There was no shortage of scare tactics during the COVID pandemic, whether that came in the form of wreaking havoc on the hospital system if you cared about freedom, the accusation of killing grannies if you did not wear a mask, saying that "you can't do such-and-such activity if you're dead," the consistently negative media coverage, or the mantra of "stay home, save lives." The fear of dying from COVID was not the only scare tactic used to try to keep people in line. There was the threat of long COVID. Long COVID, also known as post-acute sequelae SARS-CoV-2 infection (PASC), is when an individual continues to have lingering symptoms weeks or months after initial recovery from COVID. Some symptoms include shortness of breath, fatigue, brain fog, headache, and sleep issues.
CNN made it sound like nearly one in two people who have had COVID suffer from long COVID at least six months after infection. In 2021, NPR found a study saying that was more than a third who suffer from long COVID. I am not here to say that long-term effects of a disease do not happen. This was observed in multiple diseases, the Spanish flu, pneumonia, and diabetes. What I would like to know is if long COVID is running rampant or if the prevalence of long COVID has been exaggerated.
One of my big reasons for being skeptical about the media fear-mongering on this subject is that long COVID is poorly defined. Look at a CDC study on long COVID as an example (Landry et al., 2023). The CDC looked at students, faculty, and staff at George Washington University. Although the CDC acknowledges the time period is anywhere from 28 days to 6 months, the CDC emphatically stated that 36 percent of COVID cases in their study resulted in long COVID. Symptoms exhibited among these individuals included fatigue, sadness, anxiety, and trouble sleeping. Not only are these symptoms non-specific, they are also a common part of the college experience. Another example of the CDC cherry-picking data to suit an agenda.
This leads to a second reason why I express skepticism about long COVID. The non-specific nature of these symptoms could plausibly mean that there is another factor in play. Long-term fear has negative effects on the body, including many of the symptoms that are part of long COVID. As I previously brought up, the fear that the media and government peddled throughout the pandemic elevated stress levels and exacerbated mental health. Traumatic life events and long-term stress wear down the immune system. The lockdowns caused an increase of anxiety, depression, and suicidal ideation, especially amongst children. A study from the Journal of the American Medical Association (JAMA) found that pre-infection psychological distress causes 1.3-to 1.5-fold increase of self-reported post-viral symptoms (Wang et al., 2022).
What is even more intriguing is a research paper that came out of Norway a couple of weeks ago (Selvakumar et al., 2023). You can read the analysis of practicing hematologist-oncologist and professor at University of California-San Francisco Vinay Prasad on this research here.
This study looked at adolescents and young adults who exhibited long COVID symptoms. They used blood samples and other metrics to create a control group of those who previously had COVID and those who did not. The control group is key, especially since the previously mentioned CDC study did not have one. The bombshell of a finding from this Norwegian study is that having COVID had nothing to do with whether someone exhibited symptoms related to long COVID. To quote the study, long COVID "was not associated with biological markers specific to viral infection, but with initial symptom severity and psychosocial factors." This Norwegian study confirms a JAMA study that found that many people who had long COVID symptoms did not test positive for COVID antibodies (Matta et al., 2021).
I do want to emphasize that this is not me saying that long COVID does not exist or that the symptoms are not real. Much like with other diseases, there are long-term effects of infection. I would surmise the same is for COVID. At the same time, it does not make sense to lump a bunch of non-specific diseases together and call it "long COVID." It is becoming more clear that the prevalence of long COVID has been exaggerated.
But COVID cases, hospitalizations, and deaths are down. The federal government is still on track to end its COVID emergency powers on May 11. Why does this debate on long COVID still matter if the pandemic is behind us? For one, the hype surrounding long COVID was part of the justification of the litany of misguided COVID restrictions that either did little to nothing to help or made matters worse. Some of these policies are still in place, including vaccine mandates for college students and federal employees. This hype is a lesson of fear getting the best of people, including decision-makers. If we are to be prepared for the next pandemic, we need to learn from this pandemic.
The second is hinted at in the CDC's recent study, in which the authors say that "this sequela has been suggested to be the 'next national health disaster.'" I know that the topic about long COVID is ever-evolving. As more data come in, I would assume we have a clearer picture of what actually constitutes as long COVID and what is caused by other factors. The latest data suggests that there are a significant number of patients that are misattributing their symptoms to long COVID. This finding may or may not change as we acquire more data. Someone who appreciates the scientific process would be able to adjust their viewpoints when more methodologically sound findings come along our way. The CDC has shown that it is incapable of that humility or that adaptability. If they have an exaggerated understanding of long COVID prevalence, how can we expect the government to solve such a problem?
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