The rehabilitation process is long for patients with long COVID, which can limit professionals in their care of new patients. This aspect added to the other ills of the health network means that some 4,000 patients find themselves in the network of long COVID clinics, half of whom are on the waiting list.
This was shared by Simon Décary, who chairs the steering committee for long COVID clinics at the Ministry of Health. However, he is hopeful for people suffering from long COVID, as new measures are reportedly on the way to improve access.
In 2022, the Quebec government has allocated a budget of $20.5 million to deploy 15 clinics for long COVID. He does not plan to open any more in the short term. “It takes time to build this kind of network of clinics,” emphasizes Mr. Décary, “but here we are at a good cruising speed, even if we still have a lot of work to do.”
Mr. Décary specified that generally, a person will wait approximately six months between the moment they find themselves on the waiting list and their first intervention with a professional. This period may vary depending on the region. He estimates that each month, approximately 100 more people are referred to long-term COVID clinics.
Around 50 health professionals work full time in the network of long COVID clinics, reports Mr. Décary. According to him, better access does not only require more staff.
“We have an access problem because the long COVID rehabilitation process is extremely long. There are a lot of relapses and returns to treatment episodes. So, teams are not necessarily able to close a file quickly. We have people who do not improve over time, and the teams are more supportive of them in the issue of disability and return to partial work. But these are things that take time, so we cannot see as many new cases in these clinics,” he explains.
One solution that could be implemented is patient education. For example, patients with long COVID should not “exceed their energy envelope” to avoid relapses. Mr. Décary suggests that explanatory video clips before a visit to the professional could free up the latter’s time. “It’s a model that works in a health system that is under pressure,” he comments.
Large-scale training
“The issue of training professionals more broadly is really the keystone to improving access,” believes Mr. Décary, who is also an assistant professor in health services organization at the University of Sherbrooke. .
In September, a continuous quality improvement program was launched and deployment is currently continuing in Quebec. “The flagship of this initiative is a two-hour, online, free training course, which is developed by the Federation of General Practitioners of Quebec in collaboration with the Ministry of Health and the Federation of Specialist Physicians of Quebec” , indicated Mr. Décary.
This training is expected to be available in early 2025 not only to specialist doctors and nurse practitioners, but to all professionals who work on the front line with these patients, such as occupational therapists, psychologists and physiotherapists.
Over the past few years, long-COVID clinic professionals have had successes and failures trying different things with patients. “They have built a body of knowledge to help these people,” underlines Mr. Décary.
He recognizes that the training perhaps comes a little late and that many patients experience issues with access to care. “But arriving at a quality product to train thousands of doctors takes time,” he argues.
Mr. Décary said that a “pharmacological compendium” was being developed to target all the pharmacological agents that can help treat the different symptoms and comorbidities of long COVID.
Beneficial for other diseases
COVID-19 has lifted the veil on other infections that can cause disability. Diseases like myalgic encephalomyelitis or Lyme disease are also post-infectious infections and have been known for decades. “It took COVID to recognize that there is a historic failure in the care and training for this class of diseases. We have started the work and we are working as quickly as possible to close the gap in medical training,” maintains Mr. Décary.
Since no cure currently exists, some people suffering from long COVID will live with a disability, possibly permanently. These people will need follow-ups throughout their lives. For others, we sometimes see improvements in their condition over the course of a few years to the point of no longer being considered long-term COVID patients.
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