Is ‘Long Covid’ Real?

M aybe it was the presence of no fewer than three hashtags in Representative Ayanna Pressley’s social-media post. Perhaps it was the T-shirt celebrating “Long Covid Awareness Day,” along with a ribbon conveying her devotion to the cause. Either way, observers can’t help but notice a distinctly political flavor to the activism promoted by “long-haulers” and their advocates.

The congresswoman’s post seems to suggest that the afflicted for whom she speaks are a forgotten constituency in America. Anyone operating under that impression has gone to great lengths to ignore the research into this disorder or the journalism focused on those who report experiencing its symptoms.

There is still no way to test for “long Covid,” and the manifestations of the affliction are so broad and varied that they also pertain to any number of underlying ailments. That alone is not dispositive. It’s not uncommon for autoimmune disorders, for example, to present in ways that confound researchers. And yet, supposedly data-driven analyses of this particular disorder still manage to produce authoritatively determinative conclusions about its causes and effects.

One study indicated that precisely 5.8 million children suffer from the long-term effects of a Covid infection. Another indicated that the afflicted suffer severe muscle damage arising from “microclots” that all but preclude the prospect of engaging in any strenuous activity, like exercise. The malady is said to have worse effects on the quality of life experienced by its sufferers than many cancers. Those who struggle with long Covid’s “brain fog,” it is claimed, experience a level of mental impairment equivalent to the loss of roughly six IQ points.

And the number of sufferers is on the rise. A Centers for Disease Control and Prevention Study found that 6.8 percent of respondents — roughly 17.6 million people — are self-reported “long-haulers,” an increase of 1.5 percent from the CDC’s October survey. “The problem is that for however many million of us, we can’t just move on,” said one Nashville-based attorney as Joe Biden prepared to lift the states of emergency implemented in response to the pandemic. “At some point, the doctors that are researching it may just give up. Where does that leave all of us?”

But researchers did not give up. While that should leave this malady’s sufferers hopeful, they’re unlikely to welcome the conclusions some medical professionals are reaching. For instance, one study of over 5,000 adults conducted by researchers with Queensland, Australia’s public-health service recommended abandoning “terms like ‘long Covid’” altogether because they erroneously lead people to wrongly conclude that they have reason to fear the specific complications arising from a Covid infection.

“I want to make it clear that the symptoms that some patients described after having Covid-19 are real,” said Queensland’s chief health officer, Dr. John Gerrard, in a press conference last week. “What we are saying is that the incidence of these symptoms is no greater in Covid-19 than it is with other respiratory viruses, and that to use this term ‘long Covid’ is misleading and I believe harmful.” The data Gerrard and his team are preparing to present at next month’s European Congress of Clinical Microbiology and Infectious Diseases in Barcelona “found that the rates of ongoing symptoms and functional impairment are indistinguishable from other post-viral illnesses,” he said.

This particular affliction has always been a uniquely discriminating disease. In December 2022, a CDC study maintained that complications associated with post-viral Covid symptoms contributed to the deaths of 3,500 Americans, but the profile of those who suffer from the aliment is a source of skepticism.

“The relatively few patients who do get treated are overwhelmingly white and affluent enough to be able to take time off work to go to multiple appointments and spend time online finding care and support groups,” Politico wrote of the CDC’s report. Indeed, “the vast majority—or 78.5 percent—of the deaths attributed to long Covid were among white Americans.” Self-reported sufferers are far more likely to be women than men, and they are more than twice as likely to be middle-aged (35–49) than elderly (65+). Around the same time, the journal JAMA Psychology published research indicating that there was a high correlation between suffering long-Covid symptoms and struggling with “preexisting psychological distress.” Even controlling for false negatives and the possibility of fading antibody responses, research in MedRxiv found that many long-Covid sufferers “never had Covid-19 to begin with.”

The adamance with which “long-haulers” maintain that their struggle is real in contrast with the unavoidable conclusions research into their condition has produced leads medical professionals to conclude that what’s needed is “a different spirit around the research.” That’s what Yale School of Medicine professor Harlan Krumholz told the school’s student publication as its “Multidisciplinary Long Covid Clinic” began producing results late last year:

Krumholz said patients with post-acute syndromes are “desperate for answers.”

But because chronic syndromes like long COVID are poorly understood, he said many patients feel “abandoned” by doctors, caregivers and the medical system.

“There’s not one evidence-based therapy,” Krumholz said. “We even have trouble defining the condition, because there aren’t any diagnostics.”

Interested parties like Representative Pressley hope to convince the impressionable that long Covid is poorly understood because it is understudied. But the billions of dollars both private- and public-sector enterprises, including Congress, have committed to unraveling this mystery are not generating ambiguous conclusions. This affliction is especially prevalent among those who are prone to anxiety, and observational studies of its manifestations cannot discern post-viral complications unique to Covid. The research into this condition will continue until the sums devoted to it run dry, but we shouldn’t need a T-shirt to understand what we’re seeing.