By David Tuller, DrPH
Last week, just in time for Long Covid Awareness Day on Friday, the chief health officer of the Australian state of Queensland, John Gerrard, declared that the term “Long Covid” should be dropped. He based his argument on Queensland survey data suggesting that rates of prolonged disability after Covid-19 are similar to those after other respiratory illnesses.
The research, to be presented next month at a conference in Barcelona, has not been peer-reviewed. Nonetheless, the state’s promotion of these findings led to widespread news coverage and lots of criticism; his comments are really pretty stupid. In fact, Dr Gerrard has a well-deserved reputation for downplaying concerns about the pandemic.
To discuss the issue, I spoke with David Putrino, who trained as a physical therapist and neuroscientist in his native Australia and is now director of rehabilitation innovation at Mt Sinai Health System in New York. We also spoke about a new pre-print from Dr Putrino, Yale immunologist Akiko Iwasaki, and colleagues called “Sex differences in symptomatology and immune profiles of Long COVID.” (At one point, Dr Putrino searches for the name of an Australian Nobel laureate who trashed the Queensland research; it is Professor Peter Doherty, an immunologist, who tweeted his criticism here.)
I get that, in time, the term “Long Covid” may be considered not precise enough for patients suffering with post-covid sequelae, but to seek to dismiss it because it is too precise makes absolutely no sense to me. It IS important to identify what triggered a post-viral illness, not only for patients to receive the correct treatment but for willing participants to be included in the correct research. But a tactic of broadening criteria and bundling everyone in together seems to me to have been used to good effect to ensure that research never makes meaningful findings and that afflicted patients are left to struggle in the MUS swamp. When such an approach could have major global public health repercussions, I would hope that the WHO (-https://www.youtube.com/watch?v=3-CKgIdZe90) would step in to counter such narratives.
In relation to testosterone, on what basis is it thought that it might be having a protective effect? I understand that the results seem to point towards an association between Long Covid and lower testosterone levels but could covid potentially have upset a pathway or pathways resulting in lowered levels of testosterone in women and oestradiol in men? If so, treating with testosterone may not be therapeutic? (I do appreciate Dr Putrino’s caution.) Also, has Dr Putrino considered investigating Long Covid in communities of men and women who have had their gonads removed and who are on hormone replacement therapy? Does their HRT protect them from getting Long Covid?