Many Struggling With Long-COVID in Post-Pandemic World; Lack of Understanding Adds to Strain of Symptoms

The Yomiuri Shimbun
Koichi Hirahata, director of Hirahata Clinic, speaks with a long-COVID patient in Shibuya Ward, Tokyo, on May 2.

Wednesday marked one year since COVID-19 was downgraded to Category V under the Infectious Diseases Law, the same level as seasonal influenza.

Society overall has returned to pre-pandemic daily life, but many people are still suffering from the aftereffects of the disease. Experts are calling for these people to receive more support, as their condition is often not well understood by others around them.

A 51-year-old woman in Tokyo was infected with the novel coronavirus in July 2022. At the time, she was working as a clerk at a local clinic and was busy handling many outpatients with fevers amid the seventh wave of coronavirus infections.

Even after she returned to work, the woman could not stop coughing and her whole body ached, making it impossible for her to stay in her job. Even now, one year and 10 months after catching COVID, she cannot work due to such chronic symptoms as lethargy and insomnia.

“I don’t know when I’ll be cured,” the woman said. She has been living off public compensation for temporary absences from work, after her condition was recognized as an industrial accident.

“I feel like I’m in a tunnel with no light in sight,” she said.

The woman receives treatment at the outpatient clinic for long-COVID patients at Hirahata Clinic in Shibuya Ward, Tokyo, which has received approximately 7,000 patients.

“More women than men suffer from serious symptoms. Anyone can be affected, regardless of factors such as pre-existing medical conditions or sports experience,” said clinic director Koichi Hirahata, 46.

Unknown mechanism

According to the World Health Organization, long-COVID is usually diagnosed at least three months after a patient falls ill with the disease, when they have symptoms that last for at least two months and can only be explained when other conditions with similar symptoms have been ruled out.

There is no established treatment and many factors are unknown, including the mechanism behind the onset of symptoms and the number of patients.

About 10% to 20% of adults infected with the novel coronavirus said they were experiencing symptoms likely to be long-COVID in a survey conducted from November 2022 to March 2023 by a Health, Labor and Welfare Ministry’s research team. The survey targeted residents of three municipalities: Sapporo, Tokyo’s Shinagawa Ward and Yao, Osaka Prefecture.

In addition to respiratory symptoms such as coughing and being out of breath, many people also reported fatigue, malaise, sleep disorders, poor concentration and neurological symptoms such as taste and smell disorders. About 10% of those who complained of aftereffects said that their lives were severely disrupted.

“Prolonged inflammation caused by the virus is thought to damage the brain, resulting in persistent neurological symptoms such as fatigue and cognitive decline,” said Takayoshi Shimohata, a professor of neurology at Gifu University. “Considering the seriousness of the aftereffects, it is important to continue to take basic measures to prevent infection, such as frequently washing our hands.”

Hindrance to work

Many long-COVID patients are troubled by a lack of understanding from people around them.

A woman in her 30s in Fukushima Prefecture continued to be out of breath and fatigued after she was infected, but a colleague told her, “Everyone experiences aftereffects, but they put up with it and work.” Eventually, she became unable to get up and quit her job.

Her health eventually recovered, and she was interviewed for a part-time job in February of this year. However, she was told at the interview, “There’s no such thing as long-COVID,” and her health deteriorated again.

“Not being understood by people around me is the hardest thing. I want more people to know about long-COVID,” the woman said.

Okayama University Hospital in Okayama opened a COVID-19 After Care Clinic in February 2021 and has treated about 1,000 patients. Many of the patients also have psychological damage because their symptoms are not understood by people around them, according to Prof. Fumio Otsuka, director of the university’s General Medicine Department.

“A lack of consideration at the workplace or school can delay [a patient’s] rehabilitation into society. Measures are needed to accommodate people who are suffering from long-COVID, such as proposing flexible work styles in accordance with their symptoms.”