Summer and the Long-Covid Body

The challenges of heatwaves & more

Aug 04, 2024

Dearest reader,

thank you for being here! 🌻

This is the third summer I experience - and suffer through - with Long Covid. I used to love each and every season: winter for its snow and the cold; spring and fall for their changes; summer for its abundance, warmth, and sunshine. Now, summer has become the most challenging time of the year with my set of chronic conditions.

One of the many symptoms I have been living with for over two years is my body’s inability to adjust to different temperatures, and warm and hot environments are the most challenging. Temperature dysregulation and heat intolerance. This change was not immediately obvious after my initial infection, but started showing up in a bizarre way: I used to be one of those people who almost always felt cold and there I was, getting “hot flashes” in the office of a previous job.

Before I realized that my body had gone through this profound change, I dressed the way I used to for decades: in layers, and always anticipating the possibility of feeling cold. However, I suddenly felt the exact opposite. When I wore an extra layer, I’d feel stifled, like my body would boil over, and I had to shed it as quickly as possible. In a meeting space that was notoriously cold, my colleagues would wear their (winter) jackets while I came wearing a light sweater and be fine.

Now, the threshold my body can handle lies somewhere around 25-26 °C (77-79 °F). In ever-warmer summers, especially living in a big city, that threshold is quite low, even in the “temperate” climactic region of Austria. Winter, on the other hand, feels like a welcome break for my body, like a cool embrace that contributes to stability in my life.

The Biology of Heat Regulation

A number of mechanisms in the human body regulate our temperature. On the one hand, the central nervous system and spinal cord are essential and any damage might cause dysregulation. Peripheral neuropathy, that is afflicted nerve cells outside of the central nervous system for instance in skin or organs, is a possible culprit, too.

The thyroid also plays its part. An overproducion of thyroid hormones can cause heat intolerance, whereas an underproduction can lead to cold intolerance. Further, anemia, aka iron deficiency, tends to lead to a constant sense of feeling cold. And I am sure there are other mechanisms that I forgot to mention.

The symptoms of temperature dysregulation, heat and cold intolerance are common amongst people with ME/CFS. And since studies show that around 50 % of people with Long Covid live with a form of ME, it’s not surprising that the temperatures of one’s body and environment affect the severity of symptoms and well-being of individuals.

Heat and the City

In Austria, Vienna is one of the warmest places, which is most apparent in the summer. The buildings, streets, and other built spaces absorb the heat throughout the day and radiate it at night, which leads to frequent “tropical nights”.

Tropical night: when the temperature does not drop below 20 °C (68 °F) at night (a term commonly used in Europe)

Thanks to the climate crisis, heat waves have been occurring more frequently, they are longer, and we experience more tropical nights. Children, elderly people, and people with chronic illnesses and conditions are particularly vulnerable.

I live right by the Danube, a huge body of water, and there are plenty of green spaces right by my building and in the vicinity. And still. Even though I air out my apartment in the early morning hour,s close the windows once the temperature is rising, I close my blinds and open my umbrella on the balcony, it is impossible to keep the temperature as low as I would prefer.

And the heat is horrible. The threshold, around 25-26 °C (77-79 °F), marks the “red zone” for me. The slightest bit of movement, for example, changing my clothes or hanging up my freshly-washed laundry, and I start sweating profusely. Often, I will sit on my couch, attempting to move as little as possible, keeping well hydrated, and still I’ll be able to trace a drop of sweat as it follows the path of gravity down my body: on the insides of my upper arms, under my knees, from my back straight into my underwear.

Even during my not-particularly-restful sleep, I experience frequent night sweats, irrelevant of the season and whether it’s a tropical night or not. Sweating is the human body’s way of keeping cool and protecting itself from overheating. But what if your body “malfunctions” and sees safe temperatures as a threat?

Paying close attention to one’s body and vigilant practices that support it are essential. Otherwise, a worsening of symptoms and/or heat exhaustion or stroke are around the corner.

How I try to Keep as Cool as Possible, a Non-exhaustive, Incomplete List

Light clothes made of natural fabric (plastic derivatives are a b****) 🩲👕
Plenty of liquid throughout the day: water, (cooled-off) herbal teas, some coffee or other drinks containing caffeine, 1 tall glass of juice with some salt (my homemade version of an electrolyte drink or versions like here), (cooled-of) vegetable broth, the odd sports drink for extra electrolytes and energy 🥤🧃🍵🧊🧉🧂🍋. In short: hydration, hydration, hydration.
Frequent small meals and snacks (salty & sweet) 🍎🍿🍪🍦
Two fans in my apartment 🪭🌬
A cooling mask I keep in the fridge 🤿
Hand-held fans 🪭🪭🪭
Spritzing my face with water, mint hydrolate 💧
Applying cooling essential oils, such as eucalyptus, mint, citrus flavors
Avoiding warming spices, such as chili, paprika, cumin, ginger, etc. and cooking/baking
Rinsing my legs with cold water💧🦵🏻💧🦵🏻💧
If I leave the apartment, I do it in the morning 🌄
Spend more time in shops or supermarkets to cool off 🏤
Go for a quick swim, if I am well enough 🧜‍♀️
More pacing, less doing 🛌🏻