“We saw really big differences between the patients and our controls in the way that the muscle is able to generate energy using mitochondria. We know that that normally exercise is good for you and the exercise improves the mitochondrial function, but in our patients we saw the opposite happening - that it worsens.”

“The first year of this was recognising the problem and getting people to buy into that... The second year of this was describing who was most likely to get this condition. The third year of this was laying out potential biology. The current era of this now needs to be proving that each of those mechanisms is or is not driving this and… you actually have to intervene on those pathways to see if you can change either a biological measurement or change how people feel. What that means to us is doing trying to do these intense proof of concept, experimental medicine type studies, where we identify a target pathway that we think it is contributing, then we try to alter it by giving an investigational treatment and we see what happens and whether our hypothesis was correct.”

“If we’ve learned anything, this is not something anyone wants to get… The fact that there's a genomics that underlie Long Covid tells you how real it is, right? And then the fact that we will get treatments to people, all these things reinforce how big an issue.”

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“when people say what's the magic recipe for treating people well, there is no magic recipe you actually have to individualise you know, because Because Because one treatment for one person will actually totally backfire for the other person. So I do think it's, it's, you know, we're learning a lot about this is a very complex condition.”

“There are so many questions that are unanswered about Long Covid. We're just scratching the surface of this disease.. that's why it's dangerous to come to a conclusion at this stage - because we know so little. It doesn't mean that we aren't looking. We're looking very hard. I'm obsessed about trying to understand this disease, and many scientists are, so hopefully will chip away at this disease. But we need to be open minded and humble about what's going on.”

“There's some kind of indirect evidence suggesting that the sympathetic nervous is dysfunctional in POTS or Long Covid patients, and given the post-infectious nature, I suspect this is some kind of inflammatory, maybe autoimmune, reaction… probably our body is attacking our sympathetic nervous system”.

“.. if people realise that Long Covid is basically an immuno-compromised state, akin to immune compromised status of having HIV then I think …. it will actually change the course and the political momentum.”

“In ophthalmology there is a sentence - the eye is the window to the body - that’s a common theory which we use in our normal clinical life”. So could we use the eye to diagnose Long Covid?

“So the hypothesis that I had here was that Long Covid patients seem to have this constellation of symptoms that were resembling some kind of immune disturbance. So I thought that if we actually looked at underlying T cell responses to the virus, we could find a pattern that differentiated these patients from those who completely recovered after. As an immunologist, it kind of screamed let's look at the T cell response.”