COVID-19 can cause a variety of longer-lasting symptoms such as psychological difficulties and problems affecting the heart, nervous system and/or lungs.

Some common long-term symptoms are

• quickly becoming exhausted and having breathing difficulties with physical exertion
• quickly becoming exhausted by mental (cognitive) work
• numerous neuropsychological problems such as difficulty with concentration, perception or memory
• headache
• impaired senses of taste and smell
• perpetual exhaustion (also known as fatigue).

Other possible long-term effects are

• aching muscles and limbs
• sleep problems
• depressive mood and anxiety
• concentration problems
• racing or irregular heartbeat
• hair loss
• gastro-intestinal symptoms
• metabolic problems (with the uptake and digestion of nutrients)..

When the symptoms are still present three months after a SARS-CoV-2 infection and they last longer than two months, the condition is known as long COVID or post-COVID syndrome.

It is thought that about 15% of the people who become infected with SARS-CoV-2 are subsequently affected by long COVID. Children and young people can also experience longer-lasting health problems. The precise causes are still unknown. The risk is higher after severe illness than after mild illness.

Treating long COVID faces doctors and patients with particular challenges. If fatigue symptoms (tiredness, exhaustion, lack of resilience) last for several months, they can develop into chronic fatigue syndrome.

Further information about long COVID and post COVID syndrome is available in a patient guide produced by AWMF (Association of the Scientific Medical Societies) and at the Federal Health Ministry’s website gesund.bund.de.

Being seriously ill can put you in a situation in which you are no longer able to make decisions and run your personal life independently.

It makes sense to think about wills, living wills and powers of attorney in good time so that your family, or anyone acting on your behalf, can take your wishes into account later on.

• Living will (Patientenverfügung):

When you make a living will, you decide which medical procedures should and should not be used if you become seriously ill. After making one, you should check it regularly and alter it as appropriate to take account of changes in your living situation and your health.

• Power of attorney (Vorsorgevollmacht):

This enables you to choose someone to act as your official representative if you become seriously ill. It also enables you to state who should have access to your bank account, who can open and answer your post and who can act on your behalf and make decisions about such things as moving into a care home and terminating your rental agreement. Remember that you may need a bank power of attorney (Bankvollmacht) as well because many banks don’t recognize the general power of attorney (Vorsorgevollmacht). Your bank can give you more information about this.

• Will (Testament):

In Germany, if someone dies without a will, the law decides who inherits from them. That means children and spouses come first. If you have different ideas about who should inherit your possessions when you die, you need to write them down in a will.

You should see these documents as a precautionary measure and think about them when you’re still young, even though they don’t (yet) seem necessary on health grounds.

Further information, and standard versions of forms for granting power of attorney and making living wills, are available from the Federal Ministry of Justice and Consumer Protection and from the German patient protection foundation.

The Federal Ministry of Justice and Consumer Protection also provides helpful information about wills.

The COVID-19 pandemic is an enormous burden for many people. Some are sick for a long time and have great difficulty getting back into working life again; others have financial worries because their working hours have been reduced or because their income as self-employed people has disappeared.

A number of national support schemes are in place to lessen social hardship due to the pandemic. The Federal Labor Ministry’s Coronavirus guide helps you find out what support you can get.

What financial aid is available to families in the pandemic? You can find out on the family website of the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth.

The Federal Employment Agency provides information about coronavirus support for self-employed people, short-time working benefit and other potential forms of assistance.

The social advocacy organizations (VdK and SoVD) provide information about which additional benefits you may be able to receive from the pension insurance system, the federal employment agency (Bundesagentur für Arbeit) and other sources.

Talk to your health fund (Krankenkasse) to find out whether there could be additional support available that you have not yet accessed. For example, if your household includes a child or a family member in need of care, you may be entitled to household help.

The “Support” section lists more sources of advice and support including help in psychological crisis situations.

Many studies have shown that the coronavirus pandemic is an especially great burden for children and young people. Many have difficulty handling the isolation at home, the lack of things to do in leisure time and the reduction of social contact. Some respond to the psychological stress by becoming increasingly lethargic while others have outbursts of rage for no apparent reason.

Parents should be watchful and ask gently what the matter is if they notice unusual changes in their children’s behavior. It’s important to demonstrate to your child that you take their feelings seriously and accept their negative feelings.

Further useful information is available on the website kindergesundheit-info.de, which are run by the Federal Health Ministry and BzGA respectively.

Many parents want to protect their children from emotional distress and shy away from talking openly about serious illness. But even very small children notice when the mood in the family changes.

If you think your children are suffering in this situation, you should explain to them about the illness and its consequences so that they can understand what’s going on. For infectious illnesses like COVID-19, it’s especially important to explain to children about the risk of infection so that they understand why they may need to keep away for a while or why they are not allowed to visit Mom or Dad in hospital.

Children react in different ways when their parents are ill. But they generally find it easier to cope with this knowledge than with uncertainty about their parents’ behavior.

If you feel you can’t solve the problems within the family, you should get professional help. There are many sources of advice and help for families (such as local, faith-based and voluntary organizations).

The websites of groups such as Diakonie, Caritas and pro familia provide information about the advice they offer for families with problems in your neighborhood.

Child-friendly information about infectious diseases and the coronavirus pandemic is available on the websites Hygiene-Tipps-Fuer-Kids.de (run by Bonn University Hospital) and kindergesundheit-info.de (run by BZgA).

It’s not unusual to be afraid when someone close to you is seriously ill. You fear for the sick person and you may also be afraid of change and of not being able to cope.

When fear becomes a burden it needs to be faced and tackled. It’s important that you talk about your negative feelings rather than bottling them up and suppressing them. Talk openly with friends or family and be honest about your worries, even if you find it hard.

It can also be helpful to look for support in self-help groups or to talk to other affected people on internet forums or social media. Many of the statutory health funds also offer psychological support by phone or internet. Talking to a therapist, a counsellor or a representative of your faith community can also help you to cope better with your own fears.

When your partner is ill, it’s important to remember your own risk of infection as well. The risk of becoming infected at home is high, especially among older people. So wear a mask at home, keep your distance and air the rooms regularly.

The “Support” section offers more information about psychological and psychosocial support and provides links to sources of help for affected people.

The pandemic is an especially difficult time for a lot of families. Working from home, home-schooling and limited leisure time options make life stressful for parents and children and the stress is amplified by the ever-present risk of infection. In this situation, it is not surprising that many people’s nerves are on edge and frustration, conflict and arguments are quick to surface.

How can children best be supported in the pandemic? How can you overcome your own worries – and where can you go for help when you don’t know what to do next? 

BZgA offers information and tips for parents on its website kindergesundheit-info.de

The family website of the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth tells you what financial support is available for families at this time.

Have a look at the “Support” section too. It includes additional information and advice options.

Informal carers can access various forms of help to enable them to combine their caring role with their work. In some cases you can ask your employer to allow you to take time off work for caring tasks and claim care support benefit (Pflegeunterstützungsgeld) to replace the lost earnings.

Periods of time spent caring can also be recognized as contributing towards your pension. The national pension authority (Deutsche Rentenversicherung) provides information on how this works.

Further information about combining employment with caring is available from the Federal Ministry of Health.

When someone requires domiciliary or residential care, their family receives financial support towards it; the amount depends on which of the five levels of nursing care (Pflegegrad) the person is found to need. In certain cases, there may be additional benefits.

MDK provides further information about assessment of care needs and allocation to one of the five categories.

The Federal Ministry of Health offers an online care guide providing general information about types of care.

The consumer advice center offers online advice as to how you can best prepare to be assessed by MDK.

You can obtain personal advice about the available forms of care from the local care support centers.

The “Employment & social affairs” section lists additional sources of advice on benefits.

For consumable assistive equipment like incontinence pads and syringes for administering medication, the user pays one tenth of the cost of each package. The maximum amount is 10 euros for the quantity used in one month. For any other item of assistive equipment, the user must contribute between 5 and 10 euros.

Further information about assistive equipment is available from the Federal Ministry of Health.