This story originally appeared on BizWest Media on March 1, 2021. The article is behind a paywall.

LOVELAND — Chad Wittenmyer’s long, red beard has grown unmanaged since March, seemingly at the same rate as his pain.

Twelve months ago, the 40-year old father and stepfather of four was fabricating windmill blades and was in the best shape of his adult life.

But after he contracted COVID-19 in March, a host of medical issues started to emerge. Constant fatigue set in. His heart rhythm was off, and he struggled to breathe under exertion. Eventually, pains and neuropathies developed in his extremities.

Wittenmyer is among those suffering the worst form of “Long COVID,” a catch-all for ongoing symptoms that some COVID-19 survivors endure after the infection period.

Medical researchers aren’t sure why an estimated one-third of the approximately 28 million Americans who test positive have some level of worse health after their infection period, nor have they figured out why some patients report mild symptoms and others are wracked with pain.

For most of the past year, the focus of scientists and governments was to reduce the spread and death toll and to eventually vaccinate enough people to stop the virus’ threat. But after the pandemic is contained and life begins to enter a post-COVID era, how will they manage a new class of millions of Americans who may never fully recover?

Wittenmyer and his family were on a vacation in Mexico and arrived back in the U.S. two days before international travel was suspended between the countries. His employer ordered him to quarantine for two weeks since he had been abroad, and while doing so, a friend of his, who later tested positive, brought some food for the family.

On the first day after he returned to work, Wittenmyer broke a moderate fever, began coughing and struggled to breathe behind his mask at work. On the second day, he lasted 45 minutes into his shift before he lost the strength to turn a wrench.

During a video appointment, Wittenmyer’s doctor said his symptoms matched COVID and said he likely was infected. At that point, COVID tests were in such short supply that they were only used to diagnose people requiring intensive-care beds.

But Wittenmyer’s strength didn’t return.

“Before going to Mexico, I was the most physically fit I’ve ever been in my entire life,” he said. “I worked 12-hour shifts in the factory, which was very physically demanding going up and down ladders all day and lifting heavy things and moving stuff around. And then, all of a sudden, I’m not even able to do what essentially was a simple task.”

The aftershocks of illness Dr. Daniel Goldberg, a faculty member at the University of Colorado Anschutz Campus who studies medical history and ethics, said it’s fairly common for an acute medical issue to trigger lasting medical issues.

For example, myologic encephalomyelitis, or what used to be called chronic fatigue syndrome, is similar to the extreme fatigue that some Long COVID patients experience.

It’s not known what exactly causes ME, but researchers estimated that between 830,000 to 2.5 million Americans had it, and it cost the U.S. economy between $17 billion to $24 billion annually due to lost wages and medical costs.

However, Goldberg said medical practitioners have historically been poor at treating patients whose pain evades diagnostics because they often simply don’t believe the patient is as sick as they’re saying.

Those illnesses are known as “contested illnesses,” and Goldberg is not surprised that some people’s severe symptoms are being denied as real, as are their claims for disability insurance or accommodations at work.

“The central nervous (system), which is chronic pain, doesn’t show up on scans and blood work, things like that. And so that is a major factor in why people who’ve lived with chronic pain are treated so poorly by people, both within and without health systems, by health professionals and others, as well by lawmakers and, unfortunately, by family members and by loved ones,” he said.

A dispute over what’s real After he spent another two weeks quarantined on the advice of his doctor, Wittenmyer continued to struggle and went on bouts of short-term disability until he was terminated on Aug. 1 since he was no longer able to work.

His long-term disability insurer contacted his doctor and heard his list of symptoms but later denied him coverage because he had never tested positive for either an active-infection test or an antibody test that would have proven past infection.

“There have been no physical exams of diagnostic testing to support your subjective complains (sic) that would warrant restrictions and limitations from working,” the insurer wrote in a letter to Wittenmyer that was reviewed by BizWest.