In the more than three years since the World Health Organization (WHO) declared COVID-19 a global pandemic, there have been approximately 763 million confirmed cases of COVID-19 and 6.9 million deaths. Across Canada, more than 4.6 million confirmed cases of COVID-19 and approximately 51,700 deaths have been reported. Here in Alberta, there have been more than 630,000 confirmed cases and 5,685 reported deaths. What is harder to quantify, and of growing concern, is the number of people who are now living with the lingering, and increasingly devastating impact, of long COVID.
Although there is no universally recognized clinical definition, post-COVID-19 condition (PCC), or long COVID, is often described as experiencing one or more physical or psychological symptoms more than three months after getting COVID-19. According to the WHO, studies show that 10-20% of people who have been diagnosed with COVID-19 may develop long COVID, which means there are millions of people around the world who are living with long COVID. Here in Canada, as of August 2022, more than 1.4 million people are estimated to be living with long COVID.
Complex array of symptoms
For those living with long COVID, the effects can be both debilitating and bewildering. Symptoms often wax and wane and can include a range of pulmonary, cardiovascular, neurological, and physical conditions. Many people report difficulty thinking, cognitive changes, headaches, sleep disturbances, fever, chest pain, shortness of breath, ongoing cough, and general pain and discomfort. Others experience memory problems, anxiety and depression. Some have found that their voice has changed, becoming raspier, and their sense of smell remains altered. Most describe experiencing extreme fatigue and reduced stamina. Worryingly, some experience all of the above.
Long COVID often makes it impossible for people to return to the life they lived before the pandemic. Symptoms tend to worsen with physical or mental activity, which makes it difficult to work or pursue sports or recreation activities. Even elite athletes have been sidelined by long COVID. Rower Oonagh Cousins’ struggle with long COVID dashed her Olympic dreams, while 21-year-old British tennis player Tanysha Dissanayake announced her retirement from tennis due to long COVID. When it comes to long COVID, youth and physical fitness don’t seem to matter.
Economic impact
Many countries have begun to raise the alarm about the significant economic impact of long COVID. Earlier this year Canada’s chief science adviser, Dr. Mona Nemer released a report that noted the “future socio-economic implications for Canada may be far-reaching and require planning and monitoring.”
The report warns that Canada could face a “mass disabling event.” In part, this is because long COVID raises the risk of chronic diseases that will make it hard for people to return to the workforce. The report also notes that “robust modelling projections are needed to determine how many Canadians will be affected by PCC in the coming years and how to best adapt schools, workplaces, social supports and the health care system to support these individuals and their dependents.”
Countries around the world are facing similar challenges, with the UK reporting a drop of 1 million people in the labour market as of April 2022. In July 2022, the United States estimated that the economic cost of long COVID totalled $3.7 trillion, with those costs encompassing quality of life, lost earnings and medical care spending.
A personal journey
Tara Madden, an Edmonton communications professional and mother of two, caught COVID on Christmas Eve 2021. “Santa was not especially kind to me that year,” she recalls. Despite the symptoms being relatively moderate, it was clear that it was more than just a cold. “I was ill in bed for a full 10 days but was able to manage it at home.” Prior to contracting COVID, 51-year-old Madden was in good health with no underlying health conditions.
After the 10-day mark, although the acute symptoms lessened, she continued to suffer from significant fatigue and experienced shortness of breath from basic tasks like getting dressed and walking up stairs. “I was suffering from brain fog and having challenges sorting out words in my mind – which was devastating for a professional communicator,” explains Madden “I couldn’t go out of the house for very long because I would get too tired, and it was impacting family activities; even taking the dog for a walk required frequent breaks.”
Madden was lucky to have a family physician who listened to her concerns and set out to help her find answers. “She told me, I hear you and we’re going to figure this out. And that meant more than I can possibly say.” Madden also did a lot of her own research, including finding information about a local long COVID clinic. “While my doctor wasn’t familiar with it, she was very willing to go through it with me, complete the tests and the referral and also suggest some strategies to address specific symptoms in the interim. This meant everything to me – to be heard, to be acknowledged, to know she was in my corner.”
The referral to the post-COVID recovery clinic included a series of tests, which indicated she had developed asthma and was severely anemic. She also experienced damage to her vocal cords and was referred to an ENT and a voice therapist. An exercise therapist helped her work to address fatigue issues so she could return to physical activity. She describes the first six months as especially difficult. “Fortunately, my kids are teens so were able to help out more, but I often felt like I was letting them down. I struggled to have the energy to fully engage in activities. We had to schedule things for during the day because I was too fatigued come evening.
Today, Madden explains she has settled into what she calls her new normal. “The asthma is looking like it will be permanent. While I am in physically good shape and workout regularly, I have to break my workouts into segments throughout the day and I’ve had to eliminate strenuous cardio. My fatigue issues have improved, but I still fatigue more quickly than I did pre-COVID.”
Madden is quick to encourage anyone who is struggling after COVID to seek help. ”You know yourself best; if you’re not feeling fully recovered, make that clear to your family physician. Gather the information and advocate for yourself to be heard. It can be hard, but you deserve that. And most importantly, know that you are not alone.”
Banner image credit: Pete Linforth Pixabay.com