When millions of Washingtonians are immunized with a COVID-19 vaccine, countless survivors of the disease will still be left wondering if they will ever feel well.
Judy Schaefer became one of more than 240,000 Washingtonians to contract COVID-19 this year and like countless others, she is wondering how long the virus effects last.
It was on July 17 that her test results came back positive, just five days after her fiancé, a mail carrier with the U.S. Postal Service, came down with the virus along with several coworkers.
A retired federal employee, Schaefer, 56, was an avid hiker before contracting the virus. She enjoyed staying active with her fiancé, a marathon runner. Now she says it’s a daily struggle just to walk down the street.
“It’s a good day if I get out and walk my dog, but most of the time I’m just too tired,” Schaefer said.
Her first few weeks with COVID-19 left her exhausted and unable to do anything but sleep.
According to research by John Hopkins University, mild cases of COVID-19 can last up to two weeks while more serious cases can last six weeks or more.
Nearly five months later, Schaefer’s days are still largely spent reading, watching Netflix, or birdwatching out her window as she contends with a list of lingering symptoms from migraines and fatigue to back aches and shortness of breath, among others.
In that time, Schaefer has seen a general practitioner and a pulmonologist. Her tests were covered by her insurance per the state insurance commissioner’s orders, but no one seems to know how long her symptoms may persist.
At least a third of people who contracted COVID-19 and were not hospitalized are contending with long-term symptoms, according to a CDC report.
With plenty of time on her hands after falling ill, Schaefer was quick to join a COVID-19 research study conducted by the University of Washington hoping her experience could help scientists better understanding the virus.
She is now participating in a pair of two-year-long COVID-19 studies conducted by Seattle’s Fred Hutchinson Cancer Research Center in the hope that scientists can help countless other survivors.
Even though the federal government has approved two separate vaccines this month, she suspects she’ll probably be last in line to receive one having survived COVID-19.
It’s just one price many self-described “COVID long-haulers” will likely have to pay for surviving the virus.
Schaefer said COVID-19 has already taken the life of a high school friend. She says other friends of hers have contracted it. Some recovered quickly while another is a long-hauler like herself.
“I definitely never want COVID again,” Schaefer said. “My biggest worry is that I’ll be a long-hauler the rest of my life.”
Guy Palmer, professor of Pathology and Infectious Diseases at Washington State University, says there are a host of explanations for why COVID-19 long-haulers like Schaefer are still exhibiting symptoms.
Many may be infected by an unidentified strain of the virus, Palmer said. Others may be experiencing what he describes as recrudescence, which sees an infection go into remission and then intensify in response to outside stressors.
“Say I’ve had an infection, kind of got it under control, I’m feeling better,” Palmer said. “And then I’m stressed or something else happens. And if it’s the same infection, and it just multiplies and becomes symptomatic, that would be called a recrudescence. You’ve kind of got it under control, and then it comes back on you.”
Palmer says survivors of COVID-19 are likely to develop some level of immunity to the virus for some time, but it’s the immune system that could be bringing on what he calls post-inflammatory reactions.
When the body is infected, it is up to small proteins called cytokines to regulate immune responses to fight foreign pathogens, but may not “reset” afterward.
“These cytokines respond in a really vigorous manner,” Palmer said. “And that’s what makes us well. Over time, those will reset back to their pre-infection levels. But not all people reset at the same time, and some really have a difficult time resetting. That’s why we see these post inflammatory events.”
Palmer says the phenomenon is similar to what scientists see in Lyme Disease patients where inflammation only begets more inflammation.
“You have this ongoing inflammation even after you’ve cleared the virus,” Palmer said. “But you’ve triggered this inflammation, which is ongoing and is not resetting, it gets into kind of a positive feedback loop, where acute inflammation gives you more acute inflammation.”
Washington’s Department of Health has not decided whether COVID-19 survivors will be eligible for vaccinations, according to Cory Portner, a spokesperson with the department.
Vaccinations, as Palmer puts it, could “level the playing field” for survivors of the virus by providing enough antibodies to reset their immune systems.
Pfizer’s COVID-19 vaccine is expected to provide up to a year of protection after two doses taken about three weeks apart.
Washington will devote thousands of doses to its healthcare workers and long-term care facilities. Millions more doses are anticipated early next year.
Long-haulers like Schaefer will have to wait for the day when a shot in the arm could bring them back any feelings of normalcy.
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