By David Tuller, DrPH
Since the start of the coronavirus pandemic, suggesting an equivalence between COVID-19 and influenza has been a consistent approach among those seeking to downplay the current situation. So it’s not surprising to see something similar happen with comparisons between Long COVID and the delayed recovery some people experience after an acute bout of the flu. The BBC has just provided an excellent example of how this framing can appear to minimize the significance of Long COVID.
An article in PLoS Medicine, published on September 28th, offered a look at Long COVID symptoms based on data from US electronic health records. The study, called “Incidence, co-occurrence, and evolution of long-COVID features: A 6-month retrospective cohort study of 273,618 survivors of COVID-19,” tracked nine key symptom clusters: “breathing difficulties/breathlessness, fatigue/malaise, chest/throat pain, headache, abdominal symptoms, myalgia, other pain, cognitive symptoms, and anxiety/depression.”
The investigators found that 37% reported one or more symptoms during the third and sixth months following their COVID-19 diagnosis, among lots of other interesting data. In addition they compared similar symptoms among a cohort of people who had suffered from influenza. According to the abstract, “all 9 features were more frequently reported after COVID-19 than after influenza,” “co-occurred more commonly,” and “formed a more interconnected network.”
The study was conducted by investigators from the Oxford University psychiatry department. That’s a bit of a surprise, given that Professor Michael Sharpe, himself an Oxford psychiatrist, has blamed the many reports of Long COVID on the dissemination of other reports about people with Long COVID—a theory he demonstrated early this year at an insurance industry seminar by citing a Guardian article on Long COVID as likely to have triggered subsequent reports of Long COVID. (The author, columnist George Monbiot, promptly responded with another column titled “Apparently just by talking about it, I’m super-spreading long Covid.”)
Although the new study documented that a great many people are reporting symptoms that fall under the Long COVID rubric, the BBC apparently decided the study was actually about influenza. Here’s the headline of the article on the BBC website: “People also suffer ‘long flu’, study shows.” And here’s the first sentence: “People who have fallen ill with flu can suffer long-term symptoms in a similar way to long Covid, a study suggests.”
The headline and sub-head aren’t inaccurate. They’re just beside the point—or at least beside the main point, since influenza was a secondary aspect of the study. The study suggested that the higher rates of Long COVID reports compared to “long flu” could relate to greater public awareness and other factors. But the investigators concluded, as the BBC article itself noted, that “it was likely persistent symptoms were more common for Covid than flu.” Although the study did not examine or speculate about causation or mechanism, the findings certainly suggest that Long COVID is a “thing” and not a “myth,” as two recent Long COVID “denialist” articles argued. (I wrote about them here.)
And yet the BBC chose to quote two of the investigators about their opinions regarding post-flu symptoms, not Long COVID. To be clear, I don’t hold the investigators responsible for this, given that we have no idea what else they might have told the BBC. These are the quotes that made it into the published version. (Also, in an actual error, the BBC claimed that both groups of patients contained just over 100,000 people–but this is true only of the flu cohort, since the Long COVID sample contained more than twice as many individuals. )
Professor Paul Harrison, for example, declared that “many of us who have experienced flu know how you don’t always feel completely better as quickly as you’ve been hoping or expecting to.” Max Taquet, another investigator, said that “long-term symptoms from flu have probably been overlooked before.”
It is hard to deny that long-term symptoms from flu have “probably been overlooked before.” And it should be hoped that Long COVID has educated clinicians to be more alert for the possibility of such complications among influenza patients going forward. But the world is dealing with Long COVID now. That’s what the BBC should have prioritized here. It should not have spun this research as an influenza study.
Dr Nisreen Alwan, an associate professor of public health at the University of Southampton and a Long COVID patient who has been active in drawing attention to the condition, tweeted her dismayed response to the headline indicating that “people also suffer ‘long flu’”:
“Of course, they do,” she tweeted. “We knew that! But we’re living in a covid pandemic not a flu pandemic. This means loads of infections in the population in a short time generating huge disability. Saying but it also happens with flu is irrelevant to prevention policy.”
And she further tweeted this: “Now the existence of postviral illness following viruses other than covid will be used to minimise and dismiss the importance of preventing #LongCovid rather than saying actually LC has made us realise how neglected postviral illnesses have been. It’s another really bad spin.”
Comments
6 responses to “BBC’s Problematic Coverage of New Long COVID Study”
If we’re not expressly told what the motivation is behind any bundling together of Long-Covid with other post-viral illnesses (such as ‘long-flu’) then we can only speculate what it might be. It could be to minimise the importance of treating Long-Covid as the very serious problem it is, (which understandably seems to be Dr Nisreen Alwan’s concern) but it could be that, now we’re in flu vaccine season, the BBC thought that reporting on the ‘long-flu’ aspect of this study might encourage people to have a flu shot this autumn because they really wouldn’t want to end up like all the poor people who now suffer from Long-Covid. The concern in the UK is that the NHS will be overwhelmed again this winter, so I think it’s likely that anything that can be used to help keep hospital admissions down will attract the interest of the UK media including the BBC. I’m no great fan of the BBC’s reporting but perhaps other motivations could have been in play here?
That’s an interesting perspective that I hadn’t thought of. Maybe one reason it didn’t occur to me is that the BBC article made no mention of flu season, flu shots, or concern of the NHS of being overwhelmed this fall and winter again. If that were the motivation, I think the journalist or editor would have referenced it. If the outcome of the article is that some people are more likely to get a flu shot, then great. But I don’t get that argument or suggestion from the article itself.
I think it’s called ‘nudge’ and it’s clearly being used to change people’s behaviour in the UK. The BBC seems to see itself as a key instrument in winning the war on this pandemic and saving the NHS from going under so I’d be surprised if it wasn’t employing ‘nudge’ as a tactic in its reporting now. But, on the other hand, I thought that the BBC2’s Newsnight item on Long-Covid last April seriously underplayed the problem of Long-Covid and this article could have been more of the same. Who knows?
Having looked at other things that Triggle’s written…..if, post-pandemic, we will live (and die) with covid like we currently live (and die) with the flu -https://www.bbc.co.uk/news/health-55985916, then perhaps we have to accept that we will live (and suffer) with Long-covid like we’ve lived (and suffered) with long-flu and other post-viral illnesses for millenia? Could that be Triggle’s take? And could the wider thinking be that a (flu/covid) vaccine is all that can/should be offered versus both death and long-term suffering and that, once offered, the rest is up to our behaviour and fate?
Vaccines play an important role but they are (or at least should be) but one tool in the healthcare box. They shouldn’t be considered the be-all and end-all because how we live is surely more important than how we die. But I suspect that healthcare’s remit is likely to shrink now, see -https://www.youtube.com/watch?v=DqDTAHUMnq4 (especially at 1.36 mins) as economies try to recover from the financial hit of this pandemic, and we’ll all be told that morbidity is down to our psychology and our behaviour alongside a clear “Get on your bikes, you lazy good-for-nothings!” message from the media.
Another study to add to the endless pile of studies soon to be forgotten. Health records are notoriously inaccurate and biased but we are supposed to accept claims made on that data. Thanks but no thanks.
Imagine the researchers wanted to find out how many people in the US have “CFS” or even ME. How many ME patients would they find? A dozen? Even CDC admits most people with ME (or “CFS”) never get diagnosed, so obviously electronic records would have nothing tell us.
More interesting to me is the idea of 300,000 people consenting to have their data included in the study, and the for-profit company (TRINETX, LLC.) that supplied the data to the researchers.
I read the ten page supplement regarding the data set. The phrase “informed consent” does not appear even once. The entire issue is studiously ignored behind a wall of verbiage telling us everything they are doing is approved and legal. So there.
The Trinetx Board of Directors is infested with Wall Street parasites, exactly the people I do not want to have my data, especially my health data.
Trinetx calls itself a network (more like an octopus) and seems to be trying to make itself the Google of health data. With Trinetx the Wall Street crowd have found yet another way to profit from the sick and dying. Yikes.
There was a company, Surgisphere, that got in trouble in the spring of 2020 by reporting a covid meta-study based on hundreds of thousands of people from every continent except Antarctica. Eagle-eyed observers noted that it was impossible to design a study, get institutional review board approval, and informed consent from more than a half million people in the few months that covid had been raging. The whole thing unraveled.
I hope that’s not what this is.
On the other hand, my understanding is that lots of medical research can legally take place on medical data without getting informed consent from patients. You’re right, it’s another way to profit from our misery.