Listening to Long COVID: Epistemic Injustice and COVID-19 morbidity

In Long Covid, symptoms do not resolve within several weeks after acute infection with SARS-CoV-2. Patients with COVID-19 and long COVID face stigma and discrimination. One important type of discrimination is epistemic injustice which includes testimonial and hermeneutical injustices. Testimonial injustices occur when healthcare professional disregard or discount patients’ symptoms. This worsens healthcare outcomes and exacerbates challenges to adequate healthcare access at the individual level. Furthermore, testimonial injustices may lead to hermeneutical injustices – systemic underrepresentation of the experiences of the marginalized and minoritized. Healthcare professionals play an essential role in mitigating injustices and have a duty to reduce harms done to patients with long COVID. It is crucial that the clinician avoid multiplying associated harms by not engaging in epistemic injustices. We suggest the disability model as an approach to improve clinicians’ response to long covid. Epistemic injustice leads to systemic inequities that affect those with chronic disease in general, particularly in populations suffering from structural inequities. The COVID-19 pandemic provides an opportunity for solidarity with those suffering from other chronic diseases that have been marginalized and stigmatized.