Covid-19: Post-coronavirus syndrome is ‘absolutely a real thing’

The recovery rate from coronavirus stands at 92 per cent in Ireland. But what does recovery actually look like, and why are some more affected than others by the disease and post-Covid19 syndrome?

Broadcaster and former GP Ciara Kelly is not sure how she caught coronavirus, though she says the week before she became unwell she was at events involving a large number of people.

“This was way before there was any question of lockdown,” she clarifies. “I wasn’t well. I was quite fluey for about a fortnight. I would have been very tired, quite weak, a cough, short of breath.”

Although Kelly continued to present her radio show from her linen press, she says “when I wasn’t broadcasting I was mostly in bed”.

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Referring to some of the criticism she received for continuing to work, Kelly explains.

“I got it very early on. I think within two weeks of the first case I had symptoms. Bear in mind it was all very secretive at the time. We didn’t have any real names or faces of people who’d had it. Nobody was willing to say they’d had it publicly. I felt it was an act of public service broadcasting that here was somebody who had it, who was willing to talk about it publicly.

“I was fairly flattened by it. For maybe two weeks after that I was also very tired, and was quite short of breath even on minimal exertion.”

Kelly, who promotes and leads an active lifestyle, was really surprised by this. “My breathing was different all around the time I had it, which was very unpleasant. I still can’t smell. I can taste fine, but I don’t seem to have any sense of smell.

“I’ve been places with people and they’ve gone ‘oh, that’s gross, sewage’, and I go ‘what are you talking about, I can’t smell anything’. I don’t know if and when it’ll come back.

“I still seem to be able to eat like a horse,” she laughs.

Kelly says she now feels fine. “I genuinely have energy. I go for a walk pretty much every day now again – back to sort of normal stuff.”

First case

Sinn Féin leader Mary Lou McDonald has no idea how she contracted Covid-19.

“I will always scratch my head and wonder about that one. It’s all the more astonishing because my children were in the school where the first case was identified. My two heroes have been out of school since March 2nd.

“We started early with being extremely careful, with staying at home and staying apart and all of that, so it is an absolute mystery to me. I had very limited movement. I took all of the precautions but I picked it up.

“It just absolutely floored me. My fingertips hurt. It hurt to open my eyes at times. I couldn’t sustain a conversation. It just completely and utterly flattened me.

“I had many of the symptoms typically associated with it, but I was lucky in as much as my lungs held out. I don’t have great lungs, I’m an asthmatic, so I had a concern around that.”

After the virus passed McDonald discovered she had pleurisy in her right lung – Covid19’s “goodbye present” to her, she says .

“I can only describe this virus as utterly miserable. I also found it very emotionally distressing. I only hope, having had it, that I not alone have antibodies, but some effective form of immunity because I certainly would not like to catch it again.”

With McDonald’s illness coming at a time of national crisis, calls as to her whereabouts were circulating on social media.

“I didn’t actually realise this at the time, but I realised it afterwards that some were saying ‘where is Mary Lou?’. I mean in fairness people weren’t to know that you were sick. But look if you’re unwell you’re unwell, and you have to get better. Politicians don’t have special immunity from this virus.”

McDonald experienced continued fatigue for a number of weeks post-recovery. Her GP had warned her to expect this. Returning to work during a time of travel restrictions meant that although McDonald has “never been busier”, by staying local she had the opportunity to work in “chunks of time and then rest”.

She cautions those recently recovered from Covid-19 that “it will take its toll”, and they should “take it handy”.

“If you believe in God, thank God that you’ve come the far side of it. If you don’t believe in God, thank some higher power or fate or the kindness of life that you’ve come through it because remember more than 2,000 people across the island didn’t make it the far side. I feel really, really lucky that I had it, and that I overcame it.”

Movements

Anne is a stay-at-home mother of three. Stigma around Covid-19 has stopped Anne from feeling she can speak openly about her experience, and so her name has been changed to protect her identity.

She was the last in her family to become ill with Covid-19. Her husband was the first in her household to catch coronavirus, and she suspects he may have brought it home from either work or grocery shopping, as the family had completely restricted their movements outside their home.

“It was at the very start of lockdown,” Anne explains, adding that her husband received confirmation that he had Covid-19 after he had recovered from the virus. Their older two children also became ill with Covid19, but both had very mild symptoms and recovered within a week.

Anne’s baby was due her routine childhood vaccinations, however, the baby had a persistent “barking cough” and Anne did not feel comfortable to go ahead.

“The doctor decided she was to go for a test,” Anne says. “The HSE as a precaution said to me, ‘given the fact you’re so close to her, you may as well be tested’. I came back positive and she came back negative.”

At the time of the test result Anne was asymptomatic (showing no symptoms). Having seen and read numerous news reports of overflowing ICU wards across Europe, fear led Anne to "catastrophise" the situation in her head, adding to her mental anguish.

“It was about five days later my symptoms started. I had a week where I was pretty bad, and then I felt I was really turning around and I felt fine. Then it just literally hit me like a bang overnight. I was back in bed for two days and the pain in my chest, it was like as if somebody was stamping on my chest. The cough with it is horrible.

“The GP put me on steroids on a Wednesday and by Friday I was starting to come back to myself. It was like a magic pill. It was amazing the difference. In saying that, that would have been going into the third week.”

Although Anne largely feels back to herself now, she says “even at this stage I never really feel energised”.

Positive test

Garda Billy Molloy was worried about his wife who has two underlying conditions when he caught Covid-19 at work. With 19 days passing between his first symptoms and a positive test result, he took no chances and locked himself in his room for 14 days. Neither his wife nor children became infected.

Billy’s first symptom was a temperature. “I never get temperatures even when I’m sick. I got all the symptoms that are described, but I got them over a six or seven day period,” he says listing cough, headaches, aches and pains, tiredness and loss of taste and smell amongst the symptoms he experienced. “When I was well into it if I did anything, there was shortness of breath,” he adds.

“It was 7½ weeks before I was well.” By that stage Billy says all the symptoms were gone “except for the cough and the shortness of breath when I did anything. And when I say did anything, I’m talking about climbing up the stairs or a phone conversation. I got actually used to being short of breath and having a cough if I did anything

“Four, five, six weeks into it, that’s when I was starting to feel a little bit better so I used to get up every morning and think, ‘oh I’m back, I’m ready to face the world’ but by lunchtime, two o’clock, I was back to a slap in the face again.

“Probably the only thing I have left, I have a bad taste in my mouth sometimes,” says Billy, emphasising that “it’s a bad taste in my mouth more so than things not tasting properly”.

In spite of his prolonged period of illness, Billy says post-Covid-19 he has not “felt this good in years”.

I don’t know if it’s a combination of me getting my act together and I’m running and cycling and I’m eating much healthier as well, or if it’s my immune system. I would strongly advise people that you will get there, but just don’t push it. Wait until you’re proper ready, not nearly ready, before going back to work.”

Fever

ICU nurse Bindu Sam Cherian caught Covid-19 at work. "I started with fever, with a high fever" she says. The other symptoms followed: "full body aches, it's so painful. Breathing was difficult. I was very breathless, could not even speak a sentence, severe headaches and aches and pains, horrible, horrible ones – worse that what we get for flu.

“Every breath you take was like glass pieces going through your lungs,” describes Bindu, who has no underlying health conditions and is a non-drinker and non-smoker.

Bindu’s husband and children also became ill. Bindu was self-isolating in her house. Her family left meals outside her bedroom door. One day, however, her fever was so bad that she could not get up. “My husband came to my room and he gave me medicine and water.”

Bindu says watching her family become ill was “so scary” because she had seen her colleagues on ventilators. “These are all things that are running in the back of my mind.”

She got the family to practice self-proning, which involved them spending periods of time lying on their stomachs.

‘It’s very good. It opens up the lungs and it helps them to breathe. I made my entire family plus me every day, two hours in the morning, two hours in the evening, we were proning.”

Bindu says “I’m not the same person that I was”, referring to the tiredness that has remained one month on. “I’m so tired even after doing small chores.”

Yet she adds: “Every day I’m getting better.”

Sense of taste

Infectious disease expert Prof Cliona Ni Cheallaigh says post-coronavirus syndrome is "absolutely a real thing".

“People think that not being able to smell is no problem, but it really affects your sense of taste. We’ve seen it before with flu in particular.

“And people can lose it permanently, and it really can affect how people eat. So we’re particularly worried about it in older people, who maybe don’t have the same appetite, they mightn’t eat enough to keep themselves going. If you lose your sense of smell, you really lose a lot of your appreciation of food, and so you don’t tend to eat as much.”

Although it is not completely certain why some people are more affected than others in the aftermath of the illness, “it seems the more severely unwell people were in various respects, the longer it takes them to get back to normal”, says Prof Ni Cheallaigh. “That would be the same with a lot of diseases. How sick you are is a measure of all the inflammation and the things going on in your body. The more difficulty people had breathing when they were at their sickest, the more likely they are to still have some breathing difficulties now.

“We think it’s all to do with your immune system, your body’s response to the virus. Covid-19 is really interesting from a scientific point of view because it seems it’s actually your immune response to the virus that makes you sick, so people tend to not be that sick for the first week they have it, and then as their immune system kicks in to try to fight it off, that’s when people get really sick.

“ It seems like some parts of the immune system in the people who are sickest are really running out of control, getting totally out of balance.

“Fatigue is your body’s natural way of protecting itself. We think that prolonged fatigue, tiredness that people are feeling, some people might call it a brain-fog, that’s probably a reflection of their immune system still being out of kilter.”

Prof Ni Cheallaigh says we are learning lots of things about Covid-19.

“We are learning that everybody is different. It’s impossible to predict anything. Lots of people who were really sick are now back to normal. There is definitely hope.

“We’re learning. It looks like and is conceded internationally that poverty or the stress of being poor really damages your immune system. We’re seeing internationally with coronavirus there’s a big association with poverty and getting sicker. Homeless people who got it, got really sick.Poverty is really bad for your health.”