Still Here, May 6: Links and transcript

Summary

In this episode of Still Here: Science journalist Colleen de Bellefonds discusses a spinal surgery that can help reduce symptoms for some people who have a rare complication of myalgic encephalomyelitis — and, increasingly, Long COVID. And writer and COVID resource archivist Nadica Zimmerman shares experiences from people still practicing COVID safety in the midst of a lack of community support.

Also in this episode: A preprint of a study in which researchers from University of California, San Francisco, and the National Institutes of Health found that COVID-19 may increase the long term risk of cancer.

Find our Long COVID news and commentary podcast on Spotify, Apple Podcasts, Pocket Casts, Amazon Music, iHeartRadio, or listen below and jump to the start of the podcast transcript. Thanks for your patience, everyone! This episode was delayed due to technical issues. As such, we’ve omitted the COVID trends as the ones we recorded are now out of date.

Jump to a specific part of the transcript:

• Intro
• Cranio-cervical fusion for cranio-cervical instability
• Still COVIDing without community
• Research
• Outro

Still Here overlaps with The Sick Times’ newsletter, which publishes weekly.

Mentioned in this episode (in order of appearance):

• The Sick Times: This surgery fuses people’s skulls to their spines to treat a condition overlapping with myalgic encephalomyelitis
• The Sick Times: Missives from the dismissed: Still COVIDing without community
• The Sick Times: Research updates, April 22

Additional audio in this episode: 

• Rude Mechanical Orchestra: Which Side Are You On? (orig. Florence Reece) 

Transcript

Intro (0:00) 

[Instrumental snippet of theme song, the Rude Mechanical Orchestra’s rendition of “Which Side Are You On?” begins playing.]

Miles Griffis: Welcome to Still Here, a Long COVID news and commentary podcast from The Sick Times.

[Instrumental ends]

Hi, I’m Miles Griffis.

Betsy Ladyzhets: And I’m Betsy Ladyzhets. We’re the co-founders of The Sick Times. 

Miles: Many institutions are ignoring the ongoing COVID-19 pandemic and trying to erase the Long COVID crisis.

Betsy: But here at The Sick Times, we’re not. We’ll continue to bring you the latest Long COVID news and commentary each week.

Miles: Without pandemic denial, minimizing, or gaslighting, on our website, social media platforms, our newsletter and, of course, this podcast.

Betsy: Today, it’s just me and Miles. Our producer James is having some technical issues this week, but they will be back soon.

In this episode, journalist Colleen de Bellefonds will talk about a spinal surgery that can help reduce symptoms for some people who have a rare complication of myalgic encephalomyelitis.

And Nadica Zimmerman, founder of the COVIDSafeHotties archive and community, will share experiences from people who are still practicing COVID safety in the midst of a lack of community support, as a call to action to build more connection.

Miles: Alongside that, we’ll also share some other Long COVID research updates.

In today’s research update, we look at a new preprint from the University of California, San Francisco, and the National Institute of Health researchers that have found that COVID-19 may increase the long-term risk of cancer.

Researchers evaluated people with Long COVID and controls for this study.

Betsy: After a quick musical break, we’ll talk with Colleen de Bellefonds about a spinal surgery that could help provide relief for people with myalgic encephalomyelitis and other connective tissue disorders, including potentially for some people with Long COVID.

And freelance writer and archivist, Nadica Zimmerman, shares chronicles from people still practicing COVID safety in rural parts of the United States where a similar community is sparse.

[instrumental segment of theme song plays]

The Sick Times: This surgery fuses people’s skulls to their spines to treat a condition overlapping with myalgic encephalomyelitis (2:15)

Betsy: Roughly half of Long COVID patients may qualify for myalgic encephalomyelitis, or ME, diagnosis, and Long COVID doctors are already seeing warning signs of a potential ME comorbidity called cranio-cervical instability.

Also known as CCI, this is an instability in the top vertebrae in the spine. It might cause the skull to compress the brain, worsening symptoms like severe fatigue and cognitive dysfunction.

But some doctors say a spinal neurosurgery called cranio-cervical fusion can offer relief to people with CCI.

The technique has been used for years, but in this instance, for treating people with ME, it faces controversy and a lot of discussion.

Here to talk about the surgery’s history and future is freelance science journalist Colleen de Bellefonds.

Colleen de Bellefonds: Hi. Yeah, thanks for having me.

Betsy: Thanks for joining us.

So could you start by explaining for listeners who may be not familiar with it the connection between cranio-cervical instability and connective tissue disorders, as well as how this can show up in some people with ME and potentially Long COVID?

Colleen: Sure. When you think about ME or Long COVID, oftentimes you’ll think about symptoms like exhaustion or brain fog and pain.

And what some researchers and doctors are saying is that in some people, these symptoms could be worsened by, basically, a constriction of the flow of oxygen and cerebrospinal fluid between the brain and the body.

So just to back up a bit, when you have an infection like SARS-CoV-2, that can cause connective tissue damage because infections trigger mast cells, which are immune cells found in connective tissue to gobble up connective tissue.

I talked to a number of doctors who focus mainly on ME patients, but now they’re starting to treat a lot of Long COVID patients, including the main surgeon who does these surgeries, Dr. Bolognese. And he compared healthy connective tissue to like a sheet of cotton, you know, so it’s really strong. You pull on it, it doesn’t come apart, it’s taut.

And in patients with hypermobility, it’s more like cooked rib meat, so it’s like falling off the bone.

In some people who have certain predispositions, this can lead to joint hypermobility and Ehlers Download Syndrome.

And so that can lead to CCI, which is where the top two vertebrae in the spine collapsed under the weight of the head.

Dr. Peter Rowe, who’s a really well-known specialist in children’s ME, compared it to a bowling ball supported by a stick.

So basically, the head compresses the brain, it slows the flow of blood and cerebrospinal fluid cushioning the brain, and that can impact the hypothalamus, which is part of the brain that controls the hormonal system, and the autonomic nervous system, which controls breathing and heart rate.

And so, getting back to how this connects to ME and Long COVID, researchers have noticed that rates of connective tissue disorders like rheumatoid arthritis are higher after a SARS-CoV-2 infection, and we know that both ME and Long COVID are triggered by an infection, and half of people with Long COVID qualify for ME.

So, ME has been linked to this condition called mast cell activation syndrome, and basically that’s when mast cells, that’s again that immune cell that can gobble up connective tissue if they get overactivated.

There’s a small study showing that 80% of people with ME have abnormalities in their cervical spine, that’s again at those top two vertebrae at the top of the spine, and then CCI exacerbates ME and Long COVID symptoms like dizziness, fatigue, and cognitive dysfunction.

ME has also been linked to POTS, which is Postural Orthostatic Tachycardia Syndrome.

So, all these conditions, really, what researchers are seeing is there’s just higher rates of POTS, higher rates of MCAS, and higher rates of CCI in people with ME. And ME is linked to Long COVID, so they’re all really interconnected.

Dr. David Kaufman, he’s an internal medicine doctor at the Center for Complex Diseases, who treats ME and Long COVID, he’s told me that he’s evaluating 10% of his Long COVID patients for CCI.

Dr. Alba Azola, who is a rehabilitation specialist at Johns Hopkins’ COVID clinic, said 40% of our Long COVID patients have hypermobility and three [percent] have significant CCI symptoms.

Betsy: Thank you for all the explanation. Yeah, I think it’s, like, helpful to talk about these as sort of a group of conditions, where a lot of people who now have Long COVID maybe were predisposed, maybe had hypermobility prior to getting COVID, but maybe the symptoms were not so noticeable. But something about the SARS-CoV-2 infection kind of triggered more symptoms or more issues.

Colleen: Absolutely, yeah.

We talked to Jen Brea, who did the documentary on rest, and that’s basically what happened with her.

She never thought that she was hypermobile. She wasn’t super flexible, but after she had these infections and she got ME, that sort of led to this degradation of her connective tissue that led to CCI.

Betsy: Right.

Your story also talks a lot about cranio-cervical fusion, which is a surgery that is used to try and relieve CCI symptoms. Can you talk a bit about how that works and what that looks like?

Colleen: Cranio-cervical fusion or CCF, it’s a neurosurgical technique that relieves pressure on the brain.

There’s just a few doctors, really a handful in the world, that perform this surgery on people with connective tissue disorders like Dr. Paolo Bolognese.

He takes two one-inch titanium bars and six screws and just fuses those bars to the top two vertebrae in the skull. That just lifts the head up and enables the flow of blood and fluid between the brain and the rest of the body.

This surgery, it’s been around for actually a long time, because in people with a Chiari malformation — this is a congenital condition where the brain protrudes from the bottom of the skull — they sometimes get CCI.

Bolognese, actually, 20 years ago, he specialized in Chiari malformation and he performed this surgery for Chiari patients. He started to notice in one patient, and then more patients, that there was this link with hypermobility and EDS and that this was causing CCI in some of these patients.

Now he’s the surgical director of Mount Sinai’s Chiari-EDS program and he says that ME impacts roughly one in three of his patients, and he’s performed 300 roughly cranio-cervical fusions for people with connective tissue disorders from people all over the world.

Betsy: So this surgery also is controversial in the ME community.

There’s not a ton of research on it yet. People can have different kinds of complications.

So what are some of the things you would want people to know about why it’s sort of controversial?

Colleen: Well, first of all, the doctors who treat ME and Long COVID, they’re not debating that something’s going on. Like, pretty much everybody says, even the people who are against the surgery say they’re seeing these issues in their patients.

Dr. Azola, who works at Johns Hopkins, she just started working in the COVID clinic in April 2020, and she was seeing things that led her to believe in Long COVID and believe that these patients had nowhere to go.

So she began working with Dr. Rowe.

He’s one of the most respected doctors for ME in children and he was noticing these higher rates of comorbid conditions like EDS and MCAS and CCI in his patients.

So the problem with the surgery that some of these doctors have is that it doesn’t fix the underlying problem with the connective tissue.

You are raising the head, you’re fixing some of the symptoms, but that connective tissue remains sort of loosey-goosey and it can continue to cause problems.

And the other thing is there’s just really not much research, unfortunately.

I mean, Dr. Bolognese is doing research to sort of understand the impacts of this, but there’s really only one or two studies out there that are looking at this surgery in these patients. The one main study that doctors point to found that one in four people don’t get better or even get worse after the surgery.

Even Dr. Ilene Ruhoy, who works with Dr. Bolognese, told me the goal is not for patients to get neurosurgery.

The other thing is it’s common to have problems after surgery. So CCI is linked to tethered cord syndrome, which is a nervous system disorder where the tissue attachments reduce spinal cord mobility.

Brea, she noticed that she had tethered cord syndrome after her CCI surgery. So she went in and she had a surgery to address that.

But [in] a lot of patients, the tethering, can come back, re-tethering. And so then they have to have more surgeries. And sometimes the surgeries, they don’t really address all these issues, and they’re expensive.

Neurosurgery is a high-risk specialty, and so lawsuits are generally common, they’re relatively common in neurosurgery.

And Dr. Bolognese has faced at least 20 lawsuits.

All 20 have been dropped or settled, but you know, [they’ve been] malpractice and fraud for not taking proper imaging before surgery, for not diagnosing tethered cord in a timely manner, for improperly performing the surgery, inducing patients to have unnecessary surgeries.

Basically, the bottom line is doctors and researchers say we just need more research on these interconnected conditions to prevent people from developing CCI in the first place, so they don’t need surgery.

Betsy: So what is some of the research that’s going on now about these conditions or some of the studies that you’re kind of excited to keep following after your reporting on this story?

Colleen: Beth Fulick, who is a biomedical researcher at MIT who focuses on ME, Long COVID, and other complex chronic illnesses, she is really interested in researching these conditions pending funding, because as we all know right now, it’s a tricky environment for funding of medical research.

She chaired the first-ever NIH webinar discussing connected tissue disorders in ME last year, January 2024.

And the NIH after that put connective tissue disorders and spinal conditions in their 2024 ME/CFS research roadmap, which is a national research plan.

So that’s really exciting.

That means that more focus is going to be going into these issues.

And then the CDC has the sponsored physician education talks, all project echo, and they have a connective tissue and spinal disorders component now.

And then the Medical University of South Carolina is building a new EDS multi-disciplinary spinal center that hopefully should be looking into this.

Beth told me that Harvard scientists are studying CCI using stem cells to regenerate connective tissue.

So there’s a lot of really exciting research going on out there and researchers like Beth who are looking at these conditions, not as siloed but as interconnected. And they believe that it’s important to figure out how these conditions are interconnected so you can treat not just one but all of them.

I wanted to thank Beth for pointing me in the direction of the story.

She’s really passionate about this subject. She knows a lot about it and she’s really a great advocate for patients.

And so I really hope that she’s able to get the funding that she needs to do this research, as well as all these other doctors who focus on ME and Long COVID.

Betsy: Thank you so much for your work on this story and for coming on the podcast to talk about it.

Colleen: Yeah, thanks for having me.

Betsy: You can read the full story at thesicktimes.org and find it in our transcript.

The Sick Times: Missives from the dismissed: Still COVIDing without community (12:45)

Miles: For Nadica Zimmerman, collecting and cataloging open access COVID-19 news and science broadened her community.

After years of trying and failing to find a librarian job, Nadica founded COVIDSafeHotties’ community in 2023 and its online archive the following year. Through that work, she met many people from other rural places in the U.S. South and Midwest without active mask blocs or clean air clubs or other COVID-aware groups.

For The Sick Times, Nadica shares some of these collected experiences amid advice for those who might be the sole masker in their communities.

It’s also a call for action for people who have more COVID-aware community to build connection with those outside of their immediate area.

Thanks for coming to the podcast, Nadica.

Nadica Zimmerman: It’s nice to be with you, Miles.

Miles: I’m curious about how your essay came to be. It’s a topic that we haven’t covered at The Sick Times before. What led you to pitching us this essay?

Nadica: Just living in Arkansas, like I do. I notice how often things get swept into the cracks and everybody else is talking about it like, “Oh, it’s a solved issue. Oh, I have this program in my area that covers that.”

And in my area, even though it’s a fairly metropolitan area of Arkansas, it’s always just “You do you, you’re on your own, make your own way.” And that doesn’t get highlighted enough in a lot of different areas. And as mitigations were dropped, they were already dropped here.

So in places like the West Coast, in places like New York, where you’d see less masks, we had already been seeing no masks for, you know, a year.

And that kind of drove me to want to do something. It was just me and my girlfriend at the time who were really still actively masking.

There was like one person we knew who masked at work. We hang out with them. And then just everybody else was like business as normal, even though everyone was sick all the time, even though the children’s hospital that I live by is having helicopters come and go at rates I’d never heard before.

So it really just was trying to get attention to people who need attention.

It’s not just me.

It’s also, you know, people in Wisconsin, South Wisconsin, people in the middle of Illinois, people in Florida, people in Alaska, people all over the place that just really lack a cogent community based around accessibility and COVID safety.

Miles: And so this led you to founding COVIDSafeHotties.

Would you mind kind of explaining what that is and how it came to be and, I guess, sort of the conversations that you saw in it?

Nadica: It started off kind of as a joke.

We were just, you know, [saying] “Oh, we’re so hot because we’re COVID-safe, we’re COVID-safe hotties.”

But it was just, at first, me and a few COVID-safe friends on the Internet who were trying to get people to understand the lingering threat of COVID.

There was this whole, you know, “Oh, the high-risk are the only people who will die,” which is just noxious in and of itself.

We should be protecting those people.

Those people aren’t just evil old fascists or something. That’s, like, your grandma. That’s a cancer patient. That’s, like, a baby.

We attempted to just argue with people in good faith, like “Here’s what’s happening, here’s what Long COVID is, here’s the threat of these things. Here’s why ignoring COVID is a bad idea.”

And it was just kind of a space to collect and share scientific resources and well-written articles about the subjects, mostly for debunking purposes.

But as time went on, it kind of grew into a space where people would come and ask me specifically, “Hey, do you have this resource? Hey, I saw you re-blog this on Tumblr. I saw you post this on Twitter. Hey, do you have that still?”

And I would have to say, “Oh, no, I don’t.”

And so the archive started as just a resource for me. So that when someone asked me, “Hey, do you still have that paper?”, yeah, I could get them that paper.

[It] quickly evolved from there because people kept asking more and more questions.

And I’m like, “Look, I can’t do the research for you, but what I can do is give you all of the references that I have.”

And I started posting them originally on Tumblr, and then that didn’t work out so well. It’s so [laughs] — it’s hard to search.

So I went back to the old forums because it’s imminently searchable. Anyone can use it. You can sign up for free and all your stuff just stays there.

It’s somewhere I and others can collect our thoughts, collect our information, and share it with one another.

Miles: That makes sense. So as you worked on this essay, you did a lot of reporting for it. You spoke with a lot of different people in different locations across the U.S.

What are some of the main asks and goals that came from these conversations?

Nadica: For a lot of people, it was just getting more involved in some way. And that’s kind of been, as the archive has become the archive, that kind of became my goal is just interacting with other people and not shutting up about COVID.

And a lot of people, especially in their conversations with me, it really came down to that.

“I could do just a little bit more. I don’t have to move this mountain all by myself, but I do have to talk. I do have to listen to others, too.”

That was the other thing, is just being able to share what people were saying with me in those interviews with other — [after] the third interview on, I’m like, “Yeah, I’ve heard that. Yeah, I’ve heard that. Yeah, other people are saying that.”

Being able to hear all these people just light up a little bit, like, “I am not alone”, was really the core of the interviews of reaching out to so many people.

We didn’t have the space for all of those interviews to go on the article. [But] it was really enlightening.

And hopefully, the people that I talked to will be able to reach out to others who are like them, even if it is just on the internet, and discuss COVID safety and build relationships that will last.

Because really, all we have is each other at this point.

The government has basically abandoned any and all responsibility for mitigating COVID.

And as terrible as it is, “you do you” can work if you have the community and resources.

Miles: Yeah. And one topic you talked about is extending these communities.

So maybe there are COVID-safe communities more in New York, in California. How can those communities support COVID communities in more rural places?

Nadica: I think the biggest thing is definitely funding.

There are many small time mask blocs that are doing what many smaller mask blocs, many city-based mask blocs are doing — for an entire state.

Alaska has one mask bloc. I think, as far as I know, Louisiana only has one mask bloc. The Arkansas mask bloc has kind of gone dark.

The person who is running it, I haven’t been able to get a hold of them in a while.

It’s like, “I guess they’re just busy. I hope something bad didn’t happen.”

But it’s spotty. And what those organizations really need is just some direct funding so that they can buy and distribute masks so that they can help the people in their area.

And so if you can, giving just 20 bucks, giving five bucks to one of those organizations can be a real boon.

And make sure that people have the necessary medical equipment they need to keep themselves safe.

Miles: Another thing that I loved in this article is the highest hopes and realistic desires.

You spoke with all these folks across the country and compiled these solutions that they would like to see going forward. Would you mind just reading them for listeners?

Nadica: So I asked everyone I interviewed what they’d like to see regarding public health and COVID-19 concussion, both in a rainbows and unicorns fantasy world and in reality.

Some of the common and notable answers were clean air and approved ventilation everywhere, universal masking and medicine, renewed COVID-19 testing measures, broad government support for sick leave, support for remote work wherever possible, science-informed communication about public health, and a Project Warp Speed for COVID-19 prophylaxis.

Miles: In some of our social media [comments], some people are asking “What is prophylaxis?”. Would you mind explaining a little bit about what that means?

Nadica: Prophylaxis just generally is any preventative for a disease.

So in regards to STDs, that’s a condom. In regards to COVID, that is a mask. We could also be developing pharmaceutical prophylaxis, much like PrEP with HIV and AIDS.

Miles: Yeah. I really liked that section [about highest hopes]. I just thought it was important to compile all these things together, and I love that you made this neat list from all these conversations. I think that’s very important.

You ended each conversation with folks with a question.

You asked, “What can others who have more accepting communities do to help people in situation like yours?” What did you hear?

Nadica: People really want community.

They long for the days of distance and hybrid events that they could join at their leisure. Many of the people who are still COVIDing are disabled in other ways and were already excluded from society to some extent because they could not get into the venues where concerts were going on.

They could not climb up all the stairs at the anime convention. They could not go to the movies, in some cases, because there just wasn’t any accessibility besides getting into the building.

So for a lot of people, just reaching out and making those spaces available to people in other places who are still COVID-safe is really what is needed for people to feel included and feel seen in other places.

Secondary to that was funding of many types, personal funding for people’s medical bills if they have Long COVID, if they’re going to the hospital for COVID, whatever it may be.

The thing that I heard the most from everyone is they wish people would talk about it more often. They wish they would hear about it on social media. They wish they would hear about it in news interviews.

Even when people are interviewed because they’re doing something related to COVID, the word almost never comes out of their mouth.

And they don’t talk about prevention.

They’re often talking about, you know, “In the future, we need treatment.” And that’s a good thing, that’s something that we definitely need and need to work towards, but what is needed in the now is renewed prevention.

And that’s what really the biggest hope of everyone is that I talked to, was just this — more masks on faces. “Please make the grocery store safe for me again.”

And honestly, that’s really my hope too, is that especially with things like measles and tuberculosis spreading at rates we haven’t seen since the last century, in several cases, we really need a renewed effort to mitigate disease in public of all types.

And airborne diseases are vastly ignored compared to fomites and other types of spread that you can deal with while handling it and not endanger yourself. But you go into a room and someone’s been there who’s had COVID or had measles and their aerosols are just still littering the air and you’re breathing them in and you don’t even know it.

So the deepest hope of all of the people was definitely please bring back some universal masking, especially in healthcare, even if there isn’t a mandate. They really hope that people put the masks back on to help keep everyone more safe.

Miles: Is there anything else you’d like to say about your essay or anything that came up in reporting that you haven’t got a chance to say yet?

Nadica: I underestimated just how much people had to say. And I know some of the people who read that were probably like, “Oh my god, there was nothing in there that I said except for one sentence.”

And I know and I’m sorry. But that’s, you know, like — there was just so much to say.

I’ll probably go back through those interviews at some point and try and craft another essay from them in the hopes of just getting some more of those, getting some more sentiments from people out into the universe.

Because there were a lot of really powerful statements and a lot of really powerful ideas that came out of that.

It was also really enlightening just to hear the same thing over and over again, even from people who might not share the same precautions as me.

I’m definitely at more high risk myself and I’m really worried about spreading it to my elderly and immunosuppressed parents.

So I forgo a lot of things. I just kind of don’t go out most of the time. And I’m fine with that. I’m a hermit anyway. I’m very happy in my own company. But there’s a lot of other people who just cannot tolerate that kind of thing and they take a lot more risks.

And even from them, there was this hope that others would start to take responsibility again, which is really the entire idea of public health.

It is the public health. It is all of our health collectively.

And it does feel kind of like spitting into the wind, hoping that America will allow for some collectivism in the politics, in the culture.

But that was what led me to even submit the essay was, “Hey, we need to talk about this. We have to talk about this. We have to keep these ideas alive.”

Miles: Well, I’m glad you did. You can read the full story on our website and the direct link that is in our transcript.

Next, we’ll go to a research update.

Research (25:59)

[Miles’ voice echoes the word “Research” accompanied with a sound excerpted from the theme song]

Miles: So for this week in research, we’re looking at a preprint.

So this has not been peer reviewed yet, but is a big study from reputable researchers, so we thought it was important to flag as one of our main studies.

In the study, researchers from University of California, San Francisco, and the NIH, National Institutes of Health, found that COVID-19 may increase the long term risk of cancer.

They evaluated the blood of 130 participants. Compared to controls, they found immune and metabolic damage in people with Long COVID, noting that COVID-19’s ability to degrade tumor suppression genes alongside other factors may predispose cancer development over time.

The researchers also found increased expression of other aging-related genes.

PolyBio Research Foundation, who helped support the research, said in a press release on the study, “These findings parallel patterns seen in chronic infections like HIV, which are also known to deplete effective immune surveillance.”

Betsy: One thing that seems kind of notable about this study too is that the participants included not just people with Long COVID, but also people who reported they had recovered from COVID and controls some people who, as far as they do, did not have SARS-CoV-2 infections.

And from my reading of the preprint, some of the findings of immune and metabolic damage were true also in the people who stated they had recovered.

So I think this sort of adds more evidence to something that we see a lot of researchers say, which is that even if you’re not necessarily experiencing noticeable symptoms that would be described as Long COVID, we still have a lot to learn about the ways in which this virus does damage to the body in different ways over time.

But yeah, frustrating that we keep seeing study after study and still it seems like the implications don’t really get through to policymakers.

Miles: Yeah, and I think it was interesting that as I was doing these research updates, another study from this week that you can read on our website or on our newsletter was a consensus of all these different Long COVID researchers.

I think it was like 20 to 30 different countries and 170 plus experts trying to come with — to a consensus on different aspects of Long COVID.

And one of the things they talked about was that it might not be like immediately noticeable and you might not have symptoms that would take you to a clinic, that would compel you to go, and that these things could appear years later, as we know with a lot of different viruses, can cause complications later on.

Outro (28:34)

Miles: So we will continue to follow this. We’d definitely add this to a research update in the future once it is peer reviewed and put into a journal.

[Instrumental theme song excerpt plays underneath the rest of the podcast]

Miles: We’ll continue reporting the information you need to better practice care.

Betsy: Solidarity with everyone still here. 

Miles: This podcast and The Sick Times are supported by you. You can help us keep this work going by donating on our website.

Still Here is a production of The Sick Times, a nonprofit newsroom chronicling the ongoing Long COVID crisis. 

Our theme song for this episode is the Rude Mechanical Orchestra’s rendition of Which Side Are You On?, originally by Florence Reece. Our podcast producer is James Salanga and our engagement editor is Heather Hogan. Sophie Dimitriou designed our podcast cover art. And Miles Griffis and Betsy Ladyzhets are your co-hosts and The Sick Times’ co-founders.

Thanks for listening.