The world was slow to recognize long COVID as one of the most serious consequences of the coronavirus. Six months into the pathogen’s tear across the globe, SARS-CoV-2 was still considered an acute airway infection that would spark a weeks-long illness at most; anyone who experienced symptoms for longer could be expected to be dismissed by droves of doctors. Now long COVID is written into CDC and WHO documents; it makes a cameo in the newest version of President Joe Biden’s National COVID-19 Preparedness Plan.
But for all we know now about long COVID, it is still not enough. Researchers still don’t know who’s most at risk, or how long the condition might last; whether certain variants might cause it more frequently, or the extent to which vaccines might sweep it away. We do not have a way to fully prevent it. We do not have a way to cure it. We don’t even have a way to really quantify it: There still isn’t consensus on how common long COVID actually is. Its danger feels both amorphous and unavoidable. People already struggle to deal with well-known risks, let alone fuzzy, slippery ones. “You can be too afraid of what you don’t understand or just say, ‘It’s not well defined; I’m not going to think about it,’” says Erin Sanders, a nurse practitioner and clinical scientist at MIT. Concern, when we let it, can act like a gas. It expands to fill the space we give it.
Researchers have known for many months that long COVID is more a category than a monolith. Al-Aly very roughly likens it to the way we talk about cancer—an umbrella term for diseases that are related but that require distinct diagnoses and treatments. Long COVID has hundreds of possible symptoms. It can batter the brain, the heart, the lungs, the gut, all of the above, or none of the above. The condition can start from a silent infection, an ICU-caliber case, or anything in between. It can begin days, weeks, or months after the virus first infects someone, and its severity can fluctuate over time. “We lump all of that into one broad thing,” Al-Aly said. “It is not.”
The condition’s root causes, accordingly, are also diverse. In some cases, long COVID may be collateral damage from the war waged between virus and immune system; in others, it might sprout out of a chronic SARS-CoV-2 infection or, conversely, a quick viral encounter that sets bodily systems on the fritz. These hypotheses aren’t comprehensive or mutually exclusive: There are only so many ways for bodies to run smoothly, and infinite ways to throw those processes out of whack.
All of this means that even diagnosing long COVID—an essential step toward understanding it—is still a battle. We don’t have a clear-cut, consensus clinical definition, a single name for the condition, or a standardized set of tests to catch it. Even the CDC and the WHO can’t agree on how long a person must be sick before they meet the condition’s criteria.
Information from The Atlantic
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