Michael Heath was among the first wave of Wisconsin residents infected with COVID-19 in March of 2020, and nearly two years later, his symptoms linger. The Baraboo social worker still has shortness of breath and his heart races, though the effects are somewhat less severe.
“I go out walking, or do any activity, and my heart can go to 150 or higher," said Heath. "I have to be careful with how much I exercise. I could have a setback where, if I exert myself, I could end up back in bed for a week with severe migraines.”
At 53, Heath said he was active prior to becoming infected with COVID-19, walking five or more miles a day.
He is one of more than 15 million Americans with what has been termed "long COVID," or in the medical world, post-acute sequelae SARS-CoV-2 infection (PASC). Medical professionals and researchers are now working to understand the underlying causes and treatments, as they estimate about 30% to 40% of people infected with COVID will experience prolonged symptoms.
“It affects a huge number of people. Basically, before the omicron variant came in full force, the estimate was maybe 15 million people in the U.S. could be affected, and this is during their most productive years,” Dr. Aurora Pop-Vicas said. An infectious disease physician at UW Health and professor with the UW School of Medicine, Pop-Vicas anticipates the number of long COVID sufferers will increase dramatically with omicron.
She is one of many in the medical community researching long COVID, looking at the role chronic inflammation plays. Because the virus is relatively young, physicians still have much to learn, but intense research is underway to understand the biological mechanism of long COVID, Pop-Vicas said. So far, they have seen healthy people with mild cases experience ongoing symptoms or PASC.
“What we learned with long COVID is it affects…not just patients who are hospitalized, but also people who had relatively mild illness and were relatively healthy at baseline. All of the sudden, after they get over their initial acute infection, they are then plagued with these prolonged sequalae symptoms that really decrease their quality of life,” Pop-Vicas said, adding that it happens to patients of all ages, regardless of lifestyle or health.
“Who is most at risk is not entirely clear,” she added.
Heath described his bout with COVID in 2020 as moderate. A freelance photographer, he had worked a wedding on Leap Day Feb. 29 in Wisconsin Dells. After logging 29,000 steps, he expected to be tired the next morning. When he woke, he told his wife he felt like a cement truck had run him over.
“For the next four days, I slept almost constantly. My appetite was suppressed. I had migraines,” Heath said.
His only pre-existing condition was mild asthma, requiring him to use an inhaler only during allergy season. But within a week, he ended up in the emergency room. Because his fevers came on only at night, physicians would not test him for COVID-19 then, he said, adding he doesn’t blame the doctors who were still learning about the disease.
Through his work with the Coalition for Children, Youth and Families, Heath provides presentations and trainings, and often works from home. Long COVID challenged him, causing him to sleep 12 hours some days. Other days, migraines or fatigue prevented him from doing any work, and his throat had swelled.
“I would have brain fog,” he said. “I’ve always been a great writer and always done well in school. But, I couldn’t remember how to spell common words.”
No prevention or treatment for long COVID exists, so for now, health care professionals focus on symptom management, doctors say. Symptoms can range from insomnia, increased anxiety or depression, neurological abnormalities and distortions in taste or smell.
“A great majority also complain of difficultly concentrating or memory lapses or inability to focus on complex tasks the way they used to,” Pop-Vicas said. “A subset of patients do continue to experience frustrating shortness of breath with minimal exertion which precludes them from engaging in health lifestyles the way they used to with healthy exercise or even walking.”
Heath has since seen a pulmonologist for his lungs, cardiologists for his heart and a host of other specialists. He has undergone breathing testing ordered by his pulmonologist, and doctors suspect scarring on his lungs. Another test will be done this year once the numbers of omicron infections come down, he said. Heath has never been a smoker, and previously had only mild asthma but now he uses two inhalers.
Heath also fears that his immune system may have been compromised. He was infected with COVID-19 again in August of 2020.
A new normal
Heath has adjusted to what he now calls “my new normal.”
“I’ve had to really come to grips with the changes that have occurred,” he said, adding with less lung capacity, heart palpitations and some degree of brain fog, his gives himself “a lot of grace” and is far more careful about how much he exerts himself.
“On a positive note, I’m grateful I’m still here. Many times I thought I was going to die because I couldn’t breathe,” he said.
He is back at work and has felt supported by coworkers, supervisors, his agency, physician, friends and family. He’s also thankful his wife Dee Dee and their 15-year-old daughter Emily were not infected, he said.
Heath said he’s a fighter; he belongs to several long COVID support groups, and he encourages others to be strong, knowing many have experienced far worse effects from COVID. Hundreds of thousands have died.
He's hopeful more research will offer long COVID sufferers better treatment and prevention, he said.
Caution still advised
With much of the population vaccinated and indications that symptoms of omicron are milder than other COVID-19 variants, many are less fearful about getting infected. But doctors say even those with mild cases can face more severe, long-lasting symptoms.
“That’s one of the reasons why we’re continuing to stress to people, you don’t want to catch COVID, even if you think the disease is going to be less severe than maybe some of the earlier variants. We know that these long COVID symptoms can be very debilitating for many people,” said Dr. Alison Schwartz, a physician with SSM Health who specializes in infectious diseases.
And, even younger, healthy people can experience prolonged symptoms, she said, adding that doctors are seeing it “across the board” and are continuing to study it.
Schwartz said the belief is that vaccinations may reduce the risk for developing PASC, or long-haul.
“That’s another reason, in addition to trying to avoid this illness, if you get vaccinated, the data suggests you also might be unlikely to develop this illness,” Schwartz said, noting so far that trend has been reported.
Overall, she encourages people to take precautions to prevent infection, noting some young, healthy people are unafraid of the purportedly milder variant.
“Because it’s so contagious – we’re seeing a huge number of people becoming infected – there’s still the risk that some of those people are going to become severely ill,” Schwartz said. “If you become infected, you may pass the disease onto someone else who may be immune compromised or unvaccinated.”
Long COVID serves as another reminder to take precautions.
“The idea of having a 30-year-old who hasn’t been able to return to work in six months because they have mental fogginess and fatigue, I mean that could be even more debilitating,” Schwartz said, advising people to stay diligent until the infection numbers begin to decrease again.