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Surviving Covid-19 May Not Feel Like Recovery for Some Surviving Covid-19 May Not Feel Like Recovery for Some
(3 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.
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.
Updated June 2, 2020 Updated June 5, 2020
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.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
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.
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.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.)
More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
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.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
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.