GoKawiilNothing about long Covid adds up.
Consider prevalence rates: How could one study find it affected 3.3 percent of the population of the UK but others an alarming 51 percent of South Americans and 86 percent of Egyptians? Or treatment methods: The BMJ’s systematic review of ways to treat long Covid lists two as supported by moderate evidence, cognitive behavioral therapy and physical exercise. But if you attended the third annual Long Covid International Conference in Boston—as I did, late last year—you’d think the BMJ was encouraging medical malpractice. During two days of presentations, the world’s leading scientific authorities brought up exercise only to warn against it. Cognitive behavioral therapy received just one mention: “not recommended.”
Then there’s the scientific progress, or lack thereof. Six years since the height of the pandemic, the scientific community remains baffled by long Covid. Researchers still don’t know why some people’s symptoms persist or worsen after the acute phase of SARS-CoV-2 infection has passed. Almost $2 billion and half a decade of international effort have yielded little more than hypotheses about micro blood clots and spike proteins and mitochondrial dysfunction. There isn’t a single approved pharmaceutical treatment, not even a test to verify the presence of the illness.
All of this is very strange. Stranger still are patients’ stories of astonishing recoveries from severe long Covid, achieved entirely outside mainstream medicine. The stories are connected to a growing community of doctors, therapists, and self-styled coaches who insist the riddle of long Covid has been solved. Like so many health gurus, they offer a solution that depends, in part, on your faith in the process. The solution also works for a remarkable variety of ailments—classic red flags for “holistic” pseudoscience and medical charlatanry. If the stories are to be believed, they represent a neglected approach that demands urgent attention. If not, a colossal medical scandal is operating openly, exploiting sick people desperate for answers and relief.
It’s the job of the scientific community to solve mysteries like this one. Doing that job effectively, however, has two basic conditions: Researchers must know what they are studying, and they must be free to study it impartially. In the case of long Covid, neither of these conditions has been met, and patients are suffering the consequences.
One of those patients is a 37-year-old man I’ll call Andrew Larson, who came down with a bad case of Covid-19 in late 2023. After a week in bed, he recovered enough to begin working again. But a month later he noticed something was seriously wrong. Mild exertion like a short walk left his brain foggy and his body exhausted. Larson pushed through until June 2024, when he did some construction work around the house. The exertion was too much. His body began to shut down, and two weeks later Larson was bedbound.
Because so little is known about long Covid, sufferers are often dismissed by providers or passed from one skeptical specialist to the next. Symptoms vary dramatically in type and severity, which means one person might experience mild sleep issues and fatigue while another could become completely incapacitated. In those severe cases, it’s not uncommon for patients to end up in the psych ward. A privileged few land at dedicated clinics, but empathetic doctors can do little more than treat individual symptoms and hope for improvement.
Larson made his way to such a clinic, but he didn’t improve. By late 2024 and into 2025, the once-fit father had been lying motionless and mute in a darkened bedroom for months, pallid and emaciated, unclipped nails like claws, sucking pureed food from a syringe, dependent on a bedpan. Any exertion, even chewing or talking, meant waves of excruciating pain and days of bone-deep exhaustion.