Long COVID is real. Now the evidence is piling up
Finally, the hunt for answers about long COVID is yielding some clues. A new study, led by the Icahn School of Medicine at Mount Sinai and the Yale School of Medicine and published in Nature, defines some critical differences in certain biomarkers of people with long COVID. The next step is even more critical: coming up with a way to cure them.
A massive number of people in the U.S. are dealing with lingering symptoms. Two new reports this week from the Centers for Disease Control and Prevention found that in 2022, some 18 million adults said they had ever had long COVID, with about
8.8 million currently suffering from the condition. In that time, roughly 1 million children had been affected — with about 360,000 children reporting an ongoing case.
Those millions of people don’t all have the same symptoms — some experience brain fog and extreme fatigue, while others may have shortness of breath or a racing pulse — and their susceptibility to the disease is formed by a likely long list of factors. Those could include their medical histories, their previous vaccinations, prior infections, and even their genes.
Because of that, long COVID has defied simple explanations. And so far, doctors must base their diagnoses on sometimes vague symptoms, rather than on a molecule that can be measured, or a true biomarker of the disease. “Everyone wants a single biomarker, everyone wants a single treatment,” says David Putrino, director of rehabilitation innovation for the Mount Sinai Health System. “That’s not realistic for long COVID.”
A more realistic hope is that researchers can one day offer physicians a kind of “how to” manual for long COVID with a battery of tests to pinpoint what’s gone wrong and, ideally, treatments. The new study is an important step towards that goal, and should offer patients needed hope that answers could be on the way.
In what the researchers believe is a first, they did a detailed study of the differences between people with long COVID and those who are healthy (a mix of those who never had COVID and those who recovered from their infection). They wisely excluded anyone who had been hospitalized with COVID, so as not to confuse explainable lingering symptoms—for example, those caused by lung damage following a week of intubation — with the more mysterious ones that follow a mild infection.
Cory — “richer than a king” and “admirably schooled in every grace” — “put a bullet through his head”? (For generations, English majors have confronted that conundrum. Simon and Garfunkel wrote a song about it.)
As you would expect from a philosopher, Martin cites great thinkers as he puzzles out why some people are bent on self-destruction, either by addiction or other harmful behaviors, which he calls “parasuicidal,” or by suicide itself.
“Thinking about killing oneself and addictive thinking have a lot more in common than is normally recognized,” Martin writes.
“Wanting to kill yourself is like an extreme version of the relief you find after drinking a few glasses of wine, and the pungent smell of yourself seems to drift off into the breeze . ... This theory is really just an elaboration of the Buddha’s idea that the desire for self-annihilation is among our most basic forms of suffering, or Freud’s idea that the desire for life and the desire for death are two sides of the same coin.”
I was not surprised to learn that women try to kill themselves three times more often than men, but men succeed more often than women because they tend to use guns.
But I did not expect to learn that middle-aged white men are the American demographic group most at risk for suicide, or that Black women are the group least likely to kill themselves.
Given the life challenges of Black women, their low suicide rate is often referred to as a paradox. To explain it, Martin quotes from the memoir of Pulitzer Prize-winning cultural critic Margo Jefferson: “One white female privilege had been withheld from the girls of Negroland. They had been denied the privilege of freely yielding to depression.” I don’t know who first said that suicide is a permanent solution to a temporary problem (credit often goes to Phil Donahue), but it’s an aphorism that has stuck with me, and something I have shared with many a depressed loved one over the years, without realizing that many thoughtful people think it’s an extremely unhelpful thing to tell a desperate person who may well be looking for a permanent solution to their pain, which is not temporary.
And that, in essence, brings me to Martin’s ultimate advice about how to stay alive. It’s his version of the Stoics’ argument that “the door is always open.”
Yes, the Stoics say, you have the absolute right to kill yourself, but don’t walk through that door just yet.
“After all,” Martin writes, “you can always kill yourself tomorrow. Take a breath, get some space: tomorrow isn’t here yet. And maybe you’ll find you can get through today.”