It seems to be more effective with fewer side effects. It is non-invasive, so there are no needles involved. There is no coming to the surgery, having an IV line inserted and sitting in this room with a drip connected to you. None of that. It is a non-invasive, easy application, 45 minutes of treatment, maybe twice or three times a week, depending on symptoms. And each individual patient will receive the light and infrared light specifically over the brain itself or the skull region.
We use a combination of the LCD arrays as well as a laser probe, which has a much more direct light penetration and we are able to get deeper into structures, especially brain penetration. It is all painless, non-invasive therapy.
Cyril Ramaphosa: The Audio Biography
Listen to the story of Cyril Ramaphosa's rise to presidential power, narrated by our very own Alec Hogg.