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The Office of Long COVID

State of the Union: A new HHS initiative promises to “prevent” the post-viral syndrome.

A protester holds up a placard demanding research into Long
(Photo by Martin Pope/SOPA Images/LightRocket via Getty Images)

The Department of Health and Human Services on Monday announced the launch of an “Office of Long COVID Research.” The office will oversee the Biden administration's $1.15 billion RECOVER Initiative, which will fund research and clinical trials to better “understand, treat, and prevent” Long Covid.

It’s not surprising that some number of people infected with the coronavirus suffered fatigue, pain, and brain fog after recovering from their illness. Post-viral syndrome, characterized by exactly those symptoms, can occur in people recovering from a viral infection. When a person's infection is so severe that he is admitted to intensive care, it's not uncommon that lingering tissue damage will affect the patient for months after he leaves the hospital, leaving him potentially short of breath and suffering many of the same symptoms claimed by Long Covid sufferers.

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A large number of people who claim to have Long Covid, however, show no evidence of having been infected by the virus at all. And some of those claiming symptoms months, or in some cases, years later were never admitted to the ICU for their illness. In fact, one of the best predictors of suffering from Long Covid is having been depressed, anxious, or stressed before being diagnosed with the virus.

After JAMA Psychiatry published the study linking neurotic conditions to Long Covid, “experts” rallied around the flag to ensure no one drew the wrong conclusions. Jacqueline Becker, a clinical neuropsychologist at the Icahn School of Medicine at Mount Sinai, for example, told NBC News that the study “shouldn’t be misinterpreted as supporting post-Covid conditions as psychosomatic.”

Not all people's experiences of post-Covid symptoms are psychosomatic, but some of them certainly are. Many Long Covid sufferers bristle at that suggestion, but as neurologist Peter Robinson wrote for The American Conservative last year, their resistance to a psychogenic explanation stems potentially from having assumed Long Covid as part of their identities:

Seen one way, the ferocious refusal of some sufferers and advocates to accept that there is a psychogenic component to Long Covid is odd. These are almost never people who deny the reality of depression, or anxiety. These are in some cases people who would advocate for “normalizing” or “destigmatizing” mental illness. But implicit in the impassioned pleas that their own illnesses be defined the way they prefer is a demand that this disease notbe allowed to have a psychological contribution. A charitable interpretation would be that they fear their suffering will be dismissed by others if it has a psychological contribution. A cynical interpretation would be that they themselves are prejudiced against psychological suffering. The most cynical interpretation is that accepting that this has at least some psychological contribution might help heal some of them and that they intuit this. 

That's one potential explanation for the Long Covid initiative. Another is that, while some people are suffering from a real post-viral syndrome, the initiative serves the political purpose of reinforcing the public's perception of the pandemic's severity. In other words, the initiative communicates that the pandemic was so severe that some people are still suffering, and that all of the unpopular mitigation measures we took—plastic-wrapped nursing home visits, seven-person graveside funerals, school closures, locking public parks—were justified.