Have you or one of your loved ones suffered from Covid, and still don’t feel well? And, apart from a statement from doctors or those around you that you’re suffering form so-called “long Covid“, you haven’t received any care? Then read on. In February this year, my husband and I caught Covid-19, which led to what was probably my most open interview ever with Chaplain Major Tomáš Mlýnek. I had no idea that four months later I’d return to this topic, again from my own perspective. My husband suffered a severe case of Covid, which involved hospitalisation and connection to artificial ventilation. According to medical reports, the progress of my illness was moderate; I returned to my working life relatively soon, and I hoped that I would also return to my original condition and normal lifestyle. I began to devote myself to my favourite activity of walking again, and the scooter was replaced by a bike, because I simply couldn’t breathe well enough to run. My husband recovered more slowly, but in a stable fashion. When my recovery curve began to resemble shapes that I had previously connected with the theory of recovery from an economic recession – first V, then U and now even W, I started to take more of an interest in the phenomenon of so-called long Covid, or the long-term impacts of the infection. Among those around me, I know several cases where the patients have been declared healthy, but they’re far from the definition of full health, where health is more than the mere absence of illness. Hopefully this article will help them too. And maybe it will also convince those who are still hesitant to get vaccinated, as was the case with several people close to me. Although Covid-19 doesn’t have to be fatal for everyone, do you really want to risk contending with the effects of the illness for half a year, or even a year or more?
What does long Covid actually mean?
Long Covid, or post-Covid syndrome, manifests itself in at least 10% of people who have suffered an acute case of the illness. And as my, or our, case shows, there is no direct relationship between the severity of the acute illness and the development of long-term effects. Similarly, many known risk factors affecting the severity of an acute case of Covid-19 have not been shown to increase the risk of the subsequent development of long-term health problems. Post-Covid syndrome can develop in anyone who’s affected, and affect any organ system in the human body.
How does long Covid manifest itself? I feel like a textbook example with most of the symptoms. The worst was, and is, insomnia. Although I was exhausted, and actually constantly tired, I was only able to fall asleep for 4-5 hours. I feel shortness of breath almost every day, not only during physical activity but also due to stress. I still haven’t been able to return to running, even at a slow pace, and I’ll have to miss my favourite swimming memorial dedicated to Hana Greenfield in Cologne. Everyone who knows me personally knows that swimming distances over one kilometre was my great passion. In my current condition, I simply can’t swim a kilometre. And if I do, then it’s at the cost of exhaustion, to which my immune system responds by increased temperature and an eruption of cold sores.
Mental problems, memory loss, an inability to concentrate and anxiety are other factors that make life bitter. I studied history, and names and dates were my passion and hobby. I’m a passionate networker and connector of people. Now social events are often a miserable affair for me. Not only am I sensitive to the excessive noise and other stimuli, but sometimes I simply don’t recognise the people in question. I can‘t handle passive smoke from cigarettes in gardens, or a dusty environment. So I would like to apologise to everyone for meetings cancelled at the last minute, and sudden departures. The so-called Covid brain fog is a real and very fitting term. Imagine that, in the middle of a meeting about a specialised topic, you forget a term, name or important fact, and you simply know that you don’t know.
The vague pains in various parts of my body remind me of a visit to New Orleans, and voodoo dolls. Why someone is inserting needles into me, and then I feel pain in places such as under the shoulder blade, knee or big toenail, is simply a mystery. Well, and the last change isn’t directly life-threatening, but it also affected me. My hair was falling out, and my nails were breaking. My hairdresser Chris, and his art, literally saved me from voluntarily choosing the hairstyle sported by Shira Haas in Unorthodox or Sinead O’Connor in my youth, rather than constantly looking at the balls of hair ending up in the comb.
doc. MUDr. Eva Závadová CSc, immunologist
Spa treatment
Will a spa help? And how? From my own experience, I can state that definitely yes. And I really appreciate the Czech healthcare system, because my husband and I received comprehensive spa care. My husband with regard to the difficult progress of the illness connected with hospitalisation, and I as a consequence of a diagnosis of post-Covid asthma. The spa treatment really helped us, and returned my husband to his original form. I recommend that everyone who is entitled to spa treatment use this option. I would advise others to at least avail of a discounted one-week stay in the form of the vouchers that are still available.
In the spa, we had up to six procedures a day, consisting of baths, inhalations, breathing exercises and massages. We chose the Royal Spa hotel and sanatorium, which is on a hill in Mariánské Lázně, so during regular walks we had the opportunity to verify how our respiratory and physical condition is improving. By the end of the stay, we were able to walk up the hill to the hotel several times a day without stopping.
And what then?
After returning from the spa to full-time work, my condition worsened again. My workload increased, stress and the hot summer in the city made my breathing worse again, and I began to have problems sleeping. When I discussed the problems with several acquaintances from the ranks of doctors, I heard the usual “you’re a typical case of long Covid“, while friends reassured me that I have to ease off and rest even more. Thoughts raced through my head that I might have to retreat. “The lungs are a slow organ,“ was one of the most popular catch-phrases. My response, that I’m quite accelerated so it could balance itself out somehow, was more of a bon mot. I felt that my body was in a state of permanent inflammation. This theory was confirmed to me by my friend, doc. Eva Závadová, C.Sc, MD, immunologist. And at the same time she told me that long Covid often doesn’t disappear by itself, as doctors pretend to patients. On the contrary, untreated problems can lead to further complications, which apart from breathing and fatigue include neurological disorders, joint and muscle damage, visual impairment, depression, changes in concentration, inflammation of the skin, intestines and cardiac muscle, and increased blood clotting, which can have lethal consequences.
Doc. Eva Závadová has long devoted herself to immunology, both in the Czech Republic, where she teaches in a medical faculty, and abroad, having worked for many years in the USA and Austria. She’s the author of award-winning monographs (League Against Cancer) and frequently quoted publications on the topic of immunology (e.g. The Lancet). Covid, too, is primarily about immunity. Dr. Závadová was commissioned by the Ministry of Foreign Affairs to create a Czech-Israeli working group focused on supporting immunity in connection with post-Covid treatment. There is currently no recommended treatment procedure for managing long Covid in the Czech Republic or anywhere else in the world.
So Dr. Závadová travelled to Israel, where she completed internships in several university hospitals, among others in the Sheba Medical Center, which ranks among the global top ten in the area of the treatment of autoimmune diseases, a group that includes Covid. As it turns out, it’s not about the damage that the virus causes, but about the extent to which it manipulates the immune system, which produces autoantibodies that go on to settle in the blood vessels, lungs and brain, and damage them. It is therefore important to comprehensively support the immune system so that it can cope with the situation. In no case does this mean only the use of immunity-boosting drugs (e.g. Isoprinosine), which can even strengthen an inappropriate (autoimmune) response – every patient must be treated COMPREHENSIVELY. In Israel, the treatment employed by the Center for Autoimmune Diseases includes not only immunoglobulins, but also hemp, which also helps balance the immune system. There is ongoing collaboration between Charles University and top Israeli workplaces in order to really achieve so-called evidence-based medicine. I think that the afore-mentioned spa facilities might also be interested in knowing exactly how to modify or target the therapy. An inappropriate immune response is also a cause of post-vaccination complications, so here too timely action is required.
Dr. Závadová’s team is trying to objectify the best treatment procedure. They focused on immunology, psychology, rehabilitation and nutrition. The team includes nutrition expert and Dean of health science in Ariel University, professor Birk, professor Firer, an immunologist who is an expert in specific laboratory tests demonstrating the disease’s activity, and professor Schoenfeld, who built the Center for Autoimmune Diseases in Sheba Hospital and is a world expert in immunology. Lots of patients describe the so-called Covid brain fog, which can even lead to anxiety or depressive disorders. They supplemented the treatment with regular meditation and breathing exercises, in collaboration with professor Gidron, a neuro-immuno-psychologist in the University of Haifa. Stress activates the sympathetic nervous system, which produces cortisol. The stress hormones then affect the immune system. Meditation training, and general calming down, can help improve the immune profile. The first results in patients are very promising; a specific hemp product that’s used in therapy was even patented on their basis. Meetings are currently taking place with potential partners, in the areas of both product development and spa care. I hope that they will succeed soon, because right now there really are many post-Covid complications.
Is it OK not to be OK?
I hesitated for a long time before making another personal confession. I’m not used to complaining, and I’m not used to being “out of shape“ and not putting in a performance of more than 100%. However, I became interested in the book “Unwell Women“ by Elinor Cleghorn, which deals with the phenomenon of of women’s illness and its belittlement in a historical context. While the potential risk of blood clots was discussed in connection with the Covid vaccine, the much greater risk posed by regularly prescribed contraceptives leaves most of the population and the media completely at ease. By the way, some studies indicate that while acute Covid affects men more frequently, post-Covid complications are more likely to affect women. Women’s health complications are often overlooked or trivialised, evidenced among others by the case of Serena Williams, who almost died from postpartum complications in the form of a pulmonary embolism. Although she repeatedly complained of pains, the nursing staff paid her no attention and attributed the complaints to postpartum hypersensitivity. And that’s why I’m sharing the final appeal by the author of the afore-mentioned book; “Let’s allow ourselves to not be OK, and thus fight against ingrained prejudices about the female body, mind and life. We no longer have to endure these feelings in shame and silence.“
Conclusion
I haven’t discovered a magic wand or a miraculous healing formula so far. I would advise everyone that’s suffering any of the symptoms of long Covid to not let themselves be rebuffed, and have their problem diagnosed and treated. The long-term problems that appear after Covid, such as asthma in my case, reduced thyroid function or neurological disorders that weaken the muscles, do not disappear by themselves.
I’m taking Dr. Eva Závadová’s recommendations about regular meditation, yoga and swimming to heart, and I think they’re suitable for everyone who needs to strengthen their immunity and calm their soul. And because at times my spa stay was more like “working from the bathtub”, I’ll try to disconnect when on holidays. Everyone who knows me will understand that this is a real challenge for me. Keep your fingers crossed for me. I wish everyone a wonderful summer!