News from Canada

Posting mainly because it seems to be an official thing, funded by the CIHR. Looks OK, only question is whether it will sit on shelves.


Care Models for Long COVID
https://sporevidencealliance.ca/wp-...e-Models-for-Long-COVID_Update_2021.12.04.pdf

Context. It is estimated that up to 500K Canadian had or are living with Long COVID resulting in debilitating sequelae and disabilities that impact their quality of life and capacity to return to work or school. A new care model is needed for persons living with this complex and multi-systemic disease.

Objectives. To update the best-available evidence about care models for people living with Long COVID.

Design. Update of a living systematic review.

Method. We systematically searched nine electronic databases on October 5th and 7th 2021. Two independent reviewers screened titles, abstracts and full text. We included studies reporting on 1) people living with Long COVID and 2) proposing a specific care model. We extracted characteristic of studies, reporting of the care model implementation with the number of patients, clinical settings of care model, healthcare professions included in the care model, care model principles and care model components.

Results. In this update, we screened 1201 additional citations, read 65 full text and included 8 eligible articles reporting on international care models for Long COVID. The four main interfaces of our proposed patient pathway remain: coordination units to centrally receive referrals from both hospitalized and community-based patients, training of primary care teams to screen and support medical needs, integrated local multidisciplinary rehabilitation services and access to medical specialty clinics for advanced testing and diagnoses. We observe consistency for care model principles such as multidisciplinary teams and integrated care, and components such as standardized symptoms assessment and virtual care. The impact and costs of these care models are not yet reported.

Conclusion. Combining international evidence, contextualized Canadian initiatives and patient perspectives, a national public health initiative may be advisable to ensure sustainable support of provincial teams in their quest to support patients with Long COVID. This represents a unique opportunity to improve quality of care for all patients with complex chronic diseases in Canada.​

Health care is provincial in Canada. So I'm not sure how this can be made actionable. It's really a mess here for this. In the end health care services are local and don't see beyond their borders, only obvious and immediate problems.

 

Merged thread

Thousands of Canadians may have acquired long-term impairment from COVID. They need support

Some of these long COVID sufferers will join the ranks of working-age Canadians who are already coping with post-viral conditions like myalgic encephalomyelitis (ME), struggling to have their disability recognized and often unable to remain financially independent through work income alone. Even before the pandemic, persons with disabilities were at significantly higher risk of poverty, and made up the vast majority of caseloads in provincial welfare systems.

https://www.thestar.com/opinion/con...-impairment-from-covid-they-need-support.html

 

Good piece. Thanks for posting @Mij

The link doesn't work for me though. Think htm should be html. This one works for me. Corrected.

https://www.thestar.com/opinion/con...-impairment-from-covid-they-need-support.html

 

Thank you @Mij

Good article.

Same old story with our governments though.

All along Canadian federal government data releases on the news, have counted those diagnosed with COVID, and those recovered. There has been very little official mention of LC, and certainly not in the daily counts.

Unless substantial changes are made to governments' sympathies and policies, the same nightmare that has befallen millions with ME will also be visited upon the potential millions with LC.

What percentage of the population must be adversely affected before governments act? My guess is 10 to 20 percent affected would not bring about government changes.

 

COVID long-haulers dealing with issues accessing financial assistance

The World Health Organization (WHO) estimates 10 per cent of people who came down with COVID-19 become long haulers. In Canada, there have been three million COVID-19 cases confirmed to date. That means roughly 300,000 people have suffered from long COVID, but it could be much higher.

https://toronto.citynews.ca/2022/03/08/covid-long-haulers-canada-financial-assistance/

 

There are for Canada some issues around Federal or Provincial responsibilities in health. I have little knowledge there but I expect that as things change the results will be uneven and reflect regional differences in understanding and care.

Also, there has been some mention of Long-Covid in Canadian news. How impactful that will be is hard to gauge though.

https://www.cbc.ca/news/health/long-covid-coordination-1.6306761

https://www.ctvnews.ca/health/coron...k-of-long-covid-with-patients-blood-1.5759416

https://globalnews.ca/news/7998787/long-covid-canada-long-term-disability-sickness-benefits/

There are more like this. I think the level of exposure here is probably similar to elsewhere. It is a matter of how they are perceiving LC, what they are doing about it and how will the gov'ts (both Prov/Fed) respond in terms of getting the health system to work for LC/ME.

I do see some hope here. But time will tell.

 

"Dr. Bakshi started her long-COVID clinic in response to an already growing demand. She allots 90 minutes for each appointment so she has time to understand patients’ individual challenges and what realistic goals they can set".

https://www.theglobeandmail.com/can...ent&utm_campaign=long_covid&utm_id=long_covid

 

The Canadian government is conducting a national survey of Long Covid. Not sure what they mean by 2nd phase, haven't heard of a first one.

It's managed by Statistics Canada, the agency had already included questions about ME (not sure of language) and this is where the only available national data we have.

Not sure of what that test is capable of, but here is what they say

https://twitter.com/user/status/1511379740229255170

https://www.canada.ca/en/public-hea...-health-impacts-of-the-covid-19-pandemic.html

 

You need to realize that reporting COVID cases is about pubic health, and is an obligation for both the Canadian and the provinces- in order to prevent spread and to save lives.

Public health is concerned about all communicable diseases; you may have noticed that there were warnings about Zika virus a few years back. These agencies (PHAC (Public Health Agency of Canada) and CDC) surveil what is going on around the world and would advise health units and citizens about threats to their health.

Now, PHAC and medical health officers would also be concerned about certain non-communicable diseases, namely the opioid crisis, but those are few. I would suspect they were involved in recommending everyone wear a safety belt when driving, and for children to be restrained in car seats back then when it was not mandatory.

In this case, PHAC and CDC are concerned about the infectious disease, with emphasis on "infectious". Chronic disease is simply not their department.

 

@Milo
Thanks for your comments.

However, I do understand the roles for these agencies. Of course these agencies are mandated to report on public health threats.

What I was pointing out was that Long COVID received very little mention by PHAC and other government agencies.

In my opinion, not noting LC appeared to be either an oversight, or perhaps a choice.

A couple nights ago two pwLC and a medical specialist were interviewed on the CBC TV program, the National. Good to see this issue finally getting more coverage.

ETA: the PHAC website notes "Prevent and control chronic diseases..."

https://www.canada.ca/en/public-health/corporate/mandate/about-agency/mandate.html

 

Not exactly news from Canada but thought it was still appropriate to post here.

Danny Altmann, prof of immunology, posted this on Twitter
"Calling out to healthcare workers and others who were in the #Toronto SARS outbreak. Keen to be in touch and hear about long-term health outcomes. Please DM me and pass the message to any you know."

 

The SARS outbreak was almost 20 years ago, but at least they're interested in learning more.

Perhaps even go back 70 years and find out that M.E wasn't a mid-century campfire story after all?

 

The Interdisciplinary Canadian Collaborative Myalgic Encephalomyelitis (ICanCME) newsletter, May 2022, is available here:

https://us6.campaign-archive.com/?u=17faa36a9bf5a8f4dd75a5de6&id=92f01859e0

 

Quebec ME/CFS patients deserve access to new long-COVID clinics, advocates say
The network of clinics will focus on long COVID and Lyme disease, but not myalgic encephalomyelitis, leaving patients with the complex illness feeling forgotten again.

https://montrealgazette.com/news/lo...ccess-to-new-long-covid-clinics-advocates-say

 

From the article:

*AQEM : Association québécoise de l'encéphalomyélite myalgique


Nevertheless, there still seems to be hope that ME will eventually be included in these clinics as well :

However, what medical support or "treatment" will be offered ? No idea and it will certainly be to watch...

 

The trend in Canada is group learning sessions about coping and symptom management- very little in terms of treatment other than LDN, POTS meds, anti-depressants for sleep. But having a specialized clinic capable of research and clinical trials would go a long way for us.

 

Letter to Christian Dubé, Minister of Health and Social Services

full letter
https://thecanadian.news/letter-to-christian-dube-minister-of-health-and-social-services-2/

 

Extract from the letter written by AQEM (pwme association) :

The " head start ", to which AQEM refers in its letter to the Minister of Health, is I believe to have alerted and informed early about the possible PEM of long-COVID patients. I think that they were in contact with Simon Décary, professor of physiotherapy at the University of Sherbrooke. At the moment, in Sherbrooke (Province of Quebec), there is the only clinic for long-COVID patients. The waiting list is very long and the clinic is overwhelmed.

 

Pressing for pwme(s) to be a clientele also included in future clinics for Lyme disease and long COVID, the AQEM (Quebec Association for Myalgic Encephalomyelitis) has decided to send a letter of reminder to the Minister of Health of the Province :

https://aqem.org/une-semaine-depuis...-de-lyme-laqem-reclame-toujours-des-reponses/

 

Missed this one at the time.

https://twitter.com/user/status/1527372071822671872