Many other people suffer from long COVID and other post-viral syndromes. Anthony Fauci says we want to increase investment and studies now
By Emily Mendenhall
Anthony Fauci, former director of the National Institute of Allergy and Infectious Diseases, White House press briefing, Nov. 22, 2022.
Tom Williams/CQ-Roll Call, Inc. Getty Images
The first user I met during a long COVID era was Kenton Kaplan, a student I mentored at Georgetown University. Without much warning, he called me in January 2022 to leave our departmental specialization program. During our verbal exchange over the next year and a half, he told me of debilitating fatigue, dizziness, and intense memory discrepancies. He and his doctors thought those symptoms were similar to a COVID infection he had likely contracted at a New Year’s Eve party.
Kaplan recovered and graduated with honors from Georgetown, but since I’ve met him, I’ve met many others with long COVID, a syndrome of neurological, psychological, and physical disorders that lasts long after the pathogenic virus, SARS-CoV-2, disappears. missing. As a medical anthropologist, I have been fascinated by this post-viral disease as a sociocultural and biological phenomenon. Millions of people seem to have it, though some fitness pros still say that postviral syndromes are “all in the head. “I think even I suffered in some form: several months after my first COVID infection, I suffered from anxiety, depression, and fatigue that eventually disappeared. I’ve spent many hours reflecting on long COVID and interviewing other people: patients. , caregivers, doctors, nurses, academics and policymakers, about their first-hand experiences.
One of the doctors I interviewed was Anthony Fauci, former director of the National Institute of Allergy and Infectious Diseases (NIAID). As part of the book I’m writing recently on controversial chronic diseases, we talked about post-viral ailments like long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and the challenge of perceiving our bodies after an infection has devastated it. I was surprised to be informed that post-viral ailments had been on the radar of suffering doctors for about 50 years and that early studies on those ailments had been abandoned as we struggled to perceive their causes.
Fauci and I met via Zoom. I was in time, if a little disheveled. He, however, piled up and waited for me, in a position to talk about the question of whether post-viral illnesses like long COVID are real.
Fauci told me how, when he arrived at the National Institutes of Health in 1968, he saw patients with an attractive “symptomatology,” as he called it: altered physical systems, from the brain to the intestine, through the kidneys, the heart, the blood, and guts. Nerves. He believes this might have been his first specific look at what we would first call chronic fatigue syndrome and occasionally ME/CFS. Half of people who have suffered from chronic fatigue for several months or years have also had one or more of the following diagnoses: infections, anemia, thyroid dysfunction, diabetes mellitus or cancer. And neuroscientists say symptoms like fatigue likely reflect a combination of many factors triggered by an event (such as SARS-CoV-2 infection) in other people with chronic stressors, trauma that irreversibly affects the body, or past infections that persist over time. through viral reservoirs (infected cells that do not actively produce viral particles).
Fauci told me: “This was before chronic fatigue syndrome. . . It even had a name. . . [People were very sick] as a result of infections that they perceived as viral. He said that at that time, they didn’t have the diagnoses that they we do today and that “certain facets of his habit and ability to serve were markedly compromised during different periods of time.
I found that this off-the-cuff comment stood out to me because it meant that ME/CFS activists have been suffering for at least five decades to gain popularity because of their disability, despite what medical anthropologist Emily Lim Rogers described in a 2022 article as the “double challenge”: other people with ME/CFS face “the stigma caused by a lack of biological verification and social acceptance” and do so “in a timely manner. ” exhausted bodies. “
Fauci said, however, that he and other medical scientists specializing in infectious diseases were temporarily thrust into the still-present global emergency of HIV/AIDS, leaving relatively less time and resources to devote to chronic, debilitating but not debilitating diseases. fatal. These diseases do not receive the attention they deserve and many other people suffer from them without the possibility of diagnosis, let alone cure.
We’re talking about more recent COVID cohort studies that seem to indicate that more women than men are affected by long COVID. “Maybe they’re more vulnerable to dysregulation of the immune reaction that long COVID triggers,” Fauci told me.
These gender trends don’t come as a surprise. In addition to long COVID and ME/CFS, chronic Lyme disease, multiple sclerosis, and autoimmune diseases like lupus, women are more prevalent. For centuries, women have been shunned, ignored, and punished for having a different view of our bodies compared to the dominant culture. This is most intense for women whose race, social class, gender, sexuality, nationality, employment status, etc. differ from your doctor’s. But this evidence simply cannot be ignored.
Because long COVID is described as a neurological disease, one concept that intrigues me is the vagal nerves. These are to blame for many of our body’s automatic functions, such as breathing, standing, and calming. Mike VanElzakker, a neuroscientist at Harvard Medical School, has argued that SARS-CoV-2 could possibly be tricking the immune reaction by binding to this bundle of nerves, tricking the body into believing it is under attack when in fact it is relatively healthy. This would mean that the calming action of the vagal nerves is delayed, so the panic, central palpitations and constant anxiety that many other people have described to me become important. Certainly, more studies on women’s nervous systems and the interplay of immunology, neurology, and anthropology are imperative.
A lingering question is whether long COVID and ME/CFS are the same thing. Fauci noted that what differentiates long COVID from ME/CFS, even when the symptoms are the same, is the presence of an expressed virus and the knowledge of when the infection occurred. He told me that historically, we did not have the ability to identify which infectious agent had caused a user’s ME/CFS. We possibly would have gone to see what antibodies a user had against other viruses, but we never knew precisely. when the infectious occasion occurred, so we could not say with certainty what had caused the user’s illness.
Finally, Fauci pressed me on how vital it is to do more studies on post-viral syndromes and, in particular, on how long COVID affects other people differently. He told me, “There’s going to be an organization of other people who, somehow, or another. . . You will have a genetic predisposition, just as you have a genetic predisposition to diabetes, rheumatoid arthritis, or lupus. . . When [these other people] get a viral infection, [various purposes and organ systems] are dysregulated.
But the key, he said, would be the kind of long-term, multi-year investment that doesn’t necessarily count on the end results of the renovation — the kind of investment that has existed in the afterlife and that, as long as the paintings were good, he said, the researcher’s paintings would be safe. We explained that existing investment structures don’t actually allow for this kind of open-ended research.
I was amazed throughout the interview by Fauci’s candor. During the pandemic, it seemed like every single word he said was interpreted with a political connotation. I almost laughed when he casually said near the end, “I’m just giving you my clinical opinion about my experience as a specialist in immunology, virology, and infectious diseases. “”After serving NIAID for five decades, advising seven presidents, leading the country through several pandemics, and setting the bar higher than what a clinical leader can do, I believe with your words we can now put an end to the question of whether it was a long time ago. COVID is sustainable, real.
This is an opinion and research article, and the reviews expressed through the authors are not necessarily those of Scientific American.
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