A teacher with crushing chest pain that feels like a heart attack. A mother who gets dizzy and breathless when she plays with her toddler. A business owner who can no longer remember his customers’ names.
These three people have one thing in common -- they each have post-COVID-19 conditions, said Jennifer Possick, MD, during expert testimony before the U.S. House Committee on Energy and Commerce’s Subcommittee on Health on April 28, the first congressional hearing focused on the long-term effects of COVID-19.
Possick, an associate professor within the Section of Pulmonary, Critical Care & Sleep Medicine (Yale-PCCSM) at Yale School of Medicine (YSM), and the medical director of the Winchester Center for Lung Disease Post-COVID Recovery Program, joined other expert medical witnesses from across the country at the virtual hearing, including Steven Deeks, professor of medicine at the University of California, San Francisco, Francis Collins, director of the National Institutes of Health, and John Brooks, chief medical officer for the Centers for Disease Control and Prevention’s COVID-19 response. The hearing also included patient testimony.
Possick described how she and her Yale-PCCSM colleagues began seeing patients who were suffering from post-COVID-19 conditions shortly after the pandemic began in Connecticut in March of 2020. “My colleagues and I were struck by how difficult it was to tell the difference between people who were recovering from mild acute COVID-19, and those who required ICU-level care,” Possick said. “Both groups had the physical, cognitive, and psychological fallout we would expect from a critical illness.”
Possick explained that a multidisciplinary team including pulmonary, physical therapy, respiratory therapy, and social workers provides these patients with comprehensive evaluations in a single clinic visit. A broader coalition of YSM physicians in cardiovascular medicine, neurology, and psychiatry, all with COVID-19 disease expertise, works together to untangle complex symptoms, she said.
“We spent this year learning alongside our patients, about half of whom were never hospitalized,” Possick said. “They are mostly working age, and previously high-functioning. Many were frontline or essential workers.”
She described patients whose quality of life has been seriously impacted by post-COVID-19 illness. “Some can’t walk to the mailbox or remember a shopping list much less resume their everyday lives and work,” she said. “They’ve used up their paid sick leave, they’ve cut back their hours, they have left or lost jobs. They have difficulty accessing workers’ compensation benefits and family medical leave or securing workplace accommodations. Some have even cut back on food, rent or utilities to pay for mounting medical expenses.”
Possick continued, “We are a well-funded academic medical center, but we are swamped by the need in our community. This year we have seen more patients with post-COVID-19 conditions in our clinic alone than we have new cases of asthma and COPD combined. Looking ahead, the magnitude of the challenge is daunting.”
Possick said she hoped the congressional hearing would help inform the public about post-COVID-19 conditions, and how they can occur after a mild illness, in young people, and in people without preexisting conditions. She also hoped to highlight the ways in which individuals already affected by post-COVID-19 conditions must be supported as they continue to recover, and the barriers to care that must be addressed.
“We’ve made great strides, and accomplished a great deal in this unprecedented year, but as we move into the next phase of response, we must realize that we are pacing for a marathon rather than a sprint,” she said.
The Section of Pulmonary, Critical Care, and Sleep Medicine is one of the 11 sections within YSM’s Department of Internal Medicine. To learn more about Yale-PCCSM, visit PCCSM’s website, or follow them on Facebook and Twitter.