4 ms·

> 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

by timr 4y ago

> 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 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.

leereeves 4y ago
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.
- randm_sequence 4y ago
  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.
  - timr 4y ago
    > 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.

by timr 4y ago

leereeves 4y ago

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.

randm_sequence 4y ago
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.
- timr 4y ago
  > 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.