By Victor S. Sierpina, MD
“In times of deep darkness, we not only need light—we need to be a light for one another.” -Parker Palmer
While we have been staring down the gun barrels of serious illness and death from COVID plus the stuttering roll-out of sufficient vaccines, another pandemic is developing.
This is the so-called “Long Haul COVID” or” Post-COVID syndrome.” In a significant percentage of COVID cases, those who have “recovered” from the initial infection continue to be adversely affected with long-term and ongoing health impairments. According to Dr. Anthony Fauci, this situation will likely impact millions of people.
We have known for a while that some COVID patients have ongoing issues when they are released from the hospital. What is coming to light though, is that many whose infection was not so serious as to require hospitalization, even younger, healthy, minimally symptomatic cases may develop persistent health problems.
The most prominent of these are severe fatigue, ongoing pulmonary, cardiac, neurological, and gastrointestinal issues. A kind of “brain fog” has been reported, likely due to neuroinflammation, which leaves folks struggling to function at their best level cognitively. How about an enduring loss of the sense of smell, which can also affect appetite, taste, nutrition, and even lead to depression? A condition called dysautonomia also has been recognized which alters the way the body’s sympathetic and parasympathetic nervous systems work affecting everything from blood pressure to thermoregulation. Experts note that most of these go away within six or so months but for some people, they seem to continue.
UTMB–Health has an interdisciplinary Post COVID-19 Recovery Clinic which was set up by pulmonologist Dr. Justin Seashore to address these very problems. They do a 90- minute comprehensive, holistic evaluation assessing breathing issues, activity and functional capacity, mood, neurocognition, nutrition, and more.
One patient of mine, a local college professor was hospitalized for two weeks with COVID pneumonia and is, for now, tethered to a portable oxygen system. He works from home, but his fatigue keeps his work capacity limited. He reported to me high satisfaction with the thoroughness of the Post -COVID clinical evaluation.
But be aware, even if you had a mild COVID case that new, unexplained, or persisting symptoms of many types might occur and could be a result of the mild infection.
If in doubt, seek out medical advice. Your primary care doctor may the place to start as the number of cases we anticipate will likely soon overwhelm the capacity of specialized clinics like Dr. Seashore’s UTMB–Health Post-COVID-19 Recovery Clinic.
Supportive care is what we have now. This includes adequate rest, nutrition, immune support, activity modification, mental stimulation, stress management, and gradual heart and lung rehabilitation including supplemental oxygen for some.
As for vaccinations, I have a personal story. My second dose of the Pfizer COVID vaccine sent me into very strong immune response that lasted nearly a week. Though I had no reaction to the first one, the booster hit me like a train bringing a load of muscle and joint aches, fatigue, headache, gastrointestinal complaints, loss of appetite, fever, shaking chills, and strange feelings on my skin.
Even in my misery, I celebrated the robust response my body’s immune system was making in responding to the vaccine. I definitely would take it again, despite the discomfort, to protect me and others against the serious consequences of the virus infection itself.
While I can now feel protected, particularly at my clinical work where I have to be up close and personal with people, examining orifices and body parts high and low in my diagnostic and therapeutic maneuvers, I adhere to the advice of experts to remain vigilant.
Even those of us who have been fortunate enough to get the vaccine early will need to continue to mask, wash hands, and maintain social distancing for several reasons. One is that the vaccine is approximately 95% effective so we never know who is in that 1 out 20 category for which it is not. Another unknown is whether vaccinated folks can become carriers who do not have symptoms, thus conveying it unwittingly to others. Reinfections have been reported as well.
We are all in this for the long haul. The pandemic is becoming endemic, like the flu, and will be with us for the foreseeable future.
“Although the world is full of suffering, it is full also of the overcoming of it.” -Helen Keller
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