The longest of Covids: the man infected for 10 months

, The longest of Covids: the man infected for 10 months, The Nzuchi Times Guardian

Like thousands of people, Dave Smith became infected with coronavirus at the start of the first wave in the UK in 2020. But while most people, including those who suffer “long Covid”, eliminate the live virus from their bodies within a couple of weeks, Smith experienced a very different sort of long-term problem: a persistent infection lasting more than 290 days, or almost 10 months. This has been the longest recorded active Covid-19 infection to date.

During that period, Smith, 72, from Bristol, recorded 42 positive PCR tests and was admitted to hospital seven times. He said: “Whenever I went bad, I went really bad – down to death’s door. My wife started to arrange a funeral five times.”

In an interview in which he revealed his harrowing and rare experience for the first time, he added jokingly: “I called all the family in to make my peace with them. I wish I’d kept my mouth shut now.”

Smith, a retired driving instructor, was eventually cured with the same antibody cocktail developed by Regeneron that was used to treat Donald Trump. It contains two antibodies, casirivimab, and imdevimab, which bind to different sites on the coronavirus spike protein, blocking it from infecting new cells.

Smith was granted access to the drug through a “compassionate use” programme, whereby an unauthorised therapy can be given if no other satisfactory approved treatment exists. However the drug is no longer available on this basis, and is not yet clinically approved for use in the UK.

His doctors are now calling for improved access to such treatments for other patients like him, to alleviate their suffering and because of a theoretical risk of new variants evolving during the course of their infections.

Ed Moran, a consultant in infectious diseases at North Bristol NHS trust, said: “There’s not an enormous number of these patients, probably no more than a couple per hospital. Some of them get really sick early on, and die, but a number of them seem to get this relapsing-remitting type of [Covid-19] process.

“We know that these patients do acquire similar mutations to those seen in some of the new variants. It’s a theoretical risk, but it’s definitely there, which is why we don’t think you can overlook these patients when it comes to access to therapies.”

Like Smith, most people with persistent infections have low levels of virus-neutralising antibodies, either because of recent treatment for blood cancer, or because of an inherited condition which causes their antibody-producing cells to be defective.

Smith had received chemotherapy to treat leukaemia in 2019, and had just been given the cancer “all-clear” when he developed coronavirus in March 2020. “I was totally drained of energy and lost my sense of smell, which still hasn’t come back. But I didn’t have a Covid test until April, when they took me into hospital because I’d developed a chest infection,” said Smith, who has also worked as a TV extra featuring in the shows Casualty, and Only Fools and Horses.

, The longest of Covids: the man infected for 10 months, The Nzuchi Times Guardian

He was sent home after receiving a course of antibiotics but continued to feel unwell and unable to leave the house. He was readmitted in July because he was so weak. When he tested positive for Covid again the initial assumption was that he had been reinfected, but genetic sequencing of the virus suggested it was the same infection.

Then in October, University of Bristol researchers managed to grow some of Smith’s virus. “This proved that it really was there and not simply leftover little bits of RNA that were triggering the test,” said Moran.

Still Smith’s infection rumbled on, his health improving, then deteriorating unpredictably. Unable to leave the house, he and his wife, Lynda, relied on supermarket home deliveries and daytime TV repeats of Heartbeat and Homes Under the Hammer to keep them going. Smith had little appetite and dropped from 18.5 stone to 10 stone in weight.

“At one point I was bedridden for two or three months. My wife had to wash and shave me in bed because I just couldn’t stand up. Sometimes I thought, I wish they’d take me in the middle of the night, because I just can’t go on any more. You get to the point where you are more afraid of living than you are of dying.”

Smith ran through the practicalities of his death, ensuring his wife had access to the relevant paperwork and bank pass codes, and sorting though their belongings, earmarking things to be sold or thrown away. At one point he used Skype to contact his relatives in New Zealand to say goodbye, while other family members went kitted out in PPE to say farewell to him in person.

The turning point came when his doctors decided to try him on the Regeneron antibody therapy. Smith’s health did not improve immediately, but he felt progressively stronger over the following weeks, walking a few steps further each day until he could reach the bathroom unaided, then dress himself, then eventually make it down the stairs. “I was really pleased because for the first time in months I made my wife a cup of coffee. It was the first time I could do something for her, instead of her doing everything for me.”

Forty-five days after receiving the drug, Smith received a negative PCR test. “We opened a bottle of champagne that we had in the cupboard, because we don’t drink normally, and drank the whole thing between us. Then we rang up everybody, saying, ‘I’m negative, I’m negative.’”

Since then, Smith has been to Plymouth to visit his stepson, on holiday to Cornwall, and on a trip to London to go shopping in Oxford Street. He is also teaching his granddaughter to drive.

“I’ll never be 100% because the Covid has destroyed my lungs, so I run out of breath quite quickly,” he said. “But every day I live now is a bonus. I always say, when you’re lying down in the gutter, all you can see is the stars. I’ve been down to the bottom, and everything’s brilliant now.”

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