Paul Garner on Long Covid and ME/CFS - BMJ articles and other media.

We see the same thing with long covid, where several solid studies show that cognitive behavioral therapy can significantly reduce symptoms [12-14], even though we do not have a full overview of the biological mechanisms.

12. Nerli, TF, et al., Brief Outpatient Rehabilitation Program for Post–COVID-19 Condition. JAMA Network Open, 2024. 7(12): p e2450744.
Discussed here.
13. Kuut, TA, et al., Efficacy of cognitive-behavioral therapy targeting severe fatigue following coronavirus disease 2019: Results of a randomized controlled trial. Clinical Infectious Diseases, 2023. 77(5): p 687-695.
Discussed here.
14. Janse, A., et al., Efficacy of web-based cognitive–behavioural therapy for chronic fatigue syndrome: randomized controlled trial. The British Journal of Psychiatry, 2018. 212(2): pp. 112-118.
Discussed here.
 
We see the same thing with long covid, where several solid studies show that cognitive behavioral therapy can significantly reduce symptoms [12-14], even though we do not have a full overview of the biological mechanisms.

???
Words and their meaning, why bother?

The fact that demanding that ideological pseudoscience should be taught as fact is met with total indifference, that it not only does not discredit them, but is actually met with praise for the most part, explains a lot about why things have gotten so bad, how strongly this overlaps with the rise in power of people like RFK and conspiracy fantasy communities. It's not even two sides of the same coin, it's the same damn side. The pseudoscience is coming from inside the house, with official stamp of approval and complete dereliction of duty from almost everyone involved.
 
Long Covid. General practitioners and other frontline providers should explore both physical and psychological factors from the first consultation.


Well Paul, maybe you should have had a psychological assessment first before blogging about your so called long covid recovery drama. It would have saved you a lot of energy.
 
Long Covid. General practitioners and other frontline providers should explore both physical and psychological factors from the first consultation.


Well Paul, maybe you should have had a psychological assessment first before blogging about your so called long covid recovery drama. It would have saved you a lot of energy.

Yeah cos GPs never jump first of all to this kind of thing being psychological. If I recall correctly, Paul, when this happened in March-April 2020 people gathered online, sharing their experience of being told they should be better by now and maybe they have anxiety/depression.

And then all the patients, they joined up and they decided they would call this phenomenon “long Covid” and that they were really ill, physically they weren’t recovering and it wasn’t psychological. And who was the UK establishment face of those patients, Paul? Who was on GMB and BBC breakfast saying it’s real, it’s the disease, these are physical symptoms?
 

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Yeah cos GPs never jump first of all to this kind of thing being psychological. If I recall correctly, Paul, when this happened in March-April 2020 people gathered online, sharing their experience of being told they should be better by now and maybe they have anxiety/depression.

And then all the patients, they joined up and they decided they would call this phenomenon “long Covid” and that they were really ill, physically they weren’t recovering and it wasn’t psychological. And who was the UK establishment face of those patients, Paul? Who was on GMB and BBC breakfast saying it’s real, it’s the disease, these are physical symptoms?
People think “I can’t still be having these symptoms, I’m having a mental breakdown” I’ve spoken to medical doctors who have this and they think they’re having a nervous breakdown. They’re not, these are the symptoms of disease.

Thanks Paul! Good to know people shouldn’t think it’s mental?
 
Researchers and consumers comment on the #DecodeMEStudy #MECFS: a large study, results not groundbreaking, and problematic promotion of the study. A recent statement by COFFI Researchers and Consumers is now available. Summary in thread




Paul Garners follow up comments on X thread:
1. We know genes are implicated.
2. Saying the association somehow proves the condition is "real" is naive. We know it is real.
3. Stating "we see it in the blood" implies genes cause the condition and this is harmful. Patients may believe nothing can be done unless we get a biomedical cure.
4. This narrative may led them that biopsychosocial approaches are not helpful-but they clearly are. They help reduce symptoms and some to recover.
5. The paper says there are no treatments. There are. There are a range of strategies for rehabilitation, drawing on mind-body and biopsychosocial approaches.
6. The size of the effect is modest, known and expected, and seen with other conditions, such as depression. The new genes are interesting.
7. The diagnosis was on self-report, without documented infection. This heterogeneity can give flawed associations, or miss associations.
8. This has not been peer reviewed. It appears to contain some interesting findings, confirms what we know already, and needs replication.
6. We know recovery is possible, and wonder why recovered patients were not included in the study.
 
To be fair I think the headline here where they say “it’s not groundbreaking” would put off the casual observer.

The tv/print news media made a big deal of it being amazing, groundbreaking etc patients crying with joy that to start out with “acktshually* it isn’t groundbreaking” sets the tone of “here comes some party poopers/squares/nitpickers” because so many people were clearly happy with the DecodeME results.

Even if the results “aren’t that groundbreaking” a lot of people seemed to love them, what’s this moaning all about?


*this word is actually, but written in a mocking tone
 
Researchers and consumers comment on the #DecodeMEStudy #MECFS: a large study, results not groundbreaking, and problematic promotion of the study. A recent statement by COFFI Researchers and Consumers is now available. Summary in thread




Paul Garners follow up comments on X thread:
1. We know genes are implicated.
2. Saying the association somehow proves the condition is "real" is naive. We know it is real.
3. Stating "we see it in the blood" implies genes cause the condition and this is harmful. Patients may believe nothing can be done unless we get a biomedical cure.
4. This narrative may led them that biopsychosocial approaches are not helpful-but they clearly are. They help reduce symptoms and some to recover.
5. The paper says there are no treatments. There are. There are a range of strategies for rehabilitation, drawing on mind-body and biopsychosocial approaches.
6. The size of the effect is modest, known and expected, and seen with other conditions, such as depression. The new genes are interesting.
7. The diagnosis was on self-report, without documented infection. This heterogeneity can give flawed associations, or miss associations.
8. This has not been peer reviewed. It appears to contain some interesting findings, confirms what we know already, and needs replication.
6. We know recovery is possible, and wonder why recovered patients were not included in the study.

Mad how his personal view and the COFFI one, where he’s on the committee, are basically the same.
 
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