Letter to the Editor of Am J Phys Med & Rehab — Long COVID: A Major Public Health Issue, 2024, Blitshteyn and Verduzco-Gutierrez

[SNT Gatchaman]

Long COVID: A Major Public Health Issue
Blitshteyn, Svetlana; Verduzco-Gutierrez, Monica

No abstract.

Link (American Journal of Physical Medicine & Rehabilitation)

 

[SNT Gatchaman]

As physicians with expertise in long COVID, we evaluate many patients who have had COVID-19 infection and now struggle with persistent fatigue, cognitive impairment, headache, autonomic dysfunction, and a myriad of other chronic conditions. Many patients have been fully vaccinated and had either no or minimal health problems before COVID-19 infection, which was typically mild.

Key features in patients with long COVID are significant fatigue, exercise intolerance, and postexertional malaise causing inability to return to work, previous physical activity, and social life.

None of the patients, in our experience, have been able to exercise, think, or will themselves out of illness and back to health despite their best efforts; in fact, recovery rates from post-COVID conditions are usually low.

Many patients qualify for a diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome

Although there is a strong incentive to develop and implement effective rehabilitation programs for patients with long COVID with planned exercise trials as part of the RECOVER initiative, the heterogeneity of long COVID phenotypes, including patients with myalgic encephalomyelitis/ chronic fatigue syndrome, makes this endeavor challenging and nuanced. Perhaps a more practical short-term solution would be to develop individualized rehabilitation plans targeting the patient’s specific needs and functional impairment

one can argue that because of the ongoing COVID-19 and reduction or complete elimination of previous mitigation strategies, including indoor masking and free COVID testing, we might be worse and more at risk now than we were 2 yrs ago when various mitigation protocols were in place to reduce COVID-19 infection and transmission.

Long COVID is a serious public health issue in the United States and worldwide. The narrative that we are back to normal or that we must accept our “new normal” is not based in reality: it is wishful thinking at best and willful ignorance at worst.

Our “new normal” should not include trillions of dollars in economic loss due to long COVID. Our “new normal” should not include children having COVID-19 every year and risking longterm neurologic and cognitive dysfunction as a result of repeated infections. Our “new normal” should not include increased risk of heart disease, diabetes, blood clots, and stroke for every person, young and old, who has had COVID-19 once and a higher risk with each repeated infection. Our “new normal” should not include an unmitigated COVID-19 pandemic that can alter your life and your livelihood forever.

 

[rvallee]

I saw on xitter that Dr Blitshteyn had a paper rejected by an academic journal because she advocates too much for patients with Long Covid. I wonder if it's this, posted instead as a letter to the editor.

Apparently you can advocate against patients, even be openly hostile against them and work to deny them all forms of relevant support by denying and misrepresenting their illness, but you can't advocate for them. Bizarro world stuff.