COVID-19 may be in the rear-view mirror for many, but nurse practitioner Michelle Lanteigne deals with people infected with the lingering pandemic virus every day.
She runs an acute-care clinic for people with active COVID-19 and one for long COVID patients at the Owen Sound Family Health Team offices on 1st Avenue West. The clinic is only available to health team patients.
“While no one wants to talk about it, COVID’s still here,” Lanteigne said in an interview. “I think there’s also a lot of people out there that don’t know why they’re not feeling like themselves again.”
There’s been no lack of demand for services of the long-COVID clinic either, she said. As of this week, 26 patients had been discharged and 36 patients are actively in the program, which began in April 2022.
“A lot of the people who come to our clinic feel that they’re very alone. That whether it’s colleagues at work or friends, (they) just don’t understand why they’re not getting better,” Lanteigne said.
“Although we don’t know everything about this condition, we have a lot of strategies that we can use to help you feel better.”
With no universally accepted definition of long COVID and no test for it, a diagnosis is symptom-based. Lanteigne adopted the National Health Service England’s long COVID definition: having COVID-19 symptoms from four to 12 weeks and then signs and symptoms develop during or after COVID lasting more than 12 weeks.
She sees people who mostly report profound fatigue or a cough but then she finds they have other long COVID symptoms they hadn’t thought were related. There are more than 200 related symptoms reported in medical literature, she said.
Lanteigne said that at the long COVID clinic, which she runs with an occupational therapist and respiratory therapist, “we believe you when you tell us you’re having these symptoms.”
Other long COVID symptoms Lanteigne has seen include “brain fog,” shortness of breath, heart palpitations (especially when standing), lost sense of taste and smell, sudden hair loss, “noisy” breathing — be it gurgling or wheezing — dizziness, headaches, numbness or tingling in arms, legs or both, joint or muscle aches, poor appetite, nausea, diarrhea, and ringing ears or muffled hearing.
The World Health Organization in December reported that studies show around “10 to 20 per cent of people infected with SARS-coV-2 may go on to develop symptoms that can be diagnosed as long COVID.”
How many that might represent locally is unknown, Lanteigne said. “But this is a lot of people that could have long COVID and can be significantly impacted in their daily life and not be able to participate in the workforce potentially.”
One thing you can do which has been shown to help people avoid getting long COVID is to get at least three doses of COVID-19 vaccine, Lanteigne said. Even then, avoiding long COVID is not guaranteed. The shots are still available for free at some pharmacies.
In the first year of the long COVID clinic, 56 people were referred to the program.
Thirty-one patients were unable to work due to symptoms when admitted — 14 of whom returned to work. Further research will identify the number who were already unable to work prior to their COVID-19 infection, Lanteigne said.
Symptoms completely resolved for 41 per cent of those being followed for at least three months, while all noted some improvement. Inhalers, medications and ways to improve sleep and energy are all employed as needed to improve symptoms.
One patient has had long COVID for close to three years, after contracting the virus after it first appeared in 2020. He has improved but is still experiencing a number of symptoms, Lanteigne said.
Her average patient comes to the long COVID clinic two to four months after catching COVID and is in the program six to nine months. “The most improvement happens in the first year,” in her experience, which is reflected globally, she said.
Women outnumber men in the program probably 2-1, she said. Typically patients are aged between their 30s and mid-50s.
“This is a lot of mothers, who when we talk about improvement, a lot of this is rest and reducing activity, which is very difficult to do if you still have to work for the income and if you’re still managing a family,” Lanteigne said.
Seventy-one per cent of patients who’ve been in the program at least three months had improved function in the Post COVID Functional Scale, her figures show. Each of three patients discharged from hospital with home oxygen was able to discontinue using it.
Many had lung-function tests, lab workups, were involved with monitoring of heart and sleep patterns. Medicine was given to 26 patients and nine were referred to specialists.
Some went to smoking cessation, counselling, occupational therapy, the Pap clinic, memory clinic and saw a dietitian. A few went to the Grey Bruce Legal clinic for help navigating applications for worker’s compensation, EI or disability benefits.
Most who call the Acute COVID clinic are people who could get very sick from COVID because of their compromised immunity. They ask about the anti-viral drug Paxlovid, for which Lanteigne can evaluate them.
The clinics are only for patients of the health team and referrals often come from doctors or other medical professionals there. But health team patients may call either clinic without a referral, at 519-470-3030. The Long COVID clinic extension is 103.
The Acute COVID clinic, staffed by Lanteigne and two nurses, is open Monday to Friday for phone calls. The Long COVID clinic is offered one day a week.