As of Python 3.8, PATH is no longer used for loading DLLs. https://docs.python.org/3.8/whatsnew/3.8.html#bpo-36085-whatsnew
For packages that use PATH on Windows like LD_LIBRARY_PATH on Linux (all of mine are like this) I’m not really sure what to do to fix this.
One option would be to write out a sitecustomize.py that adds all the dll paths and set USER_BASE to point to it. This will probably break in certain circumstances though.
Another option would just be to static link everything on Windows.
I really hope I’m just being stupid and overlooking something obvious here!