BPS attempts at psychologizing Long Covid

[Arnie Pye]

This post is all about Hanne Kjöller's article, NOT mango, just to make it clear!

She starts off by suggesting that the proportion of covid patients who go on to develop long-term symptoms is very different from country to country. According to her, this means you can't explain it biomedically.

I can't see any reason why sentence 1 leads to the conclusion in sentence 2. Any author suggesting this sees humans as a group as amorphous lumps whether they come from Croydon, Oslo, Adelaide, or Outer Mongolia.

It implies that every country has the same illness and health problems so therefore each country's sick people should be reacting to the same infection in the same way and with the same sequelae which is absolute nonsense.

As an example...

There are parts of China where selenium deficiency is common. I looked up the symptoms of selenium deficiency on wikipedia and found this :

Source : https://en.wikipedia.org/wiki/Selenium_deficiency

Selenium deficiency in combination with Coxsackievirus infection can lead to Keshan disease, which is potentially fatal. Selenium deficiency also contributes (along with iodine deficiency) to Kashin-Beck disease.[3] The primary symptom of Keshan disease is myocardial necrosis, leading to weakening of the heart. Kashin-Beck disease results in atrophy, degeneration and necrosis of cartilage tissue.[4] Keshan disease also makes the body more susceptible to illness caused by other nutritional, biochemical, or infectious diseases.

Selenium is also necessary for the conversion of the thyroid hormone thyroxine (T4) into its more active counterpart triiodothyronine (T3),[3] and as such a deficiency can cause symptoms of hypothyroidism, including extreme fatigue, mental slowing, goiter, cretinism, and recurrent miscarriage.[5]

It has been clear to me from the limited reading I've done on Covid-19 that zinc deficiency and vitamin D deficiency increase the chances of catching covid, and lead to more severe symptoms in those who do catch it.

COVID-19: Poor outcomes in patients with zinc deficiency

Vitamin D deficiency aggravates COVID-19: systematic review and meta-analysis

So an author suggesting that differences in outcome from Covid-19 cannot be blamed on biomedical illnesses and must be due to psychological or psychiatric causes is suffering from a severe degree of stupidity.

 

[rvallee]

She starts off by suggesting that the proportion of covid patients who go on to develop long-term symptoms is very different from country to country. According to her, this means you can't explain it biomedically.

I especially love this because no country has made significant efforts to count LC so this claim is especially misleading. The numbers are expected to vary, especially as some countries simply refuse its very existence. Even the UK has vastly different numbers depending on who counts and how. As expected when eyeballing something without a known numerator or denominator.

And of course the numbers from China are actually pretty much in line. If one checks. Roughly, but still they are similar. All one has to do is check. It's not as if Covid numbers were themselves vastly different and I hope the suggestion is not that the same cultural whatever also explains why Covid infections are vastly different between countries.

This is exactly how the concept of mass hysteria came about. It's so bloody obvious by now. With primitive technology that cannot even verify the existence of pathogens, those arguments won out and became myths.

Wellness is basically a religion. Good people are healthy and fit. Bad people are poor and sick. There isn't much more to this.

 

[Amw66]

I especially love this because no country has made significant efforts to count LC so this claim is especially misleading. The numbers are expected to vary, especially as some countries simply refuse its very existence. Even the UK has vastly different numbers depending on who counts and how. As expected when eyeballing something without a known numerator or denominator.

And of course the numbers from China are actually pretty much in line. If one checks. Roughly, but still they are similar. All one has to do is check. It's not as if Covid numbers were themselves vastly different and I hope the suggestion is not that the same cultural whatever also explains why Covid infections are vastly different between countries.

This is exactly how the concept of mass hysteria came about. It's so bloody obvious by now. With primitive technology that cannot even verify the existence of pathogens, those arguments won out and became myths.

Wellness is basically a religion. Good people are healthy and fit. Bad people are poor and sick. There isn't much more to this.

As my daughter said to me recently.
Mum, I must have had a bloody brilliant previous life !

 

[Mithriel]

A great song and dance was made about ME being the latest example of millennium fever with all of us going mad because it was 1999. Not a word said about it in 2021 when we are still here, still ill and numbers not getting less.

Wessley and co made a lot of ME being spread by social media despite the fact it had been defined long before the internet.

It was also blamed on being a "fashionable" disease so everyone was just jumping on the bandwagon.

 

[alktipping]

A great song and dance was made about ME being the latest example of millennium fever with all of us going mad because it was 1999. Not a word said about it in 2021 when we are still here, still ill and numbers not getting less.

Wessley and co made a lot of ME being spread by social media despite the fact it had been defined long before the internet.

It was also blamed on being a "fashionable" disease so everyone was just jumping on the bandwagon.

but it is only medical professionals that create fads and trends in their field of so called expertise . it is about time they put the trend of patient blaming to rest.

 

[Forbin]

She starts off by suggesting that the proportion of covid patients who go on to develop long-term symptoms is very different from country to country. According to her, this means you can't explain it biomedically.

If nothing else, I would suspect that the death rate from covid varies from country to country*. In countries where the death rate is higher, you might see proportionally fewer long-covid cases simply because some people who might have gone on to develop long-covid did not survive. Conversely, you might expect to see more long-covid cases in countries with the highest survival rates.

*ETA:
Covid case death rate in the US is currently about 2.7% (475K). https://www.worldometers.info/coronavirus/country/us/
About 2.2% of covid patients are ill for 12 weeks or longer. https://covid.joinzoe.com/post/long-covid

 

[mango]

Paywalled editorial by infamous columnist/journalist Hanne Kjöller, in Sweden's largest morning paper (I can't believe they keep publishing her harmful rubbish ).

DN: Berättelsen om långtidscovid går inte ihop ("The story about long covid does not make sense")
https://www.dn.se/ledare/hanne-kjoller-berattelsen-om-langtidscovid-gar-inte-ihop/

According to posts on Twitter (I haven't been able to verify the source because of the paywall), Dr Judith Bruchfeld from the Covid clinic at Karolinska has commented on Kjöller's article:

I talked for a long time with Hanne Kjöller when she prepared this article. I took the time to inform her about the serious abnormalities we find on careful examination, even among those not hospitalized where we have now assessed just over 100 patients.

In addition, comparing this group with hospitalized Covid-19 and assuming that there are the same mechanisms that trigger both symptoms and organic impact is not scientifically correct.

Hanne Kjöller chooses to pursue her theory, ie cultural disease, without factual basis, and also completely ignores the literature and the findings I informed her about.

In addition to being a journalist, Kjöller is also trained in nursing. In both of these aspects, she is lacking here as a professional.

In her column, Hanne Kjöller further stigmatizes severely affected individuals. An apology would be in order.

Bias: Infectious disease doctor, co-responsible for the multidisciplinary and interprofessional Covid clinic Karolinska Solna where we follow up, diagnose and rehabilitate both hospitalized and cared-for-at-home Covid-19 patients.

 

[rvallee]

Hanne Kjöller chooses to pursue her theory, ie cultural disease, without factual basis, and also completely ignores the literature and the findings I informed her about.

Good response but this part here... this is how it's always done. There is no other process by which this model has ever been proposed or taken hold. In the end it's time that cements those baseless claims, if technology cannot stop them in their tracks, but this is how it's always done. Something to consider when promoting this very concept in similar circumstances.

Or does this physician think other concepts of "cultural maladies" or "mass hysteria" ever came about with actual evidence that did not ignore the literature and reality? I can easily imagine it makes sense to that person to think of ME this way. Despite the massive overlap.

 

[Dolphin]

I have only read the press release. There may be some useful points in there

https://eurekalert.org/pub_releases/2021-02/oupu-hro020821.php

NEWS RELEASE 10-FEB-2021
How research on chronic illnesses will improve COVID-19 treatment


OXFORD UNIVERSITY PRESS USA

Research News


A new paper in Oxford Open Immunology, published by Oxford University Press, examines prior findings in the field of neuroimmunology that suggest potential treatment strategies for patients suffering long-term symptoms from COVID-19.

Though COVID-19 was initially believed to be a short-term illness, lasting between one and three weeks, it's clear that a substantial number of patients will experience symptoms beyond that, with some patients suffering from health problems for more 12 weeks. In fact, for patients who were initially hospitalized, more than 80% reported at least one symptom that persisted beyond the first month.

The symptoms of long-COVID can vary widely, including cough, low grade fever, fatigue, chest pain, shortness of breath, headaches, cognitive difficulties, muscle pain and weaknesses, gastrointestinal distress, rashes, metabolic disruption, depression and other mental health conditions. In the context of other disorders and syndromes, these symptoms appear to have a strong link with a challenge to the immune system. Even mild infections and low-grade inflammation can cause depression or persistent fatigue.

As a number of causes have been proposed to explain the persistence of these long-term COVID symptoms - from the presence of persistent low viral load and reinfection, to changes in immune cell activity and tissue damage caused by the initial infection - researchers here explored insights gained in recent decades from several large-scale studies of chronic fatigue syndrome, fibromyalgia, depression and other mental health disorders that show immune abnormalities.

Researchers at King's College London here argue that several possible pathways could be relevant to understanding the persistence of long-COVID, like the involvement of glial cells and the permeability of the blood brain barrier. They also propose strategies to manage symptoms. Some of the symptoms of long-COVID, depression and other mental health problems, are related to chronic, low-grade inflammation. As such, current treatment strategies for patients with depression include anti-inflammatory medications. Psychosocial factors are also very important in regulating our immune activation. It's clear that strategies tackling a patient's level of stress with increased social support, physical exercise, and an adjusted diet could also be useful in managing long term symptoms related to COVID-19.

"We are suggesting taking advantage of what we have learnt over the years about how the brain and the immune system communicate and about the contribution of the immune system to the development of symptoms of long-COVID in other medical conditions," said the paper's lead author, Valeria Mondelli. "This is likely to accelerate our understanding of the mechanisms underlying long-COVID and the identification of effective treatments."

###

 

[Kalliope]

The Norwegian newspaper Dagbladet had a paywalled article on Monday about Long Covid where they've interviewed among others prof. Vegard Bratholm Wyller who apparently is going to do research on this patient group Seems he will be building on his previous research on Epstein Barr infection where he believes the infection is leaving some kind of symptom "imprint" or "echo" in those who do not recover.

The article is written by Jorun Gaarder - a journalist who has written articles promoting lightning process, Recovery Norge and a BPS approach to ME.

Wyller estimates in the article that 5-10% of previous Covid patients may struggle with long lasting fatigue after a year. If nothing is done, we may have a new wave of fatigue after corona.

There can be several things in the group with long term symptoms following Covid-19. Some can have continuous heart problems, lung- or neurological problems. But the largest group probably has a kind of post-infectious fatigue which one can see after Epstein Barr and other infections, according to Wyller.

He is going to study this. His goal is to recruit at least 500 previous Covid-patients between 12-25 years old and follow them over time. Then one can see if they have impaired heart muscles or lung capacity, or if there are other things that leads to post viral fatigue.

"To feel one has fever, muscle pain, fatigue and a feeling of not being able to think clearly are common symptoms for such post viral fatigue. A lot is similar, but some things are also different, depending on which infection that was the trigger.

- The patient kind of feels that the infection is still there, even though there is no sign of this in tests. After Epstein Barr virus infection, many complain of continuous sore throat, but after Covid-19 quite a few complain of heavy breathing, which is also typical in the acute phase, Wyller says.

A lung specialist at a hospital for heart and lung disease outside Oslo is also interviewed. They've had 110 Corona patients for rehabilitation so far. He says that many are struggling with fatigue symptoms which they can't explain. Some also have problems with memory. Muscle and joint pain are common, some have sleeping issues and depression.

He says he's careful not to use "long Covid syndrome" as name for this. Once you call something a syndrome, the patient has a diagnosis stuck to him or herself. He prefers to call it aftereffects of corona and says that the patients improve after a rehabilitation stay with them. The prescription is careful increase of exercise, under guidance of a physiotherapist. They also have an inter disciplinary team and have good experience from group sessions and individual sessions with psychologist.
https://www.dagbladet.no/nyheter/professor-om-langvarig-corona-faresignalene/73372699

 

[Dolphin]

The Norwegian newspaper Dagbladet had a paywalled article on Monday about Long Covid where they've interviewed among others prof. Vegard Bratholm Wyller who apparently is going to do research on this patient group Seems he will be building on his previous research on Epstein Barr infection where he believes the infection is leaving some kind of symptom "imprint" or "echo" in those who do not recover.

Discussed here:
https://www.s4me.info/threads/the-i...coffi-2018-katz-et-al.2013/page-4#post-323621

 

[DigitalDrifter]

Wessley and co made a lot of ME being spread by social media despite the fact it had been defined long before the internet.

It was also blamed on being a "fashionable" disease so everyone was just jumping on the bandwagon.

I'm not defending Wessely but when I was misdiagnosed with Fibromyalgia people on the forums would say things like "I get tired too so I must have ME as well" so there are people who jump on the bandwagon. I think part of the problem is at some point doctors started diagnosing anyone with unexplained fatigue as having ME.

 

[Mithriel]

I'm not defending Wessely but when I was misdiagnosed with Fibromyalgia people on the forums would say things like "I get tired too so I must have ME as well" so there are people who jump on the bandwagon. I think part of the problem is at some point doctors started diagnosing anyone with unexplained fatigue as having ME.

I know what you mean. It is infuriating when someone says that especially if they say they had it but they got better because of X and because they did not give into it like you It is a disgrace that the BPSers reduced the complex systemic disease of ME into the mish mash that is CFS. It was done deliberately and calculatedly to use patients for an agenda, not for any benefit to the patients.

We know it was done knowingly because of the way they said it spread on the internet, yet they knew at the time that many patients had been ill for years before the internet was invented. even today, people who are already sick see a description of ME and realise it explains the things that are already there.

Seeing the disease and then wishing it on yourself is actually a very strange concept, seeing it and lying about it is more possible such as people who fake cancer.

That sort of statement which seems reasonable when you hear it and which has overtones that people pick up on - not really ill, weak minded, deceptive, not to mention the prejudice against the new fangled such as social media - is a speciality of Wessely and his followers. You get over the message you want while it is totally deniable and seemingly innocuous.

 

[Kalliope]

The Norwegian newspaper Bergens Tidende has a paywalled article today about rehabilitation of Covid-19 patients at the institution "Health in Hardanger" (Helse in Hardanger).

Specialist in heart- and lung physiotherapy, Bente Frisk, says in the article that there aren't any large studies, but they see that Covid-19 patients improve by adapted exercise.

The institution was recently established to offer short term stay and interventions for people with anxiety/depression, back pain, Diabetes 2 or problems with breathing. The clinic is inspired by a "successful 4 day intervention for anxiety".

They've now expanded to offer rehabilitation for "post-Covid, difficulty with breathing and fatigue".

Senior doctor Marte Jürgensen says to Bergens Tidende:

- Many feel left to themselves. They have a strong desire to return to their lives, at the same time as they are insecure about what is safe to do. We want to give them a kickstart.

Marte Jürgensen has been in the paper before. She is the 2. leader of Recovery Norge. She is a psychiatrist and was diagnosed with ME and a participant in the RituxME trial. She dropped out of the trial and went to psychiatrist Bjarte Stubhaug who has a CBT/GET/Mindfullness intervention for ME and she recovered fully.

Bjarte Stubhaug's approach is discussed thoroughly in a thread about a trial from him titled: A 4-day mindfulness-based cognitive behavioural intervention program for CFS/ME.

A co author of that study, Gerd Kvale, is one of the main inventors of the "successful 4 day intervention for anxiety".

This is what Health in Hardanger write on their website (google translated) about the Covid-19 rehabilitation:

Post-covid, difficulty with breathing and fatigue


The offer is aimed at persons (18–67 years) who have significantly reduced functional level for a minimum of two months after covid-19 infection due to shortness of breath and/or fatigue. To participate, you must wish to set aside time and energy to work with us to improve your own health and daily life. It is important that you think through what you want to achieve with the treatment. The treatment is concentrated over three days, with the possibility of a new two days after a while if needed. The follow-up extended over one year. You must expect significant personal effort throughout the period.

Goals:

• better every day function
• increased physical activity
• better health
• increased participation socially and/or at work
• optimize diet
• live better with health problems

 

[rvallee]

They are counting natural recoveries as the product of their intervention, simply ignoring those who don't and no one's really counting anyway. At least this largely explains why so many people are convinced that it works. And since most will recover from LC, it looks impressive. All it would take is a rigorous scientific evaluation but that will never happen, the outcome is sought. You can easily see it in LC forums, people recovering naturally despite having done nothing special. Or at least going into remission. This is why some trials have waiting list controls, to check for the passage of time.

The same people would laugh at healing crystals that help people recover from the common cold, for the very same reason. And rightfully so. Even though it's the exact same process. But belief overrules everything else, so they do something they would consider laughable in all other circumstances and genuinely cannot find fault with it.

 

[Tom Kindlon]

https://twitter.com/TomKindlon/status/1361427332653862913

"Assessment & management of post-COVID fatigue"
https://wchh.onlinelibrary.wiley.com/doi/pdf/10.1002/pnp.698
Not impressed with dubious claims in this not in line with the research evidence e.g. (wrt #MECFS) "... CBT is relatively simple but when applied by an experienced therapist it can be transformative"
#CFS

 

[Arnie Pye]

Title : Long Covid: MPs call for compensation for key workers

Link : https://www.bbc.co.uk/news/uk-politics-56090826

Boris Johnson is facing fresh calls to compensate key workers suffering from "long Covid".

A total of 65 MPs and peers have signed a letter to the PM, asking for it to be recognised as an occupational disease.

Layla Moran, who chairs a committee of MPs looking into coronavirus, said the government should not abandon "the true heroes of the pandemic".

The government has said it will invest £18.5m into four studies looking at the longer term effects of Covid.

Long Covid presents as a range of different symptoms suffered by people weeks or months after being infected with the virus - some of whom weren't seriously ill when they had it.

According to the British Medical Journal, it is thought to occur in approximately 10% of people infected - but that number only represents those who have been tested, meaning some who caught the virus in the early stages of the pandemic will be missing from the figures.

I wondered how well this idea of compensating key workers would go down with the BPS crew.

It would also get messy for the DWP and the government if compensation depended on the job one had at the time of infection with Covid, particularly for those who never got tested.

 

[TiredSam]

Looks like various parties will now have an incentive to go into "bury it like Gulf War Syndrome" mode.

 

[boolybooly]

Title : Long Covid: MPs call for compensation for key workers

Link : https://www.bbc.co.uk/news/uk-politics-56090826



I wondered how well this idea of compensating key workers would go down with the BPS crew.

It would also get messy for the DWP and the government if compensation depended on the job one had at the time of infection with Covid, particularly for those who never got tested.

BPS crew are trying to market perverse cruelty. 50 shades of derp.

The question is, who will be running the four studies worth £18.5m?

https://www.independent.co.uk/news/uk/home-news/covid-long-term-effects-government-b1803614.html

Imperial College London will investigate what causes persistent symptoms - potentially indicating possible treatments - by looking at the common factors in the thousands of volunteers who have taken part in its React study.

Data from more than 60,000 people will help define long Covid, improve diagnoses and understand why some people develop the condition in a study from University College London.

Great Ormond Street will also research the condition in children.

Birmingham University will look at therapies for particular symptoms of long Covid.

Chief Medical Officer for England and Head of the NIHR, Professor Chris Whitty said: “Good research is absolutely pivotal in understanding, diagnosing and then treating any illness, to ease symptoms and ultimately improve lives.

“This research, jointly funded through the NIHR and UKRI, will increase our knowledge of how and why the virus causes some people to suffer long term effects following a COVID-19 infection - and will be an important tool in developing more effective treatments for patients.”

On the face of it the psychs are not invited but there looks to be a danger with the Birmingham study that BPS vampires could try to suck the govts blood and sire a new generation of believers, like they do, by inserting CBT as a treatment protocol which should be tested. It depends who is running the Birmingham study but we should probably consider taking the initiative to try to help them understand the record of unempirical study design and blatant careerist bias from the BPS school over PACE etc.

 

[Andy]

Expert Forum on secondary COVID-19 impacts
Virtual Expert Forum with internal and external experts addressing the diagnosis, management, and prognosis of the most common lasting symptoms of COVID-19

https://www.swissre.com/institute/conferences/expert-forum-on-secondary-covid-19-impacts.html

Long COVID is a term to describe the long-term health effects of COVID-19 that persist for weeks or months after the typical convalescence period of the illness. In addition, significant short-term disruptions in care delivery were observed during the pandemic, which may have long-term consequences in morbidity and survival implications for patients and otherwise healthy individuals.

The Swiss Re Institute is hosting an Expert Forum on secondary COVID-19 impacts and invited leading experts to talk about the latest insights and findings of ongoing long-term secondary COVID-19-related health research. The experts will address the diagnosis, management, and prognosis of the most common lasting symptoms of COVID-19 and will present their view on long-term consequences of patients affected by deferred acute treatments and preventive diagnostics and in individuals suffering from mental health difficulties during extended lockdown periods.

Long-haulers and chronic fatigue

Trends in fatigue due to Secondary COVID Syndrome

Michael Sharpe, Professor of Psychological Medicine, University of Oxford