A lack of information and protocols causes people with the disease to fend for themselves.
Key points you should know:
- Long COVID may affect millions of Mexicans, but a lack of information prohibits adequate medical care and innovative research.
- Some Mexican doctors are calling on the government to establish a national clinical guideline, which could direct local clinics and medical experts on how best to diagnose and treat the disease.
- Similar to other countries, the government places higher-priority on surveilling and addressing other easier-to-diagnose diseases, like dengue.
- Despite attempts to approve a clinical guideline, the government agency in charge of approvals has yet to review the proposal.
Listen to Annika Hom discuss this story on our podcast:
The only explanation Jacqueline Ventura can think of is Long COVID, also called COVID persistente in México. But though Ventura accrued a hodgepodge of symptoms for two years after getting reinfected with SARS-CoV-2, doctors never diagnosed her with the disease. Every symptom had an alternate explanation.
Like many around the world with Long COVID, the weightlifter from the State of Mexico has had to search for answers herself. She learned that many of the symptoms she had since her reinfection lined up with the disease. Yet no one would name it. Reporting from palabra found that the Mexican government ignores Long COVID and that Mexican health systems often write off the disease as psychological.
Some doctors argue if México adopts a national clinical guideline for Long COVID, the millions of Mexicans who have it could avoid what Ventura endured. But clinical guidelines, along with other basic disease strategies, are lacking in México compared to better-resourced countries.
The difference in approach puts México behind other countries which have attempted to fill the information gaps. More than 10 countries including the U.S., South Korea, and Spain have published clinical practice guidelines for Long COVID. These guidelines are standardized, evidenced-based protocols that medical professionals can apply to best treat a disease. Still, they aren’t always followed by providers, leading to medical gaslighting and poor care.
The Mexican government also keeps a master list of hundreds of practical clinical guidelines, which provide care protocols for specific diseases and per a study improved government care. The Mexican government adopted one for COVID-19 in 2020 — but did not mention Long COVID.
Without more data or standardized guidelines practitioners can use, Mexicans bear the consequences, argued a 2022 article by Dr. Mauricio Rodríguez Álvarez, a professor of medicine and the spokesperson for the university’s commission of COVID-19 emergency at the Universidad Nacional Autónoma de México.
Without one, patients may receive different diagnoses or care depending on who controls the narrative, he explained to the Revista de la Universidad de México. For example, pharmaceutical companies may benefit from prescribing unnecessary medicines, or the government may want to reduce diagnoses to cut medical costs, Rodríguez Álvarez argued.
Mexicans with Long COVID “are not being properly taken care of,” Rodríguez Álvarez told The Sick Times. “They are falling into the traps of those who tell them to take this, eat this, do this, wear this. There is no one to defend them.”
Ventura scheduled numerous appointments with specialists, doctors, and finally at México’s National Hospital of Homeopathic Medicine. Meanwhile, specialists prescribed different therapies for various diagnoses without figuring out what Ventura had. Like many with Long COVID, Ventura “lost faith in doctors” after that.
The current approaches to Long COVID aren’t enough, Ventura said. “There is no approach for public institutions to follow.”
There is no approach for public institutions to follow.
Jacqueline Ventura
The information vacuum
Like other countries where better-studied illnesses are higher-priority, Long COVID is an afterthought in México. Some doctors argue the lack of statistics, characterization, and investment in studies about Long COVID in México perpetuate prioritization of other diseases and invisibility of Long COVID.
A national case count could go a long way in characterizing the impact and thus influencing government spending priorities, including clinical guidelines. However, establishing a Long COVID diagnostic test has been elusive for the international Long COVID community, making it difficult to know exactly how many people are affected.
Still, using surveys and other data, scientists have been able to estimate. One national health survey disseminated in 2022 in México suggests more than 10 million could have experienced Long COVID symptoms at the time, or approximately 12% of Mexicans 20 years old or older.
But debate about the figure abounds among Mexicans doctors. One characterization study in 2024 estimated 37% of Mexicans experienced “post-Covid conditions” in 2021. A recent systematic review preprint found approximately 36% of the global population experienced Long COVID; as many as 38% of North Americans may have.
“In Mexico, if there’s no statistics, there’s no patients. If there’s no patients, there’s nothing to treat,” said Cesar Lepe Medina, the 34-year-old founder of the Long Covid Mexico Comunidad Solidaria Facebook group, which is a support and advocacy group with some 6,500 members. “If there’s nothing to treat, there’s no need for public policy or programs to draw attention to it.”
Compare Long COVID to dengue, a disease that is easier to diagnose due to tests and which México tracks publicly. When cases explode as they did in 2023 and 2024 — last year México confirmed more than 124,000 cases and 478 deaths — government officials and the press rushed to respond. For example, the government pushed national campaigns and prevention strategies against dengue, and state health departments implemented strategies to eliminate mosquitos.
In addition to Long COVID, Lepe Medina has contracted dengue twice. He notices the difference in how his country addresses them. While dengue is discussed, Lepe Medina said Long COVID is “taboo.”
“Here in México, they talk more about the flu and dengue than COVID-19,” Lepe Medina said. “We are collateral damage that no one wants to take on because we require a lot more money and resources.” Lepe Medina said his private medical insurance hasn’t paid “a peso” because Long COVID isn’t recognized in Mexico.
Rodríguez Álvarez suspects the government doesn’t want to take on the cost if too many Mexicans have Long COVID; with recognition, the government would be on the hook for consultations, tests, and treatments. If the narrative is up to the government doctors, “they will probably tell you that you don’t have anything,” he said.
Limited resources means México also lags behind other countries when it comes to research. In one 2024 study of global Long COVID prevalence, Mexican researchers noted that “nearly all evidence has been obtained in the U.S., Europe, and Asia.” Per another 2024 study that analyzed international Long COVID clinical studies, the authors suggested the highest number of studies occurred in the U.S., India, and Spain. Meanwhile, México has conducted only four Long COVID studies, according to a search on World Health Organization’s International Clinical Trials Platform.
“In the U.S., Germany, Great Britain, and Spain there’s more advancements overall among scientists who are doing investigations,” said Aristóteles Ramírez, a political science professor at the Universidad Autónoma de Querétaro who developed Long COVID following an infection in fall 2020. When he researched his symptom of dysautonomia, he didn’t find any Mexican studies. Only Spanish ones.
Findings from México’s scientists also aren’t making it into clinics, Ramírez added. But research is needed for new strategies to help manage symptoms. He wants more research focusing on Long COVID care strategies in México. “Don’t tell me there’s no answer,” he said.
We are collateral damage that no one wants to take on because we require a lot more money and resources.
Cesar Lepe Medina
Possible solutions despite limited government interest
A national clinical guideline would help inform treatments drawing from the latest Long COVID research. It’s “an extremely important step,” Rodríguez Álvarez said. And it may not be too far out of reach.
In 2023, Dr. Luis Del Carpio Orantes, an internist in Veracruz and an employee of México’s Institute of Social Security, proposed such a guideline to the Centro Nacional de Excelencia Tecnológica en Salud (CENETEC) in México, the body responsible for approving and implementing guidelines. Because there’s not yet a universally applicable pharmaceutical remedy for Long COVID, the proposed guidelines would focus on physical rehabilitation, cognitive rehabilitation, and speech therapy, he told The Sick Times.
Per a response CENETEC sent him, reviewed by The Sick Times, the agency promised to prioritize the proposal in 2024; that didn’t happen. CENETEC has not responded to The Sick Times’ request for comment.
Guidelines could enact change among more than 191 government-funded Long COVID clinics that treat people with the disease. Presently, the Long COVID clinic website promotes management strategies like exercise and sleeping techniques, and primarily focuses on respiratory rehabilitation. Many with Long COVID experience post-exertional malaise and have been diagnosed with myalgic encephalomyelitis (ME), which can be worsened by exercise.
Within the clinics, though, Mexicans with Long COVID told The Sick Times, doctors would accuse them of making up symptoms or that their ailments are psychological. “They say it’s anxiety,” Ramírez said. “They send you to the psychiatrist.”
These clinics and doctors staffing them “have been insufficient,” stated a 2023 study that Carpio Orantes co-authored. Speaking from personal working experience in an IMSS clinic, he said, “there are some tests that I can’t do there” to show biological issues. It’s a negative feedback loop: doctors say Long COVID “doesn’t exist,” Carpio Orantes said, and cases may be undercounted as a result.
Investing in Mexican research may help improve care at these clinics by offering more specificity about how the disease is impacting people in México. For example, the 2024 characterization study focused more on possible associations between hypertension (or high blood pressure) and Long COVID than other international studies because the authors knew hypertension is a prevalent health problem in México.
Echoing Ramírez, Lepe Medina said México needs to bridge the “substantial divorce” between Long COVID scientific findings and care in clinics. Presently, he said, “doctors can refuse to treat it and understand it, because it’s not in their clinical guidelines.” Years of accusations and waning attention regarding Long COVID in México has left Lepe Medina burnt out from advocacy. He’s skeptical that México will adopt clinical guidelines because “honestly, no one talks about it.”
That’s where Carpio Orantes said international collaborators may help: Spain already established Long COVID guidelines and conducted ample research — it can serve as a model. “The Spanish are the best to help us due to their experience, and they can guide us, too,” he said. “We can have a collaboration.”
He believes establishing a guideline, which he hopes receives renewed attention by CENETEC this year, can reduce some of the confusion Mexicans with Long COVID face as they are passed around from test to test. “That will be a very important step,” Carpio Orantes said. “By creating the guideline, we can force the health institutions to work according to what the guideline says.”
By creating the guideline, we can force the health institutions to work according to what the guideline says.
Dr. Luis Del Carpio Orantes
Annika Hom is an award-winning freelance journalist based in Mexico City, Mexico. Her work has appeared in WIRED, National Geographic, Harvard Public Health Magazine, and Mission Local. Follow her on X at @AnnikaHom.
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