Pharmaceutical Policies Are Influenced by Politics
In the ongoing battle against COVID-19, a growing concern is the long-term physiological impact of the disease. Studies reveal that a significant number of individuals continue to experience reduced health-related quality of life (HRQoL) long after the acute phase of the illness[1][3][5].
**Comparison with Other Diseases**
Both COVID-positive and COVID-negative groups (the latter likely including other respiratory illnesses or false-negative COVID cases) show prolonged impacts, with about 20% of participants in either group experiencing persistent impairments in HRQoL up to a year after illness[3][5]. This suggests that long-term physiological effects are not exclusive to COVID-19 but may be common in other serious respiratory illnesses as well.
However, COVID-positive individuals demonstrated somewhat quicker and more pronounced recovery to optimal physical and mental well-being compared to their COVID-negative counterparts, highlighting a nuanced difference in recovery trajectories[3][5].
**Potential Long-Term Health Effects on Individuals**
Persistent symptoms known as "long COVID" affect a substantial fraction of patients. Individuals in the poorest HRQoL groups had higher acute symptom severity and pre-existing conditions and reported long COVID more frequently (up to 42.4% in the poorest overall HRQoL group)[1].
Ongoing issues include physical fatigue, cognitive dysfunction, mental health challenges (e.g., anxiety, depression), and social participation difficulties[1][5]. The substantial duration of recovery and persistence of health impairments can impair daily functioning and reduce quality of life for many individuals.
**Potential Long-Term Societal Impacts**
The prolonged recovery and persistence of symptoms in a significant minority of patients can lead to increased healthcare utilization and economic costs related to disability, lost productivity, and ongoing medical care.
Beyond individual effects, there is growing evidence that the overall burden of disease has increased, with rising rates of depressive and anxiety disorders, and potentially increased deaths from other conditions influenced by the pandemic context[4].
**The Fight Against Long COVID**
The early narrative of ME/CFS, a multi-system disease with similar symptoms to long COVID, as psychogenic has been challenging to dispel, and some doctors persist in believing that ME/CFS must be psychogenic[6]. On the other hand, ME/CFS, which impacts women disproportionately and can be more debilitating than many chronic diseases, remains underfunded, with NIH funding at only 7.3% relative to its disease burden from 2013-2017[7].
The decisions made now on how to deal with the masses of newly disabled people due to long COVID will have reverberations for decades to come. The activists of ACT UP, who used a two-pronged approach of creative and confrontational acts of protest, and informed scientific proposals, to accelerate the pace of progress in HIV/AIDS research and treatment, may serve as a model for those advocating for increased attention and resources for long COVID research and care[8].
**Controversies and Minimization Efforts**
Efforts are being made to dismiss long COVID as psychogenic in high-profile platforms, such as the WSJ and New Yorker, by neglecting to interview clinicians who treat long COVID patients or cite research on the physiological damage caused by COVID-19[2]. This strategy of minimization is not new, as it bears similarities to those used in climate denial[9].
The American Institute for Economic Research (AIER), a libertarian think tank, is best known for its research denying the climate crisis and promoting a "herd immunity" approach to COVID-19[10]. These minimization efforts are often funded by the same billionaires and institutions that fund climate change denialism.
The New Yorker article set up a false dichotomy between long COVID patients and doctors, suggesting that patients disregard evidence and are impatient, while doctors appreciate the careful study design, methodical data analysis, and skeptical interpretation of results that medicine requires[2]. This portrayal of patients as irrational and doctors as the arbiters of truth is misleading and does a disservice to both parties.
In conclusion, the long-term physiological impact of COVID-19 is complex and far-reaching, affecting not only individuals but society as a whole. As we continue to navigate this pandemic, it is crucial to prioritize research, care, and resources for those affected by long COVID, and to avoid minimization efforts that undermine our understanding of this disease.
- A study comparing COVID-positive and COVID-negative groups indicates that long-term physiological effects might be common in serious respiratory illnesses, not just exclusive to COVID-19.
- The recovery of COVID-positive individuals to optimal physical and mental well-being is somewhat quicker compared to their COVID-negative counterparts.
- Persistent symptoms known as "long COVID" affect a substantial fraction of patients, with higher severity and pre-existing conditions linked to a higher frequency of long COVID.
- Consequences of long COVID include physical fatigue, cognitive dysfunction, mental health challenges, and social participation difficulties, impairing daily functioning and reducing quality of life for many individuals.
- The societal impact of long COVID could lead to increased healthcare utilization, economic costs, and potentially rising rates of other conditions influenced by the pandemic context.
- Similar to the activism of ACT UP during the HIV/AIDS crisis, advocates pushing for increased attention and resources for long COVID research and care should employ both creative and confrontational acts of protest, and informed scientific proposals.