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[–]WickedWitchOfTheWest 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (0 children)

Is Long Covid a myth? Middle-class hypochondria seems to play an important role in this ill-defined condition.

Discussing the cultural influences on the idea of Long Covid is controversial. Experts who have raised cultural factors have been demonised and harassed. And yet it’s a discussion we must have, especially us in the UK. As a headline in The Sunday Times asked back in June, ‘Why is Britain now the capital of Long Covid?’. We really are the capital. Where early Covid victim Italy has not seen a huge wave of Long Covid cases, and where even the United States hasn’t been overrun by people who claim to suffer from these strange long-term symptoms, the ‘situation in the UK has been very different’, as The Sunday Times says. Numerous Long Covid clinics were lined up here, we were told that a million or more Brits were suffering from it (now being revised down), and the media couldn’t get enough of grim, nightmarish tales about this disease.

Of course there could be any number of reasons for this disparity between nations. Perhaps Britain is just better at diagnosing Long Covid. An Italian doctor told The Sunday Times that Italy’s first-ever Long Covid clinic shut down after just six months, and this may have simply been down to the fact that Long Covid ‘is not one of the main topics on the public agenda. There isn’t a large public-health structure devoted to this problem.’ Others have noted how national, cultural factors help to shape ‘health-seeking behaviour’. Dr Rubeshan Perumal of the University of Cape Town says Long Covid is a problem in South Africa, but it is not comparable to the presumed extent of Long Covid in the UK. ‘Contextual factors play into health-seeking behaviour’, he says. ‘Some societies are better able to provide a platform for people to express their difficulty in recovering from Covid. It may be easier to express your difficulties in [the UK].’ Maybe where South Africans are more likely to persevere through fogginess and tiredness and muscle ache – out of necessity, no doubt – Britons are given to saying, ‘I can’t do this. Diagnose me.’

Jeremy Devine, a psychiatrist at McMaster University in Ontario, has caused a storm by digging down into the psychological and cultural factors that might lie behind Long Covid. He doesn’t deny that there are after-effects from Covid, but he believes that the ‘hysteria’ over Long Covid has convinced many people they have it, when they don’t. ‘It’s psychosomatic’, he says. ‘People don’t fully appreciate the ability of the psyche to convince itself that it’s sick. I don’t think people are overtly malingering. I do think they fall into a cycle of disability and it stems maybe from this subconscious desire to be sick in some cases, maybe just a belief that they are sick rooted in depression and anxiety. This is in a way a kind of mass hysteria: the more attention you give a syndrome like this, the stronger it becomes.’

A ‘subconscious desire to be sick’ – this may be a very controversial idea, and no doubt offensive to some, but it does capture something about our times. One of the most curious and worrying features of our era in which so many areas of life have been medicalised and pathologised, where feeling stressed about exams is reimagined as a mental illness and where it can be positively status-boosting to suffer from certain mental and physical ailments, desiring to be sick, or at least desiring a diagnosis that explains why you are the way you are, has become quite commonplace. It makes sense to me that in the Covid era, when so many people felt fearful, uncertain about the future and locked into their own little worlds, some would seek out a diagnosis to describe their emotional state as much as their physical one. Is it possible that middle-class hypochondria, a feeling of dread among one time go-getters who were laid low by the Covid crisis, led to an explosion in claims of Long Covid?

Jeremy Devine has also controversially dug into the national cultural factors that might be shaping the Long Covid phenomenon. ‘The reason this is so prevalent in the UK is because of the chronic fatigue lobby’, he says. ‘They have shaped the discourse on Long Covid. You guys are the origin.’ In mentioning chronic fatigue syndrome – also known as ME – Devine has tapped into deeper and more complicated questions that we really should discuss out in the open far more than we do. The question of whether some people seek medical diagnoses for what are in truth personal difficulties. The question of whether the cult of medicalisation is so entrenched that people are now wrapping diagnoses around themselves like comfort blankets, in the belief that a doctor’s note is all they need to make sense of their personal failings, fears or sense of exhaustion. The question of whether the undoubted problems that can attend recovery from viral infections in some people have been transformed into definitive illnesses – ME, Long Covid – which people covet in order to make sense of themselves and their lives.