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June 1, 2021IM -
For those who survive COVID-19, it’s a relief. After weeks, or even months of experiencing the worst of the virus—cough, shortness of breath, fever, exhaustion—you turn the corner and soon expect to be your old self. But it doesn’t happen. There is no longer a live coronavirus running amok in your system, but symptoms persist. Patients with post-COVID conditions describe shortness of breath, joint pain, brain fog, headache, and heart palpitations. Some patients complain of unrelenting fatigue.
Long COVID Syndrome or post-acute sequelae of SARS-CoV-2 infection, as per the National Institutes of Health (NIH), is the condition in which symptoms continue long after the infection has subsided. Some research indicates that 50% to 80% of patients continue to have symptoms three months after the onset of the virus, and preliminary reports say that up to 30% of COVID-19 survivors might have long-term health concerns.
Some researchers speculate that initial damage to nerve pathways precipitates a longer recovery. But a big clue for long haulers may be a robust, unabated immune response. “If you have a brand new virus and the virus is winning, the immune system may go into an ‘all hands on deck’ response,” says Dr. Nina Luning Prak, co-author of an NIH study on COVID-19 and the immune system. While all viruses find ways to evade the body’s defenses, a growing field of research suggests that the coronavirus unhinges the immune system more profoundly than previously realized.
With more patients complaining of lingering and chronic effects from COVID-19, experts say that care for long haulers requires new guidelines and an interdisciplinary approach. Though it primarily attacks the lungs and respiratory system, it is now clear that the virus can target almost any part of the body, including the heart, brain, and nervous system. Following a congressional hearing, the CDC announced that it is issuing long-COVID guidelines for clinicians.
What’s striking is that post-COVID-19 syndrome is not just afflicting people who were gravely ill with COVID. Young patients, especially, who have weathered mild cases, talk about the debilitating health problems post COVID—and how different their lives are now. Mental health practitioners say the psychological effects cannot be overstated. Physicians attribute depression and anxiety to virus-related stressors or the impact on the brain or vision-vestibular system.
Laurie Hatcher Merz of Local 30-73 (St. Paul-Minneapolis, MN) is second bassoon/contrabassoon in the Minnesota Opera Orchestra. She contracted COVID early last December. A week after she tested positive, she was quickly losing hearing in her left ear. “It was frightening,” she says. “It started with buzzing and humming. I thought this is a career ender. The loss was significant and very fast.”
A former student of Merz’s, who is an audiologist, told her to see an ear specialist immediately. Among other things, COVID attacks the vestibular nerve and can leave permanent damage. Merz had bouts of vertigo, one so severe she went into shock and landed in the hospital. After a heavy dose of steroids and physical therapy, her hearing came back at the end of January. Five months after her COVID diagnosis, though, she still has no sense of taste or smell.
“Emotionally, it drags on,” she says. “For long haulers, there’s an emotional component that doesn’t get a lot of attention.” This, along with losing more than a year of her career to COVID, has been taxing for Merz. She’s recorded with the opera and performed online, but she says, “It’s not how we were trained as musicians. The soul of music is in the interaction of people being together in a hall.”
“You have to be very creative, explore other talents, to find something that will pay the bills and will be somewhat rewarding.” In between making reeds and managing a lakeside property, she works as a hospice assistant. “It’s hard to form that new life, but still keep music a part of you—still alive and thriving.”
Merz, who also performs with the choral ensemble VocalEssence and Minnesota Sinfonia, a chamber orchestra, says that the rate of vaccination among the local orchestra community is very high and, in fact, her chamber group offered members a $100 incentive to get a COVID vaccination.
Recent reports, surveys, and at least one study indicate that some people with lingering COVID symptoms have found some relief after receiving one of the US- and UK-approved vaccines. A nonscientific survey of 450 people by Survivor Corps, one of the first grassroots advocacy groups for COVID-19 survivors, found that 171 people said that their condition improved after vaccination. For her part, Merz tells everyone to get vaccinated. “It’s necessary if we want to eradicate this disease and go back to work.”
Post Covid-19 clinics are cropping up around the country. Around 30 hospitals have units to help patients struggling with post-COVID disorders and illness. In addition, Congress has provided $1.15 billion in funding over four years for NIH research into the prolonged health consequences of COVID-19.