Hospital systems have launched active post-Covid recovery programs

Two large regional hospital systems in the central Hudson region, WMCHealth and Nuvance Health, recently launched extensive post-Covid recovery programs, with more than a thousand local patients between them. WMC started its official program a year ago, Nuvance its program last spring.

The programs are no different. They encourage post-Covid patients to explain their symptoms and learn with professional advice how to manage them.

Does a thousand patients seem like a lot to you? In the context of the Covid pandemic, it’s really not that much.

In total, more than one in ten Ulster County residents have contracted Covid, and among those who contracted it, about one in 60 infected people have died from it. As of this week, there had been 285 Covid deaths over the past year and a half in Ulster County. These are sobering statistics.

Recent figures bring the total number of Covid-19 cases in Ulster and Dutchess counties to 53,461. The number of people participating in the programs of both hospital systems represents about two percent of that total – and those two percent come from a larger geographic area. On October 21, as the number of newly infected people declined, there were still 86 new cases of Covid in one day in both counties.

The State Department of Health’s Oct. 22 scorecard assessed the positivity rate for Covid testing in Ulster County at 1.93% – the first time it has been this low in months . It’s a good sign. Many experts don’t expect a seasonal increase this winter.

In total, about one in ten Ulster County residents have contracted Covid in the past year and a half, and among those who have about one in 60 cases infected has died from it. These are sobering statistics.

Leading learning

Covid-19 has not been around long enough that many conclusive, peer-reviewed studies have been completed. The learning curve has been painfully slow. We know that vaccines against the disease have so far been almost miraculously effective, with side effects limited to a small number of people. Although a few people who have been vaccinated have contracted Covid (the so-called “breakthrough infections”), most of the incidence has been among the unvaccinated. The two local hospital recovery programs did not have readily available statistics on the past vaccination status of their patients.

Dr Gary Rogg is one of the clinical managers of WMCHealth’s post-Covid recovery program, working at Westchester Medical Center in Valhalla. Dr Rogg said symptoms of patients in the WMC program were similar to those reported in programs nationwide. Extreme fatigue, brain fog and shortness of breath, he said, are the top three symptoms reported both nationally and locally by long-term Covid patients. In their work in post-Covid recovery programs, physicians must be prepared for the bewildering variety of the full list of reported symptoms.

Dr. J. Keith Festa, Assistant Director of Medical Affairs at Mid-Hudson Regional Hospital in Poughkeepsie, leads the WMC System’s North Territory program. Both sides have the same organizational structure and follow the same protocols, he said.

Dr Sharagim Kemp heads New York’s post-Covid program for Nuvance Health. The Nuvance System has substantial assets in Connecticut and New York State, and it has two separate post-Covid recovery programs. But as with WMC, the two operations are mirrored, Kemp’s office is located at the Northern Dutchess Hospital in Rhinebeck.

The two programs do admission differently. WMC begins with a physical examination by a primary care physician. Nuvance begins with a telephone interview. Is telemedicine effective in this welcoming role? Dr Kemp says it works well if done carefully. It’s surprising how much information a doctor can gather during a 40-minute or hour-long virtual visit with a potential post-Covid patient, she said.

The road to healing

We don’t know as much as we would like about what’s called the ‘long Covid’, lingering symptoms that can persist long after the Covid-19 infection has receded.

What are the long-term effects of Covid-19? The Nuvance list consists of thirteen unlucky ones: muscle weakness and fatigue, memory loss or “brain fog”, difficulty breathing or chest pain, problems with balance and difficulty walking, weakness or numbness in the arms and legs, aches or pains. joints, headache, stroke, mood changes, abnormal heart rhythms, loss of taste and smell, rash and hair loss

It is estimated that between 20% and 25% of all people who have recovered from Covid complain of a surprisingly wide variety of illnesses that they attribute to the disease.

“The road to recovery for some Covid-19 patients may be longer than [for] others, with a wide range of symptoms that can last for weeks or even months, ”warns the Nuvance recovery program website. “The long-term effects of Covid-19 can be debilitating and prevent people from returning to their normal routine. “

“One person [in the recovery program] may wake up one morning convinced that they are finally doing quite well, “said Dr Festa,” and then complain the next day that their symptoms are worse than ever. “

Post-Covid syndrome

Successful recovery benefits from teamwork among healthcare professionals. “By creating a cohesive team of specialists across Nuvance Health, we can help patients seamlessly navigate the care they need and, ultimately, improve function and speed recovery,” quotes Nuvance’s website, Dr. Christopher Lehrach, president of Nuvance Health Medical Practices, as saying.

WMC takes a similar approach. “The tri-state region has been one of the hardest hit in the country during the Covid-19 pandemic,” its program website says. “Today, a growing number of people who have fallen ill from the coronavirus continue to face challenges related to their physical, mental and emotional health and quality of life. Sometimes referred to as post-Covid syndrome, this is a very real health problem. And it’s treatable.

Diagnosis before treatment. Both hospitals’ programs begin with a primary care provider who reviews the patient’s history and determines which specialists should be involved. Both emphasize the personalized nature of their treatment plans to deal with the various symptoms of this unusually elusive disease. Both assign patients the services of a clinical navigator as a guide in developing a treatment plan.

The state has developed a treatment plan. It’s for more intensive post-Covid research.

Governor Kathy Hochul delivered a speech on October 19, assuring New Yorkers that the state would be very active in demanding its share of the billion dollars in federal funding allocated to the National Institutes of Health for post-Covid research. “We will lead this initiative. This is what we are going to announce in the coming weeks, our plan to solve this problem because it is clear that it is still with us, ”she said. “And there are a lot of New Yorkers still struggling with this, trying to get back to work and take care of their families and get on with their lives, all while facing some very frightening unknown side effects of contracting Covid. many months ago.”

The state Department of Health webinar generated considerable interest on Monday, October 25, to educate healthcare providers about post-Covid symptoms and their treatment. Some 600 providers had already registered at the time of Hochul’s speech. She promised to “convene a panel of experts to determine what action New York State can take.”