Razina Munshi FM Fox editor & columnist
A crew of a private ambulance service in Port Elizabeth wear personal protective equipment ahead of checking on a patient affected by Covid-19 at her home. Picture: AFP/MARCO LONGARI
A crew of a private ambulance service in Port Elizabeth wear personal protective equipment ahead of checking on a patient affected by Covid-19 at her home. Picture: AFP/MARCO LONGARI

Fatigue, breathlessness, short-term memory loss and brain fog. These are the most common symptoms reported by some people who have recovered from Covid-19, months later.

There is now growing recognition that many people who get Covid-19 are experiencing lasting effects – from the infection, and in some cases, from the treatment. A recent article published by The British Medical Journal calls this “long Covid”.

Social media support groups for long Covid are fast gaining members. And in recent weeks, many people – including doctors – have shared their experiences here.

They cite symptoms including headaches, muscle pain, chest pains, ringing in the ears, and even neurological symptoms such as numbness, weakness and visual disturbances.

The novel nature of this virus means sufferers, medics and experts simply don’t know what to expect. The world continues to be taken by surprise by this virus. No-one quite believed that it would go on for such a long time.

And the people who cite experience with long Covid include those who have been hospitalised for it, and alarmingly, those who haven’t.

Aside from anecdotal evidence, little research has been conducted on the issue. But documenting cases has begun. Researchers from Italy report that nearly nine in 10 patients (87%) discharged from a Rome hospital after recovering from Covid-19 were still experiencing at least one symptom 60 days later.

The researchers set up a study in April to assess the patients. One-third had one or two symptoms and 55% had three or more. Fatigue (53.1%), shortness of breath (43.4%), joint pain, (27.3%) and chest pain (21.7%) were the most commonly reported symptoms.

The UK’s Covid-19 Symptom Study app, which collects symptom information from its nearly 4-million users, says its data shows that one in 10 people with Covid-19 are sick for three weeks or more, even if most people recover within two.

The more we learn about the novel coronavirus, the weirder it gets, says the app’s lead expert, Prof Tim Spector from King’s College London. “I’ve studied 100 diseases. Covid is the strangest one I have seen in my medical career,” he told The Guardian in this report.

So to fill in the gaps in knowledge, a new study to assess the long-term effects of Covid-19 on hospital patients was announced this month in the UK. It aims to recruit 10,000 patients, who will be followed for more than a year.

Putting aside the sheer mystery of this unknown virus and impact, there are several knock-on effects. Health facilities are already overwhelmed, so long Covid sufferers have found it difficult to access medical support. Public health systems simply aren’t geared to deal with this.

Workplaces generally give sick employees two weeks to recover. Those who haven’t recovered by this time say their employers and even their friends and family don’t always believe them, especially when they are still ill weeks later.

And there is another problem with this phenomenon. With great difficulty, those of us who work from home and have secure formal employment can ride this out. What about those don’t?

Personal accounts

Paul Garner, professor of infectious diseases at Liverpool School of Tropical Medicine, first wrote about his experience with long Covid at the seven-week mark.

“The illness went on and on. The symptoms changed, it was like an advent calendar, every day there was a surprise, something new. A muggy head; acutely painful calf; upset stomach; tinnitus; pins and needles; aching all over; breathlessness; dizziness; arthritis in my hands; weird sensation in the skin with synthetic materials.”

At 14 weeks, Garner blogged again, citing this comment he received about his illness from a woman on a WhatsApp group: “If my husband had said he was still sick with Covid-19 after a month, I’d say he was milking it.”

When he got the message, Garner had been ill for a month. “What would she say to me now at 95 days? I am unable to be out of bed for more than three hours at a stretch, my arms and legs are permanently fizzing as if injected with Szechuan peppercorns, I have ringing in the ears, intermittent brain fog, palpitations, and dramatic mood swings. Am I milking it?”

In a podcast recorded at 17 weeks, Garner said his activities influenced how he felt. A short walk, 10 minutes of yoga, or a 15-minute cycle ride could set him back for days.

Jake Suett, a 31-year-old British doctor, published this personal account of his recovery, saying he has been ill for 109 days. ”I think I am slowly improving but am left with residual symptoms that have never gone away entirely but regularly return strongly in waves.”

Suett has joined support groups on social media and was suddenly faced with the realisation that thousands of others were in the same position. “It was a bittersweet moment as it helped me to feel less alone, but on the other hand confronted me with a tremendous volume of genuine human suffering that was going unrecorded and unnoticed.”

This week CNN gave an account of the rehabilitation needed by an Italian professional diver, who contracted the coronavirus in March and spent 17 days in hospital. Three months later, the 42-year-old still experiences breathing difficulties and receives treatment at a post-Covid rehab institute in Genoa. He hopes to be able to return to work by mid-August.

The rehab centre’s director, Piero Clavario, told CNN: “What surprises me the most is that even the patients that have not spent any time in the ICU are extremely feeble: there is no evidence of a cardiological or pulmonary problem, but they are not even able to walk up a flight of stairs.”

It underscores how, when it comes to Covid-19, we still don’t know what we don’t know.

* Munshi is News & Fox editor of the FM​

This is a roundup of the best Covid-19 news from the web, brought to you in today’s FM lockdown newsletter. To subscribe, for free, click here.

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