I say YES. YOU say NO....Numero Tre! Enjoy!
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Inside 'post-Covid' clinics: How specialized centers are trying to treat long-haulers
NBC News surveyed dozens of "post-Covid" clinics across the country to find out how they're helping patients recover from an illness with no known cure.
Millions of Covid-19 survivors could become long-haulers, with symptoms lasting for months. Doctors and clinics nationwide are scrambling to figure out what treatments are best.Kailey Whitman / for NBC NewsMarch 1, 2021, 4:00 AM CSTBy Erika Edwards
As the coronavirus pandemic in the U.S. appears to be turning a corner, another health crisis is brewing: Covid-19 survivors struggling to bounce back to their former selves.
Of the more than 28 million Americans diagnosed with Covid-19, an estimated 10 to 30 percent — possibly as many as 8.4 million people — fall into the category commonly known as "long-haulers."
Despite the staggering numbers, there's no clear diagnosis, no standard care and no national guidelines for how these patients should be treated. There are hopeful signs, however. At special clinics around the country, a better understanding of the condition is emerging, according to a new analysis by NBC News.
NBC News identified more than 80 "post-Covid" clinics nationwide that are actively engaging with Covid-19 patients who continue to have symptoms months after their acute infection cleared. The 64 clinics surveyed by NBC News have seen nearly 10,000 patients — most likely just a sliver of the true number of people affected by a condition only recently given a name by the National Institutes of Health: "Post-Acute Sequelae of SARS-CoV-2 infection," or PASC. Millions of others may be seeking care with a personal physician or suffering alone.
Patients at the 64 clinics are men and women of all ages. Some had to be hospitalized with Covid-19, while many others never became that sick during their acute infection.
The majority are coping with a wide range of lingering symptoms, including life-altering fatigue, ongoing shortness of breath, headaches, even hair loss.
NIH researchers hope to provide answers now that Congress has approved $1.15 billion to study long-term symptoms of Covid-19.
If even 1 percent of them have chronic, long-term consequences, that's a whole lot of people. We need to find out everything we can about how to help them.
"28 million people in the United States have had Covid," said the NIH's director, Dr. Francis Collins. "If even 1 percent of them have chronic, long-term consequences, that's a whole lot of people. We need to find out everything we can about how to help them."
Help will take time. While the NIH combs through electronic health records, large data banks and collects specimens from patients, for people coping with persistent symptoms now, it's up to hospital systems and doctors to find relief for them.
'Staring at the walls'
Rory Martinson, 57, of Lakeville, Minnesota, is one of those patients. Diagnosed with Covid-19 in November, Martinson has been a patient at the Covid Activity Rehabilitation Program at the Mayo Clinic in Rochester, Minnesota, since early December.
Rory Martinson was on a hunting trip with his nephew in November 2020 when he developed a 103 degree fever. He was later diagnosed with Covid-19.Courtesy of Rory Martinson
Martinson was on a hunting trip, in a tree, 12 feet off the ground, when he started feeling sick. Staying in a family cabin with a teenage nephew in Park Rapids, Minnesota, Martinson spent nights sweating through fevers and the days trying to stay alert.
"I was worried I was going to fall out of the tree stand," Martinson said.
Martinson's temperature soared to 103 degrees. Upon his return home, his family insisted that he see a doctor. Martinson spent the next 16 days in the hospital, barely able to breathe on his own.
Nearly four months later, Martinson has no detectable virus in his system. But he still gets winded easily. To increase his blood oxygen levels, his rehabilitation at the Mayo Clinic has included breathing exercises, light cardio and weightlifting.
He's also learning how to do household chores, like vacuuming, in ways that use less energy. Instead of standing in one spot and moving the vacuum with his arms and his upper body, Martinson now operates the vacuum in a way that resembles mowing the lawn.
"You burn a lot more energy using your upper body than you do your lower body," Martinson said. His endurance is building back up, albeit very slowly.
"If I wouldn't have found this program," Martinson said, "I know I would still be sitting at home staring at the walls thinking, 'Why am I not getting better?'"
'No magic medication'
NBC News found that there is no medical standard of treatment for post-Covid-19 patients. Therapies vary from traditional physical therapy to medications to mindfulness. Some patients have improved; many others haven't.
"It's very hard," said Dr. Cyrilyn Walters, medical director of ambulatory services at Regional One Health in Memphis, Tennessee, "because there's not a lot of data." Her team, which partnered with the University of Tennessee Health Science Center, works with each patient to rule out conditions unrelated to Covid-19 that could be causing a patient's symptoms. Otherwise, she said, "there is no magic medication."
COVID-19 long-haulers: Patients share lasting impact of virus
DEC. 23, 202004:04Dr. Rebecca Keith, an associate professor of pulmonary and critical care medicine at National Jewish Health in Denver, is a co-director of the facility's post-Covid-19 clinic. The facility puts together a "unique care plan" for every patient, she said. Some may need help with breathing. Others have problems with racing hearts. Many complain of constant stomach illness.
"It takes a multidisciplinary approach to try to help people," she said. "Hopefully, as time goes on, science will catch up and we'll have more to offer."
Dr. Carla Sevin, director of the ICU Recovery Center at Vanderbilt University Medical Center in Nashville, Tennessee, said: "If you still need oxygen, you probably need a pulmonologist. If you have heart issues, you probably need a cardiologist. But for some of these other symptoms, it's not really clear who the best person is to see you.
Because Covid is basically a new disease, we know nothing about the natural history or the recovery or the long-term implications.
"Because Covid is basically a new disease, we know nothing about the natural history or the recovery or the long-term implications," Sevin said.
Often, the only real options for clinicians are to work with patients on the basics of a healthy lifestyle, including sleep, diet and exercise.
Adding to the difficulty, many clinic appointments are telehealth only because of the pandemic.
To help with brain fog, a commonly reported symptom, the Post Covid Recovery Team at Family Health West in Fruita, Colorado, uses speech therapists to help patients find the right words while speaking.
HEALTHMost hospitalized Covid patients have neurological symptoms, study says
For people with ongoing headaches, Dr. Ellen Price at Family Health West uses Botox injections, massage and acupuncture.
At the post-Covid-19 clinic at University Hospital of Brooklyn SUNY Downstate in New York City patients with ongoing shortness of breath are given typical medications, such as inhaled or oral allergy drugs.
Surprisingly, some get relief from eating oranges.
While there is no research suggesting the citrus fruit helps treat long-lasting Covid-19 symptoms, Dr. Mafuzur Rahman suggests a benefit from vitamin C or that the juice helps clear congestion.
"Since there are no contra-indications to eating oranges for most patients, I recommend it," Rahman, vice chair of medicine at SUNY Downstate, wrote in an email.
Most long-haul patients seeking treatment at UT Southwestern Medical Center in Dallas benefit from physical therapy to help with breathing, as well as emotional support and counseling, a spokesperson said.
A picture slowly coming into focus
Research into long-haulers has been painfully slow, patients say.
Part of that is simply because for much of the past year, hospitals have been singularly focused on treating the severely ill Covid-19 patients filling up their intensive care units.
"We understand that the medical community is completely and totally overwhelmed," said Amy Watson, 48, of Portland, Oregon. "But we've been awfully patient out here for a year now."
It was Amy Watson's trucker hat that inspired the term "long haulers."Courtesy of Amy Watson
It was Watson, a preschool teacher, who came up with the name "long-haulers." She remembers sitting in her living room weeks after her Covid-19 diagnosis, unable to shake symptoms, including fever and extreme exhaustion.
That was nearly one year ago.
As an increasing number of patients seek help, a clearer picture of typical long-haulers is emerging. Many are otherwise healthy adults in the prime of their lives with careers and families.
Patients report brain fog, an inability to multitask, trouble breathing, gastrointestinal problems, such as diarrhea, as well as profound fatigue.
"Patients are reporting that they need about a four- to five-hour nap after doing something as simple as taking their laundry up a flight of steps or taking out the trash," said Dr. Greg Vanichkachorn, an occupational medicine specialist at the Mayo Clinic. "It can be quite severe and debilitating."
From once being able to play with their kids or run around, "now they can barely get up, take a shower and pick something to eat without feeling incredibly fatigued," said Walters, of Regional One Health in Memphis.
Long-haulers appear to have a problem with the autonomic nervous system, which controls things the body does automatically, without thinking, such as blood vessel constriction, said Vanichkachorn, who's involved with Martinson's treatment. That may help explain why some patients have trouble with irregular heart rhythms or experience sudden changes in blood pressure.
How do you treat a disease you can't define?
Despite some similarities among long-haulers — often women in their 30s, 40s and 50s — there is no consensus on how to diagnose patients. Not all patients have specific lung imaging that would suggest post-Covid-19 illness, for example.
"The lungs aren't even all wrecked in the same way," said Vanderbilt's Sevin. "There are a bunch of different patterns."
Clinics also vary in determining who is eligible for treatment. Asking for a positive test result may not be possible: Many long-haulers became infected before widespread testing was available. Some clinics require patients to have had symptoms for a certain time period, from a few weeks to a few months.
Dr. Sarah Jolley, a pulmonary and critical care specialist at UCHealth University of Colorado Hospital in Aurora, called for the medical community to create standardized definitions and guidelines of care.
Learning from other long-term illnesses
Often, clinicians are relying on their experience treating other long-term illnesses.
It's long been known that patients hospitalized for extended periods in intensive care units can develop cognitive impairment and muscle weakness — usually because of strong sedatives. Recovery and rehabilitation can take six months or longer.
Those who specialize in post-intensive care syndrome are pivoting to help those with long-lasting Covid-19.
HEALTHWhy some COVID-19 patients may face problems even after recovery
Plans for a post-ICU clinic at the UCHealth hospital in Aurora were already in place when the pandemic began, Jolley said. Covid-19 "really accelerated the creation of the clinic, because we anticipated that there would be a large number of ICU patients who needed ongoing care."
The clinic evolved to include post-Covid-19 patients "across the spectrum of illness," Jolley said, including long-haulers.
Clinicians are also taking cues from what's known about other, similar long-lasting illnesses, such as chronic fatigue syndrome and fibromyalgia.
Many of these patients throughout the history of medicine had been marginalized, just because it was a very fuzzy type of diagnosis.
"Many of these patients throughout the history of medicine had been marginalized, just because it was a very fuzzy type of diagnosis," said Vanichkachorn of the Mayo Clinic.
The rapid rise in the number of long-haul patients may spur research for those conditions, as well.
"Research teams are being built to understand what's going on at the chemical level" of those conditions, Vanichkachorn said.
A sense of abandonment
Patients often arrive at the clinics after being turned away by other providers who either dismissed their illness as "all in their head" or could offer no help. The emotional fallout leads to guilt and self-doubt.
Amy Watson, seen here after finishing the 2010 Portland Marathon, now can barely walk a mile without becoming short of breath.Courtesy of Amy Watson
"The one universal thing that I've seen across all patients with post-Covid syndrome is, unfortunately, a sense of abandonment," Vanichkachorn said. "Patients often wonder: 'Why am I different from everyone else? Does this syndrome say something about my character or about my constitution or toughness?'"
Patients who were physically fit before Covid-19 infection — special operations military personnel, airline pilots and runners — tend to have more severe long-term symptoms, another mystery of the disease. Up to 30 percent of long-haulers are so debilitated that they have been forced to quit work, according to the Mayo clinic's estimates.
Watson, a marathon runner, is among the patients who never returned to work. She can barely walk a mile without getting winded.
"I want so badly to have the quality of life that I had before," Watson said. "No one wants this to be real life."
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Democrat Marcus Flowers Announces 2022 Bid For Marjorie Taylor Greene's Seat and He Looks Like a Formidable Opponent
In the summer of 2020, Marjorie Taylor Greene won the Republican primary for Georgia's 14th District. This essentially made her a shoe-in to win a seat in the House of Representatives as the district is deep red. Before the election, Democratic opponent Kevin Van Ausdale dropped out of the race, allowing Greene to run unopposed. …
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Under the circumstances I'm not at all surprised. I was a little with Sasse.
Capitol Attack Inciters Ted Cruz And Josh Hawley Vote Against Merrick Garland
Sens. Ted Cruz and Josh Hawley voted against Merrick Garland's nomination in the Senate Judiciary Committee after Garland vowed to prosecute all involved in the Capitol attack.
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I've read a few articles about Biden's approval rating, 55-60%. I read articles about his discipline and focus. Imo, when voters wake up every day and put in a hard day's work, they like seeing their President has the same work ethic they do.
I know Merrick Garland's confirmation is moving along, but it seems to be at a snail's pace. At least Miguel Cardona was confirmed as Education Secretary which sounds like a positive move for the nation's schools.
I'm tired of seeing Andrew Cuomo stories. It's possible the sexual harassment claims are true, but why is the media making the story so big? Are Republicans worried he could become the next Democratic presidential candidate so they're smearing him now? I wearied of him last year in the first few months of the pandemic when all the Covid stories seemed to center around him and New York. Yes, it was devastating to hear about their state, but it left little reporting on the rest of the country.
I'm glad the convention worshiping with that other guy is over, and it seems like mainstream media didn’t give it more coverage than necessary. Msm best be careful. I hold them responsible in part for creating 45 for ratings and money. Then they paid for it by spending 4 years having their industry continuously and viscously attacked as fake news. Once Biden was elected, quite a few stories emerged by news journalists from many different news outlets who unabashedly admitted to huge sighs of relief over a new administration, that they were finally able to catch their breath, that they were not sure how or if they'd get through the unprecedented difficulties dealing with former guy. For everyone's sake, I hope msm learned from that psychopathic whirlwind and doesn't repeat its mistakes.
One of the best things Biden does, and I’ve seen it referred to as kryptonite, is ignore 45. Absolutely does not engage in back and forth angry exchanges with him. LOVE THAT. The former guy hates indifference, and that’s exactly what Joe’s strategy is. And it’s working!! I believe it’s not just a strategy but a true belief of Biden, that his former opponent warrants no response. Far more important matters are President Biden’s focus.
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Peace comes from living a measured life. Peace comes from attending to every part of my world in a sacramental way. My relationships are not what I do when I have time left over from my work. . . . Reading is not something I do when life calms down. Prayer is not something I do when I feel like it. They are all channels of hope and growth for me. They must all be given their due. -Joan D. Chittister
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Divine: I agree with everything you have said. I also think the fact that the former guy has been banned from some of the social outlets has a positive effect as well. Quite some time ago people were voicing ( and we saw it here so much too ) how discomforting to have tweets ALL of the time. Not only the mean, nasty ones but having so often to be governed by them. To find out what new rule we would have to live by was horrid.
I think we are all better off having a leader who isn't heavily into over-exposure. The other guy was 'big brother' and you just couldn't get away from it. I think we all are a little easier at acceptance of things if we don't have to have it pounded in hour after excruciating hour. Of course, with Pres. Biden the likelihood that it will be something we hate or find extremely harsh if pretty miniscule.
President Biden is a breath of fresh air personified.
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Agree with DivineMrsM about Biden's strategy with the ex-45. Refusing to engage with a bully infuriates them but also leads them to reveal their true self and colors. Jackie, Biden is the breath of spring after 4 years of winter. Hate that he has to deal with Repugnicans who vote against his plans but then again, they are revelaing they are the obstruction to forward progress and that they do not honor the Constitution nor their oath to protect it.
Someday the news will not be centered on the ex-45 (he still doesn't accept he is an ex-), his bimbo wife, his ill-informed and rude children and the Kardashians. Personally I do not need a daily report on what Ivanka is wearing, do you? I found her clothes to be cheaply made, overpriced and seen mostly at Marshall's or TJ Maxx. Never purchased any because of the name as well.
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Jackie, you describe it well. The tweets seemed to govern our lives. It's true, too, that acceptance is easier to come by when it is not forced.
Betrayal, I have a feeling Melania is going to be a tiny blip in history. She really made no lasting statement or impression as First Lady. When she was all smiles putting that medal around Rush Limbaugh's neck, I do not think she had any idea at all what it symbolized. In her mind, she could have been placing a wreath of flowers around a winning horse's neck and they'd both mean about the same thing to her. “Oh, da Donald let me geeve medal to man in suit."
The woman made many large blunders. She cultivated her mystique by being mostly out of sight. I think it was because if you get too close, the more obvious she has no substance. She idolized Jackie Kennedy since Jackie was famously private. But Melania didn't grasp the part where Jackie knew just when and how to pull out all the pizzazz. For instance, on a trip through Europe with her husband in 1961, Jackie's style and charm made her appear even more of a massive hit with the public than her husband. They were so taken with her that in a parting speech, with a big smile on his face JFK famously quipped' “I am the man who accompanied Jacqueline Kennedy to Paris, and I have enjoyed it.“
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Speaking for Colorado, I'm so sorry. We will try to do better in the future.
Husband of Representative Lauren Boebert Allegedly Exposed Himself to Teens
Representative Lauren Boebert is no stranger to controversy. Neither is her husband, Jayson Boebert, according to court documents recently unearthed by a private investigator hired on behalf of the Colorado Turnout Project. Jayson Boebert, then unrelated to Lauren Opal Roberts (Lauren's maiden name), was arrested for allegedly exposing himself to a minor while at a bowling alley in 2004.
The incident, which took place on January 24, 2004 , at the Rifle Fireside Lanes bowling alley in Rifle, Colorado, involved a 16-year-old girl and a 20-year-old woman. According to police reports, the 16-year-old and 20-year-old were at the bowling alley talking to one another about their tattoos when Jayson Boebert overheard their conversation and stated that he has a tattoo on his genitalia.
The 16-year-old and 20-year-old provided written testimony to the Garfield County Sherifs Department that they attempted to ignore Jayson Boebert, but he approached them from behind, and "unzipped his pants, removed his genitals exposing the shaft" while "covering the head of the genitals with his hand," according to the police report discovered by our private investigator.
Jayson's now-wife, CO Representative Lauren Boebert, was also present at the scene when the indecent exposure to a minor occurred. She, along with others in her and Jayson's party, were asked by the bowling alley's owner to leave and have since been banned from returning to the establishment. 0 -
Love the new MAGA meme, Ruth! Arresting them is great, but they keep releasing them on bail. When so many were already violating probation just to go to DC, why would a judge NOT see them as flight risks?
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More good news on the vaccine roll-out:
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That is wonderful news about the vaccine. I really don't want the J&J one but fear I won't have a choice. I am so ready to be vaccinated (and my husband and daughter too). It is painful to have to wait. But ugh, I also would much rather have Moderna (or Pfizer).
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Just returned earlier from getting our second Moderna injections in Marion. We are both veterans and I was surprised when we got the call in February to choose a date to come in. I thought it would be at least June. I think if enough people are 'actually' vaccinated the J & J could be okay -- I'm still wondering whether any or all of us may have to have more shots in the future as boosters for the original shots or for something to counteract one or more of the variants.
I was coming in to share this:
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And the next thing I saw was this. I'm sorry to say I am definitely from Illinois. I did see a couple of people today with masks on - noses showing. They were older folks and in fairness they may have had some issues with breathing or something. I didn't ask -- I just kept my distance.
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Must be evangelical Kool-Aid gulpers.
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Sadly true.
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Aaargh! And now our Rep. Texas governor has announced "it is time" to open businesses 100% and lift the mask mandates. Cities and counties and businesses will be allowed to request mask wearing but no penalties for not doing so will be allowed. Guess the people who get sick because someone else did not wear a mask are the ones who are penalized. Absolutely a decision based on business thinking with no thought to the advice of scientists and infectious disease specialists. aaaargh!
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Wow! I'm not sure I knew you are a veteran, Jackie! If you don't mind, please tell us more. So glad you and your dh are immunized!
Yes, cm, they are advising get whatever vaccine comes your way first. I kinda feel the same way as you. From what I understand, tho, any of the vaccines protects strongly against needing hospitalization and death from Covid, well worth getting.
I just saw breaking news that Andrew Cuomo is going to resign.
Oh, one more vaccine note:
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I’m scheduled for my first vaccine dose tomorrow evening! We believe that all the teachers at my school are being vaccinated this week or have appointments for next week. I don’t care which vaccine I get. Even though the J&J vaccine is slightly less efficacious than the others, it is still more effective than the annual flu vaccine. Has anyone ever been so excited about a shot 😉?
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On Thursday, Ohioans age 60+ will be eligible for the vaccine. I put mine and dh’s name on a list at a pharmacy in town and they said we may be called within a couple weeks. Friends told me to also sign up at Walgreens and Krogers pharmacy as well as the county health dept but those places wont take names for this age group until Thursday. We will go to whichever place calls us first.
Ds is very happy to hear it sounds like he should be able to get the vaccine as soon as sometime in May and is surprised at how things are speeding along.
Caryn, I did not know the J&J vaccine is more effective than the flu vaccine, which dh and I have got for years and never get the flu.
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I didn't realize that the J&J vaccine was more effective than the flu vaccine either. Interesting. You bet I will take the vaccine offered to me. I just wish I could choose which one to get. But any protection is better than no protection. It still isn't clear when we will be allowed to get it. I read somewhere that getting the vaccine is the new toilet paper! So true!
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The flu vaccine varies in efficacy from year to year, but the J&J vaccine still beats them.
https://www.vox.com/22307585/covid-19-vaccine-johnson-and-johnson-efficacy
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Oh, cm! I love that! The vaccine is the new toilet paper! Sounds about right!
Beaverntx, I know how unhappy and unsettled and unsafe I would feel if the governor of Ohio lifted the mask guidelines at this time for our state, so I really feel for you! When we are so close to getting the whole country immunized from Covid in the next few months, I can’t understand the need to jump the gun right now. Beyond frustrating.
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FloriDuh has said teachers and some others age 50 and up can start getting it. My DD will be 50 in October, so must wait.
I got the first shot yesterday it was Phizer. My arm is a little sore, but doesn’t bother me at all.
The Texas governor is a bigger piece of whale poop than FloriDuh.
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Spookiesmom, and when you add in our Lt. Governor, AG, and Ted Cruz the pile is overwhelming!
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I lived in Houston for almost 9 years. I had many lovely friends and neighbors but I never truly understood the culture. When I first moved there it was perfectly legal for the driver of a car to have an open container! I was shocked beyond belief, not to mention the radio ad for a car dealership that was throwing in a free gun rack and gun for anyone who purchased a new truck. In the Bronx, only the bad guys had guns. Texas history is fascinating and the wildflowers are amazing (thank you, Lady Bird!) but there was the overall conservatism that didn’t sit well with me.
I think what the governor did was short sighted. I hope, hope, hope that it doesn’t blow up on the people of Texas.
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And the governor of Mississippi has lifted everything too.
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On top of short sighted.... Abbott is mandating that densely populated blue cities follow the same rules as rural ranches. And not allowing the the leaders on the ground to make the necessary adjustments for population differences. I'm as upset as you are Beav. I was thinking I might feel comfortable going out to eat by June. Now - no way. Yes - and the Lt Gov and the AG who has been under indictment for felony charges for 5 years and of course our favorite Cruz. It's really embarrassing admitting I live here.
SPooky - it's a contest neither of us want to win.
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