Patients who had Covid-19 are reporting that they continue to experience symptoms and suffer from health problems long after the traditional recovery period for the virus.
Many of those with 'long Covid' were previously healthy, but now continue to suffer chronic fatigue, pain, and heart palpitations.
Dr Corinna Sadlier, an infectious diseases consultant at Cork University Hospital, has treated people who are suffering from ill-health months after contracting Covid. She runs a post-Covid clinic in CUH for former covid patients.
"We have been seeing all of our Covid patients who were hospitalised, so that would be people who had severe to moderate infection, in a weekly clinic since July."
Dr Sadlier says it has become apparent that many people who had Covid have ongoing health issues beyond the initial acute infection. "The recovery period in terms of getting back to baseline is much longer than other infections. Generally, with seasonal influenza, people are symptomatic for one to two weeks.
"We are finding that about 50% of people attending the clinic still don't feel like they are at their baseline, four or five months after they caught the infection. They are recovering gradually but it's very slow."
Dr Sadlier said that of the 50 patients they see in the clinic, about half have not returned to work. "There are also ongoing symptoms. The main one would be debilitating fatigue. They are just not able to function on the level they were before, they have difficulties with concentrating, brain fog, and this [can affect] young people who were previously very active.
"They used to go to work, play sports, go to university. Now they feel like they have to go to bed and sleep in the middle of the day."
She added that people also have breathing difficulties and ongoing lung issues and damage. "CUH offered a virtual pulmonary rehab clinic which people found helpful."
There were also some more unusual symptoms, such as muscle aches and pains, headaches, numbness and rashes. "Because the number of people attending the clinic is low, it may not be representative, but these are certainly things people are describing."
"We don't know what the longer-term effects will be, in terms of people's immune functions and chronic fatigue. We are starting to get referrals from GPs for people who have ongoing symptoms [who were never in hospital]."
Dr Sadlier says more investment will be needed in terms of helping people recover from this 'long Covid'. "If people can't get back to their usual level of work or activity, there are mental health effects as well as physical. People should not be too hard on themselves, and try to be patient. Build up levels of activity gradually."
She says many people are suffering from low mood and anxiety due to their lingering symptoms, while others who were very ill in hospital may have experienced trauma if they were on a ventilator and their mental health should be supported.
Rebecca Griffin from Castlewarden in Kildare has 'long Covid'. She first started experiencing symptoms of Covid-19 the day before St Patrick's Day.
"I had a dry cough, a tightness in my chest. I worked that Wednesday after St Patrick's Day, as I was working from home, but by that afternoon I was so exhausted. The cough got worse, I just didn't feel well."
She rang her GP who referred her for a test and told her to self-isolate. Ten days later, she received a text saying her test had been cancelled. "That was because I never had a temperature throughout the whole thing," she says.
For three weeks, Ms Griffin had mild to moderate symptoms.
"Other days I was up and about, and kind of okay," she explains.
Around mid-April, she felt better. However, by May, she was still having difficulty breathing and her heart kept racing.
She ended up in hospital and was diagnosed with pleurisy. By the first week in July, she was so fatigued she had to ring her boss to ask for time off.
"I couldn't lift my head off the pillow. I could hardly speak to my husband with fatigue.
"I have been off work ever since with really severe, inhibiting fatigue. Getting out of bed isn't an option, and speaking is a chore."
Ms Griffin still has heart palpitations and breathing trouble. She has been referred for a cardiology check up in November.
"The fatigue is just indescribable, it's like being in a boxing ring."
Ms Griffin works for a pharmaceutical company and would have been driving a lot for work. Now, she can't often get behind the wheel, and even going for a walk is difficult.
She says her husband and her twin sons, who are 11, have been a great help to her: "There are people out there who have very young children who are really struggling."
While she was never tested for Covid-19, she is certain she had the virus as she had all of the symptoms. She says it has been a struggle for people to understand and believe people with 'long Covid', but there is more awareness now.
Ms Griffin is part of a support group on Facebook, which was set up for those still suffering from Covid. She says the group has been great, and she also finds reflexology and acupuncture help her energy levels.
"It's about gauging your expectations. I have to look at the smaller picture, if I can get the kids to school, but have to rest for the rest of the day, that's okay and it's still an achievement."
Nicola McGrane, who lives in Rathfarnham in Dublin, also has 'long Covid'. She contracted the virus back in March.
"I got it on March 27," she said. "I never had a fever so I was never tested."
She self-isolated immediately and experienced general flu-like symptoms. She stayed in bed, and after about five days she began to feel a bit better.
"It sort of tricked me." Then the heart palpitations and chest pains came.
"My heart rate was so high I ended up going into Vincent's hospital. I got the worst headaches, down my spine even. The doctor said I probably had Covid and I should rest at home."
For the next two weeks, she rested, but still felt terrible. "I remember I was sweating so much I was changing my sheets frequently. I could only do one pillow at a time, and I had to lie down for an hour after each one."
After a week of feeling somewhat normal, a dreadful fatigue came over her.
"I would sleep three or four times a day. My muscles were just so tired. Then I got all these skin sensations, then a rash. My doctor thought it was shingles."
Ms McGrane got to the stage where she could work for about four hours in the morning, but then had to go to bed after. Despite how sick she was, she was trying to rescue her business, Conference Partners International, which focuses on organising events and conferences.
"I started having these relapses which lasted for about a month. Then I had two weeks of where I was about 70% of my old self. No doctor could tell me what was wrong. My GP was lovely, he said I had post-viral fatigue, but there was nothing he could do."
She also had terrible joint pain in her wrists, elbows, and ankles, and her feet and hands got very numb. Ms McGrane says she found her own way of recovery, where she walked for 10 minutes every hour, changed her diet to an anti-inflammatory one, and tried to get outdoors more.
She also recorded her every move, to understand what was depleting her energy levels. Once she figured out what her baseline was, she built on it, little by little.
"I had to exert myself. Just last week I felt like I was nearly there, for the first time in six months. I had to have such a strong mental attitude, that is what helped me."