Long COVID Diagnosis and Management

"[Long COVID] has emerged as a complex and multi-system disease that is anticipated to require multidisciplinary management and treatment across the continuum of care."

Ontario Ministry of Health

"The designation of a specific code really does help us track, count and look at the burden of this across Ontario."

"It is the belief of our review that the vast majority of patients can be treated through their primary health care provider."

Dr. Kieran Moore, chief medical officer of health, Ontario

"This code is a big deal. It's helpful for us and I think it's going to help change the way health care is delivered in Ontario in the future for people with Long COVID."

"We have lots of work to do on pretty much everything to do with the treatment and support of people with it. But I think the first step is just acknowledging that it's a real thing."

"It really is critical and it's something that we've been asking for and advocating for, for a while now."

Dr. Kieran Quinn, clinical expert in Long COVID, associate professor, University of Toronto

New research out of Israel suggests most symptoms of long COVID clear up within a year, but some — like weakness and trouble breathing — are more likely to persist. CBC

"People are grieving the loss of who you were. I'm not who I was before COVID."

"It's [news of a small victory in the imposition of a new fee code recognizing the reality of Long COVID] -- just the first step of a thousand."

"We want to see a commitment from the government with some kind of strategy as to how they're going to deal with Long COVID."

Suzie Goulding, COVID Long-Haulers Support Group Canada

After the frustrating, gruelling experience thrust upon Suzie Goulding following her bout with COVID-19, leaving her with the condition now known as Long COVID, she became a warrior for the recognition of the condition, hoping that general practitioners, the first medical doctors generally who see patients suffering from the syndrome and unable to diagnose it, will begin to help others where she was failed. Early in the pandemic she became ill with COVID-19, but her family doctor did not believe what ailed her was the virus.

She has, in fact, never been formally diagnosed, since at the time of her initial bout with the SARS-CoV-2 virus, it was difficult to obtain testing without being judged qualified for the testing process. Eventually she found herself struggling to walk. She was referred to a neurologist whose opinion was she was suffering from anxiety. Low energy levels assail her; she lives with a persistent brain fog affecting her speech.

"The more that I speak, the less words I can find", she said. It occurred to her to launch a community self-help group to welcome others suffering from Long COVID in an atmosphere where it was not being taken seriously throughout the medical community. There are now 18,000 members across the country  for the COVID Long-Haulers Support Group Canada. A support group that lobbies to support researchers like Dr. Quinn in striving to understand the disease.

With his colleague, Dr.Angela Cheung, Dr. Kieran Quinn is preparing to launch clinical trials they call the Reclaim Trial, which purpose is to examine a number of treatments "to actually improve people's quality of life and to treat Long COVID directly".  This all ties in with the recognition of Long COVID by the Ontario Ministry through the release of a new billing code for the use of doctors in diagnosing Long COVID.

The code is to be used when suspected or confirmed Long COVID cases present for treatment. A condition known as well as post-COVID-19 condition. The code also becomes a mechanism through which researchers are enabled to follow patients over time, with Long COVID.  With the bulletin on the new code, came guidelines for primary care physicians to aid them in understanding how to assess and manage their patients with the condition.

Dr. Quinn, along with other researchers has been engaged in painstaking work meant to estimate how many Canadians live with Long COVID. Their conclusion is, about 1.4 million have the condition. Almost every part and organ of the body is affected by the SARS-CoV-2 virus that causes COVID-19. There are well over a hundred symptoms associated with COVID and Long COVID, the most common of which include deep-rooted fatigue, brain fog heart palpitations, insomnia and mood disorders such as anxiety and depression.

In the near term, primary care doctors will be tackling Long COVID. Before it was  disbanded, Ontario's science table informed the province in a brief that saw publication in September, that the lack of a diagnostic code for Long COVID presented as a problem; warning a month later that the heavy lifting going forward on COVID-19 would rest with primary care physicians.

This is doubly problematic given the reality of a shortage of family doctors, with 1.8 million people living in Ontario without a family doctor to call upon. Compounded by the fact that another 1.7 million Ontarians are patients of family doctors aged 65 or older. Backing up family doctors, a number of hospitals in the province have established Long COVID outpatient clinics, with eleven across the province located in cities and with one only in the province's north.