Coronavirus doctor's diary: Why are people remaining ill for so long?(bbc.co.uk)
bbc.co.uk
Coronavirus doctor's diary: Why are people remaining ill for so long?
https://www.bbc.co.uk/news/stories-53368768
152 comments
> The most infuriating part is how little help there is from medical professionals (...) the only medical advice doctors will give her is to rest
I don't think it's bad will, they simply have no idea what to do. Just see what the research looks like: "they" are still busy categorising symptoms. Understanding of this disease is still in early stages. It will improve.
Mind boggling how just a few months ago all my friends were throwing the 0.x% CFR numbers for our age group, implying that there is nothing to be afraid of. There's much so more complexity and many unknown unknowns in health!
I don't think it's bad will, they simply have no idea what to do. Just see what the research looks like: "they" are still busy categorising symptoms. Understanding of this disease is still in early stages. It will improve.
Mind boggling how just a few months ago all my friends were throwing the 0.x% CFR numbers for our age group, implying that there is nothing to be afraid of. There's much so more complexity and many unknown unknowns in health!
Yeah absolutely, they're doing their best with the information available to them. That's why I'm hopeful that all the recent news around persistent symptoms will improve awareness and make more resources available. It's a nightmare situation all-round and I have full sympathy for the situation doctors are in.
Another problem is that most of the world is still too busy trying (and failing) to control the spread of infection. They don't have much attention to spare for people who aren't deemed infectious anymore.
On top of that, downplaying the severity of covid is critical to the arguments of those who want this to be over for political, economic, or any reasons.
The focus by many has been deaths. Mortality rate can be spun to make covid seem not so bad.
If we start talking about the percentage of people whose lives are significantly affected, we create a much bigger percentage. If you’re trying to paint the opposite picture, it’s not in your interest to acknowledge or increase awareness of that percentage.
The focus by many has been deaths. Mortality rate can be spun to make covid seem not so bad.
If we start talking about the percentage of people whose lives are significantly affected, we create a much bigger percentage. If you’re trying to paint the opposite picture, it’s not in your interest to acknowledge or increase awareness of that percentage.
well tell that to the cancer, diabetes and high blood pressure ,depression victims who don't get diagnosed in time or havent gotten the proper treatment. Tell that to the people who's lifework have been destroyed and I could go on with people being significantly affected. Its not that simple.
The suggestion that everyone who is pro- aggressive disease containment has not had their life turned upside down by the global pandemic is lacks logic. Shutdowns are necessary to contain the virus, and the economic damage done from not containing the virus is far worse than the alternative. We know this because we have data.
There are multiple countries that were hit very hard in the first wave, and then managed to contain the virus and accelerate their economies after; France, Spain and Italy are all great examples. IIUC, France now has 3.6% unemployment. They had strict lockdowns, followed by mask wearing, social distancing, and contact tracing. The same tactics are working for NYC in the US.
We do ourselves a great disservice to act as if virus containment is bad because it destroys economies. No, the virus destroys economies, and containment allows us to continue once mitigated. That’s what the data clearly shows.
There are multiple countries that were hit very hard in the first wave, and then managed to contain the virus and accelerate their economies after; France, Spain and Italy are all great examples. IIUC, France now has 3.6% unemployment. They had strict lockdowns, followed by mask wearing, social distancing, and contact tracing. The same tactics are working for NYC in the US.
We do ourselves a great disservice to act as if virus containment is bad because it destroys economies. No, the virus destroys economies, and containment allows us to continue once mitigated. That’s what the data clearly shows.
First of all why the strawman? I was responding to a post that claimed there were no argument against.
You can't compare the entire US with a country. The EU have had roughly as many deaths as the US per capita. That's the correct comparison. Some countries like some states did well other didn't some areas in states did well others didn't.
To claim that the tactics are working for NYC is absurd. NYC have had the highest amount of dead, we are still mostly on lockdown here and very few things are open.
I have had two melanomas and so I get checked 4-6 times a year. So far I have been tested in january and not since.
I am not sure what data you are talking about and I am pretty sure this aint over yet.
Furthermore I would challenge you to find single country who would do lockdowns again if this happened.
They locked down because they were unprepared (it's their job to be prepared) not because it was the right thing to do.
You can't compare the entire US with a country. The EU have had roughly as many deaths as the US per capita. That's the correct comparison. Some countries like some states did well other didn't some areas in states did well others didn't.
To claim that the tactics are working for NYC is absurd. NYC have had the highest amount of dead, we are still mostly on lockdown here and very few things are open.
I have had two melanomas and so I get checked 4-6 times a year. So far I have been tested in january and not since.
I am not sure what data you are talking about and I am pretty sure this aint over yet.
Furthermore I would challenge you to find single country who would do lockdowns again if this happened.
They locked down because they were unprepared (it's their job to be prepared) not because it was the right thing to do.
>The EU have had roughly as many deaths as the US per capita
I don't believe this is true, and probably hasn't been for a while. Talking points tend to outlive changing conditions.
Europe has had 270-310 per million, depending on whether you include Russia, while the US is up to 433. And the gap continues to widen because every day twice the number of people are dying in the US compared to all of Europe.
Conversely whatever is being done clearly is working for NYC and has been long enough for the death rate to follow the new case rate down. It doesn't make a whole lot of sense to say that because of all the people who died, the efforts that stopped people dying didn't work. There were ten deaths yesterday in Manhattan+Brooklyn+Bronx+Staten Island+Queens. Miami-Dade county had almost triple. But that underestimates what's coming, because new cases were over 3200 (in a day) compared to about 300 in NYC. People have steadfastly refused to believe that new cases become new deaths over time, but you can see the numbers going up.
https://www.worldometers.info/coronavirus/
I don't believe this is true, and probably hasn't been for a while. Talking points tend to outlive changing conditions.
Europe has had 270-310 per million, depending on whether you include Russia, while the US is up to 433. And the gap continues to widen because every day twice the number of people are dying in the US compared to all of Europe.
Conversely whatever is being done clearly is working for NYC and has been long enough for the death rate to follow the new case rate down. It doesn't make a whole lot of sense to say that because of all the people who died, the efforts that stopped people dying didn't work. There were ten deaths yesterday in Manhattan+Brooklyn+Bronx+Staten Island+Queens. Miami-Dade county had almost triple. But that underestimates what's coming, because new cases were over 3200 (in a day) compared to about 300 in NYC. People have steadfastly refused to believe that new cases become new deaths over time, but you can see the numbers going up.
https://www.worldometers.info/coronavirus/
You can calculate it yourself.
Europe (exl Russia) is around 176000
Europe (exl Russia) is around 176000
Obviously you should do what you feel comfortable with, but now is a good time to go the doctor and get that checked out. The numbers are pretty low and stable for the moment. And FWIW, I had surgery last week so I'm not giving advice that I wouldn't follow myself.
I don't have a choice. My dermatologist have not been available for "non-essential" situations.
That's unfortunate. Try a different dermatologist? I've gone to flatiron dermatology in the past, and they're solid.
I am on Sloan Memorial with one of the best in the world as I have more than a thousand moles. So I can't really do that.
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Shutdown is not a good strategy:
https://unherd.com/thepost/oxford-epidemiologists-suppressio...
https://unherd.com/thepost/oxford-epidemiologists-suppressio...
It is interesting that these doctors in the UK are claiming that tactics that have already worked elsewhere don’t actually work, while their country continues to suffer a massive outbreak of the virus.
On the other hand, here is a study showing two countries that have made great strides in containing the virus, after massive waves and deaths, and did so with a harsh lockdown https://www.sciencedirect.com/science/article/pii/S004896972...
On the other hand, here is a study showing two countries that have made great strides in containing the virus, after massive waves and deaths, and did so with a harsh lockdown https://www.sciencedirect.com/science/article/pii/S004896972...
That paper doesn't actually shows that its the lockdown that responsible for the decline. Its the classic correlation does not necessarily mean causation.
Every diseases could cause inexplainable long term damage as well. Yes there is so much complexity and many unknowns in health, that doesn't mean we should be afraid of it.
Good news is for majority of the case they have full recovery.
Good news is for majority of the case they have full recovery.
Do you have a source for how many have a "full" recovery vs how many have medium to long term complications? To my knowledge this isn't something being tracked.
[deleted]
You should research Chronic Fatigue Syndrome / Myalgic encephalomyelitis.
The medical community, from my experience, does not handle this type of diagnosis well.
I’ve experienced post-viral fatigue symptoms that lasted well over 8 months, and almost all doctors I visited (ranging from primary care to neurologists) suggested simply rest and/or believed it was depression related (even though I have never suffered from depression before).
I hope your wife gets better. Remission from these symptoms is possible, but sadly, I don’t think you’ll get more information out of the doctors.
The medical community, from my experience, does not handle this type of diagnosis well.
I’ve experienced post-viral fatigue symptoms that lasted well over 8 months, and almost all doctors I visited (ranging from primary care to neurologists) suggested simply rest and/or believed it was depression related (even though I have never suffered from depression before).
I hope your wife gets better. Remission from these symptoms is possible, but sadly, I don’t think you’ll get more information out of the doctors.
I'm a medical professional that had a post- viral syndrome following the flu. In retrospect, even though I didn't realise it at the time, it may have lasted for over a year. It easily fit the definition of depression, but less so the negative symptoms. Could also be classed as stress or anxiety. It went away when I cancelled all my commitments (at the time my director of studies said I was on a course to fail, and advised I handed over other responsibilities in the run up to the exams to other people). Turned out it was overkill and I had plenty of free time. During this time I returned to my normal self, and I'm more self-aware of the issue now.
In ME/CFS one of the treatments is 'graded exercise therapy'. Given my experience, I should have done something like this earlier on.
In ME/CFS one of the treatments is 'graded exercise therapy'. Given my experience, I should have done something like this earlier on.
> The medical community, from my experience, does not handle this type of diagnosis well.
I've read some time ago that Stanford scientists developed a blood test. It'll be harder for docs to ignore once there's a proper diagnostic tool.
I've read some time ago that Stanford scientists developed a blood test. It'll be harder for docs to ignore once there's a proper diagnostic tool.
Yeah, in its initial study, the nanoneedle had a 100% specificity and selectivity, and according to Ron Davis - main author - the results have held up as they've increased the number of tested people. That said it might also give a positive result for other illnesses. Hopefully a follow-up will be published soon.
Be wary of anything that claims a 100% sensitivity and specificity. It usually indicates the wrong gold standard or poor methods.
Did you ever find a treatment other than rest?
Not an expert, but I suspect that if there were a treatment that makes a clear difference, the whole disease+treatment combo would be well known by most doctors and the treatment would be widely suggested.
I could be wrong though: are there common instances of diseases with solid cures or treatments that many doctors generally misdiagnose or believe lack treatments?
I wouldn't be surprised in either direction.
I could be wrong though: are there common instances of diseases with solid cures or treatments that many doctors generally misdiagnose or believe lack treatments?
I wouldn't be surprised in either direction.
A huge number of healthcare systems around the world still use graded exercise therapy (and CBT) and that is known to actively hurt patients with the condition, so I don't think that is sure at all. You would have thought the basis of medicine where first do no harm might be their first instinct but it really isn't.
Just wait until the professionals start referring to psychological help. Chronic health problems from previous infections do not exist in modern medicine. Besides there's very little professional help to get. I believe we can reasonably expect this to develop into massive amounts of people unable to work due to ME/CFS. The effects may last for life. There are courses where they tell you to lie to yourself and say you're healthy ("lightning process"). The breaking of personal boundaries can unfortunately for sufferers lead to permanent health and capacity reduction, so take with big grains of salt wether it's worth the risk.
What may work, if it's ME/CFS-like, is to find personal limitations and avoid too much toll, ie. less or no stressful exercise. Then find ways to live healthier and gently up those boundaries without exertion, avoiding possible permanent regressions for life. Of course also seek professional medical help, but always evaluate what kind of help one is getting where and what the consequences are.
Life can and should be joyful and one should shed fear and anger, but be sceptical of claims (even this one), and do due R&D.
What may work, if it's ME/CFS-like, is to find personal limitations and avoid too much toll, ie. less or no stressful exercise. Then find ways to live healthier and gently up those boundaries without exertion, avoiding possible permanent regressions for life. Of course also seek professional medical help, but always evaluate what kind of help one is getting where and what the consequences are.
Life can and should be joyful and one should shed fear and anger, but be sceptical of claims (even this one), and do due R&D.
Since they classed the first known outbreak of ME as mass hysteria its been constant gaslighting for sufferers for 70 odd years. Even now this article is written as if ME/CFS doesn't exist, as if doctors in the UK are completely baffled, but we know what this is and it will have the same hallmark Post Exertional Malaise but its not even mentioned in the article. The NHS doesn't recognise the international definition of the disease and continues to harm patients that show up with it every day. The Chinese after SARS didn't have issues calling it ME/CFS, around 10% of the SARs sufferers still suffer with ME/CFS to this day, they had papers calling it what it was very early on. The NHS however is going with "no clue".
We do know a lot more than we knew 2 years ago. We know the condition swells the brain in the central and front regions and that explains the memory problems, headaches and coordination issues. We know that sufferers have virus RNA in their body and in their brains, so its possible its just an ongoing infection but it also appears to be partially replicated in cells. We know that patients cells produce down to about 25% of the energy that a normal persons cells do in their mitochondria and it is at least partially to do with the Calcium ion channel being turned off with a gene switch. A sufferers plasma will shut down someone else's cell too so its probably a signal of some description in the immune system soup. What we don't know is if any of this is the root cause of the condition and there is frighteningly small amounts of research being done for a disease that can be as debilitating as MS.
We know a lot about how its not Psychological now and research is getting funded at last. But its been 70 years of "its all in your head", nothing about this condition paints doctors and researchers at all in a good light.
We do know a lot more than we knew 2 years ago. We know the condition swells the brain in the central and front regions and that explains the memory problems, headaches and coordination issues. We know that sufferers have virus RNA in their body and in their brains, so its possible its just an ongoing infection but it also appears to be partially replicated in cells. We know that patients cells produce down to about 25% of the energy that a normal persons cells do in their mitochondria and it is at least partially to do with the Calcium ion channel being turned off with a gene switch. A sufferers plasma will shut down someone else's cell too so its probably a signal of some description in the immune system soup. What we don't know is if any of this is the root cause of the condition and there is frighteningly small amounts of research being done for a disease that can be as debilitating as MS.
We know a lot about how its not Psychological now and research is getting funded at last. But its been 70 years of "its all in your head", nothing about this condition paints doctors and researchers at all in a good light.
So sorry to hear about your wife. This is an incredibly scary disease for a lot of reasons. Adding the frustration of a chronic condition to that is not what anyone needs.
The basic problem is: What do you do about a chronic condition for which there is no proven treatment? I have a few people in my life with one such condition or another. There are three responses, mostly unhelpful.
The most common response is to essentially suggest things at random. Both rest and (generic) exercise are common suggestions. This can make the patient happy, but it's often actively harmful -- obviously, both rest and exercise won't help the same thing, unless it's a specific exercise chosen with the condition in mind.
The other common response is to not suggest anything, and basically try to get the patient to go away. If you're lucky, they'll try to sympathize, but mostly you'll just get brushed off. This makes the patient feel bad, but at least it won't actively make the condition worse.
The response you'll get if you're really lucky, is that they'll refer you to participate in a study of some kind. This is lucky because it's very high variance: it could kill you, but it also could significantly improve things. Obviously that risk isn't for everyone, but it's lucky to even have the choice.
Unfortunately, without a proven treatment, there isn't a lot else for doctors to do.
The basic problem is: What do you do about a chronic condition for which there is no proven treatment? I have a few people in my life with one such condition or another. There are three responses, mostly unhelpful.
The most common response is to essentially suggest things at random. Both rest and (generic) exercise are common suggestions. This can make the patient happy, but it's often actively harmful -- obviously, both rest and exercise won't help the same thing, unless it's a specific exercise chosen with the condition in mind.
The other common response is to not suggest anything, and basically try to get the patient to go away. If you're lucky, they'll try to sympathize, but mostly you'll just get brushed off. This makes the patient feel bad, but at least it won't actively make the condition worse.
The response you'll get if you're really lucky, is that they'll refer you to participate in a study of some kind. This is lucky because it's very high variance: it could kill you, but it also could significantly improve things. Obviously that risk isn't for everyone, but it's lucky to even have the choice.
Unfortunately, without a proven treatment, there isn't a lot else for doctors to do.
> Unfortunately, without a proven treatment, there isn't a lot else for doctors to do.
Figure out a treatment? Or at least establish what is actually wrong?
Figure out a treatment? Or at least establish what is actually wrong?
> Figure out a treatment?
That'd be the "refer you to participate in a study" part. Your average medical practitioner does not do research.
> Or at least establish what is actually wrong?
How? Based on what? That's the whole point for something like this; the medical consensus does not know how to diagnose it.
That'd be the "refer you to participate in a study" part. Your average medical practitioner does not do research.
> Or at least establish what is actually wrong?
How? Based on what? That's the whole point for something like this; the medical consensus does not know how to diagnose it.
> Your average medical practitioner does not do research.
Depends on how you look at doing research. If I keep going back to my GP with various ailments we’ll keep trying things until we either figure out what is wrong and fix it, or we find some kind of medicinal dose that makes the pain/discomfort manageable.
I don’t think that falls under ‘suggest things at random’, ‘make the patient go away’ or ‘refer to a study’.
Depends on how you look at doing research. If I keep going back to my GP with various ailments we’ll keep trying things until we either figure out what is wrong and fix it, or we find some kind of medicinal dose that makes the pain/discomfort manageable.
I don’t think that falls under ‘suggest things at random’, ‘make the patient go away’ or ‘refer to a study’.
I'm fairly certain that people are indeed working on a treatment, but until it's ready what do you propose?
My sense is medicine has for some time neglected chronic symptoms from acute viral infection. During my lifetime, chronic fatigue syndrome went from a psychological malady confined to malingerers and depressed women to a physical malady associated with infection... but maybe also malingerers / depressed women.
Which was where things stood when I contracted mononucleosis in my 40s. Weeks / months long fatigue and multi-organ involvement is characteristic of mono. In my case as the other symptoms slowly abated the fatigue remained, lingering over six months with some intervening flare-ups of fever etc.
I learned that that this progression is considerably more common in older patients. Beyond that, little was known and my doctors reacted with a shrug and symptom management.
There was no know cause to these symptoms. And seemingly to me considerably less medical interest.
Perhaps Covid will yield a greater focus and fundamental understanding of chronic conditions resulting from viruses. However, given the contrast between the prevalence of CFS and attention paid... and the medical reaction to Lyme Disease I’m not entirely optimistic.
Which was where things stood when I contracted mononucleosis in my 40s. Weeks / months long fatigue and multi-organ involvement is characteristic of mono. In my case as the other symptoms slowly abated the fatigue remained, lingering over six months with some intervening flare-ups of fever etc.
I learned that that this progression is considerably more common in older patients. Beyond that, little was known and my doctors reacted with a shrug and symptom management.
There was no know cause to these symptoms. And seemingly to me considerably less medical interest.
Perhaps Covid will yield a greater focus and fundamental understanding of chronic conditions resulting from viruses. However, given the contrast between the prevalence of CFS and attention paid... and the medical reaction to Lyme Disease I’m not entirely optimistic.
I didn't know what to think of Chronic Fatigue Syndrome, but in the one specific instance of diagnosis I know of first hand, it preceded a diagnosis of terminal pancreatic cancer a bit later. Made me wonder if there could be a viral factor or something that leads to immune system problems that gradually develop over years.
I have the exact same experience.
It took about 100 days before my wife could start working again, and she is still experiencing chest pain, breathlessness and fatigue (at first symptoms + 115 days).
She was told to endure and rest. What a great plan.
It took about 100 days before my wife could start working again, and she is still experiencing chest pain, breathlessness and fatigue (at first symptoms + 115 days).
She was told to endure and rest. What a great plan.
There is no other known treatment. Or basically no known treatment.
I'm not a doctor, but I would argue against rest.
By that I mean, endure ... sure, but focus hopefully on calisthenics, breathing exercises, yoga, taking supplemental vitamins and improving physical fitness.
Typically post surgery doctors recommend PT ... I'm just saying start some regular PT post illness -- not "rest".
By that I mean, endure ... sure, but focus hopefully on calisthenics, breathing exercises, yoga, taking supplemental vitamins and improving physical fitness.
Typically post surgery doctors recommend PT ... I'm just saying start some regular PT post illness -- not "rest".
You’ve pretty much exactly described someone I know who caught the virus at the end of March as well. Approximately 40 years old, and healthy, and currently is exhausted from climbing one flight of stairs. She finally started leaving the house just a couple weeks ago. It’s been a very very gradual improvement over time, so I suspect that eventually it will go away. She’s been getting some physical therapy to help get her body moving and gradually become more active.
I don't think we have any non-trivial treatments that are safe and effective enough to use on non-hospitalized folks. Until a patient's condition gets bad enough to justify risky/unpleasant interventions, rest and hydration seem like the proper prescription.
Sorry for your experience. Because I am also the husband of a sick wife, I can relate to you. My own feelings swing between hope and despair and a dread of future is emerging.
Realistically, what do you expect from medical professionals?
Realistically, what do you expect from medical professionals?
I certainly don't expect a magic bullet that solves everything, but I would like it to be treated like any other chronic illness. A single point of contact to help track and manage her symptoms, a care plan to ease her back into life with the expectation that some symptoms will be here forever, and the hope that they won't.
> The most infuriating part is how little help there is from medical professionals. She's now 4 months in with what can only be seen as a chronic health problem, but the only medical advice doctors will give her is to rest.
They're still trying to understand what's best.
You could try looking into the type of rehab that some sepsis patients go through, because that's an emerging treatment in the UK. See for example this comment from a UK doctor: https://twitter.com/SepsisUK/status/1283316617615683584?s=20
They're still trying to understand what's best.
You could try looking into the type of rehab that some sepsis patients go through, because that's an emerging treatment in the UK. See for example this comment from a UK doctor: https://twitter.com/SepsisUK/status/1283316617615683584?s=20
Here's more information for people looking for help with long term recovery from covid or sepsis, from the UK Sepsis Trust.
https://www.youtube.com/user/TheUKSepsisTrust/videos
https://www.youtube.com/user/TheUKSepsisTrust/videos
StevenWaterman , 2 questions:
- I assume that you yourself never became sick during this period, despite being in close proximity to her?
-Did you wife have other preexisting conditions?
- I assume that you yourself never became sick during this period, despite being in close proximity to her?
-Did you wife have other preexisting conditions?
I was essentially asymptomatic. I had a tiny bit of vertigo and stomach problems for a couple of days, but I only noticed when looking back.
She had incredibly mild asthma but didn't need an inhaler (and does now). Other than that, nothing.
She had incredibly mild asthma but didn't need an inhaler (and does now). Other than that, nothing.
Post viral syndrome is a thing and may be a covid thing too.
When the answer is not simple or require new thinking your local gp doctors are not the group to ask.
Based on my humble experience, I would suggest her to take the walks in the open air. Start from small, then gradually increase. Once she reaches at least 3 km per day, the walking activities should fully rejuvenate her ability to breathe.
This should totally work out. The moderate activities and safe relaxed walks do the miracles for the usual post-pneumonia as well.
Note of caution: avoid walking in masks. A mask impairs the natural ventilation and you would not get the recovery effect. This means you should keep a healthy distance and avoid getting into crowded places.
This should totally work out. The moderate activities and safe relaxed walks do the miracles for the usual post-pneumonia as well.
Note of caution: avoid walking in masks. A mask impairs the natural ventilation and you would not get the recovery effect. This means you should keep a healthy distance and avoid getting into crowded places.
> Once she reaches at least 3 km per day, the walking activities should fully rejuvenate her ability to breathe.
And you base that on what? Seems completely arbitrary. You don't know any details of her issues.
And you base that on what? Seems completely arbitrary. You don't know any details of her issues.
Experimentation. Medicine is my life-long interest.
Yes, the exact details are missing. But I gave a solid general advice. Not sure everybody can grasp it being blinded by their own cultural expectations (which are not 100% true after all).
Yes, the exact details are missing. But I gave a solid general advice. Not sure everybody can grasp it being blinded by their own cultural expectations (which are not 100% true after all).
Again, anecdotally. But - I am a lifelong severe asthmatic. As a kid I was prevented from all running activity. It was the 80s. At 23 I decided, against all advice, to start running. It is now 25 years later and I have run 360 days a year all that time. I still have asthma, but it's just this annoying thing, like hands that grip my lungs a bit. When I get the flu ( I had a terrible flu in January this year ) I do not stop running if I have low/no fever. Running for me is just a walk to others as I do it every day. Since Covid started, so I don't wheeze and sneeze and terrify people and become a social pariah, I take one puff Budesonide, one singulair and a reactine every day. I now have zero asthma and my nasal rhinitis is 70% reduced. (no sniffles just one closed passage as I've had my whole life). I am not recommending anything but building a relationship between my experience, yours and the discussion about this pandemic flu. What is missing from all of these anecdotes is context. This is mine. I am an extremely disciplined runner, I stretch every day ( I have scoliosis which requires it so I remain mostly pain free), I run a Decolinization Think Tank and I live in the Western World and am white and currently upper middle class. I grew up in a trailer with violent neglectful parents and so I also was forced to go through a decade of self work and radical subjectivity was the product . This is my subjectivity, my context and it is directly related to how I recover from disease - or do not. We need numbers and statistics and context.
Totally agree. I am too small of an expert to provide a statically representative numbers. Medicine is my hobby, not a trade by day.
Instead, I'm using a more algebraic, inter-disciplinary approach to medicine trying to infer the outcomes in symbolic form, just like the algebra does. Sorry for non-conventional approach, I clearly understand it goes against the usual expectations of the day. To make things more weird, I do some practice too, including the light surgeries.
>I take one puff Budesonide, one singulair and a reactine every day
In this way you shape the immune response to not attack your tissues. This reduces (or even eliminates) the manifestations of asthma, but does not heal the root cause of it.
Physical activities probably tend to reduce the asthma manifestations too.
Regarding possible healing solution: it is a tough situation as the true reasons of this illness lie inside the genetic code. And this code is hard to change, especially for a grown-up organism (currently it is thought as impossible, though prominent things like CRISP do exist). In this way, asthma is considered impossible to cure.
Regarding COVID: it is not a genetic illness, so it is possible to cure.
So this is my context. Pure algebra with bits of physics, chemistry and biology.
Instead, I'm using a more algebraic, inter-disciplinary approach to medicine trying to infer the outcomes in symbolic form, just like the algebra does. Sorry for non-conventional approach, I clearly understand it goes against the usual expectations of the day. To make things more weird, I do some practice too, including the light surgeries.
>I take one puff Budesonide, one singulair and a reactine every day
In this way you shape the immune response to not attack your tissues. This reduces (or even eliminates) the manifestations of asthma, but does not heal the root cause of it.
Physical activities probably tend to reduce the asthma manifestations too.
Regarding possible healing solution: it is a tough situation as the true reasons of this illness lie inside the genetic code. And this code is hard to change, especially for a grown-up organism (currently it is thought as impossible, though prominent things like CRISP do exist). In this way, asthma is considered impossible to cure.
Regarding COVID: it is not a genetic illness, so it is possible to cure.
So this is my context. Pure algebra with bits of physics, chemistry and biology.
> Medicine is my hobby
Now there's a red flag if I ever saw one!
> I'm using a more algebraic, inter-disciplinary approach to medicine trying to infer the outcomes in symbolic form, just like the algebra does. Sorry for non-conventional approach, I clearly understand it goes against the usual expectations of the day.
WTF?
Now there's a red flag if I ever saw one!
> I'm using a more algebraic, inter-disciplinary approach to medicine trying to infer the outcomes in symbolic form, just like the algebra does. Sorry for non-conventional approach, I clearly understand it goes against the usual expectations of the day.
WTF?
>WTF?
Symbolic computation is a way to look at the problem domain from a clear analytical standpoint. For example, Noam Chomsky did that for linguistics.
Does such approach constitute a red flag in specific area of human knowledge? Depends on who you ask. In case of Chomsky, his work allowed us to have software compilers and automatic translators between spoken and written languages.
Was he a mad non-conventional scientist? Maybe. But I think he was a prominent innovator cut from above who gave us a great reminder: you cannot undercut or overcome math and algebra. Even in seemingly non-related disciplines such as linguistics or medicine.
Symbolic computation is a way to look at the problem domain from a clear analytical standpoint. For example, Noam Chomsky did that for linguistics.
Does such approach constitute a red flag in specific area of human knowledge? Depends on who you ask. In case of Chomsky, his work allowed us to have software compilers and automatic translators between spoken and written languages.
Was he a mad non-conventional scientist? Maybe. But I think he was a prominent innovator cut from above who gave us a great reminder: you cannot undercut or overcome math and algebra. Even in seemingly non-related disciplines such as linguistics or medicine.
> I am too small of an expert to provide a statically representative numbers. Medicine is my hobby, not a trade by day.
In other words, you are not an expert. Be honest with yourself and stop giving people unsolicited medical advice. Please.
Experts don't just do their own studies. They also read studies performed by others, which they base their recommendations on, and have on hand to support their advice.
In other words, you are not an expert. Be honest with yourself and stop giving people unsolicited medical advice. Please.
Experts don't just do their own studies. They also read studies performed by others, which they base their recommendations on, and have on hand to support their advice.
I'm not a medical expert. But I have my share of successes.
The only reason I voiced a suggestion is because I read desperation behind OP's lines. That's it. A moment of personal weakness caused by overwhelming human compassion.
It's a generalized advice for a general person after suspected pneumonia. It is a good solid recommendation you would get from a practicing doctor, or even from any post-pneumonia patient who experienced shortage of breath.
Please note how helpful it might be in life vs death situations when the list of other options is just empty.
I presume that OP's wife condition is a form of post-pneumonia pulmonary fibrosis. The common wisdom of crowds in western countries suggests that there is no known cure.
However if you care enough to intersect the lingual and cultural barriers, you will soon find out that the effective cures do exist. They come in form of physical rehabilitation: breathing and physical exercises are the main parts of it.
In other words: moving your body will do a good favor for the tissues of your lungs. Open air and unobstructed airflow are big bonuses as well.
Of course you can still deny everything I say. You can still be selfishly fulfilled by your comfortable ignorance.
The only reason I voiced a suggestion is because I read desperation behind OP's lines. That's it. A moment of personal weakness caused by overwhelming human compassion.
It's a generalized advice for a general person after suspected pneumonia. It is a good solid recommendation you would get from a practicing doctor, or even from any post-pneumonia patient who experienced shortage of breath.
Please note how helpful it might be in life vs death situations when the list of other options is just empty.
I presume that OP's wife condition is a form of post-pneumonia pulmonary fibrosis. The common wisdom of crowds in western countries suggests that there is no known cure.
However if you care enough to intersect the lingual and cultural barriers, you will soon find out that the effective cures do exist. They come in form of physical rehabilitation: breathing and physical exercises are the main parts of it.
In other words: moving your body will do a good favor for the tissues of your lungs. Open air and unobstructed airflow are big bonuses as well.
Of course you can still deny everything I say. You can still be selfishly fulfilled by your comfortable ignorance.
How many double blind experiments did you do with a control group with/without masks? O2 sat levels from any tests I've seen aren't affected by masks, so I'm more than a bit skeptical here.
No tests, sorry. I would gladly make some statistically significant experiments, but I am not in professional medicine. I am more math/computer/physics guy by trade.
From math/physics perspective: mask has a porous structure and stands in a way of the air. So it is clearly adds some resistance to overcome with an additional suction.
Healthy people can provide that suction, so their O2 remains untouched.
Not-so-healthy people may hit the physical limit of their suction and this is the situation when adding an additional barrier (the mask) will lead to O2 decrease.
From math/physics perspective: mask has a porous structure and stands in a way of the air. So it is clearly adds some resistance to overcome with an additional suction.
Healthy people can provide that suction, so their O2 remains untouched.
Not-so-healthy people may hit the physical limit of their suction and this is the situation when adding an additional barrier (the mask) will lead to O2 decrease.
Buy a $30 O2 saturation monitor.
Put it on your finger.
Wear the mask.
See with your own eyes that you are wrong.
Put it on your finger.
Wear the mask.
See with your own eyes that you are wrong.
>Wear the mask
You forgot the pneumonia and O2 deficit conditions. You ignored the heat conditions that may make the mask wet and thus increase its air resistance.
Even if I register O2 drop in my finger then I would need control groups to make the experiment statistically significant.
Personal medical measurements and observations have little to no scientific significance. But the ability to calculate the outcome may have big impact in life vs death situations.
I mean, it is physics and logic 1-2-3. Google "wet mask air resistance". What you get? Right, nada.
You forgot the pneumonia and O2 deficit conditions. You ignored the heat conditions that may make the mask wet and thus increase its air resistance.
Even if I register O2 drop in my finger then I would need control groups to make the experiment statistically significant.
Personal medical measurements and observations have little to no scientific significance. But the ability to calculate the outcome may have big impact in life vs death situations.
I mean, it is physics and logic 1-2-3. Google "wet mask air resistance". What you get? Right, nada.
I had COVID end of February/early March. Thankfully I didn't need hospital treatment, in fact at the time I didn't even know it was COVID. It was only recently I got it confirmed.
However several months on I still notice the effects from it. Mostly regular fatigue and almost daily shortness of breath.
Last night I was laying in bed going to sleep and got quite panicked as it feels like I am not getting enough air in each breath. I have moment like this almost daily and it is extremely unsettling and worrying.
I am in my mid-thirties and generally quite healthy. A bit overweight but before COVID I didn't get out of breath going up the stairs. I didn't find myself needing to lie down on the sofa from exhaustion. I am still able to run but no where near as long as I could just a few months ago. Putting it bluntly it is fucking scary.
I am very fortunate that two good friends of mine are doctors (a cardiologist and her husband a microbiologist) and they have been kind enough to check on me weekly with some basic lung function tests and blood work but they are seeing these kinds of issues with many recovered COVID patients.
However several months on I still notice the effects from it. Mostly regular fatigue and almost daily shortness of breath.
Last night I was laying in bed going to sleep and got quite panicked as it feels like I am not getting enough air in each breath. I have moment like this almost daily and it is extremely unsettling and worrying.
I am in my mid-thirties and generally quite healthy. A bit overweight but before COVID I didn't get out of breath going up the stairs. I didn't find myself needing to lie down on the sofa from exhaustion. I am still able to run but no where near as long as I could just a few months ago. Putting it bluntly it is fucking scary.
I am very fortunate that two good friends of mine are doctors (a cardiologist and her husband a microbiologist) and they have been kind enough to check on me weekly with some basic lung function tests and blood work but they are seeing these kinds of issues with many recovered COVID patients.
I'm experiencing the same thing after being knocked out with a COVID-like illness in early March. (At the time I could not get a test to confirm that I had it.)
My symptoms:
1. Breathlessness, with a feeling that I am not getting enough oxygen. However a pulse oximeter shows my oxygen at 97%+.
2. Thick phlegm production in my throat. I am not congested in the chest or sinuses, but I am constantly producing very thick phlegm in my throat.
3. Occasional severe fatigue and weight loss. When it occurs, I cannot get out of bed and have no appetite. I have lost 25 lbs since March.
4. Occasional headaches and eye pain, including bloodshot eyes and blurry vision.
What's interesting is the way these symptoms cycle on and off. I will go a week feeling pretty good, and that will be followed by a week or two of symptom flare-up. This has been happening for months. I've found that any heavy exertion or exercise tends to bring on the bad cycle.
My general practitioner doesn't know what to do and I feel like he's skeptical. He prescribed me antibiotics for a possible sinus infection, but that did no good. He prescribed me an inhaler, but that did no good. He doesn't even think I had COVID.
It's sounding like I could be experiencing symptoms of ME/CFS. Has anyone had any luck finding doctors willing to take this seriously? I'm starting to get depressed that my long-term future is going to be like this.
Oh, and to anyone who thinks COVID is "just the flu", fuck you.
My symptoms:
1. Breathlessness, with a feeling that I am not getting enough oxygen. However a pulse oximeter shows my oxygen at 97%+.
2. Thick phlegm production in my throat. I am not congested in the chest or sinuses, but I am constantly producing very thick phlegm in my throat.
3. Occasional severe fatigue and weight loss. When it occurs, I cannot get out of bed and have no appetite. I have lost 25 lbs since March.
4. Occasional headaches and eye pain, including bloodshot eyes and blurry vision.
What's interesting is the way these symptoms cycle on and off. I will go a week feeling pretty good, and that will be followed by a week or two of symptom flare-up. This has been happening for months. I've found that any heavy exertion or exercise tends to bring on the bad cycle.
My general practitioner doesn't know what to do and I feel like he's skeptical. He prescribed me antibiotics for a possible sinus infection, but that did no good. He prescribed me an inhaler, but that did no good. He doesn't even think I had COVID.
It's sounding like I could be experiencing symptoms of ME/CFS. Has anyone had any luck finding doctors willing to take this seriously? I'm starting to get depressed that my long-term future is going to be like this.
Oh, and to anyone who thinks COVID is "just the flu", fuck you.
Does your daily routine include a bit of exercising or/and walking? What's your daily walking distances?
I am asking because some post-pneumonia (non-COVID) patients tend to have temporary shortage of breath/fatigue syndromes. And a good way to get rid of them is to get some elementary body movements like relaxed walking among tree alleys. Nothing crazy, just comfortable stress-less motion.
It helps to clear up the lungs and balance the immune response.
I wonder if this information can be of any help in your situation.
I am asking because some post-pneumonia (non-COVID) patients tend to have temporary shortage of breath/fatigue syndromes. And a good way to get rid of them is to get some elementary body movements like relaxed walking among tree alleys. Nothing crazy, just comfortable stress-less motion.
It helps to clear up the lungs and balance the immune response.
I wonder if this information can be of any help in your situation.
I have a 7yo son so we go out pretty much every day to the park. I haven't tracked anything but ballparking it from the distance and how long we are out I probably walk around 2-3 miles a day. Some of that will be a light jog while kicking a ball around or catching frisbee.
I have had a few gentle runs as well for 5-7 miles but as previously mentioned they are exhausting me right now and exacerbating my anxiety about the impact COVID has had to my body so I have cut them out for the most part and sticking to gentler exercise with my son.
I am hoping all of this is made worse by the added stress of life right now. I am on holiday for the next few weeks so looking forward to a change of scenery and less day to day responsibilities.
I have had a few gentle runs as well for 5-7 miles but as previously mentioned they are exhausting me right now and exacerbating my anxiety about the impact COVID has had to my body so I have cut them out for the most part and sticking to gentler exercise with my son.
I am hoping all of this is made worse by the added stress of life right now. I am on holiday for the next few weeks so looking forward to a change of scenery and less day to day responsibilities.
I’m sorry to hear. I’m curious, have you had your blood oxygen level tested?
I have one of those finger monitors that always reports things as fine (>97%, almost always 99%).
It is difficult to describe what I feel. It is almost like I feel I am being partially suffocated from within my sinus if that makes sense? Like there is an obstruction. There isn't though as I have rinsed them and had doctors have a good look and even probe around in them and all is good apparently.
The only theory my doctor friends have for now (other than COVID doing lung damage) is I could have some hidden swelling in my sinus that is changing the air flow and causing my body to think it isn't getting enough air as I breath through my nose leading that to slow suffocation sensation. Apparently there is a condition people who have sinus surgery get which is very similar but I have avoided making it worse by researching it.
It is difficult to describe what I feel. It is almost like I feel I am being partially suffocated from within my sinus if that makes sense? Like there is an obstruction. There isn't though as I have rinsed them and had doctors have a good look and even probe around in them and all is good apparently.
The only theory my doctor friends have for now (other than COVID doing lung damage) is I could have some hidden swelling in my sinus that is changing the air flow and causing my body to think it isn't getting enough air as I breath through my nose leading that to slow suffocation sensation. Apparently there is a condition people who have sinus surgery get which is very similar but I have avoided making it worse by researching it.
> Apparently there is a condition people who have sinus surgery get which is very similar but I have avoided making it worse by researching it.
Yeah, here's the wikipedia page for that https://en.wikipedia.org/wiki/Empty_nose_syndrome
Yeah, here's the wikipedia page for that https://en.wikipedia.org/wiki/Empty_nose_syndrome
OK - but what are the stats here? Worldometer shows that there are more than 8 million Covid survivors, how many of them have the prolonged symptoms? 8 million is really many people - so I would not be surprised if there are a few strange stories (https://www.gwern.net/Littlewood as always).
The post has a figure with rather scary stats. Although I suppose it comes from a followup of severe cases, not from a random sample of cases? Otherwise it's really, really scary.
Ah - yeah - I though the graph was about patients who report persistent symptoms not the whole population. If indeed 60% of all Covid patients have fatigue and 40% breathlessness after more than 60 days - than it is scary indeed. But we don't know how the 143 patients where found - are they random people with Covid or are they only hospitalized Covid patients? With 8 millions we should really have better stats.
Quote from another story (by Der Spiegel):
>Long-term* symptoms reported by COVID-19 patients
>47% general fatigue
>24% prolonged respiratory problems
>*longer than 30 days; analysis of a study of COVID-19 symptoms from King's College London;
>8,065 people who tested positive, of whom 857 had long-term symptoms
https://www.spiegel.de/international/world/covid-19-many-peo...
>Long-term* symptoms reported by COVID-19 patients
>47% general fatigue
>24% prolonged respiratory problems
>*longer than 30 days; analysis of a study of COVID-19 symptoms from King's College London;
>8,065 people who tested positive, of whom 857 had long-term symptoms
https://www.spiegel.de/international/world/covid-19-many-peo...
OK - that would be compatible with the theory that the original article were about those who had long-term symptoms. Journalism is a mess. But the 10% is still scary.
Thats why I think people have been over focused on the death metric, for evey person that dies there are going to be multiples of people with lifelong or multi year complications. The us is going to have millions in the long term compliation catergory.
The good news is that we have no idea at this point how long-term long-term will end up being; maybe they go away in six months or a year. Of course, that's also the bad news -- maybe they don't.
From the article:
We know from studies of patients who had Sars - one of the family of coronaviruses - back in the 2003 epidemic, that almost half of survivors went on to have chronic fatigue or other long-lasting symptoms. So it should not be a surprise that this cunning descendant, Sars-CoV2, should have a similar inheritance.
That doesn't sound good.
We know from studies of patients who had Sars - one of the family of coronaviruses - back in the 2003 epidemic, that almost half of survivors went on to have chronic fatigue or other long-lasting symptoms. So it should not be a surprise that this cunning descendant, Sars-CoV2, should have a similar inheritance.
That doesn't sound good.
The article’s first graphic is from a randomized 60-day follow-up. It shows fatigue and breathlessness for 50% and chest pain at around 20%.
This is among diagnosed patients, not those self-selecting to seek to seek treatment for their ongoing problems. It’s possible that some bias is introduced by people who are now completely fine being less likely to cooperate. But I doubt that any durch effect would make more than marginal differences.
It also ignores everyone who did not get tested, either because they did not have symptoms, because they just assumed they had it, or who couldn’t get tested (Italy in March was...busy).
This is among diagnosed patients, not those self-selecting to seek to seek treatment for their ongoing problems. It’s possible that some bias is introduced by people who are now completely fine being less likely to cooperate. But I doubt that any durch effect would make more than marginal differences.
It also ignores everyone who did not get tested, either because they did not have symptoms, because they just assumed they had it, or who couldn’t get tested (Italy in March was...busy).
That is strange - because the numbers would be compatible with the Der Spiegel stats (from comment above: https://news.ycombinator.com/item?id=23888175) if it was only about those who report the persistent symptoms.
Also 10% sounds more plausible - if it was 50% of all diagnosed Covid survivors than for sure this would be reported earlier.
Also 10% sounds more plausible - if it was 50% of all diagnosed Covid survivors than for sure this would be reported earlier.
> We don't yet understand why these patients are having such long-term problems.
ACE2 receptors are found in the Type II pneumocytes [1] of the lung alveoli. These cells produce the pulmonary surfactant that changes the surface tension which, among other things, controls how hard it is to breath in/out.
I'd be surprised if these damaged/destroyed cells were fully regenerated. The question I have, is whether the breathlessness is due to the sensation of extra muscular effort required to breathe or a measurable lower SpO2?
Long term, I wonder if COVID-19 related pneumonia will increase the incidence of lung cancer as these individuals age.
[1] https://en.wikipedia.org/wiki/Pulmonary_alveolus#Type_II_cel...
ACE2 receptors are found in the Type II pneumocytes [1] of the lung alveoli. These cells produce the pulmonary surfactant that changes the surface tension which, among other things, controls how hard it is to breath in/out.
I'd be surprised if these damaged/destroyed cells were fully regenerated. The question I have, is whether the breathlessness is due to the sensation of extra muscular effort required to breathe or a measurable lower SpO2?
Long term, I wonder if COVID-19 related pneumonia will increase the incidence of lung cancer as these individuals age.
[1] https://en.wikipedia.org/wiki/Pulmonary_alveolus#Type_II_cel...
The Pentagon sent a memo to all military physicians. COVID survivors permanently disqualified from ever joining the military.
What do they know that we don't?
https://www.militarytimes.com/news/your-military/2020/05/06/...
There's been an edit since I last seen it, here's the updated guidance: https://www.militarytimes.com/news/your-military/2020/05/21/...
What do they know that we don't?
https://www.militarytimes.com/news/your-military/2020/05/06/...
There's been an edit since I last seen it, here's the updated guidance: https://www.militarytimes.com/news/your-military/2020/05/21/...
> What do they know that we don't?
They know exactly what we know: there are a variety of apparent delayed effects, some quite serious, and isn’t clear what the whole set is and how long they take to manifest.
This is a policy based in precautionary cognizance of ignorance, not some special detailed occult knowledge.
Once we have a better idea, the policy will be reviewed and probably eliminated or narrowed to focus on specific issues of concern.
They know exactly what we know: there are a variety of apparent delayed effects, some quite serious, and isn’t clear what the whole set is and how long they take to manifest.
This is a policy based in precautionary cognizance of ignorance, not some special detailed occult knowledge.
Once we have a better idea, the policy will be reviewed and probably eliminated or narrowed to focus on specific issues of concern.
It'll be interesting to see if the NBA starts back up, if some of the players who had COVID have issues just making laps up/down the courts. I wonder if the 'weaker' or 'long-term effected' players might take sabbaticals or sit-out a season or two or retire altogether.
Maybe that after c-19, Chinese release c-21 that kills anyone previously marked by c-19.
As someone who is experiencing these long-term symptoms for months, I can tell you that my pulse oximeter reports a blood oxygen of 97+ even when I am feeling it is difficult to breathe. I feel a tightness in my chest when it happens, primarily below the upper sternum. I'm also producing thick phlegm, only in my throat (not in my head or chest). I have no cough or fever.
When I first came down with the illness in March, I went to the emergency room but could not get a COVID test, because they were limited to people who had been in contact with someone from China. I had a chest x-ray, which showed that I did not have pneumonia. I had what doctors would call a "mild case" with fever, cough, fatigue, headaches, "red eyes", and diarrhea.
When I first came down with the illness in March, I went to the emergency room but could not get a COVID test, because they were limited to people who had been in contact with someone from China. I had a chest x-ray, which showed that I did not have pneumonia. I had what doctors would call a "mild case" with fever, cough, fatigue, headaches, "red eyes", and diarrhea.
The more important question is why people are being sick for so many years with "modern medicine" doing absolutely nothing to get them out of their sickness state. Diabetes type II, heart problems, autoimmune problems, all these chronic diseases plaguing most of the human population on planet earth for the last several hundred years (when "modern" medicine existed) and none of them going away.
Covid mostly takes the people who are already sick, and kills them. Would be nice to figure out how to not have so many people sick in the first place.
Covid mostly takes the people who are already sick, and kills them. Would be nice to figure out how to not have so many people sick in the first place.
> them out of their sickness state. Diabetes type II, heart problems, autoimmune problems, all these chronic diseases plaguing most of the human population
You mean all these diseases that are almost exclusively due to lifestyle, ie. lack of physical activity, poor diet choices, &c. ?
People knew 2000 years ago that gluttony and sloth weren't good things, it's not "modern medicine"'s role to cure our lack of will.
You mean all these diseases that are almost exclusively due to lifestyle, ie. lack of physical activity, poor diet choices, &c. ?
People knew 2000 years ago that gluttony and sloth weren't good things, it's not "modern medicine"'s role to cure our lack of will.
I'm interested to know where you got the idea that autoimmune disorders are due to lifestyle?
Please read the site guidelines and refrain from ill intentioned comments.
In my opinion DangitBobby's comment is reasonable and interesting, not ill-intentioned.
lm28469 quoted a list which includes "autoimmune problems" and linked all of them to gluttony, sloth and lack of will.
That strikes me as nonsense. To the best of my knowledge, people suffering with autoimmune problems can't just fix it with a bit of will, and life's hard enough without people making it worse by telling them their disease is their own fault.
But regardless of what I think it is perfectly reasonable to question that link.
lm28469 quoted a list which includes "autoimmune problems" and linked all of them to gluttony, sloth and lack of will.
That strikes me as nonsense. To the best of my knowledge, people suffering with autoimmune problems can't just fix it with a bit of will, and life's hard enough without people making it worse by telling them their disease is their own fault.
But regardless of what I think it is perfectly reasonable to question that link.
I assume they are primarily referring to the effects of obesity and type II diabetes on the immune system dysfunction in general.
That said, it seems that obesity also plays a major role in autoimmune disorders.
>Moreover, obesity worsens the course of RA, SLE, IBD, psoriasis and PsA, and impairs the treatment response of RA, IBD, psoriasis and PsA. Extensive clinical data and experimental models demonstrate the involvement of adipokines in the pathogenesis of these autoimmune diseases. Obesity appears to be a major environmental factor contributing to the onset and progression of autoimmune diseases.
https://www.sciencedirect.com/science/article/abs/pii/S15689...
That said, it seems that obesity also plays a major role in autoimmune disorders.
>Moreover, obesity worsens the course of RA, SLE, IBD, psoriasis and PsA, and impairs the treatment response of RA, IBD, psoriasis and PsA. Extensive clinical data and experimental models demonstrate the involvement of adipokines in the pathogenesis of these autoimmune diseases. Obesity appears to be a major environmental factor contributing to the onset and progression of autoimmune diseases.
https://www.sciencedirect.com/science/article/abs/pii/S15689...
> it's not "modern medicine"'s role to cure our lack of will.
I don't see why not. Sure, people will make bad choices and suffer the consequences thereof. However, medicine aims to cure maladies of all sorts regardless of cause, not sit in moral judgment.
I don't see why not. Sure, people will make bad choices and suffer the consequences thereof. However, medicine aims to cure maladies of all sorts regardless of cause, not sit in moral judgment.
Basic logic dictates that after medical science has found cures for 90% of diseases, you will tend to notice the remaining 10%.
"Modern medicine", as you feel apt to call it, has been nothing if not spectacular successful against infectious diseases. It strikes me as implausible that the profession is somehow corrupt in a way that specifically hinders progress against chronic diseases, compared to the banal explanation that these are more difficult, and maybe that we've had less time dedicated to their study because they only appeared when people started to routinely live to old age.
"Modern medicine", as you feel apt to call it, has been nothing if not spectacular successful against infectious diseases. It strikes me as implausible that the profession is somehow corrupt in a way that specifically hinders progress against chronic diseases, compared to the banal explanation that these are more difficult, and maybe that we've had less time dedicated to their study because they only appeared when people started to routinely live to old age.
Modern medicine has not existed for several hundred years and these diseases you are mentioning have only started killing a large part of the population after medicine dealt with infections. As we cure more and more diseases other diseases that used to be rare become more common causes of death. Maybe at the end of the tunnel lies immortality, but who knows.
I had fatigue for about 3 month after a bout with mono (mid 30s). Lost 15 kg, had to restart running from scratch after running 10k @2 times a week for years. It was scary, the doctors said there is no treatment just optimising healthy living and hoping it goes away.
Ever since this started I could not understand the people here on HN arguing there is no proof that there could be long term effects. Now we have proof of the opposite and they are out in force marginalising (its just a few people) to keep their own fears contained.
Ever since this started I could not understand the people here on HN arguing there is no proof that there could be long term effects. Now we have proof of the opposite and they are out in force marginalising (its just a few people) to keep their own fears contained.
(IANAD) I wonder if any of the neurological symptoms like depression and memory-loss are caused by chronic inflammation following infection. Virus reservoirs are mentioned in the article. Could it be that there are bits of broken up, deactivated virus floating around triggering auto-immune conditions?
They mention that in the article.
The other interesting point is - chest x-ray and sound are both normal, but someone is still getting breathless which could point to it being more about vascular involvement in many cases - perhaps the blood vessels that are responsible for uptake of oxygen from the lungs are inflamed and not working as effectively.
The other interesting point is - chest x-ray and sound are both normal, but someone is still getting breathless which could point to it being more about vascular involvement in many cases - perhaps the blood vessels that are responsible for uptake of oxygen from the lungs are inflamed and not working as effectively.
> I wonder if any of the neurological symptoms like depression and memory-loss are caused by chronic inflammation following infection.
Changes in sleep and stress patterns seem like a simpler explanation. The sensation of not being able to breathe can not be positive for either. All of these things, including inflammation, are measurable though a good baseline for what is normal for any given individual is probably rare.
Changes in sleep and stress patterns seem like a simpler explanation. The sensation of not being able to breathe can not be positive for either. All of these things, including inflammation, are measurable though a good baseline for what is normal for any given individual is probably rare.
This should be a huge wake up call for people to look after their health. We are going to see this sort of pandemic more and more regularly, so it's time to make those lifestyle changes you've been putting off! Lose that weight, cut back on the sugar, get some exercise and sleep more.
The article features a picture of one of the patients squating with 105kg before she got sick - she was extremely fit and healthy and now she gets breathless walking up stairs.
It's quite likely another pandemic will be quite a lot worse.
I see people taking the wrong lesson from this pandemic, that trying to control it was an over-reaction. So if we face a disease that kills a larger percentage of people, that lesson will not serve us well (it's not doing us any good this time around!).
I see people taking the wrong lesson from this pandemic, that trying to control it was an over-reaction. So if we face a disease that kills a larger percentage of people, that lesson will not serve us well (it's not doing us any good this time around!).
> We are going to see this sort of pandemic more and more regularly
What is this based on?
What is this based on?
Eradication of wildlife.
Please explain?
Deserves much more than that: https://duckduckgo.com/?q=virus+pandemic+wildlife+destructio...
Yes, I can see how one worldwide pandemic in 100 years leads to the direct conclusion that worldwide pandemics will happen more and more often.
How often are we talking here?
How often are we talking here?
My wife likely had covid in March (she was unable to get tested at the time due to no fever) and experiences similar symptoms described in the article (breathlessness and fatigue). Interestingly, she had a physical in February and all blood work was normal. She went for another check-up in June due to her breathlessness and found that she had hyperthyroidism. Our hypothesis is that her thyroid problem could have been caused by covid. Mentioning in case anyone else has observed this pattern.
This is a worthwhile read too, about how COVID-19 is believed to cause a new type of inflammatory syndrome, in just about everybody:
Coronavirus warning from Italy: Effects of COVID-19 could be worse than first thought: https://news.sky.com/story/coronavirus-warning-from-italy-ef...
Also:
Older Children Spread the Coronavirus Just as Much as Adults, Large Study Finds: http://archive.is/D5wQn
(The study of nearly 65,000 people in South Korea suggests that school reopenings will trigger more outbreaks.)
I understand why people want schools to reopen. I also understand that it is a place where social services are executed.
But, this is extremely problemsome.
Coronavirus warning from Italy: Effects of COVID-19 could be worse than first thought: https://news.sky.com/story/coronavirus-warning-from-italy-ef...
Also:
Older Children Spread the Coronavirus Just as Much as Adults, Large Study Finds: http://archive.is/D5wQn
(The study of nearly 65,000 people in South Korea suggests that school reopenings will trigger more outbreaks.)
I understand why people want schools to reopen. I also understand that it is a place where social services are executed.
But, this is extremely problemsome.
I have been ill since early March, never bad enough to need to go to hospital.
Have had mono a couple of times and do tend to get post-viral fatigue, this is different as I still have symptoms of covid19 as well. Sore throat and conjunctivitis are the main things that affect me, did notice that my sense of smell improved a couple of weeks ago.
Was pretty fit before this and still did competitive sport in my 50s.
Have had mono a couple of times and do tend to get post-viral fatigue, this is different as I still have symptoms of covid19 as well. Sore throat and conjunctivitis are the main things that affect me, did notice that my sense of smell improved a couple of weeks ago.
Was pretty fit before this and still did competitive sport in my 50s.
More and more, SARS-CoV-2 is sounding like polio more than any other disease in our recent history.
There are numerous studies coming out that report immunity against coronavirus does not last long:
https://www.cidrap.umn.edu/news-perspective/2020/06/chinese-...
https://theconversation.com/immunity-to-covid-19-may-not-las...
> Finally, the researchers measured how long the antibody response lasted. This is the most important data. Unfortunately, antibodies levels began falling after day 20 and only 17% of patients retained a potent level at day 57. Some patients completely lost their antibodies after two months.
It's terrifying to think that our adaptive immune system might not be good at learning Covid-19. I don't know that this is the case, but our immune system evolved to fight the things we deal with regularly over many centuries. Just like HIV, this thing is relatively new on the evolutionary scale.
Perhaps those that remain sick aren't clearing the virus completely? It may be this in some combination with vascular/organ damage and immune system depletion.
https://www.cidrap.umn.edu/news-perspective/2020/06/chinese-...
https://theconversation.com/immunity-to-covid-19-may-not-las...
> Finally, the researchers measured how long the antibody response lasted. This is the most important data. Unfortunately, antibodies levels began falling after day 20 and only 17% of patients retained a potent level at day 57. Some patients completely lost their antibodies after two months.
It's terrifying to think that our adaptive immune system might not be good at learning Covid-19. I don't know that this is the case, but our immune system evolved to fight the things we deal with regularly over many centuries. Just like HIV, this thing is relatively new on the evolutionary scale.
Perhaps those that remain sick aren't clearing the virus completely? It may be this in some combination with vascular/organ damage and immune system depletion.
Antibodies may not stay around, but it's hard to know for sure about immunity without also looking at t-cell response. At least that's my non-biologist reading of the many articles on this topic.
Sounds like Cancer symptoms
jkhaui(3)
I got sick in march with covid-like symptoms but could not get tested.
I have also experienced being out of breath when climbing stairs or walking. I also started to worry and attribute other symptoms like headache to this, but then realized that :
- I spent 3 months at home without going out much
- I'm wearing a mask everytime I go out and I noticed that masks make breating harder
- I did not move much for 3 months and worked at home. This is significantly less than my usual 30 minutes of walk + 1h of transports + climbing stairs 4 times a day
- Only seeing the world through the news has a big negative psychological effect on me
Now it is just my humble experience. I am certainly not saying that people does not have symptoms and I only am one dot of incomplete data.
I just want to say that if you got sick and then experienced long terms effects, please don't forget about the radical life-style changes that you are experiencing before attributing everything to the virus.
Understanding this helped me to rebalance my daily routine and get and feel better.
- I spent 3 months at home without going out much
- I'm wearing a mask everytime I go out and I noticed that masks make breating harder
- I did not move much for 3 months and worked at home. This is significantly less than my usual 30 minutes of walk + 1h of transports + climbing stairs 4 times a day
- Only seeing the world through the news has a big negative psychological effect on me
Now it is just my humble experience. I am certainly not saying that people does not have symptoms and I only am one dot of incomplete data.
I just want to say that if you got sick and then experienced long terms effects, please don't forget about the radical life-style changes that you are experiencing before attributing everything to the virus.
Understanding this helped me to rebalance my daily routine and get and feel better.
Downvotes to your post are unwarranted.
Western medical school tends to think that pulmonary fibrosis is incurable, despite the fact you have just provided a practical recipe for post-pneumonia rehabilitation.
Probably what happens is a casual reader just sees a statement that says that "masks make breating harder" and gives you a downvote without further thought. This is what I call a comfortable ignorance.
Kudos for finding the practical way out of this situation.
Western medical school tends to think that pulmonary fibrosis is incurable, despite the fact you have just provided a practical recipe for post-pneumonia rehabilitation.
Probably what happens is a casual reader just sees a statement that says that "masks make breating harder" and gives you a downvote without further thought. This is what I call a comfortable ignorance.
Kudos for finding the practical way out of this situation.
Keep in mind, the majority of acute cases happen to people with pre-existing conditions. Deaths have the same profile. Of course there are exceptions. "Perfectly healthy" people can be hit hard.
The articles, and many similar, consistently fail to mention the pre-existing conditions of the people in the study.
Editorial: A couple weeks ago I saw a news story about a man who "survived Covid-19" after 60 days in hospital and 40+ days on a ventilator. They showed him leaving hospital in a wheelchair. He was easily 275 lbs, perhaps 300 lbs.
You don't put on weight being fed via drip or tube. There's a reason it's called "morbidly obese." I'm glad he survived. No one deserves to die. I'm not convinced the virus was his only significant medical issue.
It's time we start being honest about the dangers in the foods we eat and the lifestyles we lead.
The articles, and many similar, consistently fail to mention the pre-existing conditions of the people in the study.
Editorial: A couple weeks ago I saw a news story about a man who "survived Covid-19" after 60 days in hospital and 40+ days on a ventilator. They showed him leaving hospital in a wheelchair. He was easily 275 lbs, perhaps 300 lbs.
You don't put on weight being fed via drip or tube. There's a reason it's called "morbidly obese." I'm glad he survived. No one deserves to die. I'm not convinced the virus was his only significant medical issue.
It's time we start being honest about the dangers in the foods we eat and the lifestyles we lead.
Just to counter some of the negative news, my wife had COVID, she picked it up at work from her colleagues where the majority of them had COVID, even the reception staff at their medical practice where she works all got COVID and when she was at home coughing I also got COVID. We all had mild symptoms, mostly a cough, fever and loss of smell and taste. We all recovered from it like from a cold or flu. At no point did anything bad happen. No organ damages. No lasting health issues. This was in April, so many weeks ago and we’ve all been super healthy and fit since then. At her work nobody even talks about it because it’s such a non thing in their eyes. I perform physically just as good as I did before I got ill. So there’s that, good first hand experiences which you’ll never hear because it doesn’t fit the current media narrative. Luckily smart people will look at science and hard statistical facts rather than individual selected stories. Anxious people will always be anxious. You can choose to call me a liar or whatever, but Prince Charles had COVID and recovered from it like from a normal cold, so did the British prime minister, lots of staff and MPs around him, so did Tom Hanks, Idris Elba, and literary hundreds of other super famous celebrities from old to young. You going to call them all liars too? It’s important to stay mentally healthy and I think people need to stop reading this fear provoking nonsense which really doesn’t change anything except making people mentally ill. The virus won’t become more or less dangerous by reading sensationalised news stories which aim at playing into people’s worst fears. I find it abhorrent.
I’m not sure what your point is here. Everyone knows by now that it’s possible to get COVID, experience mild symptoms and recover. However some people also die or recover and experience severe respiratory issues, and this is an interesting thing to study and report on. The article isn’t sensationalist or alarmist. It’s not calling anyone a liar - to be honest I’ve no idea what your “you going to call them all liars too?” comment is directed at.
> However some people also die or recover and experience severe respiratory issues, and this is an interesting thing to study and report on
I fully agree on that. I'm not disappointed about the studying, but the media coverage and amplification of people's irrational fears. There is many viruses out there which kill humans and cause all sorts of post viral effects which can last for months and we should all study them, get better at treating them, and finding new ways of curing them and that is fine, but it doesn't help to make lots of people mentally ill by singling out a disease and making people prisoners of their own fears.
For example, in Brazil people should be more worried about getting Dengue fever, which you cannot easily prevent by washing your hands and keeping social distance, yet you don't hear about Dengue at all, because it's been normalised and there's no news story today. So the media just jump on something novel where there is still potential for playing into people's fears and they capitalise on this. I'm sick and tired of watching many people around me getting depressed and falling into lows because of fears of just going even for a walk in the park.
Social media and the internet have always amplified the worst of humans. It's a joke that we've known for years that if you google for a pain in your toe you'll get diagnosed with a terminal brain cancer on the internet. It shouldn't really be a surprise that we see the same thing happening for COVID-19.
I fully agree on that. I'm not disappointed about the studying, but the media coverage and amplification of people's irrational fears. There is many viruses out there which kill humans and cause all sorts of post viral effects which can last for months and we should all study them, get better at treating them, and finding new ways of curing them and that is fine, but it doesn't help to make lots of people mentally ill by singling out a disease and making people prisoners of their own fears.
For example, in Brazil people should be more worried about getting Dengue fever, which you cannot easily prevent by washing your hands and keeping social distance, yet you don't hear about Dengue at all, because it's been normalised and there's no news story today. So the media just jump on something novel where there is still potential for playing into people's fears and they capitalise on this. I'm sick and tired of watching many people around me getting depressed and falling into lows because of fears of just going even for a walk in the park.
Social media and the internet have always amplified the worst of humans. It's a joke that we've known for years that if you google for a pain in your toe you'll get diagnosed with a terminal brain cancer on the internet. It shouldn't really be a surprise that we see the same thing happening for COVID-19.
> For example, in Brazil people should be more worried about getting Dengue fever
Huh? 700-1400+ people/day are dying of COVID in Brazil with ~200 total deaths from Dengue this year. I'm not really sure how you can equate 78k [1] deaths from COVID in Brazil so far with the ~200 [2] from Dengue.
You mentioned in your first post to look at the facts and numbers. Where are your numbers coming from?
[1] https://www.worldometers.info/coronavirus/country/brazil/
[2] http://outbreaknewstoday.com/dengue-fever-more-than-1-millio...
Huh? 700-1400+ people/day are dying of COVID in Brazil with ~200 total deaths from Dengue this year. I'm not really sure how you can equate 78k [1] deaths from COVID in Brazil so far with the ~200 [2] from Dengue.
You mentioned in your first post to look at the facts and numbers. Where are your numbers coming from?
[1] https://www.worldometers.info/coronavirus/country/brazil/
[2] http://outbreaknewstoday.com/dengue-fever-more-than-1-millio...
Who is calling you a liar? My wife's grandmother caught COVID in a nursing home and remained completely asymptomatic. Meanwhile, many others in the same home died. I know people who had your experience and others who had the worst sickness of their lives. And unfortunately I know others who have lost relatives to COVID.
The point is that it's a dice roll right now, and we know only some of the factors that come into play. We are also only now learning about possible long term effects (what this article is about). This is the 'science' and 'hard facts' you speak about. BTW, the British PM ended up in the ICU for a period of time so not really like the typical cold or flu.
Yes, there is a certain amount of risk in every day life. But, this is one I'd rather avoid taking for as long as possible. If for nothing else, every day we learn more about treatment.
The point is that it's a dice roll right now, and we know only some of the factors that come into play. We are also only now learning about possible long term effects (what this article is about). This is the 'science' and 'hard facts' you speak about. BTW, the British PM ended up in the ICU for a period of time so not really like the typical cold or flu.
Yes, there is a certain amount of risk in every day life. But, this is one I'd rather avoid taking for as long as possible. If for nothing else, every day we learn more about treatment.
> We all recovered from it like from any other cold or flu.
It's neither a cold nor flu, as "other" implies.
It's neither a cold nor flu, as "other" implies.
Thanks, now that you pointed out the grammar mistake I have corrected it. The essence of my comment hasn't changed at all though :)
The graph at the top of the article shows the percentage of the 143 people enrolled that had each symptom at their post Covid follow up. You know, 'statistics'. The media narrative in this article is that many people have lingering problems, not that everyone does.
But the enrollment criteria was being discharged from a hospital after recovery from COVID-19. It was not a random sample of infected people. None of the text leading up to the graph or any text on the graph itself makes this clear.
You're doing exactly what you're criticizing...
Anecdotes are meaningless, yours included, it doesn't matter if it's Idris Elba or the Queen of England, what matter are stats, and they don't lie, a non negligible percent of people get real sick and will have lasting effects.
Is it a coincidence that the only first world country that failed at containing the epidemic tells everyone that "it's not that bad", "not so many people will die", "there are no side effects", it's a disgrace.
Anecdotes are meaningless, yours included, it doesn't matter if it's Idris Elba or the Queen of England, what matter are stats, and they don't lie, a non negligible percent of people get real sick and will have lasting effects.
Is it a coincidence that the only first world country that failed at containing the epidemic tells everyone that "it's not that bad", "not so many people will die", "there are no side effects", it's a disgrace.
> Anecdotes are meaningless, yours included
Agreed, which is why I specifically point out to look at statistical facts and not individual stories.
> You're doing exactly what you're criticizing
No, because I specifically point out to look at the actual numbers rather than individual stories ;)
> Is it a coincidence that the only first world country that failed at containing the epidemic tells everyone that "it's not that bad", "not so many people will die", "there are no side effects", it's a disgrace.
Not sure which country you are talking about. I live in the UK and think there's many things we could have done better and many things where we overreacted. I don't think any country has contained the virus, as the virus cannot be contained. We see small outbreaks everywhere, so it's difficult to claim that anyone has contained it. For every country which has done X you'll find another country which hasn't done X and their curves still look incredibly similar. Take Sweden as an example. We haven't heard any news on Sweden for a while, which can only mean that they must be doing well now and looking at their curves they did flatten indeed and their death counts are drastically going down. So I think anyone who is smart enough not wanting to embarrass themselves will know to hold back with any premature clever comparisons until a couple years down the line.
Agreed, which is why I specifically point out to look at statistical facts and not individual stories.
> You're doing exactly what you're criticizing
No, because I specifically point out to look at the actual numbers rather than individual stories ;)
> Is it a coincidence that the only first world country that failed at containing the epidemic tells everyone that "it's not that bad", "not so many people will die", "there are no side effects", it's a disgrace.
Not sure which country you are talking about. I live in the UK and think there's many things we could have done better and many things where we overreacted. I don't think any country has contained the virus, as the virus cannot be contained. We see small outbreaks everywhere, so it's difficult to claim that anyone has contained it. For every country which has done X you'll find another country which hasn't done X and their curves still look incredibly similar. Take Sweden as an example. We haven't heard any news on Sweden for a while, which can only mean that they must be doing well now and looking at their curves they did flatten indeed and their death counts are drastically going down. So I think anyone who is smart enough not wanting to embarrass themselves will know to hold back with any premature clever comparisons until a couple years down the line.
> Take Sweden as an example. We haven't heard any news on Sweden for a while, which can only mean that they must be doing well now and looking at their curves they did flatten indeed and their death counts are drastically going down.
There's been a lot of news on Sweden.
Last week: https://www.nytimes.com/2020/07/07/business/sweden-economy-c...
Just a couple of days ago: https://www.cbsnews.com/news/sweden-covid-coronavirus-deaths...
Daily deaths have gone down, but Sweden remains the 5th worse with overall deaths per capita in the world. It will be interesting to see how the Swedish strategy plays out when the summer ends.
There's been a lot of news on Sweden.
Last week: https://www.nytimes.com/2020/07/07/business/sweden-economy-c...
Just a couple of days ago: https://www.cbsnews.com/news/sweden-covid-coronavirus-deaths...
Daily deaths have gone down, but Sweden remains the 5th worse with overall deaths per capita in the world. It will be interesting to see how the Swedish strategy plays out when the summer ends.
what matter are stats, and they don't lie
Sadly stats do lie, all the time, and especially in this particular event.
Just a few days ago it was discovered that Public Health England was defining a "COVID death" as literally any death of anyone who had ever been infected. Under this definition COVID is a terminal disease from which nobody ever recovers. The stats reported for COVID deaths in England have been completely corrupted and nobody seems to know how long this has been going on for. Is the UK really one of the "worst hit" countries given such statistical errors? Maybe, maybe not. Nobody actually knows.
The same problems are visible in other countries too. That's why there are so many cases of people reported as COVID deaths yet who actually clearly died of other cases. Governments suspended the usual judgement of pathologists, autopsies etc to find out 'true' cause of death and just assumes COVID+death = COVID death. The case count is even more corrupted.
At this point I don't think there are any stats that are reliable except all-cause mortality, and even then, people routinely read things into it that aren't there. For example by assuming all excess deaths must be caused by COVID. Not a valid inference.
So some newspaper has come up with some stats saying lots of people have weird, inexplicable yet vague symptoms after apparently recovering. Given how often these outlets have mis-labelled or mis-reported basic statistical data and always to the same end of creating more panic, I'm going to reserve judgement until far more analysis is done and with far more reliable evidence.
Sadly stats do lie, all the time, and especially in this particular event.
Just a few days ago it was discovered that Public Health England was defining a "COVID death" as literally any death of anyone who had ever been infected. Under this definition COVID is a terminal disease from which nobody ever recovers. The stats reported for COVID deaths in England have been completely corrupted and nobody seems to know how long this has been going on for. Is the UK really one of the "worst hit" countries given such statistical errors? Maybe, maybe not. Nobody actually knows.
The same problems are visible in other countries too. That's why there are so many cases of people reported as COVID deaths yet who actually clearly died of other cases. Governments suspended the usual judgement of pathologists, autopsies etc to find out 'true' cause of death and just assumes COVID+death = COVID death. The case count is even more corrupted.
At this point I don't think there are any stats that are reliable except all-cause mortality, and even then, people routinely read things into it that aren't there. For example by assuming all excess deaths must be caused by COVID. Not a valid inference.
So some newspaper has come up with some stats saying lots of people have weird, inexplicable yet vague symptoms after apparently recovering. Given how often these outlets have mis-labelled or mis-reported basic statistical data and always to the same end of creating more panic, I'm going to reserve judgement until far more analysis is done and with far more reliable evidence.
> ...recovered from it like from a normal cold, so did the British prime minister
…say what? He was in intensive care.
…say what? He was in intensive care.
The most infuriating part is how little help there is from medical professionals. She's now 4 months in with what can only be seen as a chronic health problem, but the only medical advice doctors will give her is to rest.
After she recovered and came down with the post-covid symptoms, we went to a doctor whose best guess was that she had somehow got another viral infection (despite not leaving the house). My only hope is that as these symptoms become more widespread and well-known, long-term support is made available.
It's incredibly frustrating that we've known about these issues for a couple of months (and so have many others, old.reddit.com/r/covid19positive was full of similar stories in march). Meanwhile it seems like medical professionals are only just starting to consider that it can affect you for more than a couple of weeks.