Exploring the Psychosocial Impact of Long COVID on Patients and Healthcare: Emphasis on Nigeria
"I am still bed-bound, a year later, in a dark, quiet room."
–Anonymous —
INTRODUCTION
The COVID-19 pandemic brushed through the continent of Africa, with no country intact. The shocks which followed its emergence left the Nigerian healthcare system overwhelmed. In a country where the ratio of doctors to patients is 1:9,083, the pandemic resulted in serious burdens for healthcare providers (Adebowale-Tambe, 2023). Frontline medical workers struggled with an increased number of patients, while patients, themselves, had to battle the distress of an extended period of quarantine in addition to the health implications of the virus. But the situation seems far from over as some patients still struggle with COVID-19 symptoms months to years, post-infection. This essay will attempt to explore the psychosocial impacts of long COVID-19 on patients and healthcare providers, with enough emphasis given to possible and practical solutions to support the healthcare industry going forward.
BODY
COVID-19 disease is caused by a novel type of Coronavirus called SARS-CoV-2. It is a respiratory pathogen that was first identified in Wuhan City, Hubei Province, China (Cennimo, 2023). The clinical presentations range from asymptomatic to severe illness. The victims suffer varying degrees of symptoms, and severity increases with age and comorbidities (Merga, et.al. 2022). The implications of this virus are such that there is a potential for post-COVID symptoms, a condition known as long COVID. Individuals who suffer from severe forms of this virus are more susceptible to this problem. According to the Center for Disease Control (CDC), long COVID includes a wide spectrum of health problems that can last for weeks, months, or years following a COVID infection. This condition can occur in both the vaccinated and unvaccinated, but the latter group is more susceptible to this crisis (CDC, 2023).
Recovering from COVID-19 takes a good touch of patience and commitment to the right medication, but the story is a little different for individuals with long COVID. For those patients, life is a constant search for relief, treatment, and answers. The effects of this prolonged illness have limiting impacts on the patient, the family, and health care providers.
Impact on Individual: The patient and the health care provider
COVID-19 has caused a series of mental health crises since the onset of the pandemic. The situation with long COVID has amplified the rate, as even some patients who have tested negative for the virus still have to suffer the discomforts associated with the disease. According to Lubell (2022), physicians who manage long COVID patients are often on the lookout for new-onset anxiety disorders. Patients who have a previous history of post-traumatic stress disorder (PTSD) and mood fluctuations often see an exacerbation in their symptoms during this condition.
In Nigeria, long COVID exerts significant pressure on both the patient and the health care providers.
According to Asake, the Head of the Infectious Disease Unit at the Lagos University Teaching Hospital (LUTH), about 10% of individuals managed for COVID-19 in the clinic have long COVID (Vanguard, 2023). Asake complained about this burden on the patient and the care provider. For the patient, psychiatric illness often results while the doctor grapples with managing the presenting symptoms, which are trails left by the impact of the virus. The unpredictability of symptoms could leave the patient in constant anticipation every morning—a trigger for constant emotional pain. For the physician, the inability to register a full diagnosis of the situation and dictate definitive therapy can be very unfulfilling and even emotionally depressing when the patient's state is put into consideration.
Psychosocial consequences, such as withdrawal from the community, further widen the gap between the patient and full recovery. Sometimes, forced retirement ensues as victims are unable to keep up with the demands of work. This ultimately leaves cracks in the financial buoyancy of the patient and limits the quality and quantity of healthcare the patient can afford.
Impact on Family and Relationships
While the patient struggles with controlling the demands of long COVID on individual well-being, the impact on family relationships and expectations is another challenge that begs for attention. The many facets that could be challenged include:
Parental roles: Long COVID, like all other protracted health issues, has put so much strain on the household. Anxiety disorders associated with the condition make mothers more afraid when managing the demands of their kids, especially the young ones. Brain fog, a symptom of long COVID, characterized by episodes of confusion, forgetfulness, and loss of mental clarity, could precipitate incompetence in handling children, which leaves unmet expectations in families. Also, the fatigue that follows the condition denies parents the fulfillment of engaging in activities such as school runs and outdoor play activities with kids.
Quality time: the demands of managing a long COVID have limited quality time within the family. This is due to the re-routing of time that would have been dedicated to family time to managing and caring for the ill member of the household. These alterations in circumstances significantly impact family finances, with cutbacks made to adjust to the loss of employment. Finances are used to fulfill caring responsibilities rather than spend on quality time as a family.
For Children: kids who suffer from long COVID often have their carefree nature taken from them as they are subjected to more precautionary measures of living. Because of the close monitoring required by long COVID, they are not allowed to associate as much as they would, ordinarily. This ultimately denies them the joy of childhood and all its gains. In school, concentrating during academic activities becomes a challenge as a result of the continuous loss of focus prompted by bouts of brain fog.
Sustainable measures for a sustainable future
Given these challenges, what can be done to make the situation better for the patients and the healthcare system that serves them? The solution depends on serious political will from the government, the establishment of relevant psychosocial support for victims of this condition, and a community-based approach.
Research and Development: Scientists are yet to fully establish the cause, long-term implications, and specific therapy for long COVID. Efforts must be made to boost research programmes targeted at finding lasting solutions to this condition.
Healthcare plan: given the predictable decline in the performance of patients with long COVID, government and industry heads must develop healthcare insurance schemes that will enable the accessibility of quality and expanded healthcare to people even after retirement. In addition to good insurance schemes, the government must commit more funding to the development of the health sector. Doctors who put their lives on the line every day should not be allowed to go home with almost an empty pocket. There must be enough financial support to cushion the pressure and the demands of COVID-19.
Establish support systems: Also, retraining programmes and employment support initiatives should be organized to aid patients who have developed new disabilities in the course of the disease to enable them identify alternative employment opportunities that can accommodate their needs.
Awareness creation: There is a need for agencies, the Ministry of Health and the Ministry of Information to work together to ensure that the right information is delivered to the public regarding the implications of long COVID and the ways of managing and caring for victims. The awareness programme should also be targeted at encouraging people, especially suspected and asymptomatic cases, to report any medical condition they develop to the nearest hospital.
CONCLUSION
Long COVID is denying us the pleasure of asserting victory over the virus. Its long-term impact is already debilitating millions, with serious consequences for their psychosocial states. We will have to boost research towards securing a lasting solution given the insufficiency of current diagnostic and treatment options. Through a cooperative mechanism and a restructuring of our health systems, we can boldly declare that victoria é certa!
REFERENCES
Adeniyi, B.O et Al. (2021). Long Covid in Nigeria: Beyond the Epidemic, Making Adequate Preparations for the Long-Term Effects of Covid-19. West African Journal of Medicine, vol 38, no. 12. https://www.researchgate.net/publication/358139993_Beyond_the_Epidemic_Making_adequate_preparation_for_Long_Covid_in_Nigeria_wwwwajmedorg
American Society For Microbiology (2022). Long COVID: The Next Chapter in the Covid-19 Pandemic. https://asm.org/Articles/2022/May/Long-COVID-The-Next-Chapter-in-the-COVID-19-Pandem
CDC (2023). Long COVID. COVID-19 Web Archive. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html
Cennimo, D. J. (2023). Coronavirus Disease 2019 (COVID-19). Medscape https://emedicine.medscape.com/article/2500114-overview
Guardian Nigeria (2022). Dealing with Post-Covid-19 Complications. Editorial Board. https://guardian.ng/opinion/dealing-with-post-covid-19-complications/
Lubell, J. (2022). For patients with Long Covid, look out for psychiatric sequelae. American Medical Association. https://www.ama-assn.org/delivering-care/public-health/patients-long-covid-look-out-psychiatric-sequelae
Merga, T. B. (2022). Association of Pre-Existing Comorbidities with Disease Severity Among COVID-19 Patients in Eastern Ethiopia. PubMed Central. Doi:10.2147/IDR.S362140
Skopeliti (2022). Over 2,000 Guardian readers told us about their long Covid fight: Here are the stories. The Guardian. https://www.google.com/amp/s/amp.theguardian.com/society/2022/oct/25/long-covid-fight-guardian-readers
Vanguard (2023). 10% of Covid-19 patients treated at LUTH have long Covid–Physician. https://www.vanguardngr.com/2023/01/10-of-covid-19-patients-treated-at-luth-have-long-covid-physician/amp/
