Why scrapping the term ‘long COVID’ would be harmful for people with the condition
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The assertion from Queensland’s chief health officer John Gerrard that it’s time to stop using the term “long COVID” has made waves in Australian and international media over recent days.
Gerrard’s comments were related to new research from his team finding long-term symptoms of COVID are similar to the ongoing symptoms following other viral infections.
But there are limitations in this research, and problems with Gerrard’s argument we should drop the term “long COVID”. Here’s why.
A bit about the research
The study involved texting a survey to 5,112 Queensland adults who had experienced respiratory symptoms and had sought a PCR test in 2022. Respondents were contacted 12 months after the PCR test. Some had tested positive to COVID, while others had tested positive to influenza or had not tested positive to either disease.
Survey respondents were asked if they had experienced ongoing symptoms or any functional impairment over the previous year.
The study found people with respiratory symptoms can suffer long-term symptoms and impairment, regardless of whether they had COVID, influenza or another respiratory disease. These symptoms are often referred to as “post-viral”, as they linger after a viral infection.
Gerrard’s research will be presented in April at the European Congress of Clinical Microbiology and Infectious Diseases. It hasn’t been published in a peer-reviewed journal.
After the research was publicised last Friday, some experts highlighted flaws in the study design. For example, Steven Faux, a long COVID clinician interviewed on ABC’s television news, said the study excluded people who were hospitalised with COVID (therefore leaving out people who had the most severe symptoms). He also noted differing levels of vaccination against COVID and influenza may have influenced the findings.
In addition, Faux pointed out the survey would have excluded many older people who may not use smartphones.
The authors of the research have acknowledged some of these and other limitations in their study.
Ditching the term ‘long COVID’
Based on the research findings, Gerrard said in a press release:
We believe it is time to stop using terms like ‘long COVID’. They wrongly imply there is something unique and exceptional about longer term symptoms associated with this virus. This terminology can cause unnecessary fear, and in some cases, hypervigilance to longer symptoms that can impede recovery.
But Gerrard and his team’s findings cannot substantiate these assertions. Their survey only documented symptoms and impairment after respiratory infections. It didn’t ask people how fearful they were, or whether a term such as long COVID made them especially vigilant, for example.
New Africa/Shutterstock
In discussing Gerrard’s conclusions about the terminology, Faux noted that even if only 3% of people develop long COVID (the survey found 3% of people had functional limitations after a year), this would equate to some 150,000 Queenslanders with the condition. He said:
To suggest that by not calling it long COVID you would be […] somehow helping those people not to focus on their symptoms is a curious conclusion from that study.
Another clinician and researcher, Philip Britton, criticised Gerrard’s conclusion about the language as “overstated and potentially unhelpful”. He noted the term “long COVID” is recognised by the World Health Organization as a valid description of the condition.
A cruel irony
An ever-growing body of research continues to show how COVID can cause harm to the body across organ systems and cells.
We know from the experiences shared by people with long COVID that the condition can be highly disabling, preventing them from engaging in study or paid work. It can also harm relationships with their friends, family members, and even their partners.
Despite all this, people with long COVID have often felt gaslit and unheard. When seeking treatment from health-care professionals, many people with long COVID report they have been dismissed or turned away.
Last Friday – the day Gerrard’s comments were made public – was actually International Long COVID Awareness Day, organised by activists to draw attention to the condition.
The response from people with long COVID was immediate. They shared their anger on social media about Gerrard’s comments, especially their timing, on a day designed to generate greater recognition for their illness.
Since the start of the COVID pandemic, patient communities have fought for recognition of the long-term symptoms many people faced.
The term “long COVID” was in fact coined by people suffering persistent symptoms after a COVID infection, who were seeking words to describe what they were going through.
The role people with long COVID have played in defining their condition and bringing medical and public attention to it demonstrates the possibilities of patient-led expertise. For decades, people with invisible or “silent” conditions such as ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) have had to fight ignorance from health-care professionals and stigma from others in their lives. They have often been told their disabling symptoms are psychosomatic.
Gerrard’s comments, and the media’s amplification of them, repudiates the term “long COVID” that community members have chosen to give their condition an identity and support each other. This is likely to cause distress and exacerbate feelings of abandonment.
Terminology matters
The words we use to describe illnesses and conditions are incredibly powerful. Naming a new condition is a step towards better recognition of people’s suffering, and hopefully, better diagnosis, health care, treatment and acceptance by others.
The term “long COVID” provides an easily understandable label to convey patients’ experiences to others. It is well known to the public. It has been routinely used in news media reporting and and in many reputable medical journal articles.
Most importantly, scrapping the label would further marginalise a large group of people with a chronic illness who have often been left to struggle behind closed doors.
Deborah Lupton, SHARP Professor, Vitalities Lab, Centre for Social Research in Health and Social Policy Centre, and the ARC Centre of Excellence for Automated Decision-Making and Society, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Women take more antidepressants after divorce than men but that doesn’t mean they’re more depressed
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Research out today from Finland suggests women may find it harder to adjust to later-life divorce and break-ups than men.
The study used population data from 229,000 Finns aged 50 to 70 who had undergone divorce, relationship break-up or bereavement and tracked their use of antidepressants before and after their relationship ended.
They found antidepressant use increased in the four years leading to the relationship dissolution in both genders, with women experiencing a more significant increase.
But it’s too simplistic to say women experience poorer mental health or tend to be less happy after divorce than men.
Remind me, how common is divorce?
Just under 50,000 divorces are granted each year in Australia. This has slowly declined since the 1990s.
More couple are choosing to co-habitate, instead of marry, and the majority of couples live together prior to marriage. Divorce statistics don’t include separations of cohabiting couples, even though they are more likely than married couples to separate.
Those who divorce are doing so later in life, often after their children grow up. The median age of divorce increased from 45.9 in 2021 to 46.7 in 2022 for men and from 43.0 to 43.7 for women.
The trend of late divorces also reflects people deciding to marry later in life. The median duration from marriage to divorce in 2022 was around 12.8 years and has remained fairly constant over the past decade.
Why do couples get divorced?
Changes in social attitudes towards marriage and relationships mean divorce is now more accepted. People are opting not to be in unhappy marriages, even if there are children involved.
Instead, they’re turning the focus on marriage quality. This is particularly true for women who have established a career and are financially autonomous.
Similarly, my research shows it’s particularly important for people to feel their relationship expectations can be fulfilled long term. In addition to relationship quality, participants reported needing trust, open communication, safety and acceptance from their partners.
“Grey divorce” (divorce at age 50 and older) is becoming increasingly common in Western countries, particularly among high-income populations. While factors such as an empty nest, retirement, or poor health are commonly cited predictors of later-in-life divorce, research shows older couples divorce for the same reasons as younger couples.
What did the new study find?
The study tracked antidepressant use in Finns aged 50 to 70 for four years before their relationship breakdown and four years after.
They found antidepressant use increased in the four years leading to the relationship break-up in both genders. The proportion of women taking antidepressants in the lead up to divorce increased by 7%, compared with 5% for men. For de facto separation antidepressant use increased by 6% for women and 3.2% for men.
Within a year of the break-up, antidepressant use fell back to the level it was 12 months before the break-up. It subsequently remained at that level among the men.
But it was a different story for women. Their use tailed off only slightly immediately after the relationship breakdown but increased again from the first year onwards.
Women’s antidepressant use increased again.
sk/UnsplashThe researchers also looked at antidepressant use after re-partnering. There was a decline in the use of antidepressants for men and women after starting a new relationship. But this decline was short-lived for women.
But there’s more to the story
Although this data alone suggest women may find it harder to adjust to later-life divorce and break-ups than men, it’s important to note some nuances in the interpretation of this data.
For instance, data suggesting women experience depression more often than men is generally based on the rate of diagnoses and antidepressant use, which does not account for undiagnosed and unmedicated people.
Women are generally more likely to access medical services and thus receive treatment. This is also the case in Australia, where in 2020–2022, 21.6% of women saw a health professional for their mental health, compared with only 12.9% of men.
Why women might struggle more after separating
Nevertheless, relationship dissolution can have a significant impact on people’s mental health. This is particularly the case for women with young children and older women.
So what factors might explain why women might experience greater difficulties after divorce later in life?
Research investigating the financial consequences of grey divorce in men and women showed women experienced a 45% decline in their standard of living (measured by an income-to-needs ratio), whereas men’s dropped by just 21%. These declines persisted over time for men, and only reversed for women following re-partnering.
Another qualitative study investigating the lived experiences of heterosexual couples post-grey divorce identified financial worries as a common theme between female participants.
A female research participant (age 68) said:
[I am most worried about] the money, [and] what I’m going to do when the little bit of money I have runs out […] I have just enough money to live. And, that’s it, [and if] anything happens I’m up a creek. And Medicare is incredibly expensive […] My biggest expense is medicine.
Another factor was loneliness. One male research participant (age 54) described he preferred living with his ex-wife, despite not getting along with her, than being by himself:
It was still [good] knowing that [the] person was there, and now that’s gone.
Other major complications of later-life divorce are possible issues with inheritance rights and next-of-kin relationships for medical decision-making.
Separation can be positive
For some people, divorce or separation can lead to increased happiness and feeling more independent.
And the mental health impact and emotional distress of a relationship dissolution is something that can be counterattacked with resilience. Resilience to dramatic events built from life experience means older adults often do respond better to emotional distress and might be able to adjust better to divorce than their younger counterparts.
Raquel Peel, Adjunct Senior Lecturer, University of Southern Queensland and Senior Lecturer, RMIT University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Yoga For Stiff Birds – by Marion Deuchars
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Quick show of hands, who here practices yoga in some fashion, but does not necessarily always look Instagrammable while doing it? Yep, same here.
This book is a surprisingly practical introduction to yoga for newcomers, and inspirational motivator for those of us who feel like we should do more.
Rather than studio photography of young models in skimpy attire, popular artist (and well-practised yogi) Marion Deuchars offers in a few brushstrokes what we need to know for each asana, and how to approach it if we’re not so supple yet as we’d like to be.
Bottom line: whether for yourself or as a gift for a loved one (or both!) this is a very charming introduction to (or refresher of) yoga.
Click here to check out Yoga For Stiff Birds, and get yours going!
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Radical Remission – by Dr. Kelly Turner
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First, what this is not:an autobiographical account of the “I beat cancer and you can too” pep-talk style.
What it is: a very readable pop-science book based on the author’s own PhD research into radical remission.
She knew that a very small percentage of people experience spontaneous radical remission (or quasi-spontaneous, if the remission is attributed to lifestyle changes, and/or some alternative therapy), but a small percentage of people means a large number worldwide, so she travelled the world studying over 1,000 cases of people with late-stage cancer who had either not gone for conventional anticancer drugs, or had and then stopped, and lived to tell the tale.
While she doesn’t advocate for any particular alternative therapy, she does report on what things came to her attention. She does advocate for some lifestyle changes.
Perhaps the biggest value this book offers is in its promised “9 key factors that can make a real difference”, which are essentially her conclusions from her PhD dissertation.
There isn’t room to talk about them here in a way that wouldn’t be misleading/unhelpful for a paucity of space, so perhaps we’ll do a main feature one of these days.
Bottom line: if you have (or a loved one has) cancer, this is an incredibly sensible book to read. If you don’t, then it’s an interesting and thought-provoking book to read.
Click here to check out Radical Remission, and learn about the factors at hand!
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Syringe Exchange Fears Hobble Fight Against West Virginia HIV Outbreak
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CHARLESTON, http://w.va/. — More than three years have passed since federal health officials arrived in central Appalachia to assess an alarming outbreak of HIV spread mostly between people who inject opioids or methamphetamine.
Infectious disease experts from the Centers for Disease Control and Prevention made a list of recommendations following their visit, including one to launch syringe service programs to stop the spread at its source. But those who’ve spent years striving to protect people who use drugs from overdose and illness say the situation likely hasn’t improved, in part because of politicians who contend that such programs encourage illegal drug use.
Joe Solomon is a Charleston City Council member and co-director of SOAR WV, a group that works to address the health needs of people who use drugs. He’s proud of how his close-knit community has risen to this challenge but frustrated with the restraints on its efforts.
“You see a city and a county willing to get to work at a scale that’s bigger than ever before,” Solomon said, “but we still have one hand tied behind our back.”
The hand he references is easier access to clean syringes.
In April 2021, the CDC came to Charleston — the seat of Kanawha County and the state capital, tucked into the confluence of the Kanawha and Elk rivers — to investigate dozens of newly detected HIV infections. The CDC’s HIV intervention chief called it “the most concerning HIV outbreak in the United States” and warned that the number of reported diagnoses could be just “the tip of the iceberg.”
Now, despite attention and resources directed toward the outbreak, researchers and health workers say HIV continues to spread. In large part, they say, the outbreak lingers because of restrictions state and local policymakers have placed on syringe exchange efforts.
Research indicates that syringe service programs are associated with an estimated 50% reduction in HIV and hepatitis C, and the CDC issued recommendations to steer a response to the outbreak that emphasized the need for improved access to those services.
That advice has thus far gone unheeded by local officials.
In late 2015, the Kanawha-Charleston Health Department launched a syringe service program but shuttered it in 2018 under pressure, with then-Mayor Danny Jones calling it a “mini-mall for junkies and drug dealers.”
SOAR stepped in, hosting health fairs at which it distributed naloxone, an opioid overdose reversal drug; offered treatment and referrals; provided HIV testing; and exchanged clean syringes for used ones.
But in April 2021, the state legislature passed a bill limiting the number of syringes people could exchange and made it mandatory to present a West Virginia ID. The Charleston City Council subsequently added guidelines of its own, including requiring individual labeling of syringes.
As a result of these restrictions, SOAR ceased exchanging syringes. West Virginia Health Right now operates an exchange program in the city under the restrictions.
Robin Pollini is a West Virginia University epidemiologist who conducts community-based research on injection drug use. “Anyone I’ve talked to who’s used that program only used it once,” she said. “And the numbers they report to the state bear that out.”
A syringe exchange run by the health department in nearby Cabell County — home to Huntington, the state’s largest city after Charleston — isn’t so constrained. As Solomon notes, that program exchanges more than 200 syringes for every one exchanged in Kanawha.
A common complaint about syringe programs is that they result in discarded syringes in public spaces. Jan Rader, director of Huntington’s Mayor’s Office of Public Health and Drug Control Policy, is regularly out on the streets and said she seldom encounters discarded syringes, pointing out that it’s necessary to exchange a used syringe for a new one.
In August 2023, the Charleston City Council voted down a proposal from the Women’s Health Center of West Virginia to operate a syringe exchange in the city’s West Side community, with opponents expressing fears of an increase in drug use and crime.
Pollini said it’s difficult to estimate the number of people in West Virginia with HIV because there’s no coordinated strategy for testing; all efforts are localized.
“You would think that in a state that had the worst HIV outbreak in the country,” she said, “by this time we would have a statewide testing strategy.”
In addition to the testing SOAR conducted in 2021 at its health fairs, there was extensive testing during the CDC’s investigation. Since then, the reported number of HIV cases in Kanawha County has dropped, Pollini said, but it’s difficult to know if that’s the result of getting the problem under control or the result of limited testing in high-risk groups.
“My inclination is the latter,” she said, “because never in history has there been an outbreak of injection-related HIV among people who use drugs that was solved without expanding syringe services programs.”
“If you go out and look for infections,” Pollini said, “you will find them.”
Solomon and Pollini praised the ongoing outreach efforts — through riverside encampments, in abandoned houses, down county roads — of the Ryan White HIV/AIDS Program to test those at highest risk: people known to be injecting drugs.
“It’s miracle-level work,” Solomon said.
But Christine Teague, Ryan White Program director at the Charleston Area Medical Center, acknowledged it hasn’t been enough. In addition to HIV, her concerns include the high incidence of hepatitis C and endocarditis, a life-threatening inflammation of the lining of the heart’s chambers and valves, and the cost of hospital resources needed to address them.
“We’ve presented that data to the legislature,” she said, “that it’s not just HIV, it’s all these other lengthy hospital admissions that, essentially, Medicaid is paying for. And nothing seems to penetrate.”
Frank Annie is a researcher at CAMC specializing in cardiovascular diseases, a member of the Charleston City Council, and a proponent of syringe service programs. Research he co-authored found 462 cases of endocarditis in southern West Virginia associated with injection drug use, at a cost to federal, state, and private insurers of more than $17 million, of which less than $4 million was recovered.
Teague is further concerned for West Virginia’s rural counties, most of which don’t have a syringe service program.
Tasha Withrow, a harm reduction advocate in bordering rural Putnam County, said her sense is that HIV numbers aren’t alarmingly high there but said that, with little testing and heightened stigma in a rural community, it’s difficult to know.
In a January 2022 follow-up report, the CDC recommended increasing access to harm reduction services such as syringe service programs through expansion of mobile services, street outreach, and telehealth, using “patient-trusted” individuals, to improve the delivery of essential services to people who use drugs.
Teague would like every rural county to have a mobile unit, like the one operated by her organization, offering harm reduction supplies, medication, behavioral health care, counseling, referrals, and more. That’s an expensive undertaking. She suggested opioid settlement money through the West Virginia First Foundation could pay for it.
Pollini said she hopes state and local officials allow the experts to do their jobs.
“I would like to see them allow us to follow the science and operate these programs the way they’re supposed to be run, and in a broader geography,” she said. “Which means that it shouldn’t be a political decision; it should be a public health decision.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
This article first appeared on KFF Health News and is republished here under a Creative Commons license.
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Is stress turning my hair grey?
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When we start to go grey depends a lot on genetics.
Your first grey hairs usually appear anywhere between your twenties and fifties. For men, grey hairs normally start at the temples and sideburns. Women tend to start greying on the hairline, especially at the front.
The most rapid greying usually happens between ages 50 and 60. But does anything we do speed up the process? And is there anything we can do to slow it down?
You’ve probably heard that plucking, dyeing and stress can make your hair go grey – and that redheads don’t. Here’s what the science says.
Oksana Klymenko/Shutterstock What gives hair its colour?
Each strand of hair is produced by a hair follicle, a tunnel-like opening in your skin. Follicles contain two different kinds of stem cells:
- keratinocytes, which produce keratin, the protein that makes and regenerates hair strands
- melanocytes, which produce melanin, the pigment that colours your hair and skin.
There are two main types of melanin that determine hair colour. Eumelanin is a black-brown pigment and pheomelanin is a red-yellow pigment.
The amount of the different pigments determines hair colour. Black and brown hair has mostly eumelanin, red hair has the most pheomelanin, and blonde hair has just a small amount of both.
So what makes our hair turn grey?
As we age, it’s normal for cells to become less active. In the hair follicle, this means stem cells produce less melanin – turning our hair grey – and less keratin, causing hair thinning and loss.
As less melanin is produced, there is less pigment to give the hair its colour. Grey hair has very little melanin, while white hair has none left.
Unpigmented hair looks grey, white or silver because light reflects off the keratin, which is pale yellow.
Grey hair is thicker, coarser and stiffer than hair with pigment. This is because the shape of the hair follicle becomes irregular as the stem cells change with age.
Interestingly, grey hair also grows faster than pigmented hair, but it uses more energy in the process.
Can stress turn our hair grey?
Yes, stress can cause your hair to turn grey. This happens when oxidative stress damages hair follicles and stem cells and stops them producing melanin.
Oxidative stress is an imbalance of too many damaging free radical chemicals and not enough protective antioxidant chemicals in the body. It can be caused by psychological or emotional stress as well as autoimmune diseases.
Environmental factors such as exposure to UV and pollution, as well as smoking and some drugs, can also play a role.
Melanocytes are more susceptible to damage than keratinocytes because of the complex steps in melanin production. This explains why ageing and stress usually cause hair greying before hair loss.
Scientists have been able to link less pigmented sections of a hair strand to stressful events in a person’s life. In younger people, whose stems cells still produced melanin, colour returned to the hair after the stressful event passed.
4 popular ideas about grey hair – and what science says
1. Does plucking a grey hair make more grow back in its place?
No. When you pluck a hair, you might notice a small bulb at the end that was attached to your scalp. This is the root. It grows from the hair follicle.
Plucking a hair pulls the root out of the follicle. But the follicle itself is the opening in your skin and can’t be plucked out. Each hair follicle can only grow a single hair.
It’s possible frequent plucking could make your hair grey earlier, if the cells that produce melanin are damaged or exhausted from too much regrowth.
2. Can my hair can turn grey overnight?
Legend says Marie Antoinette’s hair went completely white the night before the French queen faced the guillotine – but this is a myth.
It is not possible for hair to turn grey overnight, as in the legend about Marie Antoinette. Yann Caradec/Wikimedia, CC BY-NC-SA Melanin in hair strands is chemically stable, meaning it can’t transform instantly.
Acute psychological stress does rapidly deplete melanocyte stem cells in mice. But the effect doesn’t show up immediately. Instead, grey hair becomes visible as the strand grows – at a rate of about 1 cm per month.
Not all hair is in the growing phase at any one time, meaning it can’t all go grey at the same time.
3. Will dyeing make my hair go grey faster?
This depends on the dye.
Temporary and semi-permanent dyes should not cause early greying because they just coat the hair strand without changing its structure. But permanent products cause a chemical reaction with the hair, using an oxidising agent such as hydrogen peroxide.
Accumulation of hydrogen peroxide and other hair dye chemicals in the hair follicle can damage melanocytes and keratinocytes, which can cause greying and hair loss.
4. Is it true redheads don’t go grey?
People with red hair also lose melanin as they age, but differently to those with black or brown hair.
This is because the red-yellow and black-brown pigments are chemically different.
Producing the brown-black pigment eumelanin is more complex and takes more energy, making it more susceptible to damage.
Producing the red-yellow pigment (pheomelanin) causes less oxidative stress, and is more simple. This means it is easier for stem cells to continue to produce pheomelanin, even as they reduce their activity with ageing.
With ageing, red hair tends to fade into strawberry blonde and silvery-white. Grey colour is due to less eumelanin activity, so is more common in those with black and brown hair.
Your genetics determine when you’ll start going grey. But you may be able to avoid premature greying by staying healthy, reducing stress and avoiding smoking, too much alcohol and UV exposure.
Eating a healthy diet may also help because vitamin B12, copper, iron, calcium and zinc all influence melanin production and hair pigmentation.
Theresa Larkin, Associate Professor of Medical Sciences, University of Wollongong
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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6-Minute Core Strength – by Dr. Jonathan Su
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We don’t normally do author biographies here, but in this case it’s worth noting that Dr. Su is a physiotherapist, military rehab expert, and an IAYT yoga therapist. So, these things together certainly do lend weight to his advice.
About the “6-minute” thing: this is in the style of the famous “7-minute workout” and “5 Minutes’ Physical Fitness” etc, and refers to how long each exercise session should take. The baseline is one such session per day, though of course doing more than one set of 6 minutes each time is a bonus if you wish to do so.
The exercises are focused on core strength, but they also include hip and shoulder exercises, since these are after all attached to the core, and hip and shoulder mobility counts for a lot.
A particular strength of the book is in troubleshooting mistakes of the kind that aren’t necessarily visible from photos; in this case, Dr. Su explains what you need to go for in a certain exercise, and how to know if you are doing it correctly. This alone is worth the cost of the book, in this reviewer’s opinion.
Bottom line: if you want core strength and want it simple yet comprehensive, this book can guide you.
Click here to check out 6-Minute Core Strength, and strengthen yours!
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