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fitness

Former Long Island firefighter Sarah Apgar develops firehose fitness tool Fitfighter, wins big on ‘Shark Tank’

PORT WASHINGTON, Long Island (WABC) — A former volunteer firefighter from Long Island just won big on ABC’s “Shark Tank” for her new fitness device, which was inspired by her time as a firefighter.

Sarah Apgar, of Port Washington, is the creator of Fitfighter and the Steel Hose.

When Apgar joined the Halesite Volunteer Fire Department in 2012, she noticed the firehouse didn’t have a structured strength training program. Apgar served as a platoon commander in Iraq with the U.S. Army, so she was familiar with regimented strength and weight training programs.

She began using firehoses around the firehouse to train her colleagues.

Throughout the next few years, Apgar began developing a fitness device based upon the firehose. She used real firehose material and filled it with recycled steel shot. She called it the Steel Hose.

The longer the hose, the heavier it is. They range in weight from 5 pounds to 50 pounds.

Local gym owners and trainers started to hear about the product.

“It started to sort of snowball and we sort of thought, wow, I think we’ve got a really special valuable tool here that has applications far reaching beyond where we started for firefighters,” she said.

In 2019, Apgar, a mother of two young girls, sold $45,000 worth of the product.

When COVID struck last spring, Apgar developed an online training platform for the Steel Hose.

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In April and May, she did $40,000 in sales.

Around that time, Apgar received a phone call from producers of “Shark Tank.” They were intrigued with the product and with Apgar’s story. They invited her to appear on the show.

“It’s the dream come true, pinch-yourself-story that people describe,” she said.

The episode was filmed in August and aired November 13.

During the episode, guest Shark Daniel Lubetzky, the creator of KIND bars, bit on Apgar’s offer of $250,000 for a 15 percent stake in Fitfighter.

He offered $250,000 for a 25 percent stake.

Apgar accepted.

Since then, sales have skyrocketed for the Steel Hose and thousands of people purchased memberships to FitFighter’s online training platform. Apgar has 10 trainers. She also leads virtual classes out of her warehouse in Port Washington.

Apgar said she is on a mission to change the way people think about strength training and make them aware of the benefits it can have on people’s physical and mental health.

“I just want people to start moving and moving with weight and learning the principals of strength training,” she said.

Apgar still markets the Steel Hose to fire departments.

She said the FDNY Fire Academy has been using them for the past five years.

“I’m really proud of that. It’s very really special me,” she said.

Apgar said the majority of the production of the Steel Hose will be moving to South Carolina, but some will stay in Port Washington.

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health

Lung damage found in COVID dead may shed light on ‘long COVID’



a blurry image of a man: FILE PHOTO: An X-ray of a COVID-19 patient's lungs at United Memorial Medical Center in Houston


© Reuters/CALLAGHAN O’HARE
FILE PHOTO: An X-ray of a COVID-19 patient’s lungs at United Memorial Medical Center in Houston

By Kate Kelland

LONDON (Reuters) – A study of the lungs of people who have died from COVID-19 has found persistent and extensive lung damage in most cases and may help doctors understand what is behind a syndrome known as ‘long COVID’, in which patients suffer ongoing symptoms for months.

Scientists leading the research said they also found some unique characteristics of SARS-CoV-2, the virus that causes COVID-19, which may explain why it is able to inflict such harm.

“The findings indicate that COVID-19 is not simply a disease caused by the death of virus-infected cells, but is likely the consequence of these abnormal cells persisting for long periods inside the lungs,” said Mauro Giacca, a professor at King’s College London who co-led the work.

The research team analysed samples of tissue from the lungs, heart, liver and kidneys of 41 patients who died of COVID-19 at Italy’s University Hospital of Trieste between February and April 2020.

In a telephone interview, Giacca said that, while his research team found no overt signs of viral infection or prolonged inflammation in other organs, they discovered “really vast destruction of the architecture of the lungs”, with healthy tissue “almost completely substituted by scar tissue”.

“MASSIVE” DAMAGE

“It could very well be envisaged that one of the reasons why there are cases of long COVID is because there is vast destruction of lung (tissue),” he told Reuters. “Even if someone recovers from COVID, the damage that is done could be massive.”

Growing evidence from around the world suggests that a small proportion of people who have had COVID-19 and recovered from their initial infection can experience a range of ongoing symptoms including fatigue, brain fog and shortness of breath. The condition is often called “long COVID”.

Giacca said almost 90% of the 41 patients had several characteristics unique to COVID-19 compared to other forms of pneumonia.

One was that patients had extensive blood clotting of the lung arteries and veins. Another was that some lung cells were abnormally large and had many nuclei – a result of the fusion of different cells into single large cells in a process known as syncytia.

The research, published in the journal Lancet eBioMedicine, also found the virus itself was still present in many types of cells.

“The presence of these infected cells can cause the major structural changes observed in lungs, which can persist for several weeks or months and could eventually explain ‘long COVID’,” Giacca said.

(Reporting by Kate Kelland, editing by Gareth Jones)

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health

Employers are rethinking sick leave, work from home policies to protect COVID-19 ‘long haulers’

As the COVID-19 pandemic continues to devastate the United States, many employers are reevaluating their sick leave, work from home and disability policies to accommodate their employees, especially those now known as COVID-19 “long haulers.”

Working from home has become the de facto policy of many white-collar job employers, but employees in blue-collar or essential jobs may still be required to show up in person. This has brought up complex and thorny questions about how employers should best protect their workers while on the job.

The novel coronavirus has also brought up concerns about companies’ traditional sick leave policies. At this time, if employees do get sick with the virus, they could turn out to be asymptomatic, they could get sick and then quickly recover or they could experience aggressive symptoms and need further care. Some may need more time to recuperate than the standard two weeks of paid sick leave allows.

Some people could experience symptoms for weeks or months, and could end up needing long-term disability coverage; these people are the ones now being referred to as COVID-19 long haulers.

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“The first concern of all employers should be for the health and safety of their employees,” said Dr. Sachin Jain, an internal medicine physician, the CEO of SCAN Health Plan and the former CEO of CareMore. “Employees who return to work too soon put both their own health and the health of their co-workers at risk.”

Different companies are choosing to manage these COVID-19 complications in different ways, and many are reconsidering their in-person work setups.

“Companies should encourage employees to track their symptoms, share that information with their physicians and take [medical] leave as appropriate,” said Dr. Asha S. Collins, the U.S. country head for country clinical operations at Genentech. “We still have a lot to learn about this virus.”

PHOTO: A doctor consults a patient in this stock photo. (STOCK PHOTO/Getty Images)
PHOTO: A doctor consults a patient in this stock photo. (STOCK PHOTO/Getty Images)

When an employee becomes a COVID-19 long hauler, employers should encourage him or her to stay home in isolation, so as to protect his or her colleagues and family members.

“If an employee has symptoms of COVID-19, their employer should work with them to ensure that they have the time and space they need to recover from their illness before they return to the office,” said Jain.

According to some experts, COVID-19 could be considered a chronic illness if a person has persistent symptoms.

“[They] fall into the same category as any chronic illness with lingering requirements to have persistent care,” said Dr. Ken Abrams, the managing director and chief medical officer at Deloitte.

Employers should be prepared for this, and — if they don’t already — make sure they have policies in place to ensure that those with chronic illness are not discriminated against, Abrams said.

“It is important for us to promote the importance of recognizing the difference between infectious versus recovered, and should not be discriminating against

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medicine

The long shadow of racism in medicine leaves Black Americans wary of a COVID-19 vaccine




a close up of a sign


© Yahoo News



As the coronavirus pandemic has progressed, and the need for a vaccine has become more urgent and apparent, the number of Americans who say they would take such a vaccine keeps falling. In particular, Black Americans — who have been among those hit hardest by the pandemic — are resistant to the idea. A new Yahoo News/YouGov poll found that only 27 percent of Black Americans and 46 percent of white Americans plan to get a coronavirus vaccine if and when one becomes available.  

The perceived politicization of the vaccine process and unprecedented pace of Operation Warp Speed has led to doubts nationwide. Until very recently, President Trump was predicting that a vaccine could arrive ahead of Election Day, Nov. 3, contradicting members of his own coronavirus task force, who have repeatedly given less optimistic time frames that have turned out to be more realistic. 

But whether a vaccine is ready next month or next year, many Americans may not trust it, even after it is approved by the Food and Drug Administration. A Kaiser Family Foundation survey published in September found that 62 percent of Americans worry that political pressure from the Trump administration will lead the FDA to rush to approve a coronavirus vaccine without making sure it’s safe and effective. Whether that will change if a new administration is in office after Jan. 20 remains to be seen.

Dr. Peter Marks, director of the Center for Biologics Evaluation and Research at the FDA and self-proclaimed “FDA point person on COVID-19 vaccines,” wrote an op-ed Tuesday in USA Today attempting to alleviate those concerns.

“We hope to ensure public confidence in COVID-19 vaccines by being transparent about FDA’s decision-making process,” he wrote. “Whether a vaccine is made available through an EUA [emergency use authorization] or through a traditional approval, FDA will ensure that it is safe and effective.

“Trust means everything.”

Trust, experts say, is crucial to Americans’ willingness to accept a COVID-19 vaccine. But for many Black Americans, that trust will be difficult to earn after a long history of exploitation and abuse by the health care system has led them to be wary of the U.S. medical establishment. 



Bill Clinton wearing a suit and tie: Herman Shaw speaks during ceremonies at the White House on May 16, 1997, in which President Bill Clinton apologized to the survivors and families of the victims of the Tuskegee Syphilis Study. (Paul J. Richards/AFP via Getty Images)


© Provided by Yahoo! News
Herman Shaw speaks during ceremonies at the White House on May 16, 1997, in which President Bill Clinton apologized to the survivors and families of the victims of the Tuskegee Syphilis Study. (Paul J. Richards/AFP via Getty Images)

The Tuskegee Syphilis Study is the most famous example. Sponsored by the U.S. Public Health Service, the project enrolled uneducated Black men in the South without informing them of the purpose of the experiment, which was to study the natural progression of the disease. Participants went untreated for years after an effective cure had been discovered. A 1972 Associated Press story on the experiments, observing that “human beings with syphilis” had been “induced to serve as guinea pigs,” caused public outcry and finally brought the study to an end after 40

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health

With coronavirus exploding in Europe, hospitals calculate how long until they hit capacity

For Germany, the breaking point could come in December. France and Switzerland might crack by mid-November. Belgium could hit its limit by the end of the week.



a person sitting in front of a mirror posing for the camera: Medical staff conduct a CT scan on a covid-19 patient in the intensive care unit at Havelhoehe community hospital in Berlin.


© Fabrizio Bensch/Reuters
Medical staff conduct a CT scan on a covid-19 patient in the intensive care unit at Havelhoehe community hospital in Berlin.

Europe, in the throes of a savage second wave of the pandemic, is on the verge of a medical crisis, with intensive care units quickly filling to the breaking point. Governments are finding that when confronted by the unforgiving reality of an exponentially spreading virus, even vast investments to expand hospital capacity can be washed away in days.

Germany, Europe’s best-resourced nation, risks being swamped even after increasing its intensive care beds by a quarter over the summer. Belgium, which had doubled its intensive care capacity, is now preparing for decisions about which needy patient should get a bed.

“This huge capacity we’ve built gave a false impression of security. It gave a higher buffer, but ultimately it only represents a week when you’re in an exponential phase,” said Emmanuel André, a leading Belgian virologist who has advised the government on the pandemic — and has bitterly criticized leaders for acting too slowly this fall.



Medical personnel work at the MontLégia hospital in Liège, Belgium.


© Valentin Bianchi/AP
Medical personnel work at the MontLégia hospital in Liège, Belgium.

In retrospect, the warning signs could be seen as early as July, when cases in Europe started ticking up again after the relaxation of spring lockdowns. In absolute terms, the numbers were still tiny. Spanish emergency room doctors enjoyed a respite, after being hammered in March and April. Italian nurses headed to the beach. Central European leaders — among the worst hit now, but back then largely untouched — gathered at the end of August for a triumphant conference to discuss the post-pandemic era.

But the math for exponential growth is as simple as it is scary. When two coronavirus cases double to four, and four cases double to eight, it doesn’t take long for the numbers to reach the tens of thousands — and beyond.

[Gloom settles over Europe as days darken and coronavirus surges]

“An exponential phenomenon starts with very small numbers, and it is not tangible for weeks and weeks and weeks for people out there,” André said. “If you look at the numbers, you have very strong indicators early on that things are going wrong, but it is only at the very end that things explode.”

Europe is now feeling the explosion.

The continent reported 1.5 million cases over the past week, the highest yet during the pandemic, the World Health Organization’s Europe director, Hans Kluge, told an emergency meeting of health ministers on Thursday. Deaths rose by a third in seven days. Occupancy of intensive care units doubled in 17 days leading up to Oct. 25 in countries tracked by the European Center for Disease Prevention and Control.

“Europe is at the epicenter of this pandemic once again,” Kluge said.

A week ago, French intensive

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health

GW Launches Clinic To Help ‘Long Haulers’ With Persisting COVID-19 Symptoms : NPR

Patients with “Long COVID” have relied on social media groups to get through the worst of their symptoms. Doctors at the GW COVID-19 Recovery clinic hope to provide treatment and medical research to support them.

engin akyurt/Unsplash


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engin akyurt/Unsplash

Maureen would have been in her last year at the Georgetown University Law Center this fall, living in an apartment on H Street and preparing to graduate — in person or virtually — this spring. Instead, she deferred this past semester and has been at home in Upstate New York for months, passing time while she waits to start classes again in January.

It’s one of the ways her life has been sidetracked for the better part of a year. Maureen counts herself among the long-haulers, people who suffer from “Long COVID,” a lingering, rotating onslaught of symptoms that has affected patients of all ages and stumped doctors worldwide.

“I’ve been really healthy up until this point,” says Maureen, who preferred not to use her last name for privacy reasons. “I ran cross country in college. I was still trying to do five to seven miles of running a day. And this has just been absolutely debilitating.”

After experiencing all the symptoms associated with the disease caused by the novel coronavirus — headaches, fatigue, a sore throat, shortness of breath, body aches — Maureen still thought it couldn’t be COVID-19. She’d been social distancing, washing her hands, and wearing a mask. And besides, she was only 24 years old. “But I had the purple fingers and toes,” she says. “Once the COVID toes presented themselves, I did end up getting myself tested.”

But the test came back negative.

She and other long-haulers who spoke to DCist say one of the biggest challenges they’ve faced has been testing. They got sick in March or April, back when the District had testing shortages and there was widespread confusion about who had access to them. When these long-haulers were finally tested, they received false negative results — or, at least, it would appear that way since they still had symptoms.

A COVID-19 testing site in Fort Totten. Long-haulers say one of the biggest issues they’ve faced is getting accurate and timely test results.

Patrick Fort/DCist/WAMU


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Patrick Fort/DCist/WAMU

Despite her negative results, doctors told Maureen: “You definitely have COVID — just ride it out for 30 days,” she says. “But I’m still riding it out.”

The specialists she saw, including a pulmonologist, cardiologist, rheumatologist, and hematologist, weren’t able to provide many answers about what her specific condition was and how to treat it. Maureen says one told her, somewhat dismissively, “You know, anxiety manifests itself in the body.”

Her condition has become the subject of peer-reviewed studies and massive online support groups — some have even begun lobbying Congress about Long COVID.

Maureen turned her attention to friends in New York and found informative articles online, including a June feature published in The Atlantic, which made the

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health

Power out due to Hurricane Zeta? Here’s how long the food in your fridge, freezer will last | Hurricane Center

If you’re living in the New Orleans metro area, you likely don’t have power right now. 

Aside from wondering when the lights will come back on, your next thought might be figuring out what to do the food in your refrigerator or freezer. 



About 470,000 people without power in Louisiana after Hurricane Zeta

Most of the outages are in the New Orleans metro area.

If the power is still out at your home, do not open your freezer or refrigerator if possible.

Fridges will typically keep food cold for about four hours if not opened, according to the Food and Drug Administration. A full freezer should maintain a safe temperature for about 48 hours if the door stays closed as well. If your freezer is half-full, it should maintain its temp for about 24 hours. 

In the meantime, it’s a good idea to fill up an ice chest with ice and add perishable foods to enjoy until power is restored. 

Once the power is back, though, it’s time to start clearing out what might be spoiled. If your refrigerator reads 40 degrees or lower and the freezer reads 0 when you re-open it, your food should be safe, and frozen food that still retains ice crystals should be safe.

Hurricane Zeta may have sped its way across metro New Orleans, but what it left in its wake were downed trees, streets littered with debris an…

A general rule of thumb: Perishable food that is held at temperatures higher than 40 degrees for more than two hours may be unsafe to eat. That is because bacteria multiply quickly between 40 and 140 degrees.

Even foods that are deemed safe to eat should be thoroughly heated and cooked to minimum safe temperatures.

And, as always, when in doubt throw it out.

For more tips on preparing for a hurricane or power outage, head here.



Preparing for a hurricane: What to buy, what to eat, what to throw out in your kitchen

Now is the time to check your hurricane prep supplies. Along with generators, battery-powered radios or TVs, flashlights, electric candles (so…

Ann Maloney contributed to this report. 


MORE COVERAGE:



When will power come back on in New Orleans? Entergy hopes to get it fixed 'through the weekend'

About 400,000 Entergy customers were without power as of 7 a.m. 

90% to have electricity restored within 10 days, Entergy says



Jefferson Parish asks residents to stay home, limit warm water usage after Hurricane Zeta: report

Traffic lights are out throughout the parish.



Why did Hurricane Zeta intensify so quickly? Lack of wind shear, forecaster says

Forecasters underestimated storm’s strength but nailed its track

Source Article

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health

‘Superspreader’ wedding, birthday party in Long Island lead to 56 infections

Within two weeks, 30 guests had tested positive for covid-19. Suffolk County health officials said an additional 159 people who had potentially been exposed to the virus by wedding attendees had been forced to self-quarantine to prevent further spread of the virus.

“One-third of all of those in attendance,” Suffolk County Executive Steve Bellone said in a news conference Wednesday. “Think about that for a second.”

County officials recommended a fine of $17,000 against the club for violating a county sanitary code as well as a statewide mandate restricting gatherings to no more than 50 people, and the State Liquor Authority told the New York Times it was investigating the incident. The country club did not immediately respond to a request for comment.

A Long Island birthday party that same day limited its guest list to 50 names, but has still led to another 26 coronavirus cases in the last two weeks, Bellone said.

Those ill-fated gatherings were not the only large events to spread the coronavirus across Long Island in recent weeks. Dozens of new cases have been tied to a string of parties in Suffolk County, and hundreds of residents have been forced to quarantine after possible exposure to the virus.

“This type of blatant disregard for the well-being of others is not only extremely disappointing; it will not be tolerated,” Bellone said Wednesday. “If you violate the rules, you’ll be caught and held responsible.”

SUFFOLK COUNTY EXECUTIVE BELLONE TO ANNOUNCE NEW ENFORCEMENT ACTIONS IN RESPONSE TO RECENT COVID-19 SPREADER EVENTS

Posted by Suffolk County Executive Steven Bellone on Wednesday, October 28, 2020

The spread of the virus along Long Island is particularly concerning in the state and county that were once epicenters of the pandemic. More than 500,000 people in New York have tested positive for the virus, and at least 33,219 have died since the start of the pandemic. Even as coronavirus rates have remained low in New York in recent weeks, some social gatherings have led to hot spots.

New York Gov. Andrew M. Cuomo (D) on Wednesday urged residents to avoid even family gatherings as the holidays approach.

“My personal advice is the best way to say, ‘I love you,’ this Thanksgiving, the best way to say, ‘I’m thankful for you,’ is to say, ‘I love you so much, I’m so thankful for you, that I don’t want to endanger you, and I don’t want to endanger our family and I don’t want to endanger our friends. So we’ll celebrate virtually.’” Cuomo said. “But that is my personal opinion.”

Despite admonitions to keep social gathering small and socially distanced, or to avoid them altogether, many people have decided to come together in large groups, especially in Long Island.

A Sweet 16 party hosted at a banquet hall on Sept. 25 became the county’s first “superspreader” event, Bellone said, after 37 guests tested positive for the virus after attending the 81-person soiree. At least 270 people had to quarantine after possibly being exposed to coronavirus

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health

What Barack Obama’s memoir reveals about his long battle for healthcare reform

President Barack Obama speaks in the Rose Garden of the White House in Washington, Friday, June 26, 2015, after the Supreme Court declared that same-sex couples have the right to marry anywhere in the US.
An excerpt of former President Barack Obama’s upcoming memoir “A Promised Land” was released Monday by the New Yorker. (Pablo Martinez Monsivais / AP)

The political battle for universal healthcare within the White House was long, epic and personal.

“Each time I met a parent struggling to come up with the money to get treatment for a sick child, I thought back to the night Michelle and I had to take three-month-old Sasha to the emergency room for what turned out to be viral meningitis,” former President Barack Obama recalled in an excerpt from “A Promised Land,” the forthcoming first volume of his memoirs of his time in the White House. The excerpt was published Monday in the New Yorker.

“I remembered the terror and the helplessness we felt as the nurses whisked her away for a spinal tap, and the realization that we might never have caught the infection in time had the girls not had a regular pediatrician we felt comfortable calling in the middle of the night,” he continued. “Most of all, I thought about my mom, who had died in 1995, of uterine cancer.”

The chapter — which offers an inside look into the passage of Obamacare at the end of the former president’s first year in office — comes at a crucial moment for his signature piece of legislation, as its future could be threatened by the expected confirmation on Monday of Judge Amy Coney Barrett to the Supreme Court.

“In the middle of a pandemic, this administration is trying to dismantle the Affordable Care Act in the Supreme Court,” Obama said on Twitter Monday while presenting the excerpt. “Here’s how Joe and I fought to expand healthcare, protect millions of Americans with preexisting conditions, and actually get it done.”

The journey toward passage was messy and prone to second-guessing, particularly from Obama’s closest allies: David Axelrod, his advisor, and Rahm Emanuel his chief of staff, who warned him of the political hazards: “[This] can blow up in our faces.”

Emanuel warned Obama that the process of getting the bill passed would lead to unpleasant compromises and a potentially huge backlash. “Making sausage isn’t pretty, Mr. President,” he told his boss. “And you’re asking for a really big piece of sausage.”

In another passage, Obama writes about the rise of the Tea Party movement, which became harder for him to ignore, especially when it resurrected an old rumor from Obama’s campaign days: that he was Muslim and born in Kenya, which would have barred him from serving as president. This lie would eventually be used by Donald Trump to consolidate the base that would help make him Obama’s successor.

“At the White House,

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health

For COVID Long Haulers, Knowledge and Empathy Are Key to a Cure | Healthiest Communities

What is also undeniable is how ill-prepared the health system seems to be to meaningfully help these COVID “long haulers” return to wellness. In fact, the presentation of this apparent post-viral syndrome has stumped experts and clinicians who have struggled to find guidance on how to treat the condition. This hard reality has prompted long haulers to create or join social media-based support groups in search of answers, advice or, at the very least, solidarity.

The question, then, is: Why are we so stumped by these post-COVID long haulers?

Many medical providers have not received training on how to diagnose or treat the types of complex multiorgan disease triggered through the disruption of immune, endocrine, nervous and cardiovascular systems. Moreover, this lack of training has perpetuated the stigma that ME/CFS and similar conditions are not real. This is aggravated by the lack of a diagnostic test and the fact that most of the usual medical tests, ordered for nonspecific symptoms such as fatigue, are likely to show no abnormalities.

Although these results can provide relief that the cause of a patient’s problems is not cancer or organ failure, the related “everything seems to be fine” talk minimizes the patients’ symptoms, invalidates their experiences and marks the beginning of a lonely road. Patients blame themselves for not shaking symptoms off. As time goes by, they may perceive or be outright told that their symptoms are psychological, implying they just need to try harder to feel better. Since ME/CFS appears to be an inflammatory brain condition that can also cause anxiety or depressive symptoms, many patients are referred to mental health services, reinforcing the perception that the problem must be “in their heads”.

To be sure, there is increasing recognition that treating post-COVID-19 syndrome will require biologic and holistic approaches, as well as extensive research. These insights have led to the creation of treatment centers to try to assist these patients. Experts have published management guidelines that can aid these centers.

However, initial approaches may create challenges. Although protocols that emphasize physical therapy and cardiovascular and respiratory rehabilitation offer a correct approach in general – particularly for those who were hospitalized – there are important caveats. Many patients with disabling symptoms will have normal respiratory and cardiac function, and related tests, although necessary, may not clarify the cause.

In addition, the traditional type of physical therapy recommended for ME/CFS by what is now considered a flawed study can backfire and make symptoms worse. In fact, research has shown that pacing is a pivotal component in the management of ME/CFS. Rehabilitation should be personalized, go slow and be monitored for relapse, recognizing that neuroinflammatory illness can “flame on” when pushed too hard.

As physicians and investigators ourselves, we understand the challenges of creating treatment guidelines in the absence of a significant body of research. However, while studies are being conducted, we ought to use the evidence that does exist on ME/CFS and related conditions, such as mast cell activation, to deploy the multidisciplinary

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