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The COVID-19 Long Haulers—What Can We Learn?

Updated: Jun 25, 2020

The world struggles to understand the continuing turmoil caused by a virus.

  • China locks down a portion of the country because of a resurgence of new cases.

  • Churches, demonstrations, and large gatherings have become breeding grounds for virus transmission as disbelievers gather in unprotected groups, yet states continue to reopen.

  • Bars and restaurants are resuming side-by-side seating and merrymaking despite soaring numbers of new cases.

  • People die. People survive.

  • And now, survivors who are called the COVID-19 long haulers are finding out the continuing effects of a virus we don’t understand.

The grim statistics indicate no curve flattening. No relief. And as much as we desperately want to resume some sort of normal life, we keep getting jerked back to reality with overflowing ERs and soaring numbers of positive cases.

The naysayers and disbelievers don’t understand the short- and long-term fate of individuals who become ill and may require hospitalization and ventilator support but are fortunate enough to be dismissed from the hospital.

There are no long-term studies of these individuals, but the data that are available from case reports in the medical literature portray a grim scenario. We now know that thousands of individuals who somehow survived their illness are profoundly disabled and have had a shredding of their quality of life and view of the future. This was an unexpected development of COVID-19.

Some patients are relatively young and had been fit and now have bizarre fluctuating symptoms of shortness of breath, a rapid heart rate, and overwhelming fatigue to the point of hardly being able to take a shower unassisted.

We are now recognizing that there may be significant mental and intellectual impacts in some patients who describe a “brain fog,” which is the kind of phenomenon described by some patients receiving chemotherapy for cancer. They have trouble balancing a checkbook, finding car keys, and just participating in the usual banter of life.

For them, something is not quite right. Unfocused. A fog. They are off track, and they worry that these issues might be permanent.

This is somewhat reminiscent of the post-polio syndrome where patients who were stricken by that virus in the 1950s continued to be plagued by vague complaints that defied any obvious medical explanation. These polio survivors developed progressive muscle and joint weakness. They were fatigued and lost mental sharpness, had sleep disorders, and could not tolerate the cold.

In some studies, these lingering symptoms occurred in up to half of patients, and here is the scary part. The symptoms lay dormant and surfaced ten to forty years after the diagnosis of polio.

We’re in totally uncharted murky water with COVID-19, and the medical experts are divided about whether these long-lasting symptoms are just a transient inconvenience and a nuisance or whether this indicates long-term consequences.

For COVID long haulers, their journey into uncharted territory will be carefully watched and scrutinized.

If we do not understand history, we are destined to repeat the events of the past. With the COVID situation if we are not alert and informed, we too may be part of a future of profound emotional and physical uncertainty.

This is not seasonal flu in which you lie in bed, miserable, for five to ten days, drink chicken soup, take cough medicine, and recover. COVID-19 is very different from any previously detected viral illness, my medical colleagues and I agree.

The COVID-19 virus has not read the rule book and will follow its own trajectory. Until we know where it’s going, we better stay alert and engaged and protect ourselves from an enemy that we have never encountered before.

[Photo courtesy Tom Liggett, author of Mozart in the Garden,]

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