One of Long COVID’s Most Misunderstood Symptoms
Ed Yong on what makes brain fog so unforgiving
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Brain fog is one of the most destructive symptoms of long COVID—and one of the most misunderstood. In a recent story, our staff writer Ed Yong explains why the condition should not be conflated with depression, stress, and other experiences that some observers and medical professionals have compared it with.
But first, here are three new stories from The Atlantic.
Cognitive Collapse
Brain fog “wasn’t even included in the list of possible COVID symptoms when the coronavirus pandemic first began,” Ed Yong writes. “But 20 to 30 percent of patients report brain fog three months after their initial infection … And it can affect young people in the prime of their mental lives.”
The condition has a vague-sounding name, but it’s not just an umbrella term for various mental problems. The neurologist Joanna Hellmuth explained to Ed that brain fog is almost always a disorder of “executive function”—the group of mental abilities that includes focusing, holding information in one’s mind, and blocking out distractions. “These skills are so foundational that when they crumble, much of a person’s cognitive edifice collapses,” Ed reports.
When Ed spoke with brain-fog patients, he heard stories about minds sputtering and stalling in the middle of tasks that were once easy. One was texting when she suddenly realized she didn’t understand a friend’s latest message; another said she was unable to load a dishwasher, because, as Ed writes, “identifying an object, remembering where it should go, and putting it there was too complicated.”
Ed’s article explores how the medical community has failed in its approach to brain fog—and what we know about possible paths toward relief. His story is worth reading in full. (Many people with brain fog find reading long articles difficult, so Ed recorded an audio version, which has been embedded into his article.)
Ed told me what he’s learned since he published the article. (This interview is condensed from a phone conversation and follow-up email.)
Isabel Fattal: Tell me a bit about the response you’ve received.
Ed Yong: I’ve had a flood of messages in my inbox and on social media from people who feel seen, or who now understand what’s been happening to them, or who are relieved that a major publication has validated their often-dismissed experiences, or who now have language for talking about their experiences, or who’ve finally got something to use to explain their lives and needs to their friends, colleagues, or doctors.
This happens every single time I write about long COVID, other complex chronic illnesses, immunocompromised people, and other such groups. It’s immensely gratifying, but also profoundly sad. There are so many people out there in considerable pain, who haven’t been given the slightest trace of grace or understanding. I’m glad pieces like this can help, but I want to help make a world where they’re unnecessary.
Isabel: Were there any interesting patterns that arose in the responses?
Ed: I mentioned in the piece that many things can lead to the same exact constellation of brain-fog symptoms other than COVID, including myalgic encephalomyelitis/chronic fatigue syndrome, fibromyalgia, HIV infections, chemotherapy, and epileptic seizures. Several people have written in to say that they’ve also experienced the executive-function problems I’ve described as a result of concussions and traumatic brain injuries, menopause, and severe ADHD.
Isabel: As you note in the piece, there’s a real lack of research and understanding about this aspect of long COVID. Where should readers look to keep up with new research or attempts to understand the condition?
Ed: I would encourage people who are new to brain fog to find communities of people who have experience with the symptom. They are deep repositories of kindness and wisdom. A lot of people wrote in to say that they’ve felt so alone. But they need not be. In the words of Fiona Robertson, one of the people I interviewed, “Come to the disability community; we’ve got you.”
Isabel: Zooming out a bit, you wrote last year that “when I began to cover COVID-19 in 2020, it became clear that the usual mode of science writing would be grossly insufficient.” How has the pandemic changed science writing for you?
Ed: Science is not a neutral, passive accumulation of facts. It’s a human endeavor, and it is profoundly influenced by who gets to be a scientist in the first place, our cultural norms and values, the qualities and the concepts that we bring into it. Science cannot be dissociated from the rest of society. This was clear to me many years ago, but it became undeniable and crucial during the pandemic, when so many of our failings have come from thinking of this solely as a medical problem. A lot of my work is about telling the stories of how we know what we know, and how the culture of the medical world has contributed to the kind of dismissal that many people with long COVID or other chronic illnesses experience.
Related:
Today’s News
- Ukrainian President Volodymyr Zelensky visited the newly liberated city of Izium in Kharkiv, five days after Ukraine’s forces recaptured it.
- The West Virginia Legislature passed a near-total abortion ban yesterday, making it the second state to pass a new ban since the reversal of Roe v. Wade.
- Queen Elizabeth II’s coffin was transported to the Palace of Westminster, where her body will lie in state until Monday’s funeral.
Dispatches
- Wait, What?: Democrats finally have the upper hand in the culture wars, Molly Jong-Fast writes.
- Up for Debate: Conor Friedersdorf asks: What might Vladimir Putin do next?
- The Weekly Planet: Think twice about working for a “climate villain,” Robinson Meyer warns.
Evening Read
How to Keep Your Book Club From Becoming a Wine Club
By Emma Sarappo
Imagine this familiar scenario: A book club has decided to meet at an appointed time and place. A host has lit candles, set wine and cheese on a table, arranged chairs in a circle, and put on background music. The guests arrive, maybe holding hardcovers with stiff spines or library-laminated dust jackets. The room fills with chatter as attendees grab their glasses and sit. Then there’s some silence, some twiddling of thumbs, some sipping. Finally, the truth comes out: No one has read the book. Maybe the readers skimmed the title in question but found it boring. Maybe this is the second, or the fifth, month in a row this has happened. Someone might break the tension by asking another member about their job, or relationship, and soon the whole affair devolves into a social meetup, or—worse—things go quiet. Perhaps the club stops meeting altogether, or the gatherings end up so off-course, the group may as well just have gotten dinner together, no reading involved.
More From The Atlantic
Culture Break
Read. Summer Sisters, an adult novel by Judy Blume in which she notches up her writing’s complexity and emotional resonance.
Watch. Flatbush Misdemeanors, on Showtime, an astute—and, sadly, just-canceled—portrait of daily life in Brooklyn.
Or check out the other options on our list of 15 underseen TV shows you should watch.
P.S.
While I had Ed on the phone, I asked him to tell me about something from the science world that has filled him with a sense of wonder or possibility recently. He told me about leafhoppers, which he writes about in his latest book: “They’re little insects that sit on plants and send vibrational signals through the plants.” But these signals aren’t sounds in the traditional sense, he explained; you can’t hear them, even if you lean in close.
“The idea that the plants around us, in every park, in every garden, are thrumming with these beautiful, inaudible songs that have been around for millions of years is truly magical to me,” he said. I took a walk after talking with Ed, and the experience did feel a little different.
—Isabel