News
Lingering illness after COVID
While stressing the importance of getting vaccinated to prevent severe disease and death, four Consultant Respiratory Physicians of the Sri Lanka College of Pulmonologists look at Post-COVID where illness lingers long after the acute phase is over and also the things those who have got COVID-19 should heed.
The eminent doctors who have a strong pulse on what is happening with regard to COVID-19 at ground level were college President Dr. Geethal Perera of the Sri Jayewardenepura Hospital; Dr. Eshanth Perera of the National Hospital for Respiratory Diseases, Welisara; Dr. Wathsala Gunasinghe of the Hambantota District General Hospital; and Dr. Neranjan Dissanayake of the Ratnapura Teaching Hospital.
They point out that the need is to keep the curve of COVID-19 down as otherwise beds in hospitals will fill up.
They also caution that if there is a “lot” of the virus circulating in the community, the chances would be high of a mutant raising its head and riding the next wave to higher heights.
Post-COVID
Dr. Geethal Perera talks of the “unknown quantity” that is Post-COVID, explaining that after the Delta wave, “we had a wave of Post-COVID lung disease and Post-COVID sequelae such as thrombosis (formation of blood clots), heart attacks, strokes and psychological complications. We don’t know what will happen after Omicron”.
Pointing out that currently we don’t know the number infected at a given time as many don’t take tests, he said: “If 1% of these people get Post-COVID issues, that’s going to be a huge hit on the healthcare system in the next five to six months. So it’s important that we get ready for it now, rather than when things go wrong. You have to have the healthcare system ready to manage such a situation.”
Dr. Geethal Perera has already seen “a lot of wheezing” as have the other Respiratory Physicians. “They are not responding to treatment,” says Dr. Wathsala Gunasinghe, as Dr. Geethal Perera creates in the mind’s eye of the Sunday Times how every morning he listens to such complaints during his ward round of 36 beds. “Of them, we have to start inhalers for at least eight patients because they do not respond otherwise.”
There is also “lots of rhinitis” after Omicron. Rhinitis involves nasal obstruction or congestion, a runny nose or post-nasal drip, itchy nose and/or bouts of sneezing and in people who have had no family history of such illness before, it is learnt.
Dr. Neranjan Dissanayake says that there could also be breathlessness and interstitial pneumonia caused by Post-COVID organizing pneumonia, leading to scarring of the lungs. This would make the lungs stiffer and reduce oxygen diffusion from the lungs to the blood. This needs to be diagnosed and treated promptly.
The Specialists also caution against the false belief among people that those who got “bad” disease during the Delta wave last August will not get infected again. They “are” getting infected and they “are” getting “symptomatic” (having symptoms) illness.
Dr. Eshanth Perera echoes these views and says that people get a false sense of security that if they have got COVID-19, they will not get re-infected. They think Omicron is mild and since they have got worse disease, they will not get this mild disease again.
Adding his concerns from what he has heard from his patients, Dr. Neranjan Dissanayake says that another strongly held thought is that just because someone has taken a jab or two but is not fully vaccinated (all three doses), they will get only mild disease.
What they forget is that if not topped up fully by the three doses, the vaccine effect starts waning and they are very vulnerable to COVID-19, he says, pointing out that those who got their second doses in August are now into the fifth and sixth months and are at risk of catching the virus.
“It is very important for people to get the vaccine and not just one or two jabs but all three doses,” says Dr. Neranjan Dissanayake, urging the people to talk to those around them, like he does with those attending his clinics on the importance of the vaccines in reducing severe disease and death. “I usually make it a point to ask my patients whether they have got vaccinated and whether they have got the booster. Of about 10, sometimes 5 (half) have not got it.”
He added that any symptoms associated with the flu can be those of COVID-19, until proven otherwise. It is important for people, if they have a mild fever with body-aches, a runny or stuffy nose and throat pain, to think it is COVID-19.
“If a person has significant comorbidities even if there is the slightest suspicion that you are infected with COVID-19, seek medical intervention at the earliest stage,” he urges.
| Post-COVID clinics at state hospitals Post-COVID clinics are being run by Consultant Respiratory Physicians in all state hospitals where they are based. These hospitals include National Hospitals (Colombo and Kandy); Teaching Hospitals, Provincial General Hospitals and District General Hospitals. Any patient can seek help at these clinics. | |
| How to resume normal life after a COVID-19 infection, however mildAfter a COVID-19 infection, “everything” should be started gradually especially physical exertion, reiterates Dr. Eshanth Perera, explaining that a person cannot go to the pre-COVID level of physical exertion immediately. Giving a probable timeline, Dr. Geethal Perera says that such a person should take it easy for a “minimum” of six weeks at least after recovery from the infection. Some should not jump into physical activity for at least three months. Maybe around 95% of the people who have recovered from COVID-19 would come to normal in three months and this would go up to 98% in six months. Yet, 2% may go up to even nine months to get over it. Myocarditis, wheezing and gastroenteritis (irritation of the intestines) are things to watch out for, he says. Dr. Neranjan Dissanayake points out that even if a person has had mild COVID-19 or asymptomatic COVID-19, he/she has the possibility of developing Post-COVID Syndrome. Some of them expect that after seven days, they are completely cured and try to lift weights, while women sometimes get back to heavy housework or even their gym routines. “It should not be so. They should do it bit by bit. Take things slowly. Even if you want to climb a staircase, earlier you could have run up the stairs, but now do so step by step,” he says. All four Specialists also focus on the unseen psychological component of COVID-19. For professionals such as bank officials or teachers to name a few, the condition called ‘mental fogging’ can cause alarm. They may become fearful that they may not be able to perform their work as before. There will be anxiety over this, especially say you are counting money and miss a few notes. Decision-making may also be slower. This is part of the recovery process, says Dr. Eshanth Perera, explaining that the person needs to understand that it takes time, at least about five to six weeks. Be conscious and vigilant. Take things slowly both physically and mentally, he adds. |
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