For quite some time, since the onset of the Covid-19 pandemic in 2020, there has been a debate in the medical community and the media about post-Covid symptoms now referred to as “long Covid.” Is there really such a condition and, if so, how prevalent is it?
Nearly two years ago I published a post based upon an article written by Dr. Jeremy Devine, a psychiatry resident at McMaster University in Hamilton, Ontario, called Fake Science Behind Long Covid Symptoms. At that time there was very little known about this condition, but reports were becoming more frequent. Dr. Devine said there is no scientific basis for this condition. Yet, the National Institutes of Health announced then a $1.15 billion initiative to research the “prolonged health consequences” of Covid-19 infection.
Dr. Devine acknowledged that some elderly patients, with co-morbidities, do experience symptoms that outlast the coronavirus infection. But, as a psychiatrist, he notes that such symptoms can also be psychologically generated or caused by a physical illness unrelated to the prior infection. He says “long Covid” is largely an invention of vocal patient activist groups. Legitimizing it with generous funding risks worsening the symptoms the NIH is hoping to treat.
He based his opinions on shoddy research supported by NIH Director Francis Collins, who has ties to activist groups promoting this condition. Dr. Collins has since lost some of his credibility when it was revealed he and Dr. Anthony Fauci colluded to prevent any investigation of the origins of the Covid-19 pandemic that might look closer at the Wuhan, China laboratories, which received financial support from NIH.
Why would a scientific institution, such as NIH, support unscientific conclusions?
Dr. Devine opines that this subjugation of scientific rigor to preconceived belief reflects a common dynamic encountered in clinical practice. He says, “Patients who struggle with chronic and vague symptoms often vehemently reject a physician’s diagnosis that suggests an underlying mental health issue, in part because of the stigma around mental illness and the false belief that psychologically generated symptoms aren’t “real.”
The problem is there is no known way to positively identify “long Covid.” There is no laboratory test or imaging study that can confirm this diagnosis. The list of symptoms generally associated with “long Covid” include fatigue, “brain fog”, and other vague aches and pains. These same symptoms are also associated with chronic fatigue syndrome, fibromyalgia, anxiety and depression.
When I began medical school nearly 50 years ago, fibromyalgia was a new diagnosis. Very little was known about it then and very little more is known about it now. Like “long Covid”, there was no laboratory test or imaging study that could confirm the diagnosis. According to the National Institutes of Health, “Fibromyalgia is a chronic disorder that causes pain and tenderness throughout the body, as well as fatigue and trouble sleeping.” Patients with fibromyalgia are considered hyper-sensitive to pain. There is a high correlation between patients diagnosed with fibromyalgia and those diagnosed with anxiety and depression.
Today, there is a laboratory blood test that can be used to determine if a patient has fibromyalgia. But the test has only about 70% accuracy according to the American College of Rheumatology. A patient must have pain in at least four of five regions; symptoms have to be present for at least three months, widespread pain index score must be >7 and symptom severity scale score is >5 or widespread pain index score is 4 to 6 and symptom severity score is >9.
Even if there really is a condition called fibromyalgia, there is great pressure on physicians to make this diagnosis instead of attributing their symptoms to anxiety and depression. The population most associated with fibromyalgia is middle-aged women (some studies say 90%) and the same population is also associated with a high incidence of anxiety and depression. Since fibromyalgia is a more culturally accepted diagnosis than anxiety and depression, many women prefer this diagnosis – and pressure their doctors to agree.
All of this brings me back to “long Covid.” Is it real, or is it a more acceptable diagnosis than anxiety and depression? At this point we don’t really know, but there is certainly pressure to make this diagnosis for many reasons.
(To learn more about this subject, stay tuned to my next post.”)
