An Ultrarunner Describes Her COVID-19 Recovery Struggle

She noticed something wasn’t right while on a run during a business trip in Utah. It was early March, and although the COVID-19 chatter was getting louder in the United States, most people hadn’t yet considered it a real threat. 

But Lauren Wilke, 36, knew she was at risk. She travels extensively for her job as an engineer and often enters nursing homes to conduct building inspections. It was difficult to tell if the altitude or jetlag or general fatigue was slowing her down on that run, but by the next morning Wilke also had a dry cough.

She knew enough to not enter the building she was supposed to inspect that day, and the health-care workers there outfitted her with masks to wear on the plane back to her Pittsburgh home. By the time she arrived and had a restless night of sleep, she was severely short of breath. Wilke decided to drive herself to the hospital on the advice of her doctor. 

After a short hospitalization, Wilke, an avid runner who enjoys ultra-distances on the trails and likes to choose races where she can meet up with friends, was sent home to recover and quarantine. But now, five months later, she still hasn’t been able to run. She described her experience during a phone interview with Women’s Running because Wilke believes that not enough people know about the longer-term effects of COVID-19.

Women’s Running: First, describe your pre-COVID-19 running. What kind of running routine did you have? How’d you get started?

Lauren Wilke: Well, first, I’m a slower runner. I prefer longer distance to short distance. I’m kind of the oddball who thinks it’s easier to do a 50K than a 5K. I like to be on trails and be outside as opposed to running as fast as possible on the roads, mainly because I’m just not good at that. 

I was on the crew team in college, but that was a more of a social sort of thing. I was never competitive with it. After that I moved to Phoenix and I wanted to do something that was a challenge, because college wasn’t particularly hard for me. I tested well and was good at studying and I felt like I cruised through most things. So, I wanted to do something specifically hard. Running was that.

My apartment in Arizona was right in the middle of the Rock ‘n’ Roll Arizona race course for the marathon. My first January there, my apartment was trapped by the course. I figured if I wanted to do something next year, I’d just run the race. And that’s how I started running.

WR: Let’s turn to the COVID-19 illness. How did it hit you?

LW: I was an early case, in the beginning of March. Because I travel for work, I was on 12 flights in 14 days to start March, and that put me at very high exposure to people all across the country. My work involves me going into occupied apartments, occupied nursing homes, and face-to-face with a lot of different people in a short amount of time.

I was working in Salt Lake City when I caught this—I was almost certainly exposed on a Wednesday while I was flying there and working in Salt Lake. I went for a run Thursday afternoon and it wasn’t easy. I was worn down and breathing was a little bit hard. I thought it was altitude sickness, because Salt Lake is a little higher, and when I fly a lot I tend to get altitude sickness symptoms. I was right at my peak of flying a lot and being at altitude, I thought that’s what it was. On Friday morning I had a constant, dry cough and it was obvious it wasn’t just altitude sickness. 

WR: So you had to fly home from Utah? 

LW: I did, yes. The hardest part of it was that my job that day was inspecting a nursing home. I was supposed to go into every single room of that home. I drove there and I refused to go into the building. Everything I was being told at the time, they wanted me to go in and do it. But I refused to expose more people that way. 

I hopped onto a morning flight with fewer people. The nursing home gave me two masks to wear. At that time, they were telling people not to wear masks, but I wore a mask in the airport and when I was on the plane. I got dirty looks the entire time, even though I was clearly coughing. It was very frustrating.

When I got back to Pennsylvania and got tested, they did the swab test, but it was so early that they didn’t have anywhere to send it for testing. So, I never had a positive test result. They diagnosed me positive with COVID, they just didn’t have a way to process it. They did a flu test, which was negative. My chest X-rays were negative. The blood work was negative for everything else. They ruled out everything else. Because of that, I don’t know if I was included in the case counts or not. The day I was diagnosed, our county wasn’t recording presumed cases. I would be the 13th in our county to have it if they included me.

WR: How did you decide to go to the hospital?

LW: I could only sit upright to breathe well. I called my doctor’s office and told them what was happening. I was their first patient that had any of these symptoms. They freaked out a little. They called ahead to the hospital and gave me the phone number to call when I got there so they could come out and get me, to give me a mask and walk me in that way.

I was still in a condition that I could drive myself to the hospital and park there. I was struggling but still functioning. My husband was at work and I said I’d call him to let him know what happens and that also he should probably leave work and quarantine.

WR: Did your husband ever get COVID-19?

LW: We assume he did because he had exposure to me, but he’s not had any symptoms. So far he’s been healthy.

WR: What was the hospitalization like?

LW: They had the call that I was coming in. The head nurse came out with an N-95 mask and taught me how to put it on. They put me into a single-patient room. It was a quiet day at the hospital, but I could tell that all of the nurses and staff there could see that I was the first of what would be a bigger issue. I was almost their guinea pig there. I don’t think they had anyone that had been quite that sick yet. 

They explained that they were going to do every test they could. They took two nose swabs and learned an hour later that there was nowhere to send the COVID swab. They had me on an EKG and a pulse oximeter, they took a whole bunch of blood. I was in the hospital for about six hours while they processed everything.

I had the whole night before to think about what I’d do in the hospital, so I packed a bag and was ready to spend time there. I had a battery for my phone, so I actually did a lot of work while I was there waiting. 

WR: So, you went home to recover after that. Describe how it’s gone for you.

LW: From there my symptoms have improved and then they get worse. It’s not a linear healing at all. It was hard to breathe the first two weeks. I would walk up the stairs and have to sit down and take a break. I had been building up my running from a sprained ankle before this and was up to about eight miles at a time, pretty comfortably. In a day I went from running eight miles to not being able to walk up the stairs. 

In two- to four-week intervals I’ll improve, then get worse. I’ll be able to walk for a while, and I was up to running about two miles at a time, then it hits me again. We had a bad pollution day in Pittsburgh and it set me back all the way to where I was in March. I couldn’t walk outside the house at all. Now, I can walk outside again, but I can’t run. 

Being on my feet is also easier if I’m wearing sandals instead of sneakers. The sneakers put extra pressure on my toes—I have COVID toe. It’s an unexpected symptom. It feels like I’m walking on a Lego when I take a step.

WR: Ouch—tell me more about that COVID toe?

LW: The second and third toe on my right foot have nerve damage created by having the coronavirus. It’s limited to right there. The pain isn’t constant, but it’s more frequent than not. When I step, I’ll feel pain on the bottom of those toes. It feels like there’s a Lego wedged under my foot. The pain comes and goes. It’s acute, sharp pain. I’m still trying to figure out when it happens and if it will go away. Is it just part of life now? Because I’m an ultrarunner it doesn’t bother me too much—it’s a distinct pain that isn’t an injury and won’t get worse. In a race maybe it will distract me from the things that normally break me down. My main priority is just trying to breathe—having more oxygen may help the toes, too. It can’t hurt.

WR: Did you have any pre-existing conditions?

LW: Nothing significant. I have really low-grade asthma—if I’m working out and it’s very cold, I’ll use an inhaler for that. But it’s very minor. Other than that, there’s nothing that would make me think that I’d be a person who’d still be sick four or five months later.

WR: That sounds frustrating.

LW: My symptoms have not been to the point where I think I need to be hospitalized, so I’m in a frustrating window where I’m not healthy enough to be able to run or see people, but I’m not sick enough to get oxygen. I’m in a weird limbo space. I’m not healthy enough to live a normal life, but I’m not sick enough to take resources from other people or get more serious treatments.

WR: Is your doctor asking you to come in for follow ups at all?

LW: My doctor has pushed everything to tele-medicine, so we talk periodically through video call. But any place that she’d send me right now isn’t taking patients who aren’t critical. They’re trying to keep people out of the facilities, so I don’t know how scarred my lungs are or how much damage has been done, unfortunately. 

WR: Do you notice any specific triggers when symptoms start feeling worse again?

LW: The word I keep coming back to is “frustrating.” My healing and getting better has come and gone a bit. It’s not always triggered by something I can pinpoint. My breathing will be better for a week or two, then I’ll wake up in the morning and try to go for a walk and just struggle more. I’ll try to dial it back, but at this point I’ve learned I’m set back for a while.

My worst symptoms when I went to the hospital were triggered by a walk I went on the night before. I walked to see what I could, just around the neighborhood. It was about a mile. When I got home, I couldn’t get a full breath and my heart rate was higher. My most severe setback was two weeks ago. I went for a fairly easy run—a minute run and a minute walk break. It’s unusual for Western Pennsylvania to have ozone alert days. I got a mile away from the house and realized it wasn’t good. I turned around and walked home. I almost waved down a police car to get a ride home.

After that I was trapped on the couch for two weeks. I couldn’t catch my breath on the stairs again. I’m in an OK phase right now; each day I breathe a little easier. I can do one thing at a time—I can move, I can eat, or I can talk. If I combine two of those three, I can’t breathe. I have to be specific about choosing one thing at a time to do.

WR: What do you think runners need to know about COVID-19?

LW: I don’t want to be too mean about it, but I’ve spent several weeks of my life now on my couch and unable to walk up my own stairs. I was sincerely healthy before I caught this and did not expect to still be so sick five months later. 

It’s natural that most people think, “I’m younger, I’m healthier, I’ll be OK, it’s old people and sick people who die.” There’s so much news coverage on the number of deaths, which is certainly serious and important, but the day-to-day impact on people who have the illness and are counted as recovered is much more severe than I think most people realize. Even running friends don’t seem to realize how sick I still am, because of this.

We have several running groups in the area getting together and going for group runs—my main suggestion is just please be honest with each other about what you’re doing in your day-to-day life. If you’ve seen other people, if you’ve had people to your house, if you’ve had potential exposures in the past two weeks or three weeks, it is important to share with the people you’re running with. It’s not fair to assume that somebody is healthy and safe and put your choices on them, not knowing their medical history or who they with or come into contact with. 

Also, if you feel like you’re more run-down than normal right now, cut back sooner than you would otherwise. Take a week off and rest now rather than still be sick months later because you thought you could run 10 miles. 

WR: Do you feel like there’s light at the end of tunnel? Do you have hopes of running again?

LW: I was positive about being able to run about a month ago and I say that not being able to run at all right now. A month ago I was running 15 miles a week with walk breaks. Now, not at all. I can walk. Eventually I think it will get better. I can look ahead about a week at a time right now—that’s about all I can do. 

WR: If there’s any message you’d like runners to take from your experience, what would it be?

LW: Mostly that this is not limited to people who have pre-existing conditions, it’s not limited to people of a certain age. Just because you’re a runner doesn’t mean you’re safe. It’s very natural for runners to want to push through things and believe that they’re invincible. You can think, “I’ve run 30 marathons, I’m healthy, it’s fine,” but I’m living proof that you can run 30 marathons and then not be able to run a mile for a long time.

You don’t know the conditions of people around you. Being in groups of people, consider your own health seriously but also those around you. I was put into this situation because I didn’t have a choice at my job. I was exposed because I needed to go to work. People working at any service industry, like if you’re going on vacation at a hotel or even just buying something at a gas station, you’re in contact with people who are exposed because it’s their job. It’s really important to keep them safe. They don’t have a choice and maybe you do have a choice. If you can make a choice to keep yourself healthy, it’s the best thing you can do for everybody else. And maybe you’ll get to race in the future. All those race fees you deferred to next year? You want to be able to use those.