The sky was a smoky grayish-orange and trees a few hundred yards away had turned to ghostly outlines. This July marked the third summer since I’ve lived in Chicago that the city was covered in a suffocating blanket of smoke from Canadian wildfires, and the air quality was breaking records: as high as 753 on the air quality index one afternoon, earning an “extremely hazardous” warning. Even with all our windows closed and two air purifiers running in different rooms, I was still getting headaches, a sore throat, and burning eyes. And my arthritis pain was worsening.

I’ve lived with chronic illnesses for most of my adult life and have racked up six of them at this point (endometriosis, psoriatic arthritis, Celiac disease, Graves and Hashimoto’s diseases, and interstitial cystitis). I know that my joints hurt more in cool, wet weather, that I’m prone to overheating when the temperature spikes above the 90s. I’m not alone: I’ve talked to dozens of people with different chronic conditions about how the weather affects them. Those with lupus need to avoid the sun, while some with psoriasis get relief from it; storms can trigger migraines and joint pain; hot weather worsens postural orthostatic tachycardia syndrome (POTS). Everyone’s body has a unique pattern of interacting with the weather, such that it’s difficult for patients to predict what might cause a flare.

But what research can definitively tell us is that climate change is here, and it’s already making people sick.

Research shows links between smoke inhalation and rheumatic diseases, supporting my experience of exposure to wildfire smoke exacerbating joint pain. Elevated levels of particulate matter (the main pollutant of wildfire smoke) worsen symptoms for lupus patients and cause new cases of rheumatoid arthritis, as well as RA-associated interstitial lung disease. Breathing in high levels of particulate matter also may cause multiple sclerosis, Parkinson disease’s, diabetes, and asthma.

Wildfire smoke is hardly the only health risk we’re facing. The increased frequency and severity of floods produce mold spores, which can cause allergies, nausea, and the worsening of illnesses like long Covid and myalgic encephalomyelitis. Flood remediation also can bring people into contact with lead paint and asbestos. Lead exposure can cause kidney damage, high blood pressure, and ongoing cardiovascular issues in adults, while asbestos can lead to lung diseases including cancer.

The heat itself can be deadly, as Europeans saw this June. It’s now estimated that about 10,000 people died from the heat. Those with chronic conditions such as heart disease, diabetes, and thyroid disease are all at greater risk of heat illnesses, as are people taking certain medications (like beta blockers and some antidepressants).

But the heat doesn’t just exacerbate existing illnesses; new research suggests that high temperatures impair the immune system and can break down the epithelial barriers in the lungs, skin, and gut. These are the cells that offer protection from viruses, bacteria, and pathogens, and their disruption could lead to allergies, autoimmunity, and other health problems.

Warming temperatures are also expanding the range of ticks and mosquitoes that carry diseases like West Nile virus, Lyme disease, dengue, chikungunya, alpha-gal syndrome, and others. While many of these illnesses have treatments, the trick is detecting infections early in the disease process; otherwise, people can develop long-lasting symptoms.

And the cyclosporiasis outbreak that’s been in the news most of the summer? That, too, could be a product of climate change — and could have a chronic illness connection. The cyclospora parasite matures faster in warmer temperatures, and climate scientists have predicted that 2026 could be yet another new “hottest year on record.” But it’s not only the heat that helps foodborne pathogens. Sprinkler irrigation is used for most agricultural products in the U.S., creating moist conditions, but changing weather patterns are causing more incidences of drought and heavy rainfall. One study found that higher humidity is more likely to allow salmonella to survive and replicate on lettuce. Research suggests that the overall prevalence of pathogenic contamination will increase, thanks to the combined effects of rising temperatures and changing humidity patterns.

I experienced multiple bouts of food poisoning in 2019 that led to small intestinal bacterial overgrowth, a digestive condition in which an overgrowth of bacteria in the small intestine cause diarrhea, abdominal pain, weight loss, and malnutrition. It took months to identify and treat, during which I lost nearly 20 pounds unintentionally. That same time period is also when I developed widespread symptoms of psoriatic arthritis. Maybe it was a coincidence, but there’s research indicating such infections can result in Crohn’s, ulcerative colitis, Guillain-Barré syndrome, and other autoimmune diseases.

*PLEASE NOTE: This is specific to me personally and does not reflect the views of all people who are covid-cautious

What is a friend, anyway?

Recently, I’ve heard from a few people that they would like more guidelines about how to navigate our friendship as the pandemic rages on. Stuff like “what would you like me to do to keep you safe?” and “what kinds of activities can we do now?” Even if someone doesn’t see things exactly like I do or take the same precautions, I believe that this is coming from a place of genuine love and concern they want to be able to create a safe space for us to exist together. I appreciate when someone is unwilling to put me at risk.

If someone is choosing to be in my life, I want to cherish that effort. I do not expect perfection.

But Tesla, weren’t you unmasking for a while?

weird,

Yep! And I totally get why this might feel especially if we hung out during that time. I was super risk averse for the first three years of the pandemic, then I took fewer precautions in 2023 when I started living alone. Almost immediately after easing up I got an infection that gave me Long Covid, and I am now disabled. I can’t work full time, I have limited daily capacity, and it feels like every week I have a new or worsening health condition. Even still, it took several months to come to terms with the fact that I needed to be more careful, and admit that I was wrong. I can’t go back to a high-risk lifestyle now.

Here’s what I do:

wear a N95 or KN95 mask in all indoor spaces and crowded outdoor spaces

test regularly with RATs (to catch possible asymptomatic spread)

use nasal spray and CPC mouthwash

stay on top of infection rates and recent studies

Right now, I only share air with people who also take similar precautions, because I prioritize my

health and the health of others. This means:

no indoor dining (outdoor dining sometimes)

no peak time cinema showings

no bars

no breweries :(

no concerts or crowded events

I don’t expect you to also take all of the same precautions that I do. I have accepted that there is a widening gap of information and that I alone cannot do the job that public health is failing to do. I also recognize that there are many reasons why someone may choose not to wear a mask to protect themselves or others.

At bare minimum, what I do expect of my closest friendships is the acknowledgement of the reality. It’s very difficult for me to connect with somebody who is living a very, very risky life and not acknowledging that they are contributing to the overall problem. What that demonstrates to me is that our values are in different places (and are perhaps irreconcilable).

However, if somebody is willing to face some hard truths and learn some new things in order to keep themselves and the people around them safe, I am so so happy to go on that journey with you.

How we can stay connected:

I recognize that it may difficult for people who do not take the same precautions to continue to be in my life in a physical sense. But also - maybe not!

Here are things we can do in-person:

Go for a walk in nature

Hang out on the beach

Have a picnic in the park

Run errands together

Go to an afternoon matinee

(if we’re running errands together or sharing space indoors, wear a mask with me!)

If you want to share a meal inside or spend time together unmasked doing an activity, we can do that too, but it would require a longer conversation!

Want to hang out in real life?

Hooray! It would be super cool if you:

Test before we hang (without me asking) and send me your result

Tell me if you’re feeling unwell or if you’ve been around someone unwell

Tell me if you’ve done something risky in the last week

(examples of risky activities: dining indoors, spending time with others unmasked + indoors)

Be open to wearing masks if we’ll be in close proximity or inside together

Doing these things shows me that you care about me, and I will do the same for you, because I care about you. I strongly believe in making informed risk assessments, but I can’t do that if I don’t have relevant information :)

Maybe that’s too tough!

Here are some things we can do that do not require being in the same physical space:

FaceTime or phone call to catch up

Play virtual board games together

Watch a movie at the same time in our respective homes

Send each other memes

Have a body doubling session where we both get work done

I am fortunate to have several close friends that do not live in the same city as I do, so these harder conversations about sharing the same physical space never come up. But I still value those connections very much. :)

Don’t think we can make it work?

That’s okay! I would much rather know that you don’t believe you can acknowledge the/my current reality, or that you’re unwilling to work together or compromise, so we can go our separate ways. It’s important to me to stay connected to people for several reasons, but I don’t want to continue to put energy into a relationship that’s one-sided. Also, as a person who was raised by the Internet, it’s easy for me to transition to a more digital friendship. But I recognize that’s not the case for everybody, and that’s okay! I will continue to cherish the time we did spend together and wish you the best.

TL;DR:

My life is different now because of a Covid infection that disabled me. I am now at higher risk of future infections

Even if I were not disabled, when I updated the information I had about Covid risks, I decided I could not continue to ignore the very real pandemic and participate in eugenics

I recognize that this is not where everyone is at on the journey, so if you’re willing to a) have the conversation with me and b) make an effort to create safety and find alternatives to spend time together, I would love to continue our friendship

I take strict precautions. You don’t have to always, but there are several things that you can do to demonstrate care when we spend time together

If you do not wish to live in this reality with me, please tell me (no hard feelings, I promise) and we can go our separate ways :)

Let’s start at the beginning... no infection is good for anyone.

• Second infection in kids doubles long COVID risk | Penn Medicine

• The risk of developing an autoimmune disease after a COVID infection is 42.6%

• SARS-CoV-2 infection weakens immune-cell response to vaccination | National Institutes of Health (NIH)

• Beyond breathing: How COVID-19 affects your heart, brain and other organs | American Heart Association

• COVID-19 as a Trigger for Type 1 Diabetes - PubMed

• COVID-19 infection history as a risk factor for early pregnancy loss

• COVID-19 may increase heart attack and stroke risk for years | American Heart Association

• Changes in memory and cognition during the SARS-CoV-2 human challenge study - eClinicalMedicine

Young children and infants don’t have the language to express when something is wrong. They cannot consent to an infection; it is our responsibility as adults to protect them as best we can. First impression bias and optimism bias are perpetuating pandemic denial.

Infants and young children don’t have the language to express or describe when something is wrong with their bodies. A recent Newsweek article, titled “‘Disabling’ Chronic Illness in Children Not Taken Seriously,” mentions a new study showing that children have a 15% chance of developing long COVID after a single infection.

Children can consent to a COVID infection. They cannot consent to a disability resulting from a COVID infection. They cannot consent to long COVID. They can’t even consent to being on social media; that’s why I don’t show their faces or their bodies on social media.

The article also speaks of the enormous harm of believing that children cannot get COVID. This is already a major problem. This relates to first impression bias: the first information we receive carries more weight, and any subsequent information that contradicts it seems less credible. That’s why misinformation is so dangerous: once it spreads, our brains tend to cling to that first idea, and it’s much harder to correct. Those who spread this information know this.

At the beginning of the pandemic, many lies were told, but one of them was that COVID “didn’t affect” children. COVID is an airborne vascular disease (like measles and tuberculosis) that attacks the entire body. Among other things, it can cause strokes, blood clots, hair loss, autoimmune diseases... don’t children breathe the same air as us?

This myth was created for one reason: to prevent parents from responding to the severity of COVID. If you know that COVID will cause your child to have a stroke, it’s clear that you’ll demand protective measures (measures that not only cost money, but also make you spend less time shopping. A 2020 study found that people who wore masks spent 25% less time shopping).

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Improve your COVID knowledge and protocols

We send free masks worldwide and offer free courses on COVID-19 information. We believe in grassroots education and distributing resources on the ground. Email us at AutoDefensaSanitaria@proton.me if you want masks or information…

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a month ago · 2 likes · AutoDefensa Sanitaria

To this myth that children ‘can’t get COVID’ is added the ‘you have to be infected to become immune.’ Would anyone say that you have to be infected with HIV to become immune? Why not? Because we know the damage this virus does to the body. Reinfections devastate us. There’s no way to ‘train’ the immune system because it’s not a muscle; the damage from infections is cumulative.

All propaganda that talks about ‘training’ the immune system is lying to you to make you feel more comfortable when exposed to harmful infections. Furthermore, this idea of ‘training’ the immune system hides one thing: sacrificing those who can’t withstand such false ‘training’. The only political class that can afford infections is the bourgeoisie. Do you know any worker who could be sick for more than a week? What would happen if they became disabled thanks to COVID? Now think about this, but in children. Why create long-term disabilities in children simply because we want to live in a false sense of security?

Children are one of the groups most ignored by capital; they are the future exploited workers who must be submissive, the next source of profit for capitalism, but who are not yet. Children are being infected again and again with a virus that ravages the entire body. The number one disease among children is no longer asthma; it is now Long COVID.

There is a cognitive bias called optimism bias: the belief that bad things won’t happen to me. We see this constantly during the pandemic. Many people don’t wear masks because they believe they won’t be the ones to develop long COVID. This was already seen at the beginning of the pandemic: many people died unnecessarily because they thought it wouldn’t happen to them. And it’s still happening: people continue to die and become disabled from COVID every day, but no one thinks they’ll be one of them.

How to teach children to use masks

shishi.rose

“I started working on mask-wearing when my daughter was 15 months old, and we worked on it for about six months.

Now she does it perfectly and says, ‘My mask keeps my friends safe.’ I’ve always taught her that we put on masks for others first, because individualism isn’t my goal in parenting.

Children are getting long COVID almost as much as adults. I will do everything I can to prevent that from happening. Her future health matters to me, and I want to protect her. I’m in several Long COVID Kids support groups, and it’s DISCOURAGING.

Things I did to get her to wear a mask:

1. I started without expecting her to actually wear it. At first, the mask was there for her to touch, play with, and learn about.

2. I read children’s books about wearing masks. Her favorites were: “Mia’s Mask,” “The Dragon’s Mask,” “Heroes Wear Masks,” “Even Grumps Wear Masks,” and “Who’s Behind the Mask?”

3. We practiced indoors daily for months, putting on the mask and removing it by the straps, not by the front where germs are.

4. We started with a timer where she had to keep it on for a certain amount of time, and we celebrated/offered small rewards.

5. Once we mastered that at home, we practiced with the timer outside and gradually moved to more indoor locations. (Try me if you want to argue about this point, but I’ll just block you. A. Covid exists outside too, and B. We practiced outside so she could take more breaks with less exposure.)

6. We used the timer for months before getting rid of it.

7. We practiced with stuffed animals, putting masks on them, and kept one in the car for travel.

8. We regularly talked about hand hygiene, covering coughs/sneezes when not wearing a mask, how germs travel, etc.

9. We talked about protecting the people we love and even the people who don’t protect us. Change.

10. We look for pictures of people wearing masks, and I make up stories about how they protect their community.

11. We try on many different types of masks.

12. She asks, so I acknowledge that it IS strange that so few people are wearing masks, but we must continue.

13. I regularly tell her that I am proud of the way she cares about others.

How to talk to children and youth about Covid

From Covid Tips

Living in a pandemic is challenging. Caring for children and youth is challenging. Caring for children and youth during an ongoing global pandemic… ‘challenging’ is putting it lightly. However, we are certainly not the only people experiencing these challenges, even when it sometimes feels this way.

Here, we’ll discuss talking with general ideas and tips for talking with children in our care, some considerations for navigating a school environment, submitted suggestions from caregivers, and resources that may help.

Ideas and tips

If you are caring for a young person, you have likely realized that they are smart. They are able, adept, and capable of learning and experiencing the worlds around them. Living in a pandemic is a big experience, and most people had little preparation for this experience prior to 2020. Presented are some ideas and tips for talking with kids. Some of these might be relevant to the children in your care, and some of these may not apply. Just like adults, kids share some similarities while also being unique individuals with different needs.

These conversations will likely not all happen at once. They may arise during teachable moments in day to day life; when putting on your mask, for example, you might take this chance to discuss masking and safety.

Explain the science

For some kids, understanding the science and how things work helps them understand big concepts easier. You can explain the science of Covid in terms the children in your care will understand. Explanations should be tailored according to their age. It’s a good idea to break the idea down into pieces and then add the amount of detail that’s appropriate for their age. For Covid, some main points of discussion could be:

1. Airborne spread: Explain how the germs that cause Covid are in the air. Covid germs spread when a person who is sick breathes out germs from their lungs. When people gather indoors together, without open windows or ventilation, it’s easier to become sick because there are more germs in the air being shared.

2. Why masks work: Masks protect our nose and mouth from breathing in germs that enter our lungs. Masks help stop many different germs. The best masks are ones that fit snug on our faces, so all the air that comes in and out of our bodies is passing through the mask.

3. Safe and risky places, with solutions: Providing solutions and strategies for being in different places can be a good Q&A problem solving activity. One person (kid or adult) can toss out suggestions for potential spaces, and the other can provide the solutions. For example: Space is outdoors. Solution: If there are people nearby, we’ll wear a mask.

4. Protecting yourself and others: Emphasize how important staying as healthy as we can be is important. Being sick isn’t fun, and we all want kids to be able to do the fun things they enjoy. We know everyone is vulnerable to this virus, and we all deserve to be safe.

5. Long Covid: Some families have come up with a variety of different terms for this, including ‘forever Covid’ and ‘Covid that doesn’t go away’. Explain how this would limit the fun activities the kids can do, and the adults around them. Some kids resonate with the math: 1 out of 5 people have Covid that doesn’t go away (according to the CDC).

6. Cats and dogs can get Covid: Kids love their family pets. Talking about staying healthy for people and pets can give one more example of why keeping Covid out of the family home is important.

Science is not intended to be scary. But sometimes, science can be scary. One strategy to overcome the fear is providing concrete strategies of things we can do. For example, you might say: “Long Covid sounds scary, but we know what we need to do: avoid becoming infected with Covid. And if we do get Covid, we try really hard to not become infected again.”

If the children around you are older, they may want to see more information that they can read and understand on their own. An excellent resource is the Public Health Agency of Canada, which discusses the effects of Covid, Long Covid, and ongoing effective mitigations. The language is written in a way the general public can understand, approximately at a Grade 6 reading level.

Your perspective

For some kids, personal stories resonate greater than science. Consider sharing why you are taking the safety measures you’re taking, and why this is important. Is it to protect yourself? Or someone else? Is it to avoid the risks of Long Covid? There are so many reasons to avoid Covid. Sharing your own reasons can create greater understanding for those around you.

Prior knowledge and explaining differences

Kids come across information from a variety of different sources in many different ways, be it from their extended family, friends, the media, or elsewhere. If you are practicing strict ongoing disease mitigations, these practices may not be common in your area. Here are three effective notes to talk about this difference:

1. Being different is okay. It’s okay to do things differently, because people can be very different from one another.

2. We don’t have to be like everyone else. We do what’s best for us and those around us. If some families don’t wear masks or don’t avoid large gatherings, that is their choice. And we make our own choices that work for us.

3. Is this information true? We hear and see all sorts of information, and not all of it is correct. Comparing the source and where the information came from to a known true source is an excellent skill to have, whether we’re talking about the pandemic or not.

Respect

Just like us, children and youth are living through and navigating an ongoing pandemic. Take moments to acknowledge the incredible and commendable work they are doing. Speak to them with respect; they deserve it.

School environments

Traditional schooling has never been the only option. There are a variety of ways for students to get an education, including traditional schooling, homeschooling, or virtual schooling. For homeschooling, there are a variety of curricula available to suit many different families and cultures. Virtual school is available in many countries in a variety of forms. We can find the systems that work best for us, even when they aren’t common. The method of instruction that works best for you and your family is the right one.

Navigating Covid in the current school system can be incredibly challenging. There are many different schools that can operate in many different ways, even in the same regional area. One recommendation would be to reach out to parents who share your same concerns. If there are none in your area, the search can be widened to a larger zone. Sometimes a post on social media or messages to like-minded folks can get the momentum started (on Facebook there are many ‘Still Coviding’ regional groups). A small group of parents can be incredibly powerful, especially when there is science and compassion on their side.

Parents respond: How do you talk with your children about Covid?

I lived with a chronic illness and my daughter understands the importance of protecting my health. While I’ve recovered, she continues to wear a mask to protect others who are sick or vulnerable. We always frame it to be about the collective and social justice. She’s been such a champ.

-CC

My kid was 8 years old when Covid first started. She played the game Pandemic and watched an anime called Cells at Work, which helped explain what was going on. Plus, she’s a big aficionado of Japanese entertainment, and masks aren’t looked down upon there.

-JO

I give accurate information. They know it’s airborne, the difference between a mask and a respirator. They know what fit testing is and why it’s needed and that ‘mild’ SARS2 infection can cause immune/organ/etc damage. They know it’s easy to stop transmission with science based policies.

-FMK

Kids are in college. Every phone call ends with ‘Are you wearing a mask? Using Enovid?’

-SC

My son is autistic and masks were very difficult at first due to sensory issues. After we talked about safety and how we wear masks to protect others and ourselves, it was a non issue. He wears his mask every time we go out and even reminds others.

-LMM

She knows Covid is bad. She knows masks help reduce the risk of contracting. We’re open with her about sharing feelings on masking. She’s more concerned about her friends not masking and getting sick than she is about being the only masker.

-CO

We’ve discussed airborne transmission at length. Both kiddos understand how Covid spreads and they also know it’s bad news. I’ve tried to be honest without terrifying them, so they know it can disable you. They also know the government is hiding a lot of info from us, but I generally try to let them ask questions rather than just telling them stuff.

-SB

For masks, I use the same line as flu shots. We wear masks to protect our friends and people who can’t wear them. My kids don’t love masks. But they’ve never complained, because they know that the world they live in is bigger than they are. They also enjoy not being sick. I’m not sure if they remember what it’s like to have a cold. They have very few memories of the snotty nosed before times.

-HJ

We explain to them that because it’s a new virus we don’t know the full scope of how it’s harming people. We recently explained how the immune system works and what can happen when it’s damaged. That seemed to resonate with them as well. My kiddos are 6 and 8 years old. We have watched How do people catch a cold? Ask the Storybots a few times as kind of a springboard to chat about the difference between a cold and Covid and why masking is an excellent layer of protection.

-SSB

Resources for children and youth

Books

• COVID-19 Pandemic Children’s Book Collection by University of Virginia Library.

• Germs, Viruses and Vaccines for Kids is a staff-created list from the Chicago Public Library

Videos

For younger kids:

• How do people catch a cold? Ask the Storybots

• Nastya and a song for children about masks

For older kids:

• Airborne Spread of Covid-19: How to Prevent It, And Other Respiratory Disease

For all ages:

• Covid-19 vaccines: Keep them safe

We send free masks worldwide and offer free courses on COVID-19 information. We believe in grassroots education and distributing resources on the ground. Email us at AutoDefensaSanitaria@proton.me if you want masks or information.

Covid moves like invisible smoke

COVID spreads and moves like cigarette smoke. Think of the people around you and yourself as people who are smoking all day; it makes it easier to understand how COVID moves.

COVID aerosols can quickly fill any crowded, poorly ventilated space, moving invisibly to infect anyone in the room. These aerosols travel with air currents and remain airborne for hours after the infected person has left. COVID also spreads outdoors. You can become infected within seconds or minutes of exposure.

You don’t need to have symptoms to spread COVID

At least 50% of all transmissions are asymptomatic (you have it and you don’t even feel ill). In those symptomatic infections, it takes a couple of days for symptoms to appear, which means that you are infecting others for at least a couple of days without knowing it. Since we cannot know for sure if we have COVID at any given time, universal masking is essential.

There is no mild COVID infection.

At least 10% of infections result in long COVID.

Reinfections are devastating. There’s no way to “train” the immune system because it’s not a muscle; the damage from infections is cumulative. Any propaganda that talks about “training” the immune system is just lying to make you feel safer when exposed to harmful infections.

To say that infections are good because they help our immune system is like saying that having car accidents are good because they strengthen our bones; it makes absolutely no sense. That’s not how our bodies work.

Masks matter, find one that fits your face!

Masks are incredibly effective. They work best when everyone wears them. FFP2, KN95, KF94, and N95 masks offer aerosol filtration and should be used whenever possible. Surgical and cloth masks are less effective and do not filter aerosols. Get free masks and testing at your local mask block (maskbloc.org for searching maskbloc worldwide and you can also email us at AutoDefensaSanitaria@proton.me; we ship masks worldwide).

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Masks 101

In order to understand masks we must talk about aerosols and droplets…

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2 months ago · 6 likes · AutoDefensa Sanitaria

Make sure the mask fits snugly against your face so that the air you breathe is filtered through it. Aerosols can leak through gaps. If you can’t get a good seal, try a different brand or size.

Test frequently + understand the limitations

Rapid antigen tests produce many false negatives. A rapid antigen test only successfully detects 60% of early symptomatic infections and 22% of asymptomatic infections (OntarioHealth has a guide on how to get the most out of them, as they are the most affordable tests for the general population).

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Antigens, PCR, and Molecular Tests

Molecular tests are far superior to rapid antigen tests and are now available for home use…

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a year ago · 1 like · AutoDefensa Sanitaria

Rapid tests are much more reliable when performed repeatedly over several 48-hour periods. It can take between one week and 14 days to get a positive result, so a single negative result should not be relied upon. Molecular tests such as PCR or NAAT are much more reliable and are best performed between 3 and 5 days after exposure, although they are expensive and less accessible than rapid tests. As COVID-19 spreads, the virus mutates, and our tests become less reliable.

Vaccines cannot be an excuse for not preventing the virus.

Vaccines do not prevent infections, reinfections, or long COVID. SARS-CoV-2 infection weakens immune-cell response to vaccination, meaning that the more we are infected, the less effective the vaccines we receive will be.

They have been crucial in significantly reducing mortality and hospitalization rates from severe infections. However, antibody levels decrease significantly in the months following vaccination. Each infection leads to new mutations that make the virus more complex.

To honor the effectiveness of vaccines, we must prevent the creation of more variants. Vaccines are not an excuse not to wear a mask.

HIV and COVID: united by ignored pandemics

“The statement that SARS-CoV-2 is “airborne AIDS” may be an oversimplification, but it draws attention to emerging evidence showing that the virus induces a distinct form of acquired immunodeficiency (AID).

SARS-CoV-2 and HIV-1, though distinct, share parallels in their biochemical traits and mechanisms, long-term impacts and societal responses. Both can establish persistent infections in tissue reservoirs, immune dysfunction, vulnerability to other infections including opportunistic, systemic damage including hallmarks of accelerated biological aging, and premature neurocognitive disorders. HIV integrates into DNA, whereas SARS-CoV-2 and its parts persist in organs like the blood vessels, brain, heart, tonsils, and lungs.

As governments rolled back public health protections, leaving the public to navigate the uncontrolled spread on their own, stigma shifted to Long COVID patients and those advocating for continued precautions. These individuals are frequently dismissed as “fearmongers”, “anxious” or “overly cautious” despite the objective ongoing and significant harms caused by the pandemic. Meanwhile, Long COVID patients experience persistent gaslighting and ignorance from healthcare professionals, exacerbating their struggles to access appropriate care.

addressing SARS-CoV-2 as a systemic vascular infection with significant cumulative health impacts necessitates sustained public health measures and innovative strategies to mitigate its ongoing threat to individual and population health. It is essential to prioritize airborne infection prevention, especially while no causal therapies are available for the sequelae of SARS-CoV-2 infection.”

Right now, the disabled community is being targeted. Like HIV, COVID can affect anyone, but this time the state has chosen to use the word “vulnerable” to seek complicity in ignoring the ongoing pandemic. Just as HIV is linked to queer activism, COVID is linked to disability activism, because the state uses our identity to justify the social murder we experience due to ITS mismanagement.

Only the rich can afford to be sick: viruses are weapons of the oppressors.

Do you know any working-class person who can afford to be sick? Neither can we.

Who can afford to miss work?

Long COVID is a new disease that the system wants to portray as a disaster when it’s actually the result of a lack of prevention. In capitalism, science is used to get us back to work tomorrow, but for more complex issues, doctors tend to deny you care and tell you it’s all anxiety.

People with long COVID face enormous violence and medical neglect. Furthermore, COVID can literally cause strokes, heart attacks, and autoimmune diseases. And all of this is preventable with masks.

We, the workers, are the ones who create medicines, masks, houses, and all the basic necessities a person needs. Yet we don’t have the right to access them. We have to spend our lives being exploited for something that couldn’t be created without our labor.

Workers’ power means workers’ care. We want union strength, we want workers’ power, we want workplace safety, we want prevention of death and disability.

Getting infected with COVID at work is another form of employer terrorism. Everywhere you go, there’s a worker who has no choice but to be there. Let’s wear masks for our collective health.

If you want a more detailed explanation:

health self defense

Covid Continues To Destroy People’s Health

There’s a fanzine about this article; you can find it on the Health SelfDefense Crytpad Drive. You have the link to the Crytpad Drive and other links of interest in the linktree Health Self Defense | Linktree…

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9 months ago · 8 likes · AutoDefensa Sanitaria

health self defense

Healthcare Workers: Covid Continues To Destroy People's Health, This Is What You Need To Know

There’s a fanzine about this article; you can find it on the Health SelfDefense Crytpad Drive. You have the link to the Crytpad Drive and other links of interest in the linktree Health Self Defense | Linktree…

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9 months ago · 67 likes · AutoDefensa Sanitaria

We are all, in some way, at risk, and when this risk is perceived collectively, joint action is needed. Moreover, when risk is seen as shared, people tend not to take as much responsibility for their own hardships.

But risk perceptions are not always accurate. More people are at risk of homelessness than one might think. A hurricane or other disaster exacerbated by capitalism could leave us homeless.

Propaganda from states, corporations, the media, and other key actors significantly influences how risk is perceived. It is useful to analyze what factors change people’s perceptions of their own realities and what forces they perceive as responsible for protecting them from those risks.

Disaster is a factor that often transforms risk perceptions from individual to collective. In environmental disasters, the impacts are often seen as something that is not the fault of the individual. Therefore, the risk is collective and requires a collective response.

In the case of the COVID pandemic, we saw how capitalism tried to prolong individualism as much as possible; racism against the Chinese was used to divide us from what was happening; even today, there are still people who blame them.

Before March 2020, politicians around the world reinforced the idea that the virus “only” affected certain groups; they used the disabled to downplay its importance, and some added the elderly and the obese as part of this “vulnerable” group. Capitalism has spent years propagating the idea that anyone who cannot work is useless. With the COVID pandemic, we saw in real time how they exploited this sentiment to the fullest extent. And when did they finally act? When they had no other choice.

And even then, they spread misinformation about aerosols, telling lies such as that children couldn’t get COVID, and, of course, the enormous fallacy they had been building for years: that infections don’t make you “stronger.” It’s no coincidence that “work will make you rich” and “infections will make you strong” are so similar: the meritocracy of work is being transferred to the meritocracy of health.

The view of risk as a collective is crucial for public communication strategies regarding COVID. It’s not just about appealing to people’s self-interest, but about reorienting our perspective on fragility and solidarity.

When we want farmworkers to use sunscreen to prevent cancer, we can talk about their health individually, but this doesn’t reach them. Because the reason skin cancer isn’t prevented in workers who are constantly in the sun is because we belong to an oppressed class. And this is what we must expose. In this way, we not only point to the common oppressor (the bourgeoisie) but also give us the opportunity to act as a community (the oppressed). Capitalism individualizes workers, so it won’t be individualism that frees us from its logic. The master’s tools won’t dismantle the master’s house.

How many pandemics would we have if workers were the ones in power? Can you imagine what we could do if science were no longer hijacked by capitalism and were at our service?

If the working class produces everything, then everything belongs to us. Let’s not allow the state to convince us which lives are less valuable.

“Covid-19 still presents us with a profound opportunity to build the world we want.

While devastating, and with many committed to forgetting, this pandemic still acts as a catalyst—a longue durée of reckoning that reveals the deep injustices woven into our society and the points at which the system of the state becomes vulnerable. The old world of exploitation, inequality, and relentless profit pursuit is crumbling, and in its place, a new vision of liberation and collective care is struggling to be born.

Yet, this transformative potential is under siege. Pandemic denial is a shroud, trying to suffocate the horizon of deliverance that is within our grasp no matter how far away it seems. The forces of the status quo are desperate to maintain control, urging us to return to normalcy while reinforcing the systems that perpetuate harm.

As we navigate the complexities, collective suffering, and pain of this moment, we cannot shy away from the struggle. The challenges we face are immense, but so too is our capacity for resistance and transformation. We must deliver each other from Covid. Together, we can rise from the ashes of the old world, forging a path toward a new reality where everyone really has the means to thrive.

To seek deliverance for each other is to yearn for more than mere liberation; it’s to aim for a profound transformation that shakes the very foundations of our existence. Liberation might free us from oppression’s chains, but deliverance reclaims our souls, histories, and futures. It acknowledges that we seek more than freedom from tyranny—we seek a radical reimagining of what it means to live fully and authentically.

In this pursuit, we must confront the reality that liberation, without deliverance, risks becoming just a shift in power—an exchange of one form of control for another. We may be freed from the oppressor’s shackles, but still bound by the structures that perpetuate harm. Deliverance demands that we dismantle these systems and transform not only our circumstances but our relationships with one another and the world.

Deliverance is an embrace of our collective humanity, a defiance against the systems that seek to divide us. It compels us to remember that true freedom is not found in isolation but in the intricate web of connections we weave. In this quest, we must nurture one another, knowing that our liberation is meaningless if it doesn’t encompass the needs of the most marginalized among us.

To seek deliverance is to embody a fierce love that transcends imposed boundaries of time and space. It is a call to arms, a cry for justice that echoes in the hearts of the forgotten and abandoned. Together, we will forge a future where the scars of our past are not just reminders of loss but badges of honor that guide us in our fight for a world reborn.

Deliverance is the spark that ignites our collective struggle, freeing workers and the surplus from the weight of forgetting. It calls us to remember, to acknowledge how we will never be the same, and to stand firm against the state’s relentless demand that we abandon one another.

In this act of remembering, we refuse to be silenced or sidelined. Instead, we must over and over again rise in flagrant defiance together, casting aside the illusion of individualism the state promotes. We become the guardians of each other, creating networks of safety through solidarity and compassion. Our lives are intertwined, and through this connection, we find our strength. Vulnerability, far from weakness, becomes a testament to our humanity and capacity for love.

As we gather in defiance, we create a chorus of remembering, a song that echoes against the silence imposed by the state. In this harmony, we find the power to protect ourselves and transform our communities into sanctuaries of mutual aid. Deliverance is not just a moment—it’s a movement, a continuous unfolding of collective liberation.

Let us embrace interconnectedness, knowing that as long as we truly hold one another close, we are stronger for it. We are the architects of a future where no one is left behind, where safety is woven into the fabric of our existence. Together, we must continue to move forward into the future together, unwavering and unyielding, in pursuit of the world we know is possible.” Structural Violence and the Pandemic: An Update on Our Collective Reality (substack.com)

This Autonomia

Direct Action Planning Resource for (and by!) Sick and Disabled Comrades

l've been sitting a lot with the idea that disabled people/crips only (can) engage in direct action or support with escalation from our beds. Although many of us are bed-bound a lot of the time, I th…

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2 years ago · 35 likes · Andrea Alakran

Its aim is to provide strategies and roles adapted to different levels of mobility, understanding that there is not just one way to carry out direct action (the more normative, frontline approach).

Possible actions have been classified into four disability categories (high, medium, low, and non-mobility). These categories are defined by the disabled person themselves; it is not a rigid scheme, but rather depends on many factors. We understand disability as a broad concept that includes people with chronic illnesses, reduced mobility, neurodivergent individuals, those with psychiatric conditions, people with mental illness—anyone who falls outside the body/mind norm is considered disabled.

Forms of direct action have been classified into six categories:

1. Confrontation:

This category includes direct and confrontational actions. Example: Occupying a government building to demand the right to housing.

2. Connection:

Connection activities focus on building and maintaining support networks among comrades and the wider community. For example, if we are an antifa collective, we will want to connect with other communities fighting against fascism and with people who want to participate in this struggle.

3. Somatic:

Somatic actions are geared towards caring for the body and mind. This includes medical attention, body care, facilitating restorative spaces, and somatic support to ensure the physical and emotional well-being of participants. For example, if we have an assembly, somatic support might include having a room for emotional/physical self-regulation. Another example is having a care block at demonstrations where there are people who can accompany and help with somatic problems that may arise, such as physical harm suffered during the demonstration, a panic attack, or a sudden pain crisis.

4. Education:

This category encompasses educational and training activities. Example: being able to conduct an anti-repression workshop on rights in the face of the police.

5. Protection:

Protection actions are intended to ensure the safety and defense of comrades and the community. This may include education and practice in cybersecurity and digital security (infosec/digisec), the distribution of relevant information, and physical defense during direct actions.

6. Material:

This category refers to the logistics and distribution of material resources necessary for sustaining actions and the well-being of participants. Example: being able to distribute and provide free masks and COVID tests.

Direct Action Planning Resource For (and By!) Sick And Disabled Comrades

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High Mobility / Manageable Pain

→ Confrontation

Frontline/on-site agitation + escalation

→ Connection

Frontline/on-site connection

→ Somatic

Frontline/on-site medics and bodyworkers

→ Education

Frontline/on-site gathering and skill-sharing

→ Protection

Frontline/on-site defense

Scout by vehicle

Pick up, drop off, evacuative

Accountability processes

→ Material

Frontline/on-site material distribution

Medium Mobility / Manageable Pain

→ Confrontation

Coordinate transportation to-and-from site

Point person for legal and jail support

Off-site coordinate comms

→ Connection

Coordinate gatherings to connect and build relationships

→ Somatic

Facilitate spaces for somatic restoration and sustenance

→ Education

Facilitate workshops and classes for all learning levels and styles

→ Protection

Educate or distribute information for infosex/digisec

→ Material

Food preparation and delivery

Childcare

Gather and distro funds

Coordinating logistics and resource drop offs

Low Mobility / Manageable Pain

→ Confrontation

Research/collect information on predatory groups or individuals

→ Connection

Reach out/build distributed support networks

→ Somatic

Share offerings/digital resources for somatic support

→ Education

Agit-prop and political theory art

Banners and signmaking

Music

Documenting, archiving event

Political study

→ Protection

Learning and practicing infosec/digisec

→ Material

Gather supplies (food, PPE, building materials)

Gather and distro funds

Low–No Mobility / Unmanageable Pain

Rest if possible! Allow comrades to step in, show up, and care for you.

You can find the PDF and Word versions of this blog on our cryptpad.

Patient Led Rthm Long Covid Treatment Guide Transcription

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Long COVID Treatment Guide Patient-Led Research Collaborative and RTHM

Supplements & Over the Counter (OTC) Medications

Nattokinase and Lumbrokinase

Especially helpful for

Fatigue, cognitive impairment, feeling of weakness, post-exertional malaise (PEM), dyspnea, chest pain, tachycardia and heart pounding.

Notes

Nattokinase (NK) and lumbrokinase (LK) are derived from soybeans and earthworms respectively; patients with an allergy to one may try the other. Serrapeptase may be used in conjunction with either for more impact; however, some patients may have adverse reactions to serrapeptase. Can start with NK or LK and then add serrapeptase once adjusted. The Boluoke brand of LK is most studied and it is usually dosed at 600,000 IU three times daily in studies. Surveys around the TREATME study have shown that most patients do better on NK doses from 4,000 to 12,000 FU per day, with many landing on 4,000 FU twice daily on an empty stomach. A retrospective analysis of 1,062 patients taking 10,800 FU of NK daily for a year did not report any safety issues at this dose. NK brands with enteric coating performed better in patient surveys.

Summary

NK and LK are both enzymes with fibrinolytic activity that have been used for their antihypertensive, anti-atherosclerotic, lipid-lowering, antiplatelet, neuroprotective effects, and in addressing blood clots in DVT, stroke, and Long COVID. A clinical trial on lumbrokinase for Long COVID is underway.

The Harvard/Stanford TREATME Study

29% of individuals with Long COVID who tried NK or LK (n=341) reported “moderate to much better” symptom improvement. 32.5% of people with Long COVID who tried LK and/or NK combined with serrapeptase (N=318) reported “moderate to much better” symptom improvement.

References

PMID: 36043493, 38947233, 40627388, 14565628, 24229674, 20473377, 36080170, 36072877; Trial ID: NCT06511050, NCT07229521.

H1 Blocking Antihistamines (Cetirizine, Fexofenadine, etc.)

Especially helpful for

Mast cell activation, allergic symptoms, post-exertional malaise (PEM), cognitive impairment, gastrointestinal symptoms, insomnia, headaches, orthostatic intolerance.

Notes

10 mg once daily to twice daily. May interact with psychiatric medications. Contraindicated for ESRD. Abrupt discontinuation can cause withdrawal symptoms.

Summary

Preliminary data suggests that blocking both histamine H1 and H2 receptors may significantly alleviate symptoms in Long COVID patients with manifestations linked to mast cell activation, with 29% of treated individuals experiencing complete resolution of their condition. A UK study found 72% of Long COVID patients treated with famotidine + loratadine had a reduction of symptoms, with 20% having complete symptom resolution, with one patient worsening. H1 receptor blockers are considered the cornerstone of Mast Cell Activation Syndrome (MCAS) treatment, with combinations of non-sedating antihistamines (cetirizine, fexofenadine, loratadine) and H2 antihistamines providing synergistic histamine receptor blockade to relieve symptoms. A large cluster RCT with an arm investigating famotidine + loratadine in Long COVID is underway.

The Harvard/Stanford TREATME Study

25% of individuals with Long COVID who tried 2nd/3rd generation H1 blockers like cetirizine and fexofenadine (n=759) reported “moderate to much better” symptom improvement. 27% who tried 1st generation H1 blockers (n=114) reported “moderate to much better” symptom improvement; and 35% who tried a combination of H1 and H2 blockers (n=194) reported “moderate to much better” improvement.

References

PMID: 38526146, 37529714, 36791116, 34611034, 37389095, 40627388.

Famotidine

Especially helpful for:

Cognitive impairment, neuropsychiatric symptoms, mast cell activation, gastrointestinal symptoms.

Notes:

H2-blocking antihistamines (usually famotidine) are typically used in combination with an H1-blocking antihistamine in studies, but can also be used on their own.

Summary:

Famotidine may prevent SARS-CoV-2 spike protein entry into endothelial cells and has also been shown to attenuate the cytokine storm and inflammation in acute COVID.

Additionally, acid-related disorders are among the most common gastrointestinal conditions associated with Long COVID, which famotidine may help mediate.

Studies show that using famotidine alone improved cognitive and neuropsychiatric scores after COVID. One study showed that combination treatment with famotidine + loratadine led to symptom reduction in 72% of patients, with 20% experiencing complete symptom resolution.

Additional data suggests that famotidine may significantly alleviate symptoms in Long COVID patients with manifestations linked to mast cell activation. A large cluster randomized controlled trial (RCT) with an arm investigating famotidine + loratadine in Long COVID is underway.

The Harvard/Stanford TREATME Study:

20% of individuals with Long COVID who tried H2 blocker famotidine (n=300) reported “moderate to much better” symptom improvement.

Other H2 blockers, tried by 80 individuals with ME/CFS or Long COVID, were less effective, with 16% reporting “moderate to much better” symptom improvement.

References:

PMID: 37529714, 37327698, 35144974, 36791116, 40627388, 36882400, 35548336.

DOI: 10.1136/jim-2021-002051, 10.1186/s10020-022-00483-8.

Oxaloacetate

Especially helpful for:

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), cognitive impairment, fatigue, post-exertional malaise (PEM).

Notes:

Dose: 500 mg twice daily (morning and mid-day) with food to test tolerance for 2–3 days, then increase to 1000 mg twice daily with food as tolerated. Randomized controlled trial (RCT) studies used 1000 mg twice daily.

Taking it too late may disrupt sleep. Taking it with food helps reduce stomach upset. It may take a few weeks to see improvements.

Summary:

A 2025 randomized controlled trial on oxaloacetate in Long COVID did not meet its primary endpoint for fatigue reduction, but it did show significant fatigue reduction on a secondary endpoint questionnaire and significant improvement in cognitive testing scores.

An open-label study found that oxaloacetate reduced fatigue by 33% in ME/CFS patients and 46.8% in Long COVID patients over six weeks, with dose-dependent effects in ME/CFS.

A 2024 randomized controlled trial found that oxaloacetate reduced fatigue by more than 25% on average in ME/CFS patients, with 40% experiencing a 63% reduction and being classified as “super responders”.

Lower natural oxaloacetate levels in ME/CFS patients suggest supplementation may enhance mitochondrial energy production.

The Harvard/Stanford TREATME Study:

29% of individuals with Long COVID who tried oxaloacetate (n=14) reported “moderate to much better” symptom improvement.

16% of individuals with ME/CFS who tried oxaloacetate (n=63) reported “moderate to much better” symptom improvement.

References:

PMID: 40757370, 39664752, 35764955, 28059425, 41132887, 40627388.

Nicotine Patches

Especially helpful for:

Cognitive impairment, fatigue.

Notes:

Patients should start at as low a dose as possible, generally 3.5 mg (half a 7 mg patch), but doses as low as 1.75 mg or 0.875 mg may also be used.

It is vital to communicate that some patches cannot be cut, as this will cause all the nicotine to release at once. Some brands have two plastic sheets on the back to allow for a “half patch”, and additional plastic can be added to keep the dose smaller.

Nicotine can increase heart rate; patients with POTS and ME/CFS should be on medications that control tachycardia before starting.

Caution is advised in the two weeks after acute myocardial infarction, in unstable acute coronary artery disease, and during pregnancy and lactation.

Addiction or dependence in non-smokers using transdermal nicotine was not specifically screened for, but no cases were reported among 608 non-smokers. PMID: 15628577, 34153704

Summary:

Transdermal nicotine has been shown to improve cognitive function, attention, and memory in mild cognitive impairment and in healthy adults.

Nicotine also improves some inflammatory conditions, including ulcerative colitis, arthritis, sepsis, and endotoxemia.

A survey involving 231 Long COVID patients taking low-dose transdermal nicotine (LDTN) showed improvement in 73.5% of patients and reported remissions in one-third of cases.

A proposed hypothesis states that Long COVID may be linked to impaired cholinergic neuromodulation caused by the SARS-CoV-2 virus attaching to nicotinic acetylcholine receptors (nAChRs), disrupting neuronal communication.

A case study on transdermal nicotine for Long COVID showed symptom improvement, improved cholinergic function, and an increased number of ligand-binding sites in nAChRs.

The Harvard/Stanford TREATME Study:

43% of individuals with Long COVID who tried nicotine patches (n=7) reported “moderate to much better” symptom improvement.

17% of individuals with ME/CFS who tried nicotine patches (n=18) reported “moderate to much better” symptom improvement.

References:

PMID: 40011942, 40627388, 36650574, 22232050, 33899218, 3525101, 27699443.

Lifestyle

Pacing

Especially helpful for:

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), post-exertional malaise (PEM).

Notes:

#MEAction and Long COVID Physio have high-quality guides for implementing pacing.

Summary:

Pacing is an activity management strategy designed to prevent and mitigate PEM by keeping activity levels within an individual’s energy limits. This may involve reducing and/or adapting activities and alternating them with periods of rest.

Pacing is proven to reduce episodes of PEM and is adaptive because an individual’s energy capacity limits may change over time.

People with Long COVID who experience PEM may need assistance to implement pacing, such as caretaker support, help preparing meals and doing household chores, and workplace accommodations.

Pacing is recommended for the management of PEM in the clinical guidelines from the Mayo Clinic Proceedings of ME/CFS, Bateman Horne Center, and the 2021 ME/CFS Clinician Coalition.

The Harvard/Stanford TREATME Study:

37% of individuals with Long COVID who tried pacing (n=119) reported “moderate to much better” symptom improvement.

References:

PMID: 36461167, 40627388, 34308300.

Salt and Fluid Loading

Especially helpful for:

Postural orthostatic tachycardia syndrome (POTS), orthostatic hypotension, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

Notes:

A key component of POTS treatment is the consumption of fluids and salt, with clinical guidelines recommending 2–3 L of water and 10–12 g of salt daily.

Increased salt intake may exacerbate symptoms in some presentations of hyperadrenergic POTS.

Summary:

Studies show that a high-sodium diet significantly improved symptoms in POTS patients by increasing blood volume, lowering plasma norepinephrine levels, and reducing orthostatic tachycardia.

These findings provide strong evidence supporting sodium intake as a beneficial treatment strategy for POTS management.

Research demonstrates that short-term salt supplementation improves susceptibility to vasovagal syncope and associated symptoms, with responses most pronounced in those with baseline sodium excretion <170 mmol/day.

Salt supplementation also improved symptoms, plasma volume, and orthostatic responses in patients with POTS.

Salt and fluid loading is recommended for the management of orthostatic intolerance in the clinical care guidelines from the 2021 ME/CFS Clinician Coalition, Bateman Horne Center, 2015 Heart Rhythm Society, and the Mayo Clinic Proceedings of ME/CFS.

The Harvard/Stanford TREATME Study:

33% of individuals with Long COVID who tried oral fluids and electrolytes (n=1,169) reported “moderate to much better” symptom improvement.

References:

PMID: 35697326, 33926653, 34823150, 40627388.

Compression Garments

Especially helpful for:

Postural Orthostatic Tachycardia Syndrome (POTS), Orthostatic Hypotension (OH), and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).

Notes:

Ankle-to-high-waist compression garments with at least 20 mmHg of compression at the ankle are generally preferred; however, the exertion required to put on such compression garments may trigger post-exertional malaise (PEM). Consider compression garments with zippers or Velcro to make it easier for patients to put them on and take them off. An abdominal binder alone is a good alternative for those who cannot tolerate or become excessively fatigued by full-leg compression garments.

Summary:

Studies show that abdominal and full lower-body compression garments significantly reduced heart rate and improved symptoms in adults with POTS during head-up tilt testing. One study showed that the median reduction in heart rate in the morning was −17 beats/min with medical/prescription-style waist-high compression (WHC), compared with −10 beats/min with sport/athletic-style WHC. The percentage change in heart rate was higher with medical/prescription WHC compared with sport/athletic-style WHC. Compression garments are recommended for the management of orthostatic intolerance in the clinical care guidelines from the Bateman Horne Center, the 2015 Heart Rhythm Society, Mayo Clinic Proceedings for ME/CFS, and the 2021 ME/CFS Clinician Coalition.

The Harvard/Stanford TREATME Study:

26% of individuals with Long COVID who tried compression garments (n=430) reported “moderate to much better” symptom improvement.

References:

PMID: 33478652, 32673524. DOI: 10.1016/j.cjca.2025.11.038, 10.1016/j.jacep.2024.09.033.

Lymphatic Drainage Massage

Especially helpful for:

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), fatigue, cognitive impairment, and insomnia.

Notes:

This technique can be learned to be performed at home by the patient and is low cost. Perrin Technique™ is one type of lymphatic drainage massage, also known as manual lymphatic drainage (MLD), which aims to help with neurological symptoms by improving the flow of cerebrospinal fluid. It may trigger post-exertional malaise (PEM) due to muscle tissue manipulation. The Perrin Technique is a type of MLD used specifically in ME/CFS. In other MLD techniques, the effect of the intervention may vary.

Summary:

MLD is a treatment for ME/CFS and may help address glymphatic and lymphatic dysfunction that occurs in Long COVID. Case reports suggest that MLD may help improve Long COVID fatigue, breathlessness, cough, respiratory function, and symptom severity. One study of 20 Long COVID patients who were seen by a qualified Perrin Technique™ practitioner once a week for an average of nine treatment sessions, in addition to a daily home-based self-massage routine, reported a reduction in PFRS (Profile of Fatigue-Related States) scores of 41.8% in men and 60.5% in women. The highest subscale scores on average were for fatigue, and all subscale scores showed, on average, a similar reduction of approximately 50% after the intervention.

The Harvard/Stanford TREATME Study:

14% of individuals with Long COVID who tried MLD (n=14) reported “moderate to much better” symptom improvement. 25% of individuals with ME/CFS who tried MLD (n=83) reported “moderate to much better” symptom improvement.

References:

PMID: 38155770, 40108491, 38063653, 35441129, 40627388.

Medications

Low Dose Naltrexone (LDN)

Especially helpful for

Fatigue, post-exertional malaise (PEM), cognitive impairment, insomnia, aches and pains, symptoms related to inflammation, poor mood.

Notes

Needs a gradual increase in dose. Can start as low as 0.25–0.5 mg or as high as 1–1.5 mg, and taper up gradually to 3–4.5 mg as tolerated. Doses can go higher than 4.5 mg. Usually dosed before bed, but can be taken in the AM if interfering with sleep.

Summary

Across multiple cohort studies (36–852 patients), LDN was linked to significant improvements in fatigue, pain, energy levels, and overall quality of life in 34–58% of Long COVID patients. People taking LDN were more likely to improve compared to those doing physical therapy alone (HR = 5.04; 95% CI = 1.22–20.77; P = 0.02). In ME/CFS, improvement in symptoms was observed in 73.9% of 218 patients taking LDN in one study, with moderate to significant improvement in 26% of another study. In vitro research further showed that naltrexone restores TRPM3 calcium channel function and natural killer cell activity in Long COVID. A randomized controlled trial of LDN in Long COVID is currently underway in Canada. LDN is recommended for the treatment of neuroinflammation and sleep quality, PEM, cognitive dysfunction and small fiber polyneuropathy in the Bateman Horne Center Clinical Care Guide for managing ME/CFS, Long COVID, & IACCs, as well as the clinical care guidelines from the 2021 ME/CFS Clinician Coalition, Mayo Clinic Proceedings of ME/CFS, and AAPM&R.

The Harvard/Stanford TREATME Study:

34% of individuals with Long COVID who tried LDN (n = 287) reported “moderate to much better” symptom improvement.

References

PMIDs: 35814187, 37804660, 38267326, 38813984, 38352659, 38765011, 38740499, 40627388.

DOI: 10.1080/21641846.2019.1692770

Beta Blockers

Types

Non-cardioselective, no vasodilatory activity: Propranolol, Nadolol, Sotalol, Pindolol.

Non-cardioselective, yes vasodilatory activity: Carvedilol.

Cardioselective, no vasodilatory activity: Atenolol, Metoprolol.

Cardioselective, yes vasodilatory activity: Nebivolol, Bisoprolol.

Especially helpful for

Postural orthostatic tachycardia syndrome (POTS), inappropriate sinus tachycardia (IST), heart failure, essential tremors, autonomic symptoms, anxiety, migraines.

Notes

Low doses (often ¼–½ of the lowest hypertension dose) can be effective. Older beta blockers tend to have more risk of weight gain in the first 2–3 months. Avoid beta blockers in people with anaphylactic allergies needing epi-pens. Avoid nonselective beta blockers in people with asthma, COPD or other lung disease. Beta blockers can be helpful if a patient has a comorbid condition for which beta blockers are otherwise helpful, including migraines, essential tremor, heart failure, etc.

Summary

Low dose propranolol has the most studies supporting its use in POTS, particularly hyperadrenergic POTS or where tachycardia is the predominant symptom. If a patient doesn’t respond well to low dose propranolol, other beta blockers can be tried. POTS patients taking propranolol in low doses (20 mg daily) experience reduced heart rate and orthostatic intolerance symptom alleviation, as well as increased exercise capacity. Lower dose propranolol doesn’t lower blood pressure as much, and higher doses of propranolol don’t add additional benefit and may increase side effects. Low dose propranolol is recommended for management of POTS in the consensus guidance statement on the assessment and treatment of autonomic dysfunction in Long COVID, in the 2021 ME/CFS Clinician Coalition treatment recommendations, as well as in the clinical care guidelines from the 2015 Heart Rhythm Society, Mayo Clinic Proceedings of ME/CFS, AAPM&R, and the Bateman Horne Center, especially for those with excessive tachycardia and hyperadrenergic features. Atenolol is an alternative for patients who have fatigue, brain fog, depression or other neurocognitive symptoms, as it doesn’t cross the blood-brain barrier as much.

The Harvard/Stanford TREATME Study

51% of individuals with Long COVID who tried cardioselective beta blockers (atenolol, metoprolol, nebivolol, or bisoprolol) (n = 195) reported “moderate to much better” symptom improvement.

40% of individuals with Long COVID who tried non-cardioselective beta blockers (propranolol or carvedilol) (n = 169) reported “moderate to much better” symptom improvement.

References

PMID: 19687359, 23616163, 29500811, 3616154, 25980576, 38958137, 6115665, 40627388.

Ivabradine

Especially helpful for

Postural orthostatic tachycardia syndrome (POTS), inappropriate sinus tachycardia (IST), diastolic heart failure.

Notes

Often better than beta blockers, especially in those with hyperadrenergic POTS. Dosed at 2.5 mg daily up to 7.5 mg twice daily.

Summary

Ivabradine may help Long COVID patients presenting with POTS, as it can control heart rate without significantly affecting blood pressure. A randomized, double-blind placebo-controlled trial showed ivabradine significantly improved heart rate and quality of life with no significant side effects in hyperadrenergic POTS. Studies have demonstrated ivabradine improves symptoms in 60–78% of POTS patients. It is recommended for management of POTS in the consensus guidance statement on the assessment and treatment of autonomic dysfunction in Long COVID, in the 2021 ME/CFS Clinician Coalition treatment recommendations, as well as in the clinical care guidelines from the 2015 Heart Rhythm Society, Mayo Clinic Proceedings of ME/CFS, and the Bateman Horne Center.

The Harvard/Stanford TREATME Study

49% of individuals with Long COVID who tried ivabradine (n = 100) reported “moderate to much better” symptom improvement.

References

PMID: 33602468, 37469536, 28846151, 21062792, 40627388.

DOIs: 10.1136/bcr-2021-243585, 10.1016/j.mayocp.2021.07.004

Midodrine

Especially helpful for

Orthostatic Hypotension (OH), Postural Orthostatic Tachycardia Syndrome (POTS).

Notes

2.5–15 mg up to Q4 hours while upright. Avoid doses within 4 hours of bedtime to reduce supine hypertension. For orthostatic intolerance, low blood pressure, or orthostatic hypotension, start very low (2.5 mg QAM) and adjust based on tolerance and response. Consider serial orthostatic vitals (active stand or NASA Lean) testing and check for supine hypertension in response to medication.

Summary

It can effectively treat orthostatic hypotension and tachycardia in patients who have a baseline normal or low-normal blood pressure. Watch for supine hypertension. A double-blind placebo-controlled cross-over study of 20 patients aged 12–20 years found that midodrine improved postural tachycardia in neuropathic POTS but not in hyperadrenergic POTS. A study found that 10 mg midodrine, taken three times daily, significantly improved standing systolic blood pressure in those with neurogenic orthostatic hypotension. Midodrine is recommended for management of POTS in the consensus guidance statement on the assessment and treatment of autonomic dysfunction in Long COVID, in the 2021 ME/CFS Clinician Coalition treatment recommendations, as well as in the clinical care guidelines from the 2015 Heart Rhythm Society Expert Consensus, AAPM&R, and the Bateman Horne Center.

The Harvard/Stanford TREATME Study

26.5% of individuals with Long COVID who tried midodrine (n = 49) reported “moderate to much better” symptom improvement.

References

PMIDs: 23978222, 9091692, 35025999, 33243837, 37419532, 34144933, 38813984, 40627388.

DOIs: 10.1002/pmrj.13397, 10.1111/joim.13652.

Pyridostigmine (Mestinon)

Especially helpful for

Postural orthostatic tachycardia syndrome (POTS), orthostatic hypotension (OH), autonomic neuropathy (AN), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), post-exertional malaise (PEM), myasthenia gravis.

Notes

Drug should be carefully titrated from 15 mg 1–3x daily up to 60 mg 3x daily as tolerated; doses can go higher. GI symptoms are common adverse effects since the drug increases bowel motility.

Summary

Pyridostigmine may help Long COVID patients presenting with POTS, ME/CFS, and post-exertional malaise. A randomized, placebo-controlled trial in 45 ME/CFS patients found pyridostigmine improved exercise capacity. Of 203 POTS patients on pyridostigmine, 43% experienced significant improvement in orthostatic intolerance, with notable relief in fatigue, palpitations, presyncope, and syncope. Pyridostigmine is recommended for management of POTS, OH, and AN in the consensus guidance statement on the assessment and treatment of autonomic dysfunction in Long COVID, in the 2021 ME/CFS Clinician Coalition treatment recommendations, as well as in the clinical care guidelines from the 2015 Heart Rhythm Society Expert Consensus, AAPM&R, Bateman Horne Center, and Mayo Clinic Proceedings of ME/CFS.

The Harvard/Stanford TREATME Study

34% of individuals with Long COVID who tried pyridostigmine (n = 56) reported “moderate to much better” symptom improvement.

References

PMID: 35526605, 21410722, 38813984, 40627388

DOI: 10.1183/13993003.congress-2023.PA4639

DOI: 10.1002/pmrj.13397

Oral Ketotifen

Especially helpful for

Cognitive impairment, gastrointestinal symptoms, sleep, allergic reactions, mast cell activation, autonomic dysfunction, irritable bowel syndrome (IBS), and other inflammation-related symptoms.

Notes

Oral ketotifen has to be compounded in the US. Dosing can start at 0.5–1 mg nightly and taper up as tolerated. Doses can reach up to 6 mg per day in divided doses (i.e. 2 mg three times per day, or 3 mg two times per day). Watch for sedation and weight gain.

Summary

Ketotifen is superior to other antihistamines due to its dual mechanism of stabilizing mast cells and acting as an H1 receptor blocker. Studies have shown ketotifen can help manage skin, gastrointestinal, and neuropsychiatric symptoms in mast cell activation syndrome (MCAS) and Long COVID. A 2023 study suggests ketotifen may reduce COVID-related brain fog by stabilizing mast cells and inhibiting Kv1.3 channels, thereby suppressing neuro-inflammation and immune overactivation. Ketotifen relieves gastrointestinal symptoms in irritable bowel syndrome by decreasing mast cell activity in the intestines.

As of 11/17/25, prescriptions through RTHM Direct show that 42.4% of the total number of patients prescribed ketotifen returned for a renewal of the prescription and reported a benefit, with 36.5% reporting moderate or great improvement. The RTHM Direct patients had a variety of IACC diagnoses including Long COVID, ME/CFS, and MCAS. Of those reporting benefits, 72% had improved allergic symptoms, 56% had improved food tolerance, 61% had improved sleep, 36% had decreased GI symptoms, 34% had increased exertional tolerance, and 33% had improvement in PEM.

Ketotifen is recognized as a mast cell stabilizer and is mentioned in the Bateman Horne Center Clinical Care Guide for managing ME/CFS, Long COVID, & IACCs for treating MCAS symptoms seen in those with ME/CFS and Long COVID.

The Harvard/Stanford TREATME Study

24% of individuals with Long COVID who tried oral ketotifen (n = 50) reported “moderate to much better” symptom improvement.

References

PMID: 37389095, 36952147, 32317585, 36169154, 40627388.

Cromolyn Sodium

Especially helpful for

Gastrointestinal symptoms, cognitive impairment, allergic reactions, mast cell activation, autonomic dysfunction, irritable bowel syndrome (IBS), other inflammation related symptoms

Notes

Oral liquid vials (100mg/5mL) are most common, but dosing is difficult (often starting at ¼ or ⅛ a vial stirred in a glass of water). Can be compounded into capsules that can be opened, dumped into water and stirred. Multiple delivery options are available depending on symptoms (eye drops, inhaler, can be put into shampoo for scalp/rashes, topical gel/cream for rashes). May need to increase the dose over time due to tachyphylaxis.

Summary

Long COVID patients exhibit activated mast cells and high occurrence of mast cell activation syndrome (MCAS); cromolyn sodium is an effective mast cell stabilizer that alleviates symptoms and reduces hyperinflammation. Cromolyn sodium stabilizes mast cells, reducing inflammatory substance release to help manage symptoms like brain fog, gastrointestinal issues, and skin reactions. Cromolyn sodium is recognized as a mast cell stabilizer and is mentioned in the Bateman Horne Center Clinical Care Guide for managing ME/CFS, Long COVID, & IACCs for treating MCAS symptoms seen in those with ME/CFS and Long COVID.

The Harvard/Stanford TREATME Study

36% of individuals with Long COVID who tried oral cromolyn (n=33) reported “moderate to much better” symptom improvement. Notably, only 10.5% of individuals with Long COVID who tried intranasal cromolyn (n=38) reported “moderate to much better” symptom improvement.

References

PMID: 37389095, 34563706, 37389095, 36169154, 40627388.

Antivirals against Herpesvirus Reactivations

Especially helpful for

EBV reactivation, other herpes viral reactivations, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)

Notes

There are multiple herpesviruses that can be reactivated after COVID. The commonly reactivated ones include EBV, VZV, CMV, and HHV-6. In one study, EBV DNA was detected in 27% of people who had COVID versus 13% who did not. In another study, people over 50 were 15% more likely to develop herpes zoster after COVID. There is a lot of nuance in testing for herpesvirus reactivations that is beyond the scope of this document, so if unfamiliar with the testing, one could empirically trial antivirals without testing.

PMID: 37364815, 37748514, 36639608, 35392454, 40696312, 39207648, 36146679, 40627388

Acyclovir (Zovirax)

is used to treat herpesvirus infections and has shown some promise in treating encephalopathy and coagulopathy in Long COVID. In the Harvard/Stanford TREATME study, 19% of individuals with Long COVID who tried acyclovir (n=21) reported “moderate to much better” symptom improvement.

PMID: 37228547, 40627388.

Valacyclovir (Valtrex)

has shown promise in treating ME/CFS and is being trialed in Long COVID. In a recent preprint case series, Long COVID patients taking a combo of Valtrex, Celebrex, and 15 days of Paxlovid had a fatigue improvement of 55% greater than patients taking Valtrex and Celebrex alone (though both groups improved), with improvements persisting at least 600 days. In the Harvard/Stanford TREATME study, 22.5% of individuals with Long COVID (n=49) or 26.5% of individuals with ME/CFS (n=147) who tried valacyclovir reported “moderate to much better” symptom improvement.

PMID: 35102619, 12582420, 40627388

DOI: 10.21203/rs.3.rs-7500476/v1

Trial ID: NCT06316843

Tenofovir

(both its TDF and TAF forms) strongly inhibit lytic reactivation of EBV in vitro. Truvada is commonly used for HIV PrEP and includes TDF and emtricitabine, therefore patients may respond differently to Truvada vs Tenofovir. In the Harvard/Stanford TREATME study, 25% of individuals with Long COVID who tried Truvada (n=12) reported Truvada use. A clinical trial for Truvada in Long COVID is currently underway.

PMID: 32409608, 40627388

Trial ID: NCT06511063

Valganciclovir (Valcyte)

has shown effectiveness in the case of known CMV reactivations and HHV-6 + EBV reactivations in ME/CFS. In the Harvard/Stanford TREATME study, 21% of individuals with ME/CFS who tried valganciclovir (n=52) reported “moderate to much better” symptom improvement. Watch for bone loss and phosphorus wasting with extended use.

PMID: 35116025, 23959519, 35102619, 40627388.

Antivirals against SARS-CoV2 (Paxlovid, Ensitrelvir)

Especially helpful for

Possible SARS-CoV2 persistence or antigen persistence

Extended Courses of Paxlovid

Have shown promise in a case series and large RCT trials are ongoing; however, 2 trials with courses as long as 15 days did not demonstrate significant benefit over placebo. It is possible only a subset benefits or a longer course is needed. In a recent preprint case series, Long COVID patients taking a combo of Valtrex, Celebrex, and 15 days of Paxlovid had a VAS fatigue improvement of 55% greater than patients taking Valtrex and Celebrex alone (though both groups improved), with improvements persisting 600 days beyond the initial 120 days of treatment.

Ensitrelvir

Was demonstrated to reduce risk of Long COVID when taken during acute COVID. A clinical trial in Long COVID is underway.

The Harvard/Stanford TREATME Study

39% of the 23 individuals with Long COVID who tried Paxlovid for 10 or more days reported “moderate to much” symptom improvement, whereas 28% out of the 127 individuals who tried Paxlovid for less than 10 days reported “moderate to much” symptom improvement.

References

PMID: 39762640, 38848477, 40188838, 38972603, 40627388

DOI: 10.21203/rs.3.rs-7500476/v1

Trial ID: NCT05965726, NCT06161688

Contraindications, drug-drug and drug-condition interactions, allergies, and potential side effects should always be reviewed with a qualified clinician before initiating treatment. Treatment sensitivities are common in Long COVID, so unless otherwise directed, consider starting new treatments at very low doses and tapering up slowly according to an individual’s tolerance.

Maraviroc

Especially helpful for

Cognitive impairment, fatigue, post-exertional malaise (PEM), other inflammation related conditions

Notes

300mg 2x/day; can start at 150mg 2x/day depending on tolerance. The original protocol combined it with 10mg daily pravastatin (but other statins can be used instead).

Summary

Maraviroc and pravastatin may improve Long COVID by targeting immune dysregulation via the monocytic-endothelial-platelet axis, with significantly improved neurological, autonomic, respiratory, cardiac and fatigue scores and vascular markers. In a patient survey, 64% reported slight to significant improvement with maraviroc. A clinical trial is underway at Mount Sinai (NY). In HIV patients, maraviroc showed significant improvements in several cardiovascular parameters that have also been found to be abnormal in a proportion of Long COVID patients, including endothelial dysfunction, arterial stiffness, vascular competence, and overall cardiovascular risk.

The Harvard/Stanford TREATME Study

42% of individuals with Long COVID who tried maraviroc (n=50) reported “moderate to much better” symptom improvement.

References

PMID: 36844201, 40627388, 30968058

Trial ID: NCT06511063, NCT06974084

Clopidogrel (Plavix)

Especially helpful for

Dyspnea, chest pain, fatigue, cognitive impairment

Notes

Clopidogrel 75mg is typically dosed once daily, and may be combined with aspirin and/or apixaban after very careful consideration of the risks associated with dual or triple therapy.

Summary

In a study of 24 Long COVID patients with microthrombi markers, dual antiplatelet therapy with aspirin (75 mg) and clopidogrel (75 mg) daily led to improvements in a variety of symptoms, particularly fatigue, and reduced microclots in all participants. In another study (in preprint), 91 Long COVID patients received triple therapy with clopidogrel, aspirin and apixaban, and symptom resolution was experienced by 25.6% of patients with cognitive dysfunction, 22% with fatigue, and 23% with pain.

The Harvard/Stanford TREATME Study

30% of individuals with Long COVID who tried clopidogrel or Brilinta +/- aspirin (n=53) reported “moderate to much better” symptom improvement.

References

PMID: 36969241, 40627388.

DOI: 10.21203/rs.3.rs-1205453/v1; 10.21203/rs.3.rs-2697680/v1.

Intravenous Immunoglobulin (IVIG) and Subcutaneous Immunoglobulin (SCIG)

Especially helpful for

Neuropathy including small fiber neuropathy, immune deficiency, autoimmune diseases, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), autonomic dysfunction, non-responders to other therapies.

Notes

In the outpatient setting, immunoglobulin therapy (IVIG and SCIG) for autoimmune diseases is typically dosed at 1–2 g/kg per month, whereas primary immune deficiency dosing is typically 0.4 g/kg/month. IVIG is usually administered every 3–4 weeks and SCIG is divided into weekly self-administered doses. Proper hydration and premedication—commonly acetaminophen or an NSAID, an antihistamine like diphenhydramine or cetirizine, with optional H2 blocker and steroids—are key to minimizing infusion reactions. Infusion rate greatly determines tolerability: starting slowly and ramping up gradually can markedly reduce side effects such as headache, fever, or malaise. For IVIG, saline infusion before or during treatment often improves comfort, and splitting the total IVIG dose across several days or weeks can improve tolerability. SCIG tends to cause fewer systemic side effects than IV but may lead to local site reactions. Adjusting the number of sites, infusion rate, or using topical numbing agents can help. Thin patients may find SCIG more difficult to tolerate. Use care with IG in hypercoagulable patients as there can be active clotting factors in IG products.

Summary

Across all reviewed data, IVIG demonstrates consistent therapeutic potential for post-viral and immune-mediated syndromes. Specifically, there are five papers on post-COVID small fiber neuropathy (SFN) showing 60–100% response rates, and two studies on autoimmune dysautonomia, both reporting 40–80% functional improvement. In ME/CFS, three studies reported positive outcomes, and three mechanistic or review papers supported IVIG’s immunomodulatory rationale. The NIH RECOVER IVIG study aims to confirm efficacy. IVIG is listed as a treatment option for Long COVID and ME/CFS in the clinical care guidelines from the Mayo Clinic Proceedings of ME/CFS, the Bateman Horne Center, and 2021 ME/CFS Clinician Coalition.

The Harvard/Stanford TREATME Study

42% out of 91 individuals with ME/CFS (n=78) or Long COVID (n=13) who tried IVIG/SCIG reported “moderate to much better” symptom improvement.

References

PMID: 38630952, 36818469, 40093251, 29781817, 39389388, 37179564, 36414570, 35232750, 33382525, 38910072, 34828592, 34072494, 40627388.

Trial ID: NCT06305780, NCT05350774.

Rapamycin

Especially helpful for

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), fatigue, post-exertional malaise (PEM).

Notes

Titrate from 1 mg once weekly up to 6 mg once weekly. It is recommended to obtain baseline markers of CMP, CBC, lipids, fasting glucose, A1C and fasting insulin before starting. Not all markers are required, but rapamycin can cause some insulin resistance and elevated lipids and LFTs in some people, particularly early on.

Summary

Findings from a phase one trial on ME/CFS patients found that weekly rapamycin doses of up to 6 mg significantly improved fatigue, sleep, and orthostatic intolerance over three months. These findings suggest rapamycin’s potential as a treatment, likely due to its autophagy-promoting and mTOR-inhibiting properties, with further analyses expected to provide deeper insights. A trial for low-dose rapamycin is currently underway.

The Harvard/Stanford TREATME Study

22% of individuals with Long COVID or ME/CFS who tried rapamycin (n=18) reported “moderate to much better” symptom improvement.

References

PMID: 40627388, DOI: 10.21203/rs.3.rs-6596158/v1; Trial ID: NCT06960928.

Low Dose Aripiprazole (Abilify)

Especially helpful for

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), cognitive impairment, fatigue, post-exertional malaise (PEM).

Notes

Dosage starts at 0.1 to 0.25 mg/day and is titrated up or down based on each patient’s response, to a dose range of 0.25 to 2.0 mg/day (mean 1.1 mg/day).

Summary

A retrospective Stanford study of 101 ME/CFS patients found that 74% experienced improvements in symptoms such as fatigue, brain fog, unrefreshing sleep, and post-exertional malaise while taking low-dose aripiprazole. It is listed in the Mayo Clinic Review for the management of ME/CFS and the Mayo Clinic Proceedings for post-COVID conditions. Dopamine D2 receptor agonists have been shown to mediate neuroinflammation, microglial activation, and cell death in animal models and humans.

The Harvard/Stanford TREATME Study

32% of 133 individuals with ME/CFS (n=123) or Long COVID (n=13) who tried a ≤2 mg dose of aripiprazole reported “moderate to much better” symptom improvement. 9% of 33 individuals with ME/CFS (n=31) or Long COVID (n=2) who tried a >2 mg dose of aripiprazole reported “moderate to much better” symptom improvement.

References

PMID: 33536023, 36969241, 38813984, 40627388, 37793728, 37419575.

Modafinil (Provigil)

Especially helpful for

Somnolence, cognitive impairment, daytime fatigue.

Notes

Start at a small dose and increase slowly up to the most effective dose in the 100–200 mg/day range. Can disrupt sleep. Stimulants are most helpful when anxiety scores are low and the Epworth Sleepiness Scale is greater than 10. Watch out for post-exertional malaise (PEM) exacerbations.

Summary

Modafinil is a wakefulness-promoting agent that has shown promise for Long COVID fatigue and neurocognitive deficits through its anti-inflammatory and neuroprotective mechanisms. It is listed as a treatment recommendation for managing cognitive issues in ME/CFS and Long COVID in the clinical care guidelines from the Bateman Horne Center, Mayo Clinic Proceedings of ME/CFS, 2021 ME/CFS Clinician Coalition, as well as for cognitive issues in POTS in the guidelines from the 2015 Heart Rhythm Society. The NIH RECOVER Initiative is currently testing modafinil in clinical trials for Long COVID hypersomnia. The medication works by inhibiting inflammatory pathways and microglial activation that disrupt neuronal energy metabolism, potentially addressing the neuroinflammation underlying Long COVID symptoms.

The Harvard/Stanford TREATME Study

33% of individuals with Long COVID who tried modafinil or armodafinil (n=39) reported “moderate to much better” symptom improvement.

References

PMID: 34454716, 40627388; DOI: 10.1176/appi.ajp-rj.2022.170402

Guanfacine +/- NAC

Especially helpful for

Cognitive impairment, attention deficit hyperactivity disorder (ADHD), hyperadrenergic postural orthostatic tachycardia syndrome (POTS).

Notes

Can cause sedation, lower blood pressure, and lower heart rate. Start low on the dose at 0.5–1 mg nightly, and taper up every 2 weeks only as tolerated. Combined with N-acetylcysteine (NAC) in a case series, it showed brain fog improvements.

Summary

References

Guanfacine, a selective α2A-adrenoceptor agonist, has shown potential in improving cognitive function and frontotemporal brain activity in Long COVID patients experiencing cognitive impairment. A case series found that combined treatment with guanfacine and NAC improved cognitive function in eight out of twelve Long COVID patients, with benefits in memory, concentration, and executive function, though some experienced hypotension-related side effects. While placebo-controlled trials are needed to confirm efficacy, the established safety of these treatments suggests the use of guanfacine for addressing Long COVID-related cognitive deficits. Guanfacine is listed as a therapeutic option for cognitive impairment in the Long COVID clinical care guidelines, Bateman Horne Center Clinical Care Guide for managing ME/CFS, Long COVID, & IACCs, and for orthostatic intolerance and autonomic dysfunction in the clinical care guidelines from the 2021 ME/CFS Clinician Coalition and Mayo Clinic Review.

The Harvard/Stanford TREATME Study

36% of individuals with Long COVID who tried guanfacine + NAC (n=25) reported “moderate to much better” symptom improvement. 28% of individuals with Long COVID who tried guanfacine alone (n=25) reported “moderate to much better” symptom improvement.

References

PMID: 38934345, 40261198, 40627388.

PMCID: PMC9691274.

Trazodone

Especially helpful for

Sleep dysfunction, insomnia.

Notes

Start at 25–50 mg 1 hour before bed. Titrate up to 100–150 mg as needed and tolerated.

Summary

ME/CFS experts report success with trazodone for sleep improvement, with the Mayo Clinic Review listing it among pharmacologic therapies that can help patients with ME/CFS and post-COVID conditions. In a patient-led survey, more than 50% of respondents reported at least some improvement with trazodone, with 16.9% and 20% of people with ME/CFS and Long COVID, respectively, reporting moderate to significant improvement. Analyses combining data from over 40 randomized-controlled clinical trials found that trazodone was effective in maintaining and extending sleep duration, with patients on trazodone reporting better sleep quality than those receiving placebo. Long-term trazodone use has been associated with delayed cognitive decline, with users showing 2.6-fold slower cognitive decline compared to non-users over four years. Trazodone is also listed as a treatment option for the management of sleep in Long COVID and ME/CFS in the clinical care guidelines from the 2021 ME/CFS Clinician Coalition, AAPM&R, and Mayo Clinic Proceedings of ME/CFS.

The Harvard/Stanford TREATME Study

20% of individuals with Long COVID who tried trazodone or nefazodone (n=40) reported “moderate to much better” symptom improvement.

References

PMID: 34454716, 40627388, 39123094, 29680424, 30762713, 40261198.

GLP-1 Receptor Agonists (Tirzepatide, Semaglutide, etc.) [Emerging Therapy]

Especially helpful for

Mast cell activation syndrome (MCAS), fatigue, cognitive impairment/brain fog, edema reduction, pain, headaches, gastrointestinal symptoms, food intolerances, excessive hunger or cravings, mood, cardiopulmonary symptoms, autonomic symptoms, hypertension.

Notes

Lower doses than standard for weight loss may reduce side effects while still providing clinical benefit and can potentially be dosed more than once a week. Consider monitoring for muscle/strength loss over time, especially in those with joint or spinal instability, hypermobility and/or Ehlers-Danlos Syndrome. Because GLP-1 receptor agonists slow down gastric emptying and gastrointestinal motility, gastrointestinal-associated side effects like nausea and constipation are common.

Summary

A 2025 case series found that GLP-1s used in patients with MCAS (a common comorbidity in Long COVID) for a mix of on-label and off-label indications improved symptoms for 89% (42/47) of patients. While a significant fraction experienced some side effects, many resolved on their own, and others were manageable with lower dosing, adjusting diet, magnesium supplementation, or extra doses of H1/H2 receptor blockers. Only 11% (5/47) stopped treatment: 3/5 due to toxicities and 2/5 due to cost. Brand and compounded GLP-1s were used. Another case study reports a patient with POTS improved significantly with semaglutide, but symptoms worsened after discontinuation of the drug. Preclinical studies demonstrate that GLP-1 can suppress microglial inflammation, which may be relevant to the pathophysiology of POTS. There is a clinical trial for tirzepatide for Long COVID that completed enrollment of 1,000 US participants in December 2025 and remains ongoing.

References

PMID: 22519295, 31881271, 41180125, 40525593.

DOI: 10.1016/j.amjms.2025.07.006, 10.1007/s10286-026-01197-1.

Trial ID: NCT07128082.

Procedures

Stellate Ganglion/Sympathetic Field Blocks

Especially helpful for:

fatigue, cognitive impairment, tachycardia, paresthesia, dyspnea, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), joint pain, and headache.

Notes:

This procedure may be more likely to help people who have been ill for a shorter duration. Multiple blocks may be needed in cases of longer illness duration. Blocks may be performed unilaterally or bilaterally.

Summary:

Stellate ganglion blocks (SGBs) have been used for conditions affecting the sympathetic nervous system, including Complex Regional Pain Syndrome (CRPS), postherpetic neuralgia, refractory cardiac arrhythmias, anosmia, and PTSD. A study of 41 Long COVID patients who had been ill for between 3 and 29 months found that 86% experienced symptom improvement, with some symptoms showing higher rates of improvement than others. A trigeminal nerve block may help increase the likelihood of improving anosmia.

References:

PMID: 38947233, 37711269, 38901177.

Hyperbaric Oxygen Therapy (HBOT)

Especially helpful for:

Cognitive impairment, fatigue, sleep issues, psychiatric symptoms, and pain.

Notes:

Medical-grade HBOT can be expensive in some areas and may be time- and energy-consuming. Claustrophobia can make HBOT challenging. Treatment can begin with shorter sessions at lower pressure and gradually increase pressure and duration as tolerated.

Summary:

In a randomized, double-blind, placebo-controlled trial of 73 Long COVID patients, 40 sessions of HBOT led to significant improvements in attention, sleep quality, pain, and energy levels that persisted even one year after treatment. Echocardiogram assessments in the same cohort showed a meaningful reduction in global longitudinal cardiac strain. A separate 10-patient study reported statistically significant improvements in fatigue and cognitive function after 10 HBOT sessions over 12 days. However, an interim safety analysis from an ongoing Karolinska Institute trial noted that nearly half of participants experienced cough or chest discomfort during treatment, although it remains unclear whether these effects were treatment-related or due to underlying Long COVID symptoms.

The Harvard/Stanford TREATME Study:

38% of individuals with Long COVID who tried HBOT (n=13) reported “moderate to much better” symptom improvement. 25% of individuals with ME/CFS who tried HBOT (n=24) reported “moderate to much better” symptom improvement.

References:

PMID: 38672710, 35821512, 38360929, 31953651, 34862223, 36670365, 40627388.

Much of this article comes from another article in English that I translated into Spanish (and that I have translated again into English. Unfortunately I did not put the link to the original article correctly, I have searched everywhere and I cannot find it, if by chance you know of the article I am referring to, send an email and so I can give the credits for the detailed and precise analysis of the masks. AutoDefensaSanitaria@proton.me

A while ago a Cochrane review, which systematically evaluates multiple randomized controlled trials, made headlines after stating there was no evidence that respirators prevent the transmission of many respiratory viruses. “”There’s still no evidence that masks are effective during a pandemic,” the lead author Tom Jefferson said in a media interview. This drew an unusual rebuke from the editor-in-chief of the Cochrane Library, who said: “that statement is not an accurate representation of what the review found.”

Despite decades of evidence of their effectiveness, some of the dissent comes from a few within the medical field itself, who misuse science and endanger lives.

This wasn’t the first time something like this has happened. Late last year, a randomized controlled trial claimed that N95 respirators were no better than surgical masks for healthcare workers. While scientists, engineers, and occupational safety and health experts highlighted flaws (see comments section) in the study, these two episodes point to a more important fundamental question: whether these types of trials are suitable for testing how well physical interventions like respirators reduce viral transmission.

Masks today are the handwashing of yesteryear: progress that saves lives.

In 1847, the Hungarian obstetrician Ignaz Semmelweis observed that obstetric patients were dying of puerperal fever at a much higher rate than those treated by midwives. Based on observation and research, he suggested to his colleagues that they wash their hands with a chlorinated lime solution before examining their patients and new mothers. His idea was ridiculed and ignored. Patients continued to suffer unnecessary illness and death until the experimental confirmation of Louis Pasteur’s germ theory in 1861 was disseminated and accepted by the medical community.

Today, handwashing is a cornerstone of medical protection and basic hygiene, extending far beyond the medical field.

History repeated itself with the physician John Snow, who studied how cholera was transmitted and who was also rejected and ignored for years.

It’s clear that both Ignaz Semmelweis and John Snow exemplify the existence of two types of healthcare professionals: the revolutionaries who advance science and those who scoff at them.

Masks are now the handwashing of Ignaz Semmelweis’s time and the water purification of John Snow’s.

To say that masks don’t stop the transmission of aerosols (like COVID, flu, or tuberculosis infections) is like saying that condoms don’t stop STIs.

These “experts” lump surgical masks and quality respirators together, ignoring mask seals and the multiplier effect of masks. They judge not only incorrectly but also without nuance. A well-fitting mask is not the same as one that leaks; a surgical mask with three filters is not the same as a respirator with five; and changing it frequently is not the same as wearing it hour after hour without considering the filtering limit.

health self defense

Masks 101

In order to understand masks we must talk about aerosols and droplets…

Read more

2 months ago · 2 likes · AutoDefensa Sanitaria

Medical claims of exclusive “ownership” over the science of ventilators when used during a pandemic ignore the fact that they represent a well-understood engineering solution with decades of widespread and successful use behind them. Demands to dismiss this evidence reflect a lack of recognition and respect for the interdisciplinary expertise that has undermined the global response to the pandemic.

Prioritizing randomized trials over other types of research, such as observational, laboratory, and modeling studies, has hampered the COVID response. A randomized trial approach that allows a few studies to override a vast amount of research from other disciplines is scientifically unsound.

Placing these trials at the forefront of medical decision-making began with the best of intentions. In the 1980s, experts wanted to better integrate scientific knowledge into medicine. At the time, decisions varied widely among practitioners based on disparate readings, experiences, and education. Refining medical decision-making to make it more repeatable, consistent, and evidence-based marked the laudable birth of the evidence-based medicine movement.

This effort included establishing a “hierarchy of evidence,” the idea that some types of evidence are more useful than others to medical decision-makers. Expert opinion and observational studies are at the base of the pyramid, randomized trials in the middle, and at the top are systematic reviews of these trials, where researchers collect and review various clinical trial results to make broader, more conclusive statements, as in a Cochrane review.

Randomized trials are the foundation of much medical research because the human body is unpredictable. A chemical that is effective in a laboratory or animal model may prove useless, or even harmful, once inside the human body, or only in some people, depending on genetics, environment, or underlying disease. Randomizing trial participants averages out this noise and reduces bias. By comparing treatment outcomes between randomly selected groups, we can hope to isolate effects, making these trials a “gold standard” in medical research. However, they often require time, many participants (especially if the expected differences are small), and large budgets. Even the most rigorous trials cannot say whether a treatment would have been effective with a different protocol. For example, a test of seat belts in airplane crashes could not say whether they would work in cars.

Because these trials have such a narrow focus (and may not agree), compilations and systematic reviews like those produced by the Cochrane organization can make medical decision-making faster and easier. Relying on such reviews, of course, trades convenience for the rigor of digesting each study and gaining real knowledge; this is a concern for them.

In the case of face masks, are randomized trials an appropriate way to evaluate a basic safety system? We don’t rely on such tests for seat belts, bicycle helmets, or life jackets, and the oft-cited randomized parachute trial is an old joke. Why is that so funny? What do engineers know that doctors don’t?

In many scientific disciplines, randomized trial methods are fundamentally inappropriate, akin to using a scalpel to cut the grass. If something can be directly measured or accurately and precisely modeled, there is no need for complex and inefficient trials that put participants at risk.

Engineering, perhaps the most “realistic” discipline, does not conduct randomized trials. Its necessary knowledge is well understood. Everything from highways to ventilation systems, everything that moves us, cleans our air and water, and puts satellites into orbit, succeeds without them. This includes many medical devices. When failures occur, such as an airplane crash or the catastrophic collapse of a bridge, they are systematically recognized and analyzed to ensure they do not happen again.

“Does a face mask protect me from aerosolized viruses?” or “Does this seatbelt prevent me from being thrown out the window in a crash?” There are different kinds of questions than “Does aspirin reduce mortality rates after a heart attack?” Relegating engineering and the natural sciences to the bottom of a hierarchy of evidence (on par with expert opinion) is a mistake. As with seatbelts, it’s important for people to wear masks correctly, but no randomized trial has ever concluded that seatbelts “don’t work.” At best, that kind of trial would be a truly ineffective way to evaluate specific instructions and incentives to get people to use them correctly.

Respiratory protection, a well-established technology, has been validated for decades, with standards (NIOSH in the US, CSA in Canada) that codify protection against viruses and bacteria. Mining, biomedical research, chemical processing, pharmaceutical manufacturing, and many other industries adhere to these laws and standards worldwide. Without exaggeration, millions of people rely on the effective science of respirators in the “real world,” without the need for randomized trial testing.

“Michael D. Brown, a doctor and academic who serves on the Cochrane editorial board and made the final decision on the review, told me the review couldn’t arrive at a firm conclusion because there weren’t enough high-quality randomized trials with high rates of mask adherence.

While the review assessed 78 studies, only 10 of those focused on what happens when people wear masks versus when they don’t, and a further five looked at how effective different types of masks were at blocking transmission, usually for health care workers. The remainder involved other measures aimed at lowering transmission, like hand washing or disinfection, while a few studies also considered masks in combination with other measures. Of those 10 studies that looked at masking, the two done since the start of the Covid pandemic both found that masks helped.

The calculations the review used to reach a conclusion were dominated by prepandemic studies that were not very informative about how well masks blocked the transmission of respiratory viruses.

For example, in one study of hajj pilgrims in Mecca, only 24.7 percent of those assigned to wear masks reported using one daily, but not all the time (while 14.3 percent in the no-mask group wore one anyway). The pilgrims then slept together, generally in tents with 50 or 100 people. Not surprisingly, given there was little difference between the two groups, researchers found no difference from mask wearing and declared their results “inconclusive.”

In another prepandemic study, college students were asked to wear masks for at least six hours a day while in their dormitories, but they were not obligated to wear them elsewhere. Researchers found no difference in infection rates between those who wore masks and those who did not. The authors noted this might be because “the amount of time masks were worn was not sufficient” — obviously, college studentts also go to classes and socialize where they may not wear masks.

Yet despite their inconclusiveness, the data from just these two studies accounted for roughly half of the calculations for evaluating the impact of mask wearing on transmission. The other six prepandemic studies similarly suffered from low masking adherence, limited time wearing them and, often, small sample sizes.

The only prepandemic study reviewed by Cochrane reporting high rates of mask adherence started during the worrying H1N1 season in 2009 in Germany, and found mask wearing reduced spread if started quickly after diagnosis and if a mask was worn consistently (though its sample size, too, was small). (…)

how should we evaluate an interview in which the lead author of the Cochrane review, Tom Jefferson, said of masks that the review determined “there is just no evidence that they make any difference”? As for whether N95s are better than surgical masks, Jefferson said, “makes no difference — none of it.”

It’s no surprise that Jefferson says he has no faith in masks’ ability to stop the spread of Covid.

In that interview, he said there is no basis to say the coronavirus is spread by airborne transmission — despite the fact that major public health agencies have long said otherwise. He has long doubted well-accepted claims about the virus. In an article he co-wrote in April 2020, Jefferson questioned whether the Covid outbreak was a pandemic at all, rather than just a long respiratory illness season. At that point, New York City schools had been closed for a month and Covid had killed thousands of New Yorkers. When New York was preparing “M*A*S*H”-like mobile hospitals in Central Park, he said there was no point in mitigations to slow the spread.” Opinion | Here’s Why the Science Is Clear That Masks Work - The New York Times

Figure: schematic representation of the droplet (blue) and aerosol (green, yellow, and red) infection pathways for a respiratory disease. Both travel through the air from the infected person to the susceptible person, but ballistic droplets infect by impact, and aerosols infect by inhalation. From Milton (2020), modified by the author (pers. comm.).

1. The “aerosol” path. Aerosols are also particles of saliva or respiratory fluid, but they are smaller than about 100 μm. For this reason they can linger more in the air, from tens of seconds to hours, and the smaller ones can travel long distances. They infect by being inhaled through the nose or mouth, or (less likely) by deposition on the eyes. They reach different parts of the human respiratory tract depending on their size. These are the green, yellow, and red dots in the figure below.

2. The “large droplet” or “ballistic droplet” path. Droplets are particles of saliva or respiratory fluid (larger than about 100 μm, with 1 μm = a millionth of a meter) that are expelled from infected individuals when coughing, sneezing, and to a lesser extent, talking. They fly ballistically (like a projectile) through the air, as in the famous “angry birds” video game. They infect by impacting on the mouth, nostrils, or eyes. They are the light blue ballistic droplets in the figure above. If they don’t hit someone, they fall to the ground in 1-2 m (3-6 ft).

3. The “fomite” path, through touching a surface that is contaminated with the SARS-CoV-2 virus, such as a light switch, a door handle, or someone else’s hand. That can transfer the virus onto your hand, and then you can infect yourself by touching your mouth, nostrils, or eyes.

• Airborne pathogens should be visualized like cigarette smoke. Only then can we truly understand that masks not only work, but air quality, ventilation, and the use of fans and purifiers (which literally remove airborne pathogens) are key.

Some examples of airborne pathogens are: Chicken Pox, COVID-19, Long COVID, Influenza, Measles, Mumps, Common Cold, Rubella, Bronchiolitis, Smallpox, Whooping Cough, Diphtheria, Legionella, Meningitis, Tuberculosis and Aspergillosis.

In some cases such as Hantavirus, COVID and Avian Flu, droplets are another form of transmission.

The problem is that when a disease is transmitted through aerosols and droplets, governments will ignore the former and only talk about the latter. This decision isn’t based on science, but on prioritizing the capitalist economy. Airborne infections require more widespread care, more attention, and therefore more money.

Here is a more detailed explanation about airborne pathogens:

health self defense

Airborne Infections 101

Examples of diseases caused by pathogens that can be transmitted through the air we breathe…

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2 months ago · 2 likes · AutoDefensa Sanitaria

So how do masks work?

The Multiplicative Power of Masks

When both people wear 50% effective masks, disease transmission drops by 75%.

If you think about it, it’s surprising that a 50% effective mask can reduce the risk of infection by 75%. This is possible because when both people wear masks, the chance of infection is halved twice. This double protection makes masks much more effective than you might intuitively expect.

The four ways that COVID-19 can spread from person to person. This assumes a 50% effective mask:

Masks, like much of public health, is a collective action and shared responsibility. In societies where collective mask wearing is not established, people often do not want to stand out and wear a mask. But many, many people would wear masks if they knew that the majority would be wearing them too; In this case, people can get superior protection and do not risk standing out.

Our governments have given confusing messages about the use of masks, even outright discouraging it. We believe there should be widespread support from our governments, pro-mask campaigns and education, and free and affordable availability of quality masks. We still hope that these are actions taken in the future, but the failure of governments has left the responsibility on us. The good news is that each person who wears a mask has an impact on reducing transmission that is bigger than themselves.

The more interactions that contain masks, the better! So let’s do what we can to encourage mask-wearing and make it accessible. Every mask used has an impact! Masks work!

For a mask to work there are 2 things to take into account:

1) Filter quality

2) The airtight seal of the mask

The quality of the filter has to do with the percentage of protection it gives, and the seal is what makes it work. If you use a good quality glove but it has a hole, the quality of the glove takes a backseat. The same goes for masks, they must have a good seal, which means no leaks on the sides.

There are 4 types of masks:

1. Fabric

2. Surgical

3. Respirators

4.P100

Any mask is better than none, but understanding the basic science of how respirators work to protect you can help you understand why quality is so important.

1) Fabric: only protect droplets NOT aerosols

2) Surgical: they usually have 3 layers, they protect against droplets and aerosols but because they are very large they create enormous leaks and their effectiveness is low; Maximum safe use is around 3-4 hours

3) Respirators: they usually have 5 layers, they protect from droplets and aerosols; They can be used for a maximum of 25 hours (not all in a row). There are two things that are special about respirators. First, they create an airtight seal around your mouth and nose. Second, they have a static charge that attracts small particles and filters them effectively. Surgical masks have some of that static charge and filter out some particles, but they don’t create a seal. Cloth masks do not have this charge and do not have a good seal either. By filtering aerosols, respirators also filter pollution, smoke and dust.

Respirators have different names depending on the health regulations of each continent or country:

FFP2 = N95 ≈ KN95 ≈ KF94 ≈ P2, with minor technical differences in testing methods and manufacturing requirements.

Counterfeit KN95 respirators are fairly common. A genuine KN95 respirator should be marked with “GB2626-2019.”

KF94 respirators are similar to KN95s, but they are generally less likely to be counterfeited and tend to be slightly more expensive.

In any case, it is always important to verify the authenticity of respirators to avoid counterfeit products.

health self defense

Reusing Masks

High-quality respirators (also known as respirators\), FFP2 or N95, are expensive. But here’s the good news: you can reuse them! This reduces the daily cost of wearing a respirator by extending its lifespan…

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a year ago · 4 likes · AutoDefensa Sanitaria

Certified Reusable Masks: It may be discouraging to learn that reusable cloth masks are not effective in protecting us from aerosols, but there are other options to reduce your waste! Several brands make reusable respirators with disposable filters, such as Flo Mask and Envo Mask. These masks are very expensive, but they are designed to be reused and look really cool.

Valved masks release unfiltered exhaled air and increase the risk of contagion if you are sick, so valveless respirators offer better protection for the community.

4) P100: they are the ones that best protect us against fires, tear gas...

Comparison of use of

1) respirator without adjustment (blue on chart)

2) respirator with adjustment (orange on chart)

3) respirator + surgical (yellow on the graph)

4) respirator adding adhesive tape (purple in the graph)

5) surgical (green on the graph)

Cloth masks don’t offer very much protection at all.

Respirators provide the best protection against Covid, and they work against all variants.

There’s vast differences in inward mask leakage between N95s and other masks (and remember: leakage is what we’re trying to avoid):

· Fabric 70%

· Surgical 44.2%

· KN95 16.1%

· N95: only 0.6% (this is why they’re the safest!)

Sample leak graph:

It only takes a very small amount of viral aerosol to cause an infection, which is why respirators are the best masks for preventing infection because they filter the air best and offer the best seal.

Adding a head strap (like this one) to KNP95 (OR FPP2) earloop masks can make them fit more like an NP95 (OR FPP2). It helps create a tighter seal and also takes pressure off your ears.

What does the airtight seal have to do with masks?

When it is winter and you breathe and see a white color of some kind of smoke, those are your aerosols; we propagate them continuously. They move like smoke and can remain there for hours. Can’t you smell the cigarette smoke of a person smoking 5 meters away from you? The same thing happens with aerosols.

While a surgical mask can physically block airborne particles that can cause other diseases, without that seal around your face, you’d likely still breathe COVID (and other airborne diseases) if you’re exposed, and you’d be spreading it to others if you have it.

To wear a mask correctly, it is important to keep some tips in mind:

1. About “V” shaped masks

The wire of the mask can be adjusted to your face! As you can see, there are many masks that have a wire that forms a V that leaves a leak!

To give them the correct shape, unfold the mask completely and put it on by pressing with both hands.

Few noses are that shape so to adapt it to your nose, you flatten the wire with your fingers and then you can give it the shape you need.

Selfie of Sharyn Blum in three-quarter view. I am a white person with dark eyes, dark hair pulled back away from my face, and a lot of earrings. I’m wearing a black tank top and a black KN95 mask with a very obvious cleanly folded line down the middle from the top of my nose to the seam in the front of the mask. A colorful X icon has been pasted in over the left cheek of the mask. Photo 2: Selfie of me just as in the last image, but now in profile. A colorful square has framed the top of the mask over the nose bridge, showing nearly a quarter inch of gap between my nose and the the mask. A flustered blushing face emoji is pasted under the square.

This video of Sharyn Blum shows you step by step:

Drawing of Hazel Newlevant

Here you can see the difference:

Photo de Sharyn Blum. Photo 1: A black KN95 viewed from the top down while held up in my left hand against a white wall. It’s been slightly opened and has a clear V-shaped crease in the nose wire. A colorful X icon has been pasted in the top right corner of the photo. Photo 2: Same black KN95 viewed from the top down, but this time it’s been shaped. It’s holding a natural open without any additional effort and it has a gentle, double S curve shape in the nose wire, which meets at the middle in a sharper curve. A colorful checkmark icon has been pasted in the top right corner of the photo. Photo 3: Same black KN95 as in first photo, but now held up facing into the white interior of the mask. Again, there is a clear V-shaped crease in the nose wire. A colorful X icon has been pasted in the top right corner of the photo. Photo 4: Same black KN95 as in second photo, but now held up facing into the white interior of the mask. Again, the curves are plainly visible and clearly resemble the natural shape of a face across the upper nose and cheekbones. A colorful checkmark icon has been pasted in the top right corner of the photo.

2. Support for adjusting the mask

If the mask is a little big, you can do several things:

a) Use double-sided adhesive tape on the inside of the mask, in areas where you need a better seal.

b) Use normal adhesive tape to secure the mask from the outside to the facial skin.

c) Adding a head strap. (like this one) to KNP95 (OR FPP2) earloop masks can make them fit more like an NP95 (OR FPP2). It helps create a tighter seal and also takes pressure off your ears.

d) Use elastic bands to adjust it better to the face. There are commercial devices designed for this purpose, or you can make a homemade one using elastic bands.

Drawing of Hazel Newlevant

health self defense

How to add adjustable earloop beads to masks

By indy mask bloc…

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4 months ago · 1 like · AutoDefensa Sanitaria

3. Checking the fit of the mask

Place your hands around the mask, covering areas where air could enter or leave, and exhale forcefully.

If you notice air escaping around the edges, it means the fit is not correct.

“I can’t find a mask that fits my face!”

· N95 masks are the American standard and were primarily designed to fit the faces of white men working in industrial jobs, so it’s not uncommon to find difficulty getting a good seal. The best mask is one that fits. Try a KN95 (Chinese standard) or KF94 (South Korean standard) for a different fit and read this for further information.

· It’s possible to staple 3M Aura masks at the chin (as demonstrated by Alex here) for a tighter fit, and this hack has successfully passed fit tests.

· If you’re an adult with a smaller face, a good bifold option is the M95 mask by Lutema

· Mask braces can be a good option to ensure a tighter fit

· Check out the excellent videos made by Lola Germs to learn more about mask fit!

· Some companies make variety packs of masks so you can try a bunch and see what works for you

· Medical tape can help secure your mask to your face and ensure a good seal

· Adhesive foam can be bought online and applied to the inside of your mask to improve the fit

· IMPORTANT GUIDE TO FITTING BIFOLD MASKS HERE

· Make sure they know how to correctly wear a respirator! This link has a guide.

N95 sizing tips

· 3M Auras are a comfortable, widely-available respirator option, and they fit most people’s faces well. Start by trying these. If the 3M Aura is too big, try the CAN99, then the VFlex small. If the 3M Aura is too small, we recommend the VFlex regular.

Ultimately, the best mask for you is one that you will wear.

Some masks are really uncomfortable!

If you try a respirator and find it unbearably uncomfortable, so much so that you constantly take it off or play with it, breaking the seal, it is not the right choice for you. There’s no shame in trying something that doesn’t work, but our collective health is worth it.

Masks can be uncomfortable, like a seat belt or a condom, but that does not mean that we do not use them, but rather that we look for those that are best for us. Wearing a mask doesn’t have to make you miserable, there are mask geeks like me who will be happy to listen to you and advise you. The neurodivergent community turned to me to make a list of recommendations, there are more people like me who want you to protect yourself comfortably. And remember: social activism is also uncomfortable, but that doesn’t mean we stop moving, we wear a mask not for individual reasons, but for collective commitment. Your health is our health

if your glasses are always fogging up:

Here’s a guide that troubleshoots foggy glasses from masks

Help them make sure their mask fits and has a nosewire

Offer to give them some anti-fog lens wipes (or lens cleaner)

If your skin breaks out:

health self defense

Skin problems when wearing a mask, explanations and solutions

Thai Brows made a short and a long video talking about acne problems when wearing a mask explaining possible explanations and solutions…

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5 months ago · 4 likes · 1 comment · AutoDefensa Sanitaria

Using antiseptic mouthwash before putting on your mask might actually help prevent breakouts

Skipping makeup and sunscreen under masks helps a lot

Best practice is to avoid occlusive skin care, like rich moisturisers, during the day when wearing a mask so the occlusive environment isn’t amplified.

Wear a clean mask

Pimple patches can be worn under masks (no one will see them!)

Washing your face before and after putting on a mask seems to help a lot!

If you have a beard:

Send them this video, which has instructions on how to wear a beard cover under their masks: “Beard Cover Technique—Elastic Band“

“I don’t want to wear a mask because I’m wearing a formal outfit / I don’t want to mask because it’s not stylish.”

Fashionable mask options exist! If you’re looking for a fancier mask option, check these out:

masklab makes gorgeous masks (in adult and children’s sizes)

Private Stock Labs sells fancy KN95s in a wide range of colors (and in multiple sizes)

wellbefore sells KN95s (with nose foam!) in a wide range of colors

Benehal and BNX both sell black head strap N95s

Canada Strong Masks sells a wide variety of masks in different colors
Masks are an extra accessory, and you can absolutely find one that works with your outfit!

If you want to know more about electrostatic charge: Let’s talk about the Physics of Masks

Written by @covidsafecolorado

“How does an electrostatic charge work? Which masks have it? What are Elastomeric Respirators? (See the following slides to find out more)

The fibers of cloth or surgical masks filter particles by physically blocking them, but the fibers of an N95 mask use a great physics trick. N95s are designed for particles to stick to woven fibers. These fibers are electrically charged.

Plastic fibers carry an electrostatic charge that attracts passing particles, like a magnet. This means that particles in the air carrying viruses, dust, paint or other toxic materials remain trapped in the mask and are not inhaled.

The fibers of the mask are made of an “electron” material, a permanently electrically charged object. Other types of respirators may use electrostatic filters, such as Elastomeric Respirators. What are Elastomeric Respirators?

1. Sealed respirators made from synthetic or natural rubber materials.

2. They can be reused, disinfected, stored and reused.

3. Equip yourself with replaceable filter cartridges or flexible disc or pancake style filters.

4. They may also have sealing surfaces and adjustable straps for a better fit

Sources:

Masks, Covid Tips

The science behind masks and their use - by Bill Comeau

FAQs on Protecting Yourself from Aerosol Transmission - Google Docs

angiecibis Official: Instagram | Linktree

The Difference Between KF94 and KN95 Masks, Explained | The Strategist

How Does an N95 Respirator Work? It’s All in the (Very Small) Details

How well do face masks protect against COVID-19? - Mayo Clinic

Effectiveness of Face Mask or Respirator Use in Indoor Public Settings for Prevention of SARS-CoV-2 Infection — California, February–December 2021 | MMWR

Association of State-Issued Mask Mandates and Allowing On-Premises Restaurant Dining with County-Level COVID-19 Case and Death Growth Rates — United States, March 1–December 31, 2020 | MMWR

Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US | Health Affairs

Lifting Universal Masking in Schools — Covid-19 Incidence among Students and Staff | New England Journal of Medicine

Effectiveness of N95 Mask in Preventing COVID-19 Transmission - PMC

Risk of SARS-CoV-2 Acquisition in Health Care Workers According to Cumulative Patient Exposure and Preferred Mask Type | Infectious Diseases | JAMA Network Open | JAMA Network

Filtration Efficiency, Effectiveness, and Availability of N95 Face Masks for COVID-19 Prevention | Coronavirus (COVID-19) | JAMA Internal Medicine | JAMA Network

Elastomeric respirators are safer and more sustainable alternatives to disposable N95 masks during the coronavirus outbreak | International Journal of Emergency Medicine | Full Text
Elastomeric Respirators - Clean Air Crew

Elastomeric Respirator Resources | NIOSH | CDC

The Physics of the N95 Face Mask | WIRED

The Flow Physics of Face Masks | Annual Reviews”

Examples of diseases caused by pathogens that can be transmitted through the air we breathe:

The chart is divided into two main columns. The left column, “Pathogens,” is organized into three categories, each with a small representative icon:

1. Viruses (three colored virus icons): Includes examples such as Adenovirus, Bocavirus, Varicella-zoster virus, Coronavirus (MERS, SARS, SARS-CoV-2), Influenza A and B viruses, Morbillivirus, Paramyxovirus, Rhinovirus, Rubivirus rubellae, Respiratory syncytial virus (RSV), and Variola virus.

2. Bacteria (green bacteria icon): Includes examples such as Bordetella pertussis, Corynebacterium diphtheriae, Legionella pneumophila, Streptococcus pneumoniae, and Mycobacterium tuberculosis.

3. Fungus (red mushroom icon): Includes examples such as Aspergillus, Blastomyces dermatitidis, Coccidioides immitis, and Histoplasma capsulatum.

The right-hand column, titled “Associated Diseases” (in a purple box), lists the corresponding diseases. Lines connect each pathogen or group of pathogens to the diseases they can cause.

The diseases listed include: Chickenpox, COVID-19, Long COVID, Influenza, Measles, Mumps, Common Cold, Rubella, Bronchiolitis, Smallpox, Pertussis, Diphtheria, Legionella, Meningitis, Tuberculosis, and Aspergillosis.

Some examples of connections are: Varicella-zoster virus causes chickenpox; Coronavirus causes COVID-19 and Long COVID; Morbillivirus causes measles; Bordetella pertussis causes pertussis; and Mycobacterium tuberculosis causes tuberculosis.

Things governments and public health officials should have told us about airborne pathogens:

• Airborne pathogens should be visualized like cigarette smoke. Only then can we truly understand that masks not only work, but air quality, ventilation, and the use of fans and purifiers (which literally remove airborne pathogens) are key.

• Pathogens can remain airborne for hours.

• Masks are the tools we have to protect ourselves from airborne pathogens. It is important that they are of good quality and worn correctly, but above all: used collectively. The air we breathe is shared. Face masks must not only be worn correctly but also be of good quality. A poor seal means the mask is not fully effective. Any mask is better than none, but respirators (N95, FFP2) offer the highest percentage of protection. Here’s more about face masks:

• Vaccines should be an ADDITION, not an excuse to stop PREVENTING infections. The steps in science are 1) prevention, 2) detection, and 3) treatment. In capitalism, vaccines are used to try to skip these steps because money is prioritized over care. Few vaccines prevent disease, but what they all do is help us avoid death. We still have the responsibility to take care of each other. What doesn’t kill you creates a lifelong disability:

• Myalgic encephalomyelitis is associated with pandemic influenza infection, but not with an adjuvanted pandemic influenza vaccine

• Viral role in Alzheimer’s Disease discovered | University of Oxford

• Neurologic Manifestations of Influenza A(H3N2) Infection in Children During the 2016–2017 Season | Journal of the Pediatric Infectious Diseases Society | Oxford Academic

• Epstein-Barr virus: how does a common infection trick the immune system into attacking the brain in people with MS?

• Influenza-associated neurologic complications in children from an H3N2 outbreak in Shenzhen, China during COVID-19 lockdown - ScienceDirect

• Varicella Zoster Virus: A Not Uncommon Cause of Stroke in Children and Adults - PMC

• Frontiers | Long-Term Consequence of Non-neurotropic H3N2 Influenza A Virus Infection for the Progression of Alzheimer’s Disease Symptoms

• There’s no such thing as a good cold

• Outcomes of ME/CFS following infectious mononucleosis

• ME/CFS 7 years after Epstein Barr Virus infection — why studies that follow participants over time are important.

Vaccines are crucial for significantly reducing mortality rates, but 1) antibody levels decrease significantly in the months following vaccination, and 2) sometimes we cannot access vaccines due to government negligence or because they are not yet available. Respecting and valuing the role of vaccines gives us one more reason to prevent infections; they cannot be an excuse to minimize harm.

• Yes, in some cases, such as Hantavirus, COVID-19, and Avian Influenza, aerosols are not the only form of transmission.

Figure: schematic representation of the droplet (blue) and aerosol (green, yellow, and red) infection pathways for a respiratory disease. Both travel through the air from the infected person to the susceptible person, but ballistic droplets infect by impact, and aerosols infect by inhalation. From Milton (2020), modified by the author (pers. comm.).

1. The “aerosol” path. Aerosols are also particles of saliva or respiratory fluid, but they are smaller than about 100 μm. For this reason they can linger more in the air, from tens of seconds to hours, and the smaller ones can travel long distances. They infect by being inhaled through the nose or mouth, or (less likely) by deposition on the eyes. They reach different parts of the human respiratory tract depending on their size. These are the green, yellow, and red dots in the figure below.

2. The “large droplet” or “ballistic droplet” path. Droplets are particles of saliva or respiratory fluid (larger than about 100 μm, with 1 μm = a millionth of a meter) that are expelled from infected individuals when coughing, sneezing, and to a lesser extent, talking. They fly ballistically (like a projectile) through the air, as in the famous “angry birds” video game. They infect by impacting on the mouth, nostrils, or eyes. They are the light blue ballistic droplets in the figure above. If they don’t hit someone, they fall to the ground in 1-2 m (3-6 ft).

3. The “fomite” path, through touching a surface that is contaminated with the SARS-CoV-2 virus, such as a light switch, a door handle, or someone else’s hand. That can transfer the virus onto your hand, and then you can infect yourself by touching your mouth, nostrils, or eyes.

The problem is that when a disease is transmitted through aerosols and droplets, governments will ignore the former and only talk about the latter. This decision isn’t based on science, but on prioritizing the capitalist economy. Airborne infections require more widespread care, more attention, and therefore more money.

And capitalism prioritizes money over care. It doesn’t matter if the bourgeoisie has to sacrifice workers’ lives. They will do it without a second thought because capitalism functions on two things: a constant supply of workers who produce value and an endless flow of consumption to materialize that value as profit for the capitalist.

When we face the prospect of death and pandemics, the contradictions become starkly apparent. We realize that governments in capitalism don’t prioritize our lives, but rather the sacrifice for money.

We realize that the government doesn’t protect us; we realize that everything we have (food, housing, medicine, care) is thanks to workers. No to those who get rich at the expense of our labor. This is a revolutionary awakening that can change everything. And the bourgeoisie want to prevent the collapse of their system of oppression at all costs.

Media attention focuses on reproducing official rhetoric through opinion pieces and interviews. Scientists don’t all think alike; there are conservatives and progressives, scientists who prioritize care and those who will say anything to defend the stability of capitalism. The experts promoted by the government and most media outlets are selected based on their proximity to power, both in terms of their official appointment and their rhetorical stance.

Things governments and public health officials should have told us about the immune system:

• There is no way to “train“ the immune system because it is not a muscle. There is a common misconception that exposure to harmful germs strengthens the immune system.

• Viral diseases such as Hantavirus, COVID-19, influenza, and measles weaken the immune system, leaving the possibility of lasting damage.

• The reality is that you don’t build your immunity with repeated infections; vaccines strengthen the immune system by teaching it to recognize pathogens without all the risks. Furthermore, the infections we have weaken the immune cell response to vaccination, meaning that the more we get infected, the less effective the vaccines we receive will be. We have studies on this with SARS-CoV-2.

Focusing on infection prevention is key.

Do you know any working-class person who can afford to be sick? Neither can we.

Who can afford to miss work?

Infections can cost us our lives or leave us disabled. In capitalism, science is used to get us back to work tomorrow, but for more complex issues, doctors tend to deny you care and tell you it’s all anxiety.

People with post-viral illnesses face enormous violence and medical neglect.

We, the workers, are the ones who create medicines, masks, houses, and all the basic necessities a person needs. However, we don’t have the right to access them; we have to spend our lives being exploited for something that couldn’t be created without our effort.

Workers’ power means workers’ care. We want union strength, we want workers’ power, we want workplace safety, we want prevention of death and disability.

Getting infected at work is another form of employer terrorism. Everywhere you go, there’s a worker who has no choice but to be there. Let’s wear masks for our collective health.

Sources:

FAQs on Protecting Yourself from Aerosol Transmission - Google Docs

The science behind masks and their use - by Bill Comeau

Let’s air - Better understand the importance of indoor air renewal in enclosed spaces

Many of you have mourned her death, and from a place of love I say to you: honor Alice’s life by wearing a mask, distributing them in your community, and carrying out campaigns like Alice’s against the normalization of infections in those places where we should be cared for.

We have the tools against eugenics, for Alice, for all the disabled people who inspire us, for the people. Let’s take community care work seriously.

health self defense

Covid Continues To Destroy People’s Health

There’s a fanzine about this article; you can find it on the Health SelfDefense Crytpad Drive. You have the link to the Crytpad Drive and other links of interest in the linktree Health Self Defense | Linktree…

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9 months ago · 8 likes · AutoDefensa Sanitaria

Death Panel’s interview with Alice about the mandatory mask campaign:

Alice has launched a campaign to rally public pressure on UCSF to reinstate mandatory masking throughout its hospital system, and today’s episode is all about that campaign.

Now, obviously, UCSF is only a single hospital system. And the fact that masks are not required at hospitals across the US is a systemic problem that the CDC, CMS, or the Biden administration more generally, can and should intervene in. But we here at the Death Panel think Alice’s campaign is an important one. Not just because it’s important to protect Alice and the many people like her who don’t have as big of a platform as she does. But also because UCSF itself is a highly symbolic site of struggle. By which I mean, over the last few years, a number of prominent physicians within UCSF have played an outsized role in pushing to undo Covid protections or in otherwise minimizing the pandemic and minimizing long COVID.

Alice Wong

Even before I had my tracheostomy, I was a high risk person for COVID due to my respiratory failure because of my neuromuscular disability. I’ve been sounding the alarm since 2020 with other sick and disabled people about the pandemic about how many marginalized communities are going to be abandoned by the state and rendered expendable by the medical industrial complex.

Like a lot of other sick and disabled people I have a high pain threshold and try not to go into the ER unless absolutely necessary. I could not tolerate pain and had to come into the UCSF Health ER during the weekend to get it examined and replaced. Every hospital is a place filled with pathogens and patients coming in will be exposed to some degree, this is a realistic expectation. However, from the moment I arrived and signed in, I knew I was unsafe with a waiting room full of coughing people who were mostly unmasked and many health care workers unmasked or only wearing surgical masks which evidence clearly shows is less effective than a N95 or a respirator of higher quality.

My request for anyone entering my room in the ER to wear an N95 mask resulted in a respiratory therapist who came in being passive aggressive about it, claiming that it wasn’t necessary since I was not in his words “airborne” which was deeply disturbing to me about his lack of understanding of how airborne viruses work and that I was not the infectious one. I was the one surrounded by infectious people in an ER overflowing with patients in the hallways and rooms.

Beatrice Adler-Bolton

Why do you feel like pushing for mask mandates in healthcare settings in particular is an important site of struggle?

Alice Wong

It’s bananas to think that mask mandates in healthcare settings are controversial when healthcare workers before the pandemic mask during surgeries and dental procedures for example.

The term mandate is particularly challenging because people don’t like to be forced into doing anything while forgetting all the things they have to do to participate in society.

I think of immunocompromised people in particular who wear masks to protect themselves from others and even though that is not reciprocated by their providers which is stunning because mask wearing isn’t an arduous hardship for most people despite what’s been depicted in the media and on social media.

Mask mandates in healthcare settings is the bare minimum when it should be commonplace in other places such as schools and indoor settings with large numbers of people especially since most settings still have inadequate ventilation and filtration.

I am particularly betrayed by healthcare workers who should know better but don’t. The respiratory therapist I mentioned earlier wore his surgical mask under his nose which made mask wearing a performative farce.

A simple, low-tech, cost effective intervention that can reduce the transmission of not just COVID but other airborne pathogens should be standard of practice in all healthcare settings which is aligned with the purpose of health care, to actually, you know, save lives and help people. It seems like the oath to do no harm is meaningless.

The fact that mask mandates in healthcare settings is so contested is reflection of the biases and structural inequalities inherent in medicine which shows how long we have to go for a modicum of equity. Masks are also a visible sign of a crisis that most people want to bury.

For example, I just read this piece in the January 24th issue of The New Yorker by David Sedaris who wrote, “One of Dawn’s lungs collapsed when she was in her late fifties, so she was super cautious about covid—kept her face covered long after everyone else had returned to normal. We were in Chicago together, at O’Hare, in the spring of 2022, when I told her she needed to take it off. “But—” she said. “Let it go,” I told her. “Everyone else has.” I felt like a director coercing an actress to unhook her bra for a sex scene. “Come on,” I said…She took off her mask, and then of course immediately got covid—a bad case, too. All my fault, but she’s never held it against me.” End quote. David Sedaris is one of millions of people who want to travel, go to parties, and forget that high risk people like his friend Dawn exist and would rather her suffer from a COVID infection rather than look at her with a mask. With friends like these, you don’t need enemies. (…)

The power dynamic in healthcare settings is designed where the person in power can say whatever shit they want while patients have to give citations, articulate clearly and effectively, and have the presence of mind to push back in what can be a fast-moving, acute situation.

I’m a pretty experienced activist who knows how to code switch but this latest experience left me shook. I had a caregiver with me the first day and a family friend who helped me speak with the ICU team the following day because I was so beaten down. Even with all of my social capital and resources, I was reduced to nothing. And I think of all the patients on my floor who are alone, scared, and suffering.

This is one of many reasons why I plan to stir shit up with everything I got and call on others to join me in this collective action against medical ableism. Second, I am so glad you brought up how things build up with disabled and sick people especially those who happen to be multiply marginalized or activists. It is a social death by a million cuts. The levels of cumulative exhaustion takes a very real toll on one’s well being and it unsurprisingly prompts people to discontinue advocacy. (…)

Masking is one of the most basic lines of defense in preventing the spread of disease but it only works when the majority of people do it as a form of community care. One-way masking framed as an individual responsibility versus the status quo is one public health failure out of many. The state is only interested in a return to quote unquote normal. If people were required to wear masks in a healthcare setting it would mean the pandemic is still a threat as the state pushes the argument that the availability of vaccines and treatments are enough and prominent physicians such as Doctors Bob Wachter, Vinay Prasad, Ashish Jha, Leana Wen downplay the the pandemic because they believe the majority of the population, that is non high-risk people, are going to be ok and that people like me are outliers and acceptable losses. And this is why the virus will continue to mutate, causing more surges, and people developing Long Covid. (…)

So many horrible doctors are out there platformed by major newspapers have played a major role in the direction of the pandemic since the beginning. I feel like we need a bingo card for the most outlandish, harmful, and ableist things these people promote. I love me some disability studies and we are not only canaries but we are oracles because many of us foretold what would happen in the last four years. Oracles speak uncomfortable truths and prophecies and living at the margins gives you a certain perspective on the centered normates who do not want their comfortable bubble threatened like the selfish piece of shit David Sedaris who is such a beloved writer. And what’s wild is that by maintaining the normal, those very so-called able-bodied people like David are harming themselves too, not just us. I think normal serves the machinery that maps out the land of the normal. The normal doesn’t serve any individual but perhaps institutions and infrastructure that undergirds what we perceive as society. That might not be a good answer but that’s where my nerdy sci fi imagination takes me.

(…)

COVID denialists and minimizers framing masking as an attack on freedom and individual rights rather than common sense.

Some people, such as myself, cannot mask due to our disability. We rely on others to keep us safe. This is what community care is all about; the recognition that we are all interdependent and our wellness is tied in with the wellness of others. Masking, like the banning of smoking in public spaces, occupational health standards, and speed limits for driving, is a public safety issue which does not take away an individual’s freedom or civil rights.

Every advancement in safety and infection such as handwashing before and after medical treatment, is met with intense scrutiny and backlash until social attitudes catch up with the science. Since we are living in an age of significant misinformation, propaganda, and anti-intellectualism, it is particularly challenging to get people to mask because privileged people like David fucking Sedaris want to forget the last four years and quote unquote get their lives back while fucking over marginalized communities who are disproportionaly impacted by the pandemic.

Beatrice Adler-Bolton

I think another way you can put it is that right now we are all engaged in a struggle to normalize masking. Right now, masking, much like the identity of disabled person, chronically ill person, immunocompromised person, is seen as a negative, a deviation from the expected or desired outcome, and as such “normalcy” becomes a tool of devaluation and dehumanization—as well as a tool of social control. (…)

Like with disability, chronic illness, and for example accusations of malingering, all of which Artie and I talk about a lot in our book Health Communism, the disposability of the vulnerable is not a fact of nature. Full stop. That’s the bottom line. In the book, we discuss the concept of the surplus class, encompassing not just disabled people but anyone labeled as “surplus,” which we argue is not describing an identity but an economic relation, a relation to production, which is why we assert it’s a surplus class not just a surplus population. People enter this class when their relationship to work and tax-paying changes, and the disposability of the surplus class is naturalized as an inherent quality, but it’s imposed by our political economy—an ideology that becomes common sense, mistaken for a fact of nature. (…)

COVID-19, focusing on individual risk, has led to the organized abandonment of pandemic response by the state, shifting protection to the private market. This shift has various consequences—social, biological, and economic—demanding political repercussions. The political repercussions are things that we need to make happen, they don’t just happen on their own. The disposability of surplus populations in capitalist societies, including disabled people, is deeply ingrained and one of the biggest ideologies we are up against with regard to COVID. Left political projects will fail if they accept the argument that certain populations are irredeemable eugenic or debt burdens and normalize their disposability.

This can manifest in various ways, from organizers dismissing requests to mask at protests or meetings to large-scale divestment and state retrenchment, as seen in the so-called Medicaid unwinding. Which is why a revolutionary stance must reject this framework and recognize the economic system as a transitory social order for resource allocation and distribution, intentionally stacked against the most vulnerable. It is not a reflection of some inherent “law of nature” that we should also be upholding in our movements.

Currently, we are engaged in a struggle that disabled people are familiar with — refuting the social meaning and power that words and ideas have in tagging and labeling individuals as worth more or less, as burdens, or as disposable. Part of this project involves asserting new meanings and challenging the way these labels exist as de facto negatives. This requires asserting positive frames and conducting political education around community care.So towards that, can you talk about what community care is, for listeners who may not be familiar, and how the push to “get back to normal” is basically the antithesis of community care?

Alice Wong

Community care is giving a shit for others. It’s mutual aid, like the recent project I’m a part of called Crips for eSims for Gaza with Jane Shi and Leah Lakshmi Piepzna-Samarasinha. We can band together and offer what we have for a larger goal that will benefit others without any personal ulterior motive. As we wrote in a blog post, “There is power in numbers. We know that as disabled, sick, neurodivergent, Deaf people we are often poor or broke, but we can pool our money to collectively make a big difference. We also know that there is a rich tradition of poor and working class people donating more than middle class and rich people in general, and of poor and working class disabled people sharing what we have as a form of collective access and solidarity.” End quote. It’s about keeping each other safe when you cannot rely on the state such as Heather Ringo’s recent piece for the Disability Visibility Project profiling COVID safe businesses in the San Francisco Bay Area. (…)

My main message is you are not alone but ableism, like white supremacy, is designed to pit us against each other to fight for the crumbs. We can build power, collaborate, and stir shit up because our cause is righteous and true. It is exhausting just to exist let alone defend our humanity every day. Honestly, I think what I went through last week brought me right to the breaking point. I have never felt so beaten down and defeated. It’s important to admit those dark scary thoughts and not gloss things over just to move on or put on a brave face. Lean into your rage, despair, and fear. Being honest with ourselves and others strips away the need to constantly perform and advocate. Remind yourself it never had to be this way and that all of us can resist in big and small ways. You are a goddamn oracle and your wisdom is a light that can show us the way forward. And we will not be erased no matter how hard these bastards try.

“COVID isn’t like influenza; COVID kills and disables more people”—this phrase is unnecessary. The COVID pandemic gives us the opportunity to educate ourselves and others about the vast number of infections that, if they don’t kill you, leave you disabled.

• Myalgic encephalomyelitis is associated with pandemic influenza infection, but not with an adjuvanted pandemic influenza vaccine

• Viral role in Alzheimer’s Disease discovered | University of Oxford

• Neurologic Manifestations of Influenza A(H3N2) Infection in Children During the 2016–2017 Season | Journal of the Pediatric Infectious Diseases Society | Oxford Academic

• Epstein-Barr virus: how does a common infection trick the immune system into attacking the brain in people with MS?

• Influenza-associated neurologic complications in children from an H3N2 outbreak in Shenzhen, China during COVID-19 lockdown - ScienceDirect

• Varicella Zoster Virus: A Not Uncommon Cause of Stroke in Children and Adults - PMC

• Frontiers | Long-Term Consequence of Non-neurotropic H3N2 Influenza A Virus Infection for the Progression of Alzheimer’s Disease Symptoms

• There’s no such thing as a good cold

• Outcomes of ME/CFS following infectious mononucleosis

• ME/CFS 7 years after Epstein Barr Virus infection — why studies that follow participants over time are important.

Influenza kills and disables.

COVID kills and disables.

Imagine someone saying, “Ableism isn’t like sexism; it kills more people.” Doesn’t that sound absurd? Even if it were true, doesn’t it seem like we’re downplaying femicides? We can denounce both ableist and sexist murders. It’s not one or the other. It’s both.

The downplaying of influenza has led us to this. Many of us didn’t wear masks during influenza season, nor did we know that influenza is linked to death and widespread disability. We need humility. We need honesty. We need self-criticism.

We can talk about how infections, from measles to COVID, kill and disable. We can understand that infections that don’t kill us leave permanent consequences. We can debunk myths about both COVID and influenza.

The system has been misinforming us about influenza for years; let’s not do its work. Let’s inform people about airborne viruses as a whole. It’s strange that we only want to educate about one pandemic while saying that another doesn’t “cause as much death and disability,” isn’t it?

Ableism has been developing and shaping itself for years. The current eugenic situation surrounding COVID doesn’t surprise us when we analyze the history of oppression.

Thinking that the COVID pandemic is unique, exclusive, and the worst is incorrect and leads us to develop a flawed strategy.

We, the oppressed, have a history of struggle against eugenics. This means we can learn from past and present struggles. If we intend to discuss the COVID pandemic, we cannot do so at the expense of looking down on other pandemics, denying them, or minimizing them.

It is individualism and the trivialization of infections that have brought us here, and these will not be the tools that liberate us.

There’s no need to minimize some infections to dramatize others. We can be scientific in the social and biological analysis of viruses. Let’s not fall into the trap of understanding the immune system and viruses through simplistic and ableist thinking. Let’s use these moments of political awakening to advance our capacity to understand nuances.

This is a resource for people who want to learn up-to-date evidence on Long COVID. This Fact Sheet does not include all research available; it is a nonexhaustive list of evidence-based information. This is an updated version from the 2025 Long COVID Fact Sheet.

1. Long COVID rates remain high.
   a. In large US Electronic Health Records datasets of 3.4 and 1.9 million adults, Long COVID risk did not decrease over time, with highest risk in 2024 compared to 2021. 10-26% of adults developed Long COVID.¹
   b. The prevalence of people currently living with Long COVID has remained between 5.3-7.6% of the US adult population from July 2022 to September 2024.²
   c. 17% of 4,708 study participants developed Long COVID after Omicron infection, compared to 23% after pre-Omicron variants.³
   d. Global Long COVID prevalence was estimated at 29% of non-hospitalized confirmed COVID cases, based on a meta-analysis of 144 studies. Prevalence did not vary between 2021 and 2024.⁴
   

2. Reinfection increases the risk of developing Long COVID.
   a. People in a Canadian cohort were 1.7x more likely to develop Long COVID after 2 infections, and 2.6x more likely to develop Long COVID after 3 or more infections.⁵
   b. In an international cohort, people were 2x more likely to develop Long COVID after having COVID twice, and 3.7x more likely after having COVID 3 or more times.
   c. In a Spanish cohort of 193,000 people, those with 3 or more infections were 3-10 times more likely to get Long COVID.⁶
   d. Long COVID occurred in 24% of reinfections in a US cohort.⁷
   e. Reinfections led to higher incidence and severity of Long COVID in a Chinese cohort of more than 74 thousand people.⁸
   f. In a large database of healthcare claim records in Singapore, 2 infections raised the risk of new-onset diagnoses by 17%, with increased risk in cardiovascular, neurological, endocrine, respiratory, renal and gastrointestinal diagnoses. Increased risk associated with reinfections didn’t attenuate over 300 days of follow up.⁹
   g. Reinfection more than doubles the risk of Long COVID in children in a US cohort. Reinfected children are 3.6x more likely to get myocarditis, 2.8x more likely to get a blood clot, 2x more likely to develop heart disease, and 2x more likely to develop kidney disease, among other serious outcomes.¹⁰
   h. People who had COVID reinfections were more likely to experience severe fatigue, post-exertional malaise, perceived immune dysfunction, physical function limitation and worsened existing Long COVID.¹¹
   i. Reinfections increase the rates of long-term health problems including heart, lung, and brain issues.¹²
   

3. Long COVID is common.
   a. As of fall 2024, at least 1 in 19 US adults were living with Long COVID,¹³ with many additional cases likely going undiagnosed or misdiagnosed.
   b. In a 2024 population survey of a Brazilian nation-wide cohort of over 33 thousand people, 65% of those who had COVID had met WHO case definition for Long COVID.¹⁴
   c. An estimated 6 million children in the US have Long COVID, exceeding the number of children with asthma.¹⁵
   

4. COVID causes high rates of serious conditions and lifelong illnesses.
   a. SARS-CoV-2 infection induces high rates of permanent and debilitating conditions, including dysautonomia, myalgic encephalomyelitis,¹⁶ and diabetes.¹⁷ COVID is associated with a 49% increased rate of new-onset autoimmune diseases¹⁸ and increased risk of autoimmune and autoinflammatory connective tissue disorders.¹⁹
   b. Neurological and cognitive conditions are common; among people not hospitalized for COVID, 12 months after infection there was still an increased risk of 30 neurological disorders, including Alzheimer’s, ischemic stroke and transient ischemic attack, memory problems, peripheral neuropathy, migraine, epilepsy, and hearing and vision abnormalities.²⁰
   c. Cardiovascular and clotting conditions are common; among people not hospitalized for COVID, 12 months after infection there was still an increased risk of 18 cardiovascular conditions, including myocarditis, pulmonary embolism, and heart failure.²¹
   d. Evidence is emerging on higher risk of some types of cancer after COVID.
   i. In a large international cohort, COVID was associated with an increased risk of thyroid cancer.²²
   ii. In an Italian cohort of over 200 thousand people, incidence of new cancer diagnoses increased in comparison to pre-pandemic periods, with notable increase in new diagnosis of brain and skin cancers, even after controlling for screening rates.²³
   iii. UK BioBank data show that cancer mortality is twofold higher among those who tested positive for SARS-CoV-2.²⁴
   iv. Infection can promote awakening and expansion of dormant cancer cells.²⁵
   v. People who had herpes zoster virus (shingle) reactivations from COVID found higher incidence of multiple myeloma, acute and chronic leukemia, lymphoma,²⁶ and colorectal cancer.²⁷
   

5. The majority of people with Long COVID had mild acute COVID infection.
   a. Mild COVID cases make up the majority of people with Long COVID, since far more people had mild infections. The risk of Long COVID is higher after severe COVID, yet mild acute infections still pose a meaningful risk of long-term disease. Studies show between 76%²⁸ to 90%²⁹ of Long COVID cases were from a mild infection.
   

6. Recovery from Long COVID is rare.
   a. Only 5-9% of people with Long COVID report recovery at 2-3 years.^{30 31 32 33}
   

7. People are more susceptible to other infections after having COVID.
   a. Those who had COVID had higher rates of bacterial, mycoplasma, and influenza infections.³⁴
   b. Children aged 0-5 who had COVID were 1.4x more likely to get RSV (respiratory syncytial virus) that required medical attention.³⁵
   c. Reinfections increased the odds of reporting poor perceived immune health, including having many other infections and taking longer to recover from common infections.³⁶
   d. People not hospitalized with COVID compared to controls had increased rates of bacterial infections (blood, urine, and respiratory cultures) and viruses (Epstein-Barr, herpes simplex reactivation, and respiratory viruses). They were 17% more likely to have increased rates of outpatient bacterial, fungal, and viral infections, 46% more likely to have outpatient respiratory illnesses, and 41% more likely to be hospitalized for future infectious illnesses.³⁷
   

8. Long COVID has caused the highest rates of serious, persistent cognitive problems in the US population than any time in the last 15 years.³⁸
   a. Cognitive impairment from COVID includes problems with memory, reasoning, executive functioning, language, and processing speed.³⁹
   b. Younger people have worse and more marked cognitive impairment.⁴⁰
   c. Prevalence of self-reported cognitive disability in 18-39 year olds in the US has nearly doubled from 2013 to 2023, from 5.1% to 9.7%.⁴¹
   d. Multiple cognitive impairments persist at 4 years post-infection.⁴²
   i. Attention, working memory and memory retention did not show any improvement over time.
   ii. Where improvements were observed, they typically happened starting 24 months after infection. However, improvements generally plateaued by 32 months.
   iii. Processing speed and executive functioning scores remained well below average.
   

9. People with Long COVID experience severe functional limitations, poor quality of life, and severe fatigue at least as detrimental as many serious illnesses, including Parkinson’s disease and certain cancers.
   a. Functional ability scores in those with Long COVID ranked lower than those with stroke and were on par with those with Parkinson’s disease on a scale measuring ability to work, manage the household, engage in leisure, and maintain social relationships.⁴³
   b. Quality of life scores in those with Long COVID ranked lower than those with advanced/metastatic cancers.⁴⁴
   c. Fatigue scores in those with Long COVID were worse than those with kidney failure.⁴⁵
   

10. Long COVID substantially impacts patients’ livelihoods and ability to work, with most being unable to work or needing reduced hours.
    a. In a French cohort, at 2 years only 40% of people with Long COVID could work full-time.⁴⁶
    b. In a UK cohort, 52% had reduced work hours and lost an average of 25% of their monthly income .⁴⁷
    c. People with Long COVID in the US are nearly twice as likely to report housing insecurity, with higher housing insecurity among those with moderate or severe functional limitations.⁴⁸
    d. People with Long COVID in the US report high rates of food insecurity^{49 50} and difficulty paying utility bills.⁵¹
    e. In an international cohort, 20% of people with Long COVID were unable to work at 7 months and at 1 year follow-up. 9% lost their jobs or retired at 1 year follow-up.⁵²
    f. To continue working, 1 in 4 people with Long COVID in the US limit chores, errands, hobbies, and social life and relationships.⁵³
    

11. COVID increases risks of negative pregnancy and childbirth outcomes, and is associated with reproductive health and fertility issues.
    a. COVID infections are associated with early miscarriages⁵⁴, stillbirths⁵⁵, preterm births and cesarean deliveries⁵⁶, and preeclampsia and maternal mortality.⁵⁷
    b. COVID is associated with many reproductive health and fertility disorders including menstrual changes, endometriosis, erectile dysfunction, decreased semen quality and motility, and others.^{58 59 60 61 62 63}
    c. In an international cohort, 31% of people who menstruated had new onset reproductive health symptoms after COVID and 81% said that reinfections made them worse. Those with reinfections were more likely to experience heavy bleeding, bleeding with clots, abdominal pain, and worsening of baseline symptoms around their period.⁶⁴
    

12. Long COVID disproportionately impacts people from already marginalized groups and low-and-middle income countries.
    a. Rates of Long COVID are higher in Hispanic/Latine and Black people, trans people, disabled people, and women.^{65 66 67}
    b. US children living in a context of economic instability (poverty and food insecurity) had a higher risk of Long COVID. Those living in poorer social contexts (high level of discrimination and low social support) had double the risk of Long COVID.⁶⁸
    c. Indigenous peoples had the highest Long COVID symptom burden in a 2024 population survey of a Brazilian nation-wide cohort.⁶⁹
    d. In an international cohort of COVID hospitalized and nonhospitalized people, Long COVID prevalence was higher in participants from lower middle-income (30%) compared with high-income countries (14%). Prevalence was highest among people of Arab/North African ethnicity.⁷⁰
    

13. Long COVID has a major impact on children.
    a. An estimated 6 million children have Long COVID as of early 2024.^{71 72}
    b. 4-15% of children develop Long COVID.73 ⁷⁴
    c. Long COVID in children includes multiple forms of organ system complications
    and new-onset conditions.^{75 76}
    d. Children who get COVID are more likely to develop allergic diseases (including asthma)^,77 ADHD,⁷⁸ dyslipidemia,⁷⁹ acute and unspecified renal failure and diabetes type-1⁸⁰ and type-2,⁸¹ and autoimmune disease.^{82 83}
    e. Many biological abnormalities have been found in children,⁸⁴ including:
    i) microclots⁸⁵
    ii) systemic long-term SARS-CoV-2 persistence⁸⁶
    iii) altered cytokine profile involving coagulation and homeostasis of T-cells⁸⁷
    iv) proinflammatory and pro-angiogenetic blood chemokine profile consistent with endothelial inflammation.
    f. Many cardiac abnormalities have been found, some of which only detected by imaging or advanced testing^,88 including:
    i. pericardial effusion (collection of fluid around the heart) and coronary artery dilatation⁸⁹
    ii. impaired cardiac function on MRI with lower volume of blood collected in and pumped by the heart⁹⁰
    iii. abnormal cardiopulmonary exercise testing with lower functional capacity⁹¹
    iv. autonomic cardiac dysfunction⁹²
    g. Children with Long COVID were 3.1x more likely to have health-related chronic absenteeism (missing >18 days of school). 14% of children with Long COVID missed at least 18 days, with 11% missing at least 30 days.⁹³
    

14. Long COVID has a destructive impact on the economy.
    a. The global economic cost of Long COVID is estimated at $1 trillion per year.⁹⁴
    b. In 2024, 1.5 billion work hours were lost in the US due to Long COVID, corresponding to a potential cost of more than US $152.6 billion.⁹⁵
    c. Long COVID is responsible for massive Gross Domestic Product losses worldwide – including $24.4 billion in Saudi Arabia, $12.3 billion in Taiwan, and $11 billion in Brazil.⁹⁶
    d. Five years of Long COVID burden is projected to cost $3.7 trillion to the US economy in reduced quality of life, lost earnings, and increased medical spending.⁹⁷
    e. Long COVID disproportionately impacts certain labor sectors, particularly those with high exposure to COVID infections, like low-wage workers, farm workers, and those in education and the service industry.^{98 99 100}
    f. A quarter of US Marines who had COVID developed Long COVID, with long-term decrease in functional performance.¹⁰¹ An October 2025 analysis from the U.S. Military Health System estimated up to 20% of service members develop Long COVID.¹⁰²
    g. Lost productivity of caretakers in the UK was estimated at £4.8 billion._¹⁰³
    

15. Medical provider education about Long COVID is inadequate.
    a. Only 7% of physicians are very confident diagnosing Long COVID and only 4% are very confident treating it.^₁₀₄
    b. A majority of Long COVID patients report having had a negative experience with a healthcare provider.^₁₀₅
    c. In a national survey of primary care physicians in the US, less than 1 in 3 feel prepared to recognize or evaluate Long COVID.^₁₀₆
    d. In a US sample of 299 rehabilitation professionals, 70.2% reported awareness of Long COVID, but only 13% were aware of relevant Clinical Practice Guidelines, and only 7% used them.^₁₀₇
    e. Long COVID is underdiagnosed:
    i. In an international cohort of people with Long COVID, only 49% had an official Long COVID diagnosis. 28% said their doctors suspected Long COVID, but didn’t give them a diagnosis.^₁₀₈
    ii. In a cohort of people who were hospitalized for COVID in Brazil, 39% self-reported Long COVID but only 8% had received a Long COVID diagnosis.^₁₀₉
    

16. Lack of public awareness is causing crucial delays in care and support.
    a. Over ⅓ of people have still not heard of Long COVID despite its wide impact.¹¹⁰
    b. Lack of awareness about Long COVID particularly affects racial and ethnic marginalized communities, which have higher Long COVID risk but low awareness about Long COVID.^{111 112 113}
    

17. Research studies have described hundreds of Long COVID-associated biological abnormalities.
    a. Over 197,000 research papers on Long COVID are listed on Google Scholar, finding a wide range of biological abnormalities in Long COVID.¹¹⁴
    b. Up-to-date review papers include the scope of mechanisms and possible therapeutics,^{115 116} viral persistence^{117 118} and mechanisms to target persisting reservoirs,¹¹⁹ designing and optimizing clinical trials,¹²⁰ and roadmaps for Long COVID research and policy.¹²¹
    c. An incredible breadth of biological mechanisms have been found in Long COVID, including reduced cerebral blood flow^{122 123} and disrupted neurovascular function,¹²⁴ fibrin microclots and their downstream impacts,^{125 126} tissue damage and skeletal muscle necrosis after exercise¹²⁷, changes to the brainstem128 and hippocampus,¹²⁹ viral persistence¹³⁰ and persisting antigen,¹³¹ induced Long COVID in mice by transferring IgG from Long COVID patients,^{132 133} auto antibodies¹³⁴ and innumerable more.
    

18. The vast majority of the public and physicians believe Long COVID needs more research funding.
    a. In the US, 82% of physicians and 76% of the public believe it is important to increase research funding for Long COVID.¹³⁵

_{________________________________________________
1 https://doi.org/10.1093/cid/ciaf046
2 https://www.cdc.gov/nchs/covid19/pulse/long-covid.htm
3 https://doi.org/10.1001/jamanetworkopen.2024.17440
4 https://doi.org/10.1093/ofid/ofaf533
5 https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00015-eng.htm
6 https://doi.org/10.3390/vaccines13090905
7 https://doi.org/10.1001/jamanetworkopen.2024.17440
8 https://doi.org/10.1016/j.lanwpc.2024.101218
9 https://doi.org/10.1186/s44263-025-00222-1
10 https://doi.org/10.1016/S1473-3099(25)00476-1
11 https://doi.org/10.21203/rs.3.rs-4909082/v1
12 https://doi.org/10.1038/s41591-022-02051-3
13 https://www.cdc.gov/nchs/covid19/pulse/long-covid.htm
14 https://doi.org/10.1093/ije/dyaf143
15 https://doi.org/10.1001/jamapediatrics.2025.1415
16 https://doi.org/10.1016/j.jinf.2024.106297
17 https://doi.org/10.1016/S2213-8587(22)00044-4
18 https://doi.org/10.1007/s12016-025-09124-4
19 https://doi.org/10.1001/jamadermatol.2024.4233
20 https://doi.org/10.1038/s41591-022-02001-z
21 https://doi.org/10.1038/s41591-022-02001-z
22 https://doi.org/10.3390/biomedicines13081933
23 https://doi.org/10.1186/s12916-025-04237-1
24 https://doi.org/10.1038/s41586-025-09332-0
25 https://doi.org/10.1038/s41586-025-09332-0
26 https://doi.org/10.3389/fmed.2025.1651614
27 https://doi.org/10.3390/cancers17142306
28https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/asset/Patients%20Diagnosed%20with%20
Post-COVID%20Conditions%20-%20A%20FAIR%20Health%20White%20Paper.pdf
29 https://doi.org/10.1001/jama.2022.18931 (eTable 16 in Supplement 1)
30 https://doi.org/10.1016/j.lanepe.2023.100724
31 https://doi.org/10.1016/j.lana.2025.101026
32 https://doi.org/10.3390/jcm12030741
33 https://doi.org/10.1093/ofid/ofag040
34 https://doi.org/10.1016/j.lanwpc.2024.101218
35 https://doi.org/10.1101/2023.05.12.23289898
36 https://doi.org/10.21203/rs.3.rs-4909082/v1
37 https://doi.org/10.1016/S1473-3099(24)00831-4
38 https://www.nytimes.com/2023/11/13/upshot/long-covid-disability.html
39 https://doi.org/10.1093/arclin/acae042
40 https://doi.org/10.1038/s41598-023-32939-0
41 https://doi.org/10.1212/WNL.0000000000214226
42 https://doi.org/10.1016/j.bbih.2025.101093
43 https://doi.org/10.1136/bmjopen-2022-069217
44 https://doi.org/10.1136/bmjopen-2022-069217
45 https://doi.org/10.1136/bmjopen-2022-069217
46 https://doi.org/10.3390/jcm12030741
47 https://doi.org/10.1007/s10198-023-01653-z
48 https://doi.org/10.1016/j.ssmph.2023.101586
49 https://doi.org/10.1016/j.jand.2024.07.171
50 https://www.urban.org/research/publication/employment-and-material-hardship-among-adults-long-covid-december-2022
51 https://www.urban.org/research/publication/employment-and-material-hardship-among-adults-long-covid-december-2022
52 https://doi.org/10.1093/ofid/ofag040
53 https://www.urban.org/sites/default/files/2023-07/Employment%20and%20Material%20Hardship%20among%20Adults%20with%2
0Long%20COVID%20in%20December%202022.pdf
54 https://doi.org/10.1093/humrep/deac062
55 http://dx.doi.org/10.15585/mmwr.mm7047e1
56 https://doi.org/10.1186/s12884-024-06767-7
57 https://doi.org/10.1001/jamapediatrics.2021.1050
58 https://doi.org/10.3389/fresc.2023.1122673
59 https://doi.org/10.1038/s41579-022-00846-2
60 https://doi.org/10.1002/mco2.70240
61 https://doi.org/10.1038/s41598-025-20637-y
62 https://doi.org/10.1038/s41467-025-62965-7
63 https://doi.org/10.3390/v16071142
64 https://doi.org/10.21203/rs.3.rs-4909082/v1
65 https://doi.org/10.1007/s11606-022-07997-1
66 https://www.census.gov/library/stories/2023/05/long-covid-19-symptoms-reported.html
67 https://www.cdc.gov/nchs/covid19/pulse/long-covid.htm
68 https://doi.org/10.1001/jamapediatrics.2025.5485
69 https://doi.org/10.1093/ije/dyaf143
70 https://doi.org/10.1136/bmjgh-2024-017126
71 https://doi.org/10.1001/jama.2024.0356
72 https://doi.org/10.1542/peds.2023-062570
73 https://doi.org/10.1016/j.jiph.2023.03.005
74 https://doi.org/10.1093/cid/ciaf046
75 https://doi.org/10.1542/peds.2023-062570
76 https://doi.org/10.1183/13993003.00092-2025
77 https://doi.org/10.5415/apallergy.0000000000000245
78 https://doi.org/10.1136/bmjment-2025-301662
79 https://doi.org/10.1016/j.jpeds.2026.114996
80 http://dx.doi.org/10.15585/mmwr.mm7131a3
81 https://doi.org/10.1001/jamanetworkopen.2024.39444
82 https://doi.org/10.1016/j.bjid.2021.101585
83 https://doi.org/10.1111/1756-185X.14724
84 https://doi.org/10.1007/s00431-026-06789-7
85 https://doi.org/10.21203/rs.3.rs-7483367/v1
86 https://doi.org/10.1016/S2666-5247(23)00115-5
87 https://doi.org/10.1097/INF.0000000000004558
88 https://doi.org/10.1542/peds.2023-062570
89 https://doi.org/10.1007/s00246-022-02977-y
90 https://doi.org/10.1055/a-2684-7721
91 https://doi.org/10.1097/INF.0000000000004371
92 https://doi.org/10.1007/s00431-024-05503-9
93 https://pubmed.ncbi.nlm.nih.gov/41570188/
94 https://doi.org/10.1038/s41591-024-03173-6
95 https://impact.economist.com/perspectives/health/incomplete-picture-understanding-burden-long-covid
96 https://impact.economist.com/perspectives/health/incomplete-picture-understanding-burden-long-covid
97 https://cutler.scholars.harvard.edu/sites/g/files/omnuum5891/files/cutler/files/long_covid_update_7-22.pdf
98 https://labor.ucla.edu/wp-content/uploads/2022/01/Fast-Food-Frontline-Report-1-13-22.pdf
99 https://environmentalhealth.ucdavis.edu/research/covid-19/domestic-workers-survey
100 https://doi.org/10.1093/eurpub/ckae034
101 https://doi.org/10.1016/j.lana.2024.100909
102 https://www.health.mil/News/Articles/2025/10/01/MSMR-Long-COVID-Forecasting
103 https://doi.org/10.1007/s10198-023-01653-z
104 https://debeaumont.org/wp-content/uploads/2023/03/Long-COVID-Brief.pdf
105 https://doi.org/10.1038/s44220-023-00064-6
106 https://doi.org/10.1007/s11606-025-09387-9
107 https://doi.org/10.1097/CPT.0000000000000267
108 https://doi.org/10.1093/ofid/ofag040
109 https://doi.org/10.1186/s12939-025-02635-8
110 https://doi.org/10.3389/fpubh.2024.1360341
111 https://doi.org/10.3389/fpubh.2024.1360341
112 https://doi.org/10.1007/s40615-024-02109-7
113 https://doi.org/10.1016/j.annemergmed.2024.07.009
114 https://scholar.google.com/scholar?as_vis=1&q=%22long+covid%22&hl=en&as_sdt=0,33&as_ylo=2020
115 https://doi.org/10.1016/j.cell.2024.07.054
116 https://doi.org/10.1038/s41579-022-00846-2
117 https://doi.org/10.1016/S1473-3099(24)00769-2
118 https://doi.org/10.1038/s41590-023-01601-2
119 https://doi.org/10.1016/S1473-3099(24)00769-2
120 https://doi.org/10.1016/j.lfs.2024.122970
121 https://doi.org/10.1038/s41591-024-03173-6
122 https://doi.org/10.1016/j.jns.2026.125794
123 https://doi.org/10.3390/healthcare10102105
124 https://doi.org/10.1177/10738584231194927
125 https://doi.org/10.1038/s41586-024-07873-4
126 https://doi.org/10.1016/j.rpth.2024.102566
127 https://doi.org/10.1038/s41467-023-44432-3
128 https://doi.org/10.1093/brain/awae332
129 https://doi.org/10.1371/journal.pone.0316625
130 https://doi.org/10.1126/scitranslmed.adk3295
131 https://doi.org/10.1016/j.cmi.2024.09.001
132 https://doi.org/10.1101/2024.06.18.24309100
133 https://doi.org/10.1101/2024.05.30.596590
134 https://doi.org/10.1016/S1473-3099(25)00411-6
135 https://debeaumont.org/wp-content/uploads/2023/03/Long-COVID-Brief.pdf}

The fight against HIV means a great deal to the queer community. There were contradictions and many traitors who looked the other way, but there were also many revolutionary queers who distributed free syringes and condoms, built alliances with sex workers, people who use drugs, and every possible ally to fight against state eugenics while it was being dismissed as “the gay flu.”

health self defense

HIV/AIDS, eugenics, COVID and queer liberation

No pride in endless COVID infections…

Read more

9 months ago · 4 likes · AutoDefensa Sanitaria

Right now, it is the disabled community that is being used as a target. Like HIV, COVID can affect anyone, but this time the state has chosen to use the word “vulnerable” to encourage complicity in ignoring a pandemic that is still ongoing. Just as HIV is a queer struggle, COVID is a disability justice struggle, because the state uses our identities to justify the social murder we experience as a result of its own mismanagement.

health self defense

Covid Continues To Destroy People’s Health

There’s a fanzine about this article; you can find it on the Health SelfDefense Crytpad Drive. You have the link to the Crytpad Drive and other links of interest in the linktree Health Self Defense | Linktree…

Read more

9 months ago · 8 likes · AutoDefensa Sanitaria

Cisheterosexism looks away while framing HIV as something that is “only a gay issue.” Ableism looks away while framing COVID as something that “only vulnerable people need to worry about.”

health self defense

Do you know the relationship between the management of the COVID pandemic and eugenics?

Based on the post by @guiapandemica adding reflections…

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a year ago · 2 likes · AutoDefensa Sanitaria

While many collectives speak about intersectionality, queer struggle, and liberation, they forget those who are most oppressed: disabled people, chronically ill people, those labeled as vulnerable, and immunocompromised people. We repeat: COVID and Long COVID affect ALL OF US, but it is the disabled community that is being used to downplay the significance of this pandemic.

health self defense

The cold truth of the matter is that the motive behind COVID minimization is greed and social control

We share the excerpt from the original article in English, here is the link…

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a year ago · 3 likes · AutoDefensa Sanitaria

Racialized people, trans people, queer people, migrants, and poor people are among those most affected by this pandemic—not because of biology, but because of social oppression.

Masks adjustable? Indy Mask Bloc now has reusable silicone beads you can add to the earloop straps to make any mask adjustable! Being able to change the length of the straps on a mask can really improve the fit and seal. This can help the efficacy and make your mask fit your face better and prevent it sliding down your nose.

Here’s a tutorial of how to add the beads to your masks.

A one minute video that shows a white person’s hands over a dark stone counter. She is using a tree ornament hook to attach a silicone bead to the earloop of a black KN95 mask.

Explanation without images:

“You’ll need one of these:” small crochet hook, a bent paperclip, and a tree ornament wire.

“How to bend the paperclip:” The first paper clip isn’t changed at all, the second paperclip has the smaller middle part of the wire pulled straight so that there is now a long side with the smaller hook at one end and the bigger hook at the other. The third paper clip has this smaller hook fully straightened out so there is no bend in the small end of the paperclip. The 4th image shows that the very end of the straight end of the metal wire has been bent back down into a much thinner hook than it was originally. To make this easier you can make the tip of the hook where there will naturally form a kink in the wire when it is straightened in stage three.

1. The small hook goes through the smaller hole.” below are two square images of the small hook end of the paperclip. The left image shows the hook being placed in the smaller hole of the reusable silicone bead. In the middle of the two square images is a circular zoomed in image of two of the silicone beads held up next to each other to show that one end of each bead has a smaller hole.

2. Catch the earloop strap with the hook.

3. Pull the strap through the silicone bead. There are two photos showing the steps, the one on the left shows a person’s fingers gripping the bead to steady it as you pull the bead up the length of the paperclip towards the hook that has the earloop strap looped through it. The hook should easily slide through the silicone bead pulling the strap of the mask through the bead. The second image shows the strap fully pulled through the bead with the hook still attached. Now the bead can be used to adjust the length of the mask strap.

Explanation with images:

“You’ll need one of these:” small crochet hook, a bent paperclip, and a tree ornament wire.

“How to bend the paperclip:” The first paper clip isn’t changed at all, the second paperclip has the smaller middle part of the wire pulled straight so that there is now a long side with the smaller hook at one end and the bigger hook at the other. The third paper clip has this smaller hook fully straightened out so there is no bend in the small end of the paperclip. The 4th image shows that the very end of the straight end of the metal wire has been bent back down into a much thinner hook than it was originally. To make this easier you can make the tip of the hook where there will naturally form a kink in the wire when it is straightened in stage three.

1. The small hook goes through the smaller hole.” below are two square images of the small hook end of the paperclip. The left image shows the hook being placed in the smaller hole of the reusable silicone bead. In the middle of the two square images is a circular zoomed in image of two of the silicone beads held up next to each other to show that one end of each bead has a smaller hole.

One side is smaller. Put the hook through the bead.

2. Catch the earloop strap with the hook.

3. Pull the strap through the silicone bead. There are two photos showing the steps, the one on the left shows a person’s fingers gripping the bead to steady it as you pull the bead up the length of the paperclip towards the hook that has the earloop strap looped through it. The hook should easily slide through the silicone bead pulling the strap of the mask through the bead. The second image shows the strap fully pulled through the bead with the hook still attached. Now the bead can be used to adjust the length of the mask strap.

The WHO are NOT recommending to isolate cruise ship passengers (even high-risk contacts) UNLESS they develop symptoms.

The WHO is only recommending:

SYMPTOMATIC cases: isolation

ASYMPTOMATIC cases: monitoring

The International Hantavirus Society issued an important statement on May 7 that calls this entire strategy into question.

They clarify that “the precise timing of infectiousness remains incompletely defined”.

Infected people MAY be infectious before clear symptoms develop.

“The precise timing of infectiousness remains incompletely defined. While symptomatic patients are likely to represent the highest-risk group, available outbreak reconstructions do not support overly categorical statements that transmission can occur only after clear symptom onset. Transmission potential during prodromal, early symptomatic or minimally symptomatic phases, should be considered when designing contact tracing, testing and quarantine strategies.”

Thankfully some countries (like the UK & Spain) have confirmed that they are sensibly ignoring the WHO guidance and adopting a more cautious approach, asking ALL passengers departing the ship to self-isolate or quarantine for up to 6 weeks.

The US have also confirmed that the 17 Americans currently on the ship will be evacuated to a specialist quarantine facility in Nebraska upon repatriation to the US. (Duration of quarantine is not yet confirmed).

MODES OF TRANSMISSION

Maria Van Kerkhove was clear that the Andes Virus is known to transmit from human-to-human. She then went on to emphasise that transmission occurs “mainly among close contacts, either providing clinical care or people who’ve had close physical contact”.

This is not supported by the evidence.

In 2018, there was a major Andes Virus outbreak in Argentina which led to 34 cases & 11 deaths.

The outbreak had an R0 of 2.1 before strict quarantine measures were enforced.

Importantly, detailed investigations into this Andes Virus outbreak in Argentina in 2018 clearly revealed that multiple transmissions had taken place WITHOUT CLOSE CONTACT. The table below summarises the circumstances of these transmissions:

The 2018 Andes Virus ‘Superspreader’ study also states that:

“On the basis of both the epidemiologic and genomic investigations of person-to-person transmission events, it appears that inhalation of droplets or aerosolised virions may have been the routes of infection.”

It’s also worth noting that the UK classify the Andes Virus (hantavirus) as an AIRBORNE High Consequence Infectious Disease (HCID).

Please note the key word there: AIRBORNE.

However, despite all this readily available evidence that Andes Virus may well be airborne, María Van Kerkhove was on a calm-mongering mission.

Again & again, she confidently reassured listeners that the virus only spreads via “close intimate contact”.

“This is not SARS-CoV-2”

This feels suspiciously similar to March 2020 when, despite a lack of evidence, the WHO confidently stated that:

“COVID is NOT airborne”

The consequences of this flawed statement resulted in countless preventable deaths as countries failed to prioritise airborne mitigations.

Interestingly, the ‘Superspreader’ study was mentioned during the WHO press conference.

They emphasised its similarities to the HV Hondius outbreak but reassured that, since the 2018 outbreak only led to 34 cases, they “don’t anticipate a large epidemic” from this outbreak.

However, the WHO neglected to mention that in 2018, Argentinian health authorities enforced quarantine measures for ALL high-risk contacts for at least 40 days, even if they had NO symptoms.

A total of 142 people were quarantined to prevent the spread.

ON-BOARD MITIGATIONS

Maria Van Kerkhove outlined the following precautions currently in place on the ship:

· disinfection of rooms

· confinement in cabins (including for eating meals)

· anyone leaving room to wear a medical (surgical) mask

However this list of precautions doesn’t tally with 1st-hand accounts from the ship.

Maria says passengers are eating meals in their cabins but the NY Times suggests that:

“For meals, [passengers] are told to sit in every other chair in the dining room.”

And this account, from an ornithologist on the ship, states:

“We are neither in the cabins nor is there anyone with symptoms.”

To further reinforce the laxness of measures, he goes on to say:

“If it were Covid […], we’d all be infected in two days.”

But here’s the thing: The Andes Virus has a LONG incubation period.

Symptoms can appear up to 8 WEEKS after exposure to an infectious case.

Initial symptoms are often mild & flu-like (prodromal stage) - and it’s MOST infectious during the early stage.

The infected Dutch woman was symptomatic & almost certainly infectious for several days before she disembarked from the ship on 24 April.

Anyone who came into contact with her may now be incubating the virus - BUT symptoms may not emerge until mid-JUNE!

It’s also concerning that, despite the evidence that Andes Virus may be airborne (as per the ‘Superspreader’ paper mentioned earlier), the WHO have ONLY recommended use of medical (‘baggy blue’ surgical) masks, even when caring for symptomatic patients.

Surgical masks do NOT protect against airborne transmission.

Only respirator masks (N95/FFP3) provide adequate protection against airborne pathogens.

If there’s even a chance it could be airborne, surely the WHO should be recommending respirator masks?

TESTING

The WHO confirmed that the hantavirus tests can only detect the viral RNA in a SYMPTOMATIC patient, from the first day of symptoms.

To clarify: this means someone infected will test NEGATIVE for the entire duration of the incubation period until onset of symptoms.

This point is further reinforced by the statement issued on May 8 from the International Hantavirus Society.

“A negative PCR result early after exposure should therefore NOT be interpreted as excluding later infection.”

The CDC have also issued words of caution on the topic of testing, warning that:

“Early diagnosis of HPS can be difficult, especially within the first 72 hours of symptoms, before the virus can be accurately detected in body secretions & excretions.”

A clear example of this issue of unreliable test results in the first few days of symptoms is the British man who is currently in hospital in Johannesburg:

24 APR: Symptoms start

27 APR: 1st test: NEGATIVE

2 MAY: Repeat test: POSITIVE

With this in mind, I hope that suspected cases who test negative in the early stages of symptoms (when tests may be unreliable) continue to be isolated and undergo further testing.

This is the approach Singapore are taking.

TRANSIT TO HOME COUNTRIES

One of the journalists specifically asked whether the cruise passengers would be allowed to take commercial flights home.

The answer seemed pretty vague & evasive.

I suspect they can’t guarantee no commercial flights as yet.

Prof Allen spoke to the ship’s current doctor (a passenger who stepped up after the original dr fell ill).

He confirmed that 3 people from the ship who tested positive did NOT have any physical or close contact with the index cases.

CBC ‘Quirks & Quarks’ interviewed Gustavo Palacios, one of the world’s few experts on the Andes virus, who was one of the authors of the Argentina ‘Superspreader’ study published in NEJM.

Here he summarises some of the key findings from that outbreak.

In that 2018 Argentina outbreak, one person was infected at the birthday party despite being seated on a table some distance away and only very briefly crossing paths with the infected person on the way to the restroom.

Transmission took place WITHOUT any close physical contact.

This is another crucial point from the 2018 Argentina outbreak which may have significant bearing on what unfolds in the coming days with the cruise ship outbreak:

“The window of infectiousness was 48 hours BEFORE the onset of symptoms and 48 hours AFTER the onset of symptoms.”

Key lessons from 2018 Argentina outbreak:

probable AIRBORNE transmission

possibility of transmission from 48 hours BEFORE symptom onset

long incubation period, up to 8 weeks

containment strategy involved isolating ALL close contacts, regardless of symptoms.

The lesson from the Argentina outbreak is not panic but precaution.

Their containment strategy (rigorous contact-tracing, isolation of all possible contacts, & use of N95 masks) successfully reduced the estimated R0 from 2.1 to below 1 and brought the outbreak under control.

What we need from health leaders is honesty not calm-mongering.

They must communicate clearly & truthfully about both the evidence & the unknowns.

This outbreak should be containable, but only if the guidance reflects the evidence rather than wishful thinking.

This is a virus with a case fatality rate of 30-50% - ie. up to HALF of those who catch it will die and there are NO vaccines or specific treatments.

If those leading the response get this wrong, the implications will be fatal.

1. What is a hantavirus?

It is a family of viruses. They are found in animal hosts, often rodents (rats, voles, field mice, etc.), and sometimes in other animals (bats, fish, moles, etc.). There are many different types. These viruses are present all over the world. In humans, they can cause problems in the lungs, heart, kidneys, etc.

2. Why are we talking about this now?

Because three deaths were reported among the passengers and crew of the MV Hondius, which departed from Ushuaia, Argentina, on April 1 bound for Cape Verde (West Africa). Doctors performed tests and detected hantavirus.

3. What are the symptoms?

Fever, sometimes high, muscle aches, extreme fatigue (similar to the flu), sometimes shortness of breath, diarrhea, hemorrhages (abnormal bleeding), etc.

4. How is it transmitted?

Most hantaviruses are transmitted from animals to humans (this is called zoonosis), but very few are transmitted between humans. Unfortunately, the strain detected on the cruise ship is the Andean type, known to be more easily transmitted between humans than other strains.

There is a relatively long incubation period (that is, the time between infection and the onset of symptoms), averaging 2 weeks (ranging from 1 to 8 weeks). This is bad news; it means that many people will become infected without even realizing it, and that it may take up to 2 months for them to show symptoms.

Currently, the evidence indicates that it is transmitted via aerosols and droplets. Unfortunately, as at the beginning of the COVID-19 pandemic, governments are spreading misinformation by focusing solely on droplets. This decision to only discuss one transmission route and not the other is not based on science, but rather on prioritizing the capitalist economy.

We are seeing the same patterns of downplaying the hantavirus as with COVID. This downplaying is not based on facts, but on the greed of capitalism. The capitalist system depends on constant growth: production, consumption, and the constant expansion of profits. Even brief pauses have disastrous effects on capital. We are repeatedly told “not to panic” while failing to provide accurate information about the virus. When a pandemic threat looms, those most afraid are the capitalists, because their economy cannot withstand even a small pause.

Implementing the necessary mass prevention strategies to curb transmission (daily rapid testing, contact tracing, guaranteed paid leave for exposed workers, high-quality masks for the population, etc.) is costly and reduces profits.

For capitalism to function, two things are required: a constant supply of workers who produce value and an endless flow of consumption to materialize that value as profit for the capitalist. When we face the prospect of death and pandemics, the contradictions become starkly apparent. We realize that governments in capitalist systems don’t prioritize our lives, but rather the pursuit of profit.

Media attention focuses on reproducing the official rhetoric through opinion pieces and interviews. Scientists don’t all think alike; there are conservatives and progressives, scientists who prioritize care and those who will say anything to defend the stability of capitalism. The experts promoted by the government and most media outlets are selected based on their proximity to power, both in terms of their official appointment and their rhetorical stance.

5. Are there risks?

When you contract hantavirus, there is a risk of death. The risk varies depending on the type of hantavirus. The Andean type detected on Mount Hondius causes the death of between 3 and 6 out of every 10 infected people.

In general, it is currently very difficult to determine whether there is a real risk or not. Outbreaks caused by this virus have already occurred, and they were controlled quite quickly.

What we can say for sure is that the necessary measures were not taken (properly isolating the sick and those who were in contact with them, requiring the use of FFP2 masks, etc.) or were not taken correctly.

6. How can I protect myself?

In general, against hantaviruses, it is recommended to wear an FFP2 mask when working in places where there may be rodents, especially if dust is generated (when cleaning a room, transporting wood or soil, etc.), wear gloves, and wash your hands afterward. We recommend the widespread use of FFP2 masks.

Currently, there is no effective vaccine against hantavirus.

Press review and scientific articles for further reading:

T.A.C.T.

Andes Hanta Virus Alert: The Global Containment Test That's Faltering. Country by Country Report, Symptoms, Timelines and Much More

TACT Status Update — May 13, 2026…

Read more

4 months ago · 16 likes · TACT

- A glossary with definitions of terms used on the subject such as case fatality rate, zoonosis, reservoir species, etc.

https://www.lemonde.fr/les-decodeurs/article/2026/05/06/hantavirus-de-la-souche-andres-au-taux-de-letalite-le-lexique-pour-comprendre-les-mots-qui-circulent-avec-ce-virus_6686157_4355770.html

- A Le Monde article summarizing the situation as of May 3, 2026: https://www.lemonde.fr/planete/article/2026/05/03/un-foyer-de-syndrome-respiratoire-aigu-s-est-declare-a-bord-du-bateau-de-croisiere-mv-hondius-deux-personnes-sont-mortes-et-une-troisieme-est-en-soins-intensifs_6685243_3244.html

- Libération: “Outbreak on a cruise ship: the two patients will be evacuated to the Netherlands.” https://www.liberation.fr/societe/sante/en-direct-hantavirus-lespagne-accepte-un-accostage-du-bateau-aux-canaries-20260505_LYVENHIKJFEDNICYAEZYF6JYMU/

- El País “A Spanish passenger on the MV Hondius: ‘There are 23 people who disembarked on the island of Santa Elena two weeks ago’”

https://elpais.com/salud-y-bienestar/2026-05-06/un-pasajero-espanol-en-el-hondius-hay-23-personas-que-bajaron-en-la-isla-de-ascension-y-han-estado-dando-vueltas-por-ahi.html

- A France 24 program: “Is it aerosolized?” (Virologist’s response: We’re not sure, but probably yes.)

- The Daily Beast “Hantavirus crisis spreads to new country”

https://www.thedailybeast.com/hantavirus-crisis-spreads-to-france-as-new-case-recorded-in-french-national/

(Human-to-human transmission seemingly confirmed)

- La Monde “Hantavirus: Spain to welcome MV ‘Hondius’ to the Canary Islands within ‘three to four days’” »”

https://www.lemonde.fr/sante/article/2026/05/05/foyer-de-hantavirus-sur-un-navire-de-croisiere-l-oms-soupconne-une-transmission-interhumaine-l-espagne-accepte-l-accostage-du-bateau-aux-canaries_6685571_1651303.html

First, as an introduction, I want to make it clear that psychiatry itself is violent; I don’t intend to whitewash it; it is a pseudoscience that biologizes discomfort and was a vital weapon for systems of oppression, even long before capitalism.

The abolition of psychiatry is a movement that starts from mad people

“breaks with the idea of ​​”mental health” by raising the reality that in most cases there is no pre -existing disease. There is a situation of socioeconomic injustice. Our whole life has taught us how we behave, how we should respond to the violence they exert on us with a smile on their lips. They teach us to put the other cheek, while they burst our face. But we do not want more Andreas tied in overpopulated wings of psychiatry until his death. We do not want more Olaf being unattended by the system and ignored in its diagnoses. We do not want more crazy about benzodiazepines and other drugs for life just to be able to adjust to a corrupted system. Because talking about the traumas that accompany us would be to look at their guilty. They medicate and pathologize for life because they do not want us to be “good.” Because being well involved eliminating all these socioeconomic inequalities that mark us. It would imply ending the capitalist, traitist, rope and oppressive system in every way.

It is unlikely to ignore that health-disease dichotomy in the mental field is a construct that demonizes the behaviors categorized as abnormal or crazy. And this is easy to see when you think coldly. There is no way to measure serotonin amounts in our brain, however they always tell us that we are missing. That the fault is of that neurotransmitter or similar ones, which does not occur because our brain does not work well. As Thomas Szasz already pointed out at the time, the disease construct around madness, is nothing more than a mechanism for biologization of psychic suffering. It is a way to perpetuate the idea that everything considered erroneous is something sick. When the reality is that there is no evidence that there is an underlying disease to behaviors that are treated as such. According to Szasz, a disease must be detected in an autopsy and comply with the definitions of pathology instead of being decreed by votes by the members of the American psychiatric association. Mental illnesses are not real diseases, they are mechanisms of alienation of rebellion that is born from tiredness.

What they have never told us is that the brain is a plastic organ. That absorbs and adapts to the circumstances that are living. It is an organ that, when it has a failure, seeks how to adapt in multiple ways. Although sometimes he does not succeed or do it erroneously. The problem is not our brain, the problem is the society that causes us these hells that modify our mind. The problem is that there are beauty canons that take us to the TCA. That there is an individuality and detachment that leads us to feel alone and depression. The problem is that in the capitalist rhythm there are no care and that generates anxiety. The problem is that we are not listening and really helped when we live with other issues such as bipolarity or schizophrenia. The problem is all the situations of violence generated by the PTSD more often than any war. We are not sick, we are tired of pretending that this society is fine.

It is clearly necessary to learn to “behave” in such a way that we do not hurt anyone with our actions, we do not talk about that. We talk about what we are called hysterical to express our emotions, how we are violated when we refuse to bend. We talk that patience is considered a virtue when they exploit us and subject unspeakable violence. The reality is not that we are hysterical, crazy or deranged. The reality is that we live in a world so extremely dehumanized that our emotions, traumas and past no longer matter. It only matters to produce to exist and continue consuming. It is not conceived of that mechanism in which you are assertive as a way to survive while you shut up frustration. It is not conceived to burn everything.” Loca, desatada y enfadada. – Rebelión Feminista

Antipsychiatry

“Antipsychiatry is a criticism -oriented movement of dominant psychiatry. The term was coined in 1967 by (anti) psychiatrist David Cooper. Although there is a lot of written on the subject, it is often used as an umbrella under which to put any critical position with hegemonic psychiatry.

In this post I will try to contribute to clarify the confusion surrounding antipsychiatry. Sometimes professionals are included in it who should not, or insert in that current to the movement of survivors of psychiatry or crazy activism.

(…) As I said at the beginning, there is a tendency to understand how antipsychiatry currents that are not. Although I am not going to extend in them here, I consider it necessary at least to list them:

-Movimientos of psychiatry survivors or other similar groups such as Hearing Voices or activism in mental health and GAM (mutual support groups). Antipsychiatry is a movement carried out by mental health professionals. Certain activists may sympathy with antipsychiatric approaches. But, from my point of view, they should not understand themselves as such.

-The antipsema position; which supposes the abolition of the psystem.

-Stire the psychiatry. A paradigmatic example is the open dialogue model in Finland (in the Western Lapia area) in 1969, whose referent is Jaakko Seikkula.

-Modelos of psychiatry that question traditional psychiatry but intentionally disconnect from the prefix “anti”: critical psychiatry and postpsybiatry.

-A special mention deserves non-psychiatric thinking, called by Giorgio Antonucci and in which the liberal Thomas Szasz could be included (on which it has been said that it has inspired and influenced the entire antipsychiatric movement, although this is not entirely exact). A current on horseback between antipsychiatry and abolitionism.

This perspective leads criticism of psychiatry beyond: “Psychiatry considers as an ideology that lacks scientific content, non-knowledge, whose objective is the annihilation of people, instead of the attempt to understand the difficulties of both individual and social life and then defend people, change society and give life to a really new culture.” (Antonucci). ¿Qué es la antipsiquiatría? – Diario de una autoetnógrafa

Making this introduction, I am in many groups of people with persistent COVID and there are few psychiatry testimonies, this does not come from nothing, in post-viral matters or diseases that doctors do not want to understand the psychiatry is widely used as a form of punishment.

Many companions with myalgic encephalomyelitis (EM) have spoken of this violence (EM)

“But psychologisation doesn’t just impact which research programmes get funded, it also impacts how sick people are treated in the clinic. While there are no approved treatments for ME, several treatment options that target the metabolic, immunological, vascular, and neurological aspects of the illness exist and are prescribed off-label by knowledgable clinicians. Beyond these, there are numerous treatment options for the symptoms and comorbidities of ME, especially MCAS and POTS. Although none of these treatments constitue a cure, they can substantially improve people’s quality of life. The psychologisation of our illness serves as a justification to deny us these treatments. If ME is ultimately a mental illness, and not a physical one with immunological, metabolic, vascular, and neurological aspects, there is no reason to prescribe drugs that target these bodily systems.

Instead, there is a reason to target the alleged mental disorder (the “false illness beliefs” held for the “benefits of the sick role” and encouraged by “social contagion”) at the root of the illness. Thus in lieu of the biomedical treatments we need, we are encouraged (indeed often coerced) by clinicians to cut ties with our communities, which are sources not only of support but also, as I explained in a previous blog post, of scientific knowledge; and to undergo cognitive behavioural therapy designed to train us to dismiss and ignore our own physical symptoms, and graded exercise therapy designed to force us into a level of activity sufficient for participation in the workforce. But since the cardinal feature of ME is that it gets worse with activity (this is called post-exertional malaise or PEM), training people to ignore their symptoms and increase their activity levels on account of the supposedly mental nature of the illness has catastrophically harmed countless people: innumerable people have permanently lost even more function, many to the point of becoming bedbound, and some have died.” Sanism and the Psychologisation of Physical Illness

Dismissed and Disbelieved, Some Long COVID Patients Are Pushed Into Psychiatric Wards

“The chronic illnesses that make doctors doubt their patients often start after what “should” be a short-lived sickness. And it’s not just COVID-19; many diseases, from Lyme to mono to the flu, can lead to mysterious, lingering symptoms that are often ruinous but difficult to explain.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), for example, can follow a variety of viral or bacterial infections, leading to cognitive problems and extreme fatigue made worse by physical or mental exertion. (There is so much overlap between the symptoms of Long COVID and ME/CFS that many people now meet diagnostic criteria for both.) Today, the U.S. Centers for Disease Control and Prevention (CDC) calls ME/CFS a “serious, debilitating” biological illness—but for decades, it was written off as psychosomatic. A 1988 paper by researchers from the U.S. National Institutes of Health (NIH) suggested that it could be related to “unachievable ambition” and “poor coping skills.” And in 1996, a CDC researcher told a journalist that the condition has no viral cause, results in no immune abnormalities, and could be summed up as “hysteria.”

Because the disease was for so long dismissed as psychological, many clinicians to this day try treatments like cognitive behavioral therapy that, at best, do nothing to address the condition’s physical symptoms—and, at worst, exacerbate them. Elizabeth Knights, who is 40 and lives in Massachusetts, went through even more intensive mental-health treatment. She spent several weeks in a psychiatric ward in 2006 before finally being diagnosed with ME/CFS and finding care that dramatically improved her health.

During her senior year of high school, Knights caught a mono-like illness that never fully went away. Once at the top of her academic class and an avid skier and rock climber, Knights eventually had to withdraw from college and move in with her parents because she couldn’t function under the strain of persistent fatigue, flulike symptoms, and cognitive dysfunction—all of which her doctors chalked up to depression.

“I kept insisting, ‘There’s something else going on here,’” Knights remembers. But she didn’t know about ME/CFS at that time, and her doctors were adamant that her problems were psychological. So when physicians recommended she try inpatient psychiatric care, she went along with it. “That was the only path that was presented to me,” Knights remembers, and she took it.

The experience made things worse. She was given numerous medications to which she had bad reactions and went through electroconvulsive therapy, which she says damaged her memory to the point that she had to relearn how to talk and navigate her hometown. “Nobody was listening to me, and people were not informed enough to make a correct diagnosis,” she says. “I was being misdiagnosed and treated for something that I didn’t have.”

Rivka Solomon, a longtime ME/CFS patient advocate, says she hears this story a couple times a year: a patient, like Knights, has been wrongly admitted to or threatened with inpatient psychiatric care. And those are just the instances she learns about. “I worry about who is, right now, lying in a bed in a psych ward, too sick to function, left with no one to properly care for them, left with no one to advocate for them,” she says.” Some Long COVID Patients Are Pushed Into Psychiatric Wards | TIME

People with persistent COVID are evidence of the State’s negligence.

“The cold truth of the matter is that the motive behind COVID minimization is greed and social control. The capitalist system depends on constant growth: constant production, constant consumption, constant expansion of profits. Even brief pauses — such as a month-long stay-at-home order — have disastrous effects on capital. Implementing the mass prevention strategies necessary to slow down transmission (daily rapid testing, contact tracing, guaranteed paid leave for exposed workers, high-quality respirators, etc.) is expensive, and eats into profits. An information campaign explaining why everyone needs to stay home, instead of contributing to “the economy,” eats into profits further. Winding down all non-essential business and keeping it shuttered until the true end of the pandemic would contract the economy down to only what is necessary for society to function. The opportunities for financial capital to invest in new, profitable enterprises would vanish faster than they reemerge.

For capitalism to function, it requires two things: a steady supply of workers producing value and an unending flow of consumption to realize that value as profit for the capitalist. The onset of a pandemic presented a challenge on both of those fronts. Workers getting sick en masse and being forced to stay home for a couple of weeks — or even dying or becoming disabled and exiting the workforce altogether — was only one potential headache for the capitalist class. Far worse was the prospect of workers staying home out of precaution, thereby grinding production to a halt. Consumers staying home and buying only the essentials would prevent the realization of profits across huge swathes of the economy, cutting off the flow of capital necessary to keep the whole system running.

The moment it became obvious to market analysts that COVID was more than just a local Chinese outbreak, it triggered utter panic in the financial sector. Fears about the slowdown of profits led to several mass stock sell-offs from investors, lowering stock value, triggering even more panic-selling, across multiple different days. This wasn’t just speculation: decreased demand for oil rapidly triggered a massive price war that caused prices to spiral for months until becoming negative, with the holders of oil futures paying to offload their contracts. Without ramping demand back up, production of this and other key commodities would be financially toxic.

Capitalism also relies on a reserve army of labor to keep labor costs artificially deflated. A contracted economy, in which any worker willing to work is a rare commodity, tips the balance of power in favor of workers. Workers could more easily bargain for higher wages and safer working conditions (including liberal COVID leave). Most worryingly of all, in the context of long-term precautionary measures, the population would get used to a dangerous notion — that we have value beyond our labor and our consumption. When faced with the prospect of death or disability, the contradictions become sharpened in our eyes. Hundreds of millions of workers would suddenly ask “Why am I risking my life for this?” The frustration at a choice between abject poverty and potentially contracting a debilitating condition would galvanize workers to stand up for our rights. Waves of labor mobilization, rent strikes, workplace lockouts, boycotts, and more would sweep the country — and the world. It would be the greatest challenge to the political power of the capitalist class in a century.

Actually solving the pandemic was never in the cards for the U.S. and the rest of the capitalist world. It would have necessitated deep international cooperation, massive investment in clean air infrastructure, a persistent information campaign (and censoring of hazardous misinformation), efforts to build public trust in government, guaranteed paid leave, nationalization of key industries, and more. Basically, it would involve massively undercutting the philosophy of free market capitalism.

Instead, the explicit goal of the ruling class has been to make the pandemic simply disappear from public perception. Any reminder of the existence of a highly-transmissible, highly-dangerous, mass-disabling disease could trigger panic, or worse: organized, militant labor action. Averting this crisis required a careful campaign of culture-crafting; the people themselves needed to become convinced that there was no reason to fight. Consent for protracted mass infection needed to be manufactured.” Let Them Eat Plague! – The Red Clarion

There’s a deep silence settling like a layer of ash blanketing the millions of graves Covid-19 has already filled. This silence isn’t natural—it’s produced.

“Not from exhaustion alone, but from deliberate choices made by those in power to make us forget. Forget the losses. Forget the survivors. Forget that any of this could have gone differently. But the pandemic continues to rage, pulling lives from the present—not just the future—and in its wake, the systems that fuel this devastation persist.

Since 2020, the global pandemic has killed millions, disabled millions more, particularly concentrated among the working class, and poor, disabled, and incarcerated people. But we’re told that the real issue is “pandemic fatigue,” “learning loss,” and not being able to see each other’s smiles when we’re wearing masks.

We’re bombarded with narratives demanding we return to normal, get back to work, and stop resisting—if you do not comply you are shunned, punished, and we are all constantly forcibly exposed to a virus that devastates the body the more times you interact with it. This ideological sleight of hand masks the truth: the pandemic isn’t over because the structures responsible for it aren’t either. Instead, they’ve adapted, entrenched themselves deeper, and capitalized on our growing numbness.

The ruling class, whose pockets have swollen in this time of crisis, has an invested interest in your forgetfulness. They want the machinery of death to keep running while we call it “progress” or “normalcy.” From prisons that incubate the virus to mask bans passed in the name of “freedom,” every part of the response has been designed to keep exploitation intact and the state running ever-forward with a smooth clip. Every rollback of public health measures is not a public failure—it’s a private success. This is capitalism doing what it does best: turning catastrophe into opportunity.

The discourse of “personal responsibility” in handling Covid is just another way to market death as inevitable. It’s a rallying cry that masks the real stakes. The fact is, who lives and who dies is not a matter of personal failing—it’s a decision rooted in historical patterns of exploitation. The pandemic exposed these fault lines, but we should never think they weren’t already there. The uneven distribution of death follows the logic of racial capitalism, hitting the poor, Black, Brown, and disabled hardest.

This is why you can’t disengage, and why if you have disengaged now is the time to pick up where you left off. The same powers normalizing mass death today are the ones that have been exploiting workers, criminalizing the marginalized, and entrenching inequality for centuries. COVID has simply brought this into sharper focus. From the torture of prisoners under the guise of pandemic protections to the outsourcing of public health responsibility onto individuals, what we’re seeing is not new—it’s an acceleration of existing processes designed to preserve power for the few.

The normalization of mass death serves as a form of eugenics, where the unproductive—those who cannot be exploited for profit—are left to die. This isn’t a side effect of capitalism; it’s central to how it operates. From the start, this has been a pandemic of selective neglect. The poor, the immunocompromised, the disabled, those in low-wage work, those whose very existence threatens the perpetuity of the state—we were always going to be the ones sacrificed first. The system needs our bodies for labor and extraction, but not for care.” Structural Violence and the Pandemic: An Update on Our Collective Reality

The bourgeois government is incentivized to allow mass deaths and disablement

“because the medical industrial complex—pharmaceutical industry, healthcare conglomerates, insurance companies, etc—is just as capable of extracting profit from our disabled bodies as industry is from our labor.

This is the money model of disablement—a concept first articulated by Marta Russell—in action. Russel explains that “…persons who do not offer a body which will enhance profitmaking as laborers are used to shore up US capitalism by other means.” This is organized abandonment, a term coined by Ruth Wilson Gilmore, which is “the deliberate manipulation and disproportionate dispossession of resources from Black, Brown, Indigenous, disabled, and poor communities, rendering them more vulnerable to adverse health.”

Disabled people, i.e. people “who are deemed to be surplus[,] are rendered excess by the systems of capitalist production and have been consequently framed as a drain or burden on society. But the surplus population has become an essential component of capitalist society, with many industries built on the maintenance, supervision, surveillance, policing, data extraction, confinement, study, cure, measurement, treatment, extermination, housing, transportation, and care of the surplus. In this way, those discarded as non-valuable life are maintained as a source of extraction and profit for capital.

This rather hypocritical stance–the surplus are at once nothing and everything to capitalism–is an essential contradiction. Liat Ben-Moshe identifies this characteristic through the intersection of disability and incarceration: ‘Surplus populations are spun into gold. Disability is commodified through [a] matrix of incarceration (prisons, hospitals, nursing homes).’ Jasbir Puar, in The Right to Maim: ‘Debilitation and the production of disability are in fact biopolitical ends unto themselves… Maiming is a source of value extraction from populations that would otherwise be disposable.’”

We must expose the government’s inactions to protect the people from COVID-19 as extractive abandonment—purposefully leaving us scrambling for basic resources necessary for survival, so that when we inevitably become sicker and sicker the healthcare industry can profit off our disabled bodies.

We must recognize our humanity, recognize that a better world is possible, and that in order for us to get what we deserve—a life free from the shackles of fascist capitalist imperialism—we must “do what must be done” and do so “by any means necessary.” People’s Health Education Program

Now what

This is not simple negligence on the part of those who govern and shape our society. It amounts to social murder: the establishment of policies that place large numbers of people on the path to an early and unnatural death. You have the right to health, and that right is being deliberately stripped away from you with a policy of mass infection.” Let Them Eat Plague! – The Red Clarion

50% of infections are asymptomatic.

At least 10% of infections end in long COVID.

Reinfections destroy us. There is no way to “train” the immune system because it is not a muscle. There is a common misconception that exposure to harmful germs strengthens the immune system. Viral diseases like COVID, flu, measles weaken the immune system, leaving the possibility of lasting damage. The reality is that you don’t build your immunity with repeated infections, vaccines strengthen the immune system by teaching it to recognize pathogens without all the risks. Focusing on infection prevention is key.

A rapid antigen test only successfully detects about 60% of early symptomatic infections and about 22% of asymptomatic infections. PCR and molecular tests are the most accurate tests.

COVID spreads and moves like cigarette smoke. Think of the people around you and yourself as people who smoke all day long. It becomes more visual to understand how COVID moves.

In infections with symptoms, it takes a couple of days to show symptoms, which means that you are infecting for at least a couple of days without knowing it.

Vaccines are important, but forms of protection such as masks and air purifiers must be added. The levels of antibodies produced decrease significantly in the months following vaccination. Vaccines are not preventing reinfections, contagion, or long COVID.

You are infectious with COVID for at least 10 days.

Since the beginning of the pandemic, there has been a great deal of propaganda around the normalization of the disease and a meritocratic way of understanding immunity (the best is that you will never be affected, the weak is that you will ‘have to die’ for prosperity).

The new variants are complex because of 1) the continuous transmission that we do between humans, as well as that which occurs between humans and other animals, creating more complex mutations; 2) the lack of research, lack of socialization of barriers against COVID, of antivirals when you have infections, and of PCR or molecular COVID tests. All of this is not isolated from the world of oppression where we live, in fact, that is where its origin is. Care against COVID is community care for workers, disabled, queer, anticolonial struggle and against all forms of oppression.

We have the tools to fight against eugenics, let’s organize!

We must declare that life is more precious than capitalist economies.

“Solidarity is a group that stands together, and would do so for even its weakest member. It is that community which resists the intoxicating lie of individualism—we live for ourselves and by ourselves.”

-Cole Arthur Riley.

We must support our inherent right to health and dignity. COVID-19 is not mild, it is not endemic, and it is not “just a cold.” COVID-19 is a serious illness that can damage every part of your body, reactivate dormant viruses, permanently damage your immune system, and disable you.

The ruling classes have a long history of witch hunts to scapegoat the sick in response to infectious disease epidemics, rather than meeting the needs of the population.

Under feudal rule in what is now Europe, the bubonic plague was blamed on the Jewish people, accused of poisoning water wells. During the early AIDS epidemic, gay and bisexual men were demonized for their sexuality outside of heterosexual, monogamous, and partnered marital relationships. The denial of the severity of the COVID and long COVID public health crisis is a denial of science based on materialism. Once they have strayed from the paved path of science, medical judgments about people who report illness, pain, and disability have nowhere to travel except in the furrows of already deep historical prejudices.

Without seeking a scientific explanation (which already exists and is still being researched), doctors too often resort to pathologizing those who are oppressed based on their race/nationality, sex, sexuality, and gender expression. This creates more obstacles for those who are oppressed to access medical care. Sick people suffer from denial of credibility, unemployment, poverty, lack of health insurance, institutionalized racism, the requirement for ID, the oppression of women, and other oppressions based on sexuality, sex, and gender. Those who are oppressed and most impoverished are also more likely to be among the countless sick and disabled people who have stopped seeking medical answers or treatment, just as so many millions have abandoned their long and fruitless search for work and dropped off the unemployment rolls.

The COVID and long-COVID pandemic leaves the most oppressed and impoverished without diagnosis, care, or treatment. Institutionalized racism results, for example, in medical photographs and descriptions of rashes and other physical signs related to COVID and long COVID being documented only in light-skinned people. The long COVID pandemic affects oppressed peoples, from Native Nations on reservations to oppressed people living in impoverished rural communities.

Furthermore, the information available on the topic is available once you begin to investigate, but in many cases, the doctors themselves who talk about long COVID give completely erroneous guidelines. Many have even said that people should exercise (not understanding the fatigue of long COVID) and that reinfections are not dangerous (when there is evidence that they are). In the end, it ends up happening like other illnesses: doctors don’t center the voices of those affected and don’t understand the situated knowledge of people who experience it firsthand.

Women, LGBTQ+ people, people of color, people with other chronic illnesses, and people with psychiatric conditions who push for a diagnosis are labeled “hysterical.” Those who refute these “diagnoses” that are not derived from a scientific process find themselves medically labeled as “problem patients,” rather than patients with an as-yet-undetermined medical problem.

The downplaying of propaganda around COVID has been IMMENSE. None of us are immune to propaganda, especially on that scale.

It’s extremely normal to feel defensive when presented with a situation where your behavior doesn’t align with the values ​​you hold dear. We often want to protect ourselves from discomfort by dismissing the messenger—it happens all the time around COVID safety where people feel shame, so they accuse the messenger of shaming them. But being shamed and feeling shame are not the same thing. We’re not seeking to shame; we’re seeking to expose the harm being caused in the community, the facts. If those facts make you uncomfortable, that’s your cognitive dissonance to process; that can be the impetus for being able to commit to community care.

We’re not seeking to move through guilt. We don’t believe shame is an effective motivator; in fact, we know that conviction regarding community care can’t be achieved simply in conversation; it’s a practice of example where we must continually fight the individualism we’ve been taught. We don’t believe in coddling people or sending indirect messages. We believe in the struggles against eugenics, which have brought together affected groups, such as the Black Panther Party, which recognized that sickle cell anemia was a neglected genetic disease because the majority of those affected were of African descent. There was a rapid detection test based on a simple finger prick, but it wasn’t widely used. Or in the case of the fight against HIV, where groups spoke about the importance of not only condom use but also syringe sterilization for addicts, in the case of prostitutes, and the violence experienced with condom use. We believe in learning from our past, practicing it, and looking to the future.

You are at risk for long COVID. It’s never too late to start wearing a mask again. We have the power to protect each other. Get involved with your local mask group or clean air club. Reject eugenics, reject ableism, reject mass infection. Wearing a mask is love. Wearing a mask is community care. Wearing a mask is solidarity.

While we understand that COVID and long COVID affect the most marginalized people the most, we understand that the vulnerable/non-vulnerable dichotomy is not only a lie, but propaganda for “us” and “them” in fragility. We are all within fragility; don’t buy into the narrative of immunological neoliberalism.

We can’t talk about COVID without talking about the politics of desirability. They exist as a hierarchy that determines who deserves care and love. They are based on white supremacist ideals about beauty, youth, and productivity. Anyone who exists outside of these standards—any fat person, any Black person, any “non-conforming” trans person, anyone with disabilities, especially visible disabilities like facial or limb differences, the elderly, etc.—is dehumanized. Desire actively shapes systems of power and oppression. People who are deemed less desirable in a world that is actively constructed and centered on whiteness are relegated to the margins of society—invisible, or worse. This needs to be part of the conversation when we talk about eugenic policies around COVID. When we (especially white people, with invisible disabilities) talk about the ways in which high-risk people have been and continue to be discarded.

We understand the current state of COVID as one part of the larger fight against ableism. It’s a much larger conversation. COVID is only one part. Ableism is global and structural. This is why we understand COVID mutual aid not as distributing masks, giving air purifiers, and helping people avoid COVID, but as the study, strategies, and practices of anti-ableism as a whole.

We must declare that life is more precious than capitalist economies. Historically, colonizers and capitalists have used plagues and pandemics as weapons to maintain domination. Today, our government and healthcare systems have allowed many people to die and become ill without doing much about it, especially in already marginalized communities. We are told to ignore how diseases can affect us and to disregard the scientific evidence that shows COVID-19 can be very dangerous. We are refusing to be sacrificed in this situation.

The 10 actions for Solidarity in the Pandemic that pandemic solidarity has written.

As capitalist institutions produce mass illness and death, we must not abandon each other. Together, we have the power to shape our communities. To do so, we must prioritize the health and safety of all our people by committing to these 10 actions:

1. COVER YOUR FACE - Wear high-quality, well-fitting respirator masks (KN95/FPP2 or better) when sharing the air outside your home to protect yourself and your neighbors. (free masks in maskbloc.org)

2. CLEAN THE AIR - Purify the air you breathe by using air purifiers, opening windows, improving filtration, and monitoring air quality.

3. GET TESTED FREQUENTLY - Get tested frequently and following best practices before events, after gatherings, and in your daily life with quality PCR tests where possible. Isolate yourself from others in your home and community if you test positive or are sick. 4. MAKE A LAYERED PLAN - Create a COVID-19 safety plan that includes multiple layers of protection, a support team, and protocols for illness or positive tests.

5. SHARE RESOURCES - Share resources like high-quality masks, up-to-date information from trusted sources, and testing with your loved ones and neighbors.

6. CHANGE THE NARRATIVE - Use intentional language to promote COVID-19 safety and combat misinformation, minimization, and denial in your relationships and communities.

7. DEMAND SAFETY - Demand universal masking, testing, and clean air protocols when gathering with friends, family, colleagues, and neighbors to keep everyone safe and leave no one out. 8. PROTECT PUBLIC SPACES - Demand rigorous and robust COVID-19 safety requirements, including universal mask use and clean air protocols, at your workplaces, organizations, healthcare providers, neighborhood stores, and event venues. Boycott those who don’t implement them.

9. DEMAND GOVERNMENT PROTECTION - Demand free, accessible, and up-to-date masks, testing, vaccines, treatments, and clean air tools from your local, state, and federal governments.

10. ACT IN SOLIDARITY - Prioritize your commitment to liberation over convenience by making connections between the pandemic and ongoing liberation struggles around the world, divest from all systems of oppression, and support groups fighting for just futures.

Pandemic nihilism refers to an attitude of hopelessness and indifference towards the health crisis brought about by the COVID-19 pandemic. This perspective can manifest in the rejection of public health measures, such as mask-wearing and vaccination, as well as the belief that the situation is insurmountable or that any effort to improve it is futile.

The pandemic has exposed and amplified many pre-existing social and economic crises, leading some people to feel that there are no viable solutions. This hopelessness can lead to inaction, where people feel powerless to change the situation.

Both the capitalist belief of “your health is in your hands” and “I’m not going to do anything because nothing can be done” are individualistic thoughts that benefit capital.

Above all, it is important to recognize that these feelings of hopelessness arise because we have not allowed space for grieving over COVID.

The individualistic capitalist view of “your health is in your hands” makes us feel that there is no way out of something so enormous, but

Instead of surrendering to hopelessness, it is crucial to politicize ourselves and respond to eugenics.

Public health is a community effort. Each of us has a role to play. Individual actions, such as wearing masks and getting vaccinated, are not just personal decisions; they are decisions that impact the community as a whole.

It is essential to create spaces where people can express their fears and concerns about the pandemic. Addressing these concerns in an informed and empathetic way can help counteract nihilism.

Combating misinformation is vital. Providing accurate and accessible information about COVID-19 and its prevention measures can help change perceptions and motivate action.

It is crucial to highlight examples of resilience and collaboration within the community. Hope requires grieving.

Throughout the COVID-19 pandemic, there has been an idea that has consistently circulated, promoting the strategy of “individual rights,” consumer choice, limited government, and open markets, while normalizing infections as a way to “achieve immunity.”

This idea emerged before the rollout of vaccines and before we knew whether vaccines could prevent transmission of the virus, in addition to preventing severe illness or death. As our understanding has evolved, and we have realized that vaccines do not guarantee protection against infection and, on their own, would not stop community infections, the idea of focused protection gained acceptance beyond the conservative circles where it had been confined during the early stages of the pandemic.

We saw situations such as the declaration of victory by several governments over the pandemic in 2021. The removal of mask mandates in many countries in May 2021 created a perception of the “end of the pandemic” as a structural and social concept, before viral transmission was sufficiently low, before vaccination coverage was adequate, and before cases were truly under control. This idea has become dominant, suggesting that the best response is to allow the virus to spread among the population, relying on somehow protecting the vulnerable, as if at-risk people lived in a bubble separate from the rest of society. However, this is an unfeasible idea; you cannot protect the vulnerable without protecting everyone.

The problem with COVID-19 is that it is a disease that affects the population as a whole. Not only has the pandemic not ended, but many current plans focus on vaccines as the only tool to protect us, instead of utilizing all available strategies that complement vaccination. We have invested heavily in developing these innovative vaccines, but without providing the necessary non-pharmaceutical support to maximize their effectiveness. By applying only selective pressure on the virus, we are creating variants that jeopardize all the work done, both in the production of the vaccine and in its implementation.

The virus has not been defeated, and we are not reaching sufficient vaccination levels in the global population to eliminate non-pharmaceutical interventions, which are actions that both individuals and communities can take to help curb the transmission of viruses like the flu or COVID-19. These non-pharmaceutical interventions, also known as “community mitigation strategies,” are more effective at the community level and not when implemented under frameworks of “individual choice” and “personal responsibility.”

These interventions include, but are not limited to, requiring the use of masks, physical distancing, self-isolation, widespread access to testing and free masks, limiting the size of gatherings, mask mandates in public places and transportation, paid sick leave, childcare support, improvements to heating, ventilation, and air conditioning (HVAC) systems, air purifiers, eviction protections, support for remote work, expansions of health programs, unemployment support, rent freezes, and measures that ensure people can stay home if necessary. There are so many options that can be combined and adapted to the needs of each community.

However, since the fall of 2021, the trend has been to abandon non-pharmaceutical interventions in favor of an exclusively vaccination-based approach. When Omicron arrived, it hit at a time when our non-pharmaceutical protections were at their lowest, and as a direct result, we saw record levels of infections. A large portion of the population was infected during the Omicron wave in an incredibly short time, and there is no indication that they are protected against reinfections. It is not a viable plan to tell people to simply wait to get sick several times a year and abandon the most vulnerable. That is not a plan; it is social abandonment.

The status quo, which was already problematic before the pandemic, has not been significantly challenged.

The reality is that, under the political economy of health in many countries, healthcare and health, including population health, are conceptualized and applied in policies as something completely individualized, as a consumer good, and as a matter of personal responsibility. That “care” is distributed, not in a fair or equitable way, but based on how much care each individual can purchase, depending on their economic power, which includes socioeconomic factors like fundraising.

There have been no significant changes in the political economy of health globally. Everything we observe in the pandemic response reinforces this pattern, including the management of super-spreader events and the reluctance of authorities to respond promptly to regulatory challenges, which are often driven by arbitrary decisions from certain judges or officials. It is a structural pattern that continues to perpetuate itself.

I believe that one of the things we need to do is expand our demands on a global level. It is important to discuss and publicly highlight how persistent the anti-mask sentiment has become among various populations, including those who were previously critical of public health policies. This segment of the population, which was vocal in the early moments of the pandemic, now often downplays the severity of COVID-19.

Historically, we have seen that any success in containing the virus has been the direct result of collective pressure against pandemic policies that have not been effective. Now, those same policies—or even worse—are being proposed in different countries, but the social pressure to change these measures is not present. We know that giving space to indignation and normalizing demands for changes and new policies that keep people safe is an incredibly powerful socio-political force.

The anti-mask sentiment is often presented as a “personal preference” or a matter of “individual freedom,” but the reality is more complex. For people at high risk, such as the immunocompromised, safety is not just about avoiding infection. We cannot protect ourselves adequately if other people are not protected. It is essential that COVID transmission levels in the general community are low; it is not just about the freedom to wear or not wear masks, but about reducing the total amount of viral particles in the air. Every effort, even if not implemented perfectly, contributes to reducing the viral load in the community.

This is not just a public health emergency; COVID-19 is also a labor disaster. COVID is an airborne virus that attacks all the body’s organ systems, whether or not symptoms are experienced, and no matter how mild the initial symptoms may be. In fact, the virus becomes more lethal as it evolves, spreading unmitigated through our communities. Each time you get infected, your risk of permanent damage, or long COVID, increases. This damage may not be visible at first. But COVID causes brain damage, blood clots, strokes, heart attacks, and cancer. It is not like the flu: scientists now understand that its impact on the immune system is much more similar to HIV. And children are just as vulnerable.

Disabled people are not disposable. Our government has overlooked the serious health implications of COVID by telling us that only “high-risk” people should take precautions. (And if you’ve been infected before, you are now part of this category.) One in five cases will become long COVID. Everyone should be able to safely participate in public life. Mitigating COVID is our collective responsibility.

From the beginning, our utility as workers has been prioritized over our lives. It was “essential” workers who were not allowed to stay home and stay safe when we needed workers to run our grocery stores, hospitals, post offices, and fields. It is workers who continue to show up to work, only to get infected over and over again, worrying about childcare and rent and bills that must be paid. It is our bosses who do not protect us.

While many are ready to give up and succumb to pandemic nihilism, that is not the solution. COVID-19 is not just a risk for high-risk individuals; it is a risk for everyone. If authorities say that their priority is to keep people out of the hospital and protect vulnerable individuals, then the way to do this is by ensuring that everyone is safe from infections.

It is time to make those in power listen to us, and we must learn from other struggles against eugenics, such as the fight against HIV. We need to study the strategies and pressures that were applied in the HIV struggle and against other forms of eugenics, so we can learn from them and implement them. Support work is key; many people seek emotional support from people who don’t wear masks. Building community with those of us fighting against the eugenics of COVID is key; some of us are willing to do grassroots work and educate people who don’t wear masks, and others are not. And that’s okay. But it is important to focus on the collectives and individuals who are already fighting against COVID eugenics and give each other support. As I said, mass work is key—rather than spending time belittling people for their “indifference,” we must strive to understand people and find ways to connect with them and link them to the struggle, especially working-class people. It’s about finding ways to fight alongside them and, through that struggle, help them see the bigger picture. Your enemy wants to strip you of hope, and it begins by making you view your neighbors in the worst possible light. Look at them as whole people, humble yourself, and you’ll begin to regain your hope.

There has been a repeated narrative about focusing on vaccines as a reason for relaxation. This narrative minimizes the risk that COVID-19 represents and fosters the idea that the pandemic is over, when in reality the situation remains critical. It creates the perception that it is no longer necessary to maintain protective measures, which in turn leads to an increase in infections and complications.

Many policies are driven by austerity logic, and the media often frames approaches to health policy and any kind of public investment under the constant sense that there will never be enough resources for everyone. We must focus on people with the most complex needs and build our community protections around their needs, instead of those of the less vulnerable, as is happening in many parts of the world.

Capitalist rhetoric adheres to austerity logic, which holds that there will never be enough resources for everyone to receive an adequate response, or that there is no protective measure that is 100% effective, so it makes no sense to do anything if total effectiveness is not guaranteed. This logic is strange and, in fact, factually incorrect. It is crucial that people begin to challenge this narrative when they see it in the media.

For example, one of the arguments promoted by those who advocate for a “vaccinate and do nothing else” approach is that surgical masks are less effective than N95s, so they are not effective at all. While it is true that surgical masks are categorically less effective, that does not mean they are ineffective. Wearing a surgical mask, even if not done perfectly, is far better than wearing none at all. This is one of the “pandemic paradoxes” that has emerged and is often repeated in the media, undermining our political will for an effective COVID-19 response and affecting the cultural perception of what protections may look like.

It is essential to recognize that the pandemic is a population-wide issue. It requires solidarity, investment, collaboration, and solutions that address the needs of the entire community, not individualized approaches.

In reality, it can be considered more progressive to be against mitigation measures, as lockdowns of any kind tend to disproportionately affect people in poverty, even though COVID-19 also severely impacts these communities.

One of the things we are trying to break down and make accessible is how these simplistic arguments that emerge in the debate are actually distortions of the proposals made by those advocating for protections. COVID minimizers often take these logical paradoxes to extremes. We hear claims like: “Oh, people advocating for mask use really say that we should have lockdowns and masks forever.” Additionally, rhetoric like: “If masks are not 100% effective, then they are useless.”

All of these narratives create an environment where political will is weakened and limit the imagination of what could be possible, based on logics that are strange and unhelpful.

Furthermore, we need to talk about masks and accessibility.

It is really difficult to find masks that properly fit children in many parts of the world. This also applies to people who need to read lips, people with wider or smaller faces, people with beards, people with chronic pain who struggle to wear tight masks, people with ear pain... Masks have been created with specific bodies/minds in mind, which makes them more uncomfortable for groups that fall outside that norm. But this should not stop us or make us stay silent; on the contrary, we must talk about this repeatedly. It is essential to discuss different mask options and encourage mutual support to make masks accessible to people.

There has not been the necessary investment, research, and development to create masks that are truly well-fitting, comfortable, and easy to use for children. This is something that should have been funded immediately, but I don’t think it has received the same attention as pharmaceutical interventions like vaccine research and development.

The current situation with remote learning is challenging in many parts of the world. Teachers and students often lack the resources needed to make it effective. The reality is that many families preferred to protect their children from infection. And if we don’t offer people real options to do so, what right does that give them to “choose” a level of risk they feel comfortable with? We always frame this in terms of choice. The idea has been presented that we must choose between controlling the spread of the virus and the incalculable damage that could arise later, with or without the virus. However, there is clear, tangible, and visible harm that we are worsening by ignoring it.

The way to address issues like the failure of remote learning during the pandemic is to improve that modality and invest the intellectual and financial resources necessary to ensure that children are not left behind if they need to stay home. This extends to broader issues, as one of the biggest problems often not discussed is that when we hear experts say the real problem is not being able to close schools because of the impact on children, we should question why we didn’t focus on facilitating children’s education during a pandemic, no matter where they are. Instead of investing that effort into undermining teacher unions or manipulating concerned parents and teachers, it would be more effective to recognize the needs of those who are medically vulnerable and are also part of the school community.

The mask debate is, at its core, a discussion about human social and economic rights, not just for vulnerable people, but for everyone. It’s about the value our society wants to place on mutual protection against illness. This debate highlights the importance of recognizing our interdependence and how the suffering of some can be minimized, treated as an inevitable cost on the way to reopening, rather than addressing it as a matter of dignity and human rights.

The shift in the COVID-19 response toward individualistic frameworks of personal responsibility is, ultimately, a rejection of the right to social life for all those who have the right to refuse to consent to unnecessary infections and diseases in the name of their nations’ economic health. When I speak of social life, I’m not only referring to the right to socialize and spend time with friends, but to a broader notion of social rights that includes access to community spaces, active participation in decisions that affect our lives…

Current public health recommendations in many countries suggest that when cases are high, medically vulnerable people should, voluntarily, remove themselves from the community and social life to facilitate others’ participation without masks. This implies that the needs of those who require less protection are more important than those who require more, leading to vulnerable people having to give up their participation in social and economic life.

However, when surveys are actually conducted or people are engaged in dialogue, it becomes clear that this is not the general perception. People care about the well-being of their neighbors, friends, and coworkers. They don’t want to be the cause of someone getting seriously ill or dying. That narrative has largely been lost in the current approach to the pandemic. Finding a way to recover that sense of community is key to moving forward. It’s time to reflect on the mistakes of the early years and commit to improvement. Because what we’re doing now only contributes to the persistence of COVID. If we want to learn to live with the virus without it controlling our lives, we need to make strategic decisions about the protections we consider necessary to do so.

And to achieve this, we need to listen to the most vulnerable: to those who work in the food service industry, in nursing homes, to medically vulnerable people in various workplaces, and to those who simply don’t want to get sick repeatedly and face the impossibility of paying their bills because they can’t afford to take so much unpaid sick leave.

- Vaccines and Complexity

Saying that immunocompromised people do not respond adequately to vaccines, or that vaccines alone are not enough, is often misinterpreted as an anti-vaccine argument.

This framework has been present since April 2021 when studies began to emerge about immunosuppressed patients, such as those receiving medications like Rituxan. For example, many people with multiple sclerosis are on these treatments; hundreds of thousands of people rely on them. Studies showed that as the vaccines were rolled out, immunosuppressed people were not developing the same antibody response as those who were not immunosuppressed.

We also observed lower antibody responses in older adults. However, the discussion of these responses does not generate the same negative reaction that is observed when talking about the limitations of a strategy based solely on vaccines. These criticisms should be directed at political decisions, not at the pharmaceutical product itself. But, they are often misunderstood and contribute to a magical thinking that suggests that claims about the limitations of vaccines are seen as anti-vaccine rhetoric. In reality, this is an attempt to point out that the effectiveness of the vaccine is not just based on our wish for it to work, but depends on a broader, more supportive approach to addressing the pandemic.

Pretending that the vaccine is a panacea, in my opinion, contributes more to vaccine hesitancy than any immunocompromised person sharing their experience. However, for some, what’s more important is to discredit those who share stories that interrupt the “just get vaccinated” narrative, devaluing the voices of those who try to speak about how these policies affect their lives because it is uncomfortable. Personal narratives from immunocompromised people often highlight the structural inequities that persist in our societies.

As Travis Chi Wing Lau writes in Crippled Immunity: “Immunologists cannot continue to use the concept of the self uncritically without confronting its history and ideological implications. Immunology, in its continued adherence to the medical model of disability that diagnoses the immune system’s decline as a failure of the self, needs to confront the ableist foundations of its primary theoretical models. As global health organizations advance toward a viable HIV vaccine and pre-exposure prophylactics like Truvada become more popular, we still have the responsibility to de-stigmatize the HIV/AIDS status by validating its immunological difference.”

- Normality, Leftism, and the COVID Passport

Many people in various regions advocated for returning to normality and showed little real interest in defending immunocompromised or medically vulnerable individuals. This phenomenon is also seen in sectors that are supposedly committed to social justice and protecting vulnerable groups. This leads me to ask, what explains this? Many of the voices I hear are from people who are also medically vulnerable or public health professionals, but not from many prominent social justice advocates, whether politicians or journalists, expressing concern.

There has been an anarchist/communist inclination that has shown reluctance regarding vaccination passports, suggesting they might harm homeless people. At times, their message seems to appeal to an anti-vaccine sentiment. There’s a segment of the left that seems not to adequately consider vulnerable people, or that perceives anti-maskers as better representatives of the working class and their interests, as if both positions were opposed.

Conservatives who claim that “abortions should not be allowed, even in medical emergencies, to protect disabled people from selective abortions” demonstrate a kind of paternalism that ignores the reality that disabled people also make decisions about their reproductive health. This type of discourse often comes from those who say that protecting the vulnerable, many of whom are poor and working-class, is an offense to the working class as a whole. They ignore that, according to global data, a significant proportion of the population has some form of disability that affects their daily life.

It is a simplistic and misinformed analysis to claim that protecting medically vulnerable people goes against the needs of the working class. In fact, it is the opposite: if we truly want to support the working class, we must protect the most vulnerable, which means caring for everyone in situations like a pandemic. This misconception reflects the notion that the working class does not include people with disabilities.

This phenomenon is not exclusive to the current era; it has been present in many ideologies, including the thinking of Karl Marx. Marx and Engels, for example, conceptualize the surplus class as separate from the working class in their work. We should advocate for a framework where we can unite the struggles of the surplus class and the working class, recognizing that the divisions imposed between them are artificial and only benefit those in power.

These dynamics have existed for centuries, driving the devaluation of vulnerable lives or lives that generate fear for various reasons. Disability and chronic illness have historically been seen as existential threats to the health of the political body, represented as a “growing disease” affecting only a few. These cultural norms and stigmas are deeply rooted in sociopolitical life, reflected in the way we approach the pandemic and the limitations of certain analyses and political proposals. This includes a range of voices across the political spectrum, from those opposed to vaccines to those who support them, as well as conservative and left-wing politicians and grassroots leaders. This ideology is everywhere and does not discriminate. It is part of the legacy of the eugenics movement, which has promoted a model that prioritizes the elimination of vulnerable life rather than addressing the needs of those at a disadvantage.

Eugenics does not only manifest in reproductive control but also becomes a logic that justifies the state’s abandonment of those who need support, refusing to make changes to the built and social environment that would make life more accessible for all.

If we had a truly socialized healthcare system, it would not only focus on public funding for financial mechanisms but also aim to promote the health and social life of the population as a whole. This would include not only medical interventions but also the structural and social determinants of health. Adequate housing, clean air, and potable water are fundamental aspects of healthcare.

We need to start having these difficult conversations about who our policies truly benefit and begin to challenge and critique those who advocate for policies that are not inclusive of everyone. From our experience during the pandemic, we know that we cannot address every problem as if it were simply a matter of personal responsibility. This is the de facto policy not just in one country, but in many globally.

The issue that keeps arising, especially now, is that many, and particularly medically vulnerable people, not only feel left behind but also feel their reality and value are being questioned, in contrast to the political response, the social landscape, and the media coverage they are currently observing.

For example, some countries have changed their risk coding systems, adjusting their “community transmission” metrics to systems that, while similar in name, use completely different scales to measure infection. These changes do not reflect new scientific knowledge but a political intent to create a different perception of risk. For many people, this feels alienating and confusing. If it is assumed that these changes are made in good faith, the logic behind them is incomprehensible. It contradicts what so many people consider common sense about how COVID spreads: through the air. When COVID spreads, hospitals fill up, and people suffer. It is not just the unvaccinated who are affected, and the consequences are not solely attributable to COVID.

According to data from various global jurisdictions, there have been thousands of COVID deaths among vaccinated people, including those who have received boosters. For example, a significant portion of these deaths occurred in people who had already completed their vaccination series, challenging the narrative that this is a “pandemic of the unvaccinated.” The reality faced by many people daily, especially those working in essential services like food, education, healthcare, and retail, is very different from the simplified image presented.

In crisis situations, like the one we experienced with COVID, many people expect governments to respond to the needs of the most vulnerable. When they realize this is not happening, their faith in government institutions is shaken, leading them to feel that they are not part of the political body and that their lives don’t matter. This type of discontent can result in negative long-term consequences.

People have been convinced that they should not express their outrage. We like to think that real change happens when people are educated and silent, waiting their turn to speak, but this is not true. It is up to each of us to not consent to policies that we know will prolong the pandemic and suffering. Although it may seem like a small gesture, rejecting claims like, “If a mask is not 100% effective, it’s useless,” and having conversations about it is crucial. These rhetorical interventions are meaningful individual actions and a way to address personal responsibility in the fight against the pandemic.

For those who are medically vulnerable, it can be difficult to share their situation, and it should not be a burden for them to have to disclose their condition to ensure their safety. It is essential that people feel comfortable acknowledging their own experiences. We have witnessed this pandemic for years, and it is time to face the truth. We need to work towards a society that not only lives with COVID but thrives despite it.

COVID will not disappear; eventually, we will have to manage this reality. When will we do that? I don’t know, but the first step is to start having these conversations now. We must free ourselves from restrictive narratives that limit our political will and discourage people. Big ideas and bold plans can coexist with harsh political realities. We need ambitious demands that make us feel safe, not just those we consider feasible. It is time to aim higher and build a future that truly protects everyone.

The impact of air pollution on COVID-19 incidence, severity, and mortality: A systematic review of studies in Europe and North America - ScienceDirect

As the American West faces increasing air pollution, protecting the right to mask is vital - The Sick Times

Air pollution and long COVID: association with pulmonary function and radiological abnormalities 3–15 months post-COVID - ScienceDirect

Exposure to air pollution and COVID‐19 severity: A review of current insights, management, and challenges - PMC

Exposure to air pollution increases risk of long term health effects from COVID-19 infection. Air pollutants cause stress and inflammation of the respiratory and cardiovascular systems - two of the main systems that COVID targets. This means the damage to your lungs, heart, and bloodstream from air pollution essentially puts you at a disadvantage from already low odds of fully recovering from COVID-19 reinfections.

Air pollution could exacerbate COVID-19 prognosis in multiple ways. Both acute and long-term exposure to air pollution increase susceptibility to and severity of respiratory and cardiovascular diseases by increasing oxidative stress and inflammation (Ciencewicki and Jaspers, 2007; Mehta et al., 2013). Particulate matter can reach the alveolar sacs in the lungs and travel further into the bloodstream, causing an inflammatory response that triggers and exacerbates respiratory diseases, including COVID-19 (Lai et al., 2021).

The impact of air pollution on COVID-19 incidence, severity, and mortality: A systematic review of studies in Europe and North America

“The pollution [is] compromising the natural defenses of the body to infection, and that leads to more serious infections, or infections that happen that wouldn’t have otherwise happened.”

Afif El-Hasan pediatrician with Kaiser Permanente in Southern California and chair of the American Lung Association’s Public Policy Committee

As the American West faces increasing air pollution, protecting the right to mask is vital - The Sick Times

Oil refineries, wildfire smoke and winter inversions all contribute to Salt lake City’s poor clean air quality. Nationally, Salt Lake City was the ninth-worst city in the U.S. for ozone pollution and the 19th-worst city for short-term particle pollution in 2024, per the American Lung Association.

A growing body of research shows that polluted air is connected to poor reproductive outcomes, increased dementia risk, and more asthma attacks and other respiratory health effects.

Salt Lake City’s air quality is degrading

Historically, the Westside of Salt Lake City has faced greater environmental impacts due to a combination of industrial zoning, traffic congestion, and less green space. These conditions are partly a legacy of redlining and other harmful policies that concentrated low-income and minority communities in areas with higher pollution levels.

Studies show that short-term exposures, over hours or days, to fine particulate matter can cause cardiovascular events (strokes and heart attacks), hospitalization episodes (from shortness of breath, strokes, or heart attacks), and/or death. Long-term exposures, over months or years, can increase the risk of strokes, coronary artery disease, and premature death (American Lung Association, 2023)

The Power of Mobility: How Mobile Air Quality Monitors Reveal Neighborhood-Level Disparities

Particulate pollution also comes from dust blown from a variety of regional sources, including the dry lakebed of Great Salt Lake (hereafter “the Lake”), which has been polluted by decades of anthropogenic activity. Dust deposited in communities contains metals of concern for human health that come from the lakebed and other pollution sources

Contributions of Great Salt Lake Playa- and Industrially Sourced Priority Pollutant Metals in Dust Contribute to Possible Health Hazards in the Communities of Northern Utah.pdf