Months after COVID-19, some patients still feeling the effects

If time is supposed to heal, then the last year is a lot of time for not much recovery in Neil Bennett's eyes.

A year ago this month, the 75-year-old Iowa City resident was the first critical case of COVID-19 to be treated at an Iowa hospital, an ordeal that affects him to this day.

Bennett was admitted to the University of Iowa Hospitals and Clinics on March 10, 2020, the same day he tested positive for the virus. He and his wife, along with a dozen other Johnson County residents, were among the first Iowans to be infected with the virus in late February 2020.

Bennett, who spent several weeks on a ventilator in UIHC's intensive care unit, went on to spend about five months in health care facilities across Eastern Iowa. He finally returned home in early August.

Though he has since graduated from pulmonary rehabilitation and reduced his time at other physical therapy sessions - a signal from his doctors that he is making good progress - Bennett feels his recovery has 'slowed to a crawl,” he said this past week.

He still struggles with his balance, and needs a walker or a cane if he's walking more than a short distance. He sometimes needs to take a deep breath after a long sentence. He still hasn't been able to drive a car.

'I'm getting impatient with the comment, ‘You need to be patient, it will take time,'” he said. 'I appreciate that, but after this length of time, I feel I've exhibited a great deal of patience.”

There are thousands across the country who, like Bennett, are still recovering from lengthy hospital stays as a result of their illness. While the majority of infected individuals go on to recover fully, those who are ill enough to need hospitalization can spend weeks and months rebuilding strength in their lungs and bodies.

Some are finding that even after a relatively minor sickness, they can have devastating symptoms that linger for months afterward.

Persistent symptoms can debilitate patients

Long-haul COVID-19 patients are those who report symptoms that persist weeks, or even months, after testing positive for the virus. Estimates put the total number of these patients in the United States in the tens of thousands.

Symptoms often include persistent shortness of breath, weakness and, sometimes, trouble with memory.

In some cases, symptoms have created 'a profound disability” for some patients. UIHC pulmonologist Dr. Alejandro Pezzulo said he's seen patients who were previously high-functioning and healthy individuals who haven't been able to do normal activities for months after getting sick.

'They're trying to get better, but they're still limited,” Pezzulo said. 'And we're still trying to understand why this happens to that degree.”

Earlier this year, UIHC providers established the Respiratory Illness Follow-up Clinic, which remains the state's only dedicated clinic for patients experiencing health problems following a COVID-19 infection. Since the clinic opened last June, it has added more providers and more hours to meet the growing demand.

This trend is particularly concerning for Black and brown Americans, who were disproportionately affected by the virus over the past year. Jacquie Easley, health care of the Iowa-Nebraska NAACP, said it brings to mind a phrase: 'When America catches a cold, Black America gets pneumonia.”

Grappling with debilitating, long-term effects could have a domino effect on some families who already are facing economic barriers, especially people of color, Easley said. If the person who falls ill is the primary breadwinner, it could push more families into a low-income bracket. The increased need for food or rent subsidies could put a further strain on the community.

'It seems like we are always hit disproportionately to whatever happens to the rest of the country,” Easley said.

Even after a year of diagnosing and treating hundreds of thousands of patients with COVID-19 infections, health care providers and researchers lack a firm understanding why the novel coronavirus affects people so differently.

However, Pezzulo said he's confident the widespread impact will prompt an effort to better understand the cause.

'If you match people of similar severity of disease with other viruses, we find similar (symptoms),” Pezzulo said. 'The difference now is that many, many people get it at the same time with COVID-19. Overall it's much more deadlier than the flu or other severe virus, so we're seeing those numbers on a much bigger scale.”

Watching a loved one struggle with recovery and seeing little progress is 'heartbreaking,” said Gwen Bennett, Neil Bennett's daughter. It takes an emotional toll on the family members around the affected patient.

Bennett recently has visited a rehabilitation hospital in Chicago with the hope that physicians there could offer new treatment options and speed up his recovery. Until they find out whether that facility can help him, Bennett said he and his family are remaining optimistic.

'It's hard to wrap my mind around the fact it's been a year,” Gwen Bennett, of Illinois, said 'I'm so grateful he made it through, but it's not a happy ending quite yet.”

Virus' ripple effect on other health care

Though the virus has taken a serious toll on many who were infected with the novel coronavirus, providers are beginning to see the other impacts the pandemic has had on the long-term health and wellness of residents who were never sickened by the virus.

The number of patients coming in for cancer screenings was way down, leading some providers to speculate they eventually would see later stages of the disease. The number of patients arriving at the hospital for medical emergencies such as heart attacks and strokes was down, also, even though it's unlikely there were fewer of those than in previous years.

As a result, UIHC is struggling with a full intensive care unit, said UIHC chief medical officer Dr. Theresa Brennan.

'We see that the acuity of our patients, the sickness of our patients, is much higher than it was previously,” she said.

In addition, the number of individuals in need of mental health services has skyrocketed over the past year. Brennan predicted this will be the biggest concern facing providers in the future.

'The mental health of our nation has changed remarkably,” she said.

And with health care facilities taking a huge financial hit this past year, how can these systems cope with these new challenges while dealing with a pandemic that nearly overwhelmed its capacities?

'That's the challenge,” Brennan said. 'All of those things together make it so that we have to prioritize patients sometimes, and figure out who gets in first and who gets in later. That's pretty common in the outpatient community, but it may be that people are waiting a little bit longer.” She continued, 'It certainly means that we have to be more flexible, it means we have to be efficient in taking care of patients and that's something we continue to work on aggressively.”

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