Episode 17 | #COVIDConvo Ep. 8
#COVIDConvo Ep. 8: Long Term effects of COVID-19
Alex and Dr. Wendy Tong, MD MHA, talk about the recent events with the COVID-19 pandemic happening all over the world and discuss topics like healthcare, eldercare and keeping your loved ones safe.
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Alex (intro) – A lot of our attention thus far on COVID has been centered on how the infection presents and how it causes death…really the “here and now” of the pandemic. We’ve been thinking of COVID cases in two categories: confirmed cases and deaths. That’s the manner we present our statistics and those are the numbers we track. We really haven’t paid much attention to those who have recovered from the initial infection but are now living with residual effects from the infection that could possibly even effect them for the rest of their lives. What does this mean for these individuals and for society?
Wendy – Alex what you’ve brought up, is what those who study health at a population level, refer to as the difference between mortality and morbidity. Mortality, refers to death. Of course, a death is tragic but that loss is “contained”. The individual is no longer suffering from pain and disability that person is no longer actively incurring costs for family members. Compare that to a person who survives COVID but lives with a long term impairment that impacts their quality of life and/or productivity. This is what we call morbidity. As a rule, the costs (and I mean not only financial but also emotional, psychosocial costs) of morbidity are because they are extended over a much longer time, end up being higher than for mortality.
Alex – We are only six months out from the first COVID cases appearing in China. It seems to be still too short of a time to know what the long term complications are for those who survive the infection. But could we still use what data we do have to predict the scope of the long term effects of COVID?
Wendy – A study published by the UK National Health Services observed that of those who are hospitalized, half need ongoing care after leaving the hospital. Even for those who were hospitalized and not severe enough to be admitted to the intensive care unit, upon discharge, they still needed on average 20 days of post-discharge care. For those who were critically ill and were in the ICU, their need for ongoing care at home, is often for the rest of their lives.
Alex – when you say ongoing care, what does that mean?
Wendy – When a patient is discharged from the hospital to their home and they aren’t completely safe in their prior living situation they will need caregiver support which could be from family caregivers or from home care providers. This is my area of expertise since I own a home care agency. Nowadays because of the rate of COVID related deaths in nursing homes, people are opting to be discharged to their homes and even forego staying at a rehab center. What my Team Members provide is very customized to the needs of the patient and to their family. We know that COVID can affect any system of the body. We know that there are people who have breathing problems and fatigue easily, in those cases we might be helping them with all the household tasks that now they don’t have the endurance to perform. We know that there are people who have had strokes and need help with getting out of bed and moving around or driving. Strokes can cause memory problems, we might have to help these people with reminding them to take their medications and be their personal assistants to manage their appointments. There are people who are now suffering from post traumatic stress and anxiety and who need the companionship and reassurance of knowing someone will check in on them. These are services we’ve been providing to our elderly clients however COVID is affecting younger people. We are expecting clients who are younger than what we’ve been used to. Even though mortality rates are much lower in young people, 50% of the younger patients are physically unable to return to work when they leave the hospital. We are expecting to see requests for home care services from younger people recovering from COVID. We don’t know how long and how complete the recovery will be for patients recovering from COVID because we still haven’t had the time to study the long term consequences of COVID infection.
Alex – COVID upended how we receive healthcare with telemedicine becoming standard for physician consultation. Could home care evolve in a similar manner?
Wendy – Unlike doctors’ appointments, there isn’t a tele home care option, you still need a human being in-person to prepare meals, assist with showering, do the laundry, push the vacuum and so on. There are ways to make the delivery of home care services more efficient but you cannot completely eliminate the in-home caregiver. I foresee that home care services will be needed by populations other than the elderly and the challenge will be how to meet this increased demand when there are less young people in the workforce.
To listen to Dr. Wendy’s full Global Edge Talk episode on Coronavirus Outbreak and Healthcare System in the US click HERE.