Lasting effects of post-viral fatigue
The light at the end of the Covid-19 tunnel beckons. Still, for those fortunate enough to have survived a serious tangle with the virus, their optimistic hopes of a return to something resembling normality must be tempered by the prospect that their ordeal may be far from over. Specifically, the adverse consequences of the injurious effect of the virus itself, together with the trauma and deconditioning of a long hospital stay and post-viral fatigue, may persist for several months or longer.
“I was wobbly but relieved,” writes Roger Boyes, The Times’s diplomatic editor, when finally discharged after five weeks in St Thomas’s. The provision for “rehab” was certainly comprehensive with physios, nutritionists and occupational therapists all knocking on his door. “Yet none of their (entirely welcome) visits really dealt with my needs,” he adds – “my broken sleeping pattern, jangling nerves and memory loss”.
The psychological and physical aftershock for those like Mr Boyes, who spent 10 days on a ventilator, can be very profound, with substantial numbers of those with “post-intensive care syndrome” reporting persistent anxiety and depression precluding their return to work. Further, rheumatologist Dr Gerald Coakley anticipates that up to a third of Covid survivors are likely to experience clinically significant post-viral fatigue. “The best guide is to always do less than you think you can,” he writes.
Hay fever hero
At this time of year tens of thousands of people are indebted, if unknowingly, to the late Bill Frankland, who died in April aged 108. Born as an unexpected twin in 1912 weighing just over 3lb, his (very) long medical career, as reported in his obituary, encompassed working for both Lord Moran, Churchill’s personal physician, and Alexander Fleming, the discoverer of penicillin, as well as three brutal years as a Japanese prisoner of war.
In the early Fifties, he established the allergy clinic at London’s St
Mary’s Hospital, where he conducted the first clinical trials demonstrating the efficacy of immunotherapy for those incapacitated in the summer months by the miseries of grass pollen-induced hay fever.
The need for a long course of immunotherapy injections would eventually be eclipsed by the discovery of potent antihistamine drugs. Still, the therapeutic principle of “desensitisation” in minimising the symptoms of hay fever accounts at least in part for the reputed benefits of a daily dose of honey.
“Whenever I have a really bad attack of sneezing and raging itchy eyes, I take a spoonful of honey and within minutes it has subsided,” writes a woman from Derbyshire.
Nasal attraction
The misfortune of the gentleman recently featured in this column troubled by a dry irritation of the nostrils “that can really be quite sore” has prompted considerable interest. The most likely explanation, according to ENT specialist Andrew Mccombe, is “nasal vestibulitis”, a chronic inflammation of the internal lining of the nostrils usually associated with a low-grade infection of the nasal hair follicles.
The dryness can be countered by moisturising the lining with a combination of the natural seawater spray Sterimar, followed by a smear of Vaseline applied with the little finger or cotton bud. This needs to be done twice daily for 10 days and then continued long-term first thing in the morning. Those with signs of infection will also need to apply an antibiotic ointment (Fucidin or Naseptin), and if that does not do the trick a three-month course of low-dose tetracycline may be necessary.
The dryness, it is also pointed out, may be a secondary effect of dry eye syndrome, as the nostrils depend for their moisture on the drainage of tears down through the lacrimal ducts into the back of the nose. Finally, a woman reports that for her, if rather oddly, chocolate proved to be the culprit, as she discovered accidentally when her chronically sore nostrils markedly improved while abstaining for the four weeks of Lent, only to recur promptly when she started indulging again.
Many have reported persistent anxiety and depression precluding their return to work