Good Medicine: The Lingering Crisis of Long COVID

Long COVID is a disease frustrating to patients and clinicians alike. Also called long-haul COVID, the illness insidiously appeared during the 2020 coronavirus pandemic. A number of COVID-19 sufferers developed lingering symptoms such as headache, nausea and dizziness. Primary care providers were often stumped, dismissing many victims with a diagnosis of anxiety.

By August 2022, increasing requests for post-COVID disability benefits prompted the Social Security Administration to investigate the mysterious ailment. After an exhaustive two-year study by the National Academies of Sciences, Engineering and Medicine, the 265 page report confirmed what sufferers already knew: “Long COVID … is associated with a wide range of new or worsening health conditions and encompasses more than 200 symptoms involving nearly every organ system.” Afflicting 7% of  American adults — 19 million people — long COVID is expected to cost the United States up to $3.7 trillion in work absences, health care costs and disability. 

Researchers think that persisting fragments of the virus circulating in the bloodstream are the likely cause. The resulting inflammation can compromise the immune system and lead to minuscule clot formation — interfering with blood flow to the brain, lungs and other organs.

Long COVID can develop up to three months after the onset of the coronavirus. It can occur after any COVID-19 infection, and even a mild case offers no protection from long COVID. Symptoms can last weeks, months or years. Scientists have shown that recovery often stalls after the first year; some consider long COVID a chronic disease, similar to other post-viral illnesses like fibromyalgia or chronic fatigue syndrome.

Most common among the wide spectrum of symptoms is exhaustion so severe that one in four afflicted adults report significant limitations in their daily activities. Lack of mental clarity (“brain fog”), poor or absent sense of smell or taste (food may have a metallic flavor) and palpitations are frequently reported.

According to the National Institute of Health, undervaccination is the primary risk for developing long COVID. The CDC currently recommends that everyone aged six months or older should receive an annual COVID-19 vaccine — just like the flu shot. Currently, only 22.5% of American adults are fully vaccinated against the coronavirus. In Dutchess County, 19% are completely immunized: in Columbia County, 24%. Those with underlying health problems like diabetes, heart or lung disease are more likely to become victims, and though the reasons aren’t clear, long COVID occurs most frequently for those between the ages of 35 and 49, striking women twice as often as men.

There is no one blood test or imaging study to diagnose long COVID: Labs, EKGs and X-rays are often normal. The diagnosis is made by a detailed history and physical exam provided by your medical practitioner.

Treatments include pulmonary rehabilitation to improve breathing, olfactory retraining, physical therapy and supportive counseling. Consultation at a Long COVID Multidisciplinary Treatment Center may help.

COVID-19 infections in the U.S. are on the upswing this summer — ER visits have increased by nearly 16% — due to new Omicron variants nicknamed FLiRT. Increasing concentrations of coronavirus have been confirmed in community wastewater: The state’s Department of Health reports high levels in Columbia County and moderate levels in Dutchess County. There were nearly 400 COVID deaths each week in June 2024 — three of those in Dutchess County, five in Columbia County. Although that is a far cry from the pandemic’s peak death rate of a staggering 26,000 fatalities a week, COVID still remains the nation’s fourth-leading cause of death, behind heart disease, cancer and accidents.

The best way to prevent long COVID is to update your vaccinations and avoid getting COVID-19 in the first place. The 2024 immunization will be available by the end of August at most local pharmacies. Work at improved hygiene: Cough or sneeze into your elbow and wash your hands frequently. Open the windows as much as possible to let in fresh air; hold large gatherings outside. Follow the March 2024 CDC updates when sick with any respiratory virus: “Return to normal activities when, for at least 24 hours, symptoms are improving overall, and if a fever was present, it has been gone without use of a fever-reducing medication.” Be cautious for an additional five days; wear a  well-fitting mask and keep your distance from others to minimize disease spread.

Dr. Mary Jenkins, a contributor to the Herald and member of its board of directors, retired after nearly 40 years as a family practice physician in New York state.