A year ago today I had my first COVID symptoms, and I never recovered.

It feels fairly impossible to process what being sick for a year has been like, and what this year of watching #LongCOVID awareness and advocacy unfold has been like, but some thoughts: 1/
The first week of being sick was the easiest. I remember marking my calendar to donate plasma at the point I expected to be symptom-free, but that never came. The sirens in NYC were nonstop at that point. I watched my neighbors get taken away in ambulances. 2/
Every night from 2-4am the neighbor closest to my bedroom window had a coughing fit. It was so weird and horrifying to know we were all experiencing the same thing. In those days living in NYC was a horror show while the rest of the country had no idea how bad it was. 3/
After the second week, my symptoms got increasingly worse. I developed a cough and shortness of breath, but also debilitating headaches, tremors, phantom smells, numb limbs, tachycardia, tinnitus, and so many symptoms that wouldn't be talked about in the public for months. 4/
I truly thought the cognitive/neurological symptoms were degenerative for the first 4-5 months. I had three goals: 1) to see my family again, 2) to not die, and 3) to make it known to the public that severe neurological symptoms were happening to us. 5/
I am infinitely grateful to @itsbodypolitic & @patientled for giving me a concrete path towards #3 so early. By week 6 of my symptoms, we released the first report on #LongCOVID, which we used to communicate to the CDC, NIH, WHO, & other organizations worldwide by the summer. 6/
It isn't an exaggeration to say that until we released our second paper in December, every ounce of energy I had that didn't go to my basic needs or medical care was spent with these groups on #LongCOVID research and advocacy. 7/
I cannot describe what a gift @LisaAMcCorkell, @GinaAssaf, @herlifeinpixels, & @AthenaAkrami were, to work alongside them as I felt like I was losing my brain; they gave me an incredibly safe space that let me feel like no matter what happened, I could meaningfully contribute. 8/
I also feel grateful to have spent the year alongside a team that was also sick, which made it *so* much easier to ask for new needs, and implement them as values for the whole group, and be in an environment where health was valued first. 9/
I feel grateful to @fi_lowenstein and @itsbodypolitic, which grounded its values in the history of other chronic illnesses, and facilitated so much advocacy by learning from people who have navigated these systems before us. 10/
I feel grateful to the #pwme community who gave us *so* much of their time, to help us navigate everything from the grief of becoming disabled to disability benefits to the most important post-viral treatments like pacing. And so many thanks to @AlisonSbrana, specifically. 11/
Even though this has been an awful experience, I feel grateful to be going through it with such an enormous (& international) community. I have not felt really alone and I realize how lucky that is. #LongCOVID 12/
Things I didn't expect:

-to lose relationships with some family & friends who I'd had good, close relationships with
-how many people would be angry that I & others were talking about being sick, once #LongCOVID became known
-to be threatened & harassed for being sick. 13/
Once #LongCOVID started showing up in the news, I naively thought policy changes would happen much faster. Seeing thousands of people join support groups with the same symptoms has been heartbreaking, confusing, frustrating. 14/
At the same time, I also realize that going from a nameless phenomenon to $1.15 billion in #LongCOVID NIH funding in less than a year is unreasonably amazing for any illness, and I feel grateful for it. 15/
As for symptoms: some are better, many remain. Over the summer, @Craig_A_Spencer generously took time to talk to me about his own post-viral illness. His words resonated & made me realize there is likely no return to pre-COVID Hannah. This feels true: 16/
Many things are still hard; driving is hard, real-time conversations are hard, writing is hard, anything with executive functioning/processing speed is hard. I get fevers from zoom calls, walking too much, loud noises, etc. It's weird & hard to communicate these to others. 17/
Today I gave myself the gift of canceling some meetings, but had a lovely & validating call with the CDC, then drove along the ocean with my partner. The month leading up to this has felt full of grief, so I was really surprised that much of today felt joyful. 18/
I don't know if I'm going to "get better" - that's hard to think about at this point. My focus is on understanding my new body, understanding the new ways my brain works, understanding the new ways friendships & relationships have to work, and helping research move forward. 19/
Thank you all so much for your kind words and messages. I’m sorry this resonated with so many of you, but appreciate your love and support ❤️ #1year1virus

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More from @ahandvanish

22 Mar
An excellent piece by @DocAmali on why COVID and #LongCOVID support groups need to be ethical in their practices, including protecting the privacy of the patients who participate. Otherwise, they risk "objectification and exploitation of vulnerable participants."
This is why @itsbodypolitic is a private, patient-only support group hosted on a platform that doesn't exploit participant data, and has rules that explicitly prohibit scraping of support group data! #LongCOVID

@DocAmali's call to action: "Governments & regulators internationally should collectively develop policies to combat unconsented use of social media data for healthcare research, & also bring in new laws to prohibit unethical data mining of social media platforms."
Read 4 tweets
21 Mar
.@YoDoctorYo @brucep13 have you seen this paper? it shows elevated cytokines in early ME patients (<3 years) that decrease in patients who have ME for longer than 3 years. How does this relate to the long hauler index “improving”/decreasing? #LongCovid

advances.sciencemag.org/content/1/1/e1…
Lots of expert authors on this paper, including @mhornig @LBatemanMD @ngklimas
@YoDoctorYo thanks for replying but my question hasn't been answered. Specifically: they found similar elevated cytokines as you (like IFN-γ) in early ME patients, that decrease in later ME. How do you know a decrease means an improvement & not exhaustion as theorized here?
Read 4 tweets
20 Mar
This is one of the wilder papers I've seen - PCR tests for COVID are over twice as likely to be positive in the early afternoon. 1/

medrxiv.org/content/10.110…
"The strong diurnal sinusoid pattern in the fraction of positive tests suggests a cyclic pattern in viral shedding, with a peak in the early afternoon. This aligns with previous findings for other viruses such as influenza, herpes, and dengue... 2/
...where interactions with the immune system lead to diurnal variation in viral shedding and symptoms, and have been shown to influence vaccine effectiveness."
3/
Read 4 tweets
1 Mar
My first #LongCOVID symptom was that I couldn't read a text message.

Most of the time when I tell people this, it's met with shock or surprise, but it's not really uncommon. Here's a piece on "Long COVID's dementia symptoms" in younger people. 1/

thetimes.co.uk/article/i-left…
"Dozens of younger adults recovering from the long-term effects of coronavirus have unexpectedly displayed dementia-like symptoms, including short-term memory loss and an inability to read or form sentences." 2/
A doctor leading a study into “long Covid” said that virtually all her patients aged between 18 and 40 had neurological problems, ranging from impaired balance and motor control to physical numbness and difficulty with language. 3/
Read 6 tweets
9 Feb
Tweeting the WHO's conference on #LongCOVID (called "Post COVID-19 Condition" here) as possible.

It starts off with the amazing @LongCovidSOS video from earlier this year: 1/
Dr. Pardo-Villamizar giving us a history of the (mostly neurological) symptoms from pandemics in the past. 2/
Dr. Dale Needham on post-ICU syndrome. Symptoms are similar to non-hospitalized #LongCOVID. Mentions the 6 minute walk test - would be helpful to do on non-hospitalized patients too.

Cognitive test scores look like TBIs or mild alzheimer's, no difference in severity. 3/
Read 39 tweets
6 Feb
This is an interesting #LongCOVID theory - that there is persistent brainstem dysfunction (likely in tangent with other immune issues like immune dysregulation, reactivation of other viruses, onset of autoimmune conditions).

A thread including some new & important papers: 1/
"Persistent Brainstem Dysfunction in #LongCOVID: A Hypothesis." Would be very curious to hear researchers' thoughts on this one! 2/

pubs.acs.org/doi/10.1021/ac…
Hypometabolism found in brain PET scans in #LongCOVID patients! link.springer.com/article/10.100…

Results: a decrease in brain activity in:
-olfactory bulb
-limbic regions: memory/emotion regulation
-brainstem: autonomic functions (breathing/sleeping)
-cerebellum: motor skills/balance 3/
Read 7 tweets

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