COVID Long-Haulers

"I'm week 17. I had mono[nucleosis] when I was a kid and this is tenfold worse. I've been isolated, I'm paranoid about seeing people. It really affects you deeply."
"[First came a scratchy sore throat, then] bam -- it felt like something slammed me in the back of the neck [body aches, heartburn, a] strange, twitching feeling in my heart."
"[I'm struggling with] absolutely terrible brain fog."
"They only had a few symptoms listed [at first, back in March]. Now you go to hospital and there's a long list of symptoms. If you have anything but a cut finger."
Susie Goulding, single mother, Oakville, Ontario, COVID recovery

"I still feel strange things, but I have never been so long in my life without playing a basketball game."
"I don't know if that is it or the aftermath of the virus ... But I had experiences, a month and a half ago, which scared me. I felt like ants in my toes and wondered what it could be."
"There were quite a few little things like that."
Rudy Gobert, NBA Utah Jazz centre, 28

"Many of us have had cases that did not require hospitalization and yet we are having persistent symptoms three, four, even five months after symptom onset."
Long Haulers Support Group Canada

"This stuff is real. These people are trying to navigate an illness that bites back like a demon if you overdue it, batters you physically and mentally, and leads you to doubt your own sanity." 
"[For some people recovery from COVID-19 relates to arms and legs] permanently fizzing as if injected with Szechuan peppercorn."
Dr.Paul Garner, professor of infectious diseases, Liverpool School of Tropical Medicine

"We are seeing strokes, we're seeing hemorrhages in the brain, we're seeing some diffuse brain injury, kidney failure problems, involvement in the heart in various ways, some liver problems as well."
"I would never say that this was just some sort of a psychological manifestation and be dismissive of it -- I would never say that."
"We have to be very respectful of the symptoms that people are reporting to us and take them seriously."
"We need to keep a very open mind, not be judgmental, not be dismissive, and to study it and really understand how the virus is affecting people in often profoundly different ways."
Dr.Margaret Herridge, professor of medicine and critical care, University Health Network, Toronto

Chandra Pasma and her husband Matt Helleman say they first got sick with COVID-19 in mid-March, along with their three children. The entire family is still battling the illness 10 weeks later. (Supplied by Chandra Pasma)

According to the February statement coming out of a World Health Organization mission to China, it takes  about two weeks to recover from mild COVID-19, and for severe or critical infections, three to six weeks are required for full recovery from the respiratory disease. That was then. This is now. Now, John Hopkins researchers noted that though early testing for COVID is critical, by Day 21 of infection, the chance of a false negative result, when a virus fails to be detected where someone has contracted or was recently infected, is 66 percent.

The Public Health Agency of Canada refers to 72,000 Canadians having "recovered" from COVID-19, some of whom it is now known, are experiencing mysterious residual symptoms related to their bout with the disease. Widely reported symptoms are inclusive of mind-numbing fatigue, profuse sweating, muscle aches and joint pain, gastrointestinal complaints, bubbling, burning feelings in the chest, pounding headaches, skin rashes, and severe shortness of breath. Recovery for many is not a short-lived and symptom-free process.

Support groups have been appearing on line, enlisting the participation of thousands of long-haulers to share their symptoms and find encouragement and emotional support of others suffering similar, puzzling and life-complicating illnesses. There is strength in numbers, and in this instance a collective membership of such self-help groups can have an impact, urging federal and provincial chief public health officers to engage in research and support for those undergoing COVID symptoms of long-lasting effect.

Throughout the medical community there have been supportive doctors and alternately, many who are dismissive, telling patients that it is anxiety that is complicating their lives. A research letter coming out of a study of 143 people with COVID who were hospitalized found 87 percent reported at least one lingering symptom; in particular, fatigue and shortness of breath, and chest and joint pain, as well, 60 days following the onset of COVID, the results published in JAMA.

Of the total number in the study, only 121 percent 60 days following COVID onset, were free of any COVID-19 related symptoms, while 44 percent reported "worsened quality of life", had ensued. Research conducted by Dr.Herridge, a world expert in the legacy of critical illness, corroborated the findings, relating to her own experience as a professional in critical care.

A study of 109 people hospitalized with acute respiratory distress syndrome (ARDS),  where relatively young individuals were seen with "persistent exercise limitations and reduced quality of life", and were reported by Dr.Herridge and colleagues, published in the New England Journal of Medicine.

Caregivers reported a significant drop in mental well-being of 117 SARS-1 survivors from Toronto, 17 percent of whom had not returned to work after a year -- 51 of the total had needed 668 appointments with psychiatrists or psychologists. The illness caused by the SARS-CoV-2 virus not only attacks the lungs, causing acute respiratory distress syndrome but attacks the endothelial cells, lining the inside of blood vessels in the gut, kidney, heart and brain, as well.

"We've had five cases of patients who've had to have their gut removed. You see these cases and you say, wait a minute, the virus is doing this, too?", remarked Dr.Rochelle Walensky, infectious diseases physician at Massachusetts General Hospital. Those people who survived an ICU stay are now experiencing lingering symptoms as well; in problems linked to thinking and memory, fatigue and weak muscles. Whether this is a direct effect of the virus or instead a combination of the virus and medications meant to purposely paralyze the muscles to ease intubation is unknown.

Dr.Larry Pancer spent 17 days on a breathing machine at Markham Stouffville Hospital, where once he had directed the department of pediatrics there. He was informed that for each day spent on a ventilator, seven days are required to recover. "I was having chest pain and shortness of breath, probably for several days before I went into hospital. I'm used to being on the other side of the bed. I feel 24 hours a day like you would feel if you climbed 20 flights of stairs."

"I had to reteach myself how to walk. Cognitively, I feel okay. I'm doing well.  I'm living independent. I'm cooking and tidying and paying my bills. I've got my dogs that I walk three times a day", he says. Sealed off in the ICU, unable to see family and friends because of strict COVID-19 "no visitor" rules was the most difficult part of the situation for him. "Some are very, very weak and very fatigued", explained Dr.Mark Bayley, program medical director for the Toronto Rehabilitation Institute.

The mental health issues, depression and other symptoms afflicting some people post-COVID are theorized to be related to changes in blood flow to the brain, injuring areas vital to mood. The virus and the injury itself is responsible for the complications. "Some [people] are really anxious that they aren't going to get back to the way the were before", sad Dr.Bayley. "It's still early days -- nobody has survived a year out, of being infected with COVID, so we don't know what the long-term implications and outcomes are", explained Dr.Andrew Morris, infectious disease expert at the University Health Network in Toronto.

A nurse monitors a patient on a ventilator in a COVID-19 ward at Cremona Hospital in Cremona, Italy. Marco Mantovani/Getty Images / PNG

"But it will not surprise any of us that there will be a substantial portion of the population with severe COVID who will have lingering effects down the road."  It is the symptoms being reported by people who were not critically ill suffering dizziness, trouble sleeping, ringing in the ears that present difficulties in explaining. "It's been a three months since recovering. Now my hair is falling out, is anyone else experiencing this joyful crap?" posted a woman on the 72,000-member Survivors Corps Facebook page

"It's still early days -- nobody has survived a year out of being infected with COVID, so we don't know what the long-term implications and outcomes are."
"But it will not surprise any of us that there will be a substantial portion of the population with severe COVID who will have lingering effects down the road."
"There will be people who have had COVID infections who are definitely going to fit into this longhauler kind of category."
"And then there's probably going to be a substantial portion of those people who won't have COVID, and I think what we've learned over decades with poorly categorized illness is that there are people, for a variety of reasons, who have complaints and symptoms that we can't fully explain."
Dr.Andrew Morris, infectious diseases expert, University Health Network, Toronto

Collegial Business Ties: Canada/China

"One of the punishments that is applied for such charges [drug-smuggling] is the death penalty, and China executes more people than any other country in the world."
"My worry is that he [Canadian Robert Lloyd Schellenberg] may be more likely to be sentenced to death than would have been the case before the current breakdown in relations between Canada and China."
Michael Byers, professor of global politics, University of British Columbia

"Is it going to be affected by the current situation [Huawei dispute]? That would not be surprising."
"It would not be surprising if he gets a harsh sentence, but it may be the amount in question already justifies a death sentence [under Chinese law]."
Donald Clarke, Chinese law specialist, George Washington University Law School

"Another Canadian accused [charged with smuggling a] huge [quantity of drugs]."
"[One must] really admire the courage of this Canadian man to actually dare to smuggle drugs in China. We must know that Chinese criminal law has no sympathy for drug crimes."
runsby.com website, Lianing province, northeastern China

"China has not abolished the death penalty based on its own history and current conditions."
"Chinese courts ... won't give the wrongdoer a way out simply because the criminal is a foreigner."
Global Times, branch, Communist Party's People's Daily

A police officer stands outside a prison in Dalian in northeastern China's Liaoning Province. China still has the death penalty for drug trafficking. (Masao Mizuno/Kyodo News via AP)

Obviously it doesn't take courage but stupidity and a measure of careless audacity for a Canadian to smuggle drugs into China, and get caught doing it. Particularly as even the most dim-minded moving drugs must be aware of the penalties imposed particularly on foreigners, in south-east Asian countries which struggle with their own epidemics of drug abuse. That anyone is senseless enough to smuggle drugs into China, a country infamous for its production of chemical-laboratory-produced drugs of lethal power probably deserves to face some level of punishment.

The death penalty?

This fellow, Schellenberg, has been in a Chinese prison for "several years". He has suddenly come to the attention of Chinese authorities: a Canadian in a Chinese prison for the criminal act of drug-smuggling, what an opportunity for the Chinese government to demonstrate its full-bore displeasure with Canada, an upstart nation that has roiled ill feelings from the powerful trading giant the government of Canada is so eager to do business with in a free trade deal.

Of course, care might have been exercised through official channels to advise Meng Wanzhou that she faces arrest should she venture into Canada, even to visit her two splendid 'summer homes' in Vancouver, now that a U.S. court has issued an alert for her arrest and extradition to the U.S. Canada in honouring its treaty with the U.S. speaks earnestly of its obligation under the law to proceed as it did, naively taken by surprise at the strength of the ensuing Chinese outrage.

Surprise? That a technological communications giant linked to the Communist Government of China has suffered the humiliation of one of its chief executives and daughter of the CEO has been arrested? After all, there's a trade war ongoing between the two trade colossi, China and the U.S. With Canada whom the U.S. has done no favours to in its revision of NAFTA into the USMC trade pact and China playing it cool with a potential free trade agreement with Canada as background.

Chinese punishment under its law for the smuggling of a kilogram or more of heroin or methamphetamine ranges from 15 years to the finality of execution. The two other Canadians arrested, a businessman and a former diplomat are still in play; the third, an English teacher with an expired work permit has been released and returned to Canada. What manner of punishment that can be meted out to the other two is questionable; they can be accused of 'endangering Chinese security', but it is likely only Chinese who face such accusations will also face the death penalty.

The country that executes more prisoners than any other nation on Earth would without doubt balk at extending the final solution to a diplomat and a businessman, not one of their own, but not a drug smuggler. This, from a country that produces immense amounts of deadly fentanyl and even deadlier carfentanil, both drugs increasingly responsible for overdose deaths throughout Canada and the United States, and whose disinterest in cooperating to keep Chinese Internet operators from selling them so freely at bargain rates is partially responsible for the death toll.


On Saturday, Robert Schellenberg who was given a 15-year prison sentence for drug smuggling last month, appealed to the Higher People's Court of Liaoning Province. At the hearing, Chinese prosecutors argued that Schellenberg was, in their opinion, part of an international drug smuggling operation. The appeals court ruled that the "light punishment" of 15-years was "obviously inappropriate", sending the case back to the Dalian Intermediate People's Court for retrial.

"I can't see inside the judge's head or what his instructions from the party might be, but this is just not a good time. We're not going to get the benefit of doubt and the penalties may be more severe."
"Their system works very much more differently than ours. There is potential for party intervention in sensitive cases, in a way that's simply not possible in Canada."
Gordon Houlden, director of the the University of Alberta's China Institute

Hoping for Miracles of Divine Intervention   RESCUED!

"Inside the cave is tough. I can guarantee that we will not panic, we will not stop our mission, we will not let the sacrifice of our friend [Saman Gunan, volunteer ex Thai Navy SEAL delivering supplies underwater to the children and their rescuers who drowned from lack of oxygen in the flooded passageway on Friday] go to waste."
"We can no longer wait for all conditions [to be ready] because circumstances are pressuring us."
"We originally thought the boys can stay safe inside the cave for quite some time, but circumstances have changed. We have limited amount of time."
Thai SEAL commander Rear Adm. Arpakorn Yookongkaew

Hundreds of rescuers with equipment continue the rescue operation at the Tham Luang Nang Non cave on July 6.

"It's very likely that while the boys were in the cave but not yet discovered by rescuers that they experienced various degrees of anxiety, fear, confusion, vulnerability and dependency, and perhaps hopelessness."
"Being discovered was a moment of elation. But that is now followed by the reality that a difficult technical rescue might be necessary, which caries with it disappointment for the boys and a new set of fears."
Paul Auerback, Department of Emergency Medicine, medical school, Stanford University

On the plus side in this situation in Mae Sai, Thailand, the 25-year-old coach of the Wild Boars soccer team, who led a dozen of the team's players ranging in age from 11 to 16 into the now-monsoon-flooded Tham Luang Nang Non cave, Ekapol Chanthawong, had extensive training as a Buddhist monk where meditation, calm and humour were the elements that buoyed his elevation into the monkhood.

Under his tutelage, his calming presence and spiritual sensibilities in a society that venerates those elements of the human character that are the most reflective of the divine, videos taken from within the cave show the now-thin and weak boys in good spirits, laughing at jokes, smiling for the camera. The days'-long consultations of experts in the field of cave rescue has vacillated between swift extraction and the patience it would take for the flood waters to subside.

Both options are rife with danger.

The teammates have sent letters to their parents telling them 'don't worry'   AP

The passage through the flooded caverns and narrow passageways is a three-hour excursion each way presenting dangers of negotiation challenging those considered expert divers; to attempt to 'teach' the thirteen stranded people who have no idea even how to swim, how to navigate those waters in wetsuits and breathing apparatus goes beyond any ordinary challenge. Yet to wait out the floods means the potential that with ongoing monsoon weather the floodwaters might rise even higher.

And now, new challenges; oxygen is running out; the ambient oxygen in the chamber is being used at a much faster rate than previously, given the appearance of rescuers, the medical personnel, the providers of supplies coming and going. And for two of the smaller boys -- should the immediate extraction option be chosen in fear of rising floodwaters and oxygen depletion be chosen -- no wet suits small enough to fit them can be found.

Divers may be forced by all these circumstances to make the attempt to guide the boys to dive and manage their way through the complex route of narrow passageways; that fraught and dangerous route whose threats are enough to faze even expert divers with ample experience. The death of one of the divers can be seen as a reminder of just how dangerous that passage through the complicated cave system is for trained adults, professional cave divers.

"If we think the big rain is coming then we will have to get them out", repeated Gov. Narongsak Osatanakorn, of the boys he claims are in good health and have gained confidence in practising wearing diving masks and breathing, to prepare them for the possibility of diving.

Divine intervention? Perhaps, but it is the focus of the world on the courage, skill and determination of the rescuers that have managed to rescue four of the boys from the possibility of a watery grave, brought them safely out, and prepare now to continue their rescue of the remainder of the boys and their coach, to bring this mind-gripping issue to its conclusion...