Yvonne Shield, 58, also caught Covid as the UK entered its first lockdown. The health charity worker had a busy social life and went to the gym three or four times a week for spin classes, body combat and personal trAIning. But Covid hit her hard. Her chest and lungs hurt and she struggled to breathe. She had a continuous headache, severe fatigue, and her hair began to fall out.
After a phone consultation with her GP, Shield was prescribed antibiotics for pneumonia, but her symptoms didn’t improve. “I seemed to be in this zombie state of being very unwell for a long time, but not so unwell that I needed to be hospitalized,” she says.
Shield was furloughed for 18 months. Beyond feeling overwhelmingly tired, she had brain fog and couldn’t think as clearly as before. She did very little around the house and made only simple meals. She spent a lot of time sitting down, and could feel her fitness ebbing away and her joints seizing up. “People told me I had to go out for walks and build myself back, but it had almost the reverse effect. I’d sleep for two hours to get over a 20-minute walk. I had to learn how to pace myself.”
Shield took the breathing physio course through the long Covid clinic, which helped her to breathe more deeply again. But doctors found she had developed asthma. They prescribed an inhaler which Shield says “transformed” her life. “My symptoms improved,” she says. “They weren’t eradicated, but they improved incredibly, and it helped the fatigue as well.”
The asthma may be with her for life, but Shield feels she is gradually getting better. “My journey is one of improvement, but it is a lot slower and a lot more frustrating that I imagined it would be,” she says. “I’m probably at 70% because I can’t do what I used to do. It’s slow, but I’m going to get there.”
There is no clinical test for long Covid. Instead, patients undergo an assessment that aims to rule out other causes and then identify the components of their illness. Some symptoms can be treated with medicines: the headaches, palpitations and dizziness. Others, such as breathlessness, can be improved with breathing physiotherapy. Many patients need psychological support for the substantial mental challenge long Covid can present.
One of the most common aspects of long Covid, however, is proving harder to treat: fatigue. Patients seem to fall into two groups: some have suffered a severe loss of fitness and benefit from support to gradually recover their physical fitness. But there are others who, whenever they try to be active, find all their symptoms worsen.
“One of the most important research questions for us is why do some people get this horrible post-exertional symptom exacerbation and others don’t?” says Heightman. It means there is no single recipe for treating patients. The approach must be tailored to each individual.
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