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Long COVID burdens hospital resources: study


The impact of long COVID-19 on already-strained hospital systems is significant, with patients who were adversely affected by the disease spending extended time in hospital and using emergency resources that are few and far between,  according to a new study published Monday.


The care required to meet demand for those with long COVID has implications for Canada’s healthcare system in the near future, as two-and-a-half years into the pandemic, systems are not equipped to meet demand, according to the research published in the Canadian Medical Association Journal


With healthcare systems under strain, particularly Ontario’s which is seeing ER closures, long-wait times and staff shortages across the board— the research indicates the more people there are with severe COVID-19 cases, the more stress an already buckling system will be under, said study co-author Dr. Clare Atzema in a phone interview with CTVNews.ca.


“You put this in the context with the fall coming, and everyone’s masks are off. Many are going to get COVID and a small portion are going to get long COVID,” said Atzema, who works as an emergency physician at Toronto’s Sunnybrook Research Institute and a senior scientist at ICES.


She added that small portion is enough to send the healthcare system over the edge.


“There’s going to be a huge extra strain on the hospital system that’s already overstressed, almost at the point of collapsing,” she said. 


Throw flu season into the mix and there will be a massive impact on a population level, said Atzema.


The study, which looked at patients in Ontario using data from the Institute for Clinical Evaluative Sciences (ICES) between January 2020 and December 2021, found the greatest use of healthcare resources came from one per cent of people who tested positive for COVID-19 (those with long COVID).


Those patients spent an extra week or more in hospital over the following year, compared to those who weren’t infected, according to the study. 


According to the World Health Organization, about 10 to 20 per cent infected with COVID-19 will develop a form of long COVID. The study researchers note that estimates of long COVID rates vary by methodology and changing factors including the different types of variants, vaccination and previous infection.


However, it’s crucial for health care providers, funders and policy makers to understand the impact of long COVID on the health care system in order to allocate resources equitably now, and plan for the future, the researchers explain.


For instance, the researchers cite an estimated 45 per cent of the Canadian population was infected with COVID-19 in early 2022. By next year, one per cent of these infections will likely be admitted to hospital for an average one week longer than “similar people without infection.” They will consume about 6.6 per cent of pre-pandemic hospital bed-days, even when 20 per cent of hospitals are over 100 per cent occupancy.


“Given the number of recent infections, our findings portend substantial health care use by people in Canada,” they state. 


Atzema said healthcare workers are beyond overwhelmed, as they are helping patients who often have multiple ailments, and the patients are receiving care in hallways.


“The first two patients I saw on my shift yesterday waited more than 10 hours to be seen, one of them was over 80,” she said.


A further burden on the system will be untenable, she said.


And on an individual level, even if the risk of long COVID is low, it’s something that is possible with any COVID-19 infection and it can have a detrimental impact on your life, said Atzema.


Further, she added that all patients are impacted because those with long COVID would have to use emergency and hospital resources for longer, and more frequently. The population overall will be impacted by long COVID due to its strain on the system, regardless if they develop the disease or not.


VACCINATION DECREASES RISK OF LONG COVID


“It’s something you want to avoid at all costs,” she said. Wearing a mask indoors, and better air filtration in places like schools will make a difference, she said.


“I know you don’t look that cool if you’re wearing one anymore but we’re going into that season with flu as well, and get vaccinated. We believe vaccination decreases your risk of long COVID,” she said.


Though figures on the exact rates of long COVIDare not definitive, a new study published in Scotland last week, completed by researchers at the University of Glasgow, found that one in 20 people suffer long-term health issues after having the illness.



The research, published in Nature Communications, found that 42 per cent of people only reported feeling partially recovered between six and 18 months following a COVID-19 infection.


The study also found that those who had been vaccinated before infection seemed to have some protection against long-term symptoms.


‘WE NEED MORE HOSPITAL BEDS’


Alarmingly, those who reported long COVID had a wide range of symptoms including brain fog, chest pain, heart palpitations, and confusion. 


As cold weather comes and more people move indoors without health restrictions, cases will increase and hospital systems are not prepared, said Atzema.



“We need more hospital beds,” she said. She’s glad Ontario is implementingother clinics to get through the backlog of surgeries, but having more hospital beds staffed with nurses will help prepare for what’s to come.


“It’s the snowball effect, and we’re all about to be crushed…and then you throw in the flu season coming, it’s going to get worse,” she said.


Edited by CTVNews.ca producer Phil Hahn

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