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  • Writer's pictureDr. Bow Tie

COVID-19: Three Years Later (Pt. 3: LONG COVID)

The public health emergency (PHE) has been officially declared over. Great - problem solved, right? Well, not quite. The pandemic has not ended - just the PHE. In the wake of that, though, people have started to try and rewrite the history of the last three years. A great many people, including physicians, have found a platform in contrarianism. The truth about COVID is that it's hard, and it DID change things, and it IS still around and making people sick (and dead). There is a path to instant fame in using your platform to peddle pseudoscience and "easy" cures that have no evidence basis, and to question the actual science (which is fine if you're willing to listen to the answers) while touting their own "research" with complete confidence (when even just a little scrutiny shows glaring flaws, but if you call that out they pivot to myths and grift - that's the difference. Scientific communicators like me who actually follow evidence also acknowledge the research's flaws). Let's set the record straight.

(And don't forget to get your FREE home COVID tests through USPS!)

Post-acute sequelae of COVID-19, or Long COVID, is an entity that is still upnot as defined as it should be. It can start with any COVID-19 infection - symptomatic or not. There are a few clinics that have arisen in major cities, but not enough to handle the volume of people that are displaying symptoms. We do not have a reliable test for it, and it becomes even harder when not everyone tests for COVID during their infection (especially if asymptomatic) but develops symptoms for no other reason. They are working to develop an immune system profile, which will help identify biomarkers for which we can test, and many pulmonologists, physical medicine & rehabilitation specialists (PM&R), rheumatologists, and others are doing incredible work towards that end.

It is not the only virus that may cause such symptoms, but since it is so much more common right now than so many other viruses with serious consequences, we are seeing it more. Symptoms include "fatigue, flu-like symptoms, autonomic dysfunction, trouble with memory or concentration and post-exertional malaise." Not exactly specific, which makes it hard to identify and diagnose. There are also other neurologic and cardiac symptoms.

Note: It has been easy for certain folks to dismiss this as something in people's heads, or something psychiatric. There may be a component of anxiety or depression, sure, but these physical manifestations are not to be dismissed without a thorough work up. Unfortunately, not everyone has access to someone specializing in care for Long COVID, but please ask your doctor if you have these symptoms. Below I have linked a couple of articles demonstrating how doctors or other healthcare workers (HCWs) will sometimes dismiss these complaints, especially in women, especially women of color (one a news article about long COVID, the other from the journal of Hospital Medicine about Black people with chronic illness). We as HCWs must be diligent and wary of our own biases in such cases.

This is one of those things that people are quick to dismiss until it actually affects them. Dr. Leana Wen, one-time head of Planned Parenthood and now a commonly-sought commentator, who has consistently downplayed COVID-19 and disparaged mitigation measures, despite repeatedly being proven wrong, recently was infected with COVID-19, suffered pneumonia because of it, and has struggled with Long COVID since then. Her commentaries have flipped from dismissal of Long COVID to a call for further research and understanding of the condition.

Funny how that works.

I've linked multiple papers below. Dr. Monica Verduzco-Gutierrez, Dr. Wesley Ely, Dr. Amy Proal, and many others are doing great work in this area.


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