What's Alberta's long game on COVID-19?

This column is an opinion from Dr. Christine Gibson, a family physician and trauma therapist in Calgary. For more information about CBC's Opinion section, please see the FAQ.

My grandfather had polio as a child. I remember he walked like a newborn colt, shaky and slow. He described to me weakness so severe as a kid that he would walk on his hands to get to school. Pain, bullying, and hopelessness led him to start smoking at age eight. It changed his personality, his abilities — really his entire life.

As a family doctor, I'm seeing the potential of long COVID becoming the polio of our generation. And I'm nervous that we're sentencing more and more people, especially kids, to this fate with the recent shifts in Alberta's public health policy with 43 per cent of our population at risk.

I've managed long COVID in adults in community practice. People who don't even know what symptoms might hit them when they wake up in the morning. It could be fatigue so severe they can't get out of bed or up the stairs. It could be pain in the chest like a brutal weight. Shortness of breath and gasping for air. Losing one's voice or sense of taste. Muscle aches that aren't relieved by pain-killers. Almost all of them describe "brain fog" — confusion and cloudy thinking. Typically, mental health disorders show up — anxiety and depression — whether it's from the virus effects or frustration at physical changes, or not being validated by health care providers, that's hard to discern. Probably a combination of all these factors.

A terrifying condition

One of my friends with long COVID had a brain scan this year showing atrophy (shrinking). It turns out that this is a not-uncommon problem. Imagine being a single mom, in your 40s, and told that your brain looks like someone twice your age? It's terrifying.

Parents of children in the U.K. with long-term symptoms were surveyed, showing these kids suffer from weakness, fatigue, headaches, rashes, muscle and abdominal pain. Yet, only 4.3 per cent of these children were admitted to hospital, the metric most public health officers follow diligently. This is a hidden epidemic.

The problem is that long COVID affects 10 to 30 per cent of those infected with an undifferentiated cluster of symptoms, which makes it hard to target. Because much of my practice as a GP (general practitioner) trauma therapist relates to the way the nervous system changes after stress, it makes me curious as to whether nervous system dysregulation is an explanation.

In Calgary, we are starting to gather more resources for long COVID, mostly where respiratory complaints or dizziness are predominant. I spoke with one pulmonary doctor who confessed that there's not a lot that can be done. It's essential that we resource more research and therapeutic options around this constellation of symptoms.

This was one reason why the Healing Centred Cooperative that we founded last year applied for a City of Calgary "Change Can't Wait" grant. We found out last month that we were successful, so we will design a program of music and breath work for people affected by COVID. This first phase of the project focuses on newcomers (immigrant and refugee communities), given the disproportionate effect of the pandemic on these populations. We are eager to expand both the ideas and the scale next year.

For long COVID patients, we have to get innovative to find ways to improve their symptoms. I've seen so many patients, women in particular, being gaslighted by the medical system when they have illnesses characterized by variable symptoms (chronic fatigue syndrome, Lyme disease, environmental sensitivities) because we have no solutions. While the isolation related to social restrictions is hard on mental health, long COVID or grieving the illness or death of a loved one is harder.

The organization Long COVID Canada suggests we may have as many as half a million afflicted in this country already. If the lack of restrictions in Alberta is proposed in the name of financial savings, it's unlikely to work when we are burdened with the economic realities of chronic illness.

Target low-hanging fruit

I believe that we need to keep up the measures that target the low-hanging fruit. Putting a piece of cloth on your face by masking is an indicator that you care about your community enough that you want to keep your neighbours safe. Isolating with viral symptoms, and advocating for paid sick leave and childcare should continue. Fecal studies don't allow contact tracing and thus are inadequate. Providing sufficient ventilation in classrooms should be supported. Vaccinations should be mandatory for high-risk environments — people can choose to avoid the jab but they would also be choosing the consequences of that decision. 

We are conditioned to look after our own health. An informed choice means knowing the exact risks one takes — something we're still not sure about with the Delta variant. And, for us all to emerge from this safely, it means looking after each other. Our kids are counting on this — all 664,000 of them in Alberta who are not yet eligible for immunizations. It is likely only a few more months until they can be protected. But it's potentially a high price for them to pay if we don't continue reasonable measures until then.

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