Well I have managed to resolve the problem.

I used the following command to give NVDA a Realtime priority on the system.

wmic process where name="nvda.exe" CALL set priority 256

NVDA is working faster than it ever did.

The reason I was using task manager is that NVDA was slow.

I also found out why NVDA was slow.  Looks like my company is running some sort of data processing screen saver in the background (World Community Grid) which is working on testing for bloody covid.  So, I am giving NVDA higher priority than a deadly virus.