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researchers say many questions left to answer about long covid

preparing the province's health care system for what could be thousands of people experiencing symptoms not really understood is tricky, but that's what the sha is trying to do.

by: lynn giesbrecht
as he scans through facebook support groups for people experiencing long-term covid-19 symptoms, scotty butcher sees many stories of people who had only a mild case but have been struggling with lingering symptoms for months.
some others who had cases so severe they wound up in hospital have not been seeing the same long-term impacts.
“strangely, it’s the ones that didn’t have that severe presentation at the outset of their diagnosis or at the outset of their infection that are now having these longer term problems,” said butcher, an associate professor at the university of saskatchewan’s school of rehabilitation science. he has been researching long covid and rehabilitation methods that may help patients.
he emphasized, however, that covid-19 is too new an illness for there to be concrete data on its long-term impacts, so he can only speak anecdotally to what he has seen. as for why some people with milder cases seem to be seeing harsher, long-term impacts, butcher said no one knows at this point.
dr. gary groot, co-lead of the saskatchewan health authority’s (sha) long covid working group, agreed there are many unknowns, including what connection the severity of someone’s initial infection has to their chances of experiencing long-term symptoms.

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“we pretty much don’t know anything about this, and it’s going to take years to chart it out, but we have to treat it at the same time,” groot said.
alyson kelvin, a scientist at the vaccine and infectious disease organization (vido) at the u of s has been researching the impacts covid-19 has on organs in an attempt to better understand long covid. she has found the infection can cause high levels of inflammation in not only the respiratory tract, but also tissues in the brain, heart, kidney and intestines.
while she has some hypotheses as to why the disease creates this inflammation, she doesn’t have solid answers.
she also isn’t sure if new variants will create different long-term symptoms.
“definitely we need more research and more time, but we don’t have time. that’s the way new viruses and new diseases work,” kelvin said.
long covid is usually defined as when someone experiences symptoms more than three months after first contracting covid-19.
research from around the world indicates upwards of 30 per cent of people who have covid-19 will also have long covid, although groot believes the true number is closer to between 10 and 20 per cent.

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to date, saskatchewan has had nearly 50,000 confirmed covid-19 cases and groot expects the number of undiagnosed cases to easily be another 100,000. even if just 10 per cent of that population experiences long-term symptoms, that’s 15,000 people who may need continuing medical support.
preparing the province’s health care system for what could be thousands of people experiencing symptoms not really understood is tricky, but groot said that is what he and dr. gary linassi, provincial head for the sha’s department of physical medicine and rehabilitation, are trying to do.
“there’s lots and lots of questions that are remaining, and we would be remiss if we don’t position ourselves in setting up something provincially to also be able to answer some of those questions for our saskatchewan context,” said groot.
as leaders of the long covid working group, groot and linassi are putting together a proposal they plan to submit to the provincial government and the sha in mid-august, outlining what the province can expect to see of long covid and recommendations on how to prepare for it.
at the moment, the sha does not even have a way of tracking the number of people reporting long-term symptoms. because long covid symptoms are so varied and not everyone who experiences them has officially tested positive for the disease, it is difficult for health professionals to know exactly who the long covid patients are.

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groot also believes there are many people with long covid whose symptoms are mild enough they are managing them at home.
“that doesn’t mean their symptoms are not significant or are not challenging or having impacts for society, but they don’t need to be in hospital,” he said, noting researchers need to find ways of counting these people.
linassi worries that, with the health-care system already strained as it emerges from the pandemic as it attempts to catch up with the procedures put on hold, a high number of long covid patients could strain the system further.
health-care workers are also already exhausted, and linassi called the situation “a perfect storm” if the system does not make efforts to prepare itself.
“it’s going to require additional resources,” he said.
part of those resources may come in the form of education for health care professionals on how to identify long covid and what rehabilitation may prove helpful, said butcher. that’s a piece he is already working on.
without that education, butcher said long covid patients may go undiagnosed and untreated — something he already sees happening.
“they’re having these weird symptoms nobody’s listening to, so it’s a really big struggle for these patients to even be heard and believed,” he said.

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linassi encouraged anyone experiencing long covid to talk to their doctor about their symptoms.
the best defence against long covid, however, is to not get covid-19 in the first place. all four experts — groot, linassi, kelvin and butcher — urged people to get their first and second vaccine doses to best protect themselves against the illness.
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