Ask the Pharmacist

Q) I heard there were two studies recently released regarding the effects of long COVID in Canada. What were the findings?

A) Second only to COVID and its various vaccines, nothing seems to have captured the media’s attention more when it comes to health than long COVID. Despite all this scrutiny, long COVID has remained a subject of which little is known for certain. This pertains to such basic questions as:

· Why does it occur and what is happening inside the bodies of those who suffer from it?
· Why do some people get it while others do not? Are there risk factors that increase the likelihood of it?
· How should we treat it?
· How long does it last on average?
· How many of us currently have it or have had it in the past?
· Is it more likely to occur with repeated infections?
· What are its ramifications for our seemingly already maxed out health care system?

Given all these basic unknowns, it is high time that we start to get some real data on this syndrome. Information will be the key to helping these people fully recover while still protecting our hospitals and family doctors from being overwhelmed. To that end, two major studies were released in the last couple of weeks. These were the first of their kind in Canada and have contributed to filling in the blanks of our collective knowledge.

One was published by Statistics Canada in partnership with the Public Health Agency of Canada. It is described as the first report of its kind that is national in nature. Its biggest contribution to our knowledge base is its finding that nearly 15% of people who’ve contracted COVID-19 say they have experienced lingering symptoms for three months or more after their initial infection. The 3-month timeline seems to be the standard definition as to when a person’s ongoing symptoms cross over from being attributed to the initial infection and are instead placed in the long COVID category.

The Stats Can data also suggests some 1.4 million Canadians (close to a mind boggling 5% of our total population) have experienced long COVID. These numbers seem to be in line with other countries according to figures released by the World Health Organization. This represents a staggering number of Canadians who have gone about their lives struggling with fatigue, brain fog, dizziness and the myriad of other symptoms associated with this diagnosis. It has been a tragedy for them personally and for Canada as a country which sorely misses their contributions to its economy and can ill afford the care many have and will need.

There is a silver lining in this report however and that can be found in the findings that this diagnosis has become substantially less common since the Omicron variant became the dominant strain. The survey found that 25.8% of Canadian adults who contacted COVID- 19 before December 2021 felt symptoms lingering for longer than three months versus just 10.5% of those infected since that month. Scientists believe this drop in frequency is directly attributable to the effects that our assorted vaccines have on the severity of the infection.

As most of us know by now, vaccines are only okay at preventing infections but their benefits really shine when one looks at their effects in preventing severe disease from the virus. Data to support this hypotheses can be found in how people answered their surveys. Of those who described their initial symptoms as severe, 36.4% remained symptomatic more than 3 months later. Accordingly, 15% who described themselves as only moderately sick with COVID continued to have long term symptoms and only 6.3% who rated their initial case as mild continued to feel lousy 3 months later.

Questions not answered by this survey that would have been nice to have known include just how severe their long COVID symptoms are and at what point, if ever, their symptoms started to wane.

The other major Canadian study was released on the same day and was published in the prestigious medical journal, the CMAJ. This study looked at the use of the health care system in the months after more than 500,000 Ontarians were given a PCR test to determine whether they currently had COVID-19. These findings, not surprisingly, indicated that those who tested positive needed to use the services of their family doctors, home care and the local hospital much more often than those who were COVID free.

For instance, the researchers found that women who tested positive had a 47% increase in the average number of days spent in hospital per year while the men showed a 53% increase.

When we consider that nearly half of all Canadians were infected during the first few months of 2022, the effect on the healthcare system has been massive on a cumulative scale. Researchers calculated that an average family physician would need to find time (and the requisite staffing/ office space) to schedule a 100 more patient visits a year to accommodate these increased demands.

This increased use of healthcare resources has no doubt played a role in contributing to the horror stories we continue to hear about on the local news; longer wait times to see family physicians, patients waiting on gurneys in emergency wards overnight and the warning signs of imminent heart attacks and strokes that were ignored due to concerns about spending hours at the local emergency department.

The good news from this study is that 75% of those who have long COVID will eventually be symptom free within 12 months. But for the remaining 25%, the future is still very uncertain and somewhat depressing given the far-reaching negative consequences this infection has had on their lives. For more information about this or any other health related questions, contact your pharmacist.