Functional Medicine Associates: Lessons we are learning from the COVID long haulers

COVID-19 was originally perceived as a relatively short illness which, although deadly for some, lasted less than a fortnight for the majority.

As the pandemic progressed over time, however, we became increasingly aware of the lasting long term effects of COVID, commonly referred to as Long COVID.

Long COVID can last anywhere from a few weeks up to several months (a number of our patients continue to suffer 8 months on). Whilst we are still finding out more about its’ whole-body effects, we have seen the debilitating impact that this illness can have on its’ sufferers. Today we share some of our experiences of this illness in clinical practice. In particular, we are keen to highlight the potential effect that long COVID may have on the mental health of those affected as well as to share some positivity.

Patients with Long COVID continue to be a real challenge, with lots of uncertainty and times where both clinician and patient can sometimes feel just a bit lost. Months of symptoms such as shortness of breath, pain, fatigue and headaches leave patients feeling low in morale. Not only do they have to cope with these symptoms but they must also deal with the uncertainty of when these symptoms will resolve. Patients continue to suffer and clinicians feel frustrated when they are unable to provide the treatment strategy that will make them better. Earlier this year I wrote a piece on LinkedIn about possible strategies that may help treat post-Covid patients and we continue to use these strategies alongside some newer theories such as mast cell activation syndrome.

Covid has been a real lesson in the complexity of an illness that is so new to us. Neither patient nor clinician has a road map or timeframe for recovery and this is a vital component of their journey back to health. Unfortunately, we don’t yet have enough experience of long COVID in order to give them an indication of when it is going to end. And knowing where the end is matters! We have all run the 5km race, exhausted at the 4km mark but encouraged by the fact that the end is in sight. That knowledge gives us the strength both mentally and physically to push on.

Unsurprisingly, some patients that we have seen show increased levels of anxiety and, in some cases, depressive-like symptoms. For these patients it is even more important that as a team we stay positive, giving them hope, a regular team talk, a place for them to vent but also a steadying of the ship and a possible endpoint.  

All patients seem affected by the social isolation and loneliness that the current situation has inevitably exposed us to. It is a stark reminder of how important this aspect of human health is to all of us and especially for patients of Long Covid. Being with others on the simplest level provides safety and security and has such a positive impact on our mental well being. Social isolation and loneliness is increasingly becoming a public health issue that has only become worse as a result of the restrictions placed on us all over the past several months. The sooner we can be with others and resume ‘normal’ life the better.

As human beings, our brain is wired to crave structure, a certain routine or a plan to follow. The uncertainty of long COVID has taken away. We note a definite increase in anxiety to carry out everyday tasks and, in some cases this is largely due to the unknown length of long COVID, one day the patient may feel an improvement, only to feel worse the next day. There is a lack of certainty, which sadly causes a lack of hope. There is hope, you will recover.

The journey back to health for all our patients is a two steps forward and one step back process and it is in that step backwards where patients need that steadying ship of the clinician’s advice to put them at ease. More often than not we need to treat the set back as a positive lesson of what our body can currently cope with. Now that winter is upon us this is even more important, as we are more likely to pick up colds and infections at this time of year and for some, this can feel like a major set back. Your body won’t be as strong post-Covid as it was pre-Covid therefore don’t expect to be able to do what you did before. It is helpful that as a patient you understand and embrace the fact that you are going to need longer to recover and get back to pre-Covid health. This has been a helpful strategy for the patients that we work with, reducing their frustration around their slow recovery.

Winter may not be the best season for accelerated recovery but on a positive front, the vaccine is here and it is only a few weeks before the days start to get longer again followed eventually by the arrival of warmer Spring days. We stress to our patients that at this time of year you cannot expect too much of your body. A focus on doing the basics of good health well is key at this time. We have written about this previously.

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