Had Covid? Beware of Long Covid.

Nepal is seeing the first signs of a second Covid-19 surge even as its vaccination drive is suspended, and as survivors live with ‘Long Covid’.

Doctors and hospitals are reporting a significant proportion of infected individuals with what is now called ‘Long Covid’ or ‘post-acute Covid-19 syndrome’ in which survivors continue to struggle with extended after-effects of the illness.

Months after testing negative, many of them still suffer from fatigue, shortness of breathing, joint pains, headaches, prolonged cough, chest pain, loss of appetite and brain fog.

Long after he recovered from his coronavirus infection last October, 37-year-old Purna Rai says he is still not feeling completely well. After two weeks of isolation and testing negative, he suffered from insomnia, panic attacks and anxiety. Rai was first told he had gastritis, and later sodium deficiency. Then the doctors even referred him to a psychiatric ward to see if he had 'post-Covid' symptoms.

“I used to have difficulty breathing, it used to feel like I had stopped breathing. I even thought I might have Covid again,” recalls Rai who finally recovered with proper medication, diet, meditation, yoga and consultation with friends and families.

As Nepal’s health authorities come to terms with signs of a second wave, and the vaccination campaign on hold because of the lack of doses due to India’s export ban on Covishield, they also have to deal with patients whose symptoms have never gone away.

In addition, there is the worry that even those who have had Covid-19 in the past, the immunity erodes as time goes on and there is a danger of re-infection. It is also not known if the AstraZeneca vaccine is effective against the new strains, and if so how long the immunity lasts.

Binu Acharya, 80, was severely sick with Covid-19 along with some members of her family last September. Everyone in her family tested negative and ultimately recovered, but for Acharya, it has been one long convalescence.

“Ever since I had Covid, I have never recovered properly, I have never been myself, I have difficulty climbing stairs and breathing and feel weak all the time,” says Acharya, who adds that after she got her first Covishield dose she felt like she had the illness all over again.

Deepak Sundar Shrestha of Subekchya Internal Hospital consults patients like Rai and Acharya regularly. Studies have shown that about 20-30% of Covid-19 patients suffer from long-term symptoms of the infection.

“First of all, it is important to know and understand long Covid and that the symptoms could either be psychosomatic or real,” says Shrestha. “And because a notable portion of patients suffers from this condition, having 50,000 people in Nepal with Long Covid has a huge cost.”

A team of doctors at Sukraraj Tropical and Infectious Disease Hospital in Kathmandu has started researching Long Covid in Nepal. Preliminary findings show that women are more susceptible whereas only 28% of men suffered from long-term after-effects. Researchers are now trying to find out how many of them endured the condition for more than six months.

There is no one medication for Long Covid, but the vaccines have been found to be effective in reducing the severity of symptoms, and in some cases even treating them.

Western countries are also running post-Covid clinics with teams of dedicated physiotherapists, dieticians, lung doctors, physicians and psychiatrists. However, here in Nepal, even health professionals are sometimes unaware of the condition.

“I took every test possible to figure out why I had suddenly developed shortness of breath, palpitations, fatigue and discomfort six months after getting Covid-19,” recalls Sirju Agrawal of Vedanta Dental Clinic.

“If medical personnel like me felt like this, I can’t imagine what the general public must be experiencing. We need to better communicate and counsel people about Long Covid.”