Stress, Fuzzy Symptoms, and Long COVID

by James A. Bacon

WHRO Public Media tells the story of Chesapeake nurse Megan Temple, who contracted COVID-19 in October and has dealt with “long COVID” ever since. She got over the initial illness quickly. But in the weeks and months that followed, during which she also recovered from abdominal surgery, she developed an array of mysterious, shifting symptoms.

She suffered severe chest pains, lost muscle coordination, experienced brain fog, lost hair, and experienced vision changes. At one point, she couldn’t sleep for 48 hours or sit for more than minutes at a time. “It sounds very strange, but I just felt like I was going to die,” she said, “like my body was going to shut down.”

Before I go any further, let me make it indisputably clear that I am NOT saying that the symptoms are imaginary. Something is occurring. But when symptoms are varied, vague, impossible to measure, and make their appearance after haphazard time intervals, I think we need to take a closer look.

Humans are cognitively disposed to attribute causation to events that occur in proximity to one another. When Event A occurs before Event B, people are inclined to say Event A caused Event B. If someone recovers from COVID and later experiences brain fog, they assume that COVID caused the brain fog. Perhaps there is an underlying medical connection between the two. But perhaps the brain fog has another cause, and the timing was a coincidence. I suspect that’s true in many cases, if not most of them.

According to the Mayo Clinic Health System, here are common signs and symptoms of COVID-19 that linger over time:

  • Fatigue
  • Shortness of breath or difficulty breathing
  • Cough
  • Joint pain
  • Chest pain
  • Memory, concentration or sleep problems
  • Muscle pain or headache
  • Fast or pounding heartbeat
  • Loss of smell or taste
  • Depression or anxiety
  • Fever
  • Dizziness when standing
  • Worsened symptoms after physical or mental activities

But looky here. Here’s a Mayo Clinic list of symptoms for stress:

  • Headache
  • Muscle tension
  • Chest pain
  • Fatigue
  • Anxiety and depression
  • Sleep problems
  • Lack of motivation or focus

Now, here is a Mayo Clinic list of the primary symptoms of the ill-understood disease fibromyalgia:

  • Widespread pain
  • Chronic fatigue
  • Mental fog, or “fibro fog”
  • Migraines and headaches
  • Temporomandibular joint disorders
  • Anxiety and depression
  • And other disorders

There is an enormous overlap between the symptoms of stress, fibromyalgia, and long COVID.

The difficulty of these particular symptoms is that they are almost all self-reported by the patient. Physicians can’t see them, test for them, or measure them.

Now that more than two-thirds of all Americans have been infected by the COVID-19 virus, it is inevitable that millions encountered a variety of ill-defined maladies within weeks or months of recovering from the virus. In the pre-pandemic era, we would have attributed those free-floating symptoms to stress, fibromyalgia, hypochondria or some other cause. But once COVID struck, the virus so dominated the national imagination that it crowded out other medical explanations.

The virus itself was very real and very dangerous to specific sub-groups: the elderly, the obese, diabetics, people with lung disease, people with Vitamin D deficiency, people with immunological issues, and the like. The virus also has tell-tale signatures, such as the loss of taste and smell. Scientists are still discovering the biological pathways by which the COVID virus wreaks destruction to cells, lungs, the nervous system, and the immunological system.

But as far as I know, no one has yet identified the biological pathway by which the virus causes fatigue, brain fog, headaches, chest pains or blurry vision.

I’m no medical expert, I don’t pretend to be one, and I will willingly defer to the findings of sound science. But a lot of what we know — or think we know — doesn’t come from sound science at all.

If the COVID epidemic has proven anything, it’s how “the experts” often wing it, reaching speculative conclusions on the basis of imperfect information, sometimes revise their conclusions on the basis of new data, and sometimes persist in their conclusions despite the new data. We’ve seen how the medical and professional establishments are subject to herd thinking, social pressure and political pressure. We’ve also seen how mass media acts as an intermediary between “the experts” and the public, filtering messages through their own political and cultural biases. (We’ve also seen a lot of just-plain-crazy misinformation spread through social media, but microchips-in-the-vaccine nonsense has had no bearing on perceptions about long COVID.)

While the symptoms attributed to long COVID are real enough, I expect that when the dust settles and medical science figures it out, we’ll find that maladies like those experienced by Megan Temple have nothing to do with COVID. Indeed, we might well find that “long COVID” was a product of our collective imaginations, amplified by a media eager to magnify the dangers COVID pose to us all.