Long Covid – The Health Care Blog

A big data COVID train wreck

Mar 13, 2023• 1

BY ANISH KOKA

If there was any doubt the academic research enterprise is completely broken, we have an absolute train wreck of a study in one of the many specialty journals of the Journal of the American Medical Association — JAMA Health.

I had no idea the journal even existed until today, but I now know to approach the words printed in this journal to the words printed in supermarket tabloids. You should too!

The paper that was brought to my attention is one that purports to examine the deleterious health effects of Long COVID. A sizable group of intellectuals who are still socially distancing and wearing n95s live in fear of a syndrome that persists long after a person recovers from COVID. There are any number of papers that argue a variety of putative mechanisms for how an acute COVID infection may result in long term health concerns. This particular piece of research that is amplified by the usual credentialed suspects on social media found “increased rates of adverse outcomes over a 1-year period for a PCC (post-COVID conditions) cohort surviving the acute phase of illness.”

In this case PCC (Post-COVID conditions), is the stand-in for Long COVID, and leading commentators use this paper to explicitly state that heart attacks, strokes and other major adverse outcomes doubled in people post-COVID at 1 year…

It is a crazy statement, and anyone regurgitating this has no business commenting on any scientific papers. Let me explain why.

In order to find out about the potential ravages of long COVID researchers need to be able to compare outcomes between those who were infected with COVID and now have long covid to those who were never infected with COVID. At this point finding a large enough group of people that never had covid is impossible, because everyone in the world will have been infected with COVID many, many times. It’s also really hard to define the nebulous long COVID because a study after study finds no clear objective markers of the disease.

Last in Line: Hospitals Brace for a Chilly 2023

Feb 23, 2023• 2

BY JEFF GOLDSMITH

As they emerge from the COVID pandemic, US hospitals have a terrible case of Long COVID. They experienced the worst financial performance in 2022 in this analyst’s 47 year memory. As the nation recovers from the worst inflation in forty years, hospitals will find themselves locked in conflict with health insurers over contract renewals that would reset their rates to the actual delivered cost of care. “Last in line” in the US battle with inflation, hospitals will be exposed to public criticism when they attempt to recover from pandemic-induced financial losses.

Hospital payment rates for commercial payers are backward looking. Commercial insurance contracts between hospitals and health insurers were multi-year contracts negotiated before the pandemic. They continued in force during the pandemic, despite explosive rises in people and materials costs. As a consequence, health costs were conspicuously missing from the main drivers of the 2021-22 inflation surge– food, housing, energy, durable goods, etc.

Hospitals’ operating costs blew up during COVID due to a shortage of clinicians, the predations of temporary staff agencies, shortages of supplies and drugs and crippling cyberattacks that disabled their IT systems. Hospital losses worsened during 2022 because they are unable to place patients who are no longer acutely ill but who cannot be placed in long term, psychiatric or home-based care (a problem shared by Britain’s disintegrating National Health Service). Thousands of patients are stuck in limbo in hospital “observation” units, for which government and commercial payers do not compensate them adequately or at all.

Dr. Topol’s comment on LongCOVID and the heart is misleading/lacking context

Jul 18, 2022• 1

By ANISH KOKA

It’s been a while but Anish Koka, a one time regular writer on THCB and occasional THCB Gang member, is back publishing up a storm on his Substack channel. You may recall that his political and clinical views don’t always mesh with some of the wooly liberals we feature on THCB (cough, cough, me), but we are delighted to be back publishing some of his pieces–starting with a look at a tweet from one of America’s most prominent cardiologists.–Matthew Holt

Given Twitter’s commitment to the truth in Medicine, I thought I would try to give them a hand by analyzing a semi-viral tweet about COVID and the heart.

Earlier this year (April 2022), the most influential cardiologist in the world tweeted about a study on the long term cardiac effects of COVID (LongCOVID).

Medical trainees who trained in the early 2000s like I did know Dr. Topol as an absolute legend in the field of Cardiology. He was responsible for seminal work in Cardiology in the 1980’s on the use of clot busting drugs for patients having heart attacks, and became head of cardiology for the famed Cleveland Clinic at the age of 36! (I vaguely recall feeling like I was starting to understand Cardiology at the age of 36.) He’s since moved on to do many other things, and is a potent voice that may have been instrumental in the FDA delaying approval of the mrna vaccines until after the 2020 election.

Nonetheless, this paper that he is giving his significant stamp of approval to has significant issues. As far as I can tell individuals with LongCOVID were recruited by advertising in LongCOVID support groups. No independent assessment carried out as far as I can tell clinically. If you say you have it—> you’re in.