GET https://rct.dev.bbntimes.com/science/gaps-in-the-tale-of-covid-s-long-tail

Response
200 OK
IP
3.138.179.197
Profiled on
Token
c5b0f9

ArticleController :: show

Request

GET Parameters

None

POST Parameters

None

Uploaded Files

None

Request Attributes

Key Value
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"App\Controller\ArticleController::show"
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"_security_main"
_stopwatch_token 
"6e3ff0"
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"science"
slug 
"gaps-in-the-tale-of-covid-s-long-tail"

Request Headers

Header Value
accept 
"*/*"
accept-encoding 
"gzip, br, zstd, deflate"
connection 
"close"
cookie 
"PHPSESSID=5n5hhnsu01g68t3oidgq54ou26"
host 
"rct.dev.bbntimes.com"
user-agent 
"Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)"
x-php-ob-level 
"1"

Request Content

Request content not available (it was retrieved as a resource).

Response

Response Headers

Header Value
cache-control 
"no-cache, private"
content-type 
"text/html; charset=UTF-8"
date 
"Sat, 22 Feb 2025 13:42:48 GMT"
link 
"</build/runtime.js>; rel="preload"; as="script",</build/644.js>; rel="preload"; as="script",</build/502.js>; rel="preload"; as="script",</build/app.js>; rel="preload"; as="script",</build/view-more.js>; rel="preload"; as="script",</build/term-condition.js>; rel="preload"; as="script",</build/contact.js>; rel="preload"; as="script",</build/scroll-infinite-article.js>; rel="preload"; as="script",</build/app.css>; rel="preload"; as="style",</build/cookie-style.css>; rel="preload"; as="style",</build/term-condition-css.css>; rel="preload"; as="style",</build/contact-css.css>; rel="preload"; as="style",</build/comment-css.css>; rel="preload"; as="style""
x-debug-token 
"c5b0f9"

Cookies

Request Cookies

Key Value
PHPSESSID 
"5n5hhnsu01g68t3oidgq54ou26"

Response Cookies

No response cookies

Session 6

Session Metadata

Key Value
Created 
"Sat, 22 Feb 25 13:42:41 +0000"
Last used 
"Sat, 22 Feb 25 13:42:41 +0000"
Lifetime 
0

Session Attributes

Attribute Value
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"GdqI2gqWhgeO_TZ_vakKyD3mOgMhsHQUpWNp4CfXMSc"
_csrf/https-cookie_accept 
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Session Usage

6 Usages
Stateless check enabled
Usage
Symfony\Component\Security\Csrf\TokenStorage\SessionTokenStorage:76
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Symfony\Component\Security\Csrf\TokenStorage\SessionTokenStorage:79
Show trace 
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Symfony\Component\Security\Csrf\TokenStorage\SessionTokenStorage:52
Show trace 
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Symfony\Component\Security\Csrf\TokenStorage\SessionTokenStorage:56
Show trace 
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    "line" => 181
    "function" => "show"
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    "function" => "run"
    "class" => "Symfony\Component\Runtime\Runner\Symfony\HttpKernelRunner"
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      "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/autoload_runtime.php"
    ]
    "function" => "require_once"
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]
Symfony\Component\Security\Core\Authentication\Token\Storage\UsageTrackingTokenStorage:41
Show trace 
[
  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/security-core/Authentication/Token/Storage/UsageTrackingTokenStorage.php"
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    "function" => "getMetadataBag"
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    "type" => "->"
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    ]
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]
Symfony\Component\Security\Http\Firewall\ContextListener:171
Show trace 
[
  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/security-http/Firewall/ContextListener.php"
    "line" => 171
    "function" => "remove"
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    "function" => "onKernelResponse"
    "class" => "Symfony\Component\Security\Http\Firewall\ContextListener"
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    "function" => "__invoke"
    "class" => "Symfony\Component\EventDispatcher\Debug\WrappedListener"
    "type" => "->"
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    "function" => "callListeners"
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]

Flashes

Flashes

No flash messages were created.

Server Parameters

Server Parameters

Defined in .env

Key Value
APP_ENV 
"dev"
APP_SECRET 
"0a988e63f011514eaabfc650b599af4d"
CORS_ALLOW_ORIGIN 
"*"
DATABASE_URL 
"mysql://bbndb_rctuser:33F5W25z40or0f7@localhost:3306/rct_bbntimes"
GOOGLE_RECAPTCHA_SECRET_KEY 
"6LdV5fgpAAAAANxzTG8ZMfIjil1wu-1vrQvnUt-x"
GOOGLE_RECAPTCHA_SITE_KEY 
"6LdV5fgpAAAAAENKcn73MJAhQrbtQeqgyC4wDLMP"
MAILER_DSN 
"smtp://no-reply%40rct.dev.bbntimes.com:Bl6%26gLD48%26Of919@rct.dev.bbntimes.com:465"
MARIADB_PASSWORD 
"i!87pK&!85ezc8"

Defined as regular env variables

Key Value
APP_DEBUG 
"1"
BASE 
"/public"
CONTEXT_DOCUMENT_ROOT 
"/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com"
CONTEXT_PREFIX 
""
DOCUMENT_ROOT 
"/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com"
FCGI_ROLE 
"RESPONDER"
GATEWAY_INTERFACE 
"CGI/1.1"
HTTPS 
"on"
HTTP_ACCEPT 
"*/*"
HTTP_ACCEPT_ENCODING 
"gzip, br, zstd, deflate"
HTTP_CONNECTION 
"close"
HTTP_COOKIE 
"PHPSESSID=5n5hhnsu01g68t3oidgq54ou26"
HTTP_HOST 
"rct.dev.bbntimes.com"
HTTP_USER_AGENT 
"Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)"
PASSENGER_COMPILE_NATIVE_SUPPORT_BINARY 
"0"
PASSENGER_DOWNLOAD_NATIVE_SUPPORT_BINARY 
"0"
PATH 
"/usr/local/sbin:/usr/local/bin:/usr/sbin:/usr/bin:/sbin:/bin:/snap/bin"
PHP_SELF 
"/public/index.php"
PP_CUSTOM_PHP_CGI_INDEX 
"plesk-php81-fastcgi"
PP_CUSTOM_PHP_INI 
"/var/www/vhosts/system/rct.dev.bbntimes.com/etc/php.ini"
QUERY_STRING 
""
REDIRECT_BASE 
"/public"
REDIRECT_HTTPS 
"on"
REDIRECT_PASSENGER_COMPILE_NATIVE_SUPPORT_BINARY 
"0"
REDIRECT_PASSENGER_DOWNLOAD_NATIVE_SUPPORT_BINARY 
"0"
REDIRECT_REDIRECT_HTTPS 
"on"
REDIRECT_REDIRECT_PASSENGER_COMPILE_NATIVE_SUPPORT_BINARY 
"0"
REDIRECT_REDIRECT_PASSENGER_DOWNLOAD_NATIVE_SUPPORT_BINARY 
"0"
REDIRECT_REDIRECT_SCRIPT_URI 
"https://rct.dev.bbntimes.com/science/gaps-in-the-tale-of-covid-s-long-tail"
REDIRECT_REDIRECT_SCRIPT_URL 
"/science/gaps-in-the-tale-of-covid-s-long-tail"
REDIRECT_REDIRECT_SSL_TLS_SNI 
"rct.dev.bbntimes.com"
REDIRECT_REDIRECT_STATUS 
"200"
REDIRECT_REDIRECT_UNIQUE_ID 
"Z7nUUpDyWLT8YV1VjBpaDwAAAJA"
REDIRECT_SCRIPT_URI 
"https://rct.dev.bbntimes.com/science/gaps-in-the-tale-of-covid-s-long-tail"
REDIRECT_SCRIPT_URL 
"/science/gaps-in-the-tale-of-covid-s-long-tail"
REDIRECT_SSL_TLS_SNI 
"rct.dev.bbntimes.com"
REDIRECT_STATUS 
"200"
REDIRECT_UNIQUE_ID 
"Z7nUUpDyWLT8YV1VjBpaDwAAAJA"
REDIRECT_URL 
"/public/science/gaps-in-the-tale-of-covid-s-long-tail"
REMOTE_ADDR 
"3.138.179.197"
REMOTE_PORT 
"16373"
REQUEST_METHOD 
"GET"
REQUEST_SCHEME 
"https"
REQUEST_TIME 
1740231767
REQUEST_TIME_FLOAT 
1740231767.7372
REQUEST_URI 
"/science/gaps-in-the-tale-of-covid-s-long-tail"
SCRIPT_FILENAME 
"/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/public/index.php"
SCRIPT_NAME 
"/public/index.php"
SCRIPT_URI 
"https://rct.dev.bbntimes.com/science/gaps-in-the-tale-of-covid-s-long-tail"
SCRIPT_URL 
"/science/gaps-in-the-tale-of-covid-s-long-tail"
SERVER_ADDR 
"5.196.1.209"
SERVER_ADMIN 
"[no address given]"
SERVER_NAME 
"rct.dev.bbntimes.com"
SERVER_PORT 
"443"
SERVER_PROTOCOL 
"HTTP/1.1"
SERVER_SIGNATURE 
"<address>Apache Server at rct.dev.bbntimes.com Port 443</address>\n"
SERVER_SOFTWARE 
"Apache"
SSL_TLS_SNI 
"rct.dev.bbntimes.com"
SYMFONY_DOTENV_VARS 
"APP_ENV,APP_SECRET,DATABASE_URL,MARIADB_PASSWORD,CORS_ALLOW_ORIGIN,MAILER_DSN,GOOGLE_RECAPTCHA_SECRET_KEY,GOOGLE_RECAPTCHA_SITE_KEY"
UNIQUE_ID 
"Z7nUUpDyWLT8YV1VjBpaDwAAAJA"

Sub Requests 6

CookieController :: renderAnalysis (token = 390bf3)

Key Value
_controller 
"App\Controller\CookieController::renderAnalysis"
_format 
"html"
_locale 
"en"
_stopwatch_token 
"0511fd"

AppController :: renderHeader (token = 0c605a)

Key Value
_controller 
"App\Controller\AppController::renderHeader"
_format 
"html"
_locale 
"en"
_stopwatch_token 
"e815e4"
slug 
"home"

ArticleController :: trendingArticle (token = 34d3ac)

Key Value
_controller 
"App\Controller\ArticleController::trendingArticle"
_format 
"html"
_locale 
"en"
_stopwatch_token 
"62d718"
category 
"Science"

ArticleController :: relatedArticles (token = a02556)

Key Value
_controller 
"App\Controller\ArticleController::relatedArticles"
_format 
"html"
_locale 
"en"
_stopwatch_token 
"64a92e"
current_article 
App\Entity\Article {#1094
  -id: 8238
  -title: "Gaps in the Tale of COVID’s Long Tail"
  -slug: "gaps-in-the-tale-of-covid-s-long-tail"
  -introtext: "<p>Our collective, pandemic focus continues to vacillate with the news of the day, but if it has settled anywhere, it has settled of late on the toll of so-called “<a href="https://www.nytimes.com/2021/03/17/opinion/long-covid.html" target="_blank" rel="nofollow noopener">long COVID</a>,” now known medically as&nbsp;<a href="https://www.webmd.com/lung/what-is-long-covid-pasc" target="_blank" rel="nofollow noopener">PASC</a>:&nbsp;<em>Post Acute Sequelae of SARS-CoV-2</em>.&nbsp;</p>\r\n"
  -content: """
    \r\n
    <p>That topic is of interest to me for many reasons, not the least of which being: I have it.</p>\r\n
    <p>To be fair, my version of “long COVID,” like my COVID infection itself, is seemingly mild.&nbsp;So while I can say I have PASC, it is an entry-level case.&nbsp;I am now about 2 months post infection, with IgG to corroborate my past bout and immunity- and still subject to waxing and waning fatigue, and recurrent headaches of a unique (and rather creepy) character.&nbsp;My olfaction, which I lost completely, is at best about 50% back now, and also waxes and wanes.</p>\r\n
    <p>So, as noted, entry level, compared to those with far more severe symptoms going on for many more months.&nbsp;But then again, I don’t know yet how long all this will last; time will tell.&nbsp;I am trying to be patient, not one of my best attributes.&nbsp;I am hopeful that the single-dose vaccine I eventually receive (only one dose of any COVID vaccine is recommended post-infection) may help banish residual symptoms; there are&nbsp;<a href="https://www.nytimes.com/2021/03/17/health/coronavirus-patients-and-vaccine-effects.html" target="_blank" rel="nofollow noopener">some early indications of that effect</a>.</p>\r\n
    <p>For now, we are unsure of the remedies, but know for sure that long COVID is real; what are the major implications?&nbsp;</p>\r\n
    <p>First, while PASC is garnering a unique level of attention as all things associated with the pandemic do, this syndrome is not unique to COVID.&nbsp;Many illnesses, and most injuries engender their own suite of “post acute sequelae.”</p>\r\n
    <p>In my nearly 30 years rendering patient care, it was more norm than exception to see persistent symptoms months out from any moderately severe infection.&nbsp;Community acquired pneumonia, for instance, is deemed mild when it does not require hospitalization- but that doesn’t mean it disappears when the course of antibiotics ends.&nbsp;Patients routinely take months to feel back to baseline.</p>\r\n
    <p>So, too, for any of the other infections that assault a vital organ, from pyelonephritis, to septic arthritis, to prostatitis, and perhaps even to cellulitis- infection of the skin.&nbsp;I am not aware of a national survey exploring residual symptoms, local or systemic, following these and various other infections- but my clinical experience says they are common.</p>\r\n
    <p>As for viruses, many are notoriously “long.”&nbsp;Varicella, the virus that gives us chickenpox, resides within for decades, emerging to cause shingles.&nbsp;Herpes simplex never goes away, and can cause recurrent cold sores for a lifetime.&nbsp;These and other common viral exposures may even cause a long-form illness much like PASC, which we call by other names: chronic fatigue syndrome, or fibromyalgia.&nbsp;I have treated many patients with these conditions over the years, and at a frequency that makes coincidence unlikely, symptom onset followed some acute viral illness.</p>\r\n
    <p>And then there is a notorious “long” infection that has itself attracted considerable attention, if altogether too little respect: chronic Lyme Disease.&nbsp;This is not at all likely to be chronic “infection” any more than PASC is, but rather a chronic symptom complex that all too often follows infection with the agent of Lyme disease,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5029759/" target="_blank" rel="nofollow noopener"><em>Borrelia burgdorferi</em></a>.</p>\r\n
    <p>My hope, then, is this: the population impact of PASC will cause the medical establishment to revisit a generally dismissive attitude toward other “long” post-infectious syndromes, including the possible inclusion of chronic fatigue and fibromyalgia among them.&nbsp;</p>\r\n
    <p>There is another relevant consideration.&nbsp;We routinely say “illness and injury” as if the two are mutually exclusive.&nbsp;They are not.&nbsp;Many illnesses, SARS-CoV-2 clearly among them, cause tissue injury.&nbsp;Injured tissue takes time to heal.</p>\r\n
    <p>If we think of the injuries we know best - fractured bones, torn ligaments - they offer an orienting primer to the phases, and timeline of recovery.&nbsp;As equestrian, skier, and one-time martial artist, I know this space all too well- having recovered from some number of ligament reconstructions (thanks again, Dr. Ruwe!), and literally dozens of fractures.</p>\r\n
    <p>As with infection, an injury has an acute phase.&nbsp;Then, there is an inflammatory response as repair begins- and then subsiding inflammation as repair continues.&nbsp;Generally, about 6 weeks are required for basic, initial repair- with some variation based on the nature of the injury, age, nutritional status, and general health.&nbsp;After that initial repair, months are generally required for full recovery- and sometimes, years.&nbsp;Sometimes, episodic pain and tenderness never go away fully- and again, I can attest to this from personal experience as well as professional knowledge.</p>\r\n
    <p>Thinking about the “injury” model, involving acute phase, repair, and then a long bout of physical therapy and rehabilitation, is helping me be patient with my own PASC symptoms, and also making me wish we knew more about the underlying mechanisms.&nbsp;Is PASC about tissue injury, and if so- what tissues are involved?&nbsp;We don’t have these answers yet- and need them both to understand PASC, and know best how to overcome it.</p>\r\n
    <p>To sum up, then: long COVID is, of course, real and important- but like so much else in the pandemic, presented to us in a manner that&nbsp;<a href="https://www.linkedin.com/pulse/dramademiology-covid-pandemic-manifesto-here-now-david/" target="_blank" rel="noopener">maximizes drama</a>, and minimizes context.&nbsp;The relevant context is that many other illnesses have comparably long tails, and almost all injuries do.&nbsp;</p>\r\n
    <p>The distinction between illness and injury is far from absolute, and perhaps much of the reason for lengthy recovery is when the former causes the latter.&nbsp;We have much to learn about mechanisms of long COVID- there are important gaps in the tale thus far- and we should apply these lessons to other infections, too.&nbsp;</p>\r\n
    <p>If the medical community learns to be more uniformly compassionate and respectful when patients complain of symptoms long after the “disease” is over, that will be a welcome advance- and the COVID19 pandemic will have done us at least this one favor.</p>\r\n
    <p>&nbsp;</p>\r\n
    <p><a href="http://davidkatzmd.com/" target="_blank" rel="nofollow noopener"><strong>Dr. David L. Katz</strong></a><strong><em>&nbsp;</em></strong>is a board-certified specialist in Preventive Medicine/Public Health</p>\r\n
    <p><a href="https://www.truehealthinitiative.org/wp-content/uploads/2020/04/TotalHarmMinimization-2020-04-07.pdf" target="_blank" rel="nofollow noopener"><strong><em>Click here</em></strong></a><strong><em>&nbsp;to access the one-page summary of #TotalHarmMinimization</em></strong></p>\r\n
    <p><a href="https://www.truehealthinitiative.org/covid/" target="_blank" rel="nofollow noopener"><strong><em>Click here</em></strong></a><strong><em>&nbsp;to access the total harm minimization resource library&nbsp;</em></strong></p>\r\n
    <p><a href="https://www.youtube.com/playlist?list=PLkGAVauYKAhqnPAwZYM6Or9zb5uY8hm59" target="_blank" rel="noopener"><strong><em>Click here</em></strong></a><strong><em>&nbsp;to access a library of Dr. Katz’ “reality check” videos on the pandemic</em></strong></p>\r\n
    <p><strong><em>P.S. –</em></strong></p>\r\n
    <p><br />Some might wonder if my personal experience has altered my view about the best pandemic response policy.&nbsp;Not at all- but not because I am unwilling to change my mind.&nbsp;I do that routinely, whenever there is a good reason.&nbsp;Rather, PASC is simply one more reason why a risk-stratified response to COVID makes, and always made, the most sense.</p>\r\n
    <p>Our “one size fits all” approach to COVID failed to protect many who most needed meticulous protection, over-protected many at very low risk of bad outcomes including PASC, and misallocated vital resources.&nbsp;I stand by my prior petitions for a strategy of total harm minimization by means of risk-stratified interdiction policies, or what colleagues have since called “<a href="https://gbdeclaration.org/" target="_blank" rel="nofollow noopener">focused protection</a>.”&nbsp;</p>\r\n
    <p>Risk-stratified exposures to COVID on our way to herd immunity facilitated by fast-track vaccine development would inevitably have resulted in some harm, including cases of PASC.&nbsp;But in a pandemic, there are no completely risk-free options- the goal is not unrealistic avoidance of all harm, but realistic minimization of total harms.&nbsp;</p>\r\n
    <p>The path we did take through the pandemic resulted in massive exposure among the most vulnerable, a terrible and largely preventable casualty toll, and a high burden of PASC into the bargain.&nbsp;Selective exposure, based on knowledge of risk tiers, would have been far better and far less costly than the haphazard exposure our population has suffered.</p>\r\n
    <p>Three of my adult children went through COVID when my wife and I did.&nbsp;They recovered quickly, and completely, with no hint of PASC.&nbsp;That syndrome can occur in young, healthy people, but as is generally true for SARS-CoV-2, risks rise with both age and infirmities.&nbsp;My wife and I are fortunate to have no infirmities, but age alone puts us in a higher risk group than our adult children- and our somewhat protracted recoveries are consistent with that.</p>
    """
  -user: Proxies\__CG__\App\Entity\User {#1092 …}
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  -updatedAt: DateTime @1628459630 {#1150
    date: 2021-08-08 21:53:50.0 UTC (+00:00)
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  -metakey: "Gaps in the Tale of COVID’s Long Tail"
  -metadesc: "Our collective, pandemic focus continues to vacillate with the news of the day, but if it has settled anywhere, it has settled of late on the toll of so-called “long COVID,” now known medically as\u{A0}PASC:\u{A0}Post Acute Sequelae of SARS-CoV-2.\u{A0}"
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AppController :: renderFooter (token = cf2a68)

Key Value
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"App\Controller\AppController::renderFooter"
_format 
"html"
_locale 
"en"
_stopwatch_token 
"ebe6d0"

CookieController :: renderCookie (token = 2cccae)

Key Value
_controller 
"App\Controller\CookieController::renderCookie"
_format 
"html"
_locale 
"en"
_stopwatch_token 
"7d86c3"