Long Covid: The Forgotten Patients

Christiane Fux studied journalism and psychology in Hamburg. The experienced medical editor has been writing magazine articles, news and factual texts on all conceivable health topics since 2001. In addition to her work for, Christiane Fux is also active in prose. Her first crime novel was published in 2012, and she also writes, designs and publishes her own crime plays.

More posts by Christiane Fux All content is checked by medical journalists.

Originally, Rieke was only slightly ill with Corona. But now the student has not been able to get on her feet properly for months. Hundreds of thousands are like her - there is hardly any help.

March 2020: The sun is shining, the snow is crunching under the boards. Rieke and her friend Ben, both students from Kiel, are skiing in Tyrol. But the vacation ends prematurely: all guests have to leave, hastily discarded skis pile up in front of the rental shop.

There is chaos in St. Anton, a small town 15 kilometers from Ischgl as the crow flies - the ski resort that soon after turns out to be a pan-European Corona hub. The corona virus has spread in the Austrian ski resorts: the season will end prematurely and abruptly.

“We both got infected,” Rieke explains in an interview with They would have coughed on the hastily booked train to the north. Rieke and her boyfriend went through a flu-like course of Covid-19, which still falls into the "easy" category: Many do not realize what that can mean - fever, cough, severe headache and muscle pain, chills.

Shortness of breath when walking

But while Ben can resume his normal life after a good two and a half weeks, with studies and sports, Rieke doesn't quite get back on his feet. Even today, 15 months after the infection, she is still not healthy.

Before the infection, she jogged four times a week, now she can hardly talk to a friend while going for a walk: "Running or talking - I don't have enough air for both at the same time," she reports.

She's somehow dragging her way through her studies of communication design. She takes fewer courses than planned and has to lie down at noon every day to get through the day at all. "To be honest, the lockdown was lucky for me," she says. Without the online seminars, she would not have been able to cope with the academic year at all.

She spends most of the six months in bed and on the couch. Your asthma worsens rapidly after being infected with the corona. She cannot tell which symptoms come from the infection and which are due to asthma.

"People looking for help run into my booth"

Jördis Frommhold, rehabilitation doctor at the Heiligendamm Clinic, knows cases like Rieke: people who were comparatively easily ill with Covid-19, but still struggle months later with significant impairments: with shortness of breath and extreme exhaustion, but also, unlike Rieke, with Symptoms such as massive concentration problems, the so-called "brain fog", or hair loss. Frommhold describes them as the “third group” alongside those who have completely recovered and those who were seriously ill.

"Those who are looking for help are now running into my booth", Frommhold reports in an interview with The waiting time for a clinic place in Heiligendamm is already seven months. In order to draw attention to the problem, the rehabilitation doctor has been on the move for months in television formats from Maischberger to Tagesschau.

Hundreds of thousands are affected

Because a corona wave of a different kind has long since formed under the radar of the public and politics. According to initial studies, at least one in ten Covid 19 patients still has symptoms six months after the infection. Doctors refer to the long-term effects of the infection as “long covid” or “post covid syndom”.Around 350,000 people would already be affected in Germany. “But that's only an estimate, there could be twice as many,” says Frommhold. Many of those affected fell through the mesh because the general practitioners and specialists were still at a loss when it came to the problem.

Helpless doctors, helpless patients

That happened to Rieke too. When she does not recover even weeks after the infection, she goes to the pulmonologist. But even for pulmonologists, Covid-19 is still unknown territory in the early summer of 2020. “He didn't have a plan either,” reports Rieke. The lungs would heal on their own, that takes time, is all that he can give her as a consolation on the way. Today she is doing much better than a year ago, "but now things are somehow not going any further."

“We have now learned something new,” says Frommhold. The good news is: in most cases, significant improvements can be achieved quickly as part of rehab. The patient's lung volume is often surprisingly good, even after severe disease. It is rather the breathing technique that is lacking: "Many have got used to wrong breathing."

This can be counteracted with targeted breathing exercises similar to those used in asthma treatment. In addition, techniques that relax the auxiliary respiratory muscles have proven to be helpful. As breathing improves, other symptoms such as severe concentration disorders and deep exhaustion also improve.

Hardly any offers for Long Covid patients

The only problem is: there are hardly any offers - especially for outpatient therapy. Especially patients who have cured Covid-19 at home fall through the cracks. “These patients cannot find any contact points, that's tragic,” said Frommhold.

There are now many Covid outpatient clinics - but most of them care for their previously inpatients. “Some can hide there,” reports the rehab doctor. But the places are limited. There is no real care concept for long-covid patients. "What we need are competence centers that are accessible to all patients as quickly as possible."

Lost after the lockdown?

Frommhold is convinced that Rieke could finally find his way back to his old energy through such rehab therapy. Instead, the young woman continues to be thwarted. While the relaxations take a load off the shoulders of the people around her, Rieke sees it with mixed feelings. "In the last few months, nobody was able to do anything big, so it wasn't noticeable that I was at home so much."

After the lockdown, when life really starts again for everyone, it only gets really bitter for people like Rieke. Above all, she fears the end of the online seminars. “A whole day at university - I could somehow survive that.” But afterwards she would be very exhausted for days. In addition, many friends may not understand how badly she is actually doing. "They then say, I know that, I'm always tired too - but it actually feels completely different."

The high price of inaction

Frommhold reports that she is often asked on her reconnaissance mission how high the costs are that the pension funds would incur as a result of the rehab. "I do not know that. I'm a doctor, not an economist, ”she then says. What would worry her a lot more are the costs that would arise if patients with Long Covid were not offered any therapy. "Then we face completely different problems."

If many of the hundreds of thousands of those affected did not find their way back to their capabilities and perhaps remained permanently unable to work. In addition to the individual human tragedy, that would be a huge problem for society as a whole.

In any case, one thing is already certain: even if the pandemic has ended at some point, there is still a lot to do. Also for Jördis Frommhold and her team in Heiligendamm.

Tags:  pregnancy dental care Diagnosis