Are Long-Covid-Symptoms Just Imagination? No way, says Jördis Frommhold. The doctor has now opened Germany’s first long-Covid institute. In an interview with FOCUS online, she tells how she wants to support patients there – and how we can all protect ourselves from the disease.
Exhaustion, headaches, shortness of breath – more and more people are complaining about long-lasting symptoms after their corona infection. Experts refer to this as long or post-Covid.
However, it is controversial, at least in critic circles, whether the long Covid syndrome really exists. Because the symptoms are often very diffuse and could therefore theoretically have a different origin than the previous infection. Patients are sometimes accused of fooling themselves, imagining the disease.
FOCUS online confronted the long-Covid luminary Jördis Frommhold with these critical voices. In an interview, she explains why Long-Covid does exist, how many people are affected – and what prompted her to open Germany’s first Long-Covid Institute.
Jördis Frommhold is a specialist in internal medicine and pulmonary medicine and chief physician in the department for respiratory diseases and allergies at the Median Rehabilitation Clinic in Heiligendamm. She made the topic of long-term effects after Covid infections in the pandemic known throughout Germany early on and is considered the leading physician in matters of long-Covid.
FOCUS online: A number makes you sit up and take notice: 17 million people in Europe are affected by Long-Covid, the World Health Organization (WHO) recently announced. Your first reaction when you heard that?
Jördis Frommhold: That really is a hit. So far we had assumed 10 percent. Honestly, the 16 percent to possibly even 20 percent that the WHO is now naming was and is a shock. Could it be that the number of unreported cases is much larger than previously thought? As a professional, have I only seen the tip of the iceberg? For me it is quite conceivable: that some of the patients have symptoms and suffer, but somehow continue to struggle through everyday life. And I find that particularly worrying, because it increases the risk of long-Covid becoming chronic.
Critics say these people are fooling themselves, it’s all just imagination…
Frommhold: I know I have this discussion all the time. Also with medical colleagues, by the way. Long-Covid is still often dismissed as psychosomatic. They actually don’t have that many cognitive limitations, they say. And then a mini-study is used to prove it. I don’t want to question the results at all…
Rather?
Frommhold: For me they are like another piece of the puzzle that might help to better understand Long-Covid. But before we jump to conclusions, we need to scale up the studies, look at more patients. Only then can we work with the results. In general, I’m definitely in favor of more research being done.
But the many people affected – even if we assume 10 percent, that’s 3 million in Germany – need good care, now. Ultimately, the new figures are also a confirmation for me: we have to start treatment as early as possible, and we have to focus more on the area of prevention. For this reason, I have now opened Germany’s first Long Covid Institute.
After two and a half years as chief physician at the Median rehabilitation clinic in Heiligendamm, a new professional challenge. Why are you leaving a clinic that is considered a leader in long-Covid therapy nationwide? Frommhold: I am incredibly grateful for the time at the clinic and what I was able to learn about Long-Covid in interaction with the patients. My start back then was a very special situation, shortly afterwards the first Covid-19 cases appeared in Germany. That means that it wasn’t planned that we would become a long-Covid-focused clinic, that resulted and developed. Over time, the thought came up more and more often: if only we had known this or that earlier…
At first we didn’t even know that Covid-19 is a vascular disease. We assumed lung disease. With today’s professional knowledge and wealth of experience, completely different therapies are of course possible.
And these should not only be offered at a specialized rehabilitation clinic?
Frommhold: As many people affected as possible should be able to benefit. And not only those who go to a clinic because of comparatively severe symptoms. As already mentioned, one focus of the institute is the preventive approach.
Good cue. Autumn is getting noticeably closer. Corona should soon become an issue again. What can help with regard to a possible next wave?
Frommhold: We should neither suppress Corona, as is often happening right now, nor panic. We must now take a good look and then draw the appropriate conclusions. Long-Covid is not curable – that is only half the truth. That may be true for patients who were hit hard in the first or second wave. And in individual cases it may still happen today. But it is also true: even if we cannot cure Long-Covid, we can influence the symptoms. The evaluations of our patient surveys show how good that is.
Can you name results?
Frommhold: 68 percent of the patients subjectively felt their overall condition on admission to be less good. After three weeks of rehabilitation, 40 percent found their state of health to be satisfactory, and 28 percent even rated it as good. The figures for the further course after six months are currently being evaluated, but it is becoming apparent that the results will remain stable. A lot can be done by behaving accordingly. Fatigue may still come, but that doesn’t mean I stay in the fatigue loop forever. I may have trouble breathing. But they don’t have to manifest themselves.
Where exactly do your therapy recommendations start?
Frommhold: First of all, one caveat: I’m not that optimistic about sensitivity and cognitive disorders. Here the effects we see are smaller than in other areas. Disorders of smell and taste in particular are sometimes very persistent. But especially in the area of symptoms that can be changed through a lifestyle adjustment – such as breathing techniques but also mindfulness training – we can take preventive action.
Autoimmune processes are also said to play a role in long-Covid.
Frommhold: Right, sometimes the organism turns against the body’s own structures when fighting the virus. There is little you can do to ensure that this happens. It happens or it doesn’t happen. But when it happens and those affected allow themselves periods of rest, the excessive reactions calm down more quickly. Unfortunately, my impression is that little is known about how important protection is. It’s just a bit of a cough, I’ve heard it a lot lately. According to the motto: the five video conferences are still possible. It used to be different. sick was sick. I am convinced that our meritocracy also contributes to the fact that long-Covid has become such a problem.
“How to recognize them, why they affect so many and what really helps” by Jördis Frommhold
So after a Covid-19 infection, you should start exercising or doing sports again very moderately?
Frommhold: That’s exactly how it is. Do 50 percent, I tell my patients and – very important – pay attention to possible symptoms, especially the next day. If in doubt, you go back a bit with the performance. In fact, many do exactly the opposite.
Namely?
Frommhold: If things aren’t going well, they’re more likely to add something. Unfortunately, the massive slumps in long-Covid, also known as crushes, often come with a delay. You have to know that, otherwise you might draw the wrong conclusions. By the way, I’m definitely including myself in that. I too wanted to function much too quickly after my Covid infection in January and was then not fully productive for a few months. I won’t make that mistake again!
Are there other things you have planned?
Frommhold: Inhale with table salt, preferably with an inhalation device. Not just because it loosens mucus and moisturizes the airways, but for another reason as well. When you inhale, you consciously pay attention to your breath.
Do you breathe deeper?
Frommhold: Yes, but it’s less about breathing in. We automatically focus on this during inhalation. Exhaling, on the other hand, is often forgotten. We think it will happen by itself. Not correct!
Why is breathing out so important, especially during an infection with the corona virus?
Frommhold: Breathing out should take longer than breathing in so that – to put it simply – as much old air as possible can escape and fresh air can enter the body. Many long-Covid patients unconsciously get used to panting over time, they hyperventilate. This is not something you can hear or see, we notice it during measurements, the air often contains too little carbon dioxide after just a short exposure. A sign that the breathing process is slightly shifted. As I said: through the regular use of an inhalation device, I can learn to reverse this.
During the infection or before?
Frommhold: Anyone who inhales diligently from now on is not immune to the disease itself. But possibly before a bad course. In general, breathing leads a kind of shadowy existence in our culture. Therefore, it is certainly not a bad idea to pay more attention to it again. Incidentally, we will work with singing therapists and yoga teachers at the institute. I am less concerned with the aspect of mindfulness than with the many elements of breathing. Yoga is a classic breathing technique.
How can one imagine what is on offer at your institute?
Frommhold: Of course there will be counseling and therapy. But also a large online offer. Hopefully we can reach many people via digital instructional videos. What is Long Covid? What can I do myself? In a large part of the medical videos I will speak myself. And then, as I said, there are speakers, also social workers, by the way.
Many of those affected are young and have no idea where to get help if they are unable to work or how to apply for vocational rehabilitation. I would like to close a gap here with my institute.
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