As Alberta marks yet another grim milestone — the second anniversary of its first COVID-19 related death — we are only now beginning to grasp the far-reaching impacts of the virus, and the sheer number of lives it has changed.

On Mar. 18, 2020, a man in his 60s became the first Albertan to die due to COVID, after fighting for his life in an Edmonton ICU for nearly a week. Since then the illness has claimed 4,018 additional lives.

And while the course of the pandemic is often measured in terms of deaths and hospitalizations, COVID-19 has altered the lives of thousands of other Albertans, who are missing from those statistics.

"I think long COVID is something that we're really underestimating," said Dr. Neeja Bakshi, an internal medicine physican, who started a long COVID clinic in January through her office in Sherwood Park.

Demand is ballooning and she's now booking patients five months out.

"It's a population that has I think been screaming from the rooftops saying 'hey listen to us we're still suffering,'" she said.

"There just wasn't knowledge, acknowledgement, validation of this. And truthfully we're all learning about the disease at the same time."

Bakshi estimates roughly half of her patients are so sick they're on long-term disability and most suffer from fatigue issues and brain fog. She refers patients with respiratory and cardiac issues to other specialists, including to clinics set up specifically for people with breathing troubles.

"What I think we've all that this is actually a multi-system problem — both the acute illness and the long-term effects," Bakshi said.

"We haven't grasped the disability that this is going to cause — both the emotional and the physical. We just don't know enough about it yet."

Dr. Neeja Bakshi, an Edmonton internal medicine specialist, started a long COVID clinic in January. She says demand is high and growing. (CBC)

100,000 Albertans could be suffering

Estimates about the prevalence of long COVID vary. Alberta Health Services generally estimates 20 per cent of people infected with the SARS-CoV-2 virus have ongoing symptoms.

Using that calculation, more than 100,000 Albertans could be suffering from long COVID.

"Estimates in international literature suggest that 10 to 25 per cent of all COVID patients may have long-lasting symptoms post-infection," AHS spokesperson Kerry Williamson said in a statement emailed to CBC News.

"AHS internally uses 20 per cent as a general reference point. But the estimates vary with the population considered, and there is evidence that the incidence of long-lasting symptoms may be changing with high vaccination coverage, and also with changes in the virus."

The true magnitude of the impact COVID has had on the community may never truly be understood, according to Craig Jenne, associate professor in the department of microbiology, immunology and infectious diseases at the University of Calgary.

"The numbers that we're focusing on and the numbers that we're always trying to get down are those fatalities — which absolutely has to happen. But focusing on one number dramatically underestimates the impact of this virus on other aspects of our daily lives."

There may be people who don't even know their health problems are related to a previous COVID infection, he said.

In addition to Albertans with long COVID, there is another group to consider, according to Jenne.

"People admitted to ICU who have successfully recovered from this infection don't simply walk out of the hospital feeling normal the next day," he said.

"We know for other illnesses, admission to the ICU can often result in months if not years of negative effects — whether that be fatigue or stress or cognitive haze, fog. These poor individuals do not simply become normal again when they've fought off the virus. And this will have lingering effects."

Jenne said the mystery of this virus and the way it attacks the body — which healthcare providers and researchers are scrambling to unravel  — will continue to be felt in Alberta and throughout Canada.

"Although there is good progress being made this is a significant healthcare problem that is likely to continue to impact us both mentally but also physically for years to come."

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