BLOG -DR CRAIG SHERIDAN
Just 13 weeks ago the UK went into lockdown as we entered the first wave of COVID-19 infections.
Unsurprisingly, the rise in infections and deaths occurred earlier and in greater number in larger cities; London, Sheffield, Birmingham.
But it wasn’t long before we would recount our own personal stories about our friends and family who had fallen ill. Working in the emergency department, it felt like things changed almost overnight, but of course planning for a rise in cases was occurring in the background long before. And after just a few more weeks, we began to see the numbers of cases falling. This, thankfully, has continued to be the case thanks to the sacrifices made by us all during the lockdown. These measures have driven the virus’s reproduction rate to below 1, the number needed to suppress it. Suppress it, not remove it!
To date, we have seen over 42,000 COVID-19 related deaths and many thousands more infected and surviving. Of those infected, around 15% develop severe symptoms whilst a further 5% become critically ill. The journey towards full recovery for many is therefore likely to be a long one.
So to support this journey, the Moving Medicine Group has created a COVID recovery resource. This outlines what to expect and how to best navigate the road ahead by creating a personalised active recovery plan which you can download here.
Developing a routine, making time for rests and listening to the signs your body gives you during recovery are just a few of them. They talk about pacing, which is a term commonly used in medicine for managing conditions like chronic fatigue syndrome. But it’s a strategy that can be really helpful for managing the fatigue that can follow a number of viral infections –glandular fever being perhaps the most well-known example.
A good way to think of pacing in real life is to aim to do a little bit less than you feel you could do on a good day and a little bit more than you feel you could do on a bad day. The key here is ‘a little bit’, which guards against boom or bust exercising, which will do you no favours after illness and may even be harmful. Thinking of this recovery as a marathon rather than a sprint is a good adage to keep in mind!
‘Redefine your health’ is another suggestion, which deserves exploring further. For some, struggling to overcome this infection may cement a desire to live a healthier life going forward. For those used to feeling fit and healthy, a severe illness and difficult recovery can be physically, emotionally and psychologically challenging, particularly having to accept that, for a time at least, they can no longer do the things they once could.
Redefining health in both these examples will be an important part of the recovery process.
It’s important to say too that recovery from a significant illness or injury is generally not linear. This is a message I’ll frequently tell the injured athletes I work with. So what do I mean by ‘not linear’?
Well essentially I mean this graph:
I mean you should anticipate and accept that there are probably going to be setbacks along the way. There will be good days, bad days and days when you feel like you are going backwards. Often, these are signals from your body saying “hang on, slow down, you’ve done quite a lot recently so let’s take it easy for a few days”.
But it might even mean you need a review with your GP or hospital doctor. Then there are other factors that come into play, such as anxiety, which is common following significant illness, and even more so for a condition that affects breathing.
Why is that? Well, difficulty breathing can be a continuing symptom of COVID infection but it can occur with anxiety too. So in recovery, breathlessness may trigger worrying emotions, triggering anxiety, triggering more breathless, leading to a negative spiral.
For these and a host of other reasons, recovery from illness is rarely linear and recovery from COVID-19 will have all the same challenges and more.
Dr Craig Sheridan
GP & Specialty Registrar in Sports and Exercise Medicine
MBChB BSc (Hons) MRCGP (2013) MSc dip SEM (Distinction) MFSEM (UK)