HEILIGENDAMM, Germany (AP) – Simone Ravera rolls up her pants, takes off her shoes and socks, then steps carefully into the chilly waters of the Baltic Sea.
The 50-year-old rheumatology nurse is slowly finding her feet after being hit with COVID-19 last fall, seemingly recovering and relapsing four months later with severe fatigue and ‘brain fog’.
“The symptoms were almost as bad as they were at the beginning,” Ravera said.
She almost desperately found a clinic specializing in the treatment of people with so-called post-COVID-19 or long-term COVID-19 symptoms.
The clinic is located in Heiligendamm, a northern German seaside spa town that has been popular since the late 18th century, and specializes in helping people with lung conditions such as asthma, chronic bronchitis and cancer.
According to the medical director, Dr. Joerdis Frommhold, has become a major rehabilitation center for COVID-19 patients over the past year, treating 600 people from all over Germany.
Some of her patients were near death and now have to relearn how to breathe, rebuild their stamina, and overcome a host of neurological problems associated with serious illness.
But Frommhold is also treating a second group of patients who showed mild to moderate COVID-19 symptoms and who have spent only a short time in the hospital, if at all.
“These patients get rebound symptoms after about one to four months,” Frommhold said.
Most are between the ages of 18 and 50 and have no pre-existing conditions, she said. “They are the ones who are usually never sick.”
After they recover from a bout of COVID-19, these patients suddenly become short of breath, depressed and have trouble concentrating, Frommhold said. Some have symptoms similar to those of dementia.
A former dialysis nurse discovered that her kitchen had been flooded because she had forgotten to turn off the tap. “Others can’t do homework with their kids because they don’t understand the questions themselves,” Frommhold said.
Their symptoms are not always taken seriously by doctors.
Despite hair loss, joint and muscle pain, irregular blood pressure and dizziness, routine test results for such patients usually return to normal.
“They look young, dynamic and high performing, but they can’t do the things they used to do,” said Frommhold.
Clinic therapists primarily focus on stabilizing patients’ breathing. Then they work on the recovery of stamina and motor coordination with the help of occupational therapy and posture training. Cognitive therapy and psychological support are also part of the program.
Similar “long-distance business” clinics have sprung up around the world over the past year, including in the United StatesIn Germany, such treatment is increasingly offered by the nationwide network of more than 1,000 medical rehabilitation centers, 50 of which specialize in lung diseases.
“That doesn’t exist in many other countries yet,” said Frommhold.
It is unclear how many people suffer from COVID-19 for a long time, partly because the condition has not yet been clearly defined. Scientists are still trying to understand what’s behind the wide range of symptoms that patients report
“No two patients have the same experience and it varies from patient to patient,” said Elizabeth Murray, professor of e-health and primary care at University College London.
“The symptoms they experience this week are not necessarily a guide to the symptoms they would experience next week,” said Murray, a former primary care physician. “It makes it difficult for everyone; it makes it very, very difficult for the patients. “
The UK Office for National Statistics said a survey of 9,063 respondents who tested positive for COVID-19 found that more than 20% reported persistence of some symptoms after five weeks. About 10% of the respondents experienced fatigue, while similar numbers reported headaches or loss of taste and smell.
According to a Johns Hopkins University count, more than 140 million coronavirus infections have been confirmed to date worldwide, meaning that even a small percentage of long-term COVID-19 patients suggests millions could be affected.
“That’s a lot of extra people to be treated and no health care system has much spare capacity,” Murray said. She added that the economic impact of so many people dropping out of the workforce could be devastating, especially as many patients are women who also carry a disproportionate burden at home.
Murray is developing a digital program, funded by the UK’s National Institute for Health Research, to treat COVID-19 symptoms over the long term and reach more patients faster than through traditional rehabilitation centers so they don’t feel abandoned by it medical system.
Frommhold said a similar program could help Germany cope with the expected increase in long-term COVID-19 patients, but suggested greater acceptance of the condition will also be needed for those who do not fully recover.
“In my view, we first need a campaign like the one there was for HIV awareness that explains how there are different paths even after recovery from COVID,” she said.
Helping patients, their families and employers understand that they now have a chronic condition could prevent long-distance travelers from falling into a spiral of depression and anxiety, Frommhold said.
Heike Risch, a 51-year-old kindergarten teacher from the eastern city of Cottbus, was barely able to walk without help after recovering from COVID-19 when he left the hospital.
“I felt like I had turned 30 years old in a short time,” she said.
At the clinic, Risch was unable to balance a table tennis ball on a racket and walk backwards. She still can’t read a clock properly.
“You no longer trust your own body. You don’t trust your own head anymore, ”Risch said.
Still, she hopes to return to work someday. “I enjoy working with children, but I have to be able to concentrate. I need to be able to do two things at once every now and then, ”she said.
Ravera, the nurse, says she has come a long way thanks to the therapy in Heiligendamm and feels happy with the support of friends and family.
But Ravera doubts she will return to three-shift weekends at the hospital where she worked in Bavaria.
‘You don’t know when you’ll get better. The disease comes in waves, ”she said.
Instead, Ravera considers what she learned in rehab to help others who have trouble breathing properly after COVID-19.
“It’s a bit of a journey into the unknown,” she said.
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