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Thank you for writing this. It's sobering as hell.

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(1) Viruses are really weird and science knows surprisingly little. Anything is possible and it'd be foolish to reject this out of hand

(2) Many viral infections are associated with long-term chronic conditions (ME/CFG/IBS/etc) with similar symptoms, so it's not odd if COVID is too. That also makes it hard to distinguish causality: was it COVID or something else?

(3) Does this conform to your personal experience? i.e. roughly 10% of your friends/family? In my case, I personally know many people with chronic conditions, but none I can pin on COVID.

So while I don't reject the possibility, my current personal opinion is that COVID isn't particularly unique among viral infections. Any of us can suddenly develop all kinds of odd unexplained conditions.

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(2) I think the difference between long COVID and other post-viral illnesses is that most of the other illnesses are not something people are contracting once a year (or more) for the rest of their lives. There is "long flu", for example, but the average person only contracts flu a few times in their life. Thus, even if the odds of long flu and long COVID are similar after every infection, COVID would be far more dangerous because you're rolling the dice far more often -- say 1 flu infection in a decade, vs 10 COVID infections (or more).

(3) Yes, sadly, I would say that my anecdotal experience matches the statistics, which is what led me to explore the literature here and ultimately write this piece. I think it's fair to say that there's a narrative being pushed by the media/government that if you're young and healthy and get your vaccinations COVID can be safely ignored (literally today Biden's ex-COVID czar published an op-ed in the Boston Globe entitled "With a Few Basic Steps, Most of Us Can Finally Ignore COVID"). Personally, I've had COVID three times at this point, and every infection gets worse and brings additional lingering symptoms. This is despite working out regularly, having no pre-existing health conditions, being in my early 30s, and getting every vaccine and booster. I feel like now, 8 months after my last infection, I am finally feeling mostly recovered, but still have several lingering symptoms (e.g. smell/taste loss for nearly 2 years now since the first infection). I had hoped that I would just be a rare, unlucky person, but if people can develop long COVID after reinfections, then the same could happen to many others. I know a handful of people under 40 who are out of work because of illnesses they developed after COVID. I don't think this would be immediately visible to people because of medical privacy (e.g. Paul Rubens just passed away after a multi-year battle with cancer that he did not publicly disclose) and the politicization of COVID -- I know people who have long COVID symptoms, but won't acknowledge or define it as such due to their political beliefs.

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I have Long COVID, and have shared about it on social media. In all that time, only one person has reached out to me saying they also have it. I've reached at least 1000 people. It's a bit puzzling, even if there are many factors at play.

Still, the amount of people with significant activity limitations from Long COVID seems to only be about 1.5%. And from that, probably only a small percentile are severe like I am: https://www.cdc.gov/nchs/covid19/pulse/long-covid.htm

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3rd possibility: HIV like, the virus stays for several years before it turns to AIDS like ….

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Physician here. Your posts have been spot on. Keep up the great work!

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What you describe has happened to me. I’ve had MS for many years. Bad case of Covid Dec 2019. First week of Feb became extremely breathless. In summer developed severe sweating, dripping sweat, at minor exertion. New symptom. Weird new respiratory allergies. Severe and lasting fatigue after minor exertion. Extreme dizziness and faintness when standing. Essentially bedridden. POTS with tachycardia. Frequent plunges in blood oxygenation. I got two Pfizer shots, one Moderna, in 2021. The first csused severe vomiting. The booster caused myocarditis. The tachycardia and low oxygenation became worse. I developed Mast Cell Syndrome, with new asthma-like reactions to the smell of bleach, BBQ spices, cat urine, eating buttered popcorn and Doritos. I got permanently much worse when I had a stomach virus in Sept 2020, April 2022, and April 2023. And an episode with severe vertigo in Feb 2021. The allergic reactions have stopped, but all the other symptoms have remained very bad for three and a half years. I was active and well until Dec 2019, but have been very sick ever since. This is not life. I don’t know what to do. Thank you for writing this! I’m hoping an effective homeopathic combination remedy for long Covid will be made available. I don’t know what else might help. I’m ciaparker2 and I’m at gmail dot com.

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"Some possibilities: (1) The virus evolves in such a way that future variants no longer cause long COVID."

I would love for this to be a possibility, but I've seen no evidence yet that it is anywhere near the table

It certainly didn't happen with influenza -- 'long flu' still happens: https://www.bbc.co.uk/news/health-58726775

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