Wired Magazine: The Painful Truth About Long Covid

Here's a rebuttal to the WIRED article from Dr. Phillip Alvelda.
He writes on X:
"Deeply disappointing they published a misleading article that could cause real harm to so many people.
I had our latest research Al system deconstruct & critique it. Here's the short take-down."


Link to the article:

Summary of points in article:

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I quite like this diagram, I must admit !!
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Finding 2 — The BMJ "CBT + Exercise" Citation Is Methodologically Laundered​

This is Levinovitz's second sleight-of-hand and the more egregious one, because the receipts are public, recent, and from the kind of evidence-grading body the article itself would normally treat as authoritative.

The "moderate evidence for CBT and exercise" framing rests on a body of literature anchored by the PACE trial (White et al., Lancet 2011)<a href="https://fleet.brainworks.ai/foundry/long-covid-wired-critique/#ref-15">15</a>, a £5M UK study championed by Michael Sharpe and Simon Wessely and structurally designed around the deconditioning-plus-mistaken-belief model. Levinovitz acknowledges that PACE was "subject to scrutiny." That is a remarkable euphemism. What actually happened:

The PACE reanalysis​

Wilshire, Kindlon, Courtney, Matthees, Tuller, Geraghty, and Levin, BMC Psychology 2018 (PMID 29562932)<a href="https://fleet.brainworks.ai/foundry/long-covid-wired-critique/#ref-16">16</a>. To be precise: the original PACE recovery paper reported ~22% recovery for CBT and ~22% for GET versus ~7% for specialist medical care (control) and ~8% for adaptive pacing — but only after the trial team revised the recovery threshold mid-trial. When Wilshire et al. reapplied the trial's pre-registered protocol definitions to the same data (released under FOI), the picture changed: "rates of recovery were consistently low and not significantly different across treatment groups" — approximately 7–8% across all four arms, with CBT and GET no longer significantly outperforming control after correction for multiple comparisons. The 22% headline that built the PACE-paradigm's clinical authority was, in the reanalysis authors' words, "modest treatment effects … [that] do not exceed what could be reasonably accounted for by participant reporting biases." We note for completeness that David Tuller (co-author, and the most public PACE critic) holds a UC Berkeley senior fellow position funded by crowdfunded patient-advocate donations — a fact he volunteered to Levinovitz. It does not affect the methodology: the reanalysis is reproducible from PACE's own public protocol by anyone with the FOI-released data.

The NICE NG206 reversal (ME/CFS) and the NG188 silence (Long COVID)​

Two NICE guidelines need to be distinguished here, because Levinovitz's piece elides the relationship.

NG206 (29 October 2021) is the ME/CFS guideline<a href="https://fleet.brainworks.ai/foundry/long-covid-wired-critique/#ref-17">17</a>. NICE formally rewrote ME/CFS guidance: graded exercise therapy as a treatment was withdrawn; energy-envelope pacing replaced it; CBT-as-cure was downgraded; harm warnings were built into clinical pathways for PEM-positive patients. The reversal was methodologically driven — the committee documented the subjective-endpoint, unblinded-trial, threshold-shifting, harm-underreporting problems across the CBT/GET trial base. NICE itself notes NG206 was developed before the COVID-19 pandemic and that its recommendations "should not be assumed" to apply to post-COVID-19 syndrome — correct caution, not a refutation of the methodological audit.

NG188COVID-19 rapid guideline: managing the long-term effects of COVID-19, NICE's actual Long COVID guideline, substantively updated November 2021 and migrated to the NICE website on 25 January 2024 — does not endorse graded exercise therapy as a treatment for Long COVID either<a href="https://fleet.brainworks.ai/foundry/long-covid-wired-critique/#ref-39">39</a>. It builds precautionary language into multidisciplinary rehabilitation pathways and references the same PEM/post-exertional-symptom-exacerbation concerns that drove NG206. The BMJ "moderate evidence for CBT and exercise" framing Levinovitz inherits is misaligned with both NICE guidelines.

The methodological audit literature​

Vink and Vink-Niese, Healthcare 2022 (PMC9141828)<a href="https://fleet.brainworks.ai/foundry/long-covid-wired-critique/#ref-18">18</a>, documents the systematic flaws across the CBT/GET trial literature: subjective endpoints in unblinded behavioral-intervention trials (the most methodologically loaded combination in clinical research); harms data under-reported; post-hoc threshold changes; exclusion of severe patients who cannot tolerate the intervention, then results generalized back to the population that was excluded. The CDC's ME/CFS guidance, citing this audit literature, now opens with "ME/CFS is a biological illness"<a href="https://fleet.brainworks.ai/foundry/long-covid-wired-critique/#ref-28">28</a> — a fact the Wired piece notes in passing but does not let bear on its main thesis.

The BMJ review Levinovitz cites either predates or sidesteps this audit. The article presents it as the current scientific consensus on Long COVID treatment. It is not. It is an artifact of one evidence-grading framework that has not yet caught up with the methodological reversal. Citing it in 2026 as the state of the evidence is, on the most charitable reading, an oversight; on a stricter one, citation laundering. The rest of the article's framing makes the stricter reading hard to avoid.

PACE recovery rate before and after Wilshire 2018 reanalysis

Exhibit 3PACE trial "recovery" rate: original post-hoc thresholds (White 2011, Lancet) vs pre-registered thresholds applied by Wilshire et al. (2018, BMC Psychology PMID 29562932). NICE guideline NG206 (October 2021) formally withdrew graded exercise therapy as a recommended ME/CFS intervention.
nice :thumbsup:
 
Long Covid Advocacy Twitter/X




Long Covid Advocacy:
'We have discovered that Alan Levinovitz's new book has already sold to publishers

And it's about psychogenic illness. No wonder he thinks Long Covid is 60-80% psychogenic & why he won't reconsider his framing. He is invested

That a major publisher @HenryHolt is running this raises serious concerns'


Henry Holt Publisher
DEMONS BY ANOTHER NAME
By Alan Levinovitz
Non-fiction: Health/Medicine
September26, 2025

Author of NATURAL Alan Levinovitz's DEMONS BY ANOTHER NAME, exploring the modern face of psychogenic illness, a ubiquitous and deeply misunderstood category of human suffering, and the revolutionary healing that might come once we reckon with the beliefs, human frailties, and institutional failures keeping us sick, to Tim Duggan at Holt, at auction, by Anna Sproul-Latimer at Neon Literary (world).

Rights:

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So the big question is, what made Alan Levinovitz change his mind so drastically?

Yes, he seems to have changed his thinking. I watched small pieces of this old (2020) Joe Rogan podcast with Alan Levinovitz and their discussion is as you have described -the problems with medically unexplained symptoms being misunderstood as psychologically caused..

I don’t think they had any specific discussion of ME/CFS and Long Covid did not exist at that time.

I wish he would come back to the forum and discuss the change and why.

 
I emailed with Alan in late 2023 about an ME and LC topic (similar to what @Jaybee00 also did it sounds like), in case he was open to pitching it as a freelancer. I reached out because of his work on the 2021 Vice piece. He let me know it wasn’t his beat anymore, so something must have shifted since then..
 
Some part of me wonders if the WIRED piece was intended to provoke a reaction from the patient community; more fodder for the upcoming book. "Read the book that They tried to censor!" would not be a novel publicity stunt.

What would be an excellent piece of journalism, by contrast, would be to investigate the peddlers of these pseudoscientific 'brain training' programmes. Send journalists into their courses, record them, find some genuinely expert neuroscientists to comment on the claims that they make and the activities that they advise participants to undertake.

It's all largely neuro-babble, not neuroscience. Any real expert in the field would find most of it laughable. Like most modern manifestations of pseudoscience they adopt superficial scientific forms, but lack any of their substance.

In my view most of these programmes should be prohibited for the same reasons that unlicenced prescription-writing is prohibited, as selling medications cooked up in a kitchen is prohibited, and as making fraudulent claims in business is prohibited. The legal grey areas and exemptions that these quacktitioners inhabit should simply not exist.
 
Some part of me wonders if the WIRED piece was intended to provoke a reaction from the patient community; more fodder for the upcoming book. "Read the book that They tried to censor!" would not be a novel publicity stunt.

What would be an excellent piece of journalism, by contrast, would be to investigate the peddlers of these pseudoscientific 'brain training' programmes. Send journalists into their courses, record them, find some genuinely expert neuroscientists to comment on the claims that they make and the activities that they advise participants to undertake.

It's all largely neuro-babble, not neuroscience. Any real expert in the field would find most of it laughable. Like most modern manifestations of pseudoscience they adopt superficial scientific forms, but lack any of their substance.

In my view most of these programmes should be prohibited for the same reasons that unlicenced prescription-writing is prohibited, as selling medications cooked up in a kitchen is prohibited, and as making fraudulent claims in business is prohibited. The legal grey areas and exemptions that these quacktitioners inhabit should simply not exist.
It feels trollish, but then so does BPS
 
Some part of me wonders if the WIRED piece was intended to provoke a reaction from the patient community

Interesting idea. And of course every response that's remotely tough can be positioned as "harassment." But I think Alan believes what he is writing. Not sure if that's better, but I do think he means what he says. Of courses, I really can't know--I don't know him beyond having talked to him for and about this piece. But that's my gut feeling. I usually prefer to think people are incompetent and maybe willfully stupid than deliberately venal. But that's my preference--it's clearly often not the case.
 
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