HEILIGENDAMM, Germany (AP) – Simone Ravera rolls up her pants, slips off her shoes and socks and then walks ginger into the cold waters of the Baltic Sea.
The 50-year-old rheumatology nurse is slowly finding her feet again after being hit with COVID-19 last fall, apparently recovering and then returning four months later with severe fatigue and ‘brain fog’.
“The symptoms were almost as severe as at the beginning,” Ravera said.
Almost desperately, she found a clinic that specializes in treating people with post-COVID-19 or long-term COVID-19 symptoms.
The clinic is located in Heiligendamm, a spa town in the northern German coastal area since the late 18th century, and specializes in helping people with lung diseases 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 across Germany.
Some of her patients have come close to death and now need to learn again how to breathe properly, rebuild their endurance and overcome a number of neurological problems associated with serious illnesses.
But Frommhold also treats a second group of patients who experience mild to moderate COVID-19 symptoms and have only spent a short time in the hospital.
“These patients get rebound symptoms after about one to four months,” Frommhold said.
Most are between 18 and 50 years old and have no conditions, she said. “They are the ones who are usually never sick.”
After recovering from a COVID-19 attack, these patients suddenly develop shortness of breath, are depressed and have difficulty concentrating, Frommhold said. Some suffer from symptoms similar to those of dementia.
One former dialysis nurse flooded her kitchen because she forgot 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 the loss of hair loss, joint and muscle pain, irregular blood pressure and dizziness, the routine results of such patients usually return to normal.
“They look young, dynamic, perform well, but then they can do nothing from before,” Frommhold said.
Therapists at the clinic initially focus on stabilizing patients’ breathing. Then they work to restore endurance and motor coordination using occupational therapy and posture. Cognitive therapy and psychological support are also part of the program.
Similar clinics for ‘long-term feeders’ have sprung up around the world in recent years, including in the United States. In Germany, such treatment is increasingly being offered through the country’s network of more than 1,000 medical rehabilitation centers, 50 of which specialize in lung diseases.
“It does not yet exist in many other countries,” Frommhold said.
It is unclear how many people suffer from COVID-19 in the long term, partly because the condition has not yet been clearly defined. Scientists are still trying to understand what lies behind the wide range of symptoms that patients report.
“No two patients have the same experience, and it differs between the patients,” said Elizabeth Murray, a professor of e-health and primary care at University College London.
“The symptoms they’re experiencing this week are not necessarily a guideline for the symptoms they’ll experience next week,” said Murray, a former general practitioner. ‘It makes it difficult for everyone; it makes it very, very difficult for the patients. ”
Britain’s Office of 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. For about 10% of respondents who include fatigue, while similar numbers have headaches or loss of taste and smell.
More than 140 million coronavirus infections have been confirmed worldwide so far, according to a version by Johns Hopkins University, which means that even a small percentage of long-term COVID-19 sufferers would suggest that millions could be affected.
“There are a lot of extra people to treat, and no healthcare system has a lot of extra capacity,” Murray said. She added that the economic impact of so many people leaving the workforce could be devastating, especially since many sufferers are women who also carry an excessive burden at home.
Murray is developing a digital program funded by the UK Institute for Health Research to treat long-term COVID-19 symptoms and reach more patients faster than traditional rehabilitation facilities, to ensure they do not feel abandoned by the medical system.
Frommhold said a similar program could help Germany deal with the expected increase in long-term COVID-19 sufferers, but suggested that greater acceptance of the condition would also be needed for those not fully recovering.
“In my eyes, we first need a campaign that was there for HIV awareness, that explains how there are different paths, even after recovering from COVID,” she said.
Making patients, their families, and employers understand that they now have a chronic condition can prevent long-distance transportation from falling into a spiral of depression and anxiety, Frommhold said.
Heike Risch, a 51-year-old kindergarten teacher from Cottbus in the east, could barely walk unaided after leaving the hospital after recovering from COVID-19.
“I felt like I was thirty years old in a short period of time,” she said.
In the clinic, Risch could not balance a table tennis ball on a racket and walk backwards. She still cannot read a watch properly.
‘You no longer trust your own body. You no longer trust your own head, ”Risch said.
Still, she hopes to return to work one day. ‘I like working with children, but I need to be able to concentrate. I have to be able to do two things from time to time, ”she said.
Ravera, the nurse, says she has come a long way thanks to the therapy in Heiligendamm and feels happy to have support from friends and family.
But Ravera doubts whether she will do three shifts again on weekends in the hospital where she worked in Bavaria.
“You do not know when you will be well again. The disease is coming in waves, ”she said.
Instead, Ravera is considering using what she has learned in rehab to help others who are once again struggling to breathe properly after COVID-19.
“It’s a bit of a journey into the unknown,” she said.
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