Science
Long COVID leaves thousands of L.A. county residents sick, broke and ignored
In the three years since Los Angeles County declared an end to COVID-19 as a public health emergency, mask sales have dwindled, unopened tests have expired in their boxes and people have returned to in-person school, work and socializing.
But for thousands of L.A. County residents living with the complex, chronic condition known as long COVID, the emergency has never ended. And as the virus continues to circulate, more people are being forced to reckon with a life-altering yet often invisible disability whose relative newness offers few answers for the future and few avenues for support.
“You’re not just becoming disabled,” said Elle Seibert, 31, who has dealt with debilitating fatigue and cardiac symptoms since 2020. “You’re realizing how easily society at large and people in your life will abandon you when you cannot offer them things.”
Elle Seibert, 31, has been living with long COVID.
(Christina House / Los Angeles Times)
Long COVID is an infection-associated chronic condition, a class of illness triggered or worsened by viral, bacterial or parasitic infections. Symptoms typically affect multiple organs or body systems, and cluster around fatigue, cardiovascular problems, cognitive issues and pain.
“What causes long COVID is an abnormal immune system response [plus] dysregulation of the nervous system,” said Dr. Caitlin McAuley, director of the Keck Medicine of USC’s COVID Recovery Clinic, one of two dedicated clinics in the county (the other is at UCLA).
Researchers have also found that long COVID patients are more than twice as likely as people without the condition to have particles of the SARS-CoV-2 virus lingering in their blood — remnants of original infection that could be causing ongoing inflammation.
Though the condition strikes across age, gender, race, vaccination status and patients’ previous levels of health or activity, a few demographic patterns have emerged. Women, people of Hispanic origin, people with severe initial infections and people who have not been vaccinated against the virus appear more likely than other groups to develop long COVID.
Severity of the initial disease can’t perfectly predict the aftermath: debilitating symptoms have set in for people with mild initial infections. Patients arrive at a diagnosis once symptoms have persisted for at least three months and all other explanations have been ruled out.
Lawrence Totress, 51, was busy working full time and volunteering as his church’s office manager when he tested positive for COVID in July 2022.
For two weeks, he had the same fever, shortness of breath, dizziness and fatigue that his friends experienced. But while his fever eventually lifted, frighteningly intense cognitive symptoms descended.
Lawrence Totress, 51, at his apartment in Los Angeles. “It’s not like we’re twiddling our thumbs and trying to get some money. This is a very serious condition,” he said.
(Ariana Drehsler / For The Times)
“I could not find words,” he said recently from his home in South Los Angeles. “I would have phone calls with my supervisor, with my insurance, and I would just cry because I couldn’t even finish the conversation.” At one point, he could not recall the name of the person he’d reported to for the last two years. He scrolled through his phone contacts until he saw “Supervisor” typed below a name.
A trip to the bathroom or the front door left him without energy to return. He cycled through migraines and bouts of postural orthostatic tachycardia syndrome, or POTS, a common long COVID symptom that sent his heart rate skyrocketing when he stood up.
Through occupational therapy at Keck’s long COVID clinic, he learned skills that have allowed some semblance of independence: hydration, rest, careful management of his time and energy.
Where he once bounced from task to task, he now clears a whole day for a grocery store outing. On a bad day, he may not make it past the produce before he’s hit with fatigue so intense he can’t recall why he’s there.
He can no longer work; bills are still piling up. Like every patient interviewed for this story, his application for long-term disability was denied, despite a thick stack of medical records.
“It’s not like we’re twiddling our thumbs and trying to get some money. This is a very serious condition,” he said. “Take it as it being serious, and allow us to have the resources.”
There is no reliable data for county long COVID cases, nor for the number of people disabled by the condition.
The official county count for total confirmed COVID infections ended in mid-2023 at 3.5 million. Given the World Health Organization’s estimate that 6% of infections result in long COVID, just the first two years of the pandemic may have yielded up to 175,000 long COVID cases, a number that has only grown as the virus has continued to circulate.
In 2023, 15.6% of respondents to a countywide health survey said they had experienced COVID symptoms for at least three months after testing positive. A follow-up county survey currently underway asks more precisely whether respondents have had long COVID symptoms within the last 12 months, said Barbara Ferrer, director of the L.A. County Department of Public Health. Those results will be available later this year.
Ferrer compared the current state of public understanding to the early days of the HIV/AIDS epidemic. In both cases, she said, a new virus created a large population of people living with a complex, chronic condition with far-reaching implications for their health, housing and economic security.
“COVID-19 really has had a profound impact in terms of long-lasting symptoms that affect all kinds of different parts of the body, at a much higher rate than we usually see from other viruses,” Ferrer said.
This month, the public health department formed a physician and patient advocate working group that for 12 months will study policies and services that could help long COVID patients, Ferrer said, such as a clearer pathway to disability payments and better education for healthcare providers.
“We still hear stories about people who are saying, you know, my physician dismissed it or misdiagnosed it, or told me to just go home and wait,” Ferrer said.
Patient advocates have lobbied the county Board of Supervisors to establish a similar task force, thus far unsuccessfully.
Beth Nishida, 64, at Creekside Park in Walnut. She retired from special education administration due to the ongoing effects of a 2022 infection.
(Ariana Drehsler / For The Times)
“The goal really, in my opinion, should be how do we fix it, not just how do we count it,” said Beth Nishida, 64, of Walnut, who retired from special education administration due to the ongoing effects of a 2022 infection. “I know [long COVID] is new, but it’s not as new as it was. At some point, we have to start learning things and implementing them.”
The outlook at the federal level is grim. Last year, the Trump administration closed the Office for Long COVID Research and Practice and canceled grants for long COVID research.
“The COVID-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a nonexistent pandemic that Americans moved on from years ago,” a Department of Health and Human Services spokesperson told the magazine Science.
Yet new COVID infections are producing new long COVID patients. People who were healthy and active just a few months ago are still arriving at USC’s clinic with cardiovascular and cognitive problems that have upended their lives.
“There has been a societal move to go past COVID as if it’s not around anymore — but it definitely is,” McAuley said. “If it’s not on people’s radar, it’s never going to be addressed. And people will bounce in and out of the ER, and they will potentially have a degree of disability [to] the point where they just lose their job, and no one really is addressing it.”
Science
Shipwreck Reveals Fate of Vanished World War I Coast Guard Cutter
The sea was stormy on Sept. 26, 1918, as a convoy of merchant ships navigated the Bristol Channel in southern England. Escorting them was the Tampa, a 190-foot U.S. Coast Guard cutter with the mission of protecting the boats from German submarines.
The cutter separated from the convoy in the misty night to take on supplies and coal at a port. And then it disappeared. For more than a century, its fate has been an enduring naval mystery of World War I.
This week, British divers announced that the wreck of the Tampa had at last been found, nestled 320 feet deep in murky waters about 50 miles off the Cornish coast.
A torpedo from a German submarine killed all those aboard the cutter: 111 Coast Guardsmen, four U.S. Navy personnel and 15 British Navy personnel and civilians.
Adm. Kevin Lunday, commandant of the Coast Guard, said that the Tampa was the largest single American naval combat loss of life in World War I and that it had left “an enduring grief in our service.”
The discovery was the culmination of a three-year effort by the Gasperados Dive Team, a group of British explorers and researchers. They combed shipping logs and wartime messages, and collaborated with the Coast Guard to pinpoint the path and resting place of the vanished vessel.
Barbara Mortimer, a Gasperados researcher, collated scraps of information, sometimes single lines of text that by themselves offered little to go on. But once all the information was meticulously pieced together, she and her teammates narrowed the search to an area clustered with thousands of wrecks from warships, commercial ships and fishing vessels lost over centuries.
The timeline of the Tampa’s final moments slowly emerged.
“Urgent. Priority,” said a telegram dated Sept. 27, 1918, sent to the admiralty in London. “USS Tampa detached herself from convoy.”
The telegram provided the longitude and latitude of that last sighting. At 7 p.m., the ship was seen on the horizon, steering toward the port of Milford Haven, it said. At 8:45 p.m., a wireless operator “felt the shock of an underwater explosion,” the telegram said.
Then, in the hours that followed, Milford Haven reported that the Tampa was 12 hours overdue for its scheduled arrival.
The research team assembled a number of clues about where the Tampa ended up.
One telegram said a seaplane had spotted a “considerable wreckage” field of seven to eight square miles. Two bodies, in Tampa uniforms, eventually washed ashore and were buried in Wales, Ms. Mortimer said in an interview. She said the researchers also studied German U-boat records.
The Coast Guard provided historical records, technical data and archival images of the ship’s features so divers knew what to look for in the deep.
In April 2023, the team made its first two dives looking for the Tampa. Seven more followed, and an assortment of shipwrecks were spotted and examined.
On Sunday they zeroed in on an area where a British hydrographic survey had noted a “significant magnetic anomaly” suggesting the possible location of a steel wreck.
That information was checked against convoy records, Ms. Mortimer said. The team decided, “It’s worth a look,” she said. But she added, “I did not have high expectations.”
Dominic Robinson, one of the team’s divers, lowered himself into the cold, dark waters of the Celtic Sea in the late afternoon of April 26.
At about 311 feet down, he spotted wreckage, piled high. As he drifted slowly over the debris field, his light picked up objects from the chaotic jumble. Some stood out: There was a brass fire extinguisher, an anchor, shell casings and a high-pressure steam boiler that was used in the engines of ships like the Tampa.
Surveying the mound, Mr. Robinson said in an interview that he had a “gut feeling” that the ship had been blown apart, making the bow crumble and absorb the impact. “And the rest of the ship settled down behind it,” he said.
Then he drifted over some crockery. Another member of the team, Jacob MacKenzie, found a similar piece that was inscribed with the maker’s mark: “New Jersey.”
They had an “American connection,” Mr. Robinson said.
“That instantly connects me with the people on the ship,” he said in a video of the dive. “They would have eaten out of those bowls. All these people would have had parents, would have had nearest and dearest, and none of them knew where they are.”
The Coast Guard is gathering data from the Gasperados’ finds to confirm it as an officially designated war grave, said William H. Thiesen, the Coast Guard’s Atlantic area historian.
The Coast Guard has been contacting the families of each lost Tampa crew member over many years, awarding them a posthumous Purple Heart medal, Mr. Thiesen said.
“It provides closure to a chapter that has been open for 100 years,” he said.
Jeremy Davids, 48, of Florida said that a relative, Wesley James Nobles, died while serving aboard the Tampa at the age of 20.
“Drowned foreign waters sinking of Tampa 9-26-1918,” the official record of Mr. Nobles’ death says. Mr. Nobles had a rating of “boy,” an enlisted rank for younger crew members.
“It feels good knowing the fact that not only him but the other soldiers who lost their lives that day can finally rest in peace,” Mr. Davids said in an interview.
Science
Bald eagle ‘massaging’ its mate? AI deepfakes collide with the laws of the wild
Shadow gingerly places one taloned foot, then the other, on Jackie as she hunkers down on the nest.
With Big Bear Lake glittering in the distance, he raises each foot in a kneading motion — evoking a bald eagle massage.
“Somehow, it says everything about their bond,” reads the caption on the 15-second video posted to Facebook.
It looks tender. It looks real.
It isn’t.
The clip is AI-generated.
Jackie and Shadow — made world-famous by a 24-hour livestream — aren’t the only animals falsely depicted in deepfakes. AI wildlife videos have flooded social media platforms like YouTube, Instagram and TikTok, racking up millions of views and likes. Some are whimsical, like a handful of bunnies hopping on a trampoline. Others take a more menacing tone, like a jaguar facing off with a dog in a snowy backyard.
Far from benign, some experts say the videos can skew how people view and even interact with wildlife — potentially leading to perilous encounters. They may also undermine viewers’ growing desire to tune into nature to escape the frenetic rhythms of daily life. Repeated exposure could erode trust in media and institutions generally, with one Reddit user proclaiming, “Can’t even watch real animal videos because 90% of them are AI.” There are also legal implications.
The deception works because the depictions are often hyperrealistic. Even a producer for the Dodo, an animal-centric media outlet, admitted to falling for the bouncing bunnies. Often the videos appear to be ripped from trail or security cameras, enhancing vibes of authenticity. In the competitive economy for people’s attention, the videos can help win looks and likes, potentially driving ad revenue for those who post them.
Megan Brief, a digital marketing coordinator for Natural Habitat Adventures, an ecotourism company, had just returned from Svalbard, a far-flung Norwegian archipelago teeming with polar bears and walruses.
Her social media feed piled up with video after video of polar bear rescues, such as fishermen or scientists hauling a freezing, struggling baby polar bear onto a ship. On board, people snapped selfies with the cub before reuniting it with its mom.
She knew they were fake because she was well-versed in the behavior of the snow-white predators, which are fiercely protective of cubs. As the U.S. Fish and Wildlife Service warns, these “large, powerful carnivores” can easily injure or kill people. It would also be illegal to intervene.
But thousands of commenters took what they saw at face value.
(Photo illustration by Jim Cooke / Los Angeles Times; Source photo / Getty Images)
“It shows that you can have this close proximity with wildlife that is not only dangerous to you, but it’s dangerous to the animal,” said Brief, who is also a wildlife photographer. Social media is filled with AI animal rescues of all types.
“That’s everyone’s dream, to be one with all the animals and with wildlife,” she added, “but you have to respect their habitat and their behavior and give them the space that they need.”
On the flip side, she said the videos also can perpetuate myths that predators such as wolves and mountain lions are more dangerous than they actually are. It’s easy to see how videos could inflame heated debates over managing such animals, in California and beyond.
In a paper published last September in “Conservation Biology,” researchers said the videos also can make people think animals are more abundant, or less threatened, than they are. They might donate or volunteer less as a result.
“If the public is unable to distinguish between actual threats to biodiversity and fictionalized narratives, the perceived urgency to act may diminish,” the researchers wrote.
Jenny Voisard, media and website manager for Friends of Big Bear Valley, a nonprofit that operates cameras trained on Jackie and Shadow, said her inbox is overloaded with complaints about AI content. Grifters are nothing new — the nonprofit has long contended with fake accounts — but they’ve evolved with the technology.
People who follow the beloved eagles are fed more content about them by the algorithm, and she said AI rises to the top of the feed. (That seems to explain why this reporter is often served the fakes when opening Facebook.)
“People get very upset when they see someone depicting Jackie and Shadow in an unnatural way or wrong, or when it looks like they could be in danger,” said Voisard. Some clips showed owls and ravens attacking the couple, especially riling up fans.
The nonprofit recently trademarked its name and is in the process of copyrighting its livestream. She said the point is to protect what they create, such as merchandise and a detailed log of what the eagles are up to, from fakers.
However, ownership in the age of AI is fraught. Voisard said their livestream can be copyrighted because it’s not just a fixed camera; humans operate it and make choices, like zooming in.
Kristelia García, a professor at Georgetown Law, said such creative choices do give livestream operators a good claim to copyright. Whether something violates it is another matter.
If someone asks a large language model to create a three-minute video featuring eagles without drawing on copyrighted material, no harm no foul, she said. But if they feed the AI program the nonprofit’s footage and ask it to manipulate it, that could make for an infringement claim.
But would it be worth fighting? “Copyright litigation is really expensive and very unpredictable,” said García, who focuses on copyright law. She suspects that only if a lot of money were at stake would a nonprofit be willing to take the risk.
As for concerns about misinformation, “we don’t really have a legal recourse for, like, ‘You got fooled,’” she said. Famous people enjoy certain protections over their name, image and likeness, but famous animals don’t.
The fake video of Shadow “massaging” Jackie casts the eagles in a positive light. It arguably perpetuates the avian love story that Friends of Big Bear Valley describes in its own posts.
Yet Voisard believes people are increasingly tuning into animal livestreams to escape artificiality. Ironically, AI may drive people toward real nature precisely because it can’t replicate it.
“The livestream isn’t being in nature, but it’s the closest thing that a lot of people get,” she said. “Being outside is the best thing for us and our health and our well-being and making that connection. To me, AI is not that.”
Science
How Running Shoes Have Evolved, From Ancient Greece to a Record-Breaking Marathon Time
When the messenger Pheidippides ran from the battlefield of Marathon to Athens to announce the Greek victory over the Persians in the 5th century B.C., he did it without shoes. His time was not officially tracked.
Millenniums later, at the London Marathon on Sunday, Sabastian Sawe and Yomif Kejelcha became the first to break the two-hour barrier in an official marathon, and Tigist Assefa set a women’s world record. All three did it in featherweight footwear.
The shoe, the Adidas Adizero Adios Pro Evo 3, weighs 97 grams, or about 3.4 ounces, depending on the shoe size. It’s the lightest running sneaker approved for competition. It sold out on Monday.
The race to near-weightlessness has been a driving force of innovation in running sneakers in the 25 centuries since shoeless Pheidippides’s run.
Heavier shoes are slower, a 2016 study showed, although that analysis was only for three-kilometer time trials. The study’s authors hid lead pellets in some Nike racing shoes and didn’t tell the subjects.
“When we added 100 grams per shoe, they ran about 1 percent slower, and when we added 300 grams, they ran about 3 percent slower,” said Rodger Kram, an emeritus professor of integrative physiology at the University of Colorado, Boulder. He called the 1 percent per 100 grams “a rule of toe.”
But it took many steps before running shoes evolved to the blistering pace they now allow.
‘The Platonic ideal’
Shoes once relied on leather, wood or metal reinforcements that were heavy and stiff. The rise of the rubber sole added flexibility and waterproofing. Better durability and grip were bonuses.
People could also run or walk in rubber soles without being heard. That’s why they’re called sneakers.
The first flat-soled rubber and canvas shoe was developed in 1868, almost 30 years after Charles Goodyear discovered the process of curing rubber called vulcanization. Converse and Keds made them popular in the 1920s.
“Converse All Stars are the Platonic ideal of the sneaker,” said Nicholas Smith, the author of “Kicks: The Great American Story of Sneakers.”
He noted they have not changed much.
“Canvas on top, rubber at the bottom.”
‘Chariots of Fire’
Competitive runners soon faced a trade-off: a heavier shoe with better traction or a lighter flat sole.
The heavier option, which transferred maximum force from the runner’s foot to the ground for acceleration, came from J.W. Foster of Bolton, England, who had the insight that led to the first metal spikes in shoes in the 1890s. Top British runners, including those competing in the 1924 Paris Olympics, wore these new spikes to notch their fastest times. Their story is told in “Chariots of Fire,” the Oscar-winning 1981 film.
It was at another Olympics, in Berlin, that Jesse Owens wore six-spiked shoes created by Adidas to become the most successful runner of the 1936 Games. His shoes, made of specially tanned calf leather and cowhide, weighed 201 grams.
A broken waffle iron
Running tracks made of urethane, a rubber compound, began to emerge in the 1960s. When one was installed in 1969 at the University of Oregon, the track coach, Bill Bowerman, found that runners’ spikes dug in too deep while flat shoes offered too little traction.
Having breakfast one morning in 1971, he noticed that the grid pattern on the waffle iron his wife was using might just be what his runners needed to get a grip on the track.
He tried pouring liquid urethane into the waffle iron, but only managed to seal it shut. He kept trying other waffle irons until he had the mold he wanted, according to Nike archivists.
But Bowerman wanted more than grippier sneakers.
“He was also devoted to making the lightest running shoe possible,” said Elizabeth Semmelhack, the author of “Out of the Box: The Rise of Sneaker Culture.”
Bowerman’s shoe, which Nike called the Waffle Trainer, “stands out because it had an extremely thin rubber sole but with a high tread, and then the upper of the shoe was made out of nylon.”
The light weight also helped bring running to the masses.
“You can bet there wouldn’t be so many people running today if they had to carry all the extra baggage we had back then,” Bowerman, a Nike co-founder, said in 1979.
The waffle-pattern nubs on the soles compressed under weight and helped bring spring to a runner’s step. But they only hinted at how sneakers could be cushioned. For many runners, it was not enough.
Then Nike introduced ethylene-vinyl acetate, better known as EVA foam, on the heel of its Cortez shoe in 1972. EVA offered a thicker, air-infused layer of separation from the road and absorbed more of the shock. The age of adding thick slabs of rubber for cushioning was over.
That led to a new quest that continues today: How much cushioning can you build into a shoe?
Lighter than foam
Sneaker makers next turned to a gas and a semisolid to help spread the energy of a foot’s impact with the ground.
In 1979, the Nike Air Tailwind began the airbag era, in which pressurized gas is stored in a flexible urethane bag within the sole.
Asics pioneered gel cushioning technology in 1986 with its silicone-based shock absorption. Nike countered in 1987 with the Air Max 1, which had a “window” in the sole designed to show off the air pocket. “At the time that was the cutting edge,” Mr. Smith said.
Though air is lighter than foam, it had to be kept in a rubber vessel, which added weight. So did adding silicone gel packets to the heel and forefoot.
While air bubbles felt more springy, and gel more dampening, they both were able to absorb shocks longer than the standard foam.
An icon of the 1990s tackled a different problem: how laces become loosened during a run. Reebok, building upon its wildly successful Pump basketball sneakers, which could be inflated with the press of a button on the tongue, introduced the Instapump Fury, a colorful, open-paneled, split-soled running sneaker.
“The Instapump used an air bladder that could fit your particular foot, the nuances of your own foot, very, very closely,” Ms. Semmelhack said. “Then you didn’t have to adjust any lacing throughout your run or at any time. So it was very innovative.”
Rise of the super shoes
But as new technologies made foam lighter, shoemakers soon couldn’t get enough of it.
One brand, Hoka, wedged so much cushy foam into its soles, beginning in 2009, that the shoes looked swollen. Runners could hardly “feel the ground anymore,” Smith said. The company’s designs helped push amateur runners to chunkier shoes.
But it was the thick-soled Nike Vaporflys that captured the most attention. They came with a carbon-fiber plate in the midsole that was very light and gave stability to all the squishy foam. The plate stores and releases energy with each stride, and is meant to spring runners forward.
The Vaporflys also use polyether block amide, or PEBA, a bouncier, lighter foam. The twin technologies led to the nickname “super shoes.”
“There was concern that this additional innovation in the running shoe was the equivalent of doping,” Semmelhack said. The shoes cushioned the feet of all three medalists in the men’s marathon at the 2016 Rio de Janeiro Olympics. The New York Times found in 2019 that the shoes gave a significant advantage, but they were never banned.
Adidas used its lightest foam in the sole of the Adizero Adios Pro Evo 3, which were worn by Sunday’s record-breaking marathoners. It also said that the shoe has carbon fiber rods to mimic the human foot’s bone structure.
In other words, closer to the bare feet in Pheidippides’s run.
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