{"id":53640,"date":"2022-10-26T18:00:49","date_gmt":"2022-10-27T01:00:49","guid":{"rendered":"https:\/\/eltecolote.org\/content\/?p=53640"},"modified":"2022-12-07T15:39:39","modified_gmt":"2022-12-07T23:39:39","slug":"covid-long-haulers-advocate-for-more-research-labor-protections-and-people-centered-health-policies","status":"publish","type":"post","link":"https:\/\/eltecolote.org\/content\/en\/covid-long-haulers-advocate-for-more-research-labor-protections-and-people-centered-health-policies\/","title":{"rendered":"COVID &#8216;long-haulers&#8217; advocate for more research, labor protections, and people-centered health policies"},"content":{"rendered":"\n<p><em>[Illustration by Jaycee Felkins \u2014 Mara Cavallaro is El Tecolote\u2019s Report for America Corps Member who reports on mental health and healthcare inequality in the Latinx community.]<\/em><\/p>\n\n\n\n<p>In May of 2020, Dr. Michael Peluso saw his first patient with long COVID at San Francisco General, before long COVID had a name. She was young, he remembers, and came in for persistent falling and fainting spells that made it hard to work and take care of her kids. Her symptoms were \u201csurprising,\u201d Peluso said. \u201cShe was debilitated.\u201d&nbsp;<\/p>\n\n\n\n<p>It turned out that in her case COVID had triggered dysautonomia, a nervous system syndrome that interferes with heart rate and blood pressure regulation. In addition to fainting, common symptoms include vertigo, chest pain, migraines, nausea, and fatigue. And though sometimes present at birth, dysautonomia is often post-viral, meaning it develops in response to serious diseases or infections. \u201cAt the time, I didn\u2019t know what I was seeing,\u201d Peluso told <em>El Tecolote<\/em>. \u201cNow, I know that [she] had long COVID.\u201d&nbsp;<\/p>\n\n\n\n<p>An estimated <a href=\"https:\/\/recovercovid.org\/about\">ten to 30 percent<\/a> of people who have had COVID experience PASC, or post-acute consequences of the virus that continue following a negative test. Of this group, <a href=\"https:\/\/dysautonomiainternational.org\/pdf\/LongCOVID_Dysautonomia_PressRelease.pdf\">nearly 70 percent<\/a> developed moderate to severe dysautonomia, making the condition one of the most common manifestations of long COVID. What we still don\u2019t know, though, is why. Why some infections develop into long COVID and not others, why long COVID symptoms are so <a href=\"https:\/\/www.theatlantic.com\/ideas\/archive\/2022\/10\/long-post-covid-symptoms-mild-cases\/670469\/\">varied<\/a> \u2014 from \u201cbrain fog\u201d to heart problems to erectile dysfunction \u2014, why they are so persistent. Since the spring of 2020, patient-advocates have demanded investment in research to find answers to these \u2014 and many more \u2014 questions, and to improve both care and prevention. \u201cRight now we have an estimated 19 million people in the U.S. with long COVID,\u201d said Lisa McCorkell, Oakland-based co-founder of the <a href=\"https:\/\/patientresearchcovid19.com\/\">Patient Led Research Collaborative<\/a> (PLRC). \u201cIt\u2019s critical for anything with that severity \u2026 to be studied. The number of people that are experiencing it now makes it that much more urgent.\u201d<\/p>\n\n\n\n<p>In March of this year, thanks to patient advocacy for more research, UCSF launched a chapter of <a href=\"https:\/\/recovercovid.org\/\">RECOVER <\/a>(Researching COVID to Enhance Recovery), a three-to-four year national study on long COVID sponsored by the National Institute of Health. It encompasses lab tests \u2014 of blood, saliva, and urine \u2014 that seek to answer the biological whys, as well as surveys and interviews that seek to better understand the populations most affected by long COVID and their needs. <\/p>\n\n\n\n<p>In San Francisco, for instance, data demonstrate that Latinx people are disproportionately represented in <a href=\"https:\/\/sf.gov\/data\/covid-19-population-characteristics\">COVID cases and deaths<\/a>. The <a href=\"https:\/\/www.cdc.gov\/nchs\/covid19\/pulse\/long-covid.htm\">CDC<\/a> estimates that 17.6 percent of Latinx adults have experienced long COVID, more than \u201cnon-Hispanic\u201d white adults (13.7 percent), Black adults (12.2 percent), and Asian adults (8.3 percent), and second only to \u201cnon-Hispanics\u201d of other or multiple races (19.2 percent). More recently, the Abriendo Puertas National Family Study found that <a href=\"https:\/\/www.brookings.edu\/events\/the-socioeconomic-consequences-of-covid-19-for-latino-families\/\">one in four Latinx families<\/a> are currently suffering from long COVID symptoms.&nbsp;<\/p>\n\n\n\n<p>White people with long COVID, however, have been overrepresented in clinical treatment settings \u2014 what <a href=\"https:\/\/www.theguardian.com\/society\/2022\/oct\/14\/long-covid-care-access\"><em>The Guardian<\/em><\/a> calls an \u201cequity gap.\u201d Even in cities with predominantly Latinx populations, local clinics\u2019 patient demographics are skewed \u2014 towards whiter, wealthier patients, who have the time and resources to seek help. Now, as we approach three years of COVID, research and treatment projects are recognizing that low-income communities and patients of color have been overlooked.<\/p>\n\n\n\n<p>\u201cI want to make sure that the communities most heavily affected by COVID, \u2014 and in particular the Latino community in San Francisco \u2014 are represented in this study,\u201d Dr. Carina Marquez, RECOVER\u2019s community engagement co-lead, told <em>El Tecolote<\/em>.&nbsp;<\/p>\n\n\n\n<p><strong>Patient-led Research&nbsp;<\/strong><\/p>\n\n\n\n<p>By the time Peluso and other UCSF physicians had seen several patients with symptoms lasting weeks or months after initial infections, they began to study COVID \u201cmore formally,\u201d in a research project called <a href=\"https:\/\/www.liincstudy.org\/en\/home\">LIINC<\/a>. Across the United States, though, patients with long COVID continued to be ignored, doubted, and dismissed by medical professionals. \u201cI experienced a lot of gaslighting,\u201d McCorkell said of her experience trying to get support from Sutter Urgent Care for her persisting symptoms. \u201cThere was a point where I had extreme palpitations and a lot of chest pain, and so I went to the ER and was told I was just having anxiety. In retrospect, I know that was an episode of POTS [a form of dysautonomia].\u201d<\/p>\n\n\n\n<p>Lisa, and many others, turned to online forums \u2014 the term \u201clong COVID\u201d itself was coined by a patient on <a href=\"https:\/\/twitter.com\/elisaperego78\/status\/1263172084055838721\">Twitter<\/a> \u2014 to discuss their symptoms and be in community. In quarantine, it was these digital spaces that became information, research, and advocacy centers for \u2018long-haulers.\u2019 The Patient Led Research Collaborative McCorkell is a co-founder of, a group of researchers who have or had long COVID, itself emerged from a WhatsApp group-turned-Slack page called <a href=\"https:\/\/www.wearebodypolitic.com\/covid-19\">Body Politic<\/a> that still functions as a support group for its 11,000 members.&nbsp;<\/p>\n\n\n\n<p>\u201cIn those early days, I was very active within the support group, documenting a lot of my symptoms, asking for advice,\u201d McCorkell said. Now that she\u2019s been in it for years, \u201cit\u2019s like a family.\u201d People share news about COVID research, talk about the wins and losses of their illnesses, and send updates on \u201cyou know, life.\u201d&nbsp;<\/p>\n\n\n\n<p>In April of 2020, a small group within Body Politic began documenting long COVID symptoms and patient experiences, since the medical establishment wasn\u2019t. McCorkell had some background in data analysis, so she offered to help on the project, and by May, she had helped finalize the <a href=\"https:\/\/docs.google.com\/document\/d\/1KmLkOArlJem-PArnBMbSp-S_E3OozD47UzvRG4qM5Yk\/edit\">first formal report on long COVID<\/a>, with data from 640 respondents in over a dozen countries. (It\u2019s worth noting here that 76.5 percent of respondents were white, a reflection moreso of the national lack of outreach to people of color about long COVID than the support groups\u2019 dynamics). Regardless, \u201cthat was the birth of the Patient-led Research Collaborative,\u201d she explained.<\/p>\n\n\n\n<p>Now, McCorkell works full-time at the PLRC, an organization founded on the understanding that patient-led research is more effective and empathetic. \u201cAs a patient, you know your body best, and have done research [by living in it].\u201d Without patient input in the planning stages of research, professionals often study \u201cthe wrong things, and are not going to help us get to a solution or a treatment.\u201d Experiences of long COVID are so varied, for example, that without patient leadership, physicians may not include comprehensive lists of symptoms on surveys. Even RECOVER \u2014 which is not patient-led but for which McCorkell is a patient representative \u2014 has a study design that she says is \u201cnot really reflective of the patient experience.\u201d She describes patients who have been turned down erroneously from the study and others who are accepted but for whom the testing itself is inaccessible.&nbsp;<\/p>\n\n\n\n<p>This May, the PLRC received $5 million in funding from <a href=\"https:\/\/www.balvi.io\/\">Balvi<\/a> to fund biomedical research with patient input. Various other studies are already underway: on reinfections and long COVID, on long COVID and mental health, and on the impact of long COVID in low and middle income countries.&nbsp;<\/p>\n\n\n\n<p><strong>Long COVID Advocacy Intersections<\/strong><\/p>\n\n\n\n<p>The lack of institutional care for people with long COVID \u2014 across sectors \u2014 reflects a much longer history of neglecting other chronic conditions. Illnesses like <a href=\"https:\/\/www.theatlantic.com\/health\/archive\/2022\/09\/mecfs-chronic-fatigue-syndrome-doctors-long-covid\/671518\/\">myalgic encephalomyelitis<\/a> (or chronic fatigue syndrome), dysautonomia, and chronic Lyme disease, for instance, have not been prioritized in research funding or labor policy. Had they been, care for those with long COVID \u2014 and scientific understandings about it \u2014 would have been achieved more easily.&nbsp;<\/p>\n\n\n\n<p>Instead, the reality is that people with long COVID are faced not only with debilitating, life-altering symptoms, but also labor practices that are rigged against employees\u2014in terms of accommodations, reduced hours, and long-term sick leave. Worker\u2019s compensation requires a COVID diagnosis, and many long-haulers, like Lisa, have never been diagnosed. \u201cI couldn\u2019t get a COVID test,\u201d she says. When she got sick, tests were scarce, and you had to either have a fever or be hospitalized to be tested. In the PLRC\u2019s first survey, only 23.1 percent of people with long COVID symptoms had a positive COVID test. Over a quarter were \u201cdenied testing,\u201d 22.3 percent weren\u2019t tested, and 27.5 percent were negative. \u201cMaking these things contingent on having some sort of test is one thing we\u2019re fighting,\u201d McCorkell says.<\/p>\n\n\n\n<p>Ed Yong, who covers COVID for <em>The Atlantic<\/em>, <a href=\"https:\/\/www.theatlantic.com\/health\/archive\/2020\/08\/long-haulers-covid-19-recognition-support-groups-symptoms\/615382\/\">writes<\/a>, \u201cother sources of disability benefits and care, including private insurance and Social Security, are notoriously hard to access. Long-haulers would need to provide a history of being unable to do substantial gainful employment, and ample medical documentation of their disability to prove that it\u2019s expected to last at least a year. Many have neither.\u201d&nbsp;<\/p>\n\n\n\n<p>According to the Abriendo Puertas National Survey referenced earlier, 36 percent of surveyed Latines \u201chave depleted savings to pay for healthcare costs.\u201d 22 percent have lost jobs, 24 percent felt they were \u201cin danger of losing a job because of missed work,\u201d and 33 percent have lost wages because they\u2019ve missed work. Part of the governmental response to long COVID needs to be a reimagining of labor policies and government assistance programs, where again, low-income patients are disproportionately harmed.<\/p>\n\n\n\n<p>Instead, state and federal policymakers have opted to neglect both people with long COVID and those at risk of getting it. The president himself announced on CBS\u2019 60 Minutes that \u201cthe pandemic is over,\u201d just weeks after halting a program that mailed out free test kits. In reality, as <a href=\"https:\/\/www.thenation.com\/article\/society\/biden-pandemic-over-deaths\/\"><em>The Nation<\/em><\/a> put it, there\u2019s been \u201ca 9\/11\u2019s worth of American deaths [from COVID] every week for the past several months.\u201d Despite<a href=\"https:\/\/www.nytimes.com\/interactive\/2021\/us\/california-covid-cases.html\"> an average of 37 people dying from COVID <em>daily<\/em> in California<\/a>, the state has lifted its masking protocols. BART lifted its mask mandate in early October.&nbsp;<\/p>\n\n\n\n<p>\u201c[These decisions are] absolutely not based in any actual science, and [they\u2019re] coming at the expense of people who are most at risk in our communities \u2014 and making us feel dismissed and disposable,\u201d said McCorkell. Especially when policymakers refuse to, we need to look out for each other. Wear a mask.<\/p>\n\n\n\n<p><strong>For additional information or to join the RECOVER study, call 415-353-9306, send an email to <\/strong><strong>FiguringOutLongCOVID@ucsf.edu<\/strong><strong>, or fill out a form at: <\/strong><a href=\"https:\/\/studies.recovercovid.org\/\"><strong>Studies.RecoverCovid.org<\/strong><\/a><strong>.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>[Illustration by Jaycee Felkins \u2014 Mara Cavallaro is El Tecolote\u2019s Report for America Corps Member who reports on mental health and healthcare inequality in the Latinx community.] In May of 2020, Dr. Michael Peluso saw his first patient with long COVID at San Francisco General, before long COVID had a name. She was young, he [&hellip;]<\/p>\n","protected":false},"author":88918,"featured_media":53642,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"newspack_popups_has_disabled_popups":false,"newspack_featured_image_position":"","newspack_post_subtitle":"","newspack_article_summary_title":"","newspack_article_summary":"Long COVID is an emerging disability disproportionately impacting Latinx people, and both healthcare and labor is failing to rise to the occasion to support. ","newspack_hide_updated_date":false,"newspack_show_updated_date":false,"footnotes":""},"categories":[3570,7],"tags":[18768],"coauthors":[23520],"class_list":["post-53640","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-news","category-news","tag-covid","entry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>COVID &#039;long-haulers&#039; advocate for more research, labor protections, and people-centered health policies - El Tecolote<\/title>\n<meta name=\"description\" content=\"Long COVID is an emerging disability disproportionately impacting Latinx people, and support is lagging to reach effected people.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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