David it Up! Profile picture
Aug 24 1 tweets 6 min read Read on X
Long COVID: It’s Going to Get Worse Before It Gets Better

The PsychologyTrap - Long Covid
The psychological landscape surrounding our current health situation, particularly in relation to COVID-19, is strikingly predictable. This isn’t just a reflection of our society's response to the pandemic, but a mirror held up to the human mind itself—a mind that is inherently resistant to change and clings to familiar patterns, even when confronted with new and unsettling realities.

I’ve personally fallen into this psychological trap multiple times over the last two years. Early on, my understanding of COVID-19 was superficial at best. I was aware of the immediate dangers of the virus, but Long COVID? That was something I didn’t even know existed until I connected with the Long COVID community. Before that, I was primarily concerned with the acute risks of COVID-19, diligently following precautions but unaware of the potential long-term consequences. My perspective began to shift when I stumbled upon Long COVID groups on Twitter. Suddenly, the world of post-viral syndromes opened up before me, revealing a reality far more complex and alarming than I had previously imagined.

Over the past year, my concern deepened, leading me to significantly increase my family’s protective measures. It was during the last six months that I truly grasped the magnitude of the danger we’re facing. This wasn’t just about avoiding an infection; it was about understanding the long-term implications of COVID-19 on our health, and the systemic risks that persist long after the initial illness has passed.

One of the most potent psychological forces at play here is cognitive dissonance, coupled with normalcy bias. Cognitive dissonance arises when we encounter information that contradicts our existing beliefs or behaviors, creating a psychological discomfort that we are compelled to resolve. Normalcy bias, on the other hand, is our tendency to underestimate the likelihood of a disaster and its potential impact, leading us to continue with life as usual, even in the face of clear and present dangers.

These forces were on full display during events like the Democratic and Republican conventions, where crowds gathered in packed venues, seemingly oblivious to the ongoing pandemic. Watching these events, I couldn’t help but feel a sense of unease, a tug-of-war within my mind between what I knew to be true and the images of “normal” life playing out on screen.

Even now, as I remain steadfast in my precautions, doubts occasionally creep in. Just a few days ago, I confided in one of the co-founders of the World Health Network about how I sometimes question myself. When I walk into public spaces and see people unmasked, living as though the pandemic is a thing of the past, I start to wonder: Am I the one out of touch? Have I been caught in an echo chamber, isolated from the broader reality? These thoughts persist, despite the fact that I’ve read hundreds of research papers on the subject, grounding my understanding in solid evidence that this issue is very real.

The realization that even I, with all my knowledge and vigilance, could fall prey to these doubts is deeply unsettling. But it also speaks to a larger truth about human nature. Our minds are not always rational, and we are often guided by deeply ingrained psychological patterns that can lead us astray.

This brings me to a popular phrase that has gained traction during the pandemic: FAFO, or "F**k Around and Find Out." While it’s often used to describe the consequences of reckless behavior, I’m beginning to think we should retire this expression. It’s not just about people making poor choices; it’s about understanding the complex, and often unconscious, ways in which the human mind works.

This perspective aligns with the views of Robert Sapolsky, a renowned neuroscientist, who argues that free will is an illusion—our actions are not truly autonomous but are instead the result of biological processes. If we accept this, it becomes clear that the widespread underestimation of COVID-19 and its long-term effects is not merely a failure of individual judgment, but a reflection of our collective human nature.

As we navigate the ongoing challenges of Long COVID, it’s crucial to recognize and address these psychological forces. By understanding how our minds work, we can better equip ourselves to face the harsh realities of this pandemic, and perhaps, find a path forward that is guided by knowledge, rather than by the comforting pull of normalcy.

Ignoring Won’t Work
Continuing to ignore the reality of Long COVID is not just a matter of personal risk—it's a collective gamble with the health of our entire society. The damage caused by this virus is multifaceted, impacting not just those who suffer from its acute phase, but potentially everyone who encounters it. We are living in a moment where our response to this crisis will determine not just our own futures, but the futures of countless others who might be silently struggling with the long-term consequences of infection.

The insidious nature of Long COVID means that many of its victims may not even realize they are affected until the damage has already been done. The symptoms can be subtle, creeping in gradually and manifesting in ways that are easy to dismiss or misattribute to other causes. Fatigue, brain fog, shortness of breath, and even heart issues—these are just some of the signs that may indicate the lingering presence of the virus or its aftermath within the body.

This underestimation of Long COVID’s potential to cause harm is why we urgently need to ramp up our efforts in several key areas. First and foremost, we must develop better diagnostics. Current testing methods are focused primarily on detecting active infection, but what about those who are suffering long after the initial illness has passed? We need sophisticated viral tests that can identify persistent infection or lingering viral fragments that may be contributing to ongoing symptoms. Without this capability, we’re essentially flying blind, unable to accurately gauge the full scope of the problem.

Urgent Need For Tests Like Viral Load Tests, etc.
Alongside diagnostics, there is an urgent need to develop effective antiviral treatments. The window of opportunity to treat COVID-19 has been largely focused on the acute phase, with little attention given to what happens after the initial infection. Yet, for many people, this is where the real battle begins. Antivirals that can target and neutralize the virus even months after infection could be a game-changer, preventing the progression of Long COVID and helping those already affected to recover more fully.

But developing these tools and treatments isn’t enough—we need to be vigilant and proactive in their deployment. This means not only making these resources widely available but also educating the public on their importance. The longer we delay, the more entrenched this problem will become. Long COVID is not going to go away on its own, and the consequences of inaction could be catastrophic.

Imagine, if you will, the growing burden on our healthcare system as more and more people develop chronic conditions as a result of this virus. The economic impact alone could be staggering, with millions unable to work, requiring long-term medical care, and facing reduced quality of life. And then there’s the emotional toll—families watching their loved ones suffer from an illness that was preventable, if only we had acted sooner.

ACT UP now!
We cannot afford to wait until this crisis reaches a tipping point. The time to act is now. Every day that we ignore the threat of Long COVID is a day that we lose in the fight to protect ourselves and our communities. It’s not just about avoiding infection today; it’s about safeguarding our future.

The phrase “It’s going to get worse before it gets better” has never rung truer. We are standing at a crossroads, and the path we choose will determine the trajectory of this pandemic. We can continue down the road of denial, normalcy bias, and cognitive dissonance, but that path leads to a future where we are overwhelmed by the very thing we chose to ignore.

Alternatively, we can choose a different path—one of awareness, preparation, and action. By investing in diagnostics, antivirals, and public education, we can mitigate the damage and prevent Long COVID from becoming an even greater public health crisis. This is a battle we cannot afford to lose, because the stakes are nothing less than our collective well-being.

In conclusion, while it may seem easier to look away, to hope for the best and return to life as it was, doing so is a dangerous gamble. We need to recognize the seriousness of Long COVID, take the necessary precautions, and push for the development of tools and treatments that will protect us all. The longer we ignore this issue, the more likely it is to come back and take us all—individually, and as a society. The time to act is now, before it’s too late.Image

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More from @Dave_it_up

Jun 23
Is their evidence for viral persistence in COVID-19?

From the meticulous work of the PolyBio Research Foundation, in collaboration with the esteemed halls of UC San Francisco and Harvard Medical School, to the robust findings published in Nature and The Lancet, we are presented with compelling evidence of the virus’s tenacity. 

These studies not only confirm the presence of viral proteins and RNA months after the acute phase of infection but also suggest a troubling link to the chronic, debilitating symptoms known as long COVID.

Let’s delve into some of the evidence for the evidence pointing to viral persistence of SARS-CoV-2, 

1. PolyBio Research Foundation Study
A study published by the PolyBio Research Foundation, supported by UC San Francisco and Harvard Medical School, found that viral proteins from SARS-CoV-2 could persist in the body for up to 14 months post-infection. This study used an ultra-sensitive blood test to detect viral proteins in 25% of the 171 participants, indicating that the virus can linger in tissues and organs long after recovery from the acute phase of the infection. The likelihood of detecting these proteins was higher among those who were hospitalized or reported severe symptoms during their initial infection[1].

2. Nature Study on Persistent SARS-CoV-2 RNA Shedding
A cohort study published in *Nature* identified persistent SARS-CoV-2 RNA shedding in individuals for at least 30 days, with some cases extending to 60 days. The study found that individuals with persistent infections had more than 50% higher odds of reporting long COVID symptoms compared to those with non-persistent infections. This suggests that persistent infections could contribute to the pathophysiology of long COVID, although the exact mechanisms remain to be fully understood[3].

3. NCBI Study on Long COVID and Viral Persistence
Research published on NCBI proposed a hypothesis-driven model for long COVID, suggesting that the persistence of SARS-CoV-2 or its components (such as the spike protein) could lead to chronic inflammation and a dysregulated immune response. This model is supported by evidence of viral RNA and antigens being detected in various tissues, including the cerebrospinal fluid and feces, months after the initial infection. The study highlights the potential for viral persistence to trigger long-term health issues[2].

4. Lancet Study on Viral Persistence in Tissues
A study published in *The Lancet* examined the persistence of SARS-CoV-2 in various tissues, including blood, gastrointestinal, and surgical samples. The research found that viral RNA and proteins could be detected in these tissues long after the acute phase of infection, suggesting that the virus can persist in different parts of the body and potentially contribute to ongoing symptoms and health complications[5].

5. NCBI Study on Viral Persistence and Reactivation
Another study on NCBI explored the persistence of viral RNA and antigens in patients with long COVID. It found that viral components could be detected in blood, stool, and urine, and that the presence of these components was associated with persistent symptoms. The study also noted that viral persistence might involve either active replication or the presence of non-replicating viral RNA, which could still trigger immune responses and inflammation[4].

The evidence from these studies collectively supports the notion that SARS-CoV-2 can persist in the body for extended periods, potentially leading to long-term health issues such as long COVID. This persistence can involve both active viral replication and the presence of viral components that continue to stimulate the immune system, leading to chronic inflammation and other symptoms. 

Further research should be done to put to rest this question of viral persistence and to develop effective treatments for long-term COVID.Image
Sources
[1] COVID-19 Virus Can Persist in the Body More Than a Year after ...
[2] Long COVID: A proposed hypothesis-driven model of viral ... - NCBI
[3] Prevalence of persistent SARS-CoV-2 in a large community ... - Nature
[4] Viral persistence, reactivation, and mechanisms of long COVID - NCBI
[5] The persistence of SARS-CoV-2 in tissues and its association with ... biospace.com/article/releas…
ncbi.nlm.nih.gov/pmc/articles/P…
nature.com/articles/s4158…
ncbi.nlm.nih.gov/pmc/articles/P…
thelancet.com/journals/lanin…
Someone just let me know that there are actually two more studies that are important. I will post them as soon as I get a hold of them.
Read 6 tweets
Dec 24, 2023
Similarities of HIV and Covid.

A study reveals that SARS-CoV-2 can infect human CD4+ T helper cells, impacting the immune response in severe COVID-19 cases. The virus uses the CD4 molecule to enter these cells, leading to functional impairment and cell death. This infection results in increased IL-10 production in T cells, associated with viral persistence and severe disease. The findings suggest that SARS-CoV-2 infection of CD4+ T cells contributes to immune dysfunction in COVID-19.

elifesciences.org/articles/84790
From Merk manual for healthcare professionals.
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Also thanks for graphic @dbdugger
Read 4 tweets

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