# Contextualising Long Covid: Viral Sequelae, ‘Post-Encephalitis’ Lethargica and the Modern British Healthcare System, c. 1918–1945

## TL;DR

This paper compares Long Covid to a historical illness called Post-Encephalitis Lethargica to understand how healthcare systems shape perceptions of viral sequelae.

## Contribution

The paper introduces a historical framework to analyze how administrative healthcare structures influence modern responses to Long Covid.

## Key findings

- Long Covid was recognized as a medical condition through patient advocacy, enabling access to healthcare.
- Historical analysis of Post-Encephalitis Lethargica reveals how healthcare binaries shaped perceptions of viral sequelae.
- The study suggests current NHS divisions may still influence how Long Covid is perceived and treated.

## Abstract

In the months after March 2020, people across Britain began to seek medical attention for protracted illness following an infection with coronavirus disease 2019. Through the efforts of patients, these illnesses were eventually gathered into the diagnostic category of ‘Long Covid’ and therefore viewed as viral sequelae, in turn opening up the possibility for medical care and treatment in the British health system. This article adds to such patient-made knowledge of Long Covid through a comparative historical analysis with the problem of ‘Post-Encephalitis’ Lethargica (EL). In the early twentieth century, the viral sequelae of EL were parsed in line with and thus shaped by the binary divisions that were becoming used to structure healthcare in Britain. By telling this story of the past, this article provides a framework to understand if and how such administrative divisions within the National Health Service (NHS) might continue to inform perceptions of and responses to Long Covid in the present.