COVID-19 – Challenges with “Long Haul” or “PASC”

As we are now 2½ years into the COVID-19 pandemic. While we have seen a stubborn persistence of the virus in our population, it has evolved to become far less deadly and thankfully we are seeing a return to a more normal world. We are also finding there are some patients with continuing and ongoing problematic symptoms and issues following COVID infection. We are also finding patients experiencing reactivity and side effects from the vaccinations that are persisting and are not dissimilar to symptoms being found post-infection.

We at Green Lake Natural Medicine have been studying these issues and have techniques for more thorough evaluation as well as having treatment approaches that can help resolve these problems.

What is “Long Haul COVID” or “PASC”?

This is what the syndrome of persistent post-acute COVID symptoms are being called. This issue has been associated with a number of names: Long COVID, Long-Haul COVID, Post-acute COVID-19, Post-acute Sequelae of SARS CoV-2 (PASC), and Chronic COVID.

Why is Long Haul COVID happening?

There are various theories about why this happens in some people and not others. The realities are there are likely differing underlying causes depending on the individual person.

A simple way of thinking about this is to consider how our body works to address an acute infection. When our immune system encounters a foreign entity (such as a virus like COVID-19) it mounts a response that begins with the process of identification of the foreign entity. This then leads to the creation of specific cells that are able to seek out and kill the virus as well as others that make antibodies that attach onto the virus and neutralize it. At the root of this immune response is a significant inflammatory reaction. In other words, our bodies produce a lot of inflammation that is designed to kill off the foreign entity.

In patients that already have an underlying level of inflammation in their body (for example in a condition like poorly controlled diabetes or chronic lung disease), the significant inflammation created by the immune response becomes additive to the existing inflammation and can overwhelm the body. This is one theory of why certain people get into more trouble with the acute virus rather than others.

The natural course of things is that once the immune system is done killing the foreign entity via this inflammatory response, then the response gets “resolved” or is tempered by other types of immune cells and gets shut off.

One of the thoughts behind why Long Haul COVID happens is that this “normal” immune response is failing to get resolved properly and keeps going out of control. Many systems of the body can potentially be affected by this ongoing inflammatory reaction including neurological, cardiovascular, respiratory, gastrointestinal, and mitochondrial energy production to name a few. Symptoms manifest as a reflection of whichever system(s) are being affected.

The realities are also that no two Long Haul patients are exactly alike. The post-infection non-resolving inflammation affects everyone differently and affects different body systems and none of it is exactly predictable. So, every patient experiencing these issues must be evaluated individually and treated individually.


Diagnosis is based on mainly on the fact that someone had a COVID-19 infection and has residual clinical signs and symptoms. We evaluate these thoroughly to determine which body systems are being adversely affected. There is also blood based testing that now exists that allows us to assess white blood cell types and function that can help us identify where the specific dysfunction in the immune system lies and this helps us determine treatment strategy.


This is based on the individual’s unique presentation and what body systems are being affected. There are websites out there and doctors using various pharmaceutical medications that can potentially have side effects. We do have treatments available in the area of natural medicine that can do just as good a job as the pharmaceuticals but in a far safer way. Dr. Milkis has the knowledge and expertise to determine the best approach for you and can guide you back to health.

Other information

The CDC has updated information on Long Haul COVID should you be interested in more details.

The Patient-Led Research Collaborative has an excellent patient directed comprehensive survey of Long Haul COVID symptoms and issues should you want more information in this area. If you are experiencing Long Haul COVID yourself, you can take the University College of London SURVEY to add your information to the growing database.

If you would like to inquire about our services with regard to Long Haul COVID, please reach out by calling our office at (206) 550-7539 or use this CONTACT FORM.