Post COVID-19 recovery guide

This leaflet is designed to provide you some information about the COVID-19 virus including associated symptoms, recovery processes and some tips for helping you manage your recovery. If you have more urgent queries or concerns, you should seek advice from your GP or the Occupational Health Service.

Introduction

Coronavirus (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. The virus can spread from an infected person’s mouth or nose in small liquid particles when they cough, sneeze, speak, sing or breathe. These particles range from larger respiratory droplets to smaller aerosols.

If you are diagnosed with COVID-19 or receive a positive test result you have done nothing wrong. Anyone can contract the virus regardless of race, gender, or age.

Most people infected with the virus will experience mild to moderate respiratory illness and recover without requiring special treatment. Some people can have persisting symptoms which last a number of months after contracting the virus meaning it takes a while to return to baseline level of function. In more rare cases, people can become seriously ill and require medical attention. Older people and those with underlying medical conditions like cardiovascular disease, diabetes, chronic respiratory disease, or cancer are more likely to develop serious illness.

The best way to prevent and slow down transmission is to be well informed about the disease and how the virus spreads. Protect yourself and others from infection by staying at least 1 metre apart from others, wearing a properly fitted mask, and washing your hands or using an alcohol-based rub frequently. Get vaccinated when it is your turn and follow local guidance. (WHO, 2021) Advice for the public (who.int)

Acute/short-term symptoms of COVID-19

• A high temperature – this means you feel hot to touch on your chest or back.
• A new, continuous cough – this means coughing a lot more than an hour or 3 more
• coughing episodes in 24 hours.
• A loss or change to your sense of smell or taste.

How to look after yourself at home with COVID-19

Most people with COVID-19 feel better within a few weeks and can care for themselves
at home during this time. You may wish to ask a friend, family member or neighbour
for support with shopping while you are isolating and to check how you are doing.

Treating a high temperature

• Get lots of rest
• Drink plenty of fluids (water is best) to avoid dehydration – drink enough so your
  pee is light yellow and clear
• Take paracetamol/ibuprofen (as per packet instructions/pharmacist advice) if
  you feel uncomfortable

Treating a cough

• Try lying on your side or sitting upright if your cough is made worse by lying flat
  on your back
• Try a teaspoon of honey to ease your cough
• Contact pharmacist for advice on cough treatments

Helping Breathlessness

• Keep your room cool
• Turn heating down or open a window
• Try breathing slowly in through your nose and out through your mouth with lips
  together like you are blowing out a candle
• Sitting upright in a chair
• Relax your shoulders so you are not hunched
• Leaning forwards slightly – support yourself with your hands on your knees or
  something stable like a chair
• Try to remain calm and not panic if you are breathless as this can make it worse.

Seek advice from NHS 111 or GP if you:

• Are gradually more unwell or breathless
• Have breathing difficulties when standing or moving around
• Feel very weak, achy or tired
• Are shaking or shivering
• Lost your appetite
• Are unable to care for yourself

(NHS, 2022) How to look after yourself at home if you have coronavirus (COVID-19) – NHS (www.nhs.uk)

Long COVID-19/Post COVID-19 Syndrome

Recovery after COVID-19 varies from person to person though most people will make a full recovery within 12 weeks. Some people can have persisting symptoms which last longer than 12 weeks – this is known as “Long COVID” or “Post COVID Syndrome.” The course of recovery does not appear related to the severity of symptoms of initial infection. Some people with mild symptoms can have long-term problems.

Symptoms can persist longer than 12 weeks and symptoms can change over time and new symptoms may develop.

Symptoms of Long COVID-19

There are many symptoms which can present after contracting COVID-19. Some common Long COVID symptoms include:

• Fatigue
• Shortness of breath
• Chest pain or tightness
• Problems with memory/concentration (“brain fog”)
• Difficulties sleeping
• Heart palpitations
• Dizziness
• Pins and needles
• Joint pains
• Depression and anxiety
• Tinnitus, earaches

Contact your GP if you:

• Are worried about symptoms 4 weeks after COVID-19

(NHS, 2022) Long-term effects of coronavirus (long COVID) – NHS (www.nhs.uk)

Recovering from COVID-19

Recovering from COVID-19 is different from one person to the next. The length of your
recovery is not necessarily related to the severity of your initial illness or whether you
were in hospital. If new or ongoing symptoms occur then you should seek medical
advice.

You can find more information on management of a range of symptoms here:
Managing The Effects | Your COVID Recovery

Fatigue

Fatigue is a feeling of extreme tiredness and may limit your ability to function to the levels you are normally used to. Various conditions can cause people to experience fatigue including sleep disorders, nutritional deficiencies, infection, endocrine, neuromuscular, musculoskeletal, gastrointestinal, cardiovascular, rheumatological and respiratory diseases, such as COVID-19.

Fatigue can alter one’s physical capabilities by decreasing their strength and energy to do things. Therefore, it is very normal for those experiencing fatigue to have difficulty completing tasks that they would normally find easy to do. Fatigue can also impact people mentally by decreasing motivation, lowering mood, and limiting their ability to concentrate on tasks and remember things; this can be particularly challenging in the workplace.

Fatigue patterns

Experiencing fatigue can be extremely frustrating as you may now struggle to complete tasks that used to be easy. It is common to struggle balancing between doing too little and doing too much. It is important to continue being active and performing tasks to maintain your fitness and overall wellbeing; however, this should be at a manageable intensity for you. If you are suffering from fatigue, it is key to use strategies structured which are specific to you, and to not compare yourself, and your symptoms, to other people. Below are some common patterns in those experiencing fatigue.

• Boom and Bust – Where you do too much and go into energy debt.
• Avoidance – Where you do too little and lose strength and fitness.
• Persistence – Where you keep going and ignore your body. Leads to exhaustion/injury.
• Task Modification – Appropriate activity pacing with the energy currently available.

Management Strategies

Pace: Change the speed, time and intensity you do tasks

• Stop activities before you feel tired
• Take breaks throughout activities
• When having a better day, do not overdo it
• Slowly increase the amount/intensity of activity over time

Plan: Decide what, when and how you will do tasks

• Spread activities throughout the week
• Break big tasks into smaller steps
• Alternate heavy and light tasks

Prioritise: Understand what needs to be done and what can wait

• Try to include time for yourself and things you enjoy but first finish what must be done
• Balance what you ‘have to’ and ‘want to’ do

Activity Tracker

To help organise and balance your tasks throughout the day and week consider using
the Activity Tracker below to see the impact of your daily activities on your symptoms
and function. This approach can help you to appreciate the effects of certain activities
and allow you to plan your day to prevent symptom exacerbation and promote
recovery.

Brain Fog

‘Brain fog’ is not a diagnosis but a common term used to describe the feeling of being
cognitively impaired.

Symptoms can include:

• Confusion
• Memory problems
• Difficulties concentrating
• Slow thoughts
• Headaches
• Feeling “out of it”

To help manage symptoms of ‘brain fog’ you could try:

• Talking to others (friends, colleagues, manager) about your difficulties and how
  they could help you
• Be kind to yourself – try to pace and reward yourself for achieving a goal
• Reminders – use a diary or calendar to help you remember important things
• Reduce distractions
• Engage with healthy habits around sleep, eating a balanced diet and physical activity
• Sticking to a routine

Mental Health

The pandemic has presented many challenges and uncertainty about how COVID-19 would affect us and those around us. There has been disruption to routines, isolation and loss which can all impact mental health and wellbeing. In addition, contracting the virus can cause additional fears and concerns about the impact on your own health and those around you. Due to this, it is common to feel more anxious or lower in mood which in turn, can affect physical symptoms as well as engagement with social activity and work.

To help manage mental health you could try:

Deep breathing exercises – take a long breath in through your nose, hold for a
few seconds and gently breath out through your mouth.

• Be kind to yourself – try recording positive things which went well on good days
  and reward yourself for them. Prioritise time for self-care, meaningful and
  relaxing activities
  
• Talking to others about how you feel can help them to understand how you are
  feeling and how they may be able to help. You can refer to Occupational Health
  for support
  
• Challenge negative thoughts that you notice with alternative. E.g., “my body is
  responding to my anxiety, and this is how I feel at the moment, but it won’t last
  forever”
  
• Join a support group for peer support from others going through similar
  experiences to share ideas on managing mood and stay connected
  
• Goal setting – setting daily goals can help increase motivation and feel a sense
  of accomplishment
  
• Seek help if low mood is persistent via your GP. If you have thoughts around
  suicide or self-harm, seek urgent support here.

What about work?

Stay active at work or return to work as soon as possible, if necessary with temporary
modified duties. This helps you keep your ‘work fitness’ and prevents your body getting weak, which can prolong your pain.

Remember… You do not have to be symptom free to return to or remain at work.

Resuming and maintaining activity levels including work could help your recovery. You
may not be able to return to your full duties straight away. It may take a short period
of adjustment before you resume full duties. You can discuss this with your manager
and a short period of modified duties may be possible.

If you are unable to agree on an adjusted role with you manager, or you are still having
problems despite following this advice: your Occupational Health team can help. The
Occupational Health team can advise you on how to bridge the gap to help you return
to normal activities.

Management referral

If you feel your symptoms are having a significant effect on your ability to carry out
your role, discuss this with your manager and request a referral to the Occupational
Health Service.

Self-referral

You may self-refer to Occupational Health for physiotherapy, counselling or to discuss
your work/health related situation in connection to you COVID-19 recovery. You can
find out more information and access self-referral forms from our website here:

Newcastle Occupational Health Service – Newcastle Hospitals NHS Foundation Trust
(newcastle-hospitals.nhs.uk)
Ground Floor
Regent Centre
Regent Farm Road
Gosforth
NE3 3HD
Tel: (0191) 2821188
Email: newcastle.ohs@nhs.net