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.

A man sits on a bed, appears exhausted.
Tens of thousands of Australians, and millions of people worldwide, have long COVID.
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.The Conversation

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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  • 10 “Harsh” Truths You Probably Need to Hear

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    What do you think? Are they actually harsh? We’re not convinced, but either way they are helpful, which is the important part:

    10 Helpful Truths

    Here they are:

    1. Simple isn’t easy: simplicity doesn’t guarantee ease; focus on small, manageable habits that meet you where you are.
    2. Hard habits: the changes we resist most are often the ones we need most to grow.
    3. We stand in our own way: doubt and lack of commitment hinder progress; believe in possibilities and take consistent action.
    4. Success is failure: failure is often part of the route to success; it provides valuable lessons if we embrace and reflect on it.
    5. Nothing works forever: adapt and evolve as circumstances change; clinging to outdated habits can hinder progress.
    6. Effort doesn’t equal outcome: feeling like you’re working hard doesn’t always mean you’re making effective progress.
    7. Someone always has it easier: comparisons are inevitable but unhelpful; focus on your own unique path and progress.
    8. There’s no one best thing: results depend on creating systems that fit your lifestyle, not chasing a single magic solution.
    9. Mindset matters most: success requires examining your mindset, lifestyle, and priorities, not just physical actions.
    10. Do it anyway: push through resistance, especially on tough days; discipline and consistency create success.

    For more on all of each of these, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    How To Really Pick Up (And Keep!) Those Habits

    Take care!

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  • The Two Worst Things For Cardiac Aging

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    What do you think? There are some very reasonable top likely candidates!

    Is it ultraprocessed food? It could be, on account of science such as: Advanced glycation end-products (AGEs) and their circulating receptors predict cardiovascular disease mortality in older women

    For more on that, see: Are You Eating AGEs?

    It it, perhaps, alcohol? There’s a strong argument, as despite the popular myth of the “small glass of red per day”, any amount of alcohol increases mortality risk,, a comprehensive review in “Circulation”, a cardiovascular health journal, has suggested the French Paradox may not be so paradoxical after all, and is likely due to unrelated lifestyle factors, and historic under-reporting of cardiovascular disease by French doctors, and the World Health Organization has declared that the only safe amount of alcohol is zero: WHO: No level of alcohol consumption is safe for our health

    It’s further relevant that alcohol also increases all-cause mortality at any dose (even “low-risk drinking”): Alcohol Consumption Patterns and Mortality Among Older Adults

    For more on that, see: Can We Drink To Good Health? ← this is mostly about red wine and heart health

    Could it be red meat? Definitely a fair contender. It’s… Bad:

    For more on that, see: The Whys and Hows of Cutting Meats Out Of Your Diet

    The very two top worst things

    Researchers (Dr. Nazanin Rajai et al.) looked at this very question and found that the two biggest drivers of cardiac aging were…

    *drumroll please*

    Surprising many, financial strain and food insecurity emerged as the two strongest factors driving accelerated cardiac aging and higher mortality risk, outweighing many traditional clinical risk factors. It was a pretty comprehensive study, a cross-sectional analysis of 280,323 adult patients treated between 2018 and 2023, combining social determinants of health with AI-ECG* data and advanced statistical modeling.

    *Dr. Rajai and her team used electrocardiogram technology combined with AI modeling to estimate cardiac age; a higher cardiac age gap means the heart is biologically older than the person**, and thus indicates a greater future cardiovascular risk.

    **Notably, “biological age” is often thought of as one thing, but in reality, it’s an amalgam of many things, and different body parts/systems can age differently than others, within the same person’s body. We wrote about this here: Age & Aging: What Can (And Can’t) We Do About It? ← our mythbusting special on this topic

    As for the factors that were looked at, this particular study looked at stress, physical activity, social connection, housing instability, financial strain, food insecurity, transportation needs, nutrition, and education.

    That said, it’s worth taking into account that the other factors were important too; especially, social factors such as financial strain, housing instability, and physical inactivity predicted mortality risk at levels comparable to—or exceeding—some conventional cardiovascular risk factors.

    You can read the paper in full, here: Interplay of Social Determinants of Health and Traditional Risk Factors in Predicting Cardiac Aging

    This is consistent with what we wrote about previously, with a list of The Lifestyle Factors That Matter >8 Times More Than Genes

    …and upon narrowing it down: 6 Lifestyle Factors To Measurably Reduce Biological Age

    …and narrowing it further: Want To Age More Slowly? These 4 Social Factors Count The Most

    And in particular, and especially relevant today: Heart Health vs Systemic Stress

    As to how to address that? See: The S.T.E.P.S. To A Healthier Heart

    Want to learn more?

    You might like this book that we reviewed a while back:

    Heart Smarter for Women: Six Weeks to a Healthier Heart – by Dr. Jennifer Mieres

    Take care!

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  • When You Know What You “Should” Do (But Knowing Isn’t The Problem)

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    When knowing what to do isn’t the problem

    Often, we know what we need to do. Sometimes, knowing isn’t the problem!

    The topic today is going to be a technique used by therapeutic service providers to help people to enact positive changes in their lives.

    While this is a necessarily dialectic practice (i.e., it involves a back-and-forth dialogue), it’s still perfectly possible to do it alone, and that’s what we’ll be focussing on in this main feature.

    What is Motivational Interviewing?

    ❝Motivational interviewing (MI) is a technique that has been specifically developed to help motivate ambivalent patients to change their behavior.❞

    Read in full: Motivational Interviewing: An Evidence-Based Approach for Use in Medical Practice

    It’s mostly used for such things as helping people reduce or eliminate substance abuse, or manage their weight, or exercise more, things like that.

    However, it can be employed for any endeavour that requires motivation and sustained willpower to carry it through.

    Three Phases

    Motivational Interviewing traditionally has three phases:

    1. Exploring and understanding the issue at hand
    2. Guiding and deciding importance and goals
    3. Choosing and setting an action plan

    In self-practice, maybe you can already know and understand what it is that you want/need to change.

    If not, consider asking yourself such questions as:

    • What does a good day look like? What does a bad day look like?
    • If things are not good now, when were they good? What changed?
    • If everything were perfect now, what would that look like? How would you know?

    Once you have a clear idea of where you want to be, the next thing to know is: how much do you want it? And how confident are you in attaining it?

    This is a critical process:

    • Give your answers numerically on a scale from 0 to 10
    • Whatever your score, ask yourself why it’s not lower. For example, if you scored your motivation 4 and your confidence 2, what factors made your motivation not a lower number? What factors made your confidence not a lower number?
    • In the unlikely event that you gave yourself a 0, ask whether you can really afford to scrap the goal. If you can’t, find something, anything, to bring it to at least a 1.
    • After you’ve done that, then you can ask yourself the more obvious question of why your numbers aren’t higher. This will help you identify barriers to overcome.

    Now you’re ready to choose what to focus on and how to do it. Don’t bite off more than you can chew; it’s fine to start low and work up. You should revisit this regularly, just like you would if you had a counsellor helping you.

    Some things to ask yourself at this stage of the motivational self-interviewing:

    • What’s a good SMART goal to get you started?
    • What could stop you from achieving your goal?
      • How could you overcome that challenge?
      • What is your backup plan, if you have to scale back your goal for some reason?

    A conceptual example: if your goal is to stick to a whole foods Mediterranean diet, but you are attending a wedding next week, then now is the time to decide in advance 1) what personal lines-in-the-sand you will or will not draw 2) what secondary, backup plan you will make to not go too far off track.

    The same example in practice: wedding menus often offer meat/fish/vegetarian options, so you might choose the fish or vegetarian, and as for sugar and alcohol, you might limit yourself to “a small slice of wedding cake only; coffee/cheese option instead of dessert”, and “alcohol only for toasts”.

    Giving yourself the permission well in advance for small (clearly defined and boundaried!) diversions from the plan, will stop you from falling into the trap of “well, since today’s a cheat-day now…”

    Secret fourth stage

    The secret here is to keep going back and reassessing at regular intervals. Set your own calendar; you might want to start out weekly and then move to monthly when you’re more strongly on-track.

    For this reason, it’s good to keep a journal with your notes from your self-interview sessions, the scores you gave yourself, the goals and plans you set, etc.

    When conducting your regular review, be sure to examine what worked for you, and what didn’t (and why). That way, you can practice trial-and-improvement as you go.

    Want to learn more?

    We only have so much room here, but there are lots of resources out there.

    Here’s a high-quality page that:

    • explains motivational interviewing in more depth than we have room for here
    • offers a lot of free downloadable resource packs and the like

    Check it out: Motivational Interviewing Theory & Resources

    Enjoy!

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  • Pumpkin vs Tomatoes – Which is Healthier?

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    Our Verdict

    When comparing pumpkin to tomatoes, we picked the pumpkin.

    Why?

    Both have their merits, but there was a clear winner:

    In terms of macros, pumpkin has nearly 3x the fiber, 2x the carbs, and slightly more protein (which latter isn’t much), meaning a win for pumpkin in this round, mostly on account of the fiber.

    In the category of vitamins, pumpkin has a lot more of vitamins A, B2, B5, B7, E, and K, while tomato has more of vitamins B1, B3, B6, B9, and C, yielding a marginal 6:5 win to pumpkin.

    Looking at minerals, it’s less close; pumpkin has more calcium, copper, iron, magnesium, manganese, phosphorus, and selenium, while tomato has (slightly) more potassium, giving pumpkin an easy 7:1 victory here.

    In other considerations, it’s worth noting that both of these plants are good sources of carotenoids including lutein and lycopene, so we’ll call this round a tie.

    Adding up the sections makes for an overall win for pumpkin, but by all means enjoy either or both, as diversity is good!

    Want to learn more?

    You might like:

    Enjoy!

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  • Foods That Cause You to Lose Weight – by Dr. Neal Barnard

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We previously reviewed Dr. Barnard’s “The Power Foods Diet”, and this time his work is about weight loss.

    This time there are more recipes (which take up most of the book, so this one could be reasonably described as a cookbook), but not until after nearly a hundred pages of concepts, principles, and tips.

    The recipes themselves are again very respectable, even if some may be a little redundant (e.g. the double-page recipe for blueberry muffins is followed by a double-page recipe for banana and date muffins, instead of just saying “or substitute this”—things like that) and run the gamut from salad dressings to hearty main meals.

    A strength of the book is that it’s about what you eat, not how much of it you eat, so if you love eating (which is a very healthy trait to have in general), then you’ll enjoy that aspect.

    Bottom line: if you’d like to eat more and weigh less, then this is a top-tier book for you.

    Click here to check out “Foods That Cause You To Lose Weight”, and enjoy eating!

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  • Broad Beans vs Green Beans – Which is Healthier?

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    Our Verdict

    When comparing broad beans to green beans, we picked the broad.

    Why?

    It’s quite a straightforward one today:

    In terms of macros, broad beans have 2.5x the protein, and slightly more fiber and carbs, so we pick the broad beans as the more nutrient-dense option here.

    In the category of vitamins, broad beans have more of vitamins B1, B3, B9, and C, while green beans have more of vitamins A and B6 (with comparable margins of difference for both beans’ winning vitamins), so another win for broad beans, based on the 4:2 numerical advantage.

    When it comes to minerals, broad beans have more copper, iron, magnesium, phosphorus, potassium, and selenium, while green beans have more calcium and manganese. Again, comparable mostly margins of difference (except for broad beans bing 5x richer in selenium, which is a bit of an outlier, but it’s not because broad beans are an amazing source of selenium, but rather, that green beans have only a tiny amount), so it’s a clear 7:2 win for broad beans.

    Adding up the three wins for broad beans makes an overall win for them, but by all means, enjoy either or both; diversity is good!

    Want to learn more?

    You might like:

    Dr. Greger’s Daily Dozen

    Enjoy!

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