The Covid-19 pandemic considered by many experts to be a mass incapacitation event. Although most people fully recover from the fight with the highly contagious coronavirus, a significant number of patients develop long-lasting, sometimes debilitating symptoms – the so-called. long covid. Estimates of how many Covid patients suffer long-term symptoms vary widely. But the US Centers for Disease Control and Prevention recently estimated that nearly one in five Covid patients report persistent symptoms. With hundreds of millions of Covid-19 cases reported worldwide, even more modest estimates still suggest tens of millions are suffering lasting effects.
However, as these patients seek effective care, researchers are scrambling to define, understand and treat this new phenomenon. Many patients reported uphill battles to find care and help, including long waits at clinics and few treatment options when they see a care provider.
Strike the quacks. This situation is ripe for unscrupulous actors to step in and start offering unproven products and treatments – possibly at exorbitant prices. It’s a tried-and-true model: when modern medicine is unable to provide evidence-based treatment, quacks step in to comfort desperate, untreated patients. Amid their cute platitudes, they chide modern medicine, scowl at callous doctors, and mock the slow pace and high cost of clinical trials. With any ill-advised trust, these bad actors can peddle unproven treatments and false hope.
In the US, there are already reports of such unproven long-term treatments for Covid, such as supplements, vitamins, infusions, fasting, ozone therapy and off-label prescriptions. But British research published this week highlights a growing international trend of expensive “blood washing” treatments.
The investigation was conducted by the British company ITV News i BMJfound that thousands of long-term Covid patients travel to private clinics in various countries – including Switzerland, Germany and Cyprus – to receive blood filtration or apheresis, which has not been proven to treat Covid for long.
Apheresis is an established medical therapy, but it is used to treat specific conditions by filtering known problematic blood components, such as filtering LDL (low-density lipoprotein) in people with uncontrolled high cholesterol or removing malignant white blood cells in people with leukemia.
In the case of long-term Covid patients, apheresis treatments seem to be used to remove various things that may or may not be problematic. These include LDL and inflammatory molecules, a strategy originally designed to treat people with cardiovascular disease. Doctor of internal medicine Beate Jaeger, who runs the North Rhine Lipid Center in Germany and has started treating long-term Covid patients, advertises a method that involves filtering the blood through a heparin filter. He also prescribes a cocktail of anticoagulants to patients suffering from Covid for a long time.
Jaeger hypothesizes that the blood of people with long Covid is too viscous and contains small blood clots. She suggests that blood thinning with drugs and apheresis can improve microcirculation and overall health. But there is no evidence that this hypothesis is correct or that the treatment is effective. When Jaeger tried to publish her hypothesis in a German medical journal, it was rejected.
Said Robert Ariens, Professor of Vascular Biology at the University of Leeds School of Medicine BMJ and ITV that treatment is premature. For one thing, researchers don’t understand how microclots form, whether apheresis and anticoagulants reduce them, and whether the reduction would even matter for the disease. “If we don’t know the mechanisms by which microclots form and whether they are disease-causing or not, it seems premature to design a treatment to remove microclots, because both apheresis and triple anticoagulation are not without risk, the obvious one is bleeding,” Ariens said.
Jaeger, meanwhile, defended the treatment of patients despite the rejected hypothesis and lack of evidence. She expressed anger at “dogmatism” in medicine and claimed that she had treated patients at her clinic who arrived in wheelchairs but left. “If I see a child in a wheelchair suffering for a year, I prefer to treat rather than wait for 100 percent proof,” she said.
And Jaeger is not alone; other clinics have also started offering apheresis for long-term Covid. A British inquiry interviewed a woman in the Netherlands, Gitte Boumeester, who paid more than $60,000 – almost all of her savings – for treatment at a new Covid clinic in Cyprus after seeing positive anecdotes online. A woman, desperate for relief from her lingering Covid symptoms, signed a dubious consent form filled with misspellings, grammatical errors and half-finished sentences waiving her rights.
Daniel Sokol, a London-based lawyer and medical ethicist, said the form would be invalid under English and Welsh law. “You can’t say, ‘By the way, you agree not to sue us if we seriously injure you or kill you, even if it’s through our own negligence,'” he told investigators. “You can’t do that.”
At a clinic in Cyprus, Boumeester received a series of other unproven treatments in addition to the apheresis, including vitamin infusions, hyperbaric oxygen treatment, anticoagulants and hydroxychloroquine, which is notoriously ineffective against Covid-19. After two months in Cyprus, undergoing various treatments and draining her bank account, Boumeester said she saw no improvement in her debilitating symptoms, which include palpitations, chest pain, shortness of breath and brain fog.
“I think they should emphasize the experimental nature of the treatment more, especially because it’s so expensive,” Boumeester said. “I understood before I started that the outcome was uncertain, but everyone at the clinic is so positive that you start to believe it and be hopeful.”
This story originally appeared on Ars Technica.