Simon Spichak
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spichaksimon.bsky.social
Simon Spichak
@spichaksimon.bsky.social
750 followers 550 following 420 posts
Neuroscience MSc
🦔 dad

Founded Resolvve Inc to make therapy affordable for students

Science, health and tech journalist published in Being Patient, NYT, The Guardian's Scientific Observer, The Sick Times, and The Daily Beast
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spichaksimon.bsky.social
Your daily dose of hedgehog
November 25, 2025 at 12:05 AM
spichaksimon.bsky.social
A few charts we created for this analysis.
A Sankey chart showing the 112 exercise trials. 21 measured PEM and only 4 excluded participants who experienced it. Bar plot showing the number of Long COVID exercise trials over time that mention PEM in the registration
November 21, 2025 at 2:33 PM
spichaksimon.bsky.social
A swath of low-quality trials are often used by doctors and Long COVID clinics to justify the use of exercise as a treatment. Most of the evidence is collected by researchers who seem to be unaware that a large chunk of people with Long COVID experience PEM leading to substantial harm.
Key points you should know: A swath of low-quality exercise studies are used as justification that the intervention works for Long COVID; however, the studies included in those analyses neglected to account for PEM. Less than 15% of Long COVID clinical trials testing the benefits of exercise or cardiopulmonary rehabilitation measured post-exertional malaise, according to their trial registration, while a handful excluded participants who experience it. Some experts question the utility of these trials for Long COVID. However, the principal investigators running RECOVER-ENERGIZE, which is testing cardiopulmonary rehabilitation, declined to explain the rationale behind their study. Experts say it is important to use multiple measures, including surveys and a two-day cardiopulmonary exercise test, to track PEM. Researchers say it’s important to track PEM for up to a month after the trial ends. Despite the disproportionate focus on it as an intervention, exercise does not mechanistically connect the main pathophysiological findings or suspected mechanisms that leading Long COVID researchers are pursuing.
November 21, 2025 at 2:33 PM
spichaksimon.bsky.social
CBC's flagship program doubles down on quackery, adds patient blaming rhetoric after pushback on the Gill Deacon interview.

I've updated the story: simonspichak.beehiiv.com/p/cbc-flagsh...

Brief summary below with Alt Text.
UPDATE November 8th 2025: While The National did not directly respond to my questions, they provided this statement on November 7th: “After reviewing the interview, we concluded that it needed to be re-edited and re-posted to include further context and questions around the procedure and treatment Deacon experienced. That has now been done.” The new version is substantially worse. At 4:01 in the interview, after discussing how she joined a clinical trial that didn’t work, the program mentions she didn’t give up. “She turned to a controversial approach that is not currently offered through public health institutions to treat Long COVID.” The interview still doesn’t name the program or discuss why it’s controversial — it is not evidence-based and is accused of exploiting people with Long COVID. Then it shifts to patient blaming. At around 5:26, host Ian Hanomansing cued up a question about the legitimacy of brain retraining, which is criticized by most in the patient community. “I think there can be a tendency to double down on your ‘I am really sick’ and ‘I am really having these symptoms’ and maybe get [sic] develop some kind of reluctance or resistance to having an open mind to what else might work best,” Deacon responded. She followed up the patient-blaming rhetoric by saying she doesn’t judge people for how they handle the disease. This rhetoric is common tactic in alternative medicine where patients are blamed for not benefiting for a treatment because they aren’t trying hard enough or aren’t open-minded enough. The same rhetoric wouldn’t fly for cancer, multiple sclerosis, or other disease so but it appears acceptable for Long COVID. Are the journalistic standards more flexible when the person being interviewed is a former colleague or when they’re trying to sell a book?
November 8, 2025 at 7:16 PM
spichaksimon.bsky.social
New version is up. It is 29 seconds shorter. Will be looking to see what the difference is.

This is the note they've added referencing that they're adding context around the program Deacon experienced.
Note: This interview has been re-edited and reposted to include further context and questions around the program Deacon experienced.]
November 7, 2025 at 11:29 PM
spichaksimon.bsky.social
New version is up. It is 29 seconds shorter. Will be looking to see what the difference is.

This is the note they've added referencing that they're adding context around the program Deacon experienced.
Note: This interview has been re-edited and reposted to include further context and questions around the program Deacon experienced.]
November 7, 2025 at 11:29 PM
spichaksimon.bsky.social
My assistant when he's told he needs to help me post
November 6, 2025 at 8:12 PM
spichaksimon.bsky.social
Enter adaptive platform trials. Expensive, hard to run, but lets you test for multiple combination interventions.
November 6, 2025 at 7:29 PM
spichaksimon.bsky.social
Average =/= normal. Some people might get a good score but they still have impairments that dropped a lot. Even if they're testing in the average range, they might still have fell a lot from their baseline.
November 6, 2025 at 6:41 PM
spichaksimon.bsky.social
Goober is running the bases! ⚾ 🦔
November 2, 2025 at 3:20 AM
spichaksimon.bsky.social
Welcome to the era of vibes-based medicine!

A new study in the Lancet eClinicalMedicine finds that exercise for Long COVID is an effective treatment - and they do that by using studies of people who didn't have Long COVID.
Screenshot of paper and authors. Effects of therapeutic interventions on long COVID: a meta-analysis of randomized controlled trials Chang Tana,b,g ∙ Jiahao Menga,e,g ∙ Xingui Daic ∙ Baimei Hed,f ∙ Pan Liua,e ∙ Yumei Wua
August 14, 2025 at 6:24 PM
spichaksimon.bsky.social
🦔 🛞
July 30, 2025 at 11:05 PM
spichaksimon.bsky.social
Sometimes Goober likes to scratch himself like a dog 🦔
April 1, 2025 at 2:20 PM
spichaksimon.bsky.social
Last speaker of the day is @mjnabuurs.bsky.social.

"We are only temporarily non-disabled."
Mary Jo Nabuurs, a woman in a grey coat and purple KN95 speaking into a microphone.
March 15, 2025 at 6:37 PM
spichaksimon.bsky.social
Physician and researcher Dr. Angela Cheung speaking on #LongCOVID and what she was seeing early in the pandemic

"Even those who are not very sick [...] we're not having completely recovery."
Dr. Angela Cheung, a woman in a black coat with a blue surgical mask speaking into a microphone about Long COVID research under a white tent.
March 15, 2025 at 6:22 PM
spichaksimon.bsky.social
Rebecca, mother of a Ethan who is living with #LongCOVID, discusses the medical gaslighting they've experienced from medical professionals

"Canadian citizens deserve access to care for their children."
A woman in a respiratory speaking under a white tent about pediatric Long COVID. She is wearing a navy sweater
March 15, 2025 at 6:16 PM
spichaksimon.bsky.social
Pillow cases with #LongCOVID stories

"My mom usually feels like she has the worst flu. She's in pain all the time." Becca - 13 years old from N Vancouver
Becca 13 years old N Vancouver Her mother has long COVID after 1 infection. My mom usually feels like she has the worst flu. She's in pain all the time. We were always on adventures, now she can't even make dinner a lot of days. Anonymous 32 years old Vancouver BC One single infection. Tire very quickly, issues understanding stuff I read. Can't work anymore because I can't do computer more than 30 mins. Can't cook or do household chores because I faint. Had to give up my own business. Spent my life savings. Still don't have a family doctor. Everyone has abandoned me. I don't see a point in life.
March 15, 2025 at 5:47 PM
spichaksimon.bsky.social
Canadian researchers developing recommendations for treating #LongCOVID released these gems:

1. CBT along with pacing to treat post-exertional malaise
2. A 6 minute walk test to evaluate patients, even though it could trigger PEM

CC
@sunsopeningband.bsky.social
@longcovidphysio.bsky.social
In people with post COVID-19 condition and post-exertional malaise (PEM), the CAN-PCC Collaborative suggests cognitive behavioral therapy in addition to pacing (conditional recommendation, very low certainty in the evidence). Remarks: Cognitive behavioral therapy is aimed at providing mental health support and is a values-based intervention that relies on aligning with individual personal goals. The therapy should be tailored for each individual through collaboration between provider and patient to work within each individual's energy limit and avoid exacerbation of PEM and fatigue. Another CAN-PCC recommendation suggests using rest/pacing for adults with confirmed post COVID-19 condition and post-exertional malaise or post-exertional symptom exacerbation. Therefore, the panel decided it was reasonable to make this recommendation for cognitive behavioral therapy in addition to pacing. For adult patients with suspected post COVID-19 condition and cardiac or respiratory symptoms the CAN-PCC Collaborative suggests using a 6-minute walk test (6MWT) with oximetry versus not using a 6MWT with oximetry (conditional recommendation, very low certainty in the evidence). Remarks: If there are risk factors that place the patient at a higher likelihood of having exertional desaturation or precipitating post-exertional malaise/post-exertional symptom exacerbation (PEM/PESE), a patient-centered approach and discussion with a healthcare professional with expertise in interpreting ambulatory oximetry is required. The benefits of this test include diagnosing or ruling out important conditions, such as interstitial lung disease, but not diagnosing post COVID-19 condition.
March 11, 2025 at 9:28 PM
spichaksimon.bsky.social
Only the Greens and NDP have released a costed plan as of Feb 21.
Summary: Summary The Green Party and NDP have committed to double ODSP and OW, while the Liberals only intend to double ODSP. The Green Party will double rates immediately, the NDP have not provided a timeline, while the Liberals intend to do so over two years. None of the leaders have mentioned Long COVID or the ongoing COVID pandemic. None of the Parties or leaders have a specific plan to implement measures that prevent infections in high-risk settings like hospitals and long-term care. As of February 21st, only the Greens have put out a costed plan. (This is incorrect now because a few hours later, the NDP put out their costed plan)
February 21, 2025 at 8:09 PM
spichaksimon.bsky.social
Hey #NeuroSky, always looking to speak with anyone at the NIH with insight into what's going on with Alzheimer's and dementia research for @beingpatient.bsky.social.

Get in touch via Signal - happy to keep you anonymous. Send a message to simonspichak.64
Signal QR code simonspichak.64
February 7, 2025 at 1:55 AM
spichaksimon.bsky.social
Absolutely love when my FOI request with the Public Health Agency of Canada takes more than 120 days to acknowledge and start processing...
Hello Mr. Spichak, Please find attached the acknowledgement letter confirming that the Public Health Agency of Canada received your request (PHAC-A-2024-000083) on September 27, 2024. I sincerely apologize for the delay in processing your request. It was recently transferred to me, and I want to assure you that I am prioritizing it. I understand that you did not receive an extension notice, and I regret any inconvenience this may have caused. Please be advised that external consultations may be required, which could extend the processing time. However, I will make every effort to provide you with the release package as soon as possible. If you have any questions, please do not hesitate to reach out. Once again, I appreciate your patience and sincerely apologize for the delay.
February 5, 2025 at 6:52 PM
spichaksimon.bsky.social
I'm still reporting on the freeze going on at the #NIH and #FDA and its impact on #Alzheimers research and #ClinicalTrials for @beingpatient.bsky.social.

Got any tips, insights, emails, or memos you want to pass along?

You can DM or send a secure message on signal to simonspichak.64.
A scene from It's Always Sunny in Philadelphia where one of the characters, Charlie Kelly, who is wearing a tie and business casual office attire is pointing and gesturing to a corkboard covered in papers and red string. He is telling another character who is wearing a green vest about an overarching conspiracy in the mailroom.
January 28, 2025 at 9:45 PM
spichaksimon.bsky.social
Goober is trying to climb into my hair
January 28, 2025 at 3:35 PM
spichaksimon.bsky.social
My son Goober telling me some secrets.

(Holding his bottom so he doesn't slip and fall.)
January 6, 2025 at 10:49 PM
spichaksimon.bsky.social
Patino is frustrated and disappointed with the recommendations and the timing of the survey.
"They are rushing out recommendations because of the deadline to be done by March, but they are not considering the amount of recommendations per survey, the timing or even providing reliable research to support their arguments. I know I am not the only one this frustrated, and disappointed," Adriana Patino, Long COVID Canada
January 2, 2025 at 4:04 PM