The countless and difficult returns to work after COVID 19

The countless and difficult returns to work after COVID-19 | Coronavirus

At 36, Geneviève Marcotte was forced to return to her parents. Previously active and fond of travelling, today she struggles with standing, cooking and housework for more than ten minutes. In short, take care of yourself.

All because of the COVID-19 she contracted exactly 13 months ago. My life changed in 24 hours. The day before I got COVID I was hiking with friends, I was engaged, I loved my job. And 24 hours later I have COVID and will never go back to this state, she says.

Geneviève Marcotte was an active woman, a lover of travel and hiking before contracting COVID-19.

Photo: Genevieve Marcotte

Geneviève never returned to her position as head of trade missions at Université Laval. She is being closely monitored by a team of medical professionals as her symptoms are still numerous and most importantly incapacitating.

My energy limit is very, very low. I would say my battery is maybe at 10%. When I expend 12% of my energy, I experience post-workout discomfort. Here all my symptoms come back, but in a really exaggerated way, she says.

“I will have muscle aches, burning sensations, severe headaches and an exhaustion that will leave me bedridden […] This discomfort can last a few hours, a few days, a few weeks depending on my excess energy expenditure. »

— A quote from Geneviève Marcotte, who has been unemployed for 13 months

To make herself clear, she gives the example of a recent shopping spree that lasted less than two hours.

Despite being accompanied by someone who pushed her in a wheelchair, she relapsed from the noise, light, and atmosphere of the shops. It took me a week to get over it, she says, adding that she had to be bedridden for a few days.

Geneviève Marcotte, during an appointment with her occupational therapist via video conference

Photo: Radio Canada / Alexandre DUVAL

A new paradigm

Cases like that of Geneviève Marcotte, her occupational therapist at the Iso-Santé Réadaptation clinic, see a lot. Caroline Théberge is clearly worried about some who are stagnating in their rehabilitation after an illness.

It is certain that they exist [pour qui] it is very difficult to improve their condition and […] Even after a year of follow-up in rehabilitation with all the tools, returning to work is sometimes very difficult, she says.

Why is this so difficult? Because standard rehab practices don’t work for people with ongoing symptoms of COVID-19. Getting her to surpass herself is a grave mistake, Ms Théberge says.

“We say good good, reactivation will make it better, we will move up. But with the long COVID, the opposite is happening. As soon as people push their limits a little too much, they relapse, they make their symptoms worse. People experience misunderstandings, a lot of heartache, stress. »

— A quote from Caroline Théberge, occupational therapist at the Iso-Santé Réadaptation clinic

Caroline Théberge, occupational therapist at the Iso-Santé Réadaptation clinic

Photo: Zoom/Screenshot

Services are starting to grow and become more efficient, but at first people didn’t know! There are places full of benevolence where more traditional rehabilitation has been offered and cases have been made worse! She says.

Professor Simon Décary of the School of Rehabilitation at the University of Sherbrooke explains that science is now showing the full complexity of these cases, which are still sometimes misunderstood.

In our clinical studies, the most complex thing is getting patients to return to work because there is this balance between the need for recovery and the need for action. When I try to accelerate, I know I’m creating relapses. And every relapse is delayed [le retour au travail]he said.

thousands of people

However, the visibly widespread phenomenon of patients not being able to work fully is difficult to quantify.

According to CNESST, 501 Quebecers have been receiving income compensation for more than six months due to COVID-19. Of these, almost 80% are employed in the healthcare sector.

In addition, a recent study by the Quebec National Institute of Public Health raised concerns about this prolonged absence from the healthcare network, fearing that it could even compromise the care offered to the population.

The CNESST numbers are just the tip of the iceberg, however, as they only concern people who contracted the disease at their workplace.

Those infected elsewhere, like Geneviève Marcotte, are usually compensated by a private insurance company and not included in the statistics.

Radio-Canada has attempted to obtain estimates from the Canadian Life and Health Insurance Association, but that data does not exist, we’re told.

However, Professor Décary is categorical: people absent from work, some or all, due to persistent symptoms of COVID-19 in Quebec are very numerous.

“Do I think there are thousands of people who have not regained full working capacity since being infected? Yes, I’m pretty sure of that. »

— A quote from Simon Décary, Professor in the School of Rehabilitation at the University of Sherbrooke

Even the CNESST data seem to underestimate the seriousness of the situation. When I see the number of cases remaining [absents du travail] After six months, based on what I know about the functional impact of this disease, I tell myself that there are people who have returned to work and weren’t ready.

The Simple Judgment

Nathalie Belleau is one of the cases being indemnified by CNESST. As a nurse in the public network, she fell ill with COVID-19 in December 2021. For three months she could not return to work at all.

It has been gradually returning since March, at a rate of three half-days of four hours each per week. Difficulty speaking, declining stamina, headaches, clumsiness, chest pains: the list of its symptoms is long.

Luckily, she says she’s well supported by her team of medical professionals, but admits it all might seem like a stretch to people unfamiliar with the long COVID. “I think people, when they see that, make a quick judgment,” she said.

Nathalie Belleau, a nurse, can only work 12 hours a week, divided into three shifts.

Photo: Nathalie Belleau

As an occupational therapist, Caroline Théberge can attest to this skepticism because she has observed it herself in the healthcare network. But patient support is crucial, she says.

[Au début de la pandémie]I had many clients for whom it was necessary to write long letters to doctors to explain the problem, the approach to rehabilitation, [parce] that people told us: “I don’t feel sore, my doctor doesn’t support me.”

According to Ms Théberge, cooperation between employers is also important because the conditions for returning to work are sometimes unusual for people with long-term COVID.

When […] We arrive with a return to work of twice four hours a week, while the employer understands that returning to work at this stage can be therapeutic, they don’t really know what to give as tasks. Sometimes even the person doesn’t feel so useful, she illustrates.

A historical case

Professor Simon Décary believes that insurers must also show understanding because they will certainly have to pay claims for longer.

However, this path remains the best, in his opinion, because if we try to go too fast, we turn that person into a case with a permanent disability […] it will cost a lot more in the long run, including societal costs, he says.

In addition, Mr. Décary believes that we are collectively facing a historic case regarding insurance and return to work and that we have underestimated the impact of COVID-19 on the labor market.

“It’s not over. Scientific data shows us that despite triple vaccination and infection with Omicron, you can have a long COVID case at three months. »

— A quote from Simon Décary, Professor in the School of Rehabilitation at the University of Sherbrooke

Simon Décary, Professor in the School of Rehabilitation at the University of Sherbrooke

Photo: Simon Decary

Last December, the Department of Health and Human Services estimated that about 23,000 Quebecers may need its services at clinics dealing with long-standing COVID.

Geneviève Marcotte hopes she can go back to work. But before time stretches, the questions merge and the answers are yet to come.

What happens when I’ve reached the end of all these resources if I can’t work yet? Can I get support? Will society take care of me? What will it be, my net?

Since the pandemic began, CNESST has offered income compensation totaling $94 million to more than 55,000 people who contracted COVID at work.

However, it was not possible to know what amount was paid only to workers who show persistent symptoms of COVID-19 and whose return to work is partially or fully impaired.