Before contracting COVID-19, in November 2020, Amy Engkjer was fit, healthy, happy — and busy. She worked out three times a week, hiked regularly with her husband near their home in Missoula, Mont., ran a stained-glass business, and taught meditation.

COVID hit her hard. She suffered from fever, cough, loss of taste and smell, intense fatigue, numbness, pain, seizure-like episodes, brain fog, dizziness, and migraine attacks. Weeks after her initial infection, the list of her symptoms, including tachycardia (a racing heart), trembling hands, and problems with temperature regulation, grew longer. “Days turned into weeks and then months,” she recalls. It was anguish.

Meditation had long been part of her routine, but now she was unable to calm her mind or body. She did notice, however, that her symptoms seemed to get worse when she took in alarming stories and news reports about long COVID. And they improved when she avoided those stories and focused on nurturing feelings of hope.

What Engkjer stumbled upon was a link between her nervous system and her chronic-pain symptoms — a connection that has begun receiving more attention from researchers and health practitioners alike.

“Much of the autonomic nervous system is fragile, so any kind of severe infection, physical trauma, or emotional trauma has the capacity to result in dysfunction of autonomic functions, which include things like temperature regulation, heart rate, and blood pressure,” says Gregory Plotnikoff, MD, MTS, FACP, a functional-medicine practitioner in Minneapolis.

Researchers are still trying to understand how these connections between the brain and the body might support healing from long COVID and other chronic conditions. This is some of what they’re learning.

The Plastic Brain

In the thick of her illness, Engkjer read a book called The Brain That Changes Itself by psychiatrist Norman Doidge, MD. His focus is neuroplasticity — the ability of neurons in the brain to adapt, reorganize, and recover from trauma. Neurologists once believed the brain only generated new neurons before birth, but studies of neuroplasticity have revealed that the brain adapts throughout our lives.

“I had this idea right away that neuroplasticity could be a really big factor here,” Engkjer says. That the concept had played a role in her symptoms made sense to her. It also offered a way forward.

Many brain-retraining techniques center around neuroplasticity, including those used to help people recover from strokes and traumatic brain injuries. (These focus on retraining a healthy area of the brain to take over the functions of a damaged part.) Practitioners are now using these approaches to treat a broader range of conditions, including chronic fatigue syndrome, fibromyalgia, post-treatment Lyme disease, and multiple chemical sensitivity.

Annie Hopper, a limbic-system rehabilitation specialist and founder of the Dynamic Neural Retraining System, believes disorganized neural circuits — which can be the result of severe inflammatory illness — can lead to any of these conditions. As such, they’re akin to an acquired brain injury, one that can be healed using principles of neuroplasticity.

Engkjer began focusing on her brain to heal from long COVID. “I regularly saw a neurologist and a physical therapist. I did neurofeedback, which helped to stabilize my brain. I adopted an anti-inflammatory diet, got shiatsu, worked with neurolinguistic programming, did EMDR [eye-movement desensitization and reprocessing], even took ice-cold showers and tried IV therapy.”

Her symptoms improved, but progress was slow and setbacks frequent.

Then, about 11 months into her long-COVID ordeal, Engkjer came across the story of Paul Garner, MD, an emeritus professor at the Liverpool School of Tropical Medicine in England. He’d recovered from long COVID using brain-retraining techniques.

Brain retraining is rooted in the idea that some chronic conditions and unexplained symptoms are due not to bodily damage but to faulty signaling from the nervous system. “The brain gets ‘stuck’ in an unconscious state of chronic emergency that perpetuates illness and inflammation,” explains Hopper in her book, Wired for Healing.

Brain retraining uses tools that harness neuroplasticity to relax the threat response, normalize neural pathways, improve overall function, and reduce or eliminate symptoms.

“Everything finally clicked,” Engkjer says. “I realized I’ve been in this looping fight-or-flight pattern for so long, and I finally understood what the mechanism was.”

A year and a half after her initial COVID infection, Engkjer decided to try the Lightning Process, a mind–body training program developed by Phil Parker, PhD, that aims to help develop new neural circuits in the brain.

The Lightning Process teaches you to pause, notice the habitual reaction to your symptoms, recognize the fight-or-flight response, interrupt this pattern, and override it with messages of safety. It asks you to savor memories of feeling healthy, then move and speak as if you were in that healthier state now.

If the brain leads, in other words, the body will follow.

The Brain’s Alarm System

Physical symptoms like pain and fatigue serve as signals from the unconscious nervous system, explains physician and long-COVID specialist Rebecca Kennedy, MD, in an interview broadcast on YouTube; the body urges us to retreat and rest to boost our odds of survival.

“When the body responds to illness, our feelings and behaviors change,” writes Stockholm University professor of psychoneuroimmunology Mats Lekander, PhD, in The Inflamed Feeling: The Brain’s Role in Immune Defense. “In the short term, this seems to be a good strategy to promote our natural healing mechanisms. But in the longer term, if the reaction doesn’t shut itself down, it is not such a good thing.”

To call off a state of alarm, the brain must convey a message of safety to the body. To do this deliberately may literally sound like wishful thinking. But the brain’s ability to create changes in physiology has been well-studied — down to specific inflammatory responses.

In a study published in Cell in 2021, researchers added a chemical to the drinking water of mice that triggered a bout of colitis. They marked the neurons in the brains of the mice that became active when their intestinal inflammation peaked. Several weeks later, the researchers reactivated the neurons — which prompted a similar inflammatory response in the colon.

The idea that the brain can spark symptoms without a pathological cause is not new. In 1885, researchers stimulated symptoms in a woman with a pollen allergy by exposing her to an artificial flower she believed real.

Brain-retraining programs aim to reeducate these responses by teaching the brain to more accurately distinguish the difference between apparent and actual threats. This helps the body return to a state of safety where it can unconsciously begin to downshift any protective sickness response.

A growing evidence base offers qualified support for brain retraining’s efficacy. The process has helped relieve symptoms from multiple sclerosis, chronic fatigue syndrome, and chronic-pain conditions. Published in 2021, a systematic review of studies seemed to largely support its use, though it acknowledged not all participants found relief.

Engkjer was among those whose results were positive. “I thought I would just go through the process and see if it could help with the few things I wasn’t completely over. It ended up taking these concepts I knew theoretically and making them real. I could almost feel these new neural pathways in my brain starting to line up, and symptoms and beliefs that had come up before began to atrophy.”

Now fully recovered, Engkjer has become a passionate advocate for the tools that helped her heal. She started a nonprofit called Positively COVID, where she shares patient-recovery stories along with education and resources on mind–body tools for healing.

No one knows how many people have used brain retraining to recover from long COVID, but there are plenty of positive testimonials in online forums and videos as well as in patient-support groups.

There are also plenty of people who have tried brain retraining without success. Like most healing modalities, it can be powerful for some and have no impact for others.

Even when it does help, it’s rarely a one-size-fits-all solution, and finding an effective approach often requires persistence, patience, and trial and error. For some, the obstacles to healing have been years in the making.

The Biology of Threat

Threat signaling in the nervous system can result in conditions that are both very real and not pathological. Howard Schubiner, MD, an internal-medicine physician and author of Unlearn Your Pain, explains the difference: “When you have cancer or a fracture, that’s a pathological finding — it means there is tissue damage in the body. If you have a high heart rate when you’re stressed, that’s a physiologic finding; there is no tissue damage in the heart, and the heart is under the control of the brain and the nervous system.”

An accumulation of adverse childhood experiences, chronic stress, or trauma — even persistent overtraining without adequate recovery — can increase hypervigilance in the brain, predisposing the nervous system to this kind of “stuck” response.

In a study of 338 COVID patients, those who’d experienced at least one traumatic event during childhood were three times more likely to develop long COVID. Those who’d experienced two or more were at more than five times greater risk.

In a study of 338 COVID patients, those who’d experienced at least one traumatic event during childhood were three times more likely to develop long COVID. Those who’d experienced two or more were at more than five times greater risk.

The COVID pandemic and its disruption to our lives, work, and social connections represented a massive source of stress for us all — an important element to understand in the conversation about long COVID.

The physiological impact of the collective fear and threat that so many of us felt during the global pandemic cannot be underestimated, says Lilia Graue, MD, LMFT, a London-based physician specializing in mind–body medicine. “Even if we weren’t consciously fearful of COVID, our underlying neurophysiology was responding to a present threat that was endangering lives. That activates pathways involving inflammatory mediators and nervous-system structures like the amygdala that respond to danger and create symptoms such as pain or fatigue in order to protect us.”

Still, even those who uphold the nervous-system theory of long COVID do not see it as comprehensive. It’s well understood that many people suffer lasting organ damage after severe COVID. Undetected diabetes, autoimmunity, and thyroid disorders can also contribute to lasting COVID symptoms.

Yet many people have long-COVID symptoms that can’t be explained by known pathological mechanisms. This is where the nervous system can be a useful arena to explore.

“Out of the hundreds of patients I’ve assessed, maybe one or two fit in that category of organ damage. For the majority of long-COVID patients, most likely it’s a nervous-system issue rather than damage in the body,” Kennedy says.

Getting to the Root Cause

Even concrete pathological findings may not offer a consistent explanation for long-COVID symptoms. Many studies have reported abnormal findings in people with long COVID, such as viral remnants, high levels of blood clot–related proteins, microbiome alterations, low cortisol, immune-cell irregularities, reactivated viruses, or dysfunctional mitochondria.

Yet correlation does not necessarily mean causation, Schubiner says. The nervous system is intricately connected to the endocrine and immune systems and has two-way communications.

“When you find these endocrine and immunologic abnormalities, you could presume that they’re the cause of someone’s illness, but it might be that they’re the result of their illness,” he explains. They may be occurring downstream of the root cause, which could be the brain’s alarm system stuck in threat-response mode.

How do all of the pieces fit together?” Kennedy asks. “They fit together great when we’re looking through the lens of the brain and the nervous system, rather than through the lens of the body alone.”

Abnormalities — changes in nerve conduction, microbiome alterations, presence of food-specific immunoglobulin G antibodies, irregular MRI findings, and atypical skin-biopsy findings — have been found in a whole range of what Schubiner calls “nonspecific” conditions, such as back pain, irritable bowel syndrome, chronic fatigue syndrome, and migraine.

“And yet we routinely see people who recover using techniques that rewire the brain’s neural circuits in days, weeks, or months, despite those abnormalities,” Schubiner says.

He’s seen the same rapid recovery in long-COVID patients he’s treated, some of whom had been bedridden. “Many of the symptoms are physiologic abnormalities that are reversible.”

Specifically, they’re reversible when approached through the lens of the nervous system.

“So, how do all of the pieces fit together?” Kennedy asks. “They fit together great when we’re looking through the lens of the brain and the nervous system, rather than through the lens of the body alone.”

Reading the Signs

There are ways to differentiate a pathological condition, such as cancer or heart disease, from a condition driven by a hypervigilant nervous system.

“If the pattern of symptoms does not follow some sort of structural damage in the body — if pain, tingling, numbness, or sensations don’t follow known physiologic pathways of the nerves, if symptoms jump around, or they’re worse sometimes and better other times in a way that doesn’t make sense physiologically — that’s a piece of evidence,” Kennedy says.

A wide range of symptoms in different areas and systems of the body is another clue.

“If the pattern of symptoms does not follow some sort of structural damage in the body — if pain, tingling, numbness, or sensations don’t follow known physiologic pathways of the nerves, if symptoms jump around, or they’re worse sometimes and better other times in a way that doesn’t make sense physiologically — that’s a piece of evidence.”

“The chance that there’s an undiscovered reason due to damage in the body gets less and less with the more symptoms you have,” she adds. “If someone has nerve pain and brain fog and insomnia and a GI disorder and rashes, there is unlikely to be one pathogenic mechanism that’s going to explain all these different things.”

One method Schubiner uses is asking patients to close their eyes and imagine doing some kind of activity, then notice how they feel. “They may say, ‘I feel dizzy,’ or ‘I’m getting chest pain or a headache,’” he says. “It’s a way of demonstrating that maybe it’s not walking that’s causing the symptoms, but it’s the fear in the subconscious brain of walking.”

Understandably, mysterious and debilitating symptoms are scary — and the anxiety they provoke can lead to a feedback loop that makes them worse over time. “Fear strengthens that danger signal in the brain, and then the brain makes symptoms worse,” Schubiner explains. “It’s a feedback loop of pain or fatigue leading to fear of the pain or fatigue, leading to increased pain or fatigue.”

Absorbing the stories of others’ suffering and symptoms often adds more fuel to this fire. This may be a reason to approach social media and online patient forums with caution. Some research has shown that people who are active in online patient forums (specifically patients with chronic fatigue syndrome and fibromyalgia) report greater symptom severity and less improvement than those who choose to leave the groups.

This may, of course, be due to people leaving the community when their symptoms abate. But anecdotally, many people report shifting their focus away from stories of suffering toward stories of healing as being integral to their recovery.

Breaking the Feedback Loop

Unraveling the symptom-fear-symptom feedback loop takes time, patience, and self-compassion, says Graue. And it involves approaches that are both top-down and bottom-up.

Top-down approaches educate people about alternate possible causes for their symptoms. Releasing the conviction that there’s physical damage or an ongoing pathological threat being harbored in the body is key. “Top-down approaches address thoughts and emotions and encourage the reprocessing of sensations,” she explains.

Still, simply addressing the conscious mind isn’t enough. “Breaking free from these loops requires focusing more on the unconscious than the conscious brain,” Plotnikoff notes. “If we could think our way out of it, it wouldn’t be an issue.”

“Breaking free from these loops requires focusing more on the unconscious than the conscious brain,” Plotnikoff notes. “If we could think our way out of it, it wouldn’t be an issue.”

This is why exclusively top-down approaches such as cognitive behavioral therapy (CBT), have had limited results; CBT doesn’t generally include tools to directly calm or reset the nervous system.

Similarly, therapies that encourage physical exercise without first addressing the nervous system can even be counterproductive: If the nervous system sees exercise as a threat, it may exacerbate symptoms as a protective mechanism. “In order for neural circuits to change, the limbic system needs to move out of its chronic alarm state and into a more relaxed state where growth and repair are possible,” writes Hopper.

Bottom-up approaches aim to relax the nervous system, sending signals of calm and safety so it can make that shift. These might include breathwork, meditation, vagal-tone exercises, somatic therapy, or acupuncture.

Shamanic journeying, religious rituals, or various forms of energy healing are other practices that can bypass the rational mind to access deeper parts of the psyche and facilitate emotional release.

Different programs offer various approaches to brain retraining, including the Dynamic Neural Retraining System, Lightning Process, Gupta Program, Curable, pain-reprocessing therapy, emotional awareness and expression therapy, Safe and Sound protocol, and more. (Visit https://www.positivelycovid.org/brain-reprogramming for a thorough list.)

Different people may benefit from different programs or combinations of elements. Some may improve with the first program they try; others may need to experiment. “If you have a functional condition [rather than a pathologic one], the cure can come in a million different ways,” notes Schubiner.

Harnessing the power of the brain to orchestrate healing is also known as the placebo effect. Schubiner describes four necessary components for successful placebo treatment:

1. A believable explanation for the problem (for example, a dysregulated nervous system).
2. A technique that addresses that explanation (such as tools to calm the nervous system).
3. A treatment delivered in the context of a trusting and caring relationship with a provider.
4. A person with hope and optimism that it can work.

Because each ingredient is necessary, one may need to make multiple attempts to find the explanation, approach, and provider or guide that makes the most sense — and offers the most hope — for them.

Mixing Hope With Humility

People who recover from chronic conditions using brain retraining can become evangelical about it, says Graue, but it’s important to stay humble.

“There are some people for whom these approaches will have limited utility, particularly if they feel endangered by them,” she notes. “There can be a certainty in statements like, ‘This is helpful for everybody if you just follow steps one, two, and three.’ This leaves many people feeling like they’re doing something wrong, because it’s not working for them.”

Each successful recovery involves individuals who found their own combination of tools and approaches. “Even within mind–body approaches, there’s a wide array of frameworks that will have different usefulness for different people,” she explains. And the patient’s belief that they can heal makes a difference. (Visit “What Is a Functional Neurological Disorder?” to learn how experts are beginning to uncover these mind-body complexities — and how to treat them.)

At the same time, many people feel ongoing resistance to the idea of their pain having a nervous-system component. “People have been really hurt and dismissed in many spaces with the typical narrative that this is all in their heads,” Graue adds. “That fails to acknowledge how real these symptoms are and the impact they have on people’s lives.”

People with chronic-pain conditions have often experienced skepticism from their conventional physicians, who may lack the tools to diagnose and treat their complex symptoms. This leaves many frustrated and hurt as well as eager for a structural explanation for their symptoms so they will be recognized as legitimate. (Check out “How to Manage Chronic Pain — Naturally” to learn more about the challenges of chronic pain conditions.)

Online patient communities and media coverage may reinforce the idea that there must be a biomarker that’s being neglected — and this can amplify the drumbeat of fear, alarm, and despair.

Yet mind–body modalities suggest that the choice between a biomarker and a nervous-system explanation for a chronic illness is a false one. What we really need is a paradigm shift to understand how our brains and bodies interact to create our health, says Graue.

“We need to be doing a better job at going beyond the either-or narrative of mind versus body to a both-and explanation — one that allows for many different pathways to healing.”

The post Can Brain Retraining Help Me Recover From Long COVID? appeared first on Experience Life.

Navigate to:

A Q&A With Patrick Hanaway, MD  •  A Q&A With Jacob Teitelbaum, MD

Long COVID is real. Once viewed with skepticism as a sort of phantom or, at best, psychosomatic disease, its blood biomarkers have now been pinpointed, and immuno­phenotyping tests are 96 percent accurate in its identification.

This not only establishes the legitimacy of long COVID, but it may lead to new treatments. That’s the conclusion of researchers from the Icahn School of Medicine at Mount Sinai and Yale School of Medicine in a study published last year in Nature.

“These findings are important — they can inform more sensitive testing for long-COVID patients and personalized treatments for long COVID that have, until now, not had a proven scientific rationale,” said co-principal investigator David Putrino, PhD.

Still, while data now confirms the reality of long COVID, the condition remains a puzzling challenge for researchers and patients alike.

PostViral Fatigue

Long COVID is a postviral syndrome, explains functional-medicine practitioner Patrick Hanaway, MD. It’s closely related to myalgic ­encephalomyelitis/chronic fatigue syndrome. And a similar wave of postviral syndrome occurred following the 1918 Spanish flu pandemic, he says.

Integrative-medicine internist Jacob Teitelbaum, MD, describes how a postviral syndrome develops: “Many infections do not have the mitochondrial ‘machinery’ needed to produce their own energy. Rather, they hijack our body’s energy production to reproduce. Our body suppresses our own energy production to starve the viruses. This is one reason people feel tired during many severe viral infections.”

After recovering from COVID, an ­estimated 10 percent of people still suffer from suppressed energy production, he says. “This then triggers a chain reaction in the body with hypothalamic dysfunction, widespread muscle shortening and pain, and a form of inflammation in the brain called microglial activation. Each of these then triggers its own cascade of events. Immune activation and exhaustion occur alongside the low energy — likely two sides of the same coin.”

The Future of Long COVID

Long COVID has proven especially confusing because it features more than 200 possible symptoms, ­Hanaway says — two of the most common being brain fog and post-­exertional fatigue. “There’s no one thing going on here. . . . There’s a convergence of factors.”

And new findings on long ­COVID keep emerging: A recent study pub­lished in Cell found that sufferers have lower serotonin levels, presumably triggered by remnants of the virus lingering in the gut. The authors state that depleted serotonin could trigger neurological and cognitive symptoms, including memory issues.

1 in 10:  Estimated number of people with COVID who subsequently developed long COVID — including up to 23 million Americans, reports the National Institutes of Health.

Long COVID can strike anyone, Hanaway notes. “A third of the people with long COVID had no other health issues beforehand. None. So, it isn’t just the obese, the diabetics, the elderly who are getting it. This is actually across the whole spectrum.”

Equally concerning, he says, is that every time you contract a COVID infection, it increases your likelihood of getting long COVID.

Overcoming COVID once doesn’t seem to be protective, he explains: “That’s scary. Many people who weren’t sick are getting sick, and you’re more likely to get long COVID if you get COVID again.”

There are studies, meanwhile, suggesting vaccination lowers the likelihood of developing long COVID, though it doesn’t eliminate it. And the number of people reporting long-COVID symptoms has declined since June 2022, suggesting its symptoms may eventually resolve for many people — though it takes longer than anyone would like.

(For a report on long-COVID treatments, see “How to Treat Long-Haul COVID.”)

A Q&A With Patrick Hanaway, MD

“The epidemic of COVID is one thing, but the pandemic of long COVID is having a much more serious impact on our healthcare system,” says functional-medicine practitioner Patrick Hanaway, MD. Long COVID strikes an estimated 10 percent of people who get COVID and its price is a heavy toll; Hanaway notes that Harvard economist David Cutler, PhD, has estimated the total cost of long COVID will be $3.7 trillion in healthcare, lost wages, and quality of life.

Hanaway is working with a group of fellow physicians on treatments for long COVID, but simply understanding the genesis and ramifications of the disease has been the first great hurdle.

We spoke with Hanaway about how long COVID develops and affects our bodies.

Experience Life | There is an array of different explanations for long COVID, but they all seem to come down to this concept of it being a postviral syndrome. Can you explain what a postviral syndrome is?

Patrick Hanaway | What we’ve learned is that, after a viral infection, there are long-term changes that can occur. We first began to really recognize this in the [19]80s with the emergence of myalgic encephalomyelitis, or chronic fatigue syndrome. And when we go back and start looking, we actually find one of the biggest times this happened was following the Spanish flu epidemic that occurred at the end of World War I. Today, this is clearly seen with the SARS-CoV-2 virus. And those of us in the functional-medicine arena began to see this begin literally two months after the first infections were emerging.

EL | How does the identification of long-COVID blood biomarkers help?

PH | The biomarkers form a validation that there is a consistency of a pattern of what is referred to as the immune phenotype — that’s what’s happening with the immune system and various immune markers in the patients who have these more than 200 different symptoms of long COVID.

EL | Does finding the blood biomarkers actually direct treatment?

PH | No. The gut microbiome produces less serotonin, affecting the brain and decreasing stimulation of the hypothalamic-pituitary-adrenal (HPA) axis, leading to a decrease in cortisol production. And we know that there are imbalances in the immune system, but we don’t have specific remedies for those findings. And it also doesn’t tell us what’s the mechanism of why that’s happening. There is no one thing that’s going on here; there’s a convergence of factors. We think there are five primary drivers of long COVID:

1. ACE2 receptor damage and microclots
2. Chronic persistent inflammation
3. Viral persistence
4. Microbiome dysbiosis
5. Mitochondrial dysfunction

We know that when the virus binds to the cells, they bind at the ACE2 receptor, and there can be damage that happens where that binding occurs. So that’s the first thing.

We know that there’s acute inflammation that becomes chronic inflammation in these patients. That chronic inflammation would be represented by the immunophenotyping blood markers.

[We’re] finding is that there are fragments of virus. It’s not necessarily a whole virus, but we do know that viruses can hide and get sequestered in our bodies.

Now, there’s a question about the chronic inflammation: Is it possible that some of these people still have the virus? And what we’re finding is that there are fragments of virus. It’s not necessarily a whole virus, but we do know that viruses can hide and get sequestered in our bodies. A classic example of that would be the chickenpox virus, which is called varicella. After we are young and we have chickenpox, the varicella-zoster virus goes into the dorsal nerve roots along our spinal cord and can come out as shingles when we are immunologically weakened. There are other viruses where this can happen, like herpes simplex, human herpes virus 6, Epstein–Barr, and many other viruses. So, this is not uncommon at all.

The initial infection can affect some people’s lungs [or] some people’s heart, and [cause] inflammation of the myocardium. In some patients, it causes changes in their brain, causing brain fog or mood disorders.

We also find that there’s a signature of an alteration of the microbiome, and that people whose gut microbiomes had been altered were more likely to get long COVID. People who have long COVID have a specific signature of alterations in their microbiome. And we know that the microbiome is closely related to the immune system. There’s actually a triad of interaction because both the microbiome and immune system communicate closely with the mitochondria.

The mitochondria produce energy. From a functional-medicine perspective, when we see issues of brain fog and postexertional fatigue, which are two of the most common symptoms in long COVID, those symptoms generally derive from poor energy production, which happens in mitochondria. Suffice it to say that the brain uses more energy, ATP [adenosine triphosphate], than any other part of our body. When we exercise and we have a higher demand for ATP for energy, that can cause the system to crash afterwards. And that’s what we see with a lot of these patients: brain fog and postexertional fatigue.

EL | And how is this focusing treatments?

PH | The interesting part of this is that there’s such a broad array of different symptoms that people have that one has to take a much more comprehensive approach to treat and work with it. We know that immunologically, there’s an issue because of the relationship of what’s going on with the brain — that the body doesn’t have the same capacity to deal with stress.

Thus, the idea is to take a multisystem or multipronged approach to treat it. We don’t have it dialed yet. We hoped we could find, “Oh, there’s five or eight different subtypes. And for this subtype we do this, and for this subtype we do that.” We would love to have that, but we’re not seeing that.

We don’t have it dialed yet. We hoped we could find, “Oh, there’s five or eight different subtypes. And for this subtype we do this, and for this subtype we do that.” We would love to have that, but we’re not seeing that.

There’ve been some retrospective reviews and papers that say there’s four or six subtypes, but there’s a lot of overlap between them. So, from a practicing doctor’s perspective, it’s not very helpful; it doesn’t really guide treatment at this point in time. But many of the kinds of studies that are being done are trying to take a single agent, like the antiviral Paxlovid, and say, ‘Hey, let’s give this a try and see if we are able to resolve it.’ And if it’s able to help 20 percent of the people, but 80 percent aren’t getting better, you’re not actually going to see benefit in a clinical trial.

But that’s just statistics. If you were able to figure out the 20 percent that were having the issue with viral persistence and you gave them the Paxlovid, maybe you would be able to see that effect. But we cannot yet define that subtype.

EL | What else are we learning about long COVID?

PH | One thing is that the significant majority of people who have had long COVID had only a mild initial COVID illness. So, we know that if you had a severe illness, you’re more likely to have long COVID. But because more than 200 million Americans have had this infection, there’s a lot of people with long COVID. So, there’s two other pieces that are important here.

One is that a third of the people with long COVID had no other health issues beforehand. None. So, it isn’t just people with obesity or diabetes or the elderly who are getting it. This is actually occurring across the whole spectrum of the population. We’re seeing the loss of work, the loss of productivity, to be huge.

The other thing is that if you’ve had COVID and you did not get long COVID, having another infection increases your likelihood of getting long COVID. More infections, more long COVID. It’s not as if it is protective. That’s scary. Many people who weren’t sick are getting sick, and you’re more likely to get long COVID if you get COVID again.

We’re in this current wave [in fall 2023 and early winter 2024] where there’s a new strain and more people are getting acute COVID infection. Thus, we have to really work vigilantly to understand and take a multisystem treatment approach.

EL | What are elements of treatment?

PH | This is foundational: In order for a multisystem treatment to work, you have to help people first to be eating a good diet. That nutritional foundation — if they’re eating “crappy food,” they cannot get better.

EL | And does exercise play a role as well?

PH | Exercise is an interesting one. Small amounts of targeted exercise are good, but if you overdo it, it’s bad. We know that exercise actually increases the efficiency of the mitochondria and energy production. But one of the hallmarks of this disease, of this illness, is postexertional fatigue. You push yourself too hard and you’re wiped out for a couple of days. So, the exercise prescription has to be judicious.

A Q&A With Jacob Teitelbaum, MD

Long COVID strikes an estimated 10 percent of people who get COVID and its effects can be devastating, resulting in fatigue, insomnia, cognitive dysfunction or brain fog, chronic pain, and more, says integrative-medicine internist Jacob Teitelbaum, MD.

He brings a unique perspective to the search for treatments. “In 1975, a nasty viral infection left me homeless and having to drop out of medical school for a year, when it triggered postviral chronic fatigue syndrome [CFS],” Teitelbaum says. “In learning how to recover myself, it helped in my developing a more comprehensive approach and understanding.”

Since then, he’s been focusing on effective treatments for postviral infections and other causes of CFS and fibromyalgia — which are related to long COVID.

“There are likely multiple, potentially overlapping, causes of long COVID,” notes a review published in Nature Reviews Microbiology of 210 studies. Several hypotheses for its pathogenesis are being examined, including persisting reservoirs of the virus in tissues; immune dysregulation potentially with reactivation of underlying pathogens, such as Epstein–Barr virus, among others; impact on the microbiota; autoimmunity; microvascular blood clotting; and dysfunctional signaling in the brainstem and/or vagus nerve.

Long-COVID symptoms are myriad. As a 2023 Mayo Clinic report notes, “Distinguishing PCC [postCOVID condition, another term for long COVID] from other conditions can be challenging because patients with PCC often report numerous and vague systemic symptoms.”

We talked with Teitelbaum about emerging treatments for long COVID.

Experience Life | Can you explain how long COVID develops after the initial COVID infection?

Jacob Teitelbaum | Many infections do not have the mitochondrial ‘machinery’ needed to produce their own energy. Rather, they hijack our body’s energy production to reproduce. Our body suppresses our own energy production to starve the viruses. This is one reason people feel tired during many severe viral infections.

Normally, after the infection passes, energy production returns to normal. But not always. In about 10 percent of people after COVID, energy production stays suppressed. This then triggers a chain reaction in the body with hypothalamic dysfunction, widespread muscle shortening and pain, and a form of inflammation in the brain called microglial activation. Each of these then triggers its own cascade of events. Immune activation and exhaustion occur alongside the low energy, likely two sides of the same coin.

The body shuts down energy production to starve the virus and is unable to turn energy production back on. So multiple systems start to fail.

So that is a moderately complex way of stating what occurs. In simpler English? The body shuts down energy production to starve the virus and is unable to turn energy production back on. So multiple systems start to fail.

In most people, long COVID begins with the initial viral infection. The fatigue simply doesn’t go away but instead progresses to the rest of the symptom complex after several weeks. But in some cases, people do recover for a few weeks to months, and then the symptoms come back after initially recovering.

EL | How is long COVID related to postviral chronic fatigue syndrome?

JT | For most researchers who are experienced in the field, long COVID and postviral chronic fatigue syndrome are the same thing. The research is also confirming this. Even Dr. [Anthony] Fauci recognized this early in the COVID epidemic.

EL | You have done multiple studies on treatments for CFS and fibromyalgia and written several books on the subject, including From Fatigued to Fantastic! and The Fatigue and Fibromyalgia Solution. How can these treatments help people recover from long COVID?

JT | Basically, our research focuses on increasing cellular energy production. For example, the molecule ribose is the backbone of energy production (ribose plus phosphate plus B vitamins are essential components of ATP, NADH [nicotinamide adenine dinucleotide], and the other key energy molecules). Research showed that ribose levels became deficient in CFS and fibromyalgia. So, we published two studies, one of which showed a 61 percent average increase in energy by simply giving the ribose.

We have also studied other herbs (for example, HRG 80 red ginseng) and nutrients (ribose in combination with licorice to help adrenal function), some of which showed quite significant benefit.

Though helpful, this is not enough by itself.

Our randomized double-blind, placebo-controlled published study showed that people do best using a comprehensive approach to increasing energy. Called the SHINE Protocol, it optimizes Sleep, Hormones/Hypotension, Infections, Nutrition, and Exercise as able. This is dramatically effective, resulting in 91 percent of people with CFS or fibromyalgia improving after more than three months with an average 90 percent increase in quality of life after almost two years.

EL | What kinds of treatment are you working with for long COVID?

JT | There is no lack of effective treatments for long COVID; there is simply lack of physician education. Unfortunately, being a complex illness with low-cost treatments, there is not much financial resource for this to change. But on a brighter note, there is a lot that people can do on their own to both understand their condition and recover.

Simple ways to begin:

1. Start with a high-dose multivitamin with high levels of B complex and at least 150 mg of magnesium. RDA levels are inadequate for this condition.
2. Take a unique form of red ginseng called HRG 80 Red Ginseng Chewable Tablets — one-half to two tablets daily. It does need to be this form as other ginsengs do not have adequate levels of the active components. I recommend the chewables as it significantly cuts the cost. Even one-half tablet a day is enough for many people.
3. I would also add 5 grams of ribose powder twice daily. It looks and tastes like sugar and can be added to any drink or food. I do recommend the bioenergy form used in the study, which can be found in many products. In many people, this combination alone may double their energy.

The post Are There Biomarkers for Long COVID? appeared first on Experience Life.

The Centers for Disease Control and Prevention last week announced guidelines for the latest COVID vaccine, a frank admission that the bug is now considered endemic and that American seniors, especially, need to get used to dealing with it every year, just as we do with the flu. So, at some point in the weeks ahead, I’ll roll up my sleeve again and get jabbed for the fourth time, hoping that scientists have figured out how best to repel the latest variant.

Meanwhile, Patricia Anderson and other older adults may be left wondering why a scientific community that can reliably design effective vaccines remains so befuddled by COVID when its effects linger for months or years after contracting the infection. The normally active 68-year-old caught the bug in March 2020 and finds herself still struggling with everything from chills and breathing difficulties to cognitive troubles and nervous-system issues. “I was very sick for a long time, and I never really got better,” she tells Paula Span in the New York Times.

Long COVID is less common among the Medicare set than among younger Americans, but a recent study of U.S. military veterans suggests it presents a greater risk of metabolic disorders, cardiovascular issues, gastrointestinal distress, and cognitive problems for seniors. “There’s almost no organ system long COVID doesn’t touch,” notes Ziyad Al-Aly, MD, a clinical epidemiologist at Washington University School of Medicine, who authored the report.

And it can be challenging to diagnose. Older adults may have trouble recognizing the symptoms, often assuming that what they’re experiencing is just another product of the aging process. Their doctors may not be that helpful, either. Sheila McGrath, 71, who cohosts with Anderson an online support group for long-COVID sufferers, tells Span that coping with its effects can be an emotional trial. “Often someone winds up in tears,” she says. “They’re so frustrated with not being listened to, not being validated, being told it’s psychosomatic, being refused treatment. None of us wants to be sick.”

A similar level of frustration has seeped into the scientific community as well. As Steven Phillips, MD, MPH, and Michelle Williams, ScD, write in STAT News, long COVID remains mostly a mystery, despite a $1.15 billion research initiative launched in December 2020. “The critique is that mostly observational studies have characterized risk factors, demographics, and attributes of the clinical syndrome, but little has emerged that directly contributes to prevention or patient care,” they note.

But Phillips, a Global Virus Network board member, and Williams, a professor of epidemiology at Harvard, argue that the key to unlocking the long-COVID puzzle “is hiding in plain sight.” That’s because the illness is not really a new one; researchers should address it as they would treat chronic fatigue syndrome (CFS), which is typically triggered by a viral infection. “Although some have recognized and studied their similarities,” they explain, “it seems no one has made the simplifying observation that they are essentially the same condition.”

Researchers have been exploring CFS for decades, they note, and by building on that work public-health officials could prioritize their investments in time and money while providing a modicum of hope to long-COVID sufferers. It would also prevent what they believe are wasted efforts to link the illness to viral persistence, immune-system derangement, and other causes that CFS researchers have found to be less than fruitful.

“There is an already extensive body of patient-care experience, guidance, and resources for best practice to build on in the clinical management of post-infection syndromes,” they argue. “This should be aggressively applied to the benefit of long-COVID patients.”

This would include coordinated clinical care and rehab options for patients, as well as providing training for healthcare providers, they add. “The wheel does not need to be reinvented, only improved.”

Phillips and Williams admit that there are a few specific types of cases in which the consequences of a COVID infection, such as myocarditis, blood clots, and post-intensive care syndrome, do not fit the CFS model. But their characteristics converge far more clearly than they diverge, and that’s nowhere more apparent than in the way physicians often respond to patients like Anderson and McGrath who contract the illnesses.

Just as healthcare providers have long debated whether CFS is a “real” disease or simply psychosomatic, long-COVID patients are encountering the same obstacles today — despite ample scientific evidence to the contrary. Moving beyond that debate, Phillips and Williams argue, is essential to finding a path to more effective treatment approaches. “It allows for less contentious, more productive, and targeted patient care and research strategies; enlightened policies; and more cost-effective investments for addressing the long-COVID crisis.”

The post PUMPING IRONY: Still Clueless After All These Years appeared first on Experience Life.

Because COVID-19 has upended so many facets of our lives over the past three years, it should come as no surprise that it has had a lasting impact on our personalities.

That’s what Angelina Sutin, PhD, and her team of researchers concluded after analyzing personality assessments of some 7,100 participants in the Under­standing America Study during the “acute” (2020) and “adaptation” (2021–2022) phases of the pandemic and comparing them with prepandemic appraisals.

Focusing on five personality traits (neuroticism, extroversion, openness, agreeableness, and conscientiousness) during COVID’s spread, Sutin’s team tracked behavioral changes to determine to what ­extent this stressful global event could alter a person’s personality.

What they learned suggests people adapt at varying rates:

• Older adults reported feeling less neurotic (defined in the study as a tendency to experience negative emotions and vulnerability to stress) during the early phase of the pandemic before returning to prepandemic levels as the crisis wore on.
• Younger participants, on the other hand, reported increasing levels of neuroticism as time went on as well as declining levels of agreeableness and conscientiousness.
• Overall, study participants gradually became less agreeable, conscientious, extroverted, and open to new points of view.

“Current evidence suggests the slight decrease in neuroticism early in the pandemic was short-lived, and detrimental changes in the other traits emerged over time,” Sutin writes in the journal PLOS ONE. “If these changes are enduring, this evidence suggests population-wide stressful events can slightly bend the trajectory of personality, especially in ­younger adults.”

It’s during young adulthood that personality tends to develop and consolidate, eventually leading to “greater maturity in the form of declines in neuroticism and increases in agreeableness and conscientiousness,” Sutin explains. “Over a year into the pandemic, however, young adults show the opposite of this development trend.”

This article originally appeared as “Making the Connection: The Pandemic & Altered Personalities” in the May 2023 issue of Experience Life.

The post Has the Pandemic Changed Our Personalities? appeared first on Experience Life.

In March 2020, Gez Medinger came down with COVID-19. The London-based filmmaker was 41 years old, busy with work, sports, and training for the London Marathon. “Exercise and activity were a huge part of my life,” he recalls. “I was near the end of my marathon training, and I was the fastest and fittest I’d ever been.”

Medinger’s bout of COVID was mild. “At the time, we were told there were basically two possible outcomes. If you’re old and have preexisting conditions, you might end up in the hospital and it might go very badly. If you’re young, you’ll get over it in a week and you’ll be fine.”

Feeling that he was in the latter category, Medinger returned to marathon training in the second week of his infection. “I started going on some gentle runs every day — because I didn’t want to lose fitness,” he says. “Looking back, I wish I hadn’t.”

After each run, he felt exhausted. But he kept powering through.

One morning, about five weeks after his initial infection, he woke up with a distinctly gristly feeling in his throat and chest. Medinger remembered having the same feel­ing 20 years earlier when he had mononucleosis, the illness caused by Epstein-Barr virus (EBV).

“It took me a year to get over mono. I thought, Am I looking down the barrel of another year like that now?”

Medinger struggled with intense fatigue, headaches, heart palpitations, and brain fog. Then he heard about others experiencing the same. So he decided to devote his YouTube channel to exploring the science of postviral fatigue and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), which shares many symptoms with long COVID.

His videos soon attracted hundreds of thousands of views, many of them from fellow long-haulers — people who had also found themselves unable to return to their pre-COVID baseline.

Medinger has found some pro­vocative commonalities among his extensive community of long-haulers. “It’s a subject that’s quite sensitive to address for those with a history of ME/CFS, but we’re seeing a surprisingly high proportion of people who previously exhibited type A personalities,” he says. “And when you dig a bit more, they frequently have some history of significant prior physical or emotional trauma.”

He’s also noted that a disproportionate number of athletes and highly fit people have been affected. In an informal poll of 1,200 long-haulers, Medinger found that two-thirds had engaged in vigorous exercise at least three times a week before their ­COVID-19 infection.

“The patients I’ve disproportionately seen in the long-COVID program are those who spend a lot of time on cardio-based activities — marathon runners, people who are really into biking. Less frequently, I see patients who do more weightlifting or yoga types of exercise.”

This mirrors UCLA Health Long COVID Program director Nisha Viswanathan, MD’s experience. “Interestingly, the patients I’ve disproportionately seen in the long-COVID program are those who spend a lot of time on cardio-based activities — marathon runners, people who are really into biking. Less frequently, I see patients who do more weightlifting or yoga types of exercise.”

These anecdotes do not qualify as scientific data. But if they point toward an underlying vulnerability among highly fit, active, and driven types, what might be the cause?

“The thing that gives this theory merit is that there are downsides to being a type A personality and being an overexerciser in terms of immune function,” says Joel Evans, MD, director of the Center for Functional Medicine in Stamford, Conn. Whether physical or psychological, “stress decreases the efficiency of the immune system and could conceivably increase the likelihood of developing long COVID.”

Whether physical or psychological, “stress decreases the efficiency of the immune system and could conceivably increase the likelihood of developing long COVID.”

High levels of activity can also stress the autonomic nervous system (ANS), adds Medinger. The ANS controls bodily functions that aren’t consciously directed, such as breathing, heart rate, and digestion.

“When those autonomic systems are running in a high state of stress, it’s relatively easy for them to be tipped over into this dysregulated state,” he explains. Indeed, many long-COVID sufferers experience dysautonomic symptoms: a racing heart, shortness of breath, headaches, dizziness, and extreme fatigue.

This may also explain why prior trauma could increase one’s vulnerability to the illness. Medinger explored this in video interviews with clinical psychologist Sally Riggs, DClinPsy. Riggs also suffered from long COVID, but she found relief through an approach that included addressing past emotional trauma.

“If you’ve got prior trauma, especially in childhood, you find yourself existing in a constant state of sympathetic overdrive, because that has become familiar,” says Medinger. “Going into rest-and-digest mode actually feels uncomfortable, so you do stuff to keep yourself in fight-or-flight mode — hence the type A personality. You may think you’re living a healthy lifestyle, but your whole body is on a knife’s edge.

“Then this pandemic virus comes along and knocks you over the edge.”

This was excerpted from “How Long COVID Affects Your Ability to Exercise” which was published in the December 2022 issue of Experience Life.

The post Is There a Long-COVID “Type”? appeared first on Experience Life.

Many people with long COVID have tried a vast array of nutritional supplements, searching for one — or a combination — that will help. “Anecdotally, patients say some of these supplements work, but we have no studies showing any one thing has been superior for all patients,” says UCLA Health Long COVID Program director Nisha Viswanathan, MD.

Gez Medinger, a long-hauler, agrees. “You can find someone for any supplement, saying, ‘This fixed me.’ There’s a list as long as your arm, and you can spend thousands of dollars on them. Do any of them really seem to help consistently across the board? No.”

Nutrients that support mitochondria, such as carnitine, thiamine, riboflavin, magnesium, CoQ10, and alpha-lipoic acid, can help enhance mitochondrial function and energy production.

Still, Evans notes that quercetin (a bioflavonoid found in onions, green tea, apples, and berries) is important for immune function. And nutrients that support mitochondria, such as carnitine, thiamine, riboflavin, magnesium, CoQ10, and alpha-lipoic acid, can help enhance mitochondrial function and energy production (see “The Care and Feeding of Your Mitochondria” to learn more about these “energy factories” that are essential to energy, focus, vitality, and metabolism).

Restoring gut health with probiotics is also important and supported by research. (For more on probiotics and gut health, see “Everything You Need to Know About Probiotics“.)

Just as everyone will have unique supplement needs, dietary approaches work best when personalized. Viswanathan has seen some patients improve on an anti-inflammatory, low-histamine diet that limits carbs and omits meat, lactose, and alcohol.

But this highly restrictive approach can be difficult to maintain over time. Working with a functional nutritionist or doctor can help someone with long COVID chart a sustainable, personalized path forward.

This was excerpted from “How Long COVID Affects Your Ability to Exercise” which was published in the December 2022 issue of Experience Life.

The post What Supplements Can I Take to Support Long-COVID? appeared first on Experience Life.

A standard approach to graded exercise — walking one mile one week, two the next, etc. — isn’t likely to work for people with long COVID. “Pushing through ‘the wall’ is more detrimental for them than allowing the body to rest,” says Nisha Viswanathan, MD. She charts a gradual, tiered exercise-recovery process:

1. Minimal movement, keeping the heart rate below 100 bpm
2. Slowly increasing the duration of gentle activity, keeping the heart rate low
3. Building toward brief bursts (five to 10 minutes) of movement with higher heart rates

How to Pace Yourself After COVID

Pacing was developed in the late 1980s as a tool for patients with chronic fatigue syndrome. Now, many long-COVID patients struggling with fatigue are finding it useful. The goal is to allow for as much activity as possible while limiting the frequency and severity of relapses.

People with severe fatigue usually have good and bad days. Good days present the temptation to accomplish as much as possible to make up for lost time, but this often backfires and leads to a crash.

Pacing takes a different approach. “When you have a good day, you do more things than on a bad day, but you don’t push yourself to the limit,” explains Leonard Calabrese, DO.

You calibrate an “energy envelope” for the day, allocate it carefully, and make sure you keep some in reserve. “It’s almost an art form,” he adds. This careful balance of activity and rest helps to manage a damaged aerobic energy system.

Pacing also requires a reappraisal of what constitutes activity. Anything that takes effort, whether mental, physical, or even postural (such as being upright), comes out of the day’s energy budget. Reading, talking on the phone, attending a Zoom meeting — these all count as activities.

“With pacing, I tell people to find ways to savor the good days and do things that bring joy,” says Calabrese. “If this is successful, the good days get more frequent and the bad days get less frequent and less severe.”

This was excerpted from “How Long COVID Affects Your Ability to Exercise” which was published in the December 2022 issue of Experience Life.

The post Do’s and Don’ts of Exercising With Long COVID appeared first on Experience Life.

We can handle only so much drama and trepidation, so I’m not surprised to discover that, nearly three years into the current pandemic, U.S. seniors seem to have largely stopped worrying about COVID, casting their collective fate to the wind.

It’s difficult to draw any other conclusion from recent reports revealing the woeful response among my contemporaries to the latest round of COVID boosters. About seven in 10 seniors rolled up their sleeves for the first booster, fewer than half have been jabbed with the second, and they’ve essentially ignored the updated bivalent booster — only about one in 10 have received the latest shot.

“Most older people were vaccinated; they weren’t hesitant or opposed,” Anne Sosin, MPH, a public-health researcher at the Rockefeller Center for Public Policy, tells the New York Times. As each additional booster came along, however, seniors have mostly demurred. “They’re not very motivated and they haven’t been given a reason to be,” she adds. “There’s more of a sense of ‘Why bother?’”

It’s not just that many of us have become inured to the threat; it has also receded at the public-health level, creating a lack of urgency. “The messaging on boosters has been very muddled,” Sosin argues. And that has exacerbated the generally laissez-faire attitude many seniors have adopted toward the virus, producing what could be a dangerous environment as we move into and through the holiday season. “Older people are entering the winter with less protection than at earlier points in the pandemic,” she notes.

I rolled up my sleeve for the third booster last week, a move that I hope will continue to ward off the virus into the foreseeable future. But I’ve been struck in recent days by reports from public-health experts — as well as stories from neighbors, friends, and colleagues — that suggest even multiple doses of the vaccine do not guarantee immunity against the ever-evolving bug.

You may have seen the news story last week reporting that the pandemic is now killing more vaccinated than unvaccinated Americans. “Fifty-eight percent of coronavirus deaths in August were people who were vaccinated or boosted,” McKenzie Beard wrote in the Washington Post. “In September 2021, vaccinated people made up just 23 percent of the coronavirus fatalities,”

And, if we didn’t immediately get the message, Beard laid it out in simpler terms: “It’s no longer a pandemic of the unvaccinated.”

The story went on to encourage people to get their shots, but you needed to dig down to the eighth paragraph before you’d find an explanation for the troubling shift: “At this point in the pandemic, a large majority of Americans have received at least their primary series of coronavirus vaccines, so it makes sense that vaccinated people are making up a greater share of fatalities.”

And further down: “Unvaccinated people 50 and up had 12 times the risk of dying from COVID-19 than adults the same age with two or more booster doses.”

When I noticed My Lovely Wife scanning the story in our local newspaper, I found myself fumbling for the obvious explanation. I can only imagine how the headline — “Vaccinated people now make up a majority of COVID deaths” — played among our cohort who haven’t yet decided whether the booster is worth the trouble.

I suspect those of us seniors who have kept up with our vaccinations understand we’re far less likely than our unvaxed contemporaries to land in the ER or the local mortuary as a result of contracting the virus, but we’re still getting sick. The septuagenarian couple next door, who had managed to avoid the bug since the plague first struck, came down with a nasty case earlier this month. Cases among friends and colleagues have also become almost commonplace in recent weeks. The fact that all these people were vaccinated and boosted tends to challenge the notion that vaccines alone will allow us to dodge each succeeding version of the virus.

The threat COVID presents is “reduced, but it’s not gone,” William Schaffner, MD, a Vanderbilt University infectious-disease specialist, tells the Times. “You can’t forget it. You can’t put it in the rearview mirror.”

It seems a bit paranoiac to even consider returning to some version of the shelter-in-place mindset that dominated the early days of the pandemic, but I can’t help thinking some caution is warranted. It’s simply naive to assume COVID is in retreat. The most recent variant currently making the rounds, BQ.1.1, is about 175 times more resistant than the original virus to the body’s immune defenses.

And while that knowledge has not yet convinced MLW and me to avoid our favorite coffee shop (the tables are well spaced, we tell ourselves) or seriously reconsider our options for dining out, we remain skeptical of large gatherings and generally find ourselves more circumspect today than we were a few months ago.

COVID may have been in our rearview mirror, but we’re beginning to understand that it’s closer than it may appear. Here’s hoping our contemporaries are paying more attention as well.

The post PUMPING IRONY: Why Bother? appeared first on Experience Life.

The post How Long COVID Affects Your Ability to Exercise appeared first on Experience Life.

You’ve no doubt noticed, as I have, that pretty much everybody is coming down with COVID these days. The cases are typically milder than during the initial phases of the pandemic, but the currently circulating Omicron variants still pack enough of a wallop that even those of us who have been vaxxed and boosted should be on guard: Of COVID-related deaths in the U.S., the percentage who had been vaccinated has risen from less than 20 percent last August to more than 40 percent in February.

And prior infection doesn’t seem to offer much protection either. I know a few people who have already suffered through a second bout with the virus, despite getting a full dose of vaccinations and the first booster. There’s plenty of evidence showing that immunizations are saving lives, but immunity wanes, and every new variant seems to be more transmissible than its predecessor.

You’d think those numbers alone would be enough to persuade more of my contemporaries to get all the available shots, but as Liz Szabo explains in Kaiser Health News, the obstacles they face are many and varied. And the federal government has not been particularly helpful.

“The booster program has been botched from day one,” argues Eric Topol, MD, director of the Scripps Research Translational Institute. “This is one of the most important issues for the American pandemic, and it has been mismanaged.”

The messaging has been muddled from the beginning, Topol says. The Centers for Disease Control and Prevention (CDC), for instance, has never included the booster shot in its definition of a “fully vaccinated” person. “If the CDC would say, ‘This could save your life,’ that would help a lot.”

But the agency has not made that clear, and though about 90 percent of seniors have received a full dose of the Moderna, Pfizer, or Johnson & Johnson vaccine, only 69 percent have rolled up their sleeves for the first booster.

A lack of consensus about the need for boosters among public-health agencies certainly slowed uptake. And the government’s staggered rollout — focusing on those with vulnerable immune systems last August, people over 50 in October, all adults in November, and kids 12 and up in January — didn’t help. Especially at a time when restrictions were easing, and Americans were finally emerging from their cocoons and eagerly anticipating the end of the scourge.

“We finally got to a place where we got people to get two shots, and then we said, ‘Oh, by the way, you need a third one,’” says LaTasha Perkins, MD, a Washington, D.C.–based family physician. “That was jarring for a lot of communities. ‘You convinced me to buy in, and now you’re saying that two shots aren’t good enough?’”

Distribution issues have also played a role in the lack of booster uptake, notes David Grabowski, PhD, a healthcare policy professor at Harvard Medical School. When the vaccines first became available early last year, the federal government actively coordinated delivery to thousands of sites across the country while aggressively promoting immunization. There’s been far less urgency — and effectiveness — from Washington in the distribution and promotion of the boosters.

“I felt like we were getting hit over the head originally and all roads led to vaccines,” Grabowski says. “Now, you have to find your own way.”

Nursing homes, understaffed and often poorly managed, are now responsible for procuring and administering booster shots for their residents. But those seniors may actually be better served than those living independently, who are left to search for the shot on their own amid a primary healthcare system that former CDC director Thomas Frieden, MD, calls “life-threateningly anemic.”

The system, Frieden explains, simply isn’t structured to handle a public-health mission. Providers haven’t invested in the technology necessary to securely track their patients’ vaccination history and reach out to them to schedule follow-up immunizations in a timely manner. And, not surprisingly, physicians have no financial incentive to keep their patients current on their shots.

And then, of course, there’s our yawning chasm of healthcare equity: Even before the pandemic struck, a large chunk of the U.S. population (about 78 million people) couldn’t claim a regular source of healthcare.

Those who, like me, are fortunate enough to enjoy access to a clinic may nonetheless find themselves flummoxed in their pursuit of a booster. Online scheduling systems can be difficult to navigate, and transportation options for some may be limited. “If people have to take two buses or take time off from work or caregiving for their family, people are less likely to be vaccinated,” notes Lori Smetanka, JD, executive director of the National Consumer Voice for Quality Long-Term Care.

All these obstacles have not prevented seniors here in Minnesota from answering the call: About eight in 10 of my counterparts have been boosted, the best showing of any state in the country, according to the CDC. And although that uptake offers some assurance against a virus that continues to mutate, reality has a way of intruding on complacency. My longtime golfing pal, the Commissioner, recounted last week how his 75-year-old vaxxed and boosted body battled through its second bout with the bug — much milder than the first time, but still. . .

The earliest appointment I could secure for my second booster is July 5. I’m tempted to call it COVID Independence Day, but something tells me freedom from this pandemic is still a long way off.

The post PUMPING IRONY: In Need of a Boost appeared first on Experience Life.