In It for the Long Haul with COVID and No End in Sight

Always athletic, Conn Davis is fighting through long-haul COVID to reclaim his active lifestyle. (Submitted photo)

It’s been almost two years since Conn Davis contracted COVID-19, and neither he nor the world’s health experts know when he’ll finally be completely over it. Or if he ever will.

The 37-year-old Davis, who grew up on St. Thomas and currently helps run a family business on-island, is one of what seems to be an increasing number of so-called COVID long-haulers: people who exhibit one or more of a mixed bag of symptoms many weeks or months after their initial exposure to the disease.

Davis was living and working in New York as an investment banker in 2020, just as the pandemic was getting a foothold in Europe. Soon after he returned to the U.S. after a business trip to Italy in February of that year, he discovered he had contracted the COVID.

“Patient 37” in New York, he was in and out of the hospital for weeks, suffering an abnormally high heart rate, trouble breathing, – “My oxygen level never got quite low enough to be on a respirator” – insomnia, “brain fog,” and other symptoms.

The most severe immediate effects are long gone, but Davis is still coping with lingering problems. He’s getting only about three to five hours of sleep every 24 hours; he has digestive problems; his manual dexterity is not what it used to be, and he has trouble with things like typing. And then there’s the physical anxiety.

“You feel all jittery,” he said, trying to explain the sensation. He can be sitting quietly or lying, relaxed, in bed, and suddenly for no obvious reason, his system is pumping adrenalin. “Your body’s giving you that fight or flight reflex … It’s like you’re being chased by a bear.”

While he thinks his lung capacity was not compromised – in a diving course last summer, he was able to hold his breath for five minutes – he said he has difficulty controlling the mechanics of breathing. It isn’t automatic all the time. “I find myself holding my breath. … Things just aren’t in sync. I have to think about breathing a lot. My command center’s off if that makes sense.”

A recent small pilot study conducted in England and described in various media outlets over the past few weeks suggests that impaired lung function may be a problem for a significant percentage of long-haulers.

While X-rays and other traditional types of imaging hadn’t revealed physical damage to the lungs, by using xenon gas and magnetic resonance imaging (MRI) scans, researchers were able to trace the path of oxygen moving from the lungs into the bloodstream – and showed that vital transfer was happening at an abnormally low rate for subjects with long-haul COVID. The research was not conclusive, and further study is underway.

On its website, The U.S. Centers for Disease Control and Prevention lists the following as common long-haul conditions:

· Difficulty breathing or shortness of breath
· Tiredness or fatigue
· Symptoms that get worse after physical or mental activities (also known as post-exertional malaise)
· Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
· Cough
· Chest or stomach pain
· Headache
· Fast-beating or pounding heart (also known as heart palpitations)
· Joint or muscle pain
· Pins-and-needles feeling
· Diarrhea
· Sleep problems
· Fever
· Dizziness on standing (lightheadedness)
· Rash
· Mood changes
· Change in smell or taste
· Changes in menstrual period cycles

And that is not an all-inclusive list. For instance, if there was kidney damage, it could mean long-term kidney disease and the need for dialysis, according to the Johns Hopkins University Medical Center website. The center also references a study that showed 60 percent of people who recovered from COVID showed signs of ongoing heart inflammation.

The variety of symptoms is one thing that is confounding medical understanding of post-COVID conditions. Another is timing. When does the disease turn into “post,” and how long is “long-haul?”

The CDC defines the condition as “a wide range of new, returning, or ongoing health problems people can experience four or more weeks after first being infected with the virus that causes COVID-19.”

With some of the earliest known COVID patients still experiencing effects, it’s impossible to know how long they will last.

Initially, medical experts thought that only patients who had had severe cases of COVID were likely to suffer long-lasting effects. But now, they recognize it is not uncommon among people who had mild cases, and in some instances, people who had no symptoms.

Also still unknown is the percentage of people who contract COVID who have become long-haulers or who are likely to.

Estimates vary widely, with some officials citing anywhere from five percent to 60 percent. The currently accepted rule of thumb seems to be about 20 percent or one in five. National and state health agencies report meticulous data on such immediate pandemic impacts as weekly positive test results, daily hospitalizations, and daily deaths, but there is no scorecard for long-haul conditions.

That is also the case in the Virgin Islands, where there are no available statistics even on the number of residents who are experiencing long-term effects from COVID. Territorial Epidemiologist Esther Ellis said that currently, the Health Department does not track COVID patients long-term, but it does have records on all those who have tested positive and so does have that ability.

Nationally, it took a while even to officially recognize the phenomenon. But as of July 2021, it is considered a disability under the Americans with Disability Act.

And more attention is being paid to helping people cope with their long-term symptoms. That’s what Davis is concentrating on these days.

Early on, he learned about Postural Orthostatic Tachycardia Syndrome, which is a blood circulation disorder first recognized and named in the 1990s. It’s usually triggered by a viral infection (according to a recent NPR story), and it seems to have exploded in the wake of COVID.

Dr. Tae Chung, a specialist in physical medicine and rehabilitation, runs the POTS program at Johns Hopkins and Davis said “I was very lucky to get into his clinic.”

There’s no magic pill to resolve issues, Davis noted, but “I’ve been managing it. … It’s really trying to manage your lifestyle and your diet and whatnot.” He has cut back on alcohol and caffeine – eliminating coffee completely for several weeks and limiting it other times – and drinking a lot of water, sometimes taking salt tablets, and exercising, and trying to relax.

After his initial recovery, Davis left his job in New York and returned home to St. Thomas, where he helps run the Community Medical Lab, the business his mother Deborah Davis started about 25 years ago.

Growing up on St. Thomas, Davis was a sports star at Antilles School. His athletic ability brought him some fame early on, and he has continued to garner some celebrity status.

Since he contracted COVID, he’s become a cautionary tale for anyone who doesn’t take the disease seriously.

“In 2002, I was the Athlete of the Year on St. Thomas and still ended up getting COVID,” he said. Now, “I am a very long long-hauler.”