Don't want a long COVID?  Don't Catch COVID, Doctor Says About Chronic Symptoms of Virus

Don’t want a long COVID? Don’t Catch COVID, Doctor Says About Chronic Symptoms of Virus

increasing demand for further treatment; Health Secretary says county is acting ‘faster than anywhere else’

The demand for long-term COVID treatment is growing with each wave of the pandemic, and the five clinics established in British Columbia so far likely won’t be enough, says a retired doctor from the Vancouver Emergency Team who hosted a recent briefing on COVID’s long-term impact.

“We are really going to have a pandemic after the pandemic, because the number of people affected by the Covid virus for a long time is increasing with each wave and becoming so prevalent that we cannot ignore it,” said Dr. Lynn Viliatroult. COVID clinics are needed to meet current and future demand.

Viliatrolt spoke about complications including heart attack, stroke and blood clots after contracting the COVID virus, at the event sponsored by Protect Our Province BC, a group of doctors, nurses and health experts who advocate for evidence-based health policies.

Referrals to the post-COVID recovery clinic at Royal Jubilee Hospital — the fifth such clinic in the county when it opened in March — more than doubled to 152 from 60, according to Island Health.

Clinic Victoria patients must be 3 months past the initial symptoms of COVID and be referred by a doctor or nurse practitioner.

Health Secretary Adrian Dix said more is known about COVID and the protracted COVID each day, and that BC is moving “more quickly than anywhere else,” after it built a long COVID network of health care providers across the county.

The Post-COVID-19 Multidisciplinary Clinical Care Network says its goal is to support the best possible outcomes for people recovering from chronic symptoms after contracting COVID-19, through research, education and care.

The network, a partnership of the County Health Service, county health authorities, patients and research organizations, provides multidisciplinary clinics, supports primary care providers and resources to help those affected manage their symptoms.

“It’s never going to be just clinics — you’re going to have to have a network of providers all over the county who know what they’re doing,” Dix said. “That’s why we put our network in place first, linking all of our health authorities together. The five clusters are just one aspect of that.”

With the lack of data on the prolonged COVID, Viliatrolt said, it’s hard to know the extent of the problem.

“It’s been two years since this and I can’t tell you how many patients in British Columbia have had COVID for a long time. We don’t know how many patients have contracted COVID after the last wave. We don’t know the waiting times across the province for the long COVID clinics,” Villarault said. “We need the data.”

Dix said the data the county has been collecting on COVID for a long time will be made public. He said research from around the world must be in the hands of clinicians if they are to respond effectively to this new chronic disease.

Dr. Neja Bakshi, an internal medicine specialist in Edmonton who has taken care of acute COVID cases for the first two years of the pandemic, opened a long COVID clinic in January and said referrals had been “over the limit,” with three- to four months backlog.

She said that Covid-19 was initially thought to be just a respiratory disease, and soon it was discovered to be a systemic inflammatory disease, affecting not only the lungs, but many other areas and organs in the body. And just as COVID can affect every system in the body, COVID can affect a prolonged period of time or complications from the virus.

Bakshi said long-term COVID-19 is generally defined as symptoms of the virus that do not go away after eight to 12 weeks.

The World Health Organization and the Centers for Disease Control and Prevention list more than 200 displays, but Bakshi said common symptoms include fatigue, fever, chest pain, shortness of breath, and tachycardia (high heart rate with fatigue or even no known cause). Cognitive impairment is often called brain fog and forgetfulness.

Bakshi said she also sees patients with symptoms that resemble a range of autoimmune conditions, including severe joint pain or swelling, sinusitis, or autonomic dysfunction such as the flight-or-fly reaction for no known cause, she said. Less common reported symptoms include diarrhea and bloating.

“We know at this point that there is no magic pill,” Bakshi said. “We knew what we were going to focus on was symptom management, as well as a collaborative model, so the premise was born and we decided to open it in January of 2022.”

She said appointments take about 90 to 120 minutes in person or by phone or video to “really get to know” how to help each patient.

Bakshi said that in addition to prolonged COVID, internists are receiving more referrals for metabolic concerns — heart disease, stroke and type 2 diabetes — in patients aged 40 to 60 who have had COVID.

While some cases could be explained by people who were less active and spent more time indoors during the pandemic, “we also likely need to consider the risks of diabetes, high blood pressure or heart disease from contracting coronavirus,” he said. Bakshi.

“I think as clinicians and I think as the medical community, we tend to wait for a lot of evidence and a lot of research before we act on things, but I think we’re in a state of crisis right now, with so many Canadians having COVID and we’re going to have to quickly start adapting to it.”

With everything she’s seen after treating severe COVID patients and now running a long COVID clinic, Bakshi said her best advice to avoid COVID for the long haul is simply to avoid infection, whether through vaccination or other preventive measures.

“The biggest take-home message, and I say this to everyone who asks me ‘how do I not get COVID for so long’ is – I don’t get COVID,” Bakshi said.

“It may sound very cliched, but the truth is until we know more about who is affected by the long-term coronavirus and why some populations are affected by the long-term coronavirus, we won’t really know the risks of who gets it.”

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2022-05-25 10:05:00

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