• Skip to main content
  • Skip to primary sidebar
virology blog

virology blog

About viruses and viral disease

Trial By Error: An Upcoming “Biopsychosocial” Long Covid Conference in Finland

23 February 2023 by David Tuller

By David Tuller, DrPH

What is it with the health care establishments in northern Europe? Why are they so devoted to non-evidence-based approaches to treating serious medical conditions? Why do they trust arguably fraudulent research, like the PACE trial and Professor Esther Crawley’s pediatric Lightning Process study? Why are the authors of these studies respected and even esteemed among some high-level circles in these countries?

The mind boggles.

The latest on this front is an upcoming gathering in Finland that provides a platform to leading lights of the CBT/GET/’amygdala retraining” ideological brigades. Sponsored by Helsinki University Central Hospital (HUS) and scheduled for March 16th, it is called “Navigating the Unknown: Exploring Realities and Best Practices for Long Covid.”

Here are some of the questions the conference promises to explore: “What is the difference between long Covid and Post Intensive Care Syndrome? What are the relations of Long Covid and chronic fatigue syndrome (ME/CFS)? Are there some risk factors for developing symptoms of Long Covid?” Well, that all sounds reasonable enough.

Then there’s this: “This symposium will focus on the bio-psycho-social aspects of this disorder.” Uh, oh! More biopsychosocial propaganda.

Millions Missing Finland, an ME/CFS advocacy organization, has tweeted concerns about the gathering. In a thread that highlighted the problematic views of most of those presenting, the organization noted that “we find the speaker list peculiar and worrying.”

The list of speakers is indeed problematic but not surprising.

A prominent HUS physician, Helena Liira, is opining about “the Finnish experience from the Long Covid outpatient unit.” Dr Liira and I exchanged e-mails last year after I criticized a clinical trial for which she is the lead investigator. The trial, sponsored by HUS, is studying an intervention for people with “functional” disorders, including long Covid. The intervention is described as “amygdala and insula retraining”–even though the study includes no effort to measure anything related to anyone’s amygdala or insula.

Dr Liira is essentially running a trial of the Gupta Program—one of the multiple mind-body approaches currently being marketed to people with chronic illnesses, including long Covid. The eye-catching claim—that amygdalae and insulae are being retrained–is solely a marketing device derived from grand-sounding but largely meaningless speculations about the brain by the Gupta Program’s founder, Ashok Gupta. Whatever might be happening, there is no evidence that any amygdalae or insulae have undergone retraining.

Dr Liira and the ethical review committee that approved the study apparently see no problem with describing an intervention as purporting to involve something as complex as “amygdala and insula retraining”–even though this has zero to do with the study itself. They don’t think this sort of promotional hyperbole can possibly bias any of the study subjects. I disagree. Since the trial is already flawed for multiple reasons, as I discussed here, this nomenclature issue simply further undermines the credibility of any findings.

**********

Professor Sharpe is having a Norma Desmond moment

Also on the Helsinki conference schedule is Professor Michael Sharpe, one of the lead investigators of the PACE trial. Professor Sharpe frames legitimate criticism of his disastrous study not only as “harassment” but as an attack on Science itself. Whatever. The relevant point is that PACE and its GET/CBT approach have been rejected by the US Centers for Disease Control and Prevention, the UK’s National Institute for Health and Care Excellence, and other leading health agencies. The PACE trial has been used as a pedagogical tool in epidemiology graduate seminars at UC Berkeley–as a case study in awful, unethical research. And 100+ experts from around the world signed Virology Blog’s open letter to The Lancet about PACE’s “unacceptable methodological lapses”–as reported in The Times and BMJ.

Nonetheless, this Oxford don is having his Norma Desmond moment! (Watch this clip from the Hollywood classic Sunset Boulevard if you don’t know what I’m talking about.)

Besides his upcoming appearance in Helsinki, two major features in high-profile US publications—New York Magazine and The New Republic—recently included respectful interviews with Professor Sharpe. The articles presented long Covid as largely a “functional” or psychosomatic disorder and allowed Professor Sharpe to spout some of his standard self-serving slop. Apparently the journalists believe it is fine for a study to include participants who were already “recovered” on key outcomes at baseline–as was the case in the PACE trial. Apparently the organizers of the Helsinki conference agree. Enough said.

And then we have Professor Paul Garner discussing “how to recover from long covid.” It has been surprising to watch the entire BPS world, which claims to care about evidence-based medicine, accept one person’s illness narrative as proof that everyone should be able to cure themselves with strong manly thoughts—just like Professor Garner. I wrote about him here.

A psychologist from Bergen, Norway, Professor Gerd Kvale, is offering a talk on “concentrated treatment” for long Covid. Professor Kvale and colleagues have developed a three-day rehabilitation program, conducted in small groups, involving “a combination of teaching, individual conversations and physical activity and training.” And this: “Understanding and acceptance of the health challenges combined with techniques that aim to increase flexibility and activity are important. In particular, emphasis is placed on recognizing and getting help to break patterns that can contribute to maintaining the ailments.”

Hm. Sounds like a concentrated program of CBT/GET to me, perhaps with a little amygdala and insula retraining thrown in.

Avindra Nath, who is intramural clinical director of the National Institute of Neurological Disorders and Stroke at the US National Institutes of Health and a leading long Covid investigator, is giving a remote presentation called “What is long covid?” Dr Nath’s participation in the event has generated some comment and discussion on social media. Given the conference’s frank embrace of the biopsychosocial approach, his appearance could be seen as lending legitimacy to this overall orientation. To counter any criticism, the organizers could point to Dr Nath’s appearance, and maybe that’s why they invited him.

On the other hand, there’s value in injecting some scientific and biomedical realities into this slate of presentations. Perhaps Dr Nath’s talk will highlight enough hard facts to inoculate at least some audience members from buying into the psychosomatic framework that will otherwise dominate the proceedings. 

In any event, among those who care about serious science in this domain, the conference certainly risks damaging the medical center’s international credibility and reputation. Sad.

.

Filed Under: Uncategorized Tagged With: Finland, gupta, liira, Long Covid, Sharpe

TWiV 985: Bambi’s revenge

19 February 2023 by Vincent Racaniello

TWiV reviews an outbreak of Marburg hemorrhagic fever in Equatorial Guinea, wild poliovirus type 3 shedding from a laboratory in the Netherlands, and white-tailed deer as a reservoir for previous SARS-CoV-2 variants of concern.

Hosts: Vincent Racaniello, Dickson Despommier, and Rich Condit

Click arrow to play
Download TWiV 985 (66 MB .mp3, 109 min)
Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email

Become a patron of TWiV!

Show notes at microbe.tv/twiv

Filed Under: This Week in Virology Tagged With: coronavirus, COVID-19, hemorrhagic fever, IPV, marburg virus, pandemic, poliovirus, poliovirus essential facility, SARS-CoV-2, variant of concern, viral, virology, virus, viruses, white-tailed deer

Trial By Error: Correctives from Putrino & Iwasaki (and Others) to the Long-Covid-Is-Psychosomatic Claims

18 February 2023 by David Tuller

By David Tuller, DrPH

When the pandemic began, everyone involved in the ME, CFS, and ME/CFS domain assumed that there would be a wave of post-acute, prolonged complications, since every virus seems to leave in its wake a small but still significant number of people who report a range of non-specific symptoms. It was also widely predicted that many in the medical world would interpret these physical complaints as psychosomatic, psychogenic, or “functional,” to use the current buzzword in this complicated field.

That has all come to pass.

[Read more…] about Trial By Error: Correctives from Putrino & Iwasaki (and Others) to the Long-Covid-Is-Psychosomatic Claims

Filed Under: David Tuller, ME/CFS Tagged With: Long Covid, new republic, new york magazine, Putrino, ryan prior

TWiV 984: Clinical update with Dr. Daniel Griffin

18 February 2023 by Vincent Racaniello

In his weekly clinical update Dr. Griffin discusses the political polarization of COVID-19 treatments among physicians and laypeople in the United States, seven alternatives to evidence-based medicine, Malawi’s cholera death toll crosses 1,300 in its deadliest outbreak on record, impact of coronavirus infections on pediatric patients at a tertiary pediatric hospital, maternal mRNA COVID-19 vaccination during pregnancy and delta or omicron infection or hospital admission in infants, yes masks reduce the risk of spreading infection, despite a review saying they don’t, COVID-19 and airborne transmission: science rejected, lives lost. can society do better, what were the historical reasons for the resistance to recognizing airborne transmission during the COVID-19 pandemic, a randomized trial comparing Omicron-containing boosters with the original COVID-19 vaccine mRNA-1273, SARS-CoV-2 neutralizing antibodies after bivalent vs. monovalent booster, the impacts of SARS-CoV-2 vaccine dose separation and targeting on the COVID-19 epidemic in England, intra-host evolution provides for the continuous emergence of SARS-CoV-2 variants, real-world use of Nirmatrelvir–Ritonavir in outpatients with COVID-19 during the era of Omicron variants including BA.4 and BA.5 in Colorado, viral burden rebound in hospitalized patients with COVID-19 receiving oral antivirals in Hong Kong, and guidance on the use of convalescent plasma to treat immunocompromised patients with COVID-19.

Click arrow to play
Download TWiV 984 (26 MB .mp3, 43 min)
Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email

Become a patron of TWiV!

Show notes at microbe.tv/twiv

Filed Under: This Week in Virology Tagged With: antiviral, coronavirus, COVID-19, delta, inflammation, influenza, Long Covid, monkeypox, monoclonal antibody, Omicron, pandemic, poliovirus, SARS-CoV-2, vaccine, vaccine booster, variant of concern, viral, virology, virus, viruses

Trial By Error: Once More Regarding Inflated FND Rates–and a Reprise of a Letter to a Yale Neurologist

11 February 2023 by David Tuller

By David Tuller, DrPH

Last July, I sent a letter to Benjamin Tolchin, a neurologist at Yale, about the statement, in a 2021 paper for which he was the lead author, regarding prevalence rates for functional neurological disorder (FND). Last month, I sent it again. I’ve still had no response.

I am reposting it below because related claims about the prevalence of FND has recently been highlighted by the charity FND Hope UK. The charity organized an FND Parliamentary Awareness Day, which took place on Wednesday of this week. Before the event, the organization sent out an appeal for people to write to their member of Parliament. The sample letter included in the appeal stated categorically that FND is “the second most frequent reason for a neurology outpatient appointment.”

[Read more…] about Trial By Error: Once More Regarding Inflated FND Rates–and a Reprise of a Letter to a Yale Neurologist

Filed Under: David Tuller, ME/CFS Tagged With: FND

Trial By Error: A Response to Call for “A New Paradigm” for Long Covid in Lancet Respiratory Medicine

2 February 2023 by David Tuller

By David Tuller, DrPH

Update, Feb 3rd:

After less than 24 hours, our letter was rejected by the journal. Here’s the message I received:

Dear Dr Tuller,

Thank you for your recent submission to The Lancet Respiratory Medicine. We have now had time to consider your manuscript and unfortunately, on this occasion, we have decided not to publish it because we have limited space in the journal and cannot give your paper priority over other letters we have in the pipeline.

Although this decision has not been a positive one, I thank you for your interest in the journal and hope it does not deter you from considering us again in the future.

Yours sincerely,

Dr. Emma Grainger
Editor-in-Chief, The Lancet Respiratory Medicine

**********

[Read more…] about Trial By Error: A Response to Call for “A New Paradigm” for Long Covid in Lancet Respiratory Medicine

Filed Under: David Tuller, ME/CFS Tagged With: Lancet, Long Covid, new paradigm

  • « Go to Previous Page
  • Go to page 1
  • Go to page 2
  • Go to page 3
  • Go to page 4
  • Interim pages omitted …
  • Go to page 416
  • Go to Next Page »

Primary Sidebar

by Vincent Racaniello

Earth’s virology Professor
Questions? virology@virology.ws

With David Tuller and
Gertrud U. Rey

Follow

Facebook, Twitter, YouTube, Instagram
Get updates by RSS or Email

Contents

Table of Contents
ME/CFS
Inside a BSL-4
The Wall of Polio
Microbe Art
Interviews With Virologists

Earth’s Virology Course

Virology Live
Columbia U
Virologia en Español
Virology 101
Influenza 101

Podcasts

This Week in Virology
This Week in Microbiology
This Week in Parasitism
This Week in Evolution
Immune
This Week in Neuroscience
All at MicrobeTV

Useful Resources

Lecturio Online Courses
HealthMap
Polio eradication
Promed-Mail
Small Things Considered
ViralZone
Virus Particle Explorer
The Living River
Parasites Without Borders

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.