Ethics Grand Rounds | It Doesn't Have to Be This Way: Long COVID & an Alternative Model of Health in the U.S.

It Doesn’t Have To Be This Way: Long COVID and An Alternative Model of Health in the US

Headshot of Zachary Berger
Zackary Berger, MD, PhD


In the first months of the COVID-19 pandemic, many types of patient stories – later to be repeated thousand fold – were heard for the first time. Some were easier to understand: people tragically taken ill and eventually dying in the ICU or alone at home. Some were easier to bear, though still accompanied by suffering – e.g. those with mild illness from which they recovered. Still other people, however, experienced illness in a model that has always resisted solution. Those with long COVID ask one question of themselves, their caregivers, their clinicians, and society at large. “Why aren’t I getting better, and what can be done?” As with so many COVID-related phenomena, chronic illness (likely incurable for some) is not new, and it sheds light not on discontinuities in US healthcare but on the very chasms it is founded on. Thus to understand how Long COVID might be approached requires a thoroughgoing revision, re-envisioning, of US healthcare. 


Zackary Berger, MD, PhD, is Associate Professor in the Johns Hopkins Division of General Internal Medicine and Core Faculty at the Johns Hopkins Berman Institute of Bioethics, with joint appointment in the Johns Hopkins Bloomberg School of Public Health. With an active practice in primary care internal medicine at Johns Hopkins, Dr. Berger focuses his clinical, educational, and research work, as well as his widely read publications for the lay public, on the ways in which shared decision making in the doctor-patient encounter might be in conflict with medical evidence and the political, social, and psychological realities of the patient. Dr. Berger teaches residents in their internal medicine clinic and medical students on the wards at Johns Hopkins Hospital, and is part of a Berman faculty team which teaches bioethics to residents in a number of Johns Hopkins specialty programs. He is also staff physician at the Esperanza Clinic Health Center, a free clinic serving undocumented Spanish-speaking immigrants. Dr. Berger is the author of two books for the lay public on doctor-patient communication and on patient preference in the context of medical evidence.