Category: Health

Of all the nicknames I have for my cat Calvin—Fluffernutter, Chonk-a-Donk, Fuzzy Lumpkin, Jerky McJerkface—Bumpus Maximus may be the most apt. Every night, when I crawl into bed, Calvin hops onto my pillow, purrs, and bonks his head affectionately against mine. It’s adorable, and a little bit gross. Tiny tufts of fur jet into my nose; flecks of spittle smear onto my cheeks.

Just shy of a decade ago, cuddling a cat this aggressively would have left me in dire straits. From early childhood through my early 20s, I nursed a serious allergy that made it impossible for me to safely interact with most felines, much less adopt them. Just a few minutes of exposure was enough to make my eyes water and clog my nasal passages with snot. Within an hour, my throat would swell and my chest would erupt in crimson hives.

Then, sometime in the early 2010s, my misery came to an abrupt and baffling end. With no apparent interventions, my cat allergy disappeared. Stray whiffs of dander, sufficient to send my body into conniptions mere months before, couldn’t even compel my nose to twitch. My body just up and decided that the former bane of its existence was suddenly totally chill.

What I went through is, technically speaking, “completely weird,” says Kimberly Blumenthal, an allergist and immunologist at Massachusetts General Hospital. Some allergies do naturally fade with time, but short of allergy shots, which don’t always work, “we think of cat allergy as a permanent diagnosis,” Blumenthal told me. One solution that’s often proposed? “Get rid of your cat.”

My case is an anomaly, but its oddness is not. Although experts have a broad sense of how allergies play out in the body, far less is known about what causes them to come and go—an enigma that’s becoming more worrying as rates of allergy continue to climb. Nailing down how, when, and why these chronic conditions vanish could help researchers engineer those circumstances more often for allergy sufferers—in ways that are actually under our control, and not just by chance.

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All allergies, at their core, are molecular screwups: an immune system mistakenly flagging a harmless substance as dangerous and attacking it. In the classic version, an allergen, be it a fleck of almond or grass or dog, evokes the ire of certain immune cells, prompting them to churn out an antibody called IgE. IgE drags the allergen like a hostage over to other defensive cells and molecules to rile them up too. A blaze of inflammation-promoting signals, including histamine, end up getting released, sparking bouts of itching, redness, and swelling. Blood vessels dilate; mucus floods out in gobs. At their most extreme, these reactions get so gnarly that they can kill.

Just about every step of this chain reaction is essential to produce a bona fide allergy—which means that intervening at any of several points can shut the cascade down. People whose bodies make less IgE over time can become less sensitive to allergens. The same seems to be true for those who start producing more of another antibody, called IgG4, that can counteract IgE. Some people also dispatch a molecule known as IL-10 that can tell immune cells to cool their heels even in the midst of IgE’s perpetual scream.

All this and more can eventually persuade a body to lose its phobia of an allergen, a phenomenon known as tolerance. But because there is not a single way in which allergy manifests, it stands to reason that there won’t be a single way in which it disappears. “We don’t fully understand how these things go away,” says Zachary Rubin, a pediatrician at Oak Brook Allergists, in Illinois.

Read: What they aren’t telling you about hypoallergenic dogs

Tolerance does display a few trends. Sometimes, it unfurls naturally as people get older, especially as they approach their 60s (though allergies can appear in old age as well). Other diagnoses can go poof amid the changes that unfold as children zip through the physiological and hormonal changes brought on by toddlerhood, adolescence, and the teen years. As many as 60 to 80 percent of milk, wheat, and egg allergies can peace out by puberty—a pattern that might also be related to the instability of the allergens involved. Certain snippets of milk and egg proteins, for instance, can unravel in the presence of heat or stomach acid, making the molecules “less allergenic,” and giving the body ample opportunity to reappraise them as benign, says Anna Nowak-Węgrzyn, a pediatric allergist and immunologist at NYU Langone Health. About 80 to 90 percent of penicillin allergies, too, disappear within 10 years of when they’re first detected, more if you count the ones that are improperly diagnosed, as Blumenthal has found.

Other allergies are more likely to be lifers without dedicated intervention—among them, issues with peanuts, tree nuts, shellfish, pollen, and pets. Part of the reason may be that some of these allergens are super tough to neutralize or purge. The main cat allergen, a protein called “Fel d 1” that’s found in feline saliva, urine, and gland secretions, can linger for six months after a cat vacates the premises. It can get airborne, and glom on to surfaces; it’s been found in schools and churches and buses and hospitals, “even in space,” Blumenthal told me.

Read: The next weird way we’re changing cats

For hangers-on like these, allergists can try to nudge the body toward tolerance through shots or mouth drops that introduce bits of an allergen over months or years, basically the immunological version of exposure therapy. In some cases, it works: Dosing people with Fel d 1 can at least improve a cat allergy, but it’s hardly a sure hit. Researchers haven’t even fully sussed out how allergy shots induce tolerance—just that “they work well for a lot of patients,” Rubin told me. The world of allergy research as a whole is something of a Wild West: Some people are truly, genuinely, hypersensitive to water touching their skin; others have gotten allergies because of organ transplants, apparently inheriting their donor’s sensitivity as amped-up immune cells hitched a ride.

Part of the trouble is that allergy can involve just about every nook and cranny of the immune system; to study its wax and wane, scientists have to repeatedly look at people’s blood, gut, or airway to figure out what sorts of cells and molecules are lurking about, all while tracking their symptoms and exposures, which doesn’t come easy or cheap. And fully disentangling the nuances of bygone allergies isn’t just about better understanding people who are the rule. It’s about delving into the exceptions to it too.

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How frustratingly little we know about allergies is compounded by the fact that the world is becoming a more allergic place. A lot of the why remains murky, but researchers think that part of the problem can be traced to the perils of modern living: the wider use of antibiotics; the shifts in eating patterns; the squeaky-cleanness of so many contemporary childhoods, focused heavily on time indoors. About 50 million people in the U.S. alone experience allergies each year—some of them little more than a nuisance, others potentially deadly when triggered without immediate treatment. Allergies can diminish quality of life. They can limit the areas where people can safely rent an apartment, or the places where they can safely dine. They can hamper access to lifesaving treatments, leaving doctors scrambling to find alternative therapies that don’t harm more than they help.

But if allergies can rise this steeply with the times, maybe they can resolve rapidly too. New antibody-based treatments could help silence the body’s alarm sensors and quell IgE’s rampage. Some researchers are even looking into how fecal transplants that port the gut microbiome of tolerant people into allergy sufferers might help certain food sensitivities subside. Anne Liu, an allergist and immunologist at Stanford, is also hopeful that “the incidence of new food allergies will decline over the next 10 years,” as more advances come through. After years of advising parents against introducing their kids to sometimes-allergenic substances such as milk and peanuts too young, experts are now encouraging early exposures, in the hopes of teaching tolerance. And the more researchers learn about how allergies naturally abate, the better they might be able to safely replicate fade-outs.

One instructive example could come from cases quite opposite to mine: longtime pet owners who develop allergies to their animals after spending some time away from them. That’s what happened to Stefanie Mezigian, of Michigan. After spending her entire childhood with her cat, Thumper, Mezigian was dismayed to find herself sneezing and sniffling when she visited home the summer after her freshman year of college. Years later, Mezigian seems to have built a partial tolerance up again; she now has another cat, Jack, and plans to keep felines in her life for good—both for companionship and to wrangle her immune system’s woes. “If I go without cats, that seems to be when I develop problems,” she told me.

It’s a reasonable thought to have, Liu told me. People in Mezigian’s situation probably have the reactive IgE bopping around their body their entire life. But maybe during a fur-free stretch, the immune system, trying to be “parsimonious,” stops making molecules that rein in the allergy, she said. The immune system is nothing if not malleable, and a bit diva-esque: Set one thing off kilter, and an entire network of molecules and cells can revamp its approach to the world.

I may never know why my cat allergy ghosted me. Maybe I got infected by a virus that gently rewired my immune system; maybe my hormone levels went into flux. Maybe it was the stress, or joy, of graduating college and starting grad school; maybe my diet or microbiome changed in just the right way, at just the right time. Perhaps it’s pointless to guess. Allergy, like the rest of the immune system, is a hot, complicated mess—a common fixture of modern living that many of us take for granted, but that remains, in so many cases, a mystery. All I can do is hope my cat allergy stays gone, though there’s no telling if it will. “I have no idea,” Nowak-Węgrzyn told me. “I’m just happy for you. Go enjoy your cats.”

Hume AI scored $3 million from Northwell Holdings, the investment arm of New York-based health system Northwell Health, to continue developing machine learning models that aim to understand speech and expression.

WHAT IT DOES

The startup builds natural language-understanding tools that take text, audio, video or images and try to capture meaning, as well as emotion and other expressions. According to the company, some of its tools are meant to note feelings like surprise, pain or sarcasm, or to capture vocal sounds like gasps, sighs and laughs. 

Hume AI plans to use the capital to refine these ML models for healthcare, including clinical research, patient screening and accessibility technology.

“Technologies that draw upon the latest scientific research to help us better understand not just what people say, but how they say it, have profound potential to benefit patients,” Rich Mulry, CEO and president of Northwell Holdings, said in a statement.

“We already see rising demand for this technology in treatment, clinical research, telehealth applications and more. To promote the careful development of these potentially transformative technologies, we are excited to launch our partnership with Hume AI through an investment that reflects our confidence in Dr. Alan Cowen and his groundbreaking team.”

MARKET SNAPSHOT

As physicians report increasingly high levels of burnout, some startups have pushed AI-backed tools to cut down on their administrative work. Abridge, which offers a tool that records, transcribes and organizes information gleaned from conversations with patients, recently raised $12.5 million in Series A-1 funding.

Another voice assistant for doctors, Suki, announced it scooped up $55 million in Series C funding late last year.

Meanwhile, Northwell has been expanding its investments in AI. Last year, the health system partnered with Aegis Ventures on a joint venture focused on the use of AI to address quality, equity and cost problems in healthcare. Hume is also a portfolio company of Aegis Ventures. 

In April the startup studio and Northwell announced the launch of Ascertain, a platform that aims to develop and commercialize healthcare AI companies.

Northwell also recently announced a partnership with Google Cloud to use cloud technology and AI to automate administrative workflows and identify patient risk factors for early intervention.

Today, four astronauts headed to the International Space Station (ISS) as part of SpaceX’s 5th Commercial Crew mission will begin a six-month venture into space-based research.

Launched from NASA’s Kennedy Space Center, the Crew-5 astronauts brought multiple research investigations sponsored by the ISS National Lab. 

Throughout the mission, the astronauts will support hundreds of research and technology development investigations, several of which are sponsored by the ISS National Laboratory.

One such investigation is from biotechnology company Lambda Vision – a company that’s previously launched investigations into space – whose goal is to create a protein-based artificial retina that can restore vision for patients with degenerative eye diseases.    

“LambdaVision hopes to demonstrate that manufacturing the artificial retina by building multiple thin layers of protein on a surface in microgravity improves its overall uniformity,” according to a statement. 

Additionally, a study from Los Alamos National Lab in collaboration with ISS National Lab Commercial Service Provider Rhodium Scientific accompanied the astronauts. This investigation evaluates gut microbes, looking more deeply into specific gut microbes that only change in space. They could affect astronauts and future space travelers. The project builds upon the team’s prior study onboard the space station.

Over the next six months, the astronauts will work on the above investigations and dozens of other projects going to the space station on NASA-funded Commercial Resupply Services missions. 

“ISS National Lab-sponsored projects set to launch on upcoming missions will leverage the orbiting laboratory for research in life and physical sciences, advanced materials and technology development,” according to a statement.

THE LARGER TREND

As space exploration increases, health and safety concerns are prevalent, especially regarding long space missions.

Earlier this year, Brain.space, the maker of an EEG helmet, emerged from stealth with $8.5 million and a plan to measure the neurological activity of three astronauts aboard the ISS to assess the effects of spaceflight on the brain. Each astronaut was to participate in experiments before, during and after the mission.

To study astronauts’ health and performance during commercial spaceflights, the Translational Research Institute for Space Health (TRISH) at Baylor College of Medicine launched EXPAND (Enhancing eXploration Platforms and Analog Definition). This research platform collects data from flights and keeps it in a centralized database to improve the health of astronauts and find innovations for use on Earth.

When Rafy Evans, 25, was a teenager, she adopted a mantra to guide her blossoming career aspirations: “I want my work to be about my life, and I want my life to be about my work.”

Evans came of age in what she calls the “girlboss” era, idolizing female entrepreneurs like Nasty Gal’s Sophia Amoruso and Glossier’s Emily Weiss. After graduating college, she threw herself into demanding jobs in Los Angeles’ influencer economy, building a reputation for being available 24/7 and valuing career achievement above all else.

Today, however, Evans’ teenage slogan makes her cringe. After reading a recently published book that made her question the large role work played in her life, she quit her job in June and took a couple months off to rest and recover from burnout (a huge privilege, she acknowledges). She is currently building healthy boundaries between her personal life and her new job in public relations, and is working on “unlearning” the always-on mindset with which she started her career. “I’m just trying to achieve more peace,” she says. “That’s my big goal in everything that I’m doing.”

Evans isn’t alone in taking a step back from the corporate grind. First came the “Great Resignation,” followed recently by the phenomenon of “quiet quitting.” Many surveys have also pointed to a sense of malaise and fatigue sweeping the American workforce, apparently culminating in a common desire to do less.

Read More: Why a Class on Doing Nothing Is So Popular

For example, more than half of surveyed workers said they’re questioning the purpose of their jobs and the role work should play in their lives in a January report from research firm Gartner. As of July, roughly half of U.S. workers were looking for a new job, according to the Society for Human Resource Management (SHRM), and 29% of those who had recently resigned said they did so because they wanted better work-life balance. In the second quarter of 2022, only about a third of U.S. workers said they were engaged with their jobs, while almost 20% said they were actively disengaged—the lowest ratio of engagement to disengagement in about a decade, according to Gallup research. That could be because, according to other SHRM research, more than half of U.S. workers feel exhausted at the end of the day. It’s not hard to imagine how that exhaustion turns into a desire for a less-stressful job.

In essays and news articles, many people have described their newly lax attitudes toward work as a loss of ambition. But it’s hard to say whether ambition is actually dropping across the U.S. population, according to Timothy Judge, a professor at the Ohio State University’s Fisher College of Business who has studied the concept. There are some objective measures of ambition, and it can be measured in research if it’s well-defined, but Judge says that’s not often done. Some surveys that ask people to self-report their own ambition, however, suggest it’s alive and well. In a 2022 CNBC/Momentive poll, about half of female respondents and two-thirds of Black women described themselves as “very ambitious.”

Meanwhile, the idea of phoning it in at work is nothing new. The concept today known as “quiet quitting”—basically, staying at a job but doing the bare minimum—has shown up in research (often under some variation of the name “work withdrawal”) for decades, says John Kammeyer-Mueller, a professor at the University of Minnesota’s Carlson School of Management. Still, recent data on quit rates, work attitudes, and employee engagement do suggest our collective relationship with work has hit a rocky patch, Kammeyer-Mueller says.

As with nearly any societal shift observed over the last three years, the pandemic is one obvious explanation. But what, exactly, about the COVID-19 era has made people want to stop striving?

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For many people, the COVID-19 pandemic served as a giant pause button—and not everyone is eager to hit “play” again, says Natasha Crosby, a Texas-based therapist. “The pandemic forced people to slow down and actually evaluate their lives and how they were spending their time,” Crosby says. When they stopped for a moment, many high-achieving people saw all the things they’d been missing—time with loved ones, time to relax, time for hobbies—and decided there was a better way to live, Crosby says.

Remote work is a major factor in the current cultural shift, Kammeyer-Mueller agrees, but he thinks it’s for a different reason. Despite the narrative that working from home turns people into slackers, Kammeyer-Mueller thinks the problem is actually that people are working too much at home, burning out, and pulling back from their careers as a result. Being physically separated from coworkers may also make people feel less committed to their jobs, which zaps their motivation to put in extra effort, he says.

But “people are still motivated to achieve things; they just don’t want to do it at work as much anymore,” Kammeyer-Mueller says. Anecdotally, he’s noticed many people doubling down on hobbies and creative projects, instead of pulling extra hours at the office.

Read More: Forget Physique. Mental Health Is the Newest, Hottest Fitness Goal

Of course, not everyone was able to work from home and find new hobbies during the pandemic—and renouncing ambition is an undeniably privileged position to be in, since many people can’t afford to slow down. Nonetheless, it isn’t just remote office workers who are going through a reckoning, federal data show. From April 2020 to November 2021, quit rates were highest among people working in industries like food service, hospitality, and retail.

In many cases, however, hourly and essential workers aren’t quitting because of “angst about ambition,” says Stefanie O’Connell Rodriguez, a journalist who writes a newsletter about ambition. They’re quitting because they don’t want to work jobs that provide few benefits and barely pay the bills. That may help explain why workers at Amazon and Starbucks are unionizing, and why many Great Resigners are taking advantage of labor shortages to negotiate for better-paying jobs.

Even for privileged, white-collar office workers, O’Connell Rodriguez thinks it’s not as simple as people spontaneously “losing” their ambition. She believes the current discourse is about a rupture in the social contract, a mass realization brought on by the pandemic that working hard doesn’t always guarantee stability and enough savings to weather an emergency. “It’s a reckoning with the workplace, and it’s a reckoning with the social safety net more broadly,” she says. “When your health care is tied to your employment and you get laid off in a pandemic,” it’s natural to reevaluate the way you spend most of your waking hours.

Read More: The Pandemic Changed Paid Sick Leave, But Not For Everyone

Income inequality is also worse than it’s ever been, adds Jacques Forest, a psychologist and professor at the University of Quebec in Montreal who studies motivation and ambition. When a handful of very rich people hold more wealth than the vast majority of the population, he says, it leads to questions like, ‘Why should I kill myself at my job’” if it won’t pay off?

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Is it healthy to break up with ambition? Here, too, opinions vary.

In 2012, Judge, the Ohio State professor, and Kammeyer-Mueller, the University of Minnesota professor, published a study based on data from a group of 700 people who agreed to be tracked for decades. They found that ambition was strongly linked to career achievement, and was also associated—albeit to a lesser extent—with life satisfaction. “Usually when somebody describes someone else as ‘ambitious,’ it insinuates [something] derogatory,” Judge says. “But I think the evidence does not necessarily support that view.” Instead, his research suggests that ambitious people are just as likely to be happy as their more easygoing counterparts.

“Ambition, in and of itself, is not bad,” Forest agrees. The “what” and “why” behind that ambition—the goal someone is striving toward and their motivation for doing so—often matter more. In scientific research, ambition is often assessed by measuring someone’s desire for higher education, career success, prestige, or income. But striving outside the professional realm may actually be healthier, Forest says.

Forest is a proponent of self-determination theory, which argues that humans’ key psychological needs are autonomy, competence, and relatedness (or connection with other people). Self-determination research suggests that ambition can be positive if it fulfills those needs, such as through doing work that feels meaningful or pushing for productive changes in one’s community. But if people are striving due to external motivators—like money, prestige, or social status—they’re likely to feel unfulfilled and may even act in antisocial ways, research shows. (There are exceptions, such as people who aspire to make enough money to lift themselves out of poverty or give charitably, Forest says.)

Read More: Why Doctors Are Prescribing Nature Walks for Stress

To Forest, it’s a good thing that many people are thinking critically about work and, in some cases, choosing to scale back. “When you see people renounce ambition, that’s [usually] the mainstream American capitalist ambition,” he says. “And if people are dropping out of this, that’s good news.”

Still, work is inescapable for most of us. And O’Connell Rodriguez thinks it’s dangerous for people to think they’ve simply stopped being ambitious on an individual level without considering larger cultural factors, like unsustainable workloads, unfair or unsafe working conditions, and health care being tied to employment. “When you misdiagnose the problem, you cannot come up with an effective solution,” O’Connell Rodriguez says. “It takes the responsibility away from the employer, from the culture, and the government to address everything that is contributing to this burnout, resignation, and loss of ambition.” Burnout researchers have known for years that workers can’t “self-care” their way out of the problem; employers have to make systemic changes for sustained progress.

Those changes are happening in some industries, buoyed by unionization efforts and employees pushing for higher salaries and better working conditions. But the progress has been slow and hard-won, leading some people who can afford to step back to forgo corporate ladder-climbing in favor of more satisfying social, family, or personal lives. That’s not necessarily bad, O’Connell Rodriguez says, but it’s also a choice people shouldn’t have to make.

“How do we enable a system,” she asks, “where we’re allowed to experience ambition in all facets of our lives?”

Evans, the public-relations rep redefining her relationship to work, is asking herself similar questions. She wonders how her life might look now if she’d had a more balanced outlook in her teens and early twenties, rather than buying into hustle culture. She’d probably have carved out more time for her personal writing, she thinks, and devoted more time to leisure and relationships that had nothing to do with networking.

She’s trying to find those things now, and is determined not to let her career take over her life again. “I look back now,” she says, “and I don’t know why I ever glorified your life being like this.”

Write to Jamie Ducharme at [email protected].

(PORTLAND, Maine) — Wildlife agencies in the U.S. are finding elevated levels of a class of toxic chemicals in game animals such as deer—and that’s prompting health advisories in some places where hunting and fishing are ways of life and key pieces of the economy.

Authorities have detected the high levels of PFAS, or per- and polyfluoroalkyl substances, in deer in several states, including Michigan and Maine, where legions of hunters seek to bag a buck every fall. Sometimes called “forever chemicals” for their persistence in the environment, PFAS are industrial compounds used in numerous products, such as nonstick cookware and clothing.

The U.S. Environmental Protection Agency launched an effort last year to limit pollution from the chemicals, which are linked to health problems including cancer and low birth weight.

Read More: Want to Stop the Next Pandemic? Start Protecting Wildlife Habitats

But discovery of the chemicals in wild animals hunted for sport and food represents a new challenge that some states have started to confront by issuing “do not eat” advisories for deer and fish and expanding testing for PFAS in them.

“The fact there is an additional threat to the wildlife—the game that people are going out to hunt and fish—is a threat to those industries, and how people think about hunting and fishing,” said Jennifer Hill, associate director of the Great Lakes Regional Center for the National Wildlife Federation.

PFAS chemicals are an increasing focus of public health and environmental agencies, in part because they don’t degrade or do so slowly in the environment and can remain in a person’s bloodstream for life.

The chemicals get into the environment through production of consumer goods and waste. They also have been used in firefighting foam and in agriculture. PFAS-tainted sewage sludge has long been applied to fields as fertilizer and compost.

In Maine, where the chemicals were detected in well water at hundreds of times the federal health advisory level, legislators passed a law in 2021 requiring manufacturers to report their use of the chemicals and to phase them out by 2030. Environmental health advocates have said Maine’s law could be a model for other states, some working on their own PFAS legislation.

California Gov. Gavin Newsom, a Democrat, signed a bill in September that bans the chemicals from cosmetics sold in the state. And more than 20 states have proposed or adopted limits for PFAS in drinking water, according to the National Conference of State Legislatures.

Read More: How to Find Out If Your Drinking Water Is Safe

More testing will likely find the chemicals are present in other game animals besides deer, such as wild turkeys and fish, said David Trahan, executive director of the Sportsman’s Alliance of Maine, a hunting and outdoors advocacy group.

The discovery could have a negative impact on outdoor tourism in the short term, Trahan said. “If people are unwilling to hunt and fish, how are we going to manage those species?” he said. “You’re getting it in your water, you’re getting it in your food, you’re getting it in wild game.”

Maine was one of the first states to detect PFAS in deer. The state issued a “do not eat” advisory last year for deer harvested in the Fairfield area, about 80 miles (129 kilometers) north of Portland, after several of the animals tested positive for elevated levels.

The state is now expanding the testing to more animals across a wider area, said Nate Webb, wildlife division director at the Maine Department of Inland Fisheries and Wildlife. “Lab capacity has been challenging,” he said, “but I suspect there will be more facilities coming online to help ease that burden — in Maine and elsewhere in the country.”

Wisconsin has tested deer, ducks and geese for PFAS, and as a result issued a “do not eat” advisory for deer liver around Marinette, about 55 miles (89 kilometers) north of Green Bay. The state also asked fishermen to reduce consumption of Lake Superior’s popular rainbow smelt to one meal per month.

Some chemicals, including PFAS, can accumulate in the liver over time because the organ filters the chemicals from the blood, Wisconsin’s natural resources department told hunters. New Hampshire authorities have also issued an advisory to avoid consuming deer liver.

Read More: Industrial Farming Causes Climate Change. The ‘Slow Food’ Movement Wants to Stop It

Michigan was the first state to assess PFAS in deer, said Tammy Newcomb, senior executive assistant director for the Michigan Department of Natural Resources.

The state issued its first “do not eat” advisory in 2018 for deer taken in and near Oscoda Township. Michigan has since issued an advisory against eating organs, such as liver and kidneys, from deer, fish or any other wild game anywhere in the state. It has also studied waterfowl throughout the state in areas of PFAS surface water contamination.

The state’s expanded testing also has proven beneficial because it helped authorities find out which areas don’t have a PFAS problem, Newcomb said.

“People like to throw up their arms and say we can’t do anything about it. I like to point to our results and say that’s not true,” Newcomb said. “Finding PFAS as a contaminant of concern has been the exception and not the rule.”

The chemical has also been found in shellfish that are collected recreationally and commercially. Scientists from the Florida International University Institute of Environment sampled more than 150 oysters from around the state and detected PFAS in every one, according to their study in August. Natalia Soares Quinete, an assistant professor in the institute’s chemistry and biochemistry department, described the chemicals as “a long-term poison” that jeopardizes human health.

Dr. Leo Trasande, a professor of pediatrics at NYU Grossman School of Medicine who has studied PFAS, said the best way to avoid negative health effects is reducing exposure. But, Trasande said that’s difficult to do because the chemicals are so commonplace and long-lasting in the environment.

“If you’re seeing it in humans, you’re likely going to see the effects in animals,” he said.

Wildlife authorities have tried to inform hunters of the presence of PFAS in deer with posted signs in hunting areas as well as advisories on social media and the internet. One such sign, in Michigan, told hunters that high amounts of PFAS “may be found in deer and could be harmful to your health.”

Kip Adams, chief conservation officer for the National Deer Association, said the discovery of PFAS in states like Maine and Michigan is very concerning to hunters.

“With the amount of venison my family eats, I can’t imagine not being able to do that,” Adams said. “To this point, everything we’ve done has been about sharing information and making sure people are aware of it.”

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Associated Press climate and environmental coverage receives support from several private foundations. See more about AP’s climate initiative here. The AP is solely responsible for all content.

Contact us at [email protected].

The Centers for Disease Control and Prevention reported that American life expectancy had taken a nosedive during the pandemic, with the biggest drop occurring among non-Hispanic American Indians and Alaska Natives. It was reassuring to see coverage of this terrible trend; but largely absent was the context and history underlying these disparities. The reasons why indigenous people were hit hardest by COVID-19 go beyond the fact that they also have very high rates of underlying comorbidities—like obesity, high blood pressure, diabetes, and cardiovascular disease. Instead the roots of health disparities among indigenous people are inextricably linked with the complex history of our nation’s mistreatment of indigenous peoples.

I cared for Native patients at Indian Health Service and tribal health facilities in Arizona, New Mexico, and Maine before the COVID-19 pandemic. I saw firsthand how the doctrine of Manifest Destiny—the belief that colonial settlers had a divine right to eliminate indigenous peoples and appropriate their lands—has been an engine for sickness and death, even today, centuries after our nation was founded.

Manifest Destiny was widespread attack on indigenous lands and peoples. The U.S. military forced relocations of Native peoples disrupting native foodways of hunting, fishing, gathering, and farming. The military intentionally targeted indigenous food sources, destroying crops and livestock. “We were seen as the enemy. And so we were fed like prisoners of war,” said Martin Reinhardt, a professor at Northern Michigan University. The people were given measly rations of flour, sugar, salt, and lard—the ingredients to make fry bread, what many think is a traditional indigenous food, but is in fact a food of oppression, cooked up out of necessity. Later, the U.S. government would provide “commodity foods”—mystery meat, canned vegetables, and yellow cheese—to fulfill their treaty obligations. These commodity foods would become staples of Native kitchens and lead to sky-high rates of obesity, high blood pressure, diabetes, and cardiovascular disease among indigenous peoples.

In the 1800s and early 1900s, as settlers moved west, the federal government dammed rivers and built reservoirs, siphoning water away from the tribes. “The Hoover Dam providing electricity, damming up Colorado River. So you have access to power, access to water. And this is how the West was created,” said Amber Crotty, a Navajo Nation Council delegate. Water is a precious commodity, especially out west. Without access to safe water, indigenous people haul water by truck over long distances or turn to unsafe sources tainted by contaminants ranging from bacteria to uranium. They might not wash their hands or bathe as frequently, increasing their risk for various infections. It’s hard to prepare food safely. They might drink diabetes-promoting sugar-sweetened beverages because they’re cheaper than bottled water.

Indigenous lands have also been under the assault of extractive industries in search of natural resources like uranium and oil. Abandoned uranium mines now dot the southwest. The radioactive waste still hasn’t been cleaned up. Native people exposed to the toxins suffer from higher rates of lung cancer and other cancers, scarring of the lungs, asthma and emphysema, blood disorders, birth defects, and more. In other parts of the country, the oil and gas industry has driven up cancer rates while also destroying the shoreline, displacing indigenous peoples yet again.

Missing in the media coverage of dropping American life expectancy was that among indigenous people, deaths from unintentional injuries, mostly drug overdose deaths, were almost tied with deaths from COVID-19, followed closely by chronic liver disease and cirrhosis, largely related to alcohol use.

Long before the so-called “diseases of despair”—alcohol-related liver disease, drug overdoses, and suicide—drove down life expectancy among low-income, less-educated white non-Hispanic Americans at the beginning of the 21st century, these same afflictions were killing indigenous peoples. The causes are similar: the destruction of a way of life and the decline of family and community. Despair comes from “the loss of meaning, of dignity, of pride, and of self-respect,” write Anne Case and Angus Deaton in Deaths of Despair and the Future of Capitalism. Family separations and the loss of cultural knowledge and identity caused an epidemic of despair among indigenous peoples that’s been passed down over generations.

The attack on indigenous peoples evolved over time. It began with overt genocide—“the only good Indian is a dead one” said General Philip Sheridan in the 1860s. Then came the era of assimilation. “Kill the Indian in him, and save the man,” said Captain R. H. Pratt, the founder of the Carlisle Indian Industrial School, which like so many other Indian boarding schools, sought to “civilize” Native children. Indigenous children were separated from their families and sent to boarding schools or fostered or adopted out to non-Native families. Later in the 20th century, more sophisticated tools were used to control the population, like contraception and even forced sterilization. Indigenous peoples have “…a fear that white doctors don’t have your best interests at heart. And those are not fears that came from nowhere. Those are fears that were passed down from generation to generation,” said Sarah Deer, a Muskogee Creek citizen and a professor at the University of Kansas. Just as mistrust has been a barrier to engagement with the health care system among other communities of color, so, too, is it among indigenous communities.

The violence against Native peoples continues. They are twice as likely to be victims of homicide as other racial and ethnic groups in the U.S., and more than 40% of those murder victims are killed by someone of another race, in sharp contrast to homicide victims of other races who are largely killed by persons of their same race. About half of indigenous women experience intimate partner violence and sexual violence, with over 95% non-Native perpetrators. “Non-natives, in particular white men, know they can come into tribal communities and they can hunt us as Native women with impunity, because they know that we can’t touch them,” said Lisa Brunner, an enrolled member of the White Earth Ojibwe Nation in Minnesota.

Tribal reservations are often in remote places. The FBI doesn’t go out to investigate unless a major crime has been committed, and even then, U.S. Attorneys Offices are far less likely to prosecute crimes perpetrated in Indian Country, including violent crime, than elsewhere. “…[I]magine your own community where certain people didn’t have to abide by the law. And what does that do to a community, when that happens?” said Alfred Urbina, attorney general for the Pascua Yaqui tribe. Victims of violent crime are more likely to adopt high-risk coping behaviors like alcohol and drug use. They’re also more likely to experience poor mental health, chronic pain, diabetes, high blood pressure, and other chronic conditions.

Much of this history has been brushed aside and forgotten. What we’re left with are public health statistics taken out of context and medical diagnoses whose socio-pathophysiology we don’t fully understand. And so, our prescriptions and treatment plans fail. Victor Lopez-Carmen, a Hunkpati Dakota-Yaqui student at Harvard Medical School, says he’s often been told, “[I]f we only will stop eating the bad foods, if we’ll only stop smoking, if only stop drinking, if we’ll only behave ourselves, then we’ll have better health outcomes.” But that’s not why Native people are sick and dying.

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One of my favorite places on earth is the Ali’i Kula Lavender farm on Maui. I went there on a lark, not even expecting to enjoy it. My wife dragged me there on a trip years ago—she’s a huge essential oils fan and particularly lavender oil fan—and I fell in love. It’s acre upon acre of rolling hills covered in lavender fields, Buddhist shrines, meandering trails, and great views of the ocean. And always, in the background and foreground, is the fragrant scent of lavender. Any stress melts away (not that the stress is much an issue in Hawaii) and you’re perfectly content just wandering calmly through the fields. Every time you brush against a plant the scent intensifies and follows you for a bit.

The stress-melting effects couldn’t have just been from the lavender—the walking, the fresh air, the fact that I was on vacation in Hawaii all played a large role—but the lavender was also a factor.

But how? Are there ways to get those same benefits without visiting a lavender farm in the middle of the Pacific Ocean?

Yes. Lavender oil, or lavender essential oil, contains the essence of the lavender plant—all the aromatic constituents that provide the pharmacological effects we see from the whole plant.

The Benefits of Lavender Oil

Lavender Oil Reduces Anxiety

Lavender oil aromatherapy is one of the most common treatments for surgery or medical treatment-related anxiety.

In dental patients nervous about treatment, lavender oil aromatherapy reduces anxiety. This is also effective in children with anxiety undergoing dental treatment. Other studies confirm this effect.

Not all studies are positive. The pre-surgery lavender oil inhalation for general anxiety sometimes works, sometimes doesn’t, but the balance of evidence shows that it probably helps. One interesting study found that lavender oil aromatherapy before a medical procedure reduced anxiety, stress, and pain levels while improving oxygen saturation.

Oral lavender oil can also work. Oral lavender oil seems just as effective (without the side effects, like drowsiness and extreme addiction) as Xanax at reducing general anxiety. In Germany, oral lavender oil is considered to be a legitimate treatment for anxiety disorders.a

It’s mixed, then, but I think the evidence is fairly strong that lavender oil can reduce anxiety in people.

Lavender Oil Lowers Stress

It seems that reduction in stress I felt wasn’t just placebo or a result of me being on vacation in Hawaii. The bulk of published research finds that lavender has real effects on biomarkers and subjective sensations of stress.

In one study, smelling either lavender or rosemary essential oils for 5 minutes lowered cortisol levels in human subjects. Lavender was far more potent than rosemary, with a 1000x dilution of lavender being just as effective as a 10x dilution of rosemary.

In another study, lavender essential oil inhalation was also effective at reducing math test-induced rises in a biological stress marker.

In subjects undergoing needle insertion, those who wore an oxygen mask with lavender oil aroma pumped through it experienced less subjective stress. Furthermore, the pain of getting injected was reduced.

Subjects in another study watched a stressful video. Half of them underwent lavender oil aromatherapy during the video while half did not. Those who got the lavender oil had reduced stress markers compared to those who didn’t get the lavender oil.

After heart surgery, however, lavender oil aromatherapy has little to no effect on most markers of stress, other than a mild reduction in blood pressure.

Lavender Oil Increases Wound Healing

Lavender oil actually increases expression of an essential wound healing factor known as transforming growth factor beta. After wounding rats (I know, it sounds bad), researchers applied lavender oil to the wound. By day four, collagen deposition had increased along with the presence of fibroblasts (which help lay down collagen).

Overall, the bulk of research finds that lavender oil can speed up wound healing, increase growth factors at the wound site, and improve collagen synthesis. Even when it doesn’t speed up healing any better than control, it does appear better at reducing pain and improving comfort during the healing process. Slow wave sleep is very important for learning, memory consolidation, and muscle recovery.

Other studies have found that lavender oil inhalation can improve sleep quality, counter insomnia, and even increase melatonin levels. Wearing a lavender oil aromatherapy patch at night improves wakefulness in the morning.

If you’re interested in using aromatherapy for sleep, my wife loves the Vagus Nerve Pillow Mist. I can never bring myself to buy it for myself, but I’ll certainly borrow hers for a spray or two. Spray this stuff on your pillow before bed and you’ll get a great night’s sleep. This isn’t just lavender oil, but the lavender oil is quite prominent and responsible for many of the effects.

How to Use Lavender Oil

There are a few different ways to use lavender oil.

Aromatherapy

The simplest way to do “aromatherapy” is to open the bottle of lavender oil and smell it. Quite literally just hold it up to your nose and sniff whenever you get a hankering. However, most studies have subjects smell the lavender for 5-10 minutes for the strongest effects. You can also use a diffuser or wear an aromatherapy patch.

Oral

Most lavender oils aren’t meant to be consumed orally. I’m not saying they’ll hurt you, but that’s not their intended use so I can’t suggest that you try it. You can take a dedicated oral lavender oil supplement.

Massage

Simply add a few drops of lavender oil to your massage oil of choice—about 2 drops for every tablespoon of carrier oil. Olive oil, jojoba, MCT, avocado, or coconut all make great massage oils.

Direct application

If you’re trying to heal a wound, directly apply a drop or two of lavender oil mixed in a tablespoon of carrier oil (just like the massage oil) and apply that to the wound.

Who Shouldn’t Use Lavender Oil?

For most people, lavender oil is a risk-free essential oil that may help with wound healing, anxiety, stress, and sleep.

I would caution against using lavender oil products on children, as lavender oil may have estrogenic effects if used to excess. A number of studies have even found links between lavender oil exposure and early breast growth—in both girls and boys. To be fair, the children in these studies were exposed to high levels of lavender fragrance on a daily basis for years on end.

I would also recommend against using lavender oil on a daily basis, particularly for men. Use as needed, not chronically. You don’t want chronic estrogen increases.

That’s about it, folks. I hope you have good success if you give lavender oil a try.

Take care.

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As a pulmonary specialist, I spend most of my clinical time in the hospital—which, during pandemic surges, has meant many long days treating critically ill COVID-19 patients in the ICU. But I also work in an outpatient clinic, where I also treat those same sorts of patients after they’re discharged: people who survived weeks-long hospitalizations but have been dealing ever since with lung damage. Such patients often face the same social and economic factors that made them vulnerable to COVID-19 to begin with, and they require attentive care.

Patients like these undoubtedly suffer what researchers have been calling post-acute sequelae of SARS-CoV-2, or PASC—which, according to one highly publicized recent CDC study, afflicts some 20 percent of COVID-19 survivors ages 18 to 64. Other studies have yielded lower estimates of the condition also called long COVID, and while differences in study methodology account for some of this variability, there’s a more fundamental issue eluding efforts to uncover the one “true” estimate of the likelihood of this condition. Quite simply, long COVID isn’t any one thing.

From the April 2021 issue: Unlocking the mysteries of long COVID

The wide spectrum of conditions that fall under the umbrella of long COVID impedes researchers’ ability to interpret estimates of national prevalence based on surveys of symptoms, which conflate different problems with different causes. More importantly, however, an incomplete and constrained perspective on what long COVID is or isn’t limits Americans’ understanding of who is suffering and why, and of what we can do to improve patients’ lives today.

The cases of long COVID that turn up in news reports, the medical literature, and in the offices of doctors like me fall into a few rough (and sometimes overlapping) categories. The first seems most readily explainable: the combination of organ damage, often profound physical debilitation, and poor mental health inflicted by severe pneumonia and resultant critical illness. This serious long-term COVID-19 complication gets relatively little media attention despite its severity. The coronavirus can cause acute respiratory distress syndrome, the gravest form of pneumonia, which can in turn provoke a spiral of inflammation and injury that can end up taking down virtually every organ. I have seen many such complications in the ICU: failing hearts, collapsed lungs, failed kidneys, brain hemorrhages, limbs cut off from blood flow, and more. More than 7 million COVID-19 hospitalizations occurred in the United States before the Omicron wave, suggesting that millions could be left with damaged lungs or complications of critical illness. Whether these patients’ needs for care and rehabilitation are being adequately (and equitably) met is unclear: Ensuring that they are is an urgent priority.

Recently, a second category of long COVID has made headlines. It includes the new onset of recognized medical conditions—like heart disease, a stroke, or a blood clot—after a mild COVID-19 infection. It might seem odd that an upper respiratory tract infection could trigger a heart attack. Yet this pattern has been well described after other common respiratory-virus infections, particularly influenza. Similarly, various types of infections can lead to blood clots in the legs, which can travel (dangerously) to the lungs. Respiratory infections are not hermetically sealed from the rest of the body; acute inflammation arising in one location can sometimes have consequences elsewhere.

But mild COVID-19 is so common that measuring the prevalence of such complications—which also regularly occur in people without COVID-19—can be tricky. Well-controlled investigations are needed to disentangle causation and correlation, particularly because social disadvantage is associated both with COVID exposure and illnesses of basically every organ system. Some such studies, which analyzed giant electronic-health-record databases, have suggested that even mild COVID-19 is at least correlated with a startlingly wide spectrum of seemingly every illness, including diabetes, asthma, and kidney failure; basically every type of heart disease; alcohol-, benzodiazepine-, and opioid-use disorders; and much more.

To be clear, this research generally suggests that such complications occur far less often after mild COVID-19 cases than severe ones, and the extent to which the coronavirus causes each such complication remains unclear. In other words, we can surmise that at least some of these complications (particularly vascular complications, which have been well-described in many studies) are likely a consequence of COVID-19, but we can’t say with certainty how many. And more importantly, we don’t yet understand why some people with mild COVID recover easily while others go on to experience such complications. However, an estimated 81 percent of Americans have now been infected at least once, so the public-health ramifications are large even if COVID causes only some of the aforementioned recognized diseases, and even if our individual risk of complications after a mild infection is modest. Regardless of cause, patients who do develop any such chronic diseases require attentive, ongoing medical care—a challenge in a nation where 30 million are uninsured and even more underinsured.

Another category of long COVID is something rather more quotidian, if still very distressing for those experiencing it: respiratory symptoms that last longer than expected after an acute upper-respiratory infection caused by the coronavirus, but that are not associated with lung damage, critical illness, or a new diagnosis like a heart attack or diabetes. Symptoms such as shortness of breath and chest pain are common months after run-of-the-mill pneumonia unconnected to the coronavirus, for instance, while many patients who contract non-COVID-related upper respiratory infections subsequently report a protracted cough or a lingering loss of their sense of smell. That a COVID-related airway infection sometimes has similar consequences only stands to reason.

Read: Long-haulers are fighting for their future

However, none of these may be what most people think of when long COVID is invoked. Some may even argue that such syndromes are not, in fact, long COVID at all, even if they cause long-term suffering. “Long Covid is not a condition for which there are currently accepted objective diagnostic tests or biomarkers,” wrote Steven Phillips and Michelle Williams in the New England Journal of Medicine. “It is not blood clots, myocarditis, multisystem inflammatory disease, pneumonia, or any number of well-characterized conditions caused by Covid-19.” Instead, for some the term may invoke a chronic illness—a complex of numerous unexplained, potentially debilitating symptoms—even among those who may barely have felt sick with COVID in the acute phase. Symptoms may vary widely, and include severe fatigue, cognitive issues often described as brain fog, shortness of breath, “internal tremors,” gastrointestinal problems, palpitations, dizziness, and many other issues around the body—all typically following a mild acute respiratory infection. If the other forms of long COVID seem more easily explainable, this type is often characterized as a medical mystery.

Teasing apart which kind of long COVID a person has is important, both to advance our understanding of the illness and to best care for people. Yet lumping and splitting varieties of long COVID into categories is not easy. A given patient’s case might have features of more than one of the types that I’ve described here. Some patient advocates and researchers have tended to exclude patients in the first category—that is, survivors of protracted critical illness—from their conception of COVID long-haulers. I would argue that, insofar as we define long COVID as lasting damage and symptoms imposed by SARS-CoV-2, the full variety of severe long-term manifestations should be included in its scope. “Clinical phenotyping” studies now under way may eventually help scientists and doctors better understand the needs of different types of patients, but patients in all categories deserve better care today.

The biological mechanisms by which an acute coronavirus upper respiratory infection might lead to a bewildering range of chronic, burdensome symptoms even in the aftermath of mild infections are debated. Some scientists, for instance, believe that the virus causes an autoimmune disease akin to lupus. Meanwhile, one group of researchers has argued that even a mild respiratory infection from SARS-CoV-2 causes tiny clots to block tiny blood vessels all over the body, depriving tissues of oxygen throughout the body. Still others believe that the coronavirus causes a chronic infection, as such viruses as HIV or hepatitis C do. Meanwhile, some have emphasized the possibility of structural brain damage. While some published studies have provided support for each theory, none has been adequately validated as a central unifying thesis. Each is, however, worth continuing to explore.

A recently published investigation, conducted at the National Institutes of Health, suggests that clinicians and scientists should consider additional possibilities as potential drivers of symptoms for at least some patients. The researchers found far higher levels of physical symptoms and mental distress among subjects who had had COVID (many with long COVID) than among those who had not. Yet symptoms could not be explained by basically any test results: Researchers found effectively no substantive differences in markers of inflammation or immune activation, in objective neurocognitive testing, or in heart, lung, liver, or kidney function. And yet these patients were suffering from such symptoms as fatigue, shortness of breath, concentration and memory problems, chest pain, and more. Notably, researchers did not identify viral persistence in the bodies of patients reporting troublesome symptoms.

What this means in practice is that there are some people suffering from long COVID symptoms without evidence of structural damage to the body, autoimmunity, or chronic infection. Psychosocial strain and suffering, moreover, appears common in this population. Even pointing this out is sensitive territory—it leads some people to wrongly suggest that long COVID is less severe or concerning than those suffering from it describe, or even to question the reality of the illness. And, understandably, the invocation of psychosocial factors as potential contributing factors to suffering for some individuals may make patients feel as though they are being second-guessed. The reality, though, is that psychosocial strain is an important driver of physical symptoms and suffering—one that clinicians should treat with empathy. All suffering, after all, is ultimately produced and perceived in one place: our brain.

Severe depression, for instance, can inflict debilitating and severe physical symptoms of every sort, including crushing fatigue and withering brain fog, and is itself linked to having had COVID-19. And notably, a recent study in JAMA Psychiatry found that pre-infection psychosocial distress—e.g. depression, anxiety, or loneliness—was associated with a 30–50 percent increase in the risk of long COVID among those infected, even after adjustment for various factors. A false separation of brain and body has long plagued medicine, but it does not reflect biological reality: After all, diverse neuropsychiatric processes are associated with numerous “physical” changes, ranging from reduced blood flow to the brain to high (or low) levels of the stress hormone cortisol.

Illnesses of any cause that result in protracted time off one’s feet can also instigate (likely in conjunction with other factors) reversible cardiovascular deconditioning, wherein the blood volume contracts and the amount of blood ejected by the heart with each squeeze falls—changes that can lead to a racing heart rate or faintness when standing, as decades of studies have shown. Diverse neurological symptoms can also be produced by a glitch in the function rather than the structure of the brain—or what has been described as problems of brain “software” rather than “hardware”—resulting in conditions known as functional neurological disorders. Similar glitches, known as functional respiratory disorders, can disturb our breathing patterns or cause shortness of breath, even when our lungs are structurally normal. My point is not to speculate on some overarching hypothesis to explain all symptoms among all patients with long COVID. The whole point is that there’s unlikely to be just one. And there is still much to learn.

Research is underway to better understand this spectrum of illnesses, and their causes. But whichever diverse factors might be contributing to patients’ symptoms, we can take steps—both among clinicians and as a society—to improve lives now. Social supports can be as important as medical interventions: For those unable to work, qualification for disability assistance should not depend on a particular lab or lung-function test result. All patients with long-COVID symptoms deserve and require high-quality medical care without onerous cost barriers that may bankrupt them, which further compounds suffering. Universal healthcare is, that is to say, desperately needed to respond to this pandemic and its aftermath.

Additionally, while no specific long-COVID medications have emerged, some treatments may be helpful for improving certain symptoms regardless of the specific type of illness, such as physical rehabilitative treatments for those with shortness of breath or reduced exercise tolerance. Ensuring universal access to such specialized rehabilitative care is essential as we enter the next stage of this pandemic. So is helping patients avoid the emerging cottage industry of dodgy providers hawking unproven long-COVID therapies. Health-care professionals also need more education about the broad spectrum of COVID-19-related issues, both to improve care and reduce stigmatization of patients with all types of this illness.

Read: The pandemic after the pandemic

Doctors and scientists still have much to learn about symptoms that continue—or first turn up—months or weeks after an initial COVID infection. What’s clear today is that long COVID can be many different things. That may confound our efforts to categorize it and discuss its implications, but the sheer variety should not get in the way of care for all who are suffering.