Doctors have nowhere to report their long-Covid cases

Because at the moment nobody knows how many people in Switzerland are affected by Long Covid. Experts fear that social security will face enormous follow-up costs.

About 20 percent of adults suffer from long-term consequences three months after the first Covid 19 symptoms.

Christian Beutler / Keystone

They are so exhausted that they can hardly get out of the house; their brain keeps having misfires, they keep forgetting things; they no longer have a sense of smell: The family doctor Res Kielholz from Uster has more than a dozen long-Covid patients. Some of them have been suffering from the consequences of the corona infection for several months. What irritates Kielholz: The authorities do not seem to be very interested in his patients and their symptoms.

“While I was able to report all Covid vaccination side effects to Swissmedic, there is still no way to report my long-Covid cases to a central registration office,” criticizes Kielholz. It would be easy for general practitioners to send data on affected persons to the Federal Office of Public Health (BAG) via the protected Health Info Net channel, says the doctor. “Not only the dead and those hospitalized, but also the survivors with long-term consequences should increasingly concern the BAG.”

He fears that enormous consequential costs will also be incurred by social security. In order to be able to estimate how big this phenomenon actually is, reliable data from practice would be very valuable. “If there were a reporting obligation for Long Covid, such data could be generated quickly,” emphasizes Kielholz.

No legal basis

On request, the BAG confirms that there is currently no central contact point for doctors who want to report their long-Covid cases. Even hospitals only keep their own registers, without any national link. A spokeswoman for the Federal Office says there is no legal basis for launching monitoring by the federal government. In addition, the clinical picture of Covid-19 long-term consequences and the associated symptoms have not yet been sufficiently researched and defined. “It therefore makes sense that the phenomenon should first be researched in various research projects and cohort studies.”

In fact, there is a lot going on in this area. For example, the University of Zurich is conducting three cohort studies on the long-term effects of Corona, one of which focuses on children. There are similar efforts at Geneva University Hospitals. On behalf of the FOPH, the Swiss School of Public Health, a coordinating body of the major Swiss universities, is also evaluating the national and international literature on Long Covid issues.

The following findings have emerged from this research work so far:

  • About 20 percent of adults suffer from long-term consequences three months after the first Covid 19 symptoms. In view of the 1.6 million confirmed corona cases in Switzerland to date, around 360,000 people would have been affected or affected. With the omicron wave, the number of infected people is likely to rise sharply again. However, it is still completely unclear what long-term damage the latest corona variant will cause.
  • Approximately every third person with a severe course and approximately every sixth person with a mild or asymptomatic course is affected by long-term consequences.
  • Around 2 to 3 percent of children and adolescents who have contracted the coronavirus suffer from long-term consequences. With 300,000 confirmed corona cases in 0 to 19 year olds, that would be several thousand affected minors.
  • Women are more affected by the long-term effects than men.

In a motion, the Health Commission of the National Council points out the large number of long-Covid cases that have never been hospitalized, but have been at home the whole time. These people often fall through the cracks in the system and are left to their own devices. “The best thing you can do is turn to your family doctor, who is usually helpless and helpless.”

“a matter for the cantons”

The health politicians therefore asked the Federal Council to create a contact point to which those affected can turn. In December, the Council of States, as the second chamber, approved the initiative. Health Minister Alain Berset would therefore now be obliged to develop a corresponding legal basis. In its response to the motion, however, the Federal Council has already made it clear that, from its point of view, the monitoring of long-Covid cases would actually be a matter for the cantons.

But how justified are the fears that the long-term consequences of the pandemic could lead to a heavy burden on social services? The BAG does not want to venture any forecast due to the not yet solid data situation. Disability insurance (IV) would probably feel the quickest effect. So far, no rush of corona victims has been detected there.

No IV pension yet

According to a report by the “Sonntags-Zeitung”, only 1364 people had applied for a pension because of Long Covid by October 2021. And monthly enrollments were already falling again in midsummer and fall compared to May and June. Even if the number of Corona-related pension applications should increase to 5,000 or 6,000, this would be little in relation to the more than 247,000 IV pensioners.

For this reason, the Federal Social Insurance Office is currently not expecting a large jump in expenditure on the IV. So far, the insurance company has not spoken a single pension because of Long Covid.

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