Long Covid in the Community
There’s no doubt that Victorians have experienced life changing effects caused by Covid-19 in all walks of life. At Kadia Occupational Therapy, we care strongly for metro and rural community members who struggle their way through Covid symptoms or who are caring for an infected loved one. If suffering Acute Covid wasn’t hard enough with its potential life-threatening symptoms, and need for hospitalisation and quarantine, then what are we to expect from Long Covid?
What is Long Covid, you may ask?
- Short or Acute Covid is defined as an interval of less than 10 days between symptom onset and end, without a subsequent relapse. Whereas, Long Covid is defined as symptoms that persist for more than 4 weeks, 8 or more than 12 weeks between symptom onset and end. Symptoms usually present within the first 3-4 weeks after the initial onset, and are relapsing in nature over the course of 3-4 months or longer.
What can you expect from Long Covid?
- Symptoms are highly variable across musculoskeletal, cardiopulmonary, neurological and psychological body systems. However the majority of symptoms are associated with fatigue, headache and upper respiratory complaints (shortness of breath, sore throat, persistent cough and loss of smell) and/or ongoing fever and gastroenterological complaints. Studies describe patients’ battle with extreme tiredness, which is overwhelming and not relieved by sleep or rest. The body is described as rapidly losing energy without effective replenishment, therefore the body conserves energy only to fight infection.
The technicalities explained:
- Studies performed in Europe and the UK attest to the existence of Long Covid as its traits fall under the umbrella of Post Viral Fatigue. Long Covid however, comprises unique features as it specifically imposes injury and inflammation to the myocardium (the heart muscle) and is abundantly expressed in the heart and lungs.
- Cardiomyocytes (heart muscle cells) express receptors that attract the Covid virus, making those with pre-existing cardiac conditions prone to intense illness during acute and post viral stages. Profound stress is placed on the heart. Conditions such as hypoxia (low oxygen levels in the body’s tissues), ischaemia (insufficient blood flow), and atrial fibrillation (rapid arrhythmia) are prone to occur. In combination with cardiovascular disease, the conditions cause troponin (protein found in the heart muscle) leakage into the bloodstream, further inflaming the myocardium and reducing the heart’s pumping action.
How OTs can help:
- There is a call for OTs in the space of Long Covid as community members continue to suffer symptoms weeks to months after the initial onset of disease. Due to the relapsing nature of the disease, during periods of short remission, there can be great temptation to push the body and exert oneself. However, premature physical activity only re-exacerbates the illness, causing further relapsing into breathlessness, pain, flu-like symptoms, nausea, sensory sensitivities and complete exhaustion, leading to days or weeks in bed.
- OTs are called to deliver therapeutic interventions to assist the client to remain within their ‘energy envelope’ so to speak. Strategies to achieve this are best achieved in close collaboration with an Occupational Therapist and other health professionals such as the GP, psychologist or nutritionist.
Basic strategies that your OT may deliver are:
- Managing fatigue during infection with rest, low activity levels, sufficient nourishment, ceasing work and study.
- Managing fatigue during recovery with light activity, cognitive activities, rest, maintaining daily structure, careful and gradual return to exercise, work or study.
- Psychological management by recognising difficulties, adjusting expectations, practising mindfulness and self-compassion, accepting energy levels, seeking support, disclosure to the workplace or university, and adjusting responsibilities at home and work.
- Managing rest with breathing techniques, meditation and states of restoration to mitigate stress responses.
- Pacing techniques, which assist the individual to stop and rest before feeling exhausted, taking regular rest breaks every hour for 10-15 minutes for example. Including the pacing of preferred activities to boost motivation, wellbeing and regulate mood. Increasing activity levels through daily occupations rather than exercise, building weekly by 10-20% and allowing the body to enhance its activity tolerance.
- Managing healthy nutrition with diverse regular meals with focus on proteins and reduction of sugar and stimulants.
- Managing sleep hygiene, including regular bedtimes and wake-times and possible inclusion of short daytime naps.
- Management of prolonged return to work phase, including frequent rest breaks and reasonable adjustments to reduce the risk of exacerbation of symptoms.
The role of the OT includes the implementation of many other possible strategies to help those fighting Long Covid to recover to their fullest potential. OTs also greatly contribute to the intensive care management of symptoms, which may put individuals at high risk of long-term physical, cognitive and emotional complications. OT rehabilitation has also been identified as crucial for individuals affected by physical distancing, including those experiencing exacerbations of mental illness as a result of social isolation; individuals becoming deconditioned because of prolonged immobilisation and musculoskeletal deterioration; and people at risk of functional regression. OTs continued provision has heightened importance to enable engagement in activities that provide meaning in life, at a time when participation in regular routines and activities is particularly challenged.
At Kadia, we make it our business to foster that engagement, participation in activities and cultivate meaning in life.
To learn more about the world of Kadia Occupational Therapy, stay tuned to our regular blogs. If you are an OT consumer or simply have areas of pending confusion about anything OT related, interventions or assistive devices, do not hesitate to contact us.
From the friendly Kadia Team.