Returning to activity is difficult, but possible with long COVID

Steamboat Springs resident Scott Ford is an avid backcountry flyfisher, but long COVID-19 symptoms limited his fishing adventures this summer.
Scott Ford/Courtesy photo

Scott Ford, a Steamboat Springs resident of 30 years, tries to hike to his favorite backcountry fishing spot every summer. This year, however, lingering symptoms from COVID-19 kept Ford from that 26-mile round-trip getaway to the south fork of the White River.

“The biggest change is I didn’t have the endurance I used to have. It was the stamina issue that bothered me the most,” said Ford, 68. “I’m a pretty active fly fisherman. I used to walk for 45 minutes and rest, but I would walk 15 minutes and needed to sit down. It kind of put a wet blanket on some of the stuff I wanted to do over the summer.”

Ford had been vaccinated and boosted against COVID-19 and did not believe he let his guard down too much with precautions while traveling in May. But after a long train trip to a family gathering for Mother’s Day, the retired economist tested positive for COVID-19.

“I had coughing spasms where you cough so often that your ribs hurt,” Ford said. “I got over the rough part in about five days.”

Ford experienced six weeks of more severe fatigue, but five months later, he still is not back to his previous stamina levels.

Ford is not alone in the recreation-driven Yampa Valley in experiencing a common post-COVID symptom called post-exertional malaise that may last for months.

“Long COVID is affecting millions of people in America and around the world,” according to the American Academy of Physical Medicine and Rehabilitation, a group coordinating information and research to better understand long COVID.

That low energy and low mood after exertion is one common symptom for long-haulers, and such symptoms could last up to 12 to 18 months, said Dr. William Niehaus, who treats long COVID at the UCHealth Rehabilitation Unit at University of Colorado Hospital in Aurora.

Niehaus advised people with long COVID to be patient with their recovery, increase activity levels gradually and get plenty of sleep. A check-up with a primary doctor after four weeks of lingering viral symptoms is advisable to make sure more serious issues are not ignored, Niehaus said.

Dr. Brian Harrington, a family physician at Yampa Valley Medical Associates, noted COVID-19 can lead to lingering cardiac, pulmonary or nerve issues. However, the most common long-term symptoms include fatigue, malaise and brain fog, said Harrington, who has diagnosed several dozen patients with long-haul COVID-19.

Dr. William Niehaus is part of the collaborative medical team that treats Long COVID at University of Colorado Hospital in Aurora.
UCHealth/Courtesy photo

“You can do activities up to a point where you get significant symptoms or experience limitation of your activities,” Harrington advised. “Each individual is going to have to find that middle ground where they balance their return to regular life with symptoms and physical limitations.”

Dr. David Niedermeier, who specializes in family medicine at Steamboat Medical Group, said long-COVID patients should “stay active but not push it too hard and listen to your body.”

Doctors do not have a single diagnostic test to verify long COVID, Harrington said, and diagnosis remains challenging. The diagnosis is through a process of exclusion, or when symptoms cannot be explained by other conditions and can be connected to an initial COVID-19 positive test or exposure.

“It is challenging to diagnosis conclusively because the symptoms can be so vague,” Niedermeier said. “It’s so hard to predict who is going to have long symptoms.”

Harrington said a long-COVID diagnosis in children can be even more challenging, yet children typically get less sick with COVID-19 and thus result in fewer long-haul cases.

Harrington said surveys show some risk factors that increase the chance of contracting long COVID include being age 65 or older, being hospitalized or very sick with original diagnosis, having a symptomatic infection or a higher viral load at initially, and being unvaccinated against COVID-19.

The World Health Organization released a clinical definition of “post COVID-19 condition” in October 2021 that outlines 12 identifying factors, such as a “time-course nature of symptoms fluctuating, increasing, new onset, persistent and relapsing.” The guideline says symptoms present as a cluster of issues, continue at least two months and exhibit impairments such as cognitive dysfunction, fatigue and shortness of breath.

More information also is available through the Centers for Disease Control and Prevention webpage Long COVID or Post-COVID Conditions.

Expert long COVID-19 care

The hospital on Aurora’s Anschutz Medical Campus is home to a multidisciplinary consortium of physicians and professionals working to help patients with long COVID. Patients who might wish to self-refer for care by the team can contact the UCHealth Pulmonology Clinic at 720-848-0748.

Colorado participants currently are being recruited for the nationwide RECOVER study created by the National Institutes of Health to learn about the long-term effects of COVID.

Information is available at, or individuals can reach out to the University of Colorado Hospital at, according to Elen Feuerriegel, a study program manager.

Feuerriegel said potential study participants are welcome from across Colorado but must be willing and able to travel to Aurora for occasional visits for four years with some reimbursement for travel.