Scientific concern over “long-haulers”–former COVID patients who endure months of ongoing symptoms after recovery–is fueling a fresh wave of research into what is often called post-viral syndrome. Post-COVID care programs that focus on the after-effects of the virus are opening up around the US and abroad.
Post-COVID long-haulers are struggling with symptoms such as insurmountable fatigue, shortness of breath, “brain fog,” joint and chest pain, headaches, depression, and more. Their experiences tally with earlier studies of recovered SARS and H1NI influenza patients (a 2009 study of former SARS patients found that 40% suffered from chronic fatigue 4 years after recovery). Infectious diseases expert Anthony Fauci has said that lingering post-COVID symptoms are “highly suggestive” of myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS), which often originates with viral infection. And these after-effects are not confined to those who had severe cases of COVID-19. In a study released in July, the CDC found that “COVID-19 can result in prolonged illness even among persons with milder outpatient illness, including young adults.”
Again, that is only possible by reversing the decades of wooificiation of medicine from the BPS/MUS/FND ideology. Not a realistic proposition without doing the necessary hard work. As impossible as dealing with climate change without abandoning fossil fuels. It's not a nice-to-have, it's a necessity.What can be done for the long-haulers at present? First and foremost, listen to post-COVID patients’ accounts of their symptoms, and do not discount what they are saying. The substantial number of healthcare providers who have had the virus and are still suffering has made it harder to disregard the reality of long-haul effects. Zijian Chen, MD, who heads the Mount Sinai post-COVID recovery program, told MedPage Today, “I have colleagues affected by COVID-19 who have persistent symptoms. These are some of the hardest working and most honest people I know. I don’t see anything on their scans, but I believe them. We have to believe our patients to make sure we’re not neglecting them.”
This is sensible, but naive of how medicine works and the history of this very issue. Those names were always arbitrary and rejected as inaccurate by the patient community. In the end all those names will change once the work ramps up and stupidity stops dominating the issue. But there is too much baggage tied to it.“Long Covid” has clearly struck a chord. However, it’s not the only term being used to describe persistent symptoms: we’ve also seen post-acute covid-19, postcovid syndrome, and chronic covid-19. As patients and professionals, we see “Long Covid” as better able to navigate the socio-political, as well as clinical and public health challenges, posed by the pandemic in the coming months, for a number of reasons:
1 Long Covid acknowledges that cause and disease course are as yet unknown
2 Long Covid makes clear that “mild” covid-19 is not necessarily mild
3 Long Covid avoids “chronic,” “post” and “syndrome”
4 Long Covid draws attention to morbidity
5 Long Covid centres disabled people
The wheels on the bus go thump thump thump...
Why we need to keep using the patient made term “Long Covid”
https://blogs.bmj.com/bmj/2020/10/01/why-we-need-to-keep-using-the-patient-made-term-long-covid/
This is sensible, but naive of how medicine works and the history of this very issue. Those names were always arbitrary and rejected as inaccurate by the patient community. In the end all those names will change once the work ramps up and stupidity stops dominating the issue. But there is too much baggage tied to it.
It's remarkable that as they make the exact same arguments the ME community made decades ago, and ongoing, they would be happy throwing us under the bus, not quite aware that this whole song-and-dance has been unfolding for decades. Yet there is no solving the newest issue without solving its underlying basis.
How many years have been wasted on those issues? On the names, on the definitions, on the criteria? All pointless without someone doing the work that will give the answers to those. Decades of wasted opportunity and this conversation could have happened as is well before the BPS sabotage. Or, well, had it happened decades ago none of this would have come to light and long Covid would have never even been identified, dismissed as yet another episode of mass hysteria. It's the sheer number and the ability to coordinate instantly that changes everything.
At the very least, I hope this puts to rest the complete nonsense of seeking illness labels and other absurdities like that. Of course a discriminated disease considered a non-disease by medicine is not something anyone would want anything to do with. This was always obvious, basic common sense, but one good thing from this throwing-under-the-bus shows is precisely how nonsensical this idea is.
Ironically, the words are rejected for reasons that all circle back to the issue they want to avoid. They are rejected as being inaccurate, making assumptions. They are rejected as being trivializing, and they are rejected as being easy to abuse with language to dismiss under various aspects of psychosomatic ideology, precisely because we have been abused by those words, a situation no one wants to find themselves into. They dismiss them for the same reasons we have.
Elisa Perego is Honorary Research Associate at University College London. Her current research focuses on health and disability in present and past societies. @elisaperego78
Felicity Callard is a Professor of Human Geography at the University of Glasgow whose research focuses on health, patient/service user experiences, and medical humanities. @felicitycallard
Laurie Stras is Research Professor of Music at the University of Huddersfield, and Professor Emerita of Music at the University of Southampton. @LaurieStras
Barbara Melville-Jóhannesson runs a linguistics and artificial intelligence project, funded by Creative Informatics at the University of Edinburgh. @keyeri
Rachel Pope is Senior Lecturer in European Prehistory at the University of Liverpool, her research focuses on archaeological data analysis. @preshitorian
Nisreen A Alwan is an Associate Professor in Public Health at the University of Southampton and an Honorary Consultant of Public Health at University Hospital Southampton NHS Foundation Trust. @Dr2NisreenAlwan
#LongCovid #CountLongCovid
Competing interests: All authors have experienced prolonged covid-19 symptoms, and have participated in various kinds of Long Covid advocacy.
Somehow I assume that if someone knew where to look we would find several very similar articles with those arguments about PVFS and/or ME going back decades. Just never published prominently by an outlet like BMJ but still.For those who don't follow the link, here are the authors. Some of them have already been discussed on this thread:
I don't have the brain power right now to make sense, especially in twitter condensed form. If anyone has the cognitive bandwidth to explain why leaving out decades of history by separating from it is not going to work out:
My comment: I wonder whether reversing the order, so it becomes ME/PVS, might be a bit more suitable as it is comparable to ME/CFS. And then similarly it would be COVID19/PVS
Also:
I think a major point about ME is that it takes a long time for a patient to figure things out. Its like its an alien experience, and it is alien to everyone's prior experience unless they knew someone with ME very very well. Its to be expected it will take time. Its also to be expected that many with long Covid have post viral fatigue and not ME, though they may develop ME later. There is also the issue that many problems are caused by clotting and scarring that is not common in ME, and so is often outside OUR experience.I think people need to be careful not to too harshly criticize people that have long covid
https://www.virology.ws/2020/10/01/tria-by-error-royal-society-of-medicine-webinar-on-long-covid/Proponents of cognitive behavior therapy and graded exercise therapy as treatments for CFS, ME, or their variants keep trotting out their favored interventions for patients suffering from persistent fatigue and other symptoms after acute Covid-19. Last week, the Royal Society of Medicine conducted an online webinar called “Long COVID: Understanding the shadow of the virus.” Three physicians participated: Alastair Miller, an infectious disease expert from Liverpool who used to run a local CFS/ME clinic; Carolyn Chew-Graham, a professor of general practice research at Keele University in Staffordshire; and Nisreen Alwan, an associate professor of public health at the University of Southampton.
It's déjà vu all over again.![]()