The Exaggeration of Long Covid Lingering symptoms after a respiratory infection are common. Most cases are too mild to worry about. By Marty Makary
Long Covid is real. I have reliable patients who describe lingering symptoms after Covid infection. But public-health officials have massively exaggerated long Covid to scare low-risk Americans as our government gives more than $1 billion to a long Covid medical-industrial complex.
The Centers for Disease Control and Prevention claims that 20% of Covid infections can result in long Covid. But a U.K. study found that only 3% of Covid patients had residual symptoms lasting 12 weeks. What explains the disparity? It’s often normal to experience mild fatigue or weakness for weeks after being sick and inactive and not eating well. Calling these cases long Covid is the medicalization of ordinary life.
Two studies published this month put long Covid in perspective. The first, in the Journal of the American Medical Association, looked at a spectrum of wellness indicators in 1,000 people who recovered from symptomatic Covid or another respiratory infection. It found that 40% of patients who had tested positive for Covid “reported persistently poor physical, mental, or social well-being at 3-month follow-up.” For Covid-negative patients who had other upper-respiratory infections, the figure was 54%. Covid patients did better than non-Covid patients. While there are certainly unique hallmark conditions of Covid, such as loss of smell, any respiratory infection—flu, RSV, other cold viruses—can knock you down for a while.
The second study, in Lancet Regional Health, looked for long Covid in 5,086 children 11 to 17 and found that symptoms present during infection rapidly declined over time. The researchers found that among children who tested positive and negative for Covid “prevalence patterns of poor well-being, fatigue and Long COVID”—defined by its symptoms without the need for a past diagnosis of the disease—“were broadly similar.” (The study also found that loneliness in children increased steadily in the year after Covid illness.)
The National Institutes for Health has been intensely focused on studying long Covid, spending nearly $1.2 billion on the condition. To date, the return on investment has been zero for the people suffering with it. But it’s been terrific for MRI centers, lab testing companies and hospitals that set up long Covid clinics. I’ve talked to the staff at some of these clinics and it’s unclear what they are actually offering to people beyond a myriad of tests.
An Annals of Internal Medicine study ran an exhaustive battery of tests on 48 people with long Covid and 50 people without. The researchers found no biochemical or physiologic abnormalities in people with long Covid. “Levels of plasma inflammatory markers, levels of biomarkers for cardiac and central nervous system injury, and presence of select autoantibodies were similar between groups,” they concluded. The only medical factor that predicted long Covid was pre-existing anxiety, associated with a 2.8 times increased risk of developing long Covid.
The NIH hasn’t invested nearly as much in studying masks, natural immunity, vaccine complications, boosters in children or even vitamin D, which was found last month to lower Covid mortality—a study that tragically came two years too late. The most stunning absence of Covid research is in children. After imposing tremendous restrictions on tens of millions of healthy children for nearly two years, no government study or public-health official can tell us how many otherwise healthy children have died of Covid, or even if any have. Dedicating research dollars to magnify Covid complications while ignoring other pressing Covid research questions continues the politicization of the disease.
Last month Food and Drug Administration Commissioner Robert Califf tweeted that “preliminary epidemiological findings point to the distinct possibility of the bivalent vaccines and antivirals reducing risk of long Covid.” If Pfizer tweeted that, it could be fined for making a claim beyond an FDA-authorized indication. Mr. Califf’s Twitter thread included no data. The bivalent vaccine was authorized by the FDA without a vote of its scientific expert advisory committee.
White House Covid coordinator Ashish Jha declared last month that the science supporting the bivalent vaccine is “crystal clear.” In fact, it was authorized based on data from eight mice. To date, there has been no randomized trial data on the bivalent vaccine. It’s authorization was reamed through by regulators over the objections of experts like Paul Offit, who argued that it should be evaluated as a new medication.
The NIH’s fear-mongering around long Covid has also been used to argue for keeping Covid restrictions in place. In November, the Biden administration issued a report on long Covid stating that mask mandates and vaccination “protect people from infection or reinfection and possible Long COVID,” despite no scientific evidence to support the claim.
Given the broad reach of population immunity to Covid today and the less severe nature of the illness, long Covid is less common and less severe than it was in 2020 or 2021. In my experience treating thousands of patients over two decades, people are forgiving if you are honest with them. If public-health officials want to regain the public trust, they should show more humility when it comes to Covid, including long Covid.
Dr. Makary is a professor at the Johns Hopkins University School of Medicine and author of “The Price We Pay.”
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