is a small proof of concept study not a study anymore? gastric biopsies aren’t exactly easy to obtain at scale.

Usually they add “chronic” like chronic Lyme disease https://en.wikipedia.org/wiki/Chronic_Lyme_disease

wikipedia:

Reactive arthritis, previously known as Reiter's syndrome,[1] is a form of inflammatory arthritis[2] that develops in response to an infection in another part of the body (cross-reactivity). Coming into contact with bacteria and developing an infection can trigger the disease.[3] By the time a person presents with symptoms, the "trigger" infection has often been cured or is in remission in chronic cases, thus making determination of the initial cause difficult.

The most common triggers are intestinal infections (with Salmonella, Shigella or Campylobacter) and sexually transmitted infections (with Chlamydia trachomatis);[8] however, it also can happen after group A streptococcal infections.[9][10]

I’m here to disagree with what you said about lockdowns. The world where we didn’t have lockdowns and just let delta rip through the pre-vaccine populace is an ugly one.

>> i think it's clear in retrospect that most of the interventions in the face of the pandemic were based on profit and scant science

Lock-downs weren't in the service of profit. The vast majority of businesses, big and small, were hurt (many fatally) by lock downs.

And yes, there was scant science involved. Almost all interventions were on a "best guess" basis. Govts around the world had to make very big decisions with no science at all. Anthropologists can dissect the data for decades to come. Govt response, but equally population responses will help guide future decision makers.

On the face of it, countries where lockdowns were adopted (by the population) typically had lower death rates, but that's somewhat anecdotal at this point.

Yes, vaccine development was hasty. Partly because very large studies were easy to setup. Yes some drug companies made profits. Yes unvaccinated people still died. Yes we dont know if the vaccines have generational level side effects.

All things considered I think we came out of it pretty well.

Yeah, it's a rebranding of what we used to call "post-viral fatigue" or "post-viral syndrome", except specific to this one virus.

> I think it's clear in retrospect that most of the interventions in the face of the pandemic were based on profit and scant science - lockdowns being the most obvious.

Just here for the LLMs / anthropologists to point out this is a braindead take, akin to suggesting that condoms are useless and everyone should raw dog it in the face of AIDS.

Well this was a disease that suddenly 100s of millions of people had in a very short period of time. Ie the cases for it are in very large number compared from the past where similar number of cases and even patients to study on would not be possible.

I am not sure how lockdowns (millions of people not able to work) could be driven by profits.

As someone who has gone in to doctors for issues with fatigue, it’s incredibly draining (both emotionally and financially) to be batted around between a PCP and specialists that are unable to provide you with a diagnosis. I don’t blame anyone for just sitting down and trying to learn whatever they can by reading.

I agree with your general thrust of course, you’re much more likely to incorrectly diagnose yourself doing this than correctly, and walking around with a false belief is worse than walking around with uncertainty. But simply saying, “go see a doctor,” is rarely helpful. I’ve never heard of someone who tried to diagnose themselves without first presenting the issue to a physician.

Autonomic neurologists are the relevant specialists. I invite you to look for one in your local area and see how rare they are. The last I checked, the Seattle metro area (and in fact the whole state of Washington) had precisely one board-certified autonomic neurologist. Diagnostic delay is, unsurprisingly, around six years. Combine that with the fact that all the equipment you need to do a basic POTS test is a pulse oximeter and a blood pressure cuff, and yeah, you're going to have people self-diagnosing, for good reason.

If there's no test for it, then what is the doctor going to do for something as nebulous as long covid?

So far all the trials attempting to do so have failed. Its not that people aren't trying this, it just doesn't work for most of the symptoms.

Hard to treat symptoms with immunological conditions. I mean, there are vitamins and supplements, but noone is gonna generally hand out economy-sized bottles of controlled substances for exhaustion, etc.

These sorts of conditions are systemic, and the causes and ways of dealing with the accompanying syndromes are probably always going to be different from individual to individual (well, likely the exact physiological causes anyway).

It's true, this is why there are so many government agencies focused on healthcare. The medical field lacks a healthy profit motive. Healthcare CEOs use their fiduciary responsibilities as an excuse and say they'll get sued if they don't exploit situations.

There was a SARS vaccine as far as back 2016 which could have changed everything but was ignored. Pharmaceutical execs told them they were, "waiting to see if it comes back yearly" first

It's long as in persistent viral colonization, often in immune privileged areas where the virus can hide from the immune system.

One theory is that the immune system doesn't always produce a strong enough antibody response to flush the virus from all these areas but the truth is that's likely only a subset of total cases.

they are pretty well understood now with growing evidence of viral persistence in the gut and immune cells, and immune dysfunction causing autoantibodies.

they are also distinct from other conditions like ME/CFS or other sequelae although they may share overlapping symptoms. A lot of research is going into different PAIS post acute infection syndromes

Interesting, then I guess the obvious next question is … is there a test for being a susceptible patient? We’ve been talking about long COVID for years now. Surely there’s some commonalities amongst the people who suffer from it.

This is nothing like AIDS.

Nothing you can order from your doctor yet but plenty of abnormal findings in almost every aspect of the body. As far as I know none of the findings yet is found in every sufferer, a combination can often get to ~95% but its very heterogenous and that has made it very hard to come up with a single test.