FOR MANY HAWAII RESIDENTS WHO HAVE SURVIVED A BOUT WITH COVID‑19, THE BATTLE CONTINUES WITH WHAT IS NOW CALLED LONG COVID.

LONG COVID INCLUDES A NUMBER OF SYMPTOMS THAT MAKE IT DIFFICULT FOR THOSE DEALING WITH ITS EFFECTS TO RETURN TO THEIR PRE‑COVID LIVES.

JOIN OUR DISCUSSION ON WHAT WE KNOW AND WHAT WE AND DON’T KNOW NEXT ON INSIGHTS.

IT HAS BEEN MORE THAN TWO YEARS COVID MADE ITS WAY TO HAWAII.

HUNDREDS OF PEOPLE TESTING POSITIVE EVERY DAY.

SEEMS BOOSTERS AND WIDELY AVAILABLE TREATMENT OPTIONS HELPED TO LENS COVID IMPACT.

WHO ABOUT THE LONGTERM HEALTH RAMIFICATION FOR SURVIVORS JOIN US AS WE DISCUSS THE LONGTERM EFFECTS OF COVID‑19.

LIVE BROADCAST AND LIVESTREAM OFINSIGHTS ON PBS HAWAII START NOW.

¶¶ ¶¶ ALOHA AND WELCOME TO INSIGHTS ON PBS HAWAII.

I'M OLENA HEU.

THE FIGHT AGAINST COVID‑19 CONTINUES.

SOME SURVIVORS ARE NOW FACING AN ADDITIONAL CHALLENGE.

IT HAS BEEN CALLED LONG COVID, LONG HAUL COVID, AND “POST COVID‑19 CONDITION.” THESE TERMS REFER TO THE LINGERING EFFECTS THAT APPEAR USUALLY 3 MONTHS AFTER THE ONSET OF COVID‑19 IN TEN TO TWENTY PERCENT OF COVID SURVIVORS.

SYMPTOMS MAY PERSIST FOR MONTHS FOLLOWING INFECTION AND INCLUDE FATIGUE, PERSISTENT COUGH, SHORTNESS OF BREATH, COGNITIVE DYSFUNCTION, AND DEPRESSION.

WHAT IS BEING DONE TO HELP THOSE DEALING WITH THE LONG TERM EFFECTS OF THE CORONAVIRUS?

WE LOOK FORWARD TO YOUR PARTICIPATION IN TONIGHT'S SHOW.

YOU CAN EMAIL US OR CALL US WITH YOUR QUESTIONS.

WE ALSO ENCOURAGE YOU TO GET INVOLVED WITH THE CONVERSATION ON OUR FACEBOOK PAGE.

NOW, TO OUR GUESTS.

JOINING US ALL THE WAY FROM PHILADELPHIA IS DR. ALBERT RIZZO.

HE IS THE CHIEF MEDICAL OFFICER FOR THE AMERICAN LUNG ASSOCIATION AND A BOARD CERTIFIED PHYSICIAN IN INTERNAL, PULMONARY, CRITICAL CARE, AND SLEEP MEDICINE IN NEWARK, DELAWARE.

HE HAS VOLUNTEERED WITH THE AMERICAN LUNG ASSOCIATION SINCE 1984.

ANGELA KEEN IS A FORMER HAWAII MEDIA PERSONALITY WORKING AS A REPORTER AND ANCHOR FOR OVER 15 YEARS AT KGMB AND KHNL.

AFTER RECOVERING FROM COVID‑19, SHE HAS SINCE BATTLED LONG COVID.

SINCE THE START OF THE PANDEMIC SHE HAS ACTIVELY LOBBIED FOR SAFER REGULATIONS IN HAWAII WITH HER HAWAII KAPU BREAKERS GROUP.

DR. GEHAN DEVENDRA MD IS A PULMONARY AND CRITICAL CARE PHYSICIAN AT THE QUEEN’S MEDICAL CENTER AND THE DIRECTOR OF MEDICAL EDUCATION‑CRITICAL CARE FOR THE UNIVERSITY OF HAWAII INTERNAL MEDICINE RESIDENCY PROGRAM.

HE SEES PATIENTS WHO HAVE PULMONARY COMPLICATIONS DUE TO LONG COVID.

DR. PHILIP VERHOEF MD, PHD WORKS WITH THE HAWAII PERMANENTE MEDICAL GROUP IN CRITICAL CARE MEDICINE.

HE MOVED TO HAWAII WHEN HIS WIFE, WHO IS FROM HONOLULU, ACCEPTED A POSITION AS AN EPIDEMIOLOGIST FOR THE STATE.

DR VERHOEF ALSO SERVES AS AN ASSISTANT PROFESSOR AT THE JOHN A. BURNS SCHOOL OF MEDICINE AT THE UNIVERSITY OF HAWAII.

>>Olena: AGAIN, WE ALSO WELCOME YOUR QUESTIONS.

FEEL FREE TO CALL IN OR JOIN US ON FACEBOOK.

FIRST QUESTION I WOULD LIKE TO ADDRESS TO IF YOU COULD PERHAPS EXPLAIN WHAT IS LONG COVID AND IS THERE A DEFINITION FOR IT?

>> AS YOU MENTIONED, STARTED OFF, NUMBER OF DIFFERENT THINGS.

BY THAT, MEANING COUPLE DIFFERENT SYNDROMES.

REALLY DON'T HAVE ALL THE ANSWERS TO.

REALLY IS A COMBINATION BRAIN FOG, MUSCLE PAIN, SHORTNESS OF BREATH.

OCCUR IS NOT ONLY IN PEOPLE SEVERE INFECTION WITH COVID‑19 BUT ALSO THOSE MILD ONES.

MAY SHOW UP WEEKS OR LATER AFTER THE INITIAL INFECTION.

WE STARTED SEEING ALL OF THIS BACK IN 2020.

SHORTLY AFTER THE PANDEMIC BEGAN.

THEN MORE AND MORE, INDIVIDUALS WILL BE RECOGNIZED AND CENTERS ACROSS THE COUNTRY MANY ACADEMIC CENTERS DEVELOPED CLINICS TO SPECIFICALLY DEAL WITH WHAT NOW CHRONIC COVID OR LONG HAUL SYNDROME.

AND TALK A LOT MORE ABOUT WHAT THE PARTICULAR ISSUES ARE.

PERPLEXING PROBLEM THAT OCCURS AFTER OTHER VIRAL INFECTIONS.

COVID‑19 SEEMS TO BE MAKING IT MORE COMMON.

>>Olena: WHAT IF YOU SAY THEY DON'T BELIEVE LONG HAUL COVID OR COVID IS AN ACTUAL THING.

>> PEOPLE CERTAINLY HAVE SAID THAT.

I THINK IT'S, FIRST OFF, FROM MY STANDPOINT, AS A PHYSICIAN, MY JOB IS TO LISTEN AND TRY TO UNDERSTAND WHAT PEOPLE ARE FEELING AND WHY THEY'RE FEELING IT.

AND HONESTLY, WE HAVE SEEN SO MANY CASES NOW OF LONG COVID THAT THERE'S JUST TOO MUCH EVIDENCE IT'S A REAL THING.

IT'S FUNNY, DOCTOR MENTIONED THIS HAPPENS AFTER VIRAL INFECTION.

I THINK THAT'S TRUE.

NEVER HAD A SINGLE TIME IN OUR RECENT HUMAN HISTORY WHERE SO MANY PEOPLE HAVE GOTTEN THE SAME VIRAL INFECTION WITHIN SHORT PERIOD OF TIME.

IN A WAY THAT'S MAGNIFIED SIGNIFICANTLY THE NUMBER OF PEOPLE THAT ARE HAVING THESE SYMPTOMS OF LONG COVID.

I THINK IT'S ABSOLUTELY TRUE THAT IS THIS PROBABLY A DISEASE THAT'S BEEN AROUND.

BUT NOW, BECAUSE WE HAVE SO MANY PEOPLE IN SUCH A SHORT PERIOD OF TIME CATCHING COVID, WE ALSO HAVE SO MANY PEOPLE NOW SUFFERING FROM THESE LONG HAUL SYNDROME SYMPTOMS.

IT'S REALLY A TRAGEDY.

>>Olena: WHAT IF SOMEBODY WAS DIAGNOSED WITH COVID, THEN 3 WEEKS LATER AFTER RECOVERY, PRESENTED THE SAME SYMPTOMS UPON FIRST INFECTION?

WOULD THAT BE LONG HAUL COVID OR COULD THAT BE ANOTHER COVID‑19 INFECTION?

>> IT'S REALLY HARD TO SAY.

SOMETIMES IT COULD BE ANOTHER INFECTION.

USUALLY WE DON'T SEE ANOTHER INFECTION THAT SOON AFTERWARDS.

SO A LOT OF THE TIMES WE SEE LONG COVID AND REALLY, DEFINITION IS REALLY THERE'S NO OFFICIAL CONSENSUS FOR THE DEFINITION.

BUT MANY INVESTIGATORS HAVE SAID THAT AROUND 30 DAYS OR MORE, AFTER HAVING YOUR INITIAL INFECTION, WOULD CLASSIFY YOU AS HAVING LONG COVID.

I THINK THE MAIN THING TO KNOW IS IT'S REALLY NEED TO TALK TO YOUR PATIENT.

HOW ARE THEY FEELING.

WHAT ARE THEIR SYMPTOMS.

SOMETIMES PEOPLE CAN HAVE SECONDARY INFECTIONS THAT COME ON.

WE REALLY NEED TO GO BACK TO THE PATIENT AND SAY, HEY, HOW ARE YOU FEELING?

WHAT ARE YOU DOING?

WHAT SYMPTOMS ARE YOU HAVING?

AND BRING IT BACK TO THE INDIVIDUAL.

>>Olena: AS A COVID‑19 SURVIVOR, CAN YOU SHARE YOUR STORY WITH US?

>> OH, BOY.

TRY TO MAKE IT AS SHORT AS POSSIBLE.

I CONTRACTED COVID FIRST WEEK OF MARCH.

AFTER CONDUCTING WEDDING FOR A FAMILY FROM AUSTRALIA.

AND THE BEST MAN HAD COVID.

HE SHARED THE MIC WITH ME.

AND THAT WAS ENOUGH.

I CONFIRMED LATE WHERE THE FAMILY, THAT WAS THE FIRST WEEK OF MARCH.

DIDN'T HAVE ANY TESTING.

NOBODY REALLY KNEW WHAT COVID WAS.

IT WAS A VERY DIFFICULT START FOR ME.

LASTED FOR 8 WEEK.

I DIDN'T END UP IN THE HOSPITAL BECAUSE MY DOCTOR FELT, SHE FELT IT WAS BETTER FOR ME TO STAY AT HOME AND I WOULD BE SAFER THERE.

RECOVER BETTER.

I HAD ALL THE MEDICAL NECESSITIES BECAUSE OF MY CONNECTIONS AND HAD OXYGEN AND NEBULIZERS.

A LOT OF ANTIBIOTICS.

MULTIPLE STEROIDS.

NOTHING PUT A DENT IN IT.

CONTINUED TO GET WORSE.

8 WEEKS, DOCTOR BROUGHT ME INTO THE CLINIC.

GIVE GAVE ME STEROID COMMONLY USED FOR COVID.

WITHIN 72 HOURS CLEARED UP.

ABOUT A MONTH LATER, STARTED GETTING FATIGUE.

TO THE POINT WHERE IT FEET FELT LIKE I HAD JETLAG EVERY DAY.

MUSCLES ACHE AND PAINS PROBLEM EAR, NOSE AND THROAT, HEADACHES, MEMORY LOSS, DEPRESSION AND BY THE TIME I GOT HELP, MOST RECENTLY, BRAIN WAS THAT OF AN 80‑YEAR‑OLD WOMAN.

IN A STATE OF PREDEMENTIA.

I HAVE CAN SCANS TO PROVE IT.

VERY REAL.

STRUGGLE.

GLAD TO GETTING MY BRAIN BACK FINALLY.

BACK TO MY OWN SELF.

>>Olena: THANK YOU FOR SHARING YOUR STORY WITH US AND BEING SO OPEN AND HONEST.

ONE OF THE DOCTORS, PEOPLE ARE TRYING THEIR BEST TO GET ON WITH THEIR LIVE.

IS THERE ANYTHING THAT YOU WOULD YOU WOULD SAY, THAT WOULD HELP.

SEE ANYONE EXPERIENCING LONG COVID.

FAMILY MEMBER MAY EXPERIENCING IT.

WHAT ARE SOME OF THE SIGNS WE COULD ALSO LOOK FOR?

>> I THINK AS DOCTOR MENTIONED EARLIER BIGGEST THING WE CAN DO IS LISTEN.

VERY SUPPORTIVE.

AND EMPATHETIC.

REAL SYNDROME.

THAT THESE PATIENTS ARE HAVING TO DEAL WITH.

REASON MANY CLINICS CROPPED UP ACROSS THE COUNTRY WAS THAT MULTIPLE SPECIALIST MAY NEED TO BE INVOLVED TO TREAT A PATIENT LIKE THIS.

MULTIDISCIPLINARY APPROACH WITH A NEUROLOGIST, CARDIOLOGIST, PULMONARY SPECIALIST.

BEHAVIORAL SPECIALIST.

MAY BE NEEDED TO HELP TO REHABILITATE THE PATIENT NOT ONLY PHYSICALLY, BUT ALSO MENTALLY.

TO GET THROUGH THIS.

MULTIDISCIPLINARY APPROACHED WORKED.

>>Olena: WHY DO YOU THINK THERE ARE THESE LONGTERM EFFECTS?

>> I THINK NUMBER OF THEORY.

SOMETIMES IT'S SEVERITY OF THE INITIAL INFECTION DOES LEAD SCARRING IN THE ORGANS.

HEART, LUNG.

CAT SCANS.

MANY PATIENTS HAVE MILD SYMPTOMS.

DON'T SHOW ANYTHING DURING THAT CUTE INFECTION.

RESULT OF THE VIRUS ITSELF OR THE RESPONSE BY THE BODY TO THE VIRUS LEADING TO INFLAMMATION AND DAMAGE OF THE ORGANS BECAUSE OF THE IMMUNE RESPONSE.

STILL A LOT OF WORK TO BE DONE.

NATIONALLY NATIONAL INSTITUTES OF HEALTH DOING SEVERAL LARGE STUDIES TO LOOK AT THE CHRONIC SYMPTOMS.

>> SORRY.

I WAS GOING TO JUMP IN.

I THINK THAT'S A REALLY IMPORTANT POINT DOCTOR JUST MADE.

ONE OF THE THINGS THAT WE'VE SEEN WITH COVID IS THAT PEOPLE CAN GET REALLY CRITICALLY ILL.

SPEND A LOT OF THE TIME IN THE ICU AND ON VENTILATORS.

JUST THAT CRITICAL ILLNESS CAN RENDER PEOPLE PRETTY DISABLED.

CERTAINLY REMEMBER TAKING CARE OF PATIENTS AT KAISER AND I KNOW THEY HAVE AT QUEEN'S, REQUIRED TRACHEOTOMIES AND LONGTERM PHYSICAL THERAPY AND REHAB.

IMPORTANT TO DISTINGUISH LONG COVID FROM JUST THE CONSEQUENCES OF CRITICAL ILLNESS.

MANY PEOPLE WERE EITHER MINIMALLY SYMPTOM MAT YOU CAN OR JUST FELT LIKE THEY HAD A MILD COLD OR WEREN'T MANY AS SICK AS ANGELA WAS CONTINUING TO EXPERIENCE SYMPTOMS.

REALLY VERY MUCH A DIFFERENT KIND OF DISEASE FROM JUST HAVING BEEN CRITICALLY ILL FOR A LONG TIME, AND HAVING THE EFFECTS OF THAT CRITICAL.

>>Olena: HOW ARE YOU ABLE TO DISTINGUISH THAT THAT IS FROM COVID ALSO?

>> I CAN PROBABLY JUMP IN THERE.

I THINK REALLY, IT'S REALLY HARD TO KNOW.

BUT A LOT OF THE TIMES, WHAT WE DO SEE IS EVEN WITH MILD SYMPTOMS, PERHAPS 15% OF PATIENTS MAY HAVE PERSISTENT SHORTNESS OF BREATH.

MAY HAVE MINOR ABNORMALITIES LONG FUNCTION TEST.

SEE THESE IN PATIENTS WHO DO HAVE LONG COVID.

THINK IT'S IMPORTANT TO FOLLOW THESE PATIENTS AND I THINK THAT BIGGEST THING IS WE DON'T HAVE ENOUGH INFORMATION.

I THINK THAT IS WHY HAVING A LIKE DOCTOR SAID, REALLY COMBINED MODALITY IN TRYING TO FIGURE OUT WHAT IS GOING ON.

YOU GET SPECIALISTS FROM NEUROLOGY.

CARDIOLOGY, PULMONARY COME TOGETHER IN COVID CARE CLINIC.

HAVE COVID CARE CLINIC AT QUEEN'S RUN BY DOCTORS.

DO FANTASTIC WORK LOOKING AT THESE PATIENTS OVER THE LONGTERM.

FURTHERMORE, I THINK IT'S REALLY IMPORTANT TO KNOW THAT WE NEED TO STUDY LONG COVID.

AND THAT IS WHY THE NATIONAL INSTITUTES OF HEALTH HAS INITIATED RECOVERED TRIAL.

LIKE TO SAY WE'RE HAPPY TO BE PART OF THE RECOVER TRIAL.

DR. CHAU, DR. SHIKUMA I'M ONE OF THE COINVESTIGATORS IN PART OF THE RECOVER TRIAL.

ONCE THAT TRIAL GETS STARTED, BEEN ABLE TO ENROLL PEOPLE AND REALLY SEE HOW WE CAN HELP THESE PATIENTS OVER THE LONG HAUL.

>>Olena: DEFINITELY.

ANGELA, WHEN DID YOU FIRST REALIZE THAT YOU WERE EXPERIENCING LONG COVID SYMPTOMS AND HOW DID YOU CONNECT THE DOTS?

>> ABOUT 30 DAYS ACTUALLY ALMOST TO THE DAY, AFTER I RECOVERED, I NOTICED THAT WITH MY KAPU BREAKERS GROUP, I WOULD GET EXHAUSTED.

GROUP MEMBERS WOULD HAVE TAKE OVER.

I WOULD GET EMOTIONAL AND CRY FOR NO REASON.

AND THEN I STARTED SEARCHING.

MY BACKGROUND IS JOURNALIST.

REPORTER.

SO I'M A LITTLE BIT MORE THE KIND THAT'S GOING TO DIG.

I STARTED DIGGING AND FOUND SOME SUPPORT GROUPS ON FACEBOOK AND SOCIAL MEDIA AND AS SOON AS I STARTED READING PEOPLE'S COMMENTS, WAIT A SECOND.

THIS IS 100% WHAT I HAVE.

TO SHARE THOSE STORIES AND TO DIG UP THAT INFORMATION, WAS AN EYE‑OPENER.

>> KIND OF SCARY.

TIMES WHEN I WAS ALSO IN DENIAL.

I THOUGHT THAT I WAS MUCH BETTER.

VACCINE DID HELP ME A LITTLE BIT.

BUT IT WAS THE MEMORY PROBLEMS AND EXHAUSTION THAT JUST STUCK WITH ME.

WHEN I WENT TO GO BACK TO WORK, AND I THOUGHT I COULD DO IT, I LASTED FOR ABOUT A MONTH.

AND I COULDN'T DO IT ANY MORE.

I HAD TO LEAVE MY JOB.

SO IT'S BEEN A LONG JOURNEY BUT YEAH, JUST ABOUT EXACTLY WHAT THE DOCTORS ARE ALL SAYING ABOUT 30 DAYS AFTER, DIAGNOSIS WHEN I STARTED TO GET BETTER IS WITH THE SYMPTOMS CAME ON.

>>Olena: ANTHONY FROM FACEBOOK ASKED A QUESTION.

WOULD MICROBLOOD CLOTS EXPLAIN MANY OF THE LONG COVID AILMENTS?

>> CERTAINLY ONE OF THE THEORIES THAT'S BEEN PROPOSED.

MANY OF YOU MIGHT KNOW THAT WHEN YOU GET A CUTE COVID, OR A COVID INFECTION, YOUR BODY IS MUCH MORE PRONE TO FORMING BLOOD CLOTS.

AND WE'VE SEEN LOTS OF THAT AS WE MANAGED THESE PATIENTS.

CERTAINLY, ONE OF THE THEORIES THAT'S BEEN PUT FORTH IS THAT YOU HAVE BOTH LARGE CLOTS BUT ALSO SMALL CLOTS FORMING THROUGHOUT THE BODY.

IN SOME OF THESE TISSUES.

THE DAMAGE CAUSED BY THOSE LITTLE BLOOD CLOTS IS PERPETUATING SOME OF THESE SYMPTOMS.

STILL A THEORY.

NOT CERTAINLY ABSOLUTELY PROVEN.

BUT CERTAINLY, PEOPLE ARE INVESTIGATING THAT AS A POTENTIAL EXPLANATION.

>>Olena: WE HAVE ANOTHER VIEWER QUESTION.

DOES THE PANEL THINK WE'LL BE ABLE TO SAFELY GO WITHOUT MASKS SOON?

PERHAPS IF YOU WANTED YOUR THOUGHTS ON MASK‑WEARING AS WELL.

>> I THINK MASK‑WEARING, IT'S ALL ABOUT MITIGATING YOUR RISK.

CERTAINLY, EARLY ON RISK OF SOCIETY BECAUSE OF THE ABUNDANCE OF THE PEOPLE WHO WERE NEEDING HEALTH CARE SERVICES, INUNDATING OUR HOSPITALS.

BUT I THINK MASKS DO PROTECT THE INDIVIDUAL.

MAY PROTECT THE PEOPLE AROUND THEM AS WELL.

IF COMPROMISE, CHRONIC ILLNESS, COMPROMISE DRUGS, I THINK YOU ERR ON THE SIDE OF BEING SAFER BY WEARING MASK.

NEGATED TO A POINT WHERE MASK MANDATES COMING DOWN ACROSS COUNTRY.

PEOPLE STARTING TO FEEL BETTER THAN THEY'VE BEEN BOOSTED.

>> UP TO DATE WITH COVID‑19 VACCINE AND BOOSTERS.

STARTING TO FEEL MORE RESISTANT TO GETTING INFECTION.

IT DOES BOIL DOWN TO PERSONAL RISKS.

DECIDING WHEN YOU WANT TO TAKE THAT RISK.

ESPECIALLY IF YOU'RE LIVING WITH PEOPLE UNVACCINATED.

SMALL CHILDREN, NOT VACCINATED, YOU DON'T WANT TO CARRY THAT VIRUS HOME.

>> RISK GETTING LONG COVID SYNDROME IS A LOT LESS AMONG VACCINATED PEOPLE THAT HAVE SO‑CALLED BREAKTHROUGH INFECTIONS.

PEOPLE IMMUNIZED, 2 OR 3 SHOTS DEVELOP COVID INFECTION.

A LOT LESS LIKELY TO DEVELOP THIS LONG HAUL SYNDROME.

SO FAR AS WE'VE SEEN.

WHICH IS ENCOURAGING.

IT CERTAINLY GIVE IT IS THE SAME IDEA THAT THINGS WE CAN TO DO TO PROTECT OURSELVES FROM GETTING INFECTION IN THE FIRST PLACE.

IF YOU DON'T GETTEN INFECTION, YOU CAN'T GET THE LONGTERM SEQUELAE.

>> IMPORTANT TO KNOW THAT EVEN DESPITE VACCINATION, YOU CAN DEVELOP LONG COVID.

THE RISK IS DEFINITELY LESS IF YOU HAVE BEEN VACCINATED.

REALLY GOOD STUDY DONE BY ANTONELLI LOOKED AT IN THE U.K., LOOKED AT THERE WAS A REDUCTION IN THE AMOUNT OF LONG COVID SYMPTOMS IN THOSE INDIVIDUALS WHO WERE VACCINATED.

SO I THINK AS DOCTORS HAVE BEEN SAYING.

HOW DO YOU LESSEN YOUR RISK?

WEARING A MASK WILL LESSEN YOUR RISK.

GETTING VACCINATED AND SUBSEQUENTLY BOOSTED WILL LESSEN YOUR RISK.

I THINK DOING ALL OF THESE THINGS IN COMBINATION REALLY GOOD FOR NOT ONLY FOR THE INDIVIDUAL, BUT FOR ALL THE PEOPLE AROUND US IN OUR COMMUNITY.

>>Olena: ANGELA, WHAT KIND OF PROCESS DID YOU GO THROUGH TO TRY TO TREAT YOUR LONG COVID SYMPTOMS?

>> I'VE BEEN THROUGH EVERYTHING I COULD TRY.

I DID DO A LOT OF RESEARCH.

AS A MEDICAL REPORTER BACK IN THE DAY.

TELL MY VIEWERS THAT HAVE TO BECOME THEIR OWN EXPERT.

I'M SOMEBODY WHO HAPPENS TO LIKE READING MEDICAL JOURNALS THAT'S SOMETHING I WAS DOING.

I LOOKED AT ALL DIFFERENT KINDS OF THINGS.

DIET.

WHICH I'M ON AS ANTI‑INFLAMMATORY THING.

I DID WELL AND THAT HELPED WITH MY E AND T ISSUES AND EARS.

BIGGEST THING FOR ME WAS MY BRAIN.

SO WHEN I FOUND WAS REPETITIVE MEDICAL STIMULATION.

NOT INVASIVE.

HELP PEOPLE WITH MEMORY PROBLEMS.

BRAIN FOG, FORGETFULNESS, CONCUSSION, AND WHEN I WENT TO DOCTOR AT BRAIN HEALTH HAWAII, TOLD ME IT'S LIKE I HAVE A CONCUSSED BRAIN.

I HAD CONCUSSION.

PROBABLY I'M GUESSING FROM ALL THE INFLAMMATION.

I'VE GONE THROUGH TREATMENTS NOW SINCE OCTOBER.

I WAS AT THE HIGHEST DEMENTIA OR NOT DEMENTIA.

DEPRESSION AND LOW DEMENTIA THAT I COULD EVER GET.

AND SINCE GETTING TREATED EVERY DAY WITH REPETITIVE TMS, I HAVE KNOCKED MY DEPRESSION TO 0.

MY BRAIN ACTIVITY IS COMING BACK.

AND HE HAS THIS UNIQUE WAY THAT NOBODY ELSE DOES.

SUCH A BRAIN IAC.

REALLY.

THAT IS MY EEG'S AND BRAIN SCANS WEEK LIMIT TWEAKS MY TREATMENT AS THOUGH IT'S LIKE A PRESCRIPTION.

I CAN SEE THE SQUIGGLE LINES COMING IN AREAS WHERE IT WASN'T ACTIVE BEFORE.

SO THE LAST PART THAT I NEED TO DO IS MY FRONTAL BRAIN.

FRONTAL LOBE.

THAT'S WHAT WE'RE WORK ON RIGHT NOW.

NICE TO BE ABLE TO GET UP IN THE MORNING, I WANT TO EXERCISE, GET OUT OF BED AND DO THINGS AND LIVE LIFE FOR THE FIRST TIME IN 18 MONTHS.

I WOULD SAY THAT THE BIGGEST HELP FOR ME WAS THE REPETITIVE STIMULATION.

>>Olena: CONGRATULATIONS.

TO THE DOCTORS ARE THERE ANY OTHER TYPES OF TREATMENT THAT YOU WOULD RECOMMEND AS WELL?

>> I THINK IMPORTANT MESSAGE IS FIND A DOCTOR LISTENS TO YOU AND WORKS WITH YOU TO DEVELOP ADVISED PLAN.

IMPORTANT.

BECAUSE SOME PEOPLE, BRAIN FOG IS KEY LONGTERM SYMPTOM.

OTHERS IT'S THE TACHYCARDIA.

THAT THEY HAVE.

WHEN THEY STAND UP.

OTHERS SHORTNESS OF BREATH.

FATIGUE.

SO EACH OF THOSE SYNDROMES HAVE CERTAIN REHABILITATION AND CERTAIN DEVICES THAT MECHANISMS THAT WE LOOKED AT.

ALL OF THESE THINGS BEING STUDIED.

NOT ONE SIZE FITS ALL THE SO IMPORTANT THAT REALLY INDIVIDUALIZING THE TREATMENT PLAN, AND ALSO, GETTING INVOLVED IN STUDIES, I THINK REALLY, THAT IS ONE OF THE REALLY IMPORTANT THINGS IS BE A PART A STUDY.

SO THAT WE CAN HELP YOU.

WE CAN FIND THINGS THAT WILL HELP YOU IN THE END.

>>Olena: ANY OTHER IDEAS OR THINGS YOU'RE DOING AT THE MOMENT?

>> I THINK THE ONE THING TO REMEMBER IS WHEN YOU'RE DEALING WITH A SYNDROME LIKE LONG COVID.

DIFFERENT FOR EVERYBODY.

EVERYBODY IS GOING TO NEED A DIFFERENT TREATMENT.

I THINK IT'S REALLY HARD.

YOU REALLY NEED TO FIND A PARTNER IN A PROVIDER, PROVIDER TEAM TO WORK WITH.

BECAUSE WHAT WORKS FOR ONE PERSON, MAY NOT WORK FOR ANOTHER.

INTERESTING.

SOME OF THE STUDIES OF PEOPLE WITH LONG COVID YOU FIND ACTUALLY DO WORSE WHEN THEY DO MORE EXERCISE, FOR INSTANCE.

AND I THINK INTUITIVELY, YOU MIGHT SAY OH, GOSH I'M REALLY FATIGUED.

>> GUESS I NEED TO PUSH MYSELF HARDER BUT THAT MAY NOT BE THE THING TO DO.

REALLY DRIVES HOME THE FACT THAT THIS IS, ONE, SYNDROME, DISEASE THAT WE DON'T UNDERSTAND VERY WELL.

AND TWO, SOMETHING THAT REALLY MANIFESTS IN DIFFERENT.

NEEDS PERSONALIZED APPROACH TO CARE.

>>Olena: DO YOU THINK BODY WAS NOT QUITE READY YET?

>> IT'S HARD TO SAY.

IF THERE'S ANYTHING THAT THIS WHOLE PANDEMIC HAS DEMONSTRATED TO US, HOW LITTLE WE UNDERSTAND ABOUT THE BODY.

I CAN'T TAKE ANY COVID PATIENT THAT I TAKEN CARE OF AND PREDICT WHICH ONES ARE GOING TO HAVE LONG HAUL SYMPTOMS AND WHICH SYMPTOMS THEY'RE GOING TO HAVE.

SO FOR US, IT'S BEEN VERY HUMBLING AS A CARE PROVIDER.

>>Olena: I SEE YOU NODDING YOUR HEAD.

>> FOR ME, TRIAL AND ERROR BEGINNING.

I WORKED WITH THERAPISTS.

PSYCHIATRISTS.

PCP.

AND I WENT THROUGH SIX DIFFERENT MEDICATION.

PSYCH MEDICATIONS ADHD MEDICATIONS TO SORT OF TRY TO WAKE UP MY BRAIN.

REALIZING THAT MY BRAIN DOCTOR, DR. KIEFER, SAYS YOU GOT CONCUSSED BRAIN.

CAN'T WAKE UP NEURONS.

THROW ALL THE ADDERALL AND STIMULANTS AND COFFEE YOU WANT NOT GOING TO WAKE UP YOUR BRAIN.

THAT'S WHY I WENT TO THIS TREATMENT.

AFTER FAILING THOSE MEDICATIONS.

I TALKED TO SO MANY LONG HAULERS SAY BEEN ON THE PSYCH MEDS.

BEEN ON ADDERALL.

TRIED COFFEE.

JUST THEY'RE JUST NOT GETTING ANY WHERE.

SO REALLY TO DO TRIAL AND ERROR, SO FAITH IN YOUR POSITIONS, LOOK AT ALL DIFFERENT AVENUES AND BE OPEN TO WHATEVER YOU CAN.

TO HELP YOURSELF GET BETTER, AND THE OTHER THING IS WHEN YOU HAVE SPURT OF ENERGY WHICH MANY OF US LONG HAULERS DO, WE GO AND CLEAN OUR HOUSE.

DO THE DISHES.

WE MAKE THE BED.

WE FEEL AMAZING BECAUSE WE HAVE ONE GREAT DAY AND THEN TOMORROW, FLAT OUT IN THE BED.

BECAUSE WE OVERDID IT.

SO PEOPLE REALLY HAVE TO PACE THEMSELVES.

>>Olena: TAKE IT EASY.

HAVE KIND OF LENGTHY QUESTION FROM MAPUANA FROM FACEBOOK.

SAYS, I AM AT A MONTH AFTER INFECTION AND STILL STRUGGLING.

WAS FULLY VACCINATED.

AND BOOSTED AND GOT INFECTED AROUND MY 3 MONTH MARK.

STILL STRUGGLING PHYSICALLY.

SHE'S MOST WORRIED ABOUT HER 3‑YEAR‑OLD UNVACCINATED AND ALSO INFECTED WITH A HIGH FEVER.

ANY TREATMENTS FOR TODDLERS?

ALSO BEEN TOLD THAT TODDLERS HAVE BEEN ADVISED TO TAKE OVER THE COUNTER MEDICINE FOR CHILDREN.

WHAT WOULD YOU GUYS RECOMMEND?

>> MIGHT BE ONLY PEDIATRICIAN ON THE LINE HERE.

UNFORTUNATELY, THERE'S NOT A WHOLE LOT THAT WE HAVE TO OFFER.

YOU HEAR ABOUT ALL OF THESE NEW THERAPIES THAT ARE BEING DEVELOPED ANTIBODY THERAPIES.

HAVEN'T BEEN APPROVED OR STUDIED 3‑YEAR‑OLDS.

LARGELY LEFT WITH SIMPLY WHAT WE CALL SUPPORTIVE CARE.

GIVING MEDICINES TO KEEP THE FEVER DOWN WHEN THEY HAVE A FEVER.

LETTING THEM SLEEP.

STAYING WELL HYDRATED.

KIDS ARE LESS RISK OF DEVELOPING LONG COVID.

THERE'S CERTAINLY SOME SMALL PERCENTAGE OF CHILDREN THAT DO.

BUT YOU KNOW, MY HEART GOES OUT TO YOU.

REALLY TOUGH SPOT TO BE IN FOR YOU.

BOTH FEELING SICK YOURSELF BUT ALSO, WORRY BEING YOUR CHILD.

I WISH I COULD SAY THAT WE HAD ARMY OF THERAPIES THAT WERE APPROVED FOR 3‑YEAR‑OLDS, WE DON'T EVEN HAVE A VACCINE FOR THEM AT THIS POINT.

SO THIS IS FOR PARENTS OF KIDS OVER THE AGE OF FIVE, SCARY TIME.

>>Olena: DAN FROM IT KAILUA.

IS THERE A SPECIFIC AGE GROUP THAT MAY BE MORE PRONED TO LONG COVID?

>> SHORT ANSWER, REALLY, NO.

WE SEE LONG COVID IN MANY INDIVIDUALS.

WE ALSO KNOW THAT IF YOU HAVE UNDERLYING HEALTH ISSUES, AS WELL, YOU MAY BE AT INCREASED RISK.

SO REALLY, LIKE DOCTOR SAID, REALLY WISH WE COULD PREDICT WHO WOULD GET LONG COVID AND WHO WOULD NOT.

>>Olena: DOCTOR?

>> NO, I THINK THE POINT IS AS DOCTOR SAID EARLIER, LARGE STUDIES LIKE RECOVERY TRIAL GOING TO ANSWER EXACTLY THAT.

WHAT IS THE CERTAIN PREDISPOSITION FOR SOME INDIVIDUALS TO DEVELOP COVID LONG HAUL SYNDROME COMPARED TO OTHERS.

SOMETHING THAT IS GENETIC.

BASED ON IMMUNE SYSTEM?

WE JUST DON'T KNOW THE ANSWER YET.

>>Olena: ANOTHER QUESTION.

C.J.

IN HONOLULU ASKING.

HAS THE PANEL SEEN LONGTERM EFFECTS IN OTHER VIRAL DISEASES, FOR EXAMPLE, H1N1.

>> AS I MENTIONED EARLIER, FIRST TIME STARTED TO DEVELOPED.

LIKENED TO OTHER SYNDROME.

CHRONIC DISEASE SYNDROME.

POST FATIGUE SYNDROME.

OTHER INFECTIONS WITH OTHER INFECTION.

INTENSITY AND NUMBER OF INDIVIDUALS AFFECTED NOW, BROUGHT IT TO A WHOLE NEW LEVEL.

REALLY REQUIRES A LOT MORE STUDY.

>>Olena: AND I THINK WE MAY HAVE ANSWERED THIS EARLIER.

FACEBOOK SAYS, HOW DO YOU KNOW IF THE SYMPTOMS ARE INDEED LONG HAUL COVID OR IF IT'S JUST SOME OTHER AILMENT OR DISEASE PRESENTING ITSELF?

>> HARD TO ANSWER THAT.

WE HAVE CRITERIA FOR MAKING DIAGNOSIS.

TYPICALLY, HAVE YOU TO BE BEYOND A CERTAIN PERIOD OF TIME FROM YOUR INFECTION.

VERY OFTEN PEOPLE WILL ALSO GET A LAB TEST TO SHOW THAT YOU HAVE HAD ANTIBODIES AGAINST THE VIRUS.

AS AN INDICATION YOU WERE PREVIOUSLY INFECTED.

YEAH, TYPICALLY, IT'S BEYOND FOUR WEEKS AFTER YOUR PRIMARY INFECTION THAT YOU BEGIN TO THINK THAT THIS COULD BE LONG HAUL COVID AS OPPOSED TO NEW INFECTION.

IT DOESN'T MEAN, I THINK IT'S INCREDIBLY REASONABLE TO GO TO YOUR DOCTOR AND SAY, I'M NOT FEELING VERY WELL.

WE CERTAINLY HAVE A VARIETY OF OTHER THINGS WE CAN TEST FOR.

OTHER VIRAL AND BACTERIAL INFECTIONS.

IN THE ABSENCE OF HAVING SLAM DUNK DIAGNOSTIC TEST TO SAY, THIS IS LONG COVID, OFTEN IT'S WHAT WE CALL DIAGNOSIS OF EXCLUSION.

RULE OUT OTHER THINGS AND ARE LEFT WITH THE FACT THAT WE KNOW THAT YOU HAD A COVID INFECTION.

WE CAN DOCUMENT THAT WITH BLOOD WORK.

VERY LIKELY SYMPTOMS ARE CONSISTENT WITH.

>> IMPORTANT TO REMEMBER THAT JUST BECAUSE COVID HAPPENED ALL THE OTHER DISEASES HAD A CAUSED THESE SIMILAR SYMPTOMS ARE STILL OUT THERE.

PART OF THE WAY COVID LONG HAUL OR NOT, ELIMINATE OTHER MORE COMMON DISEASES WE'LL BEEN DEALING WITH ALL ALONG.

>>Olena: HOW WOULD YOU TEST FOR SOME OF THOSE OTHER DISEASES?

>> CERTAINLY, IF YOU'RE WORRIED ABOUT SHORTNESS OF BREATH, CARDIAC EVALUATIONS, STUDIES, LOOKING FOR ANEMIA, LAB WORK, A LOT OF THINGS WE CAN DO TO LOOK FOR THOSE OTHER CONDITIONS.

THEN DECIDE THIS MAY ACTUALLY BE POST COVID SYNDROME.

>>Olena: ANGELA, YOU WERE TALKING ABOUT BOUTS OF DEPRESSION AND FINDING OTHER GROUPS OF PEOPLE WHERE YOU IDENTIFY YOURSELF.

THAT'S ME!

WHAT DID YOU LEARN FROM DISCUSSING THESE THINGS WITH THE GROUPS AND WHAT KIND OF ADVICE DO YOU HAVE FOR CARETAKERS AND CAREGIVERS?

>> WOW, IT WAS INTERESTING BECAUSE WHEN WE STARTED SHARING STORIES AND WE FOUND SIMILARITIES WE LOOKED AT THOSE TIMELINES.

SO FOR ME, IT WAS THE FIRST WEEK OF MARCH, 2020.

AND THOSE WHO HAVE COVID AROUND THE SAME TIME, ALL HAD THE SAME SIMILAR SYMPTOMS.

I WOULD GET MESSAGES, DM'S FROM FORMER COLLEAGUES, FRIENDS, HEY, I HAD COVID.

I KNOW YOU HAD COVID.

WHAT IS GOING ON?

THAT IT IS REALLY INTERESTING.

BUT CAREGIVER, I WOULD SAY, PATIENCE.

ESPECIALLY WITH THE BRAIN ISSUES, DEPRESSION, I DON'T THINK, NO, I KNOW FOR SURE IN MY LIFE, I'VE PRETTY MUCH ALWAYS BEEN A HAPPY PERSON AND TO BE THAT LOW, TO BE THAT HEIGHT OF DEPRESSED, AND READY TO CHECK MYSELF INTO THE MENTAL WARD, I JUST CAN'T BELIEVE IT.

TO KNOW THAT THERE IS SOMEBODY BY THEM THAT CARING FOR THEM, THAT PATIENT, THAT ALOHA, THAT JUST UNDERSTANDING THAT FITS APP.

DRY SPELLS HAPPEN.

FRUSTRATION HAPPENS.

YOU FEEL LIKE YOU'RE JUST NEVER GOING TO GET BETTER.

THIS IS ALWAYS THAT MONKEY ON YOUR BACK YOU'RE TRYING TO GET RID OF.

SO THAT YOU CAN GET BACK TO LIFE.

I THINK REALLY FOR THE CAREGIVERS, IT'S ABOUT PATIENCE.

FOR THOSE SEEKING TO SHARE THEIR INFORMATION.

LOOK FOR PEOPLE LIKE YOURSELF HAVE SO.

SAME SYMPTOMS.

SO YOU CAN COLLABORATE TOGETHER.

CAMARADERIE AND SHARE YOUR IDEAS WHAT WORKED FOR YOU.

>>Olena: WE HAVE GRAPHICS WE CAN PRESENT TO YOU GET TO TREATMENT.

FACILITIES ON ISLAND TO CALL OR SEE A DOCTOR.

I WANTED TO ASK, IF YOU HAVE LONG COVID, WOULD YOU BE CONSIDERED CONTAGIOUS AT ALL?

>> NO.

NO.

WHEN YOU HAVE LONG COVID, FIRST OF ALL, WE DON'T KNOW THE EXACTLY MECHANISM WHICH IS CAUSING LONG COVID.

BUT WE DO THINK THERE ARE MANY THEORIES.

ONE THEORY IS ARE THERE MICROCLOTS CAUSING THE BRAIN FOG?

OTHER THEORIES AUTO ANTIBODIES DIRECTED TO OTHER PARTS OF YOUR OTHER CELLS OR OTHER AREAS OF YOUR BODY THAT COULD BE CAUSING YOUR SYMPTOMS.

>> SO I THINK THAT THE REAL THING IS NO, YOU'RE NOT GOING TO BE CONTAGIOUS PER SE WITH YOUR LONG COVID SYMPTOMS.

>>Olena: OKAY.

GOOD TO KNOW.

I'M SURE SOME PEOPLE ARE COUGHING.

FAMILY MEMBERS MIGHT BE CONCERNED.

WE HAVE ANOTHER QUESTION.

PEDRO FROM HONOLULU.

WHAT SHOULD BE THE COURSE OF ACTION IF ONE BELIEVES THAT THEY HAVE LONG COVID?

>> DISCUSSION WITH YOUR PHYSICIANS FIRST THING TO DO.

SEE IF YOU NEED HELP FROM OTHER SPECIALISTS.

WHAT THE SYMPTOMS ARE.

THAT DIALOGUE HAS TO BEGIN WITH YOUR PHYSICIAN.

>>Olena: HOW OFTEN ARE LOCAL DOCTORS SEEING THAT OR HEARING THAT?

>> I'LL LET THE LOCAL DOCTORS ANSWER.

>> I THINK MAIN THING IS JUST AS DOCTOR, IF YOU ARE HAVING SYMPTOMS OVER FOUR WEEKS AFTER YOUR INITIAL INFECTION, REALLY NEED TO HAVE THAT CONVERSATION WITH YOUR PHYSICIAN.

>> BOOK AN APPOINTMENT.

SEE THAT PHYSICIAN.

REALLY RELATIONSHIP THAT YOU HAVE WITH YOUR PRIMARY CARE DOCTOR.

AND THEN AFTER THAT, ANY OTHER SPECIALISTS THAT COME ON BOARD, THAT ARE SPECIFIC TO WHAT YOUR SYMPTOMS ARE.

>>Olena: SO ARE YOU ‑‑ >> I THINK I WANT TO EMPHASIZE, I THINK AS I THINK I READ SOMEWHERE, WE'VE HAD UPWARDS OF 100,000 CASES IN THE LAST MONTH ALONE.

IF YOU THINK ABOUT THOSE NUMBERS, THAT MEANS EXPECT TO SEE 15, 20,000 NEW CASES OF LONG COVID HERE IN THE ISLANDS OVER THE NEXT MONTH.

AND SO YOU WON'T BE ALONE IF YOU'RE FEELING THIS WAY.

AND YOUR DOCTOR IS VERY LIKELY SEEN LOTS OF OTHER PEOPLE WITH IT.

SO EVERYBODY IS BASICALLY PUTTING IN PLACE SYSTEMS AND SETTING UP CLINICS AND BASICALLY, CREATING INFRASTRUCTURE FOR TAKING CARE OF YOU.

BECAUSE IT'S GOING TO BE JUST AS MUCH PANDEMIC OF PEOPLE SUFFERING FROM THIS AS IT IS FROM THE ACUTE INFECTION.

>>Olena: WOULD YOU SAY THAT THERE ARE ANY PARTICULAR VARIANTS MORE PRONED TO LONG COVID.

>> I DON'T THINK WE HAVE INFORMATION.

ESPECIALLY NOW WITH THE RECENT OMICRON VARIANT, WE DON'T KNOW IF THAT'S GOING TO HAVE INCREASED LONG COVID SYMPTOMS OR NOT.

>>Olena: WHAT KIND OF ADVICE WOULD YOU HAVE FOR PEOPLE WHO WERE DIAGNOSED WITH COVID‑19 SHOULD THEY BE ON LOOKOUT ABOUT 3 WEEKS LATER?

GO ON WITH THEIR LIVES?

TAKE THINGS SLOW?

>> I THINK YOU WANT THEM TO BE ATTENTIVE TO SYMPTOMS.

I WOULD HOPE THEY DON'T DWELL ON THE FACT THAT THEY'RE GOING TO GET LONG COVID.

I THINK IT'S IMPORTANT TO RECOGNIZE SYMPTOMS.

IF THEY PERSIST BEYOND WHAT SEEMS NORMAL TO THEM, AGAIN, DISCUSSION WITH YOUR DOCTOR.

REALLY WHERE YOU WANT TO START.

>>Olena: OKAY.

SO ANGELA, OBVIOUSLY, THIS HAS BEEN SUCH A CHALLENGING TIME FOR YOU.

WOULD YOU SAY THAT HAD AN IMPACT ON YOUR FAMILY AND WHAT KIND OF THINGS DID YOU DO TO TRY TO OFFER SUPPORT FOR THEM AS WELL?

>> OH, GOSH.

SO STRESSFUL.

I THINK PROBABLY MY HUSBAND GETTING ANGEL WINGS.

BECAUSE HE'S DONE SUCH AMAZING JOB OF PUTTING UP WITH ME.

PUTTING ONE MY DEPRESSION.

MY VERY MUCH NEEDINESS.

MY FAMILY HAS BEEN NOTHING BUT SUPPORTIVE.

MY COMMUNITY GROUP, KAPU BREAKERS GROUP INCREDIBLE TAKING OVER ON DAYS THAT I COULDN'T.

I THINK THERAPY IS REALLY IMPORTANT.

NOT JUST FOR PATIENTS, BUT FOR FAMILY MEMBERS.

AND TO SHARE NEWS ARTICLES.

TO SHARE EXPERIENCES.

IT WASN'T UNTIL MY HUSBAND SAW MY BRAIN SCANS, MY BRAIN MAPS, MY EEG, THAT HE UNDERSTOOD REALLY HOW DAMAGED, HOW MANY ISSUES WERE GOING ON WITH MY BRAIN.

SO NOW, I'M HEARING ALL KIND OF SOUNDS I DIDN'T NOTICE BEFORE.

YEAH, THERAPY, PATIENTS, TALKING IT THROUGH AND SHARING INFORMATION.

>>Olena: WONDERFUL.

WITH THE AMERICAN LUNG ASSOCIATION, WHAT KIND OF CHANGES HAVE YOU SEEN WITH COVID‑19 PRESENTED ITSELF AND WHAT KIND OF THINGS CAN YOU DO IF YOU'RE A VOLUNTEER FOR AMERICAN LUNG ASSOCIATION OR HOW CAN PEOPLE HELP.

>> INCREASED FUNDING AROUND COVID‑19.

ACCUSE ANALYSIS SUPPORTING SEVERAL NIH STUDIES FOR LONG COVID.

JUST MENTIONED, SUPPORT GROUPS ARE IMPORTANT.

DEVELOPED ONLINE SUPPORT GROUPS.

LUNG.ORG THROUGH THE INSPIRE PLATFORM.

PEOPLE CAN SHARE THEIR STORIES.

PATIENTS LEARN A LOT FROM OTHER PATIENTS.

LISTEN TO THEIR DOCTORS BUT LISTEN TO PATIENTS VERY WELL.

IMPORTANT MESSAGE TO GET OUT.

GOOD INFORMATION.

NOT ALL THE INFORMATION IS IN HOWEVER.

WE NEED TO STUDY MORE.

SUPPORTING THE RESEARCH.

SUPPORTING THE INDIVIDUALS WITH WEBSITE INFORMATION.

AND THE SUPPORT GROUPS REALLY WHERE WE'RE FOCUSING OUR EFFORTS.

>>Olena: YOU WERE NODDING ALONG THERE.

>> ABSOLUTELY.

IT'S REALLY IMPORTANT, ONE, RELATIONSHIP, WITH YOUR PHYSICIAN.

TWO, GETTING INVOLVED IN ANY CLINICAL TRIALS THAT ARE COMING ONLINE.

REGARDING LONG COVID.

WE PART OF THE RECOVERED, OTHER TRIALS THAT ARE GOING TO BE OUT THERE.

GET INVOLVED.

BECAUSE ULTIMATELY, THE MORE INFORMATION THAT WE CAN GET ABOUT THIS DISEASE, THE MORE WE CAN HELP.

AND I THINK THAT IS THE BIGGEST MESSAGE IS WE ALL, THE WHOLE MEDICAL COMMUNITY, REALLY WANTS TO HELP OUR PATIENTS GET OVER THIS.

BECAUSE THIS IS TRAGIC.

IT'S HEARTBREAKING.

TO SEE LIKE ANGELA STORY, WHAT SHE'S BEEN GOING THROUGH DURING THIS.

IT BREAKS ALL OF OUR HEARTS AS PHYSICIANS.

WE REALLY NEED TO BE THERE FOR OUR PATIENTS.

AND WE REALLY NEED TO LEARN MORE ABOUT THIS DISEASE.

>>Olena: WHAT IF SOMEONE IS APPREHENSIVE ABOUT REACHING OUT TO THEIR DOCTOR BECAUSE THEY DON'T THINK IT'S ALL THAT SERIOUS AND THEY DON'T WANT TO TAKE TIME AWAY FROM OTHER PATIENTS THAT MIGHT BE MORE SERIOUS?

>> OH, GOSH.

I REALLY WOULD SAY PLEASE, PLEASE, WE DON'T WANT TO SEE YOU SUFFER.

WHILE I KNOW WE'RE ALL SITTING HERE SAYING GOSH, WE DON'T KNOW WHY IT HAPPENS.

WE DON'T KNOW HOW IT HAPPENS.

BUT IT ALSO MEANS WE'RE REALLY MOTIVATED TO HELP YOU TO TRY AND UNDERSTAND.

WITH THE SUPPORT OF GROUPS LIKE AMERICAN LUNG ASSOCIATION, AND THE CLINICAL TRIALS THAT ARE ONGOING.

YOU KNOW, I THINK IT'S SUCH AN IMPORTANT THING FOR US TO LEARN FROM, AND TO TRY AND HELP YOU.

SO PLEASE, COME AND SEE US.

I KNOW THAT HAWAII DOESN'T HAVE ENOUGH DOCTORS.

AND I KNOW SOMETIMES IT CAN BE HARD TO GET IN TO SEE SOMEBODY.

HONESTLY, IT'S INCUMBENT ON US TO TRY AND HELP YOU.

THAT'S WHY WE ALL GOT INTO THIS FIELD.

WE'LL DO THE BEST WE CAN.

YOUR HEALTH MATTERS SO MUCH TO US.

TELEHEALTH IS HELPFUL.

IF YOU WANT TO MESSAGE YOUR DOCTOR EMAILING AND ALSO ASKING ADVICE NURSE FOR SOME THINGS.

>> AMAZING HOW PANDEMIC HAS ADVANCED TELEHEALTH THE WAY THAT IT HAS.

IT'S NOT PERFECT.

WE ALL MISS SEEING PATIENTS IN PERSON.

BE ABLE TO SEE THEM AT ALL HAS BEEN GOOD AND I THINK IT'S HELPED PEOPLE BE ABLE TO ACCESS CARE WHEN EARLY ON IN THE PANDEMIC, WE WERE AFRAID OR TRYING TO AVOID GOING OUT.

TELEHEALTH ADVANCING THAT WAS A REAL ADVANTAGE.

>>Olena: WE HAVE ANOTHER VIEWER QUESTION.

CONSTANCE FROM THE BIG ISLAND.

SHE SAYS, VIEWER RECEIVED SEVERE REACTION FROM THE PFIZER VACCINE AND DOES NOT HAVE COVID BUT HAS THE SYMPTOMS OF LONG COVID.

ARE THERE ANY OTHER PEOPLE EXPERIENCING THIS?

HAVE YOU HEARD OF THIS BEFORE?

PERHAPS?

>> I'VE READ SOME REPORTS WHERE PEOPLE MAY HAVE A REACTION TO THE VACCINE.

CONCERNING FOR BEING SIMILAR TO LONG COVID.

I HAVEN'T SEEN THAT PERSONALLY MYSELF.

SO I'M CERTAINLY NOT GOING TO DISCOUNT SOMEBODY'S EXPERIENCE.

I KNOW THAT WE'VE GIVEN BILLIONS OF DOSES OF THE VACCINE AND IT'S GENERALLY WELL TOLERATED.

BUT THIS IS A NEW DISEASE AND ANYTHING IS POSSIBLE.

SO I CERTAINLY NOT CARED FOR ANYBODY WHO DEVELOPED SYMPTOMS AS A FUNCTION OF THE VACCINE.

BUT I'VE HEARD IT INTO COULD BE LIKELIHOOD THAT THE PERSON GOT A FALSE NEGATIVE PERHAPS?

>> ENTIRELY POSSIBLE.

>>Olena: JAN FROM PEARL CITY SAYS, VIEWER'S HUSBAND DEVELOPED PULMONARY FIBROSIS FROM LONG COVID.

NO CURE.

WHAT TREATMENT SHOULD THEY DO?

ALREADY SEEING A DOCTOR.

>> I THINK, ONE OF THE BIGGEST THINGS WITH PULMONARY FIBROSIS, REALLY IS SCARRING OF THE LUNGS DUE TO THE VIRUS ITSELF, AND WITHOUT KNOWING MORE ABOUT WHAT HAPPENS, WE DO SEE A SCARRING OF THE LUNGS IN PEOPLE WHO HAVE BEEN HOSPITALIZED PUT ON VENTILATOR MACHINES.

CONDITION KNOWN AS ACUTE RESPIRATORY DISTRESS SYNDROME OR ARDS.

AND WE SEE THAT.

AT THIS TIME, IT'S PART OF IT IS TIME.

THERE ARE SOME CLINICAL TRIALS IN FRANCE AND IN CHINA LOOK AT SOME OF OUR MEDICATIONS FOR INTERSTITIAL LUNG DISEASE IN THESE PATIENTS.

ONGOING TRIAL.

>> COMMENT FROM A VIEWER.

SAYING RECOVERY STUDY OPEN AT THE UNIVERSITY OF HAWAII MEDICAL SCHOOL.

CHRIS ALSO GAVE A PHONE NUMBER.

AND EMAIL.

COVID‑19HI@GMAIL.COM.

ALSO HAVE ANOTHER QUESTION OR COMMENT.

THERE HAVE BEEN SOME REPORTS THAT THE COVID‑19 PASSES THROUGH THE BLOOD BRAIN BARRIER.

AND IN ADDITION, MAY ATTACK THE VAGUS NERVE.

IS THAT TRUE?

>> I THINK THERE'S A LOT OF THEORIES OUT THERE WHAT'S HAPPENING WITH THE VIRUS BUT RESPONSE TO THE VIRUS.

RELATED TO MICROCLOTS OR RELATED TO THE IMMUNE INFLAMMATION A RESULT OF THAT.

ANY OTHER COULD BE INVOLVED.

I CAN'T SPECIFICALLY SAY ANYTHING ABOUT THAT VAGAL NERVE COMMENT.

UNLESS THE OTHER DOCTORS HAVE SOME INFORMATION.

>> I THINK THERE WAS ARTICLE RECENTLY PUBLISHED LOOKING AT CERTAIN TYPE OF CARDIAC PRESSURE, LOOKING AT THAT.

PERHAPS IT'S DUE TO THE VAGUS NERVE.

I DON'T KNOW MUCH MORE ABOUT THAT.

DO YOU KNOW OF ANY OF THOSE STUDIES?

>> YEAH, I SAW THAT STUDY AS WELL.

YOU KNOW, I THINK ONE OF THE THINGS THAT WE'RE ATTEMPTED TO DO IS TRY TO IDENTIFY A CAUSE AND THEN BE ABLE TO TARGET THERAPY AT IT.

WHAT IS SO HARD WITH HAVING A SYNDROME LIKE THIS.

SO SORT OF VARIOUS IN MANIFESTATIONS.

SO I THINK THE TEMPTING TO WANT TO SAY, OH, IT'S ALL IN THE VAGUS NERVE.

MAYBE WE NEED TO USE A VAGAL NERVE STIMULATER.

SOME OTHER THERAPY TARGET VAGUS NERVE AND GOING TO MAKE EVERYTHING BETTER.

THINK WE HAVE TO BE VERY CAREFUL AND THOUGHTFUL ABOUT HOW WE EVALUATE A LOT OF THIS.

REALLY IS UNCHARTERED TERRITORY.

>> ALSO IMPORTANT TO KNOW THAT I DON'T WANT ANY OF OUR PATIENTS TRYING TO GET INVOLVED WITH NONPROVEN TYPE THERAPIES.

BECAUSE THERE ARE A LOT OF PEOPLE OUT THERE WOULD ARE POTENTIALLY OUT THERE TO SCAM PATIENTS.

WE JUST NEED DO I THINK IT COMES BACK TO THE RELATIONSHIP WITH YOUR PHYSICIAN.

AND TO TRY TO FIND TREATMENTS FOR THE SPECIFIC POST COVID SYNDROME THAT YOU HAVE.

BECAUSE THE LAST THING WE WANT TO DO, HAVE PATIENTS DO, IS TRY REALLY FAR OUT TYPE THERAPIES THAT COULD BE POTENTIALLY HARMFUL.

OR EXTREMELY COSTLY.

FOR THAT INDIVIDUAL.

>>Olena: ANGELA, YOU WERE DIAGNOSED SO EARLY ON.

DURING THE PANDEMIC.

HAVE YOU SEEN AN EVOLUTION OF TREATMENT AND WHATNOT SO FAR?

>> I HAVE.

INTERESTING WHEN YOU TALK ABOUT GADGETS.

I ACTUALLY HAVE A VAGUS NERVE SIMULATOR TO USE AT HOME.

I'M ONE OF THOSE PEOPLE THAT JUST TRY TO THROW SPAGHETTI AT THE WALL AND TRIED TO FIND WHATEVER I COULD.

IT WAS FOR ME NOW, IT'S THE BRAIN TREATMENT THAT I'M GETTING THAT HAS REALLY RESOLVED ALL BITS AND PIECES ALL THE THINGS.

YEAH, I HAVE SEEN EVOLUTION.

I DON'T KNOW IF WE'RE REALLY THERE YET FOR FINDING THE WHOLE EVERYTHING IN A BAG KIND OF THING.

>>All: THE EXPERTS ARE SEARCHING FOR ALL THE LITTLE PIECES THAT CAN HELP EACH INDIVIDUAL PATIENT BECAUSE EACH ONE IS UNIQUE.

EACH ONE HAS DIFFERENT STAGES.

HAS DIFFERENT TYPES OF ISSUES.

EVERYTHING FROM THE HEART ISSUES TO MY BRAIN ISSUES TO EYESIGHT TO ORGANS, HEART RHYTHM.

I MEAN, IT'S JUST SO, SOME, SO MULTIFOCAL AS A PHYSICIAN WOULD SAY.

SO MANY DIFFERENT THING THAT COME TOGETHER.

SO YOU REALLY KIND OF HAVE TO GET THAT GUIDE, NAVIGATOR MEDICAL EXPERT THAT IS GOING TO HELP YOU AND BE YOUR ADVOCATE.

BE AN ADVOCATE FOR YOURSELF.

AND TRY WHAT YOU CAN AS LONG AS IT'S APPROVED.

MINE IS FDA APPROVED.

>> I HAVE NO PROBLEM WITH THAT.

MY INSURANCE PAID FOR IT BECAUSE SO MANY MEDICATIONS.

FOR ME, IT'S NOT ONE SIZE FITS ALL.

I THINK WE'RE GOING TO COME INTO A GENERATION OF LONG HAULERS AND EVENTUALLY, WE WILL FIGURE IT OUT.

JUST LIKE THEY FIGURED IT OUT FOR MS. AND FIBER MYALGIA AND CHRONIC FATIGUE SYNDROME.

CFS AND OTHER CONDITIONS.

JUST KEEP AT IT.

DON'T GIVE UP.

>>Olena: WE ALSO HAVE COMMENT FROM A VIEWER.

I HAVE YET TO HEAR THE PANEL ADDRESS IMPORTANCE OF DIET AND VITAMINS HEALING OURSELVES.

WOULD YOU HAVE ANY RECOMMENDATIONS?

>> I THINK IN GENERAL, WE ALL FEEL THAT THERE ARE CERTAIN KEY THINGS TO BEING HEALTHY.

PROPER SLEEP.

PROPER EXERCISE.

BALANCED NUTRITION.

CERTAIN VITAMINS.

WE KNOW CAN DEVELOP DEFICIENCIES.

I THINK YOU WANT TO BE CAREFUL ABOUT NOT OVERDOING ANY ONE MODALITY THAT IS RECOMMENDED OUT THERE.

SIMILAR TO WHAT THE DOCTOR SAID.

DON'T WANT TO LOOK FOR MAGIC BULLET.

USE COMMON SENSE.

TRUSTED SOURCES AND DO WHAT WORKS FOR YOU.

>>Olena: THANK YOU.

OBVIOUSLY, THIS IS A NEW EXPERIENCE THAT WE'RE ALL GOING THROUGH OF THE LIVING THROUGH THIS PANDEMIC.

CHANGING.

SO I THINK MAYBE BEING PATIENT WITH OURSELVES AND BE PATIENT WITH EACH OTHER.

AND SO DOCTOR, IF COULD YOU TALK A LITTLE BIT ABOUT WHAT YOU'RE SEEING AS FAR AS PATIENTS COMING TO SEE YOU NOW LOCALLY AND WHAT KIND OF TREATMENTS YOU'RE OFFERING.

>> SO I WANT TO BE TOTALLY CLEAR.

MOST OF MY PATIENT CARE IS IN THE HOSPITAL.

I'M TAKING CARE OF PRIMARILY HOSPITALIZE PATIENTS.

SO CERTAINLY, WE'RE SEEING PEOPLE ADMITTED TO THE HOSPITAL WITH COVID.

WE'RE SEEING PEOPLE WHO HAVE HAD COVID PREVIOUSLY.

WHO ARE DEALING WITH THE SEQUELAE OF THAT ON TOP OF THEIR OTHER MEDICAL ILLNESSES.

AND VERY OFTEN, IT'S VERY HARD FOR TO US KNOW HOW TO MANAGE THOSE LONG HAUL SYMPTOMS OTHER THAN SYMPTOMATICALLY.

I THINK DOCTOR MENTIONED, TO IS SORT OF ALL THE OTHER DISEASES THAT WE TAKE CARE OF HAVEN'T GONE AWAY.

SO WE'RE TAKING CARE OF HOSPITALIZED PATIENTS NOW MORE AND MORE OF THEM WHO HAVE A HISTORY OF COVID THAT MAY BE COMPLICATING THE OTHER DISEASES THAT THEY HAVE.

WHETHER IT'S DIABETES OR EMPHYSEMA OR HEART FAILURE.

SO CERTAIN, TRYING TO MANAGE THEM AS EFFECTIVELY AS WE CAN.

BIG PART OF WHAT WE'RE DOING.

MAYBE TALK TO THE DOCTOR AND SEE WHAT YEAR SEEING AT THE CLINICS.

>> SEEING IN CLINICS IS MOSTLY PEOPLE WITH EITHER CHRONIC COUGH, SHORTNESS OF BREATH, AND THEN THE FATIGUE.

FATIGUE IS REALLY MAJOR COMPONENT THAT WE SEE WITH THESE PATIENTS.

AT THIS POINT, WHAT I'M PRESCRIBING REALLY IS HEALTHY DIET, BUT ALSO IS NOT A ONE SIZE FITS ALL.

SOME PEOPLE AS YOU STATED, BEFORE, EXERCISE MAY HELP.

SOME PEOPLE EXERCISE DOESN'T.

AND SO WE NEED TO FIND WHAT IS THE BALANCE FOR THAT INDIVIDUAL AND TRY TO MAXIMIZE.

UNTIL WE HAVE REALLY GOOD PROVEN STUDIES, THAT SHOW ONE MODALITY WORKS OVER NEXT.

I THINK AT THIS POINT, WE NEED TO BE HAVE THAT RELATIONSHIP.

WE NEED TO GET INVOLVED IN STUDIES.

>>Olena: THANK YOU.

AND WE ARE RUNNING OUT OF TIME.

SO JUST WANTED TO ALLOW DOCTOR TO PERHAPS SHARE A FINAL STATEMENT.

>> MAIN THING MAINTAIN GOOD DIALOGUE WITH PHYSICIAN.

TRUSTED SOURCES.

AMERICAN LUNG ASSOCIATION.

LUNG.ORG A GOOD PLACE TO GO FOR INFORMATION.

>>Olena: DOCTOR?

>> I THINK IT COMES BACK TO THE RELATIONSHIP WITH YOUR PHYSICIAN.

REALLY ENCOURAGE THAT RELATIONSHIP.

ALSO, WE ALSO HAVE TO THINK THAT COVID IS NOT JUST A BIOLOGIC DISEASE.

WE HAVE TO ALSO THINK OF IT AS A SOCIAL DISEASE AS WELL.

SO IT'S REALLY IMPORTANT THAT SOCIAL ISOLATION, THINGS LIKE THAT, REALLY WILL INCREASE YOUR STRESS.

SO REALLY GET INVOLVED LIKE ANGELA HAS GOTTEN INVOLVED IN GROUPS.

GET INVOLVED IN THOSE GROUPS BECAUSE THAT IS ULTIMATELY GOING TO HELP YOU BECOME WHOLE AGAIN.

>>Olena: THANK YOU.

AND ANGELA?

>> WELL, I WOULD SAY BE YOUR OWN EXPERT.

BE PATIENT WITH YOURSELF.

GIVE YOURSELF TIME TO RECOVER.

AND TRY WHAT YOU CAN.

IF ANYBODY NEEDS TO REACH OUT, I WILL ALWAYS BE HERE.

PBS HAWAII HAS MY CONTACT INFORMATION.

CAN YOU GET ME THROUGH KAPU BREAKERS OR THROUGH FACEBOOK OR SOCIAL MEDIA.

BUT I JUST WANT TO SEND ENCOURAGEMENT TO THOSE BATTLING THIS AND FAMILY MEMBERS BESIDES THEM AND BEING THEIR WARRIORS AND INFORMATION GETTERS AND HELPERS.

BE PATIENT.

AND DO WHATEVER YOU CAN WHEN YOU CAN, DON'T OVERDO IT.

AND SEEK THE INFORMATION, BE YOUR OWN EXPERT.

>>Olena: FINALLY, DOCTOR?

>> JUST WANT TO EMPHASIZE THIS IS NEW.

THIS IS NOT LIKE ANYTHING ANY OF US HAVE EVER SEEN.

WE'RE NOW MORE THAN 2 YEARS INTO IT AND WE'RE STILL LEARNING SO MUCH.

AND I THINK WHAT THAT MEANS IS UNDERSTOOD WE MAY NOT HAVE ALL THE ANSWERS FOR YOU BUT WE ARE CERTAINLY INVOLVED IN DOING THE BEST THAT WE CAN.

WE CARE ABOUT YOU.

WE WANT EVERYONE HERE TO BE HEALTHY AND SO WE'RE ALSO LEARNING AS MUCH AS YOU ARE AS WELL.

AND WE ARE CERTAINLY DOING THE BEST THAT WE CAN TO HELP THE PEOPLE OF HAWAII.

>>Olena: ALL RIGHT.

YOU DID MENTION THE AMERICAN LUNG ASSOCIATION AS A GOOD RESOURCE ON THEIR WEBSITE.

WHAT KIND OF THINGS CAN PEOPLE FIND THERE?

I APOLOGIZE.

THE DOCTOR IS NOT AVAILABLE.

FOR THE LOCAL DOCTORS HERE, DO YOU HAVE A WEBSITE YOU WOULD RECOMMEND AS WELL?

>> I THINK CDC HAS A LOT OF GOOD RESOURCES.

SO LOOK AT THE CDC RESOURCES.

THEY HAVE A LOT OF GOOD RESOURCE.

AND NIH ALSO HAS A LOT OF GOOD INFORMATION.

THOSE ARE GOOD PLACES.

ALSO, ANOTHER GOOD PLACE IS SOME OF LIKE THE AMERICAN THORACIC SOCIETY DOES HAVE SOME PATIENT FLIERS GEARED TOWARDS LONG COVID.

AND TO READ SOME OF THOSE.

HAVING THAT INFORMATION.

SO THOSE ARE THE RESOURCES I WOULD SUGGEST.

>>Olena: ANGELA, WHEN YOU WERE SEARCHING FOR RESOURCES ONLINE, IT WAS JUST LIKE ON FACEBOOK?

>> YEAH.

STARTED WITH FACEBOOK.

AND THEN JUST KIND OF WENT FURTHER OUT.

BUT I FELT THAT FACEBOOK WAS A WAY TO CONNECT WITH PEOPLE WHO ARE GOING THROUGH THE SAME THING.

NOT FORGETTING MEDICAL INFORMATION.

IF I WANT MEDICAL INFORMATION, I'M GOING TO GO CDC.

GOING TO THE DEPARTMENT OF HEALTH.

MAYO CLINIC.

THOSE ARE THE PLACES.

AND REALLY, I JUST WENT IN AND LOOKED AT THOSE MEDICAL RESOURCES.

SOMEHOW, LUCKY ENOUGH TO FIND WHAT I NEEDED.

>>Olena: MEDICAL JOURNALISTS.

WE WANT TO THANK ALL OF OUR GUESTS FOR JOINING US THIS EVENING.

WE REALLY APPRECIATE YOU AND THANK YOU SO MUCH FOR YOUR TIME.

DR. ALBERT RIZZO FROM THE AMERICAN LUNG ASSOCIATION, ANGELA KEEN, COVID SURVIVOR, DR. GEHAN DEVENDRA, PULMONOLOGIST AT THE QUEEN’S MEDICAL CENTER AND DR. PHILIP VERHOEF, WITH CRITICAL CARE MEDICINE AT KAISER PERMANENTE.

NEXT WEEK ON INSIGHTS WE TAKE A LOOK AT HAWAII’S COFFEE INDUSTRY.

HAWAII‑GROWN COFFEE WAS ONCE A ROBUST AND PROFITABLE EXPORT BUT NOW GROWERS HERE ARE FACING MANY CHALLENGES FROM PESTS, FUNGI, AND MAINLAND COFFEE COMPANIES THAT THREATEN THEIR LIVELIHOOD.

PLEASE JOIN US THEN.

FOR INSIGHTS ON PBS HAWAII, I’M OLENA HEU.

ALOHA AND A HUI HOU.