My home was darkish. Tinfoil coated the home windows. The one mild I might tolerate got here from dimmable crimson bulbs. Ten weeks earlier than, I had examined constructive for COVID. On week three of my an infection, I went to the emergency room with a debilitating migraine. On my third journey to the ER, I used to be hospitalized for seven days. I got here dwelling to a modified life. All of the clichés about complications are true—a pile of bricks on the pinnacle, a vise grip on the temples, an axe by means of the cranium. The ache altered my consciousness. Attempting to maneuver or entry a thought was like attempting to see previous a flashlight shining in my eyes.
It was 2024—some extent at which most individuals in America thought-about the pandemic lengthy since over. Nevertheless it wasn’t for me.
Some days, I couldn’t cease crying. It was greater than despair at my circumstance: Lengthy COVID can dysregulate temper and has been linked with melancholy. And the illness hijacked my stress-response system, leaving my physique in a continuing state of alarm. Any sudden sound, even getting a textual content message, would set off a jolt of panic by means of my physique, the identical sensation as slamming on the brakes whereas driving. I misplaced my capacity to manage. I broke a window in my home. I put a gap within the wall.
Researchers know extra about lengthy COVID than they as soon as did, however it’s nonetheless exhausting to outline. The clearest consensus is that it’s a posh assortment of signs that may have an effect on virtually each organ system within the physique. Theories of why COVID can linger abound, and embrace ongoing irritation, the virus by no means absolutely going away, and tissue harm. Many scientists agree that a number of components probably contribute. In the meantime, medical doctors are nonetheless struggling to deal with the illness; lower than half of medical doctors know tips on how to diagnose lengthy COVID and even fewer—28 %—report realizing tips on how to deal with it, in accordance with one 2023 survey. Lengthy-COVID sufferers are nonetheless reporting that medical professionals don’t imagine them, and although in some circumstances sufferers’ self-diagnosis could be off the mark, the truth is that many individuals residing with lengthy COVID merely aren’t getting the care they want.
In my case, that one who was in mind-numbing ache, unable to learn, unable to write down, unable to Google issues or have a look at screens, unable to drive, drained by speaking on the telephone, spiraling in despair, and barely in a position to go away the home needed to navigate the American health-care system. That I wanted look after lengthy COVID solely made my predicament worse. From listening to chronically unwell and disabled individuals talk about their experiences, I knew that to be sick on this nation is a hell unto itself. However realizing one thing is true and experiencing it are totally different. I do know that the Grand Canyon is deep, however I’ve by no means seen it with my very own eyes. For our health-care system, I’ve been to the underside.
According to the newest federal survey as of September 2024, multiple in 20 adults in america had lengthy COVID—outlined as signs that last more than three months. (The survey doesn’t ask concerning the severity of signs.) Vaccines could assist shield towards the illness, however getting COVID nonetheless means risking lengthy COVID. The coronavirus can go away sufferers with blood clots, mind dysfunction, organ harm, immune issues, and extra; a few quarter of individuals with the illness report that it considerably disrupts their capacity to carry out each day actions. There are not any FDA-approved drugs to deal with lengthy COVID. Many medical establishments created specialty clinics to see sufferers with the illness, however a lot of what even the perfect clinics can supply is symptom administration. Pinning down restoration charges from lengthy COVID has been troublesome, however in accordance with a number of research, after two years, the vast majority of individuals residing with lengthy COVID had not absolutely recovered.
Three months into my sickness, I had been handled for migraines and a concussion—COVID’s impression can mirror a traumatic mind harm—however not lengthy COVID. The tribe that I belong to, Cherokee Nation, runs the biggest outpatient facility of any tribe within the U.S., however my primary-care supplier there informed me she didn’t know tips on how to deal with lengthy COVID. I used to be referred to my tribe’s specialty clinic for uncommon and infectious ailments. Once I managed to get that appointment, nonetheless, the supplier informed me he knew tips on how to deal with solely pulmonary long-COVID signs (which many long-COVID sufferers don’t have). Nowhere in Indian Well being Companies, the treaty-based federal program that serves 2.8 million Native Individuals nationwide, is there a long-COVID clinic. (An IHS spokesperson stated the Biden administration would have wanted to arrange such a clinic.)
I began trying exterior Indian Well being Companies and located a long-COVID clinic an hour’s drive from my home. Once I referred to as, I realized the clinic had shut down. The state the place I stay, Oklahoma, doesn’t have a long-COVID clinic. My dad discovered one in Arkansas. Like many long-COVID clinics, it required that sufferers apply to get in. However after I submitted all of the paperwork, I didn’t hear again.
I noticed that to entry care, I would wish to journey. On the time, I used to be unable to drive, and my signs restricted how a lot time I spent exterior my home. Once I referred to as the Cleveland Clinic, I used to be transferred 4 occasions till I used to be unintentionally forwarded to the customer-satisfaction survey. I spoke with one receptionist who informed me her clinic didn’t take sufferers from out of state, and one other who warned that touring to her clinic most likely wouldn’t be definitely worth the money and time. (A spokesperson for the Cleveland Clinic wrote that sufferers ought to be capable of make an appointment with no referral, and that the clinic and its employees “try to supply sufferers with well timed entry to scheduling and care.”)
In my first telehealth appointment with a nationally acknowledged COVID clinic, the physician wouldn’t focus on her suggestions however stated I might learn them within the affected person go to notes. Once I defined that my signs made studying inconceivable, she requested me if somebody might learn the notes for me. Later, my mother learn me a copied-and-pasted listing of healthy-lifestyle info, resembling the advantages of taking a each day probiotic and the significance of getting sufficient sleep. The listing included the physician’s favourite bedtime teas. I informed my mother to cease studying.
A few months into the pandemic, some sufferers reported that their signs weren’t going away. By their advocacy, lengthy COVID obtained its title. By 2022, lots of of long-COVID clinics had opened throughout the nation. There isn’t any normal for what sort of care these clinics present: Some are multidisciplinary groups, however many are one specialist or one nurse practitioner. This patchwork system of care has solely deteriorated as consideration on the illness has dwindled.
Lots of the long-COVID clinics that popped up throughout the pandemic have closed. As a part of my reporting for this story, I compiled an inventory of 171 clinics, drawing from the Survivor Corps web site, a patient-led resource-and-advocacy group, and from looking out on-line for long-COVID clinics by state. I then referred to as every clinic to confirm which of them have been nonetheless working. Of these, 79 have been nonetheless open and accepting new sufferers, 5 weren’t accepting new sufferers or exterior referrals, 61 had closed, and 15 have been unreachable after two makes an attempt. Eleven extra have been marketed as long-COVID clinics however don’t have a medical physician or nurse on employees; they supply providers resembling speech or occupational remedy. (My assistant Sydney Anderson and intern Cheyenne McNeil, who’ve been serving to me work by means of my sickness, contributed to this reporting.)
Based mostly on the listing we assembled, 22 states don’t have any long-COVID clinics accepting new sufferers. Given COVID charges in these states, we estimated that just about 3 million individuals who at present have lengthy COVID reside there. Due to insurance coverage insurance policies, licensing and telehealth legal guidelines, and the price of journey, not having a close-by clinic can simply imply that sufferers gained’t entry care. Of the long-COVID clinics which can be nonetheless open, some have wait lists, don’t settle for exterior referrals, don’t take insurance coverage, deal with solely particular long-COVID signs, or don’t take sufferers from exterior of their geographical space.
Getting in contact with the long-COVID clinics which can be nonetheless open is one other barrier. I spoke with operators who had by no means heard of their establishment’s long-COVID clinic; I obtained transferred to the workplace that schedules COVID assessments; I obtained transferred to disconnected strains; I referred to as numbers that rang and rang and rang and rang. In the future, I spent two hours on the telephone and spoke with solely three individuals who might present info. Once I referred to as Yale New Haven Well being System’s clinic, some of the well-known within the nation, I obtained transferred to a disconnected line. I referred to as again and obtained transferred to the customer-satisfaction survey. I referred to as a 3rd time and left a message. I referred to as a fourth time, attempting a special quantity, and spoke with a receptionist who stated the clinic was closed. (The clinic continues to be open; in an announcement, Yale New Haven Well being stated that the telephone quantity for the long-COVID clinic is on its web site, that the quantity of calls the clinic receives could be very excessive, and that it had not beforehand heard of sufferers having problem accessing the clinic.)
If you’re wholesome, this would possibly all sound just like the acquainted nightmare of customer support to which we have now all change into accustomed. However for people who find themselves sick, it’s a wall that stands between them and the care they want. When you find yourself sick, you have a look at that wall and assume, I’m not properly sufficient to climb it.
The closure of long-COVID clinics lately has affected sufferers who want care. I talked with individuals who, like me, have been residing with lengthy COVID later within the pandemic. Ryan Parker lives in Portland, Oregon; is a member of the Northern Cheyenne tribe; and used to work in philanthropy. Like many individuals with lengthy COVID, Parker tried to work by means of his sickness. He informed me he returned from one work journey so sick that he couldn’t get off the bed for a month. Final fall, the long-COVID clinic that was treating him closed. Due to the illness, Maeve Sherry has been disabled and unable to work for 3 years. They discovered a long-COVID clinic in Nice Falls, Montana, three hours from the place they lived on the time, however it closed in December of 2023, they stated. There are actually no long-COVID clinics in Montana. When Myisha Hill was nonetheless struggling to do family chores, maintain her children, and even discuss weeks after a COVID an infection, she seemed up the long-COVID clinic close to the place she lives in Las Vegas, she informed me. Nevertheless it, too, had closed. There are actually no long-COVID clinics in Nevada.
A spokesperson for the College Medical Heart of Southern Nevada wrote that the clinic closed “amid low demand.” Different clinics echoed this response, saying they suspended operations after affected person numbers dwindled. A couple of clinics additionally said that they now refer long-COVID sufferers to major care. A number of spokespeople informed me as a reporter that their clinics have been nonetheless open, however after I referred to as as a affected person, I used to be informed the clinic was closed. And even when clinics are open, sufferers nonetheless face boundaries: I spoke with individuals with lengthy COVID who informed me they couldn’t entry care as a result of a clinic didn’t take their insurance coverage, their physician didn’t ship a referral, or the clinic rejected them as a affected person.
The choice to enrolling in a clinic is to attempt to see an everyday neurologist or heart specialist. However many specialists have prolonged wait occasions, and long-COVID sufferers are twice as probably as most people to report that that is why they will’t get care. Parker, for example, is attempting to see a specialist for myalgic encephalomyelitis/continual fatigue syndrome, a type of debilitating fatigue that’s widespread with lengthy COVID. The primary accessible appointment is 9 months out.
And when sufferers are lastly seen, the care itself may not be competent. Parker’s primary-care supplier recommended that his debilitating fatigue was a product of tension. A number of medical doctors have additionally informed Kelly Rider that her drawback was simply anxiousness—and one stated it was perimenopause. Typically medical doctors prescribe issues that exacerbate signs—resembling train for continual fatigue. When Diem-Han Dinh’s physician ordered a stress check, she defined that she was unable to run. He didn’t imagine her. On the stress check, she virtually fainted.
Eight months into my sickness, I boarded a airplane and traveled with my mom to Rochester, Minnesota. The long-COVID clinic I lastly obtained into was Mayo. The off-label medicine they prescribed didn’t do a lot, however I realized about my sickness and tips on how to handle my signs, which has improved my high quality of life. Different issues have helped too. Because of an arsenal of migraine therapies, my headache—though not gone—is much less extreme. Because of eight months of imaginative and prescient remedy, I can now focus my eyes and am working towards studying. And, in writing this text, I’ve gotten again to reporting. What I needed to undergo to get right here, I might not want on anybody.
The sources our system of medical care can supply to these eager to study, deal with, and heal from what COVID has completed to their physique are past insufficient, and are more likely to worsen. In February, the Trump administration ordered the Division of Well being and Human Companies to dissolve its advisory committee on lengthy COVID. In March, the division introduced it could shut its Workplace for Lengthy COVID Analysis and Apply, and commenced canceling grants from the Nationwide Institutes of Well being for COVID research.
Sick and disabled individuals have been pushed to the margins of our society for a very long time. There was a second throughout the pandemic after I noticed our collective concern targeted on the unwell. Dwelling with lengthy COVID, I typically marvel the place that concern went. I really feel just like the wounded antelope picked off from the herd. Everybody else has moved on, whereas I’m caught in my sickness. I may very well be offended at every particular person hypocrisy—every one who preached the significance of masks solely to return to regular with out me—however I’m not. As an alternative, I’m unhappy that what’s extra highly effective than our concern for the sick is the indifference of our health-care system.