Long COVID will have health, economic impact for years to come, says expert

Prince Edward Island and the rest of the Maritime provinces have done "extraordinarily well" keeping COVID-19 in check, says a member of the Ontario Science Table.

But Omicron has changed the playing field, says Dr. Fahad Razak, and now P.E.I. and even the territories need to be prepared for what comes after COVID: long COVID.

"This health system burden, the societal burden, the economic burden, I think it's going to be something all the provinces and territories will be grappling with for years to come," said Razak, an internist and epidemiologist at the University of Toronto.

For most of the pandemic P.E.I. remained relatively COVID-free. But since mid-December, daily case counts have climbed to the point where they are some of the highest in the country on a per-capita basis.

Of the 6,800 total cases on the Island since the pandemic began, 94 per cent occurred after Dec. 15, 2021.

A report co-authored by Razak for the Ontario Science Table forecasted that 10 to 14 per cent of Ontarians who contracted COVID would end up with long COVID.

Based on P.E.I.'s case count so far, that would equate to between 680 and 950 cases.

This health system burden, the societal burden, the economic burden, I think it's going to be something all the provinces and territories will be grappling with for years to come.— Dr. Fahad Razak, internist and epidemiologist at the University of Toronto.

"This is the real worry," said Razak. "We're having these waves of infection go through and, rightfully, there is a lot of focus on hospitalization as the most important outcome."

But long COVID, he said, represents "this long legacy effect, and it may last for years. It may last longer."

Long COVID refers to any combination of more than 200 chronic symptoms which have been identified in people who were infected with COVID-19.

Those symptoms can appear even if the COVID-19 infection itself was mild or completely asymptomatic. The most common symptoms include fatigue, shortness of breath, pain, sleep disturbances, anxiety and depression.

"Many people with the post-COVID-19 condition have difficulty returning to baseline levels of function and have high rates of health-care utilization," according to the report Razak co-authored, released in Sept. 2021.

'Like losing little bits of you'

Susie Goulding of Oakville, Ont., was infected with COVID-19 during the first wave, in March 2020.

She now counts off the things in life she's had to give up, because nearly two years later she still suffers from lingering symptoms, many neurological in nature — what long COVID sufferers have come to refer to as "brain fog," along with a constant fatigue that makes the things she used to do just too demanding.

"I gave up skiing … I was a ski patrol, [a] very active mom with a son who's loving snowboard," said Goulding, now 54, who says she was 52, fit and healthy when she contracted COVID.

She's also had to give up driving and switch to a new line of work, because even her day job as a florist was more effort than she could sustain.

She said her 12-year-old son has also lost the mother he used to have, because she's just not that person anymore.

"It's like losing little bits of you over and over again, and grieving the process," said Goulding. 

She started an online support group through Facebook which now has more than 15,000 members across the country — including some in P.E.I.

"Many people are suffering from anxiety and depression from all the changes in their lives," she said. 

Having a condition that didn't exist before has made it a struggle to obtain a diagnosis, to get support from programs like worker's compensation "and even their families in some cases are not being supportive."

Now that Omicron has launched a "tsunami" of infection that's reached every corner of the country, including in P.E.I., Goulding predicted a fresh wave of "long-haulers will be coming to join our group within the next few months."

Province seeing few long COVID cases, Morrison says

P.E.I.'s Chief Public Health Officer Dr. Heather Morrison said the province has seen only "very small" numbers of COVID long-haulers so far, but given the recent caseload she said it's now important for the province to "enhance surveillance" for the condition and ensure doctors and nurse practitioners are prepared to recognize the symptoms.

That can be a challenge, Razak said, particularly when testing capacity across the country has been stretched to the point where many people with COVID-19 might never have received a positive test. 

"This is going to be a real burden for the health system, to try and disentangle what is long COVID [and] what is some other illness."

Razak said there is no known treatment for long COVID, but symptoms are less likely to show up in people who are vaccinated.

He said with Canada approaching 3 million total confirmed COVID cases, at least one tenth of those — 300,000 — have likely suffered from long COVID.

Goulding is encouraging people to take every precaution to avoid getting COVID-19 in the first place, and takes issue with the characterization of Omicron or any version of the disease as "mild.

"There is a large number of people who are not recovering, and we wouldn't consider that these cases are mild. They may start off mild, but in the long term they can be completely debilitating."