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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4 ways to cut down on meat when dining out – and still make healthy choices
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Many of us are looking for ways to eat a healthier and more sustainable diet. And one way to do this is by reducing the amount of meat we eat.
That doesn’t mean you need to become a vegan or vegetarian. Our recent research shows even small changes to cut down on meat consumption could help improve health and wellbeing.
But not all plant-based options are created equal and some are ultra-processed. Navigating what’s available when eating out – including options like tofu and fake meats – can be a challenge.
So what are your best options at a cafe or restaurant? Here are some guiding principles to keep in mind when cutting down on meat.
Mikhaylovskiy/Shutterstock Health benefits to cutting down
Small amounts of lean meat can be part of a healthy, balanced diet. But the majority of Australians still eat more meat than recommended.
Only a small percentage of Australians (10%) are vegetarian or vegan. But an increasing number opt for a flexitarian diet. Flexitarians eat a diet rich in fruits and vegetables, while still enjoying small amounts of meat, dairy, eggs and fish.
Our recent research looked at whether the average Australian diet would improve if we swapped meat and dairy for plant-based alternatives, and the results were promising.
The study found health benefits when people halved the amount of meat and dairy they ate and replaced them with healthy plant-based foods, like tofu or legumes. On average, their dietary fibre intake – which helps with feeling fuller for longer and digestive health – went up. Saturated fats – which increase our blood cholesterol levels, a risk factor for heart disease – went down.
Including more fibre and less saturated fat helps reduce the risk of heart disease.
Achieving these health benefits may be as simple as swapping ham for baked beans in a toastie for lunch, or substituting half of the mince in your bolognese for lentils at dinner.
Filling your plate with fibre-rich foods can help lower cholesterol. Wally Pruss/Shutterstock How it’s made matters
For a long time we’ve known processed meats – such as ham, bacon and sausages – are bad for your health. Eating high amounts of these foods is associated with poor heart health and some forms of cancer.
But the same can be true of many processed meat alternatives.
Plant-based alternatives designed to mimic meat, such as sausages and burgers, have become readily available in supermarkets, cafes and restaurants. These products are ultra-processed and can be high in salt and saturated fat.
Our study found when people replaced meat and dairy with ultra-processed meat alternatives – such as plant-based burgers or sausages – they ate more salt and less calcium, compared to eating meat or healthy plant-based options.
So if you’re cutting down on meat for health reasons, it’s important to think about what you’re replacing it with. The Australian Dietary Guidelines recommend eggs, legumes/beans, tofu, nuts and seeds.
Tofu can be a great option. But we recommend flavouring plain tofu with herbs and spices yourself, as pre-marinated products are often ultra-processed and can be high in salt.
What about when dining out?
When you’re making your own food, it’s easier to adapt recipes or reduce the amount of meat. But when faced with a menu, it can be difficult to work out what is the best option.
Eating a range of colours is one way to ensure variety. Mikhail Nilov/Pexels Here are our four ways to make healthy choices when you eat out:
1. Fill half your plate with vegetables
When cutting down on meat, aim for half your plate to be vegetables. Try to also eat a variety of colours, such as leafy green spinach, red capsicum and pumpkin.
When you’re out, this might look like choosing a vegetable-based entree, a stir-fry or ordering a side salad to have with your meal.
2. Avoid the deep fryer
The Australian Dietary Guidelines recommend limiting deep fried foods to once a week or less. When dining out, choose plant-based options that are sautéed, grilled, baked, steamed, boiled or poached – instead of those that are crumbed or battered before deep frying.
This could mean choosing vegetarian dumplings that are steamed not fried, or poached eggs at brunch instead of fried. Ordering a side of roast vegetables instead of hot chips is also a great option.
3. Pick wholegrains
Scan the menu for wholegrain options such as brown rice, wholemeal pizza or pasta, barley, quinoa or wholemeal burger buns. Not only are they good sources of protein, but they also provide more dietary fibre than refined grains, which help keep you fuller for longer.
4. If you do pick meat – choose less processed kinds
You may not always want, or be able, to make a vegetarian choice when eating out and with other people. If you do opt for meat, it’s better to steer clear of processed options like bacon or sausages.
If sharing dishes with other people, you could try adding unprocessed plant-based options into the mix. For example, a curry with lentils or chickpeas, or a vegetable-based pizza instead of one with ham or salami. If that’s not an option, try choose meat that’s a lean cut, such as chicken breast, or options which are grilled rather than fried.
Laura Marchese, PhD candidate at the Institute for Physical Activity and Nutrition, Deakin University and Katherine Livingstone, NHMRC Emerging Leadership Fellow and Senior Research Fellow at the Institute for Physical Activity and Nutrition, Deakin University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Calm For Surgery – by Dr Chris Bonney
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As a general rule of thumb, nobody likes having surgery. We may like the results of the surgery, we may like having the surgery done and behind us, but surgery itself is not most people’s idea of fun, and honestly, the recovery period afterwards can be a pain in every sense of the word.
Dr. Chris Bonney, an anesthesiologist, gives us the industry-secrets low-down, and is the voice of experience when it comes to the things to know about and/or prepare in advance—the little things that make a world of difference to your in-hospital experience and afterwards.
Think of it like “frequent flyer traveller tips” but for surgeries, whereupon knowing a given tip can mean the difference between deeply traumatic suffering and merely not being at your usual best. We think that’s worth it.
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5 Steps To Beat Overwhelm
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Dealing With Overwhelm
Whether we live a hectic life in general, or we usually casually take each day as it comes but sometimes several days gang up on us at once, everyone gets overwhelmed sometimes.
Today we’re going to look at how to deal with it healthily.
Step 1: Start anywhere
It’s easy to get stuck in “analysis paralysis” and not know how to tackle an unexpected large problem. An (unhealthy) alternative is to try to tackle everything at once, and end up doing nothing very well.
Even the most expert juggler will not successfully juggle 10 random things thrown unexpectedly at them.
So instead, just pick any part of the the mountain of to-dos, and start.
If you do want a little more finesse though, check out:
Procrastination, And How To Pay Off The To-Do List Debt
Step 2: Accept what you’re capable of
This one works both ways. It means being aware of your limitations yes, but also, of your actual abilities:
- Is the task ahead of you really beyond what you are capable of?
- Could you do it right now without hesitation if a loved one’s life depended on it?
- Could you do it, but there’s a price to pay (e.g. you can do it but it’ll wipe you out in some other life area)?
Work out what’s possible and acceptable to you, and make a decision. And remember, it could be that someone else could do it, but everyone has taken the “if you want something doing, give it to someone busy” approach. It’s flattering that people have such confidence in our competence, but it is also necessary to say “no” sometimes, or at least enlisting help.
Step 3: Listen to your body
…like a leader listening to an advisory council. Your perception of tiredness, pain, weakness, and all your emotions are simply messengers. Listen to the message! And then say “thank you for the information”, and proceed accordingly.
Sometimes that will be in the way the messengers seem to be hoping for!
Sometimes, however, maybe we (blessed with a weighty brain and not entirely a slave to our limbic system) know better, and know when it’s right to push through instead.
Similarly, that voice in your head? You get to decide where it goes and doesn’t. On which note…
Step 4: Be responsive, not reactive
We wrote previously on the difference between these:
A Bone To Pick… Up And Then Put Back Where We Found It
Measured responses will always be better than knee-jerk reactions, unless it is literally a case of a split-second making a difference. 99% of our problems in life are not so; usually the problem will still be there unchanged after a moment’s mindful consideration, so invest in that moment.
You’ve probably heard the saying “give me six hours to chop down a tree, and I’ll spend the first four sharpening the axe”. In this case, that can be your mind. Here’s a good starting point:
No-Frills, Evidence-Based Mindfulness
And if your mental state is already worse than that, mind racing with threats (real or perceived) and doom-laden scenarios, here’s how to get out of that negative spiral first, so that you can apply the rest of this:
Do remember to turn it on again afterwards, though
Step 5: Transcend discomfort
This is partly a callback to step 3, but it’s now coming from a place of a clear ready mind, so the territory should be looking quite different now. Nevertheless, it’s entirely possible that your clear view shows discomfort ahead.
You’re going to make a conscious decision whether or not to proceed through the discomfort (and if you’re not, then now’s the time to start calmly and measuredly looking at alternative plans; delegating, ditching, etc).
If you are going to proceed through discomfort, then it can help to frame the discomfort as simply a neutral part of the path to getting where you want. Maybe you’re going to be going way out of your comfort zone in order to deal with something, and if that’s the case, make your peace with it now, in advance.
“Certainly it hurts” / “Well, what’s the trick then?” / “The trick, William Potter, is not minding that it hurts”
(lines from a famous scene from the 1962 movie Lawrence of Arabia)
It’s ok to say to yourself (if it’s what you decide is the right thing to do) “Yep, this experience is going to suck terribly, but I’m going to do it anyway”.
See also (this being about Radical Acceptance):
What’s The Worst That Could Happen?
Take care!
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The Wandering Mind – by Dr. Michael Corballis
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Our mind’s tendency to wander can be a disability, but could it also be a superpower? Dr. Corballis makes the case for such.
While many authors focus on, well, how to focus, Dr. Corballis argues in this book that our wandering imagination can be more effective at problem-solving and creative tasks, than a focused, blinkered mind.
The book’s a quick read (184 pages of quite light reading), and yet still quite dense with content. He takes us on a tour of the brain, theory of mind, the Default Mode Network (where a lot of the brain’s general ongoing organization occurs), learning, memory, forgetting, and creativity.
Furthermore, he cites (and explains) studies showing what kinds of “breaks” from mental work allow the wandering mind to do its thing at peak efficiency, and what kinds of breaks are counterproductive. Certainly this has practical applications for all of us!
Bottom line: if you’d like to be less frustrated by your mind’s tendency to wander, this is a fine book to show how to leverage that trait to your benefit.
Click here to check out The Wandering Mind, and set yours onto more useful tracks!
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Minimize Aging’s Metabolic Slump
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝I know that metabolism slows with age, are there any waypoints or things to look out for? I don’t know whether I should be eating less, or doing less, or taking some other approach entirely. What’s recommended?❞
Age and sex count for a lot with this one! As metabolism is in large part directed by hormones:
- For men, declining testosterone (often from around 45 onwards) can result in a metabolic slump
- For women, declining estrogen with the menopause does have an effect, but progesterone is the bigger factor for metabolism in the sense you are talking about.
In both cases, simply taking more of those hormones can often help, but please of course speak with an endocrinologist if that seems like a possible option for you, as your circumstances (and physiology) may vary.
If you’d like to go to that conversation well-armed with information, here are some good starting points, by the way:
- The Testosterone Drop, & Topping Up Testosterone
- Menopausal HRT: Bioidentical vs Animal (It Makes A Difference!)
And if you’re wondering about the natural vs pharmaceutical approaches…
- What Does “Balance Your Hormones” Even Mean?
- What You Should Have Been Told About The Menopause Beforehand
About your metabolic base rate
We tend to think of “fast metabolism good, slow metabolism bad”, and that’s a reasonable general premise… but it’s not necessarily always so.
After all, if you could double your metabolism and keep it there all the time, without changing anything else, well… You’ve heard the phrase “burning the candle at both ends”? So, having at least some downtime is important too.
See for example: Sleep Deprivation & Diabetes Risk
What’s critical, when it comes to base metabolic rate, is that your body must be capable of adequately processing what you are putting into it. Because if your body can’t keep up with the input, it’ll just start storing the excess chemical energy in the quickest and easiest way possible.
…which is a fast track to metabolic disorder in general and type 2 diabetes in particular. For more on the science and mechanics of this, see:
How To Prevent And Reverse Type 2 Diabetes
As for portion sizes…
Your body knows what you need, so listen to it. There is no external source of knowledge that can tell you how much food you need better than your own body itself can tell you.
You may be wondering “how exactly do I listen to my body, though?”, in which case, check out:
The Kitchen Doctor: Interoception & Mindful Eating
As for exercise…
When you exercise, your metabolic rate temporarily increases. After most kinds of exercise, your metabolism slumps again afterwards to compensate.
There are two ways to avoid this:
- Exercise Less, Move More ← it’s about maximizing time spent not sitting still
- High Intensity Interval Training ← a special kind of exercise, the only one known to keep the metabolism running high for a couple of hours afterwards, with no counter-slump
…which makes it pretty effective indeed
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Latest Alzheimer’s Prevention Research Updates
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Questions and Answers at 10almonds
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
I am now in the “aging” population. A great concern for me is Alzheimers. My father had it and I am so worried. What is the latest research on prevention?
One good thing to note is that while Alzheimer’s has a genetic component, it doesn’t appear to be hereditary per se. Still, good to be on top of these things, and it’s never too early to start with preventive measures!
You might like a main feature we did on this recently:
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