Long Covid, Cognitive Impairment, and the Stalled Decline in Disability Rates
federalreserve.gov
federalreserve.gov
> In this note, I use two survey datasets to document four facts about long COVID in the United States. First, long-term COVID symptoms are much more prevalent among women, adults under 65, Hispanics and Latinos, and non–college graduates than among other demographic groups. Second, COVID "long haulers" cite specific physical and cognitive impairments commonly associated with the condition in media and medical reporting. Third, the share of working-age adults reporting serious difficulty remembering, concentrating, or making decisions has risen steadily since the start of the pandemic. Fourth, growing shares of women and of non–college graduates report simultaneously (i) being out of the labor force due to disability and (ii) experiencing these cognitive difficulties.
I'm generally interested in a good summary of what medical research tells us about long COVID. Reason being I think it's fair to hypothesize that the following facts are at least fair confounding factors:
1. Whenever economic situations become weaker, disability rates rise. This is largely because people who are "on the cusp" may find it worth it to find a job in good times, but in bad times find it's not worth it to "push through" their disability.
2. There has been so much news coverage about long COVID that it's difficult for me to tell how it compares to other long term viral syndromes. E.g. infection with Epstein Barr virus has long been implicated in a lost of long term conditions like CFS and MS. Is long COVID more common in COVID sufferers than these other syndromes are in EB infection?
3. There have been huge societal changes that have occurred in the past couple years that can make it difficult to tease out the effects of COVID alone.
Not trying to discount any individual suffering from long COVID symptoms, but I think caution is warranted when trying to ascertain the effects at a society-wide level, especially when all the data for this article appears to come from self-reports.
> As of now, the true extent of PAISs remains uncertain, as there is a significant risk that a lot of cases, especially under sporadic circumstances, remain unrecognized.
> The research that is available concentrates on PAISs in the context of either well-monitored acute infectious diseases, or as a follow-up of outbreaks and epidemics.
Unfortunately both long covid and vaccine side effects are underplayed.
It depends also on case by case basis, however long COVID is diagnosed in some patients with/as vaccination side effect. Even if it might be possible that these can be clearly differentiated, it's not done. It is also not that clearly defined and therefore overlaps with some other syndroms like fibromyalgia, which might be a confounding factor as well.
Has there been any good summaries?
Sorry for the complete non sequitur, but this is the first time I've seen a reference to Epstein-Barr outside of the Sopranos (Tony's sister Janice is on disability because of it). I had no idea it was linked to MS.
If one thinks “long COVID” is imaginary, one can read these facts as confirmation of placebo effects or mass sociogenic illness.
https://en.wikipedia.org/wiki/Mass_psychogenic_illness
Or, if one thinks it’s plausible, each can be read the other way, for instance:
>> long-term COVID symptoms are much more prevalent among women, adults under 65, Hispanics and Latinos, and non–college graduates than among other demographic groups
OK, so groups least likely to choose to isolate, or be able to isolate (because they have to work).
>> Second, COVID "long haulers" cite specific physical and cognitive impairments commonly associated with the condition in media and medical reporting.
Put another way, reporting and media sound like what people cite.
>> Third, the share of working-age adults reporting serious difficulty remembering, concentrating, or making decisions has risen steadily since the start of the pandemic.
Condition attributed to a disease known to be experienced by a steadily increasing population share, steadily increases share reporting — confirmed!
>> Fourth, growing shares of women and of non–college graduates report simultaneously (i) being out of the labor force due to disability and (ii) experiencing these cognitive difficulties.
So these go together, and see #1 — everything is as expected.
Remarkable how simultaneously contradictory all four interpretations can be, almost as if crafted to be so.
1. Long COVID is a real disease that can cause debilitating symptoms.
2. A significant number of people who claim to suffer from Long COVID actually suffer from something else.
The only thing that puts me more in the "I think #2 is a lot more prevalent than people think" camp is the astronomical amount of press that "Long COVID" has received, coupled with the fact that the majority of people in the US have been exposed to COVID, so it's easy to attribute any general feeling of being unwell (e.g. fatigue, brain fog, etc.) to the fact that you probably had COVID in the not-too-distant past.
Even so: it's possible for most of it to be "not real" or "something else"-- but still carry a terrifically high disease burden.
There seems to be evidence that tiny blood clots are causing the wide variety of symptoms. https://worldfreedomalliance.org/au/news/could-tiny-blood-cl...
They then did a massive battery of tests - inflammation biomarkers, nerve damage biomarkers, lung function, congestive ability, etc.
And the conclusion? There was no difference between the groups: there are no diagnostic findings that would allow you to even say for sure that post-Covid even exists, biochemically.
This is the "I closed your bug report because it works on my machine" of medicine.
When people complain of lung or heart problems but all tests are normal (oxygen levels, cardiac efficiency, lung capacity, exercise tolerance).
When people claim cognitive decline yet all measures of cognitive ability are normal.
It would point to a strong psychological component for at least some people - which was found in the study. Symptoms were correlated with those having a history of anxiety disorders (prior to Covid).
There was also another study (I can’t find it right now) of self-reported long Covid suffers.
They ran tests and many of them had never even been infected with Covid..ever.
This isn’t to say that post-viral syndromes aren’t real. But it does suggest that self-reporting isn’t all that accurate.
To anticipate: "Objective" measures are of course useful, but only form part of any picture.
And this data helps to narrow down possible treatments based on solid data with regards to system dysfunction.
So we search deeper. And sometimes we find something: https://mylongcoviddiaries.medium.com/i-finally-have-a-diagn...
If you have issues make sure you have dealt with possible microclotting issues, it is the main thing everyone must check/treat who had covid.
As others mentioned in thread, check FLCCC's IRecover protocol and also study antifibrinogens and Gustavo Aguirre's work. He was months before anyone else from the start regarding both covid and post covid treatment.
I myself manage a hungarian long covid group with almost 6K people now, started 1.5 years ago. Curating resources, translating studies, gathering good docs and protocols.
List of treatments to have a look at: lysine (2000-2500mg, slowly increasing not to break microclots too fast), lumbrokinase/nattokinase/serrapeptase/bromelain, high dose B1 (even 2000-3000mg HCl form), in case of brain fog you might consider fluvoxamine, and of course there is the one which helped A LOT of long haulers I know but is censored...: www.ivmmeta.com Also diet/antihistamines might help for some and in case of low energy (if microclots are surely gone, if not I'd focus on it first) then high dose flush niacin. Proved many times.
It is so absurd they can still censor it and that many docs blindly following orders.
- Robin Sharma
I have had health complications that caused the same problem as long covid seemingly causes; tiny tiny clots wreaking havoc on capillaries. I think it depends on where the viral load landed and grew, but if it was in your lungs, you would maybe need to treat it as if you have chronic bronchitis.
If it was in your sinuses and mouth, messing up your senses, then I'm sorry, idk what to do. ...maybe a similar approach with anti-inflammatories, hopefully something for your nerves too.
Hope you're good atm
https://www.cdc.gov/aging/publications/features/lonely-older...
Humans are social animals. COVID response policy to encourage more physical isolation could have deadly implications.
What society did over the last two and a half years is shameful. Society encouraged and cheered on what is basically mental illness.
Anecdotes are really not useful for teasing out general effects.
You have not made some epistemological breakthrough with your anti-scientific take.
Single examples are useless for discovering generalized properties of reality.
Medical case studies are only useful in conjunction with knowledge about causative associations that were discovered through statistical analyses.
Luckily he's one to take it well when his patients bring up internet-sourced thoughts or suggestions :)
Some anacdata: This strange temperature dysregulation feels somewhat similar to what a too high dosage of my ADHD meds does to me.
Anyway thanks for your comment. I'll be seeing a doctor about this for sure.
Yup, ADHD medicine will activate the sympathetic nervous system and too much of that will cause dysautonomia.
If you have LongCovid and ADHD it’s reasonably likely you’re also hypermobile and have a condition called hypermobile Ehlers Danlos Syndrome (hEDS). It runs in families on an autosomal dominant basis. Doctors rarely know anything about hEDS either. The normals tests done by those that do have a 90% false negative rate.
You know your stuff well!
Saw the doctor today and brought this all to him. He has opened cases with and referred me to two specialists: one for the potential long covid symptoms, and one who will be taking another and more thorough look at the hypermobility and associated symptoms.
This information would have never reached me in such an actionable format if it weren't for your detailed comments. Thank you, I really appreciate it!
After I felt better I observed that I was feeling much more tired than I usually felt.
Now, after two months I feel a little better but not that much... Could this be related to my covid infection? Is there a way to improve my situation?
I did a normal check up but didn't get anything abnormal...
I am still getting winded easily and while i was already out of shape i notice after riding a bike or being active for a full day i still feel bad the following day
If any of that sounds familiar, you may want to get some more extensive tests done. I don't know what will come of it, pretty much the only thing that has helped my brother so far is a regular low dose of Benadryl. There's a bit of edgy research or internet driven anecdata (not sure which) that led him to try it, but it is better than nothing, at least.
That supposedly can cause dementia. Just FYI.
I found that exercising - starting with 10 min yoga / stretching and then slowly ramping up over 1-2 weeks - got me back to normal.
In a tweet, here’s the start of a trail of very good information from solid research into these conditions: https://twitter.com/putrinolab/status/1557403364941496320
FLCCC I-RECOVER protocol: https://covid19criticalcare.com/covid-19-protocols/i-recover...
"Could tiny blood clots cause Long COVID's puzzling symptoms?" (article reports some people have had success with anti-coagulant therapies, but be especially careful with those): https://www.nature.com/articles/d41586-022-02286-7
Theory of Long COVID as Mast Cell Activation Syndrome (from one of the physicians who pioneered use of fluvoxamine in treatment): https://twitter.com/farid__jalali/status/1315060197988036608
From personal anecdata, I took a PQQ/CoQ10/NAC combo supplement recommended by the local supplements store after both of my two infections, and have never had any long-term symptoms. NAC in particular seems to show up often in the various recovery protocols that are floating around.
Also add, that breaking microclots is the main goal not necessarily with anti-coagulants, they are similar but not the same. Anti fibrinogens are more useful in that post covid phase and it has been shown that live virus DOES live in those microclots so that's why antivirals (eg lysine, shown to bind to spike protein and also wide spectrum antiviral) to be used together with them.
Check out dr Gustavo Aguirre's work, he was months early every time.
https://www.researchgate.net/publication/344325326_COVID-19_...
Weird
One oddity I noticed is that among the people I know, the fittest and most physically active had the worst "mild" covid, which surprised me since it is well known that physical activity is good for immunity (up to a point). They tend to feel like shit for a week or two, and take weeks to months to get back to their pre-covid levels. I attributed it to some kind of bias: when you are lifting weights for instance, you can easily measure your fitness level by noting how much you are able to lift, a measure that couch potatoes don't have and therefore don't notice their weakness. But if you are saying that making efforts just after infection negatively and significantly affects recovery, that could be an explanation.
Also, there are so many articles along the lines of "I used to run marathons, now, with long covid, I can barely walk". It is rarely about "normal" people (in the US, that would be couch potatoes). Again I believe these cases are selected because the before/after contrast makes a better point, but again, "don't exercise after infection" could be an explanation.
>>Newly available data from the Household Pulse Survey—an experimental Census Bureau product launched at the start of the pandemic—provide the first large-scale, population-level detail on the prevalence of long COVID.2 Starting with the survey's June 2022 wave, respondents who report having had a diagnosed case of COVID are asked,
>>"Did you have any symptoms lasting 3 months or longer that you did not have prior to having coronavirus or COVID-19?"
We have no idea if it was COVID that was responsible for these symptoms (the most common of which is anxiety) or a response to COVID, like stress, or two weeks isolation after diagnosis, or the pandemic-related restrictions on social interaction.
The best evidence available suggests most cases of "long COVID" are misattribution:
https://jamanetwork.com/journals/jamainternalmedicine/fullar...
I've seen estimates as high as 4 million Americans out of work due to being disabled with Long Covid. Add some more people who now can't work because they are taking care of disabled family members.
To me, the only news story that really matters is that we're crippling 2 million+ working age Americans a year, many of them concentrated in very high need areas such as nursing. At this rate, hospitals and schools will functionally (if not officially) collapse within the next few years at most.
A country where you cannot go to the ER when you're sick because there is nobody there to work the ER, and a country where there are no teachers and they've had to bring out the national guard to merely babysit students, is a failed state.
What expert was suggesting that in 2020? As I recall, we shut down schools and restaurants and basically everything else we could for more than a year, except for very limited re-openings (e.g. outdoor dining, in the dead of winter) months later.
We couldn't shut down everything because people need grocery stores to get food!
For the lockdowns and all the other nonsense you should see at least an order of magnitude difference between places that instituted them and those that didn’t. It shouldn’t require fancy statistics or expensive studies to confirm. It should be complete obvious to any reasonable person there was a very large difference.
https://www.mayoclinic.org/diseases-conditions/fibromyalgia/...
https://old.reddit.com/r/covidlonghaulers/
I wonder if some % of the population can be extrapolated from that
It's not far-fetched to assume that this substance is not atypical and educated people make in general more health-conscious choices.
It's also unbelievable that these groups don't differ in frequency of having Covid, vaccination rates, likelihood of having had Covid in 2020 vs. post vaccination, etc. Since we know vaccination has some protective effect against long-covid, that's another factor.
This doesn't mean these reports reflect underlying reality permanently (maybe a desk jockey reports disability differently than someone with a physically demanding job, maybe other factors make people less likely to report). But there are plenty of ways education can predict outcomes that aren't just reporting bias.
Reason: College grads are more likely to get vaccinated against COVID than non-grads. Leading to a reduction in symptom severity and perhaps long covid.
https://healthpolicy.usc.edu/evidence-base/education-is-now-...
The reason I say placebo is because any of these pre-existing conditions could be blamed on long COVID. Think about it: you don't know much about diseases, you see CNN/Fox News/MSNBC talking about long COVID. You think to yourself, hey I've got those symptoms! You blame long COVID, even though the underlying cause could have been obesity, diabetes, sedentary lifestyle, diet, etc.
We know obesity is harmful yet the fat acceptance movement exists. Do you think those people are going to blame their symptoms on their obesity?
I think highly educated people are often simply indoctrinated with facts and beliefs rather than trained to be intelligent and knowledgeable.
Edit: I see nothing in the submission showing there’s no substance abuse effect, clearly or otherwise.
[1] https://www.niaaa.nih.gov/news-events/research-update/deaths...