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A conversation about “long COVID”

Police officer, mid-twenties, discusses long-term effects of COVID-19

Fit and ready for duty

After having a conversation with Jakob, I had to reevaluate my definition of the word “athletic.” I used to think the word applied to people who are able to smile while taking a jog through the park. In Jakob’s case, it meant much more:

“I did a lot of physical training before the pandemic – both at work and during my time off. I work as a police officer in the Hundertschaft. Physical training is just part of the job. Apart from that, we manage events.”

Most people probably picture something else when they think of managing events. In Jakob’s case, it refers to large-scale deployments of the mobile police squad in Berlin. When you hear on the news that there was rioting and violence at a mass demonstration, there’s a good chance that Jakob was involved – in a professional capacity of course! 

“We often spend very long hours on duty. We have to stay fit and keep up the whole time. A normal shift lasts from 10 to 12 hours. But if you are involved in a major operation, 12 hours is more likely to be the minimum, and you often end up working for 14 hours.”Spending your working day in heavy gear and a safety helmet is one thing. Never knowing if the situation will escalate and you’ll have to intervene – at the risk of getting injured – is another. Physical fitness is not enough. Mental stamina and nerves of steel are definitely called for as well. Jakob had both of these things. And that’s not all:“Our working hours include time dedicated to physical training. A minimum level of fitness is expected – and checked. But I also did a lot of sports in my free time. I went to the gym four or five times a week and, of course, went running in the evenings as well. I also practiced martial arts three or four times a week.”

Needless to say, all of this activity sometimes resulted in fatigue, not to mention the occasional bruise. But Jakob knew his limits and was otherwise in perfect health. He had never experienced an illness that could put him out of action for a significant amount of time. 

Six months later, he sees things differently.

A trip cut short

Most people remember where they were at the beginning of the coronavirus pandemic. Jakob had just arrived to the scenic landscapes of Central America.

“When people started talking about lockdown, I was on vacation in Mexico. We heard on the news that everyone had to fly back to their home countries immediately. Some didn’t make it back at all. We were lucky.”

Most people would consider it unlucky to end a vacation early, but this is just one of the many examples of Jakob’s positivity.

“I traveled around Mexico with eight others and five of us ended up getting sick.”
His first symptoms appeared the day after he returned home. Since he had spent only seven days in Mexico, he assumes that he was infected before leaving for his trip.Jakob was deployed to several demonstrations with large crowds in the week before his vacation. Back then, there were no physical distancing rules and masks were not mandatory.“I traveled around Mexico with eight others and five of us ended up getting sick. But the others didn’t show any major symptoms – just an occasional slight cough.”When the group landed in Berlin, the lockdown had already begun and the streets were deserted.

From a sore throat to 12 kg weight loss

There’s not just one typical course of COVID-19. The disease has many faces.“In the beginning, it was more like a sore throat. It started in the same way as a normal cold or flu while I was sitting at home one evening. I took an ibuprofen and went to bed, hoping I’d feel better in the morning. When I woke the next day, I had excruciating pains in my head and limbs, chills, a severe cough, extreme sweating and persistent nausea and vomiting.”But that’s not all.“Shortly after, my throat started to feel tight. I was lying in bed covered in blankets because I felt freezing cold, even though I was sweating the whole time. The pains in my head and limbs were like nothing I had ever experienced before. That’s how I knew something was seriously wrong.”Jakob continues calmly, but the story doesn’t get any better.“The coughing started after two or three days and was slight at first. After one week, I had a really bad cough and was coughing up green mucus. I monitored my temperature the whole time but never once had a fever. The highest temperature I had was 37 degrees.”Due to his productive cough and lack of fever, Jakob and his doctors initially thought he had the flu. While they did consider the possibility of a coronavirus infection, a dry cough and fever were still considered to be the key symptoms of COVID-19 at the start of the pandemic.“For me, the worst symptoms were the headache and aching limbs, which made it absolutely impossible to get out of bed or even move. I was extremely sensitive to light and noise and the headache was bad. Painkillers didn’t help. Having to vomit regularly when it hurt so much to move was also very difficult. It hurt to lie in bed. It hurt to cover myself with a blanket. It was just pure and constant pain. At times it became so unbearable that I had to take a lot of painkillers just to be able to sleep.”Jakob got in touch with his doctor right from the start. At least it was possible to get a sick note by telephone. The doctor on duty at Jakob’s workplace was also informed. Although Jakob hadn’t been ordered to quarantine, he wouldn’t have been able to leave home anyway.“I was living alone and couldn’t take care of myself. I had to depend on my parents completely. But I was lucky –  they delivered meals to my door from day one.”There it was again: Jakob’s remarkable optimism. “I’d say I vomited once an hour. I really struggled to eat and drink. If I managed to drink something, I wasn’t able to hold the fluids down for long. I lost an awful amount of weight at that point.”
Jakob's symptoms

Pushed to the limit

After five long weeks of complete isolation, Jakob was symptom-free for the first time. His body weight had dropped from 85 kg to just 73 kg. On account of his intensive exercise routine he had a very low body fat percentage from the start, so most of the weight he lost was muscle mass. After five weeks, Jakob’s ordeal seemed to be over. But after so much time in bed, it’s a struggle even without symptoms. The isolation had taken its toll on his mental health.“I have to say it wasn’t too bad being on my own in the beginning. I was preoccupied with myself, the illness, and the severe symptoms. I was only really awake for a few hours a day. The rest of the time, I was asleep or unaware of what was going on. It only got bad later on, and of course the last few weeks were extremely tough.”

This man in his mid-twenties who previously trained seven days a week now needed every last ounce of strength and determination just to walk up three flights of stairs. In total, Jakob spent six weeks alone in his apartment. After seven weeks, he was allowed to go back to work.

When COVID-19 becomes “long COVID”

Jakob is back at work and glad to be getting on with his life. But life has changed for him. He still gets short of breath after minor exertion and his lungs seem to reach their limits very quickly. “At the beginning I always described it like this: It’s like a cat sitting on your chest. You notice a slight resistance and you can’t take a really deep breath. And I noticed that I was gasping for air at times.”His employer has been very understanding and has assigned him less strenuous duties for the time being. Jakob, meanwhile, is making every effort to catch up with his colleagues when it comes to training. Even though his muscles are slowly recovering, he continues to have difficulty breathing.“I’ve been thinking a lot about this disease. It’s no joke. There are a bunch of reports about how aggressive it can get and what kind of long-term damage it causes.”Over the summer, Jakob gradually started running again – albeit with severe restrictions.“I started wheezing very quickly. Short sprints or flights of stairs were possible, but took so much out of me that I needed to rest for long periods afterward. Mentally, it’s been a very negative experience for me, going from extremely intense physical activity to my current situation”Then October brought another shock.“I suddenly started having attacks every day for two weeks, with severe, stabbing chest pains, spasms in my lungs, racing heart, and sweating. Of course I was worried.”He visited his lung specialist and cardiologist again but all tests were normal. Both doctors are at a loss. And they’re not the only ones. Researchers are only starting to investigate the long-term consequences of COVID-19 – also referred to as “long COVID.”Jakob’s experience as a young person with long COVID is not an isolated case. Even when the initial symptoms are mild, there have been many reports of symptoms that occur late in the disease and linger.Here again, we see Jakob’s overwhelming determination and enduringly optimistic outlook.
“I think it’s a mistake to panic.”
While it’s true that Jakob is still a long way from reaching the performance required of him, he is working hard to get there. After all, he is already back at his old job. “Someone in the public health department suggested that I write down all my symptoms, which is why I have been able to remember them so well and give precise answers to the doctors’ questions.”Throughout this interview too, Jakob’s descriptions are surprisingly detailed.“And emotionally, it was my personal attitude that helped me most of all. I think it’s a mistake to panic. It only makes things worse, especially when you have symptoms involving your lungs. I’m not saying that people shouldn’t take the disease seriously – just that you have to make the best of it.”Jakob’s positive outlook is truly impressive. 

Author's note: Jakob is not the man’s real name. We changed his name for this article to protect his identity. No other details have been changed. 

The contents of this article reflect the current scientific status at the time of publication and were written to the best of our knowledge. Nevertheless, the article does not replace medical advice and diagnosis. If you have any questions, consult your general practitioner.

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