After “recovering” from Covid-19, many people have suffered lingering malaise: labored breathing, foggy thoughts, chronic fatigue.
It’s awful, and it’s ill-understood. Trials are ongoing to try to help people, but, honestly, medical doctors don’t know what to do. Akiko Iwasaki, an immunologist at Yale, has been investigating Long Covid since late 2020 and has a long list of experimental therapies that her team would like to test.
In an interview with Jennifer Couzin-Frankel for Science magazine, Iwasaki said “As a basic scientist, of course I’d like to have all the pieces of the puzzle” before giving people untested therapies, “but the patients, they cannot wait.”
Unfortunately, longstanding prejudice in the medical community about what counts as a “real” disease has meant that a promising medication, Prazosin, apparently isn’t even on the list of therapies to try.
Full recovery from an upper respiratory infection like influenza or Covid-19 often takes months. This timeline is very noticeable among athletes, whose performance is exquisitely sensitive to any disturbances in breathing. Even though young people recover from many illnesses much more quickly than others, an elite high school athlete who catches a bad respiratory infection will often suffer for an entire sports season.
This is after the acute phase of coughing and viral production has passed: bodies can take a long time to heal.
Diabetes, heart damage, and a wide range of autoimmune conditions can also be triggered by viral infections (or, often, a body’s immune response to viral infection). Even after a virus has been cleared from a person’s body, the collateral damage caused by the infection or the person’s immune response can result in lingering maladies.
We shouldn’t be surprised that a wide range of persistent problems would appear after the vast majority of the world’s population just had their first encounter (and second, and third …) with a novel coronavirus.
Also, common symptoms of Long Covid – sleep disturbances, muddled thoughts, chronic fatigue, unexpectedly low cortisol, “odd” immune responses, gastrointestinal distress – match common symptoms of PTSD. For many people, Long Covid probably is PTSD.
Please note that I’m not saying that Long Covid isn’t real!
PTSD is real. PTSD causes real physical effects. But for some reason – perhaps because PTSD has a partly psychological origin – PTSD is often considered a less meaningful condition by both the professional medical community and our society at large.
In an opinion essay for the New York Times – “If You’re Suffering After Being Sick with Covid, It’s Not Just in Your Head” – sociologist Zeynep Tufekci inadvertently perpetuates this prejudice, the idea that conditions that have mental causes aren’t as important. I don’t believe that this was Tufekci’s intent – after all, she does an excellent job listing many conditions that the medical community incorrectly discounted in the past.
But conditions that target the brain matter, too! Honestly, it shouldn’t be a hard sell to convince people that brains are at least as important to the human experience as kidneys, lungs, livers, or arteries.
And yet, here we are, living in a world where migraines, depression, or PTSD are considered less “real” than other conditions.
Most likely, what we’ve been calling Long Covid will turn out to be a variety of different conditions. Some people have suffered inflammation or damage to their hearts or lungs that will last a long while after viral clearance. Some people are experiencing the opportunistic reactivation of other latent viruses.
But many cases of Long Covid are probably PTSD. Which is a real condition, with real physiological effects, and there are real medications – like the blood pressure medication Prazosin – that can help in recovery.
We shouldn’t let prejudice about which conditions count keep people from the treatments they need.