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Surviving Covid-19 May Not Feel Like Recovery for Some Surviving Covid-19 May Not Feel Like Recovery for Some
(7 days later)
ROME — When Morena Colombi tested negative for the coronavirus on March 16, the official tallies counted her among the Covid-19 recoveries, a success amid the tragedies overwhelming Italy. But she was nowhere near recovered, her cough and crippling fatigue nowhere near gone.ROME — When Morena Colombi tested negative for the coronavirus on March 16, the official tallies counted her among the Covid-19 recoveries, a success amid the tragedies overwhelming Italy. But she was nowhere near recovered, her cough and crippling fatigue nowhere near gone.
Five weeks later, on April 21, she returned to her job developing colors for a cosmetics company, but with shortness of breath and aching muscles, she found herself unable to take even short walks. Another test confirmed that she was no longer infected. But 11 weeks after testing positive, on the same day Italy first quarantined towns, she is still not back to normal.Five weeks later, on April 21, she returned to her job developing colors for a cosmetics company, but with shortness of breath and aching muscles, she found herself unable to take even short walks. Another test confirmed that she was no longer infected. But 11 weeks after testing positive, on the same day Italy first quarantined towns, she is still not back to normal.
“It takes a long time,” said Ms. Colombi, 59, who lives in Truccazzano, outside the northern city of Milan. “I can’t get back into my natural rhythms.”“It takes a long time,” said Ms. Colombi, 59, who lives in Truccazzano, outside the northern city of Milan. “I can’t get back into my natural rhythms.”
Italy was the first European country to be hit hard by the pandemic — its intensive care units inundated and its elderly dying in droves before the tsunami reached Spain, France, the United States or Britain. And so Italy is also ahead in coming to grips with the long duration of the illness and the lasting consequences for some survivors.Italy was the first European country to be hit hard by the pandemic — its intensive care units inundated and its elderly dying in droves before the tsunami reached Spain, France, the United States or Britain. And so Italy is also ahead in coming to grips with the long duration of the illness and the lasting consequences for some survivors.
Many Italians have grown painfully familiar with the way the infection can hang on for weeks, the symptoms can linger for weeks more, and full recovery can take longer still — if it ever arrives. Of the more than 218,000 people in Italy who have tested positive, more than 30,000 have died and the government lists more than 103,000 as recovered.Many Italians have grown painfully familiar with the way the infection can hang on for weeks, the symptoms can linger for weeks more, and full recovery can take longer still — if it ever arrives. Of the more than 218,000 people in Italy who have tested positive, more than 30,000 have died and the government lists more than 103,000 as recovered.
The stubbornness of the virus and the length of the convalescence have become topics of conversation in northern Italy where some of the longest-suffering Italians are finding themselves in physical and financial uncertainty, unable to shake sickness and fatigue and get back to work.The stubbornness of the virus and the length of the convalescence have become topics of conversation in northern Italy where some of the longest-suffering Italians are finding themselves in physical and financial uncertainty, unable to shake sickness and fatigue and get back to work.
Their experience may also be instructive to other nations struggling to get their economies moving again.Their experience may also be instructive to other nations struggling to get their economies moving again.
“We have seen many cases in which people take a long, long time to recover,” said Alessandro Venturi, the director of the San Matteo hospital in the Lombardy town of Pavia, adding that the discomfort often seems to last even longer for people with lighter symptoms. “It’s not the sickness that lasts for 60 days, it is the convalescence,” he said. “It’s a very long convalescence.”“We have seen many cases in which people take a long, long time to recover,” said Alessandro Venturi, the director of the San Matteo hospital in the Lombardy town of Pavia, adding that the discomfort often seems to last even longer for people with lighter symptoms. “It’s not the sickness that lasts for 60 days, it is the convalescence,” he said. “It’s a very long convalescence.”
Most people who catch the virus have few symptoms or none, but some get very sick, most often with pneumonia. Any pneumonia damages the lungs, which can take months to heal, and doctors warn that the harm might not be completely reversible.Most people who catch the virus have few symptoms or none, but some get very sick, most often with pneumonia. Any pneumonia damages the lungs, which can take months to heal, and doctors warn that the harm might not be completely reversible.
Studies also point to kidney, heart, liver and neurological damage, often from secondary infections, and no one knows what the long-term prospects are for those patients.Studies also point to kidney, heart, liver and neurological damage, often from secondary infections, and no one knows what the long-term prospects are for those patients.
But even some of the infected who have avoided pneumonia describe a maddeningly persistent and unpredictable illness, with unexpected symptoms. Bones feel broken. The senses dull. Stomachs are constantly upset. There are good days and then bad days without apparent rhyme nor reason.But even some of the infected who have avoided pneumonia describe a maddeningly persistent and unpredictable illness, with unexpected symptoms. Bones feel broken. The senses dull. Stomachs are constantly upset. There are good days and then bad days without apparent rhyme nor reason.
The afflicted find the simplest tasks taxing. Testing is still mostly reserved for the hospitalized, and so people suffering less severe but stubborn symptoms are trailed by doubt about whether they have the virus.The afflicted find the simplest tasks taxing. Testing is still mostly reserved for the hospitalized, and so people suffering less severe but stubborn symptoms are trailed by doubt about whether they have the virus.
Dr. Annalisa Malara, an intensive care physician in Codogno, southeast of Milan, who diagnosed Italy’s first case of the outbreak in February, said there was still no clear understanding of why the virus and its effects lingered so long.Dr. Annalisa Malara, an intensive care physician in Codogno, southeast of Milan, who diagnosed Italy’s first case of the outbreak in February, said there was still no clear understanding of why the virus and its effects lingered so long.
“Lack of energy and the sensation of broken bones” are common, she said, adding that fatigue often lingered “even after the more intense symptoms are gone.”“Lack of energy and the sensation of broken bones” are common, she said, adding that fatigue often lingered “even after the more intense symptoms are gone.”
In the north of Italy, the epicenter of the contagion in that country, a partial lifting of the lockdown this month has allowed more family and friends to compare notes on their experiences.In the north of Italy, the epicenter of the contagion in that country, a partial lifting of the lockdown this month has allowed more family and friends to compare notes on their experiences.
“It never finishes,” said Martina Sorlini, a 29-year-old math and physics high school teacher who has been running a low-grade fever since the beginning of March. She said that the cough and sore throat eventually went away, and that after three weeks she got her sense of taste and smell back, and even found enough energy to run and tend vegetables in her garden.“It never finishes,” said Martina Sorlini, a 29-year-old math and physics high school teacher who has been running a low-grade fever since the beginning of March. She said that the cough and sore throat eventually went away, and that after three weeks she got her sense of taste and smell back, and even found enough energy to run and tend vegetables in her garden.
Then came stomach aches, fatigue and the return of fever. And it hasn’t left, making it extremely tiring to teach her online high school classes.Then came stomach aches, fatigue and the return of fever. And it hasn’t left, making it extremely tiring to teach her online high school classes.
“I was convinced that I was better. They don’t know what happened,” Ms. Sorlini said. “They are seeing everything for the first time too.”“I was convinced that I was better. They don’t know what happened,” Ms. Sorlini said. “They are seeing everything for the first time too.”
Some say the experience of the long-suffering, if not critically ill, deserves more attention.Some say the experience of the long-suffering, if not critically ill, deserves more attention.
Edmondo Cirielli, a member of Parliament with the right-wing Brotherhood of Italy party, has argued that the health ministry should pay more attention to cases like his.Edmondo Cirielli, a member of Parliament with the right-wing Brotherhood of Italy party, has argued that the health ministry should pay more attention to cases like his.
On the weekend of March 7, Mr. Cirielli ran a fever and suffered cold-like symptoms, and became convinced he had picked up the virus by touching an infected surface in the Parliament chamber. He tested positive that week.On the weekend of March 7, Mr. Cirielli ran a fever and suffered cold-like symptoms, and became convinced he had picked up the virus by touching an infected surface in the Parliament chamber. He tested positive that week.
Almost immediately, he said, his fever and cough faded, and he thought he would be fine. Then he had what he called a “small respiratory crisis” that put him in the hospital.Almost immediately, he said, his fever and cough faded, and he thought he would be fine. Then he had what he called a “small respiratory crisis” that put him in the hospital.
But he had no pneumonia, so he went home to self-quarantine. There, he suffered debilitating fatigue, sore throat, diarrhea and intense pain at the base of his neck that made it impossible to concentrate.But he had no pneumonia, so he went home to self-quarantine. There, he suffered debilitating fatigue, sore throat, diarrhea and intense pain at the base of his neck that made it impossible to concentrate.
“One day I was fine, the next bad. There was no building to a peak and then coming back down. It was up and down for a month,” he said.“One day I was fine, the next bad. There was no building to a peak and then coming back down. It was up and down for a month,” he said.
Updated June 24, 2020 Updated June 30, 2020
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
Then things got stranger.Then things got stranger.
After 40 days of feeling lousy, he tested negative for the virus, but his eyes still burned and bouts of diarrhea continued, he said.After 40 days of feeling lousy, he tested negative for the virus, but his eyes still burned and bouts of diarrhea continued, he said.
At the end of the month, he finally felt better, but another test result came back positive, forcing him to spend weeks more in isolation, where he kept busy watching “Versailles” on Netflix.At the end of the month, he finally felt better, but another test result came back positive, forcing him to spend weeks more in isolation, where he kept busy watching “Versailles” on Netflix.
Testing has been imperfect, and not everyone has access to it.Testing has been imperfect, and not everyone has access to it.
Ingrid Magni, 44, got fever and chills on March 21.Ingrid Magni, 44, got fever and chills on March 21.
“It never left me,” she said, adding that she started suffering intense headaches after about three weeks. Doctors could only recommend over-the-counter painkillers and bed rest. She got winded just making her bed.“It never left me,” she said, adding that she started suffering intense headaches after about three weeks. Doctors could only recommend over-the-counter painkillers and bed rest. She got winded just making her bed.
“I had to sit down,” she said. “I was too tired.”“I had to sit down,” she said. “I was too tired.”
Without the eligibility to receive a swab test, which is usually reserved for hospital patients, she told her boss at a chemical plant that she would get an antibody test, which could be used to trigger an official swab test for the virus itself if antibodies are detected.Without the eligibility to receive a swab test, which is usually reserved for hospital patients, she told her boss at a chemical plant that she would get an antibody test, which could be used to trigger an official swab test for the virus itself if antibodies are detected.
But the results have not come back. She is eager to get back to work by the middle of the month and is not sure how many more sick days the doctor will sign off on.But the results have not come back. She is eager to get back to work by the middle of the month and is not sure how many more sick days the doctor will sign off on.
Others just want to feel better.Others just want to feel better.
Albertina Bonetti, 77, from Trescore Balneario, near Bergamo, developed nausea and fever on March 7, followed by dry heaves and diarrhea. After 10 days of fever, her legs began hurting so much that she could not put her feet on the ground.Albertina Bonetti, 77, from Trescore Balneario, near Bergamo, developed nausea and fever on March 7, followed by dry heaves and diarrhea. After 10 days of fever, her legs began hurting so much that she could not put her feet on the ground.
She needed an oxygen tank from March 20 to the end of April, but when she went to a hospital, the staff refused to admit her — so she, too, remained untested.She needed an oxygen tank from March 20 to the end of April, but when she went to a hospital, the staff refused to admit her — so she, too, remained untested.
Ms. Bonetti said that she still had shortness of breath and fatigue and that her senses remained out of whack. She misses normal life and the taste of her latte in the morning.Ms. Bonetti said that she still had shortness of breath and fatigue and that her senses remained out of whack. She misses normal life and the taste of her latte in the morning.
“It leaves something inside you,” she said of the virus. “And you never go back the way you were before.”“It leaves something inside you,” she said of the virus. “And you never go back the way you were before.”
Emma Bubola contributed reporting from Milan.Emma Bubola contributed reporting from Milan.