‘Long COVID’

As the COVID-19 pandemic unfolds, there is a danger that people will shrug their shoulders and say, “Oh, most people survive anyway.”

But illness is illness, and even mild and moderate cases mean lost work days and medical expenses, the expenses mounting with the severity of the illness. Survivors of severe COVID-19 have racked up bills reaching into the millions, for which PhilHealth will reimburse only P750,000, if at all given its financial mess brought about by corruption.

Several months into the pandemic and with tens of millions of COVID-19 survivors, another problem is emerging. It’s referred to as “long COVID,” or the long-term effects of the disease for weeks, even months, after a person has supposedly recovered. People with long COVID are sometimes called “long haulers.”

Not all are affected by long COVID, and it’s too early to say just what percentage will be affected. But the symptoms and complications are not to be shrugged off: persistent fatigue, muscle and joint pains, headaches, intermittent fever.

There are also a growing number of reports in the medical journals indicating that there are serious multi-organ complications. COVID-19 clearly causes inflammation not just during the height of the illness but also in the long COVID. The organ systems that are affected include the cardiovascular, respiratory, renal or kidney, and even dermatological (rash and hair loss have been reported).

Most worrisome is the range of neurological symptoms that affect mental health. Many of those with long COVID report brain fog or difficulty with thinking and concentration. Other symptoms include difficulty with sleeping, impaired memory, and a persistence of smell and taste common when a person is first affected.

Amid the numerous reports coming out in scientific journals, filled with statistics and medical jargon, it was useful to read a personal account from Paul Garner, a professor of epidemiology at the Liverpool School of Tropical Medicine, published in the British Medical Journal on June 23, 2020. Give it to the Brits for vivid descriptions. Here is an excerpt from what happened to him 95 days after COVID-19 symptoms first appeared:

“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.”

An American physician, Jeffrey N. Siegelman, also gives a personal account in the Nov. 11, 2020 issue of the Journal of the American Medical Association. Siegelman “only” had mild COVID-19 and was never hospitalized, but he quarantined himself for 40 days in his home basement because he had persistent low-grade fevers and he was worried he might still be infectious.

Both Siegelman and Garner consider themselves fortunate, with job security and access to medical resources.

Siegelman says his being a COVID “long hauler” changes the way he will interact with COVID-19 patients, declaring “the lack of objective data does not preclude illness” and this will include “vague abdominal pain, or fatigue… or any of the myriad conditions that are uncomfortable on the inside but look fine on the outside.”

He also calls for more support from society, to give more opportunities for possible long COVID patients to seek help and be listened to, given the tendency of health professionals, employers, and even relatives to “require” people to snap out of an illness after some time, and to dismiss continuing complaints as malingering (technical term for “OA,” overacting, or KSP, kulang sa pansin, wanting attention).

In the Philippines, we have had at least 300,000 recovered patients. I wonder how many of them are long haulers, and if they are getting help and support.

No need to give their names, but we also have that terrible tragedy in Manila City Hall where a lawyer clerk of court killed his boss, a judge, then turned the gun on himself. Eyewitnesses say he was nervous and shuddering while talking with the judge about his possible resignation because the quality of his work had deteriorated.

Yes, he had supposedly recovered from COVID-19. Was he a long hauler? Could there have been ways to help him and prevent the double tragedy?

The term long hauler brings to mind long-distance drivers who have to keep going with their buses or trucks, driving long hours through dark nights and lonely highways. Let’s hope our COVID-19 long haulers don’t have to go through similar ordeals.

mtan@inquirer.com.ph