What have we learned about the long Covid? – Living in Switzerland Guide

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Most people who contract Covid-19 will not become seriously ill, but a significant number have had long-term problems after being infected. How serious is the problem? How does society cope with it? Is Long Covid a threat to the health system? Research on the long Covid is still in its infancy in Switzerland with many open questions.

Extreme fatigue, difficulty coping with everyday life, shortness of breath, loss of smell or taste: these are just a few of the many symptoms of long Covid. Some people who have recovered from the initial infection may have lingering health problems, such as “brain fog” or depression, while others complain of joint and muscle pain.

The long list of symptoms shows that Covid-19 affects the whole body. However, many questions remain open: what is the extent of the disease? What are the therapies? Who are the groups at risk? What challenges will employers, institutions and the insurance industry face in the long term?

Different results

Several in-depth and lengthy studies on the Covid have been carried out in Switzerland, in particular by the universities of Geneva, Lausanne and Zurich.

Despite this work, the exact number of Swiss residents suffering from long symptoms of Covid six months after the initial infection remains uncertain, as the results vary widely between studies.

Two studies conducted by the University of Zurich found that 20 to 25% of adults (PLOS One) and around 2% of children (Journal of the American Medical Association) who tested positive were affected by the long Covid.

In its study published in the Annals of Internal Medicine, the University of Geneva found that 39% of participants reported residual symptoms. However, these results are preliminary, as research continues.

Milo Puhan, principal investigator of the Zurich Coronavirus Cohort Study, attributes the varying results to the different times of data collection. But he told SWI swissinfo.ch that the results were all in the same direction.

The Federal Office of Public Health (FOPH) recently commissioned Puhan to summarize 70 long Covid research papers from around the world. It was not an easy task, he explains: “The definition of long Covid differs from country to country, and tests were carried out at different times,” he explains.

Regarding the prevalence of long Covid, Puhan believes that the Swiss studies were comparable to other studies. “However, the medical effects and impact of Covid-19 on our daily life and our work are still difficult to determine,” he says.

The health system called into question

Puhan is certain that the long duration of Covid will place an additional burden on the Swiss health system.

“We have to be prepared when it comes to providing special care and maybe even social services. This means we have to keep an eye on developments and be prepared to meet needs – from low-threshold services to specialist consultations, ”he says.

In the summer of 2020, the University Hospitals of Geneva (HUG) introduced the Long-Covid Consultations, which today assist around 350 patients. The Geneva study is considered one of the first and most in-depth on the long Covid in Switzerland, as pointed out by Mayssam Nehme, first author and member of the consultation team.

“In March 2020, we started following Covid-19 patients who had received outpatient care because we didn’t understand what was going on,” she told swissinfo.ch. At one point, the medical team realized that some people had long-term symptoms of Covid-19, such as fatigue, shortness of breath, headaches, loss of taste and smell.

“So we decided to do a prospective study on the same people we were following in March 2020. We will continue to follow them for months and maybe years to see how their symptoms progress.”

It is still unclear whether some of the symptoms discussed in the studies only occur after a Covid-19 infection or whether they can be attributed to other infections or have different causes. For a more in-depth analysis, a control group is now looking at the Geneva studies.

How is Switzerland doing?

Compared to other countries, Switzerland’s long Covid search is quite advanced, says Nehme.

“Switzerland was one of the first countries to start, along with the United Kingdom and the United States. So we took it seriously early on, ”she says.

One of the challenges that Swiss scientists face is the relatively small number of patients they can study. Puhan adds that linking the different databases was also problematic in Switzerland. Connecting them would allow scientists to know who suffered from a long Covid and who needed repeated medical treatment after the initial infection. “Denmark, Norway and England have systems in place that allow such links,” he says.

No research funds

Puhan deplores the lack of money for long research on the Covid.

“Apart from Germany, Norway, England or the United States, there have been no calls for tenders for long research on the Covid in Switzerland,” he says.

In the United States, the National Institutes of Health (NIH) have invested more than a billion dollars (920 million Swiss francs) in lengthy research on the Covid. Nehme hopes that the next Swiss national fundraising calls will include long Covid projects. The Swiss National Science Foundation (SNSF) has already launched two calls for tenders for research projects related to Covid, namely the special call on coronaviruses and PNR 78 “Covid-19. Another project, the NFP 80 “Covid-19 in Society”, is currently in the planning phase. The three aforementioned studies include lengthy Covid studies, SWI swissinfo.ch has learned.

Critics of the victims

In Switzerland, people with Covid for a long time struggled for help and recognition, but eventually their plight was recognized, says Nehme.

“There is more recognition in scientific circles. The science working group talked about it, and they even started discussing it at the political level, ”says Puhan. She agrees that the authorities are finally taking the Covid seriously for a long time.

One of the criticisms voiced by those who have long struggled with Covid was that scientists placed too much emphasis on numbers rather than researching what exactly helped individual patients recover.

The SNSF responded by inviting patients to participate in its clinical trials initiated by researchers to assess funding requests. The program aims to answer medical questions “important for society, but not a priority for industry”, specifies the SNSF on its website.

“I am a big fan of involving affected people in research,” Puhan says of the SNSF program. He also mentions another project – the Long Covid Science Board – which was established in Zurich. “With around thirty people affected, we are trying to set up a research program that reflects their perspectives,” he says.

Nehme explains that researchers first had to understand the disease and determine the percentage and frequency before they could study the risk factors. “But we have to understand what helps,” she said. “We know that a multidisciplinary and structured approach has helped our patients a lot because all their symptoms are recognized. “

Hotels are reinventing themselves

She stresses that the first point of contact should always be a family doctor, but the center could help in the long term.

“A center for the long-term Covid can offer a structured and multidisciplinary approach because you have your doctor, you have your tests, and you have your physiotherapy,” she explains.

There have even been recent reports of Swiss hotels reinventing themselves amid the pandemic and providing care for long-term Covid patients. “It is important that patients talk to each other and share their experiences, also with those who have recovered. It will certainly give them some hope, ”says Nehme.

Translated from German by Billi Bierling


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