The 10-30% is pure junk reporting and usually requires including people who have a cough that persists for a month after infection or non-specific symptoms like brain fog. I've had coughs that lasted two months after an infection from other diseases - it sucked, but in the long run I was fine. Now, a cough lasting a year would indeed be something else and far more terrible, but it sure as hell isn't 10-30% of people who have symptoms that last a year after covid.
I don't know about everything else you mention, but dismissing brain fog is very dangerous. It can make you completely unable to think clearly for extended periods of time, and thus completely unable to work. In general it makes no sense to me we dismiss diseases that are "non-specific" (i.e. poorly understood) while ignoring the magnitude of the harms. I'm much more worried about getting something poorly understood.
Not dismissing it, I had brain fog for three months and it was terribly disconcerting. I say 'nonspecific' because it can be caused by a huge number of things, including extreme stress or burnout or anxiety, and because most people will still eventually recover with sufficient time. It's like fatigue after EBV - very few actually develop CFS.
In other words, having symptoms for 3-6 months sucks, I don't deny it, but with the very likely prospect of recovery for most it's not the worst thing. Anecdotally though I don't know a single person who has had covid who is still reporting any symptoms after ~2 months (n=~20).
Fair enough. I've heard about it happening. I've seen how it's underreported, so I suspect it's undercounted.
I understand others may want to take the gamble that, while there are short and medium term symptoms, Covid has minimal long term effect. Until there's much better research that doesn't make sense to me. I'd rather take the known small suffering of wearing a mask and avoiding indoor activities instead of accepting the unknown risk of never being able to code large projects, climb, or hike for the rest of my life.
My 'case' is that the persistence of long covid is absolutely not guaranteed and most people will recover. It's people making it out like it's a death sentence or going to last for the rest of their lives that are causing huge amounts of psychological damage at the moment. Spare a moment for the people who will recover but have to live with the opinions of so many on the internet that no, in fact, they're utterly and completely doomed. Does wonders for preventing horrible, profound depression. Does it need to be said that becoming horribly depressed does few wonders for improving health conditions?
They may start there, but they don't end there. You can objectively measure many symptoms (e.g. physical exams, blood tests, cognitive tests).
Once you start extending symptoms to "unverifiable claims made by the patient", it can be very real for the patient, but you can never eliminate the possibility that the mind is creating the symptom, and nothing is physically wrong.
That "fatigue" is one of the most common "long covid" symptoms, for example, is confounded by the fact that fatigue is one of the major symptoms of depression.
And where do you imagine this "mind" exists which is separate from physical reality for it to exist while "nothing is physically wrong"?
The answer of course, is that there is no such thing. Perhaps the fatigue/depression is due to issues with neurotransmitters or the organs that regulate them, neurons, blood oxygen levels, blood-brain barrier issues, brain structure, nerves in other parts of the body, endocrine function, etc.
If we figured out tomorrow that we could treat it with an injection of B vitamins or a pill of serotonin or a session of magnetic therapy or a fecal transplant to change the patient's gut microbiome or whatever new thing, then you could easily point to the "physically wrong" thing which was causing it. But treating "the mind" as a separate, non-physical thing is no different than suggesting some other supernatural, non-physical thing like God or spirits or curses is causing it.
My point isn't to get into a debate about metaphysics. I only emphasized that to head off the usual sorts of criticisms that get flung at someone who points out (correctly) that psychosomatic illness is a real thing. Symptoms caused by the mind are still real symptoms. They just aren't caused by a virus.
Also, the existence of a treatment no more implies the existence of a physical mechanism than the existence of a placebo implies the existence of magic. Every illness is a mixture of biological and psychological factors, and simply feeling like someone is caring for you can cure even intransigent symptoms.
Is Covid causing depression? Nobody knows. But leaping to the conclusion that it is -- and therefore we must do X,Y or Z in response -- is irresponsible when there's a more parsimonious explanation: people have have just lived through a mass cultural event that is causing a great deal of depression, everywhere.
Not a junk symptom, I said it's junk reporting. Real figures where people are quite disabled are low single digits in the worst case. A mild but persistent cough that lasts for a few months is hardly disabling even though some people will count it as 'long covid'.
Brain fog is very real, and I never said it was not.
Coughs notably persist beyond the illness that causes them - they can become self perpetuating by causing inflammation that in turn makes you cough. I've found taking cough drops is a great way to break this cycle.
So... yeah, persistent cough is a non-symptom, and I suspect a decent amount of long COVID research is a function of perverse incentives in medical research.
