106 comments

[ 1.9 ms ] story [ 160 ms ] thread
> "More than a year after contracting the coronavirus, 18% of Long COVID patients had still not returned to work."

> Between 1 January 2020 and 31 March 2022, the New York State Insurers Fund analysed more than 3,000 workers' compensation claims for COVID-19.

Hard to take this at face value; I could easily see the vast majority of these claims being grift.

Agree. I remain skeptical of, e.g., the depression claims. Now, someone will jump in and explain that the virus can affect neural pathways, and (hand-waving) that can cause depression. Without hard evidence, which I have not seen, this is a tenous connection.
Whether it's grift or not, it's still keeping people out of the workforce.
Zero evidence. Are you writing off a bunch of people's medical issues due to your medical degree, or knowledge of their specific cases? If not, your opinion is worth nothing.
The onus is on proving that all these disparate symptoms were caused by covid. The evidence remains (as far as I’ve seen) circumstantial.
It's fascinating to me that we have widespread incidence of long-term health complications in people who caught a relatively new, not-deeply-understood virus, and the evidence being (as far as you've seen) circumstantial means that it must be made up, by default. Why exactly is it necessary to prove that these symptoms are COVID-related when that's the most natural conclusion? What is your alternative hypothesis that explains everything and is supported by better evidence?

People with long COVID - even if you believe it's all psychosomatic, or caused by fibromyalgia, or whatever - have had a lot of trouble accessing treatment this whole time. Even if 90% of them were somehow making it up, I think it's awful that the remaining 10% of "real" cases had to deal with so many barriers to access care. All as a part of our societal effort to pretend the virus is over.

I‘m not part of any societal effort to pretend it’s over :-)

Someone says they still have problems breathing 6 months after a moderate covid case? I’ll believe them by default.

Someone says they feel demotivated at work 6 months after a mild case? I’ll be skeptical.

That's a fair assessment, IMO. I believe that only a small, small minority of humans are going to be out to scam or do fraud (personal belief, obviously) and so from that lens, I hate it when people try and paint a group of people with a broad brush simply because they might believe something that is not factually correct, but in reality it's the best solution for now.

What I am arguing here, is that the 3000 people who have "long covid" aren't responsible for categorizing their disease, they are sick and just want to feel better. It's the medical community's responsibility to determine if that's because "long covid" is an actual disease, or if it's a set of disparate symptoms that many people have that were kicked off by covid, or something else entirely. Just because their "government services applications paperwork" (or whatever we call that stuff) says "long covid" that does not mean that later we should say they were defrauding the goverment if we find out they were actually suffering from a major lung cancer and it just so happened to coincide with some symptoms many other people were having due to everyone getting covid around the same time and as such their doctor(s) put "long covid" down as a probable cause.

It's a logical fallacy that the OP made, and I pointed out that it is unlikely all 3000 are scammers. I am sure some percentage of those people are scammers, statistically.

> The onus is on proving that all these disparate symptoms were caused by covid.

Says who? My prior is that all, or at least most, of the symptoms of long covid are caused by covid. Why is your prior better than mine?

Because you can’t prove a negative. May as well claim that the symptoms are Gods Will and demand proof to the contrary.
> Says who? My prior is that all, or at least most, of the symptoms of long covid are caused by covid. Why is your prior better than mine?

It's called the burden of proof. The person(s) making a claim is the one obligated to provide proof of it.

How can I prove to you that I have a headache? At a certain point you just have to listen to patients and trust them.

It’s really weird to get super skeptical of people’s claims only for a specific disease or a specific type of person.

My skepticism is not whether they really have foot pain or are unmotivated at work. The question is whether it was caused by a mild COVID case half a year ago.
If you're interested in winning a debate, a naive "burden of proof" analysis works. But if you're interested in aligning your beliefs with the truth, you should be using Bayesian reasoning. (Not to sound too much like Eliezer Y here.)
Here’s evidence:

Harvard study linking preexisting mental illness to Long Covid claims: https://news.harvard.edu/gazette/story/2022/09/depression-an...

Journal article: https://www.wsj.com/articles/the-dubious-origins-of-long-cov...

Overlap with fibromyalgia, which is also untestable and mainly in depressed middle age white women: https://pubmed.ncbi.nlm.nih.gov/34426540/

It’s hokum.

Not evidence that proves 3000 people are scamming. If anything, that evidence might show that we're not totally sure long covid is a thing, or it's underlying issues being surfaced.

I specifically am arguing against jumping to the "scammer" conclusion immediately and without any question. I totally forgot HN is full of medical doctors who know everything about covid and it's effects.

These types of cringeworthy responses are really common and it's really a detriment to society.

Whether it be astroturfing or other means originally founded by pharmaceutical companies knowing they originally did not test drugs for mitochondrial toxicity prior to Phase 1 trials, the source remains to be seen.

The fact is that people are by and large developing metabolic dysfunction earlier on, and things like antibiotics drastically accelerate the problem. Bactericidal antibiotics are widely known in research now to be seriously toxic to mitochondria and the damage they cause leads to chronic processes because mitochondria do not have effective repair mechanisms outside of copies. When they start reproducing mutated copies, the person does not get off scot-free anymore. Processed foods and air pollution and chemical exposures from foods and other things all additionally cause more dysregulation. This is all becoming way more widely known.

Some percentage of people will just not bounce back after these insults. Respiratory viruses and bacterial infections induce a large amount of oxidative stress in the human body, largely caused by your own immune system. Normally, your body has redox mechanisms to balance this out so you are fine in the end (otherwise running would cause a lot of problems really quickly!). But combining our toxic environment, toxic antibiotics that most people take (and many women take bactericidal antibiotics for UTIs!), high processed food diets leading to excessive baseline OS, you potentiate the risk for the individuals own mitochondrial machinery to be severely damaged from a high OS insult. After that, you don't bounce back. You develop chronic fatigue and severe exercise intolerance, and have much more precarious relationships with other illnesses.

This is what's happening. Depression other mental disorders are already strongly associated with metabolic dysregulation in research.

Don't blame the victims. It's likely you'll become one yourself before you're very old. Everyone is getting sicker.

This is a very good comment. So you put metabolic syndrome down to impairments in mitochondrial function? What’s your view on reversing the damage? I’ve seen studies that saying fasting can improve mitochondrial function.
Lots of things can improve it. eating healthy, reducing chronic stress, sleeping well, fasting, HIIT.

mitochondria are the victims of everything detrimental to the body because they're integral to the body in general.

Likewise they are benefactors of many things beneficial to the body.

Mitochondrial function impairment is integral to most chronic disease processes. It's not really like a novel thing. It's just expected.

None of these are evidence of anything.

1. The Harvard write-up explicitly disagrees with you:

> Mental health is known to affect the outcomes of some diseases. . . In other acute respiratory tract infections, such as flu or common cold, mental health conditions are associated with greater severity and longer duration of symptoms. Previous studies have also suggested that distress is associated with chronic symptoms following Lyme disease and in chronic fatigue syndrome and fibromyalgia, which have symptoms similar to those of long COVID.

2. The Wall Street Journal opinion piece was written by a medical trainee and widely ridiculed by established professionals. It was also rebutted in separate Wall Street Journal opinion pieces at https://www.wsj.com/articles/covids-lasting-effects-deserve-....

3. The PubMed abstract also explicitly disagrees with you. You said "mainly in depressed middle age[sic] white women". The linked page says "Conclusion: Our data suggest that clinical features of FM are common in patients who recovered from COVID-19 and that obesity and male gender affect the risk of developing post-COVID-19 FM." Emphasis mine.

Hard to take this at face value; I could easily see the vast majority of these claims being grift

Given that it's exceptionally hard to get on the disability rolls in the US, it's likely that those 3000 claims actually have merit.

> > "More than a year after contracting the coronavirus, 18% of Long COVID patients had still not returned to work."

I wonder how fast would their long COVID disappear if their sick pay was cut immediately, miraclous cure! The reason why you don't see self employed people with "long COVID".

Are you a doctor? Have you worked with any of these patients? If not, what is your basis for such confidential dismissal of a problem actual medical professionals are taking seriously?
[flagged]
Correct. Harvard study:https://news.harvard.edu/gazette/story/2022/09/depression-an...

Journal article: https://www.wsj.com/articles/the-dubious-origins-of-long-cov...

Overlap with fibromyalgia, which is also untestable and mainly in depressed middle age white women: https://pubmed.ncbi.nlm.nih.gov/34426540/

Your own link shows it’s not correct. The researchers identify it as a real problem, and while they linked existing distress with an increased chance of developing long COVID that doesn’t mean nobody else can develop it – that’s up to 40% over the baseline of people who lack those factors, not 0.
Women being more effected than women is crazy!
> as women are affected more by mass hysterias (see: transgenderism)

In terms of direct participation or support? I believe the former leans heavily towards males (assigned at birth etc), so I assume you mean the latter. Wonder if you’ve seen numbers somewhere or just personal experience? Curious as I haven’t seen any numbers in either direction, and I would not have assumed a big difference there.

Long Covid is likely not a real disease, and appears to be linked to other psychosomatic illnesses like fibromyalgia.

https://news.harvard.edu/gazette/story/2022/09/depression-an...

That article doesn't say what your comment says.
To flesh out your argument:

“To the best of our knowledge, this is the first prospective study to show that a wide range of social and psychological factors are risk factors for long COVID and daily life impairment due to long COVID,”

This statement could also be used to argue that people with social and psychological factors are more likely to be impaired by Long COVID symptoms, not that they are more likely to have it.

"After analyzing the responses and comparing those who developed long COVID to those who did not, the researchers determined that distress before COVID-19 infection, including depression, anxiety, worry, perceived stress, and loneliness, was associated with a 32 percent to 46 percent increased risk of long COVID. These types of psychological distress were also associated with 15 percent to 51 percent greater risk of daily life impairment due to long COVID."

This very clearly does not say that Long COVID is psychological.

I understand that you want to expose people to more information and view points they haven't considered, but speaking in absolute terms and posting the same links over and over again in multiple comments is not a means that will get people to warm up to your message.

If you want to help people learn more, then speak in terms of growing understanding, yours and their, share links, and focus on looking for a collaborative effort to find good answers, whatever those answers might be. Show the same open mindedness you want others to show.

> Psychological distress, including depression, anxiety, worry, perceived stress, and loneliness, before COVID-19 infection was associated with an increased risk of long COVID, according to researchers at Harvard T.H. Chan School of Public Health.

Where does it say long covid isn’t real? Did you take 2 seconds to read the article you’re spamming?

You have a personal belief which you appear to be passionate about but actual scientists don’t share it. Rather than spamming the thread with your misinterpretation of the study, why not use the time to educate yourself about what clinicians are dealing with?
Ironically, that article literally says that psychological health needs to be taken more seriously because it was more strongly correlated with bad outcomes than other 'physical health risk factors' that included smoking.

Lol, your linked article completely disagrees with you

It doesn't, people can have mental issues even without COVID, you know there were people with mentail issues prior COVID and nobody denies it, just don't call it "long COVID" because it's now buzz word.
If you look at this paper: https://jamanetwork.com/journals/jamanetworkopen/fullarticle...

People who got covid vs other viruses. When you follow up with them 3 months later, there is no difference in symptoms between the groups. In other words, long covid symptoms are no worse than any other respiratory virus.

So is it covid causing the symptoms, or the pandemic? All signs point to the pandemic, and the response.

Every other long covid study are observational, and are likely confounded. Strongly recommend looking deeper at these studies. Very few have control arms, like this study does.

[flagged]
“Long Covid” is just our euphemism for adverse reactions. The fact that you’re not even allowed to bring this up casts serious doubt on all studies into the phenomenon.
Maybe the severity of the symptoms is worse; or maybe people are getting medical care more than is common for 'common' colds.

The smart parts of the response to the pandemic included: limiting risk / exposure, additional precautions while exposed, and a higher standard of care.

Now that the Endemic phase is here we must continue to limit risk where realistic, take precautions (and vaccinations) seriously, and it really would be nice if the _right_ to healthcare were made law and reality.

[flagged]
There's really not much information in just seeing that situation. When I drove for 2min between a supermarket and a clinic, I didn't bother taking it off for example. (Also a good idea not to touch it anyway) You'll need to actually have the context of why they have it on.
[flagged]
> If you're not ripping the mask off first chance you get it's most likely because it gives you psychological comfort like a blankey or a teddy bear.

Or maybe their sister has an autoimmune disease and their mother just had open heart surgery. For fucks sake you don't know what's going on in other people's lives.

I've driven around with my mask on. You're busy and having worn it for hours already you dont really think or notice it, until you do half way to your destination type thing.

Aligning someone wearing a mask in their car to so mass brainwashing, Id suspect its more likely an innocent reason such as mine vs people thinking they need to wear it in a car.

How does that prove anything?

Maybe it's not their car, or some other passengers just got our, etc. Etc.

Maybe nobody cared who they were until they put on the mask. It doesn't matter who they are, what matters is their plan...
Driving alone in a car with a mask on is pretty pointless, but I haven't seen people do that since the height of the pandemic, personally. Probably still happens, but certainly doesn't seem anything on a "mass psychosis" level.

On the other hand, I drove with a mask on a few times - but that's when I was sick and attempting to reduce the chances of getting family members present in the car sick too.

I'd do it when I had several stops to make. No point taking it off and potentially contaminating my hands just to put it back on again. I suspect that accounts for many others doing so too.
> People who got covid vs other viruses. When you follow up with them 3 months later, there is no difference in symptoms between the groups. In other words, long covid symptoms are no worse than any other respiratory virus.

Erm, doesn't that also just mean that there is "Long <Insert Any Virus>" that we have been ignoring prior to Covid?

Post viral symptoms aren’t new. They don’t happen in the prevalence that people claim long COVID at.
I think that's pretty much the accepted explanation in the medical field? A small percentage of people have always been getting autoimmune and other disorders after a virus infection. With Covid it's just become a lot more obvious given the volume.

The way Covid makes the immune system cause irreparable lung scarring that then sticks with people for the rest of their life also probably compounds other problems.

Yes, probably.

One thing is really different though : I had the flu (the real one) once in my life. I had covid at least twice (the third time I didn't bother getting checked) I as many years.

That’s where my thoughts have been leading, too. I remember when people used almost the same kind of condescending tone dismissing myalgic encephalomyelitis as “Incline Village yuppie syndrome” until the weight of evidence won out. I think we’re sort of primed for it with the combination of hard-to-diagnose symptoms and various cultural tropes about whingers, disability cheats, etc. — if it caused unambiguous problems (e.g. polio’s paralysis or when COVID causes lung scarring visible on X-rays) almost everyone would accept that it was real without arguing but when you have the combination of relatively low incidence and things which aren’t easy to find on a simple test, it’s just a bit too easy to dismiss. I suspect the continuing improvements in diagnostic technology are going to push out the upper bounds for how long a case of many diseases can linger.

There’s probably also some link to the reminder of our own mortality & the degree to which luck matters: a lot of people are uncomfortable with the idea of disability and want to believe they have more agency than they do.

Yes, to an extent. But many people are reporting symptoms like anxiety, depression, or brain fog, which, while could be caused by the virus, could also be caused by the pandemic. Fear, isolation, lack of social interactions can cause detrimental damage, and this should not be overlooked.
This is an incorrect interpretation of this paper. It is comparing COVID positive to assumed COVID non-positive. Also, the methodology is deeply flawed as they took the first 1000 folks to respond. This is an incredibly biased approach, akin to believing that individuals who submit reviews online are from a normal distribution.
I don't really get how people can be so quick to dismiss long covid as made up. Is it too much to just admit that you don't have enough evidence to decide whether it's real instead of trying to write claimants off as grifters or mentally ill?

Further, it's odd that some people aren't willing to even entertain the possibility that it could be real, given that a number of examples of post-viral syndromes have been observed in other viruses. E.g. post-Ebola virus syndrome [1] and Epstein-Barr's role in the development of multiple sclerosis [2]. At the very least, this warrants taking claims of long COVID seriously, does it not?

[1] https://en.wikipedia.org/wiki/Post-Ebola_virus_syndrome

[2] https://med.stanford.edu/news/all-news/2022/01/epstein-barr-...

there are definitely people with symptoms that could be described as long covid; there are many others who are pathological hypochondriacs that latch onto whatever is floating around the memetic ecology that explains the physical manifestations of their distress and anxiety
It may be that that ultimately proves to be the most likely explanation, but I strongly disagree with the level of certainty you're attaching to that claim in this case.
The correlation with anxiety disorders makes me highly skeptical of long COVID claims:

> “We were surprised by how strongly psychological distress before a COVID-19 infection was associated with an increased risk of long COVID,” said Siwen Wang, a researcher in the Department of Nutrition at Harvard Chan School who led the study. “Distress was more strongly associated with developing long COVID than physical health risk factors such as obesity, asthma, and hypertension.”

https://news.harvard.edu/gazette/story/2022/09/depression-an...

It is well known that psychological distress can weaken the immune system making individuals less able to clear a novel virus.
How many? So many. And that’s not just my opinion; it’s my strongly held opinion
I've seen long COVID, my workmate would be fine then faint all of a sudden for a fortnight or so after he was off with the coof.

I myself had a lot of breathing issues for a week or two after I had it, took me a month to get back into the swing of the gym.

That being said, I've never seen anyone hit hard for more than a week or two. So I don't really know what to think here, but I have noticed that interest groups seem hellbent on riding this disease all the way into big funding grants and political power.

A week or two wouldn't generally be considered Long Covid I don't think. That would just be extended acute symptoms.

As one anecdotal data point: I'm 29, and was a previously fit (would regularly play sport, go for long hikes / bikes rides, etc), and I haven't been able to recover that fitness nearly 3 years later. I was not expecting this (I had covid early on in April 2020 before there was much talk of long covid), but I found that my endurance was greatly reduced post infection (I essentially get the same fatigue that anyone would get once they've completely exhausted themselves through strenuous exercise, just much, much quicker and with exercise that shouldn't be exhausting me). And when I have tried to push myself to regain fitness made those symptoms worse not better (after pushing myself, I could barely get out of bed for a couple of days - I've tried this 2 or 3 times).

I'm lucky in that I can still do every day tasks (work, shopping, etc) just fine. Some people with more extreme symptoms can't even manage that.

(comment deleted)
[flagged]
You are making a claim, probably similar to "I scraped my knee badly and it was fine, so how can someone scrape their knee in a similar way and be in agony?"

You are making assumptions that pain is objective, not subjective. A knee physically scraped in the same way will have the same levels of pain. I don't see any reason to believe that.

I could easily see the same injury on two different people resulting in different levels of pain. I could also see a kid who's parents pushed them off a bike in an act of abuse resulting in a knee scrape re-experiencing the emotional trauma of the abuse through the physical pain of the knee. I could also see an injury in the same spot over time turn into something debilitating.

I don't deny that there are people who take advantages of bad sets of incentives, but there are also people who aren't taken seriously because people look at the incentives involved and say they must be faking it.

I don't think it's just to punish the innocent along with the guilty.

I'm making no such claim.

I'm saying because there's a non-zero percentage of the population that has learned to milk playing the victim, the rest of the population tends to look at ambiguous self-reported ailments like long covid with suspicion.

It's not for me to say if long covid is real or not, I'm just noting the social problem with this situation and why many people are so dismissive.

I think people are very attached to the thought of everything being ok.
I do think some people are quick to dismiss it.

Though I must admit that I'm also not quite sure what is happening here. The problem seems to be very much real, but the link to Covid is tenuous.

The only symptom with a plausible causal link is the shortness of breath, and most symptoms of long-covid are the kind of psychosomatic symptoms that, while real, could be a symptom of something else and may have been exacerbated by a heavy illness, rather than caused by it.

The other problem is the lack of people not infected by Covid. Pretty much everyone close to a burn-out would experience increasing fatigue, weakness, depression with a very sharp increase at the point where they may have gotten hit by Covid. A bit like how spring always seems to arrive suddenly, simply because an average increase temperature happened to coincide with a sudden change in weather.

The lack of any common treatment or known causal link makes it very tricky to get a grasp of the situation. So far the only thing that I think is well established is that it is a problem, but I'd really like to know more about how it came about and what can be done about it.

> The only symptom with a plausible causal link is the shortness of breath

That seems quite presumptious given that there is clear evidence that covid attacks organs other than the lungs (such as the heart and kidneys). Chronic fatigue is also well-established as a post-viral syndrome following other viral infections, and even though we don't understand what causes it.

> Is it too much to just admit that you don't have enough evidence to decide whether it's real instead of trying to write claimants off as grifters or mentally ill?

The fundamental problem is that essentially all of the "science" around Long Covid is abysmal -- phone surveys and uncontrolled, retrospective analyses of medical billing codes; many don't even bother to check if the respondent had Covid -- and the few studies that actually do achieve any level of rigor have read out negative results.

For example, the NIH ran a controlled, longitudinal study where they ran a battery of tests on 189 people confirmed to have Covid, and 120 controls...and found nothing objective that would define a disease state. This tweet thread does a great job of summarizing the results, and where the good science on Long Covid mostly stands at the current time:

https://twitter.com/awgaffney/status/1528876982754476032

We don't generally accept someone's self-reported illness without objective verification. It's too easy to do harm, and hypochondria is a real thing. Does that mean that Long Covid doesn't exist? No, of course not (among other things, post-hospitalization syndrome is a real thing! People who spend time in the hospital generally take time to get better!)...but it also doesn't mean that we should accept silly headlines and hyperbolic claims at face value.

Even the definition of the disease is abysmal: "continuation or development of new symptoms three months after the initial SARS-CoV-2 infection", a post hoc ergo propter hoc diagnosis.

And "the main symptoms are a shortness of breath, fatigue and weakness, depression, anxiety, and symptoms associated with memory difficulties." I have several of those symptoms and I never even had Covid. In my case, I blame aging and inactivity, but if I had caught Covid, I could probably get a diagnosis of Long-Covid.

Study any population of people "over 60 or with co-morbidities" in any three month period and you'll find people who develop those symptoms at that time. So as you said, it's really important to have properly controlled studies to isolate the effect of Covid.

LongCOVID is a persistent viral infection. Most RNA viruses that afflict humans are persistent (like Hepatitis). Right now, zero dollars are being invested in developing the diagnostics required to detect the virus. Thus, an irrefutable test is not available. Note that SARS and MERS patients also longhauled. If you look at other species, a coronavirus (FIPV) can infect cats in a chronic fashion. In fact, Feline Infectious Peritonitis Virus is treated with the *exact* same antivirals as COVID. It is incredibly difficult to detect FIPV in cats due to irregular shedding by the virus. There are now dozens of papers that have detected SARS-CoV2 viral RNA and viral proteins in longhaulers up to 12+ months after the initial infection.

HIV initially causes a flu like illness in over half of individuals who contract the virus. These symptoms clear. The virus is still in the body and, untreated, results in AIDS and ultimately death.

> LongCOVID is a persistent viral infection.

No, this is an opinion, not a fact.

> Most RNA viruses that afflict humans are persistent (like Hepatitis).

No. The genome structure of a virus an orthogonal property, and extrapolating that "this is an RNA virus, therefore it must cause latent infection" is wrong.

Just to underscore the point: the most common examples of latent human infection -- HSV1 & 2 -- are double-stranded DNA viruses. HIV also causes latent infection, but has a completely different RNA structure.

It's like saying, "a car has an engine, a plane also has an engine, therefore I can fly in my car".

> Right now, zero dollars are being invested in developing the diagnostics required to detect the virus.

Also false. PCR is exquisitely sensitive. There is approximately zero chance that we could fail to detect latent viral infections with PCR, and many, many labs are working on this. The NIH just funneled something like a billion and a half dollars into "Long Covid research", and you can bet that diagnosis is a big part of this.

I have read at least a half-dozen papers in the last two years where people tried to find "latent" SARS CoV2 in various body tissues. If we aren't seeing latent infection, it's not because nobody is trying to find it.

> If you look at other species, a coronavirus (FIPV) can infect cats in a chronic fashion.

The fact that some unrelated virus in another species exhibits latent infection is...unrelated. You're leaping to conclusions.

> It is incredibly difficult to detect FIPV in cats due to irregular shedding by the virus.

When a viral infection is in its latent form, it's latent, and isn't causing active infection. So yes, it's hard to detect, but it also shouldn't be causing symptoms.

You don't get to have it both ways: claiming that the virus is so rare and hidden that we can't find it with molecular tools capable of finding a single copy of RNA, and simultaneously claiming that it's causing systemic, disabling illness. Both things cannot be true at the same time.

Look: for every problem in the world (and in your city, and in your neighborhood, and in your family), there are people who just don’t want to hear it.

They’re generally not the same people from problem to problem, but there’s always a bunch of them. They have their own problems, their own hangups, their own way of seeing the world, etc. They have a thousand totally personal and idiosyncratic reasons. And the easier it is to dismiss the problem, the more staunchly they’ll do so.

It just so happens that autonomic body issues and subjectively assessed complaints are very easy to dismiss because they’re really nebulous and sometimes genuinely psychogenic or iatrogenic. So the people who just don’t want to deal with this problem right now have a really easy time taking a pass on it.

That’s the way it’s gone for hundreds of years and will go for hundreds more. Getting yourself caught up in frustration or confusion over those people isn’t going to do you a lot of good.

If you care about this problem, help people who are suffering from it or work with other people who care about with you. Don’t worry about the people who don’t. They’re not going anywhere.

>At the very least, this warrants taking claims of long COVID seriously, does it not?

Well clearly those Ebola survivors are also grifters who are 'just depressed'.

It's grifters and depression all the way down!

/s

The onus is on the people making the claim to prove its real.

So far theyve collected information on it so negligently it should really just be called data fraud. Pretty obvious whats happening when thats the case.

I recommend that you read up on the history of the last large scale viral infection that greatly impacted society - HIV - and how slowly the medical community accepted the illness and the gaslighting that happened to patients.
Long covid can be measured directly or indirectly in a blood sample? Please provide literature on that.
The simple answer? It’s too scary and nebulous for most people to handle - so they attack and deny it.
I work with an older guy who's been out of work for over a month now from COVID. I'm pretty worried about him long term
I have long covid.

I used to bike to the train so I could get to work and back again at the end of the day for a total time of being on the bike per day of over an hour. There's a brutal hill to climb up to get to my house from the train and I did it every day.

1 month after getting the disease last February, I wasn't able to bike to work anymore. I simply couldn't get my air. I was able to bike immediately after getting over the disease, but over the course of the next month or so things got worse. I could barely get up the stairs.

I went to my general practitioner last March and he give me a prescription for heartburn (which had also magically become a problem when it wasn't before) and a rescue inhaler, which helped. He told me to report back in 2 weeks if it was still a problem. It was. I reported a little later than 2 weeks; it was 6 weeks, but it doesn't matter.

I live in Utah County, Utah. He told me to go up to Salt Lake, to the University of Utah hospital, 40 minutes north. They had a covid clinic up there. He got me an appointment to get up there in June. Apparently they had a backlog.

When I saw the nurse practitioner in Salt Lake, she said I probably had asthma and to go to a pulmonary specialist. She gave me a referral. I was able to use that referral to get another appointment with the pulmonary specialist... in December.

So I waited 6 months and then had an appointment in December with the pulmonologist. During that time when I would go to bed my lungs sounded like pop rocks. Snap, crackle, pop. Wheeze, wheeze, wheeze. My throat was constricted so much that you could hear a whistling sound when I breathed out and in. It was hard during the day, too. I would climb a flight of stairs and my coworkers would ask why I was out of breath and sweating like I had just run a mile.

The time finally came to see the specialist. He appeared to be a venerable gentleman at the end of his career, with white hair and a polished demeanor. He gave me a new inhaler, which eventually helped, and an extension of the heartburn prescription. I had new chest x-rays done and he ran a bunch of tests on me. I walked the hall a few times timed. They took my blood pressure before and after. I had to breathe into a tube really hard several times in different ways (spirography). All the tests came back normal. No asthma. He said he's getting a lot of long covid patients where all the tests are coming back normal.

When I told him I had stopped biking because of covid he was incredibly surprised. "Do you mean to tell me that you've stopped all physical activity?" Said he. I said, "Why do you think I've come here? My pulse is over 90 (100? Can't remember) just sitting here. Look at me; I'm all sweaty." Replied he, "But surely you are sweaty because you had to come up the stairs to get here." (The pulmonologist's office was on the third floor). "No", I said. "I took the elevator." And for all that I owe the hospital a hefty bill because it was a specialist.

Well the pulmonologist recommended that I take pulmonary rehabilitation. Basically it's physical therapy. The first time I went they said I had to start walking 6 minutes four times a day. Then I had to start walking or biking 10 minutes three times a day. I'm up to 12 minutes three times a day now, sometimes back on my bike, and it feels pretty good. So far this is what has helped the most. I don't feel like I need the rescue inhaler anymore, I've stopped wheezing and pop rocking, and I notice less when I go up the stairs now.

But understand me when I say that people who think that long covid isn't real are in a most enviable position. I can assure you, it's real and it's not fun. I remember biking yesterday and feeling so alive. Not being able to do that for so long has been really rough. You don't know what you miss until it's taken away from you.

Edit: it's not depression, see my other comment:

I do not want to discount your personal experience, but could it be that you are/were just depressed? I know my depression got severely worse during COVID. Depression can make you feel sluggish, especially when you give up physical activity entirely for a while due to illness and then try to start again. And then it also makes sense that with progressive physical therapy you realize you can afford more and more physical effort.
I have a long history of depression and anxiety and ADHD. I have lots of experience with it and I go to a psychiatrist for it. It is well controlled at this point.

Depression feels like I don't want to do anything. This doesn't feel like that. This feels like someone put a plastic bag over my head and I can't breathe. It is a real physiological thing. It's like somebody put a really strong rubber band around my entire lung section. I woke up perfectly happy that day and ready to work, and I tried to bike, and it was like I was biking but then somebody blocked my airway with a really thick towel.

When I say I can't bike I'm not talking about a "first world" or even "the struggle is real" kind of can't. I'm talking about a physical reality, a "car engine can't run without oxygen, body is ordering me to stop" kind of can't.

One time shortly after the disease I got really annoyed that my ability was decreasing and just biked anyway. The next day my lungs were so bad that I had to get work off.

I also wanted to comment on the brain fog comments. Brain fog from long covid isn't a "life has no meaning, why try" problem like depression has been in the past for me. Brain fog is a physiological problem. Your brain consumes 30% of the oxygen you breathe. If you're getting less oxygen, you can't think as much. It becomes harder to remember the name of the item that you use to control the TV ("remote") or the name of your second born son. I remember one time it took me ages to remember that the word for that thing you used to strain pasta is called a collander.

> I have a long history of depression and anxiety and ADHD.

So you basically confirmed this has nothing to do with COVID and there is no such thing as "Long COVID". Nobody denies whatever you feel, but trying to link it to COVID is just latching on buzz word.

It's interesting people with history of depression, anxiety and other mental issues are much more likely to report long COVID than people without such history , it's almost as their condition had nothing to do with COVID. And we can take it even further, prevalence of Long COVID with drugs/shrinks addicted US is much higher than anywhere else in world, while in most of the world they don't even hear about some "long COVID" cases, because people can't afford "long COVID" over there.

Your comment makes me feel like you didn't read the whole thing. If you had, you might have had another complaint, but not this one.
I had a similar experience. I was sick for 4 months at the start and took over a year to recover. Most of my symptoms were mental health related (anxiety, low energy, brain fog, etc). I'm bipolar... so no medical professional is going to take me seriously.

I know myself, my moods, and my body extremely well. Without that, I wouldn't be able to work a full time job even with my existing accommodations.

If something is off, I can usually pin-point it pretty fast. Something was off for a long time.

1. It wasn't medication because that hasn't changed since mid-2019. I'm still on the same meds and dosages. (Minus a single minor adjustment for pre-existing ADHD symptoms.)

2. It wasn't isolation. A few friends and I isolated together. We had plenty of social interaction.

3. It wasn't worry. I've never been concerned about sickness or death for myself, my family, or my friends. They are facts of life. Eat, drink, and be merry, for tomorrow we die. Live while you got it. :)

4. It wasn't lack of exercise. I did a lot of walking in parks.

By process of elimination, covid is all that stands out. shrug

The general demeanor in this thread is something else, there are a lot of awfully strong opinions and confidence from a lot of people who are probably aren't frequent readers of their field's journals...

I think what should shake everyone's biases a bit is a story about COVID and Ivermectin with one conclusion:

Ivermectin is actually effective in improving covid outcomes, but only in areas with a high incidence of parasitic worms like India.

Here, in my opinion, is one of the best science reads to come out of COVID: https://astralcodexten.substack.com/p/ivermectin-much-more-t...

US National Institute of Health on Long Covid:

"Symptoms of COVID-19 can last months — or even longer — after infection with SARS-CoV-2, the virus that causes COVID-19. Symptoms vary from person to person and can affect almost any part of the body."

https://covid19.nih.gov/covid-19-topics/long-covid

Statement by Mayo Clinic:

"Research suggests that between one month and one year after having COVID-19, 1 in 5 people ages 18 to 64 has at least one medical condition that might be due to COVID-19...."

https://www.mayoclinic.org/diseases-conditions/coronavirus/i...

Johns Hopkins:

https://www.hopkinsmedicine.org/health/conditions-and-diseas...

Long Covid sucks. It has had a detrimental effect for sure. I was lucky to have it early at a young age and being physically healthy. I am now mostly recovered 2 years later. I could not imagine having it being older.

https://jondouglas.dev/long-covid/

The studies on the effectiveness of nattokinase, Bromelain + NAC, and nitric oxide are seriously worth considering if you suspect you have it. I wish I knew about those earlier.

https://pubmed.ncbi.nlm.nih.gov/36080170/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999995/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9295384/

Nattokinase had been a godsend for me.
Long Covid is real. If you don't think it's real, you're either completely nontechnical in biology or just have been out of the loop and are regurgitating garbage you're spreading around that makes you feel better about not being sick or something. I don't know the reason, but it's harmful as fuck to society regardless.

Whether it be astroturfing or other means originally founded by pharmaceutical companies knowing they originally did not test drugs for mitochondrial toxicity prior to Phase 1 trials, the source remains to be seen. It's also possible they just weren't aware of the problems before they became problems. Heterogeneous damage to cellular respiration does not generally become apparent until it's obvious for example in really old people.

The fact is that people are by and large developing metabolic dysfunction earlier on, and things like antibiotics drastically accelerate the problem. Bactericidal antibiotics are widely known in research now to be seriously toxic to mitochondria and the damage they cause leads to chronic processes because mitochondria do not have effective repair mechanisms outside of copies. When they start reproducing mutated copies, the person does not get off scot-free anymore. Processed foods and air pollution and chemical exposures from foods and other things all additionally cause more dysregulation. This is all becoming way more widely known.

Some percentage of people will just not bounce back after these insults. Respiratory viruses and bacterial infections induce a large amount of oxidative stress in the human body, largely caused by your own immune system. Normally, your body has redox mechanisms to balance this out so you are fine in the end (otherwise running would cause a lot of problems really quickly!). But combining our toxic environment, toxic antibiotics that most people take (and many women take bactericidal antibiotics for UTIs!), high processed food diets leading to excessive baseline OS, you potentiate the risk for the individuals own mitochondrial machinery to be severely damaged from a high OS insult. After that, you don't bounce back. You develop chronic fatigue and severe exercise intolerance, and have much more precarious relationships with other illnesses.

This is what's happening. Depression other mental disorders are already strongly associated with metabolic dysregulation in research.

Don't blame the victims. It's likely you'll become one yourself before you're very old. Everyone is getting sicker.

I got a DVT and a peripheral neuropathy from the first two Pfizer COVID shots so I could not get any boosters. Then I got Covid first week of 2023. I had fatigue for two months but then started taking Nattokinase which has helped my fatigue tremendously. Now I have more good days than bad days.