Commentary on the Long Covid article by Alan Levinovitz in WIRED magazine

By Dr Elke Hausmann

Audio available in Substack

We are pleased to welcome the return of Dr Elke Hausmann as a guest writer. In this article she examines the controversial WIRED article which has sparked significant concern among patients and advocates for its portrayal of Long Covid, recovery narratives, and brain retraining approaches.

What a headline. Ok, so generally journalists are not responsible for the headlines to their articles. But there are several tropes here, so this is where I’ll start.

‘The Truth’ – remember, this article appeared in a US American magazine. ‘The Truth’ as a concept is BIG in Trump’s America, and it is always a ‘Truth’ withheld from the public by nebulous forces, and only whispered by those in the know, because there are always evil people out to punish those who dare to speak ‘The Truth’. There are definitely some evil people making an appearance in this article. Patients.

‘Finally’ a ‘way forward’?? The brain retraining approaches and ideas around fear and fight and flight that are promoted in this article long predate the pandemic. There is nothing new here.

Early on in my own Long Covid ‘journey’ I came across a book promising a ‘way out’ of chronic pain, which I briefly thought might help me (spoiler: it didn’t).

6 years later, recovery has not been granted to me. Why is that? Let’s try to understand through this article.

The article starts with stating that there was a BMJ systematic review that showed moderate evidence for the effectiveness of CBT and physical exercise for the treatment of Long Covid. There is a lot that has already been said about this review which I will not repeat.

The author uses this as a starting point for setting up two sides: those ‘baffled’ scientists who study and don’t understand Long Covid (yet), but still ‘warn against exercise’, and the group of healers and recovered patients ‘outside the mainstream’ that show results of cure that he wonders may be too good to be true, only to (in the rest of the article) reveal that they are the ones that are leading the ‘way forward’ for treatment.

There is a first case study of a very unwell patient whose wife thought he was mentally ill and who got better with brain retraining – ‘thank God’! (remember, the author is a professor of religion). There are more stories of recovery courtesy of brain retraining further on in the article.

The author has spoken to exercise physiologist Todd Davenport who is quoted as saying that patients are often labelled as either ‘lazy’ or ‘crazy’, which the author agrees is unwarranted, and he makes a point of saying that it is very important for patients that their illness is seen as ‘real’, which he says it is. Not ‘in the head’ (ie psychological), but in the brain (’real’!). Further on in the article there are lots more contortions about what is to be considered biological and what psychological; I won’t go into further detail here.

The author talks about a paradigm shift between the old cohort of British psychiatrists who thought that sick people cursed themselves by believing that their illness was of biological origin (when it wasn’t) and thus thought they had no control over it, when in reality CBT and GET could help them (the PACE trial, Wessely and Sharpe get a good long mention), and the new paradigm as of 2025, where everybody agrees that Long Covid is a biological disease, but apparently that brings with itself its own issues.

There is a long extract discussing the difficulties around defining Long Covid – if the author had looked at more recent research, for example the studies that were presented at the ME conference in Berlin last month, then he’d know that among proper scientific researchers it is recognised that for progress to be made in terms of understanding the underlying pathophysiology and finding successful treatments, finding subgroups is key, and there is actually a lot of work going on in that space, and I fully expect that in another year we will be able to see some results.

According to the author, the reason why we are in this pickle now where we need to be all-inclusive in terms of who can claim to have Long Covid, is apparently because we are already in a cultural moment where ‘honouring lived experience is imperative’ as well as ‘believing women and taking them seriously’, which is providing fertile ground for the voices of patient advocates for a women-dominated disease actually being heard (is that a bad thing??). It is not that the author seems to be against believing patients including women about their ‘symptoms’, but he does not want to go as far as believing them about their ideas regarding the ‘cause’ and ‘resolution’ of those symptoms.

In the section on exercise and PEM (post-exertional malaise), I am quoted as saying:

we need to use the precautionary principle of “first do no harm” and not offer physical rehabilitation to patients with Long Covid and ME, or only with the greatest caution

which is immediately counterposed with a section where we are told that not exercising in itself can cause harm (no shit, Sherlock). I was actually infuriated by the way this was presented – it shows a complete ignorance of the reality of PEM and even sheds doubt on the existence of PEM. I will explain:

PEM is NOT a ‘false belief’ that exercise will have negative consequences – and those of us with PEM are very aware that deconditioning potentially has further serious consequences for our health, which is already poor.

Indeed, the only ‘false belief’ I constantly come up against is thinking on better days that I can do more again, so I do more, in the expectation that this time I’d get away with it, which can often be sustained for up to a few days because of the delayed nature of PEM that hits when you least expect it (because you DON’T expect it, you expect to be ok, until you are not). I’m constantly testing my boundaries in the hope that they may have shifted, because I want to be able to run, cycle, swim again, and because I am witnessing my muscles softening and I hate it, and I know it’s bad for me being so inactive.

The choice is not between no exercise and getting deconditioned, or exercise and preventing deconditioning; it’s about finding a balance between keeping moving as much as possible without negative consequences so as to keep as conditioned as possible – as more exertion leads to more crashes leads to MORE deconditioning. The harm of promoting exercise consists of risking the illness getting worse AND deconditioning getting worse. Pacing will help with the severity of the illness AND with remaining as conditioned as possible. If you don’t understand that, you have understood nothing about PEM.

I did a quick straw poll among some Long Covid peers whether they could imagine doing HIIT (as suggested in the article) – not surprisingly, the response was somewhere along the lines of WTF.

There is a long section on the problems of doing research trials that involve exercise, because ‘patients have read about the perils of exercise and don’t want to enrol’. What kind of statement is that? It’s along the lines of social contagion and mass hysteria, where it is imagined that irrational beliefs get passed between people that bear no relation to reality. I would suggest that the people who don’t want to enrol will already have had their own practical experiences with the struggles around exercising – it’s the body, not the mind that says ‘no’ here!

There are some anecdotes of researchers and patients being cancelled if they dare to talk about recovery. There is also talk about how it is impossible to do research into any psychological aspects of Long Covid: psst, “the patients are listening,” he [another unnamed researcher afraid of patients] whispered, “talking about psychology can destroy your career”. Curiously, I can think of some excellent psychologists doing work on Long Covid in Germany whom nobody wants to cancel; I wonder what they are doing differently?!

In among all this stuff we can find some very sensible quotes from sensible people: Todd Davenport is quoted as saying that if any of the therapies mentioned in this article would really work, we would know about it by now. Absolutely, people wouldn’t whisper, they’d shout it from the rooftops!

David Tuller agrees that the claims of mind-body therapies cannot be sustained (have I mentioned yet that Paul Garner pops up in this article – of course).

The placebo effect gets a mention – as ‘the power of the mind to produce symptom improvement’ – which the author seems to suggest is how mind-body approaches ‘work’. This is actually quite funny really, because it means they don’t work. When we do placebo-controlled treatment trials, we are precisely trying to find out if a treatment does MORE THAN placebo, or belief. Yes, the mind can impact our experience. Of course. Attention or not to a symptom can affect how we experience it; we all know that. The idea that us patients who experience our illness as a physical or biological issue have no awareness of our own psychology is a weird distortion of reality. But belief really cannot overcome a symptom like PEM, and it cannot cure Long Covid.

And then we are back to fear. The final statement, where the author reveals himself as benign and well-meaning and on the side of the patients, states that he’d like society to adjust in such a way that nobody has to fear having their symptoms not taken seriously, having their illness seen as not ‘real’, having their needs for support not being met, etc. Which would be great if we could achieve that (in today’s climate?! You’re having a laugh), as it would definitely enhance our lives while living with this horrible illness.

What I don’t understand though is how he can suggest that the fear (actually, reality) of facing these extra obstacles is keeping us ill, and removing them could make us better. I really don’t get it. He states that the only reason we hold on to the ‘belief’ that our illness is ‘biological’ is to give it legitimacy (I thought we all thought that now in 2026?).

Has it not occurred to him that we hold on to that notion because it actually is ‘The Truth’ of the matter?!

Anyway, so why am I not recovered? Is it because I have ‘cursed myself’ by believing that my illness is biological and as a consequence there is nothing I can do about it?

Is it because I haven’t done lots of different brain retraining courses (curiously, one of the supporting arguments in this article for brain retraining working appears to be that some people try lots of different programmes which DON’T work, only for one finally to work – really?! Or was it just their body recovering over time, which happened to coincide with yet another attempt at brain retraining?)

Or could it be that it’s simply because I have an illness for which we don’t have a cure yet?

You tell me.

Recommended Reading: Schomerus, G. (2026) What is the Role of “the Psyche”? Long COVID and ME/CFS as Test Cases for Evidence-Based and Patient-Centered Psychiatry and Psychotherapy, Psychiat Prax. Available in German; English abstract available. Available at: Thieme PDF