Coronavirus doctor's diary: Why are people remaining ill for so long?

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!

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.

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.

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.

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.

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.

Realistically, what do you expect from medical professionals?

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

- 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?

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.

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.

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.

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).

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/...

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.

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.

"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.

Simple answer is that it’s a cultural difference which has a positive impact on health. Wearing a mask was normal behaviour before covid so it’s a non issue to wear one during the peak. There is no one screaming about their independence being taken away by being “forced” to wear a mask. All the homeschooler supermom Karens and anti vax types protesting about their right to choose a mask or whatever looks really really bad over here and Taiwanese people generally think westerners are retarded in regards to covid.

Also, asians are healthier, slimmer with Well rounded diets (on average.) Tons of smokers here though. A lot of Taiwanese people are happy homebodies too.

This doesn't really mesh with the situation on the ground.

Singapore has done about as well as they reasonably could given the dorm outbreak. Ex-dorm community cases are still quite low, and we're mostly business as usual. No idea who this Aussie you're talking about is, either.

South Korea is constantly battling new flareups, and Hong Kong has effectively gone back into lockdown as of today with an exploding caseload.

The only one of those countries that can really be said to have "crushed it" is Taiwan, which is probably due in part to being a self-sufficient island and in part to the extreme level of skepticism with which they treat anything from the mainland government.

Both Lawrence Wong and Gan Kim Yong are Singaporeans.

https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Singapore

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.

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.

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!).

What is this based on?

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.

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.

It's neither a cold nor flu, as "other" implies.

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.

…say what? He was in intensive care.