In September 2020, Nepal Airlines’ instructor pilot Vijay Lama got infected with Covid-19 during his return flight with Nepal army personnel from Sudan’s peacekeeping mission.

After his condition became severe, Lama, 58, was admitted to the critical care unit at a private hospital in Kathmandu where he was treated for 17 days.

Two years after his infection, Lama still suffers from the effects of the deadly disease.

“I still experience shortness of breath, severe body ache, and weakness,” Lama told the Post.

Lama is among the hundreds of people who have been suffering from “long Covid.”

Long Covid refers to a wide range of health problems that can affect coronavirus patients even after recovery, for weeks, months, or even years.

Weight gain, heart palpitations, vitamin B12 deficiency, increase in fatty liver, and tiredness are some of the health problems Lama has been struggling with after his Covid infection.

Doctors attending the patients suffering from long-term effects of Covid infection say that people who have been infected with the virus in the past complain of persistent dry cough, hoarse voice, headaches, diarrhoea, loss of appetite, and shortness of breath for a long time after the virus has left the body.

“Some complain of loss in concentration, hair loss, brain fog, chest pain, respiratory problems and anxiety, among other issues,” said Kabin Maleku, programme head at Danfe Care, an organisation that offers telemedicine services. “We also found that patients of long Covid are also suffering from psychological effects of the infection.”

The organisation, which provided telemedicine services to thousands of infected people in the first, second, and third waves of the pandemic, contacted over 600 former Covid patients recently, to inquire about their health conditions.

“We found that one of our clients died of a heart attack. Many have told us about respiratory problems, tiredness, and problems in concentration, among others,” said Maleku. “We also found flare-ups in chronic diseases like diabetes. A detailed study is needed to reach any conclusion but Covid infection could be one of the reasons for their recently-acquired health problems.”

Hundreds of thousands of people were infected during the first, second, and third waves of the pandemic. The Ministry of Health and Population said that 1,125,114 people have tested positive until Sunday, but the actual number of infected across the country could be several times more. The lull in the number of Covid cases in the past few months, barring the past few weeks, could be attributed to the decrease in testing as only those going abroad have been opting for tests.

The Centers for Disease Control and Prevention (CDC) of the United States says that people with more severe Covid-19 illness and underlying health conditions prior to contracting Covid-19 may be more vulnerable to long Covid.

As the long-term effect and symptoms of infection vary from person to person, doctors say it is difficult to diagnose long Covid. Doctors attending people suffering from health problems akin to that of long Covid said that some patients exhibited signs of depression, suicidal and homicidal ideations, which is a dangerous sign and needs attention from psychiatrists and clinical psychologists immediately.

Those with physical problems such as swollen legs or those suffering from signs of heart attacks or strokes should immediately consult medical experts.

“I have been suffering from severe pain in my knees and hair loss after the infection,” said Dr Alina Shrestha, a physiotherapist.

She was infected with Covid during the second wave of the pandemic.

“I massage my scalp with restorative oils to prevent hair fall and also do physical therapy and exercises to relieve the pain in my knees,” she said.

The CDC says that among Covid patients, those who are unvaccinated are at higher risk of developing post-Covid conditions compared to vaccinated people.

Nepal has seen a rise in the number of new cases in the past two weeks. However, despite the surge, authorities concerned have not been able to increase the uptake of booster shots.

So far, 7,212,622 people, or around 24.7 percent of the total population, have received booster shots.

The Health Ministry said that 20,538,963 people, or 70.4 percent of the total population, have been fully immunised.

On Tuesday, Nepal reported two deaths and 638 new cases—4oo in 2,215 polymerase chain reaction tests and 238 in 2,840 antigen tests.

Active cases stand at 3,714 in the country.

Experts say long Covid problems, although not easy to diagnose at this stage, can be taken care of with the help of a group of experts including psychologists, nutritionists, physiotherapists, and many other experts in the related fields of medicine.

“First we must identify the problems to determine whether they are serious or not,” said Dr Prabhat Adhikari, an infectious disease expert. “If the problems are severe, they should be addressed immediately.”

Lama, the instructor pilot with the Nepal Airlines, said that he is still trying to shed the extra kilos he gained in the last two years since his infection. Post-Covid his weight went up to 104 kg, a considerable increase from 88 kg before he was infected.

“I have reduced my weight to 90 kg and I aim to shed 10 kg more,” said Lama. “I am also undergoing various tests including electrocardiogram and consulting experts. Long Covid problems can be managed with the help of medical experts.”