Calgary gets 2nd COVID clinic to treat long-haul respiratory problems

A new COVID-19 followup clinic — designed to help people struggling with long-term respiratory problems after a diagnosis — is set to open at Calgary's Peter Lougheed Hospital next month.

This is the second clinic of its kind in Calgary and one of just three in Alberta. A similar centre opened in Rockyview General Hospital in September. There is another at the University of Alberta Hospital in Edmonton.

"I know there's going to be a need for these patients," said Dr. Jason Weatherald, a pulmonologist and assistant professor at the University of Calgary who works at the Peter Lougheed Centre in northeast Calgary.

"When I was working on the COVID units in the hospital, I really realized that northeast of Calgary was disproportionately being affected by COVID — in the community but also in terms of the number of hospitalized cases."

He decided to open the clinic after watching some patients survive COVID-19 only to find themselves back in hospital with serious complications, including blood clots in their lungs and heart problems.

"I've seen one other patient who developed very severe scarring in their lungs after their COVID infection, so I know that these people are out there," he said.

It is unclear how many Albertans diagnosed with COVID-19 will go on to develop long-term health problems. According to Weatherald, studies from Europe have documented symptoms such as shortness of breath 100 days after being discharged from hospital.

"So I think about a third of patients will likely have shortness of breath still at three months after their infection. The other thing we don't know is how many patients who are infected … who didn't get hospitalized, how many of them are going to go on to still have persistent symptoms? And those patients may not have … access to specialists."

To begin, three specialists will work at the clinic, which will be open, by referral, to patients who had a COVID-19 diagnosis and are still experiencing symptoms, including shortness of breath, coughing and chest pain, at least 12 weeks later. It will be available to both those who were hospitalized and those who weren't.

Clinic close to home

A key factor motivating the launch is the need Weatherald sees for his patients to have a followup clinic in their community. According to Weatherald, many of his patients aren't able to get to the clinic at Rockyview General Hospital in the city's southwest for socio-economic reasons.

"We realize there are other limitations for people — in particular in our part of the city — for accessing care, whether its transportation [or] work restrictions," he said. "We really wanted to makes sure that it was easy for them to access followup care for COVID-19 in that quadrant of the city. And that was the real motivation for starting our own clinic."

The decision to launch came at a time when doctors at the city's first COVID-19 followup clinic at the Rockyview were witnessing the same concerning trend.

"What we do not want are patients who due to demographic means [or] geographic means simply can't get to a clinic — that they're not being seen when we could establish another clinic in their vicinity," said Dr. Patrick Mitchell, a lung specialist at the Rockyview clinic.

Surge expected

The Rockyview clinic opened in September and was established to help people manage and monitor their long-term respiratory health problems. Since its launch, doctors there have seen roughly 30 patients with long lasting pulmonary problems, and there are another 15 on a wait list for February. 

"This number is, unfortunately, set to increase given the surge we've actually suffered from over the last couple of months," said Mitchell.

"Despite the best intentions of a lockdown, we are going to be see these post-COVID pulmonary issues coming to us. We want to be prepared. We're hoping we don't need to be as prepared as we are." 

There are nine specialists, four nurses and a team of respiratory therapists, along with support staff, working at the Rockyview clinic.

The patients Mitchell has treated so far include those with ongoing breathlessness (leaving people unable to do regular activities such as climb stairs or chase their kids). Others are showing up with a cough they can't shake. And, according to Mitchell, a minority of patients experience chest pain for months after their COVID-19 infection.

Both clinics will help paint a picture of the long-term impact COVID-19 is having on Albertans —an aspect of the pandemic that doctors , scientists and public health officials do not yet fully understand.

"Establishing a database and a collective idea of who these patients are and why they got this will enable us going forward to provide much more help, care [and] management," Mitchell said.

Both doctors are hoping to get their message out so people who are suffering in the community can get help.

"To date, we have had, thankfully, small numbers of referrals from family physicians. But we are concerned that this actually represents the tip of the iceberg in terms of recognition that these clinics actually do exist," said Mitchell.

The Peter Lougheed COVID-19 followup clinic is set to open Feb. 17.