Two Years Later, We Still Don’t Understand Long Covid. Why?

The Ezra Klein Show

New York Times Opinion

Society & Culture, Government, News

4.6 • 11K Ratings

🗓️ 21 June 2022

⏱️ 57 minutes

🔗️ Recording | iTunes | RSS

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Summary

Depending on the data you look at, between 10 and 40 percent of people who get Covid will still have symptoms months later. For some, those symptoms will be modest. A cough, some fatigue. For others, they’ll be life-altering: Debilitating brain fog. Exhaustion. Cardiovascular problems. Blood clotting. This is what we call long Covid. It’s one term for a vast range of experiences, symptoms, outcomes. It’s one term that may be hiding a vast range of maladies and causes. So what do we actually know about long Covid? What don’t we know? And why don’t we know more than we do? Dr. Lekshmi Santhosh is an assistant professor at UCSF Medical Center, and the founder and medical director of UCSF’s long Covid and post-ICU clinic. Her clinic opened in May 2020 and was one of the first to focus on treating long Covid patients specifically. We discuss the wildly broad range of symptoms that can qualify as long Covid; the confusing overlaps between Covid symptoms and other diseases; whether age, race, sex and pre-existing conditions affect a person’s chances of contracting long Covid; why it’s so difficult to answer a seemingly simple question like, “How many people have gotten long Covid?”; what to make of a recent study that seemingly undermines the biological existence of long Covid; how worried we should be about correlations between Covid and medical disasters like heart attacks, strokes and abnormal blood clotting; and more. Mentioned: “Post–COVID Conditions Among Adult COVID-19 Survivors Aged 18–64 and ≥65 Years — United States, March 2020–November 2021” by Lara Bull-Otterson, Sarah Baca1, Sharon Saydah, Tegan K. Boehmer, Stacey Adjei, Simone Gray and Aaron M. Harris “Long COVID after breakthrough SARS-CoV-2 infection” by Ziyad Al-Aly, Benjamin Bowe and Yan Xie “A Longitudinal Study of COVID-19 Sequelae and Immunity: Baseline Findings” by Michael C. Sneller, C. Jason Liang, Adriana R. Marques, et al. “Positive Epstein–Barr virus detection in coronavirus disease 2019 (COVID-19) patients” by Ting Chen, Jiayi Song, Hongli Liu, Hongmei Zheng and Changzheng Chen “Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID Symptom Study app” by Michela Antonelli, Rose S. Penfold, Jordi Merino, Carole H. Sudre, Erika Molteni, Sarah Berry, et al. “Understanding and Improving Recovery From COVID-19” by Aluko A. Hope “Markers of Immune Activation and Inflammation in Individuals With Postacute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 Infection” by Michael J. Peluso, Scott Lu, Alex F. Tang, Matthew S. Durstenfeld, et al. Book Recommendations: In Shock by Dr. Rana Awdish Every Deep-Drawn Breath by Wes Ely Mountains Beyond Mountains by Tracy Kidder We're hiring a researcher! You can apply here or by visiting nytimes.wd5.myworkdayjobs.com/News Thoughts? Guest suggestions? Email us at [email protected]. You can find transcripts (posted midday) and more episodes of “The Ezra Klein Show” at nytimes.com/ezra-klein-podcast, and you can find Ezra on Twitter @ezraklein. Book recommendations from all our guests are listed at https://www.nytimes.com/article/ezra-klein-show-book-recs. “The Ezra Klein Show” is produced by Annie Galvin, Jeff Geld and Rogé Karma; fact-checking by Haylee Millikan and Michelle Harris; original music by Isaac Jones; mixing by Jeff Geld; audience strategy by Shannon Busta. Our executive producer is Irene Noguchi. Special thanks to Kristin Lin, Kristina Samulewski, Dr. Ziyad Al-Aly and Lauren Nichols.

Transcript

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0:00.0	I'm Ezra Klein, this is the Ezra Conch Show.
0:21.1	Before we begin today, we're looking for a researcher to join the show.
0:24.7	This is going to be someone who gets the show deeply, who is both broad and obsessive
0:29.6	in their interests, and who can read and synthesize and communicate a lot of information
0:35.1	passed.
0:36.1	That is really the core of this.
0:38.2	Location wise, New York is preferred, but we're open to remote work, and we're going
0:41.2	to be closing the position in two weeks.
0:43.8	So now's the time to apply.
0:45.6	You can find the listing at nytco.com slash careers, and there'll be a link in the description
0:50.3	for this episode.
0:52.4	But for today, depending on the data you look at, between 10 and 40% of people who get
0:59.2	COVID, we'll still have inexplicable symptoms months later.
1:04.0	For some people, that's going to be modest, to a cough, some fatigue.
1:08.6	For others, it can be life-altering, debilitating brain fog, constant exhaustion, cardiovascular
1:15.0	problems, blood clotting.
1:17.8	This is what we call long COVID.
1:19.8	It's this one term for this vast range of experiences, of symptoms, of outcomes.
1:27.2	This one term that may be hiding, a lot of different conditions, maybe even a lot of different
1:32.1	causes.
1:34.2	We've known long COVID is a thing for years now.
1:37.8	But to try to dive into the literature here is to realize very quickly how little we actually
	...

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