I EDIT an academic nursing journal, and very early in the covid ‘pandemic’ (2020) the editor of another journal and I published an editorial titled: ‘The Covid-19 epidemic of manuscripts’. This was in response to the deluge of submissions we were receiving on covid, largely of a very poor standard and clearly trying to achieve publication on the crest of the ‘pandemic’ wave.
Most of the studies reported in the manuscripts asked mundane research questions and gathered data that were easy to obtain. Typically, studies addressed issues such as stress levels in nurses during covid (always higher), nursing students’ attitude to online learning (always mixed) and how nurses felt when a covid patient died (sad).
Some initial studies of this nature were, perhaps, justified despite the predictability of the responses. But study upon study reporting precisely the same phenomena arrived in our inboxes and it was clear that the covid bandwagon was gathering momentum. A great many studies emanating from China extolled the virtues of the ‘white angels’, the nurses at the ‘front line’ of the covid ‘pandemic’.
I began automatically rejecting any studies referring to ‘white angels’ and, very soon, long before covid was a thing of the past, I had stopped putting any covid manuscripts forward for review. I continue to receive articles of the same type, all of which receive my standard response: ‘We were inundated with Covid-19 studies, all saying much the same thing, and the “pandemic” is long over.’
However, it appears that the covid publication industry is flourishing in some areas, especially around the dubious phenomenon of ‘long covid’. It strikes me that provided you work ‘long covid’ into your title, you are on to a winner. This is exemplified by one recent article in Journal of the American Heart Association which shows, well, nothing really.
I did not need to read much beyond the title of the article titled: ‘Lower fitness levels before infection linked to long COVID’ before asking myself if all that was being shown here was that people who were less fit before they had covid were still less fit now, regardless of whether they had covid. Turns out I was right.
I found the link to the article in CIDRAP, the organ of The Center for Infectious Disease Research and Policy, University of Minnesota. CIDRAP is no stranger to these pages and the link came from our other old favourite Global Health Now which has pushed the long covid narrative relentlessly.
The study involved 1,666 people who purportedly had been infected with covid-19. Eighty of them (5 per cent) reported having long covid and they were the ones who, ‘on average’, had lower fitness levels before covid.
The main symptom of the long covid group was shortness of breath. Following a treadmill test, they also had lower measures of metabolic fitness than those not reporting having long covid. Again, not convincing evidence that covid played any role in their relative lack of fitness. Seems to me these people, who were unfit and reported lower levels of activity pre-covid, simply remained unfit, a key sign of which is shortness of breath on exertion, post-covid.
The authors conclude that ‘lower levels of self‐reported physical activity before Covid may be associated with subsequent long Covid’. Note the word ‘may’ and note that pre-covid physical activity is reported subjectively and not based on any clinical measurements.
Therefore, to be clear, what the study found was:
- People who reported long covid had lower fitness levels even before they had covid;
- After covid, their fitness remained lower than others not reporting long covid;
- However, the decline in fitness (change over time) was not greater in the long covid group compared to others.
It should also be pointed out that the association between long covid and lower fitness is observational, not causal.
I often regretted, well into my academic career, that I had not chosen to study cancer. It seemed to me that my nursing colleagues who did study it got the biggest research grants and were published in the best journals. When I asked one of my cancer care colleagues about this, she referred sarcastically to the ‘sanctity of cancer’.
Many cancer researchers are aware of this and exploit the phenomenon whereby almost any research related to cancer, however tenuous the link, must be funded and the outcomes published. Those of us working in dementia care and cardiac care, both major killers, simply do not enjoy the glow of sanctity that working in cancer care conveys.
It strikes me that a similar ‘sanctity’ has been conferred on covid-related research and especially on long covid research. The paper reported here would be very unlikely to have been published years ago on the basis that the conclusions are speculative at best and unsupported by the evidence presented. But the ‘pandemic’ changed everything and, when it comes to publishing inconclusive studies, long covid is the new kid on the block.
