6 Jarrod Micallef

By Tara Barton & Danielle Hitch

Jarrod is a 42-year-old man who lives in the inner-city suburb of West Hobart. His mother and father were born in Australia. His father’s family migrated from Malta following World War II, and his mother’s family lived in Tasmania for many generations. Jarrod is a self-employed painter and decorator, and he has just taken on a first-year apprentice (Tyson). He loves to ride, run and hike in the bushland and parks around the city. Jarrod is also a member of the local amateur Australian Rules Football team called the West Hobart Warriors.

“I’m a simple bloke – all I need is footy and the great outdoors”

Home Life

Jarrod is single and lives alone after his divorce from his wife (Emma, aged 40) around three years ago. They share three children (Olivia, aged 9; Harry, aged 7; and Ava, aged 4) and co-parent successfully as they live in the same neighbourhood. He left school at 16 to begin his painting and decorating apprenticeship and has owned his successful business since the age of 23. Jarrod has a reputation for being a reliable and skilled painter and has built a loyal customer base over the years. He met Emma in high school, and they married as soon as he finished his apprenticeship. After years of trying to start a family, they saved up enough money to undergo in vitro fertilisation (IVF) to support all three of their pregnancies. Their marriage ended amicably, and they remain on friendly terms.

Jarrod inherited his house from his grandmother and has been renovating the property since moving in two years ago. He sees his parents (who also live nearby) at least once a week but rarely sees his brother, who lives in the North West of Tasmania with his young family. Emma is an aged care worker in a local nursing home, and despite the challenges, she thoroughly enjoys her job. She is in the second year of Nursing at the University of Tasmania and juggles her working hours around her course, job, and childcare responsibilities. Olivia and Harry attend the local state primary school, while Ava splits her time between kindergarten (2 days per week) and childcare (3 days per week). Jarrod is generally able to arrange his work around Emma, and their flexible custody arrangements mean their children are always with one or the other parent.

“All in all, we are doing OK. We may not be together anymore, but we’ve got to work as a team for the kids” 

Community

West Hobart is close to the CBD of Tasmania’s capital city, Hobart. Due to its location, Jarrod can walk to most local conveniences, and he occasionally uses public transport in preference to driving his trade van. All their children’s friends live within close proximity, and his social network encompasses friends from school, Park Run and his football club. Jarrod wishes he could be more active in the community (particularly in groups that support sports and green spaces), but his jobs don’t leave much spare time.

 

The suburb includes a mix of modern and historic homes and has experienced gentrification in recent years due to its prime location. The suburb is known for its friendly community, an abundance of parks and recreational facilities, and a thriving arts and cafe culture. Jarrod feels very lucky to live in such a nice neighbourhood, which would not have been possible without the inheritance from his grandmother. However, he is conscious that his house is not as well kept as the others in his street, prompting him to renovate the property room by room.

“They say you should have the worst house in the best street, but I know it looks scruffy” 

Health

Before the COVID-19 pandemic, Jarrod had always been relatively fit and healthy. A notable feature of his medical history was a very rare drug reaction he experienced in childhood, which resulted in an extended hospital admission. After being prescribed penicillin for an ear infection, Jarrod developed Stevens-Johnson Syndrome (SJS) with widespread blistering and peeling of the skin and mucous membranes. He has been left with some scarring on his abdomen but does not appear to have suffered any longer-term issues. Jarrod has, however, been told there is a small risk of re-occurrence every time he is prescribed a new medication.

Jarrod is extremely avoidant of medical attention for any illness or injuries as he finds this extremely anxiety provoking. His reluctance to seek help when unwell greatly concerns Emma and his parents, who worry that he may miss opportunities to identify and treat problems early as he ages. In more recent years, Jarrod has noticed more joint pain in his knees and lower back, which he attributes to the physical nature of his work as a painter and ongoing involvement in football. This pain had been becoming more persistent (particularly in the colder weather), and Jarrod was managing this with a combination of Deep Heat and glucosamine.

“I can handle this myself – I don’t need some doctor making a mistake and setting all that off again” 

COVID-19

Acute Infection

Jarrod caught COVID-19 in early April 2020 from one of his customers who had just returned from visiting family in the Northwest of the state. While the community was becoming more aware of COVID-19, there were no coordinated testing sites available, and knowledge of the virus was generally very poor. Jarrod woke up one morning with a terrible migraine (which he rarely experiences) and took two Panadol before driving to work. However, after picking up Tyson and heading to his current job (repainting a heritage property), he suddenly felt incredibly fatigued. Jarrod ended up sleeping in the van while Tyson continued painting the house. Upon returning home, he went to bed immediately and began sweating profusely. After tossing and turning all night, he went to Emma’s to pick up the children for school. There he noticed his morning coffee tasted completely different, and he couldn’t smell Emma’s cooked breakfast. He fell asleep with his head on the kitchen table about 5 minutes after sitting down to drink his coffee, and when Emma took his temperature, it was almost 40C.

After she dropped the kids at school and kindergarten, Emma cancelled her work shift and convinced Jarrod to come with her to the emergency department of Hobart Hospital. Upon arrival, the emergency department staff quickly identified Jarrod as a possible COVID-19 case and significant infection prevention measures were put into place. He sensed the staff were panicking somewhat and had a panic attack in response to his own anxiety about being in the hospital. Jarrod tried to convince the nurses that he should be discharged home, who responded by stationing a security guard at his door for the remainder of his admission. He stayed at the hospital for five days until his fever broke before being deemed well enough to go home. He was transported home from the hospital by non-emergency parademics in fully Hazmat personal protective equipment and saw some of this neighbours watching his arrival. No one could visit Jarrod in the hospital, and access to phone contact was very limited. None of his contacts (including Emma and the kids) subsequently tested positive for COVID-19.

Upon discharge, Jarrod isolated himself in his home and conscientiously followed all directions from the authorities. Emma dropped food and other supplies at the door wearing a mask and gloves, but he asked his parents to stay away, given their age and his father’s failing health. Jarrod’s fever had abated somewhat; however, he continued to have spikes in temperature over the next ten days. He felt tightness in his chest and was breathless, but while this was uncomfortable, he felt confident it would resolve due to his overall fitness. Jarrod’s smell and taste remained disordered, and he had to force himself to eat. He subsequently lost 7 kilograms over two months. Jarrod felt too unwell to work for three weeks, but after that, he returned to work with Tyson. He felt OK overall, and the only remaining symptoms were mild fatigue and an ongoing loss of smell and taste.

Developing Long COVID

Jarrod knew his recent COVID-19 infection gave him some immunity, but he stayed home as much as possible to reduce the risk of passing an infection on to other family members. He was particularly careful to protect the kids from exposure, as both girls had asthma, and their son experienced recurrent chest infections. Jarrod returned to Park Run and the football club, joking, “at least I’m bulletproof because I got it out of the way early”. However, when stories began to emerge of people being re-infected, he minimised his interaction with others in the community. While some of his friends supported this choice, others (including Jarrod’s parents) thought he was “going over the top” and expressed disappointment and concern about the impact this might have on his kids.

“They just don’t get it … they haven’t lived it yet.”

After being back at work for a month, Jarrod suddenly experienced a noticeable increase in his knee and back joint pain. He also began to experience new symptoms – increasing muscle pain occurring all over his body, swollen and bloodshot eyes, and dry skin. He also felt his ears were ‘full’ and began experiencing transient episodes of dizziness. Jarrod wondered if this was due to his COVID-19 infection or whether he had picked up another virus from somewhere. He did not seek medical treatment and continued to try and work full-time, but his new symptoms (particularly his worsening muscle pain) began to impact his daily life severely. After doing his own research, Jarrod began to wonder whether he had developed ‘Long COVID’, and he began to connect with some online support groups.

Jarrod became very careful about who he told about his infection after an incident with a client. He mentioned his infection in general conversation with them, was sacked on the spot and told never to return to the house as they had a family member who was immunocompromised. Due to public health restrictions and the general impact of the pandemic, the business had dried up, and he and Tyson applied for COVID-19 Job Keeper for financial support. He felt bad about Tyson, given that he was starting his career and had nothing to fall back on. However, they were both able to continue working for lesser hours, mainly on commercial properties. Over time, Tyson began to take on more and more of the work, but Jarrod worried that he was beginning to give him too many responsibilities due to his own limitations.

Jarrod’s health continued to worsen, and things came to a head when he experienced severe shortness of breath one day at work. He had been hauling some heavy storage buckets on site when his breathlessness suddenly worsened, and he was no longer able to take a deep breath. Another tradesman working on the site called an ambulance, and he was transported to the emergency department. When he gave his history to the doctor on duty, they said it probably had nothing to do with his COVID-19 infection because “everyone gets better pretty quickly”. However, they were able to diagnose a partial lung collapse and identified biomarkers that indicated unusual immunological responses. With his symptoms under control after a couple of hours, he was again discharged home.

“You just never know what you’re going to get with Long Covid … and I think they just wanted to get rid of me after last time”

From Emma’s point of view, the emergency department visit had still been helpful because Jarrod now had some information on record about his post-COVID-19 health status. However, Jarrod was incredibly frustrated by the lack of response he received from the hospital and felt that he was constantly wasting what little energy he had trying to convince others of his experience. As time wore on, any exertion or physical activity seemed to make him feel worse, which in turn also had a negative impact on his mental state. He came to believe that he wouldn’t improve unless he took a complete break from work and other activities to allow himself to recuperate. So, he decided to put his business on hold for three months. He offered to pay Tyson partial wages from his own savings to keep him on, but Tyson decided to move on to another painting business, and they reluctantly parted ways. Jarrod’s daily routine became much more sedentary as he slept approximately 16 hours daily and became increasingly restricted to his home environment.

Current Situation

Three years have passed, and Jarrod continues to participate far less in daily life than before his COVID-19 infection. While some of his symptoms have now abated (like the dizziness and bloodshot eyes), overall, any improvements in his health have been very slow, and he has experienced several relapses. Jarrod still experiences daily joint and muscle pain, which he thinks has been exacerbated by not moving around as much as he used to. He deeply wants to be well enough to rehabilitate back to running but still experiences extreme fatigue after short walks. After encouragement from Emma, he has linked in with a local General Practitioner (Dr Singh) who has been monitoring him fortnightly and running many tests. None of the tests returned abnormal results. Dr Singh agreed to work with Jarrod around his new physical and energy limits by continuing his gentle walks, pacing daily activities and resting. Jarrod has made it clear that he is not interested in taking any medication to help with his pain and other symptoms, and Dr Singh has respected his decision.

The past three months have been very difficult on the wider family, and his relationship with Emma is under immense strain. She now does all the domestic, community and childcare tasks they share due to the kids, and she struggles to keep up with her nursing course. While she is supportive of Jarrod overall, Emma is becoming increasingly frustrated with his insistence on ‘rest’ and is starting to question his commitment to getting better. She also wonders whether the online Long COVID support groups he belongs to are helpful because “they seem a bit like echo chambers at times”. His parents are urging him to become more active and to pitch in with childcare more often. Jarrod has lost touch with many of his friends from before the pandemic, as they have all returned to their usual activities as part of the world adjusting to ‘COVID normal’.

“If I don’t get this right, I will crash as soon as I get back to work and its going to be hard enough to rebuild it from the ground up as it is”

Life Roles

Since developing Long COVID, Jarrod has experienced changes in many of his life roles.

	Before COVID-19	Currently
Student	Regularly participated in trades training and worked through an online Certificate IV in Small Business.	No longer participating in any educational courses.
Worker	Full-time self-employed painter and decorator with a first-year apprentice.	Not currently working, and business has been put on hold.
Volunteer	Volunteered every week at the local Park Run event and was an active member of the West Hobart Warriors committee.	While not a player, he does small jobs for the football club (such as timekeeping and changing room assistant on match days).
Caregiver	Co-Parenting with his former wife (Emma) and is heavily involved in the daily life of his children. Performed domestic tasks (such as gardening and handiwork) for parents due to their age and poor health.	Only sees his children if Emma brings them to the house, which is happening less often. He is no longer able to help his parents with domestic tasks.
Home Maintainer	Completed all tasks independently.	No longer gardening or doing handiwork. He is able to complete light laundry tasks, but Emma and his mother often collect laundry to complete for him.
Friend	Friends from children’s school, Park Run, football club and his work. Regularly went on bushwalking trips with friends and occasionally camping with footy teammates.	Lost touch with a lot of his social contacts. One friend from the local Park Run group has come to accompany him on some light walks, which he hopes to continue. The football club is in regular contact and goes out of its way to find ways for him to continue contributing off the field.
Family Member	Regularly sees parents who live locally. He has little contact with his brother and family, who live approximately four hours away. Other family members located around Australia, who he would occasionally see face-to-face at big family events.	Does not see his parents as often and feels as though his mother, in particular, is ‘treating him like a child’. Brother is sympathetic to his situation, and they have been speaking more regularly on the phone. Other family members are in touch sporadically online.
Hobbyist / Amateur	Player for an amateur Australian Rules Football team (West Hobart Warriors). Enjoyed cycling, running and hiking.	Not playing football currently. Able to walk relatively short distances, but not currently cycling, running or hiking.
Informal organisation member	Not applicable	Member of two Long COVID online support groups, with whom he connects daily.
Community member	He had regular informal contact with his elderly neighbour, who knew his grandparents well and had known Jarrod since he was a baby. Jarrod would often help him with odd jobs and gardening.	Neighbour drops in every 1-2 weeks for a coffee and a chat. Sometimes they do light gardening (approximately 30 mins) in each other’s backyards.

Activities of Daily Living

Along with these changes in his life roles, Long COVID has negatively impacted many of Jarrod’s activities of daily living.

Renovations. Photo by Tima Miroshnichenko from Pexels. / Backyard Tomatoes. Photo by Juan Carlos Fonseca Mata, CC BY-SA 4.0, via Wikimedia Commons. / Park Run. Photo by Paul W, CC BY-SA 4.0, via Wikimedia Commons.

	Before COVID-19	Currently
Showing / Bathing	Independent with no difficulties.	At his worst, Jarrod was unable to shower regularly due to the impact it had on his fatigue and pain levels. Can now complete this activity most days, but it takes much longer as he tries to avoid exacerbating his symptoms. Joint and muscle pain makes it difficult to hand his hands above shoulder level and to bend down to wash his lower body. Renovations on the house had stopped before completion, meaning his bathroom remains barely functional.
Toileting	Independent with no difficulties.	Transferring on and off the toilet is painful at times (particularly first thing in the morning), but able to complete this task without assistance.
Dressing	Independent with no difficulties.	Able to complete independently, but lower body dressing often causes pain due to reaching and bending.
Eating / Drinking	Independent with no difficulties.	His sense of smell has returned, but he perceived odours differently than previously (e.g. vegemite smells sweet). Taste is now closer to normal, but not entirely like before COVID-19. His food intake remains less than before, and he has not regained the weight he lost during his acute infection.
Walking / Moving Around	Independent with no difficulties.	Jarrod is able to mobilise around the house without difficulty but has limited endurance for longer distances in the community. Walking or standing for approximately 15 minutes also exacerbates his knee and muscle pain.
Personal Hygiene / Grooming	Independent with no difficulties.	Independent, but less able to hold hands above shoulder level for extended periods of time (such as when shaving).
Sexual Activity / Intimate Relationships	Single for the past three years. Independent with no difficulties.	Remains single and is not currently looking for a partner. Reports his libido is currently ‘non existent’ and is worried that will never return.
Caring for others	Provided regular low-level support to parents and neighbours. He shared childcare responsibilities with his ex-wife.	No longer providing care for parents or neighbours. Emma supports him in having contact with his children as often as possible, but she is always present and often helps him with other tasks at the same time.
Communication with others	Independent with no difficulties.	Able to communicate independently, but Jarrod has fewer opportunities to socialize with others. He also reports that he ‘can’t be bothered’ due to bad experiences with others who questioned the reality of Long COVID and its toll on his energy levels.
Driving / Public transport	Independent with no difficulties.	Very limited walking in the local community, and no longer uses public transport. Continues to drive his van short distances but prefers to get a lift from others as he often finds it hard to concentrate.
Money management / Budgeting	Jarrod often ran short of money for household expenses and forgot to pay bills. Prior to his divorce, Emma took full responsibility for the household budget.	He is under significant financial stress due to his significantly reduced income. Currently living on Job Seeker and continues to incur debts over time. His parents and Emma provide additional help on a regular basis in the form of small loans, none of which he has been able to repay.
Home maintenance activities	Independent with no difficulties	He cannot complete any home maintenance activities, meaning his house is slowly falling into disrepair. His current priorities are to clean the gutters, fix a small leak in his room and tidy up the garden. His mother or Emma collects and returns his laundry for him, as he finds hanging it on the line exhausting, and he does not have a dryer.
Meal preparation / Clean up	Independent with no difficulties. However, mainly consisted of microwave and simple meals, as Jarrod did not enjoy cooking.	Independent with no difficulties with microwave meals and drink preparation. Eating fast food delivered by meal delivery services when his budget allows.
Safety / Emergency Management	Independent with no difficulties. Able to call 000 if required. Smoke and carbon monoxide detectors have already been installed.	Independent with no difficulties. However, the smoke detector battery needs replacing. This has been alerting him frequently to burning food in the microwave (and the occasional stovetop meal he prepares) because he can’t smell smoke.
Shopping	Independent with no difficulties	Undertaking all shopping online, which is delivered to his home. Delivery drivers sometimes help him put the heavier items away, but if not, he waits until his mother or Emma come over, and they lift them up into the cupboards for him.
Taking care of your health	He is very reluctant to seek medical attention and opposed to using medication to manage any of his health issues.	Sees GP on a monthly basis for monitoring and medical certificates. Jarrod has come to trust him, and they have a good relationship. He is not currently receiving any treatment or medication, as per his preference. Jarrod is interested in increasing his activity levels but doesn’t know how. He feels frustrated and worried by the need to avoid pushing himself too far to prevent a relapse in his symptoms.
Rest / Sleep	Independent with no difficulties	Still sleeps 12-14 hours per day but acknowledges that sometimes this is due to boredom more than fatigue. Disordered sleep pattern. Sleep 3-4 hours at a time across all times of the day and night.
Education	Independent with no difficulties	No longer undertaking education, which is not currently a priority for Jarrod.
Work (Paid or Voluntary)	Independent with no difficulties	The painting business remains on hold. Jarrod retains all registrations and major equipment required but would need to fund a significant restock when he returns to work.
Play / Leisure	Independent with no difficulties	No longer participating in riding, running, and walking on a regular basis. A friend from Park Run visits him twice a week to walk around local streets, and they are slowly extending the distance walked (currently approximately 2 kilometres). Jarrod is wary of increasing his walking, as he has experienced ‘collapses’ on some occasions, which have increased his symptoms in the short term.
Community Participation	Independent with no difficulties	Attends football games and training when he can and has begun to take on small jobs (timekeeping) when he is having a good day. Feels connected to and supported by the club.
Family relationships	Independent with no difficulties	His parents and ex-wife are becoming increasingly frustrated at his lack of progress with recovery. While Jarrod feels bad about relying on them for so much, he also feels angry because he feels they don’t understand how much difficulty he has with daily life.
Friendships	Independent with no difficulties	Lost a lot of social contacts he previously had via his children’s school. Regular contact with a friend from Park Run, football club and neighbour. However, Jarrod doesn’t feel like he contributes much to these friendships.

Jarrod’s Goals

Jarrod is able to identify a couple of areas where his health has improved, but overall, he feels that his life is on pause, and he is not sure how to move forward. He wants to work with people who know about Long COVID and acknowledge the massive changes it has bought to his life. Jarrod is focused on returning to work because this will solve his financial problems and, in his words, ‘give me back some of my dignity’.

His goals (in no particular order) are to:

• Return to work as a painter and decorator or in a related job.
• Feel less pain and stiffness in his body.
• Get back to completing all his activities for himself and no longer rely on others.
• Spend more time with his kids, including looking after them on his own.
• Get back into regularly riding, running and hiking to reconnect with nature.