Post-COVID symptoms have a major impact on quality of life (social, personal and professional). Some people with long-term symptoms are unable to resume their normal activities or work because they have fluctuating symptoms of unpredictable duration.
Interdisciplinary care is recommended.
These services are currently covered by basic health insurance, like any other medical treatment. In addition, some individuals suffering from persistent symptoms causing incapacity in their daily lives have made benefit claims under the invalidity insurance scheme in Switzerland.
Support is essential during this difficult time. We suggest that you to talk to your paediatrician or primary care physician to find the best care.
Associations and support groups in Switzerland and the French-speaking world:
Switzerland:
- Long COVID Switzerland (in French or German)
Set up by patients on 26 March 2021 in Bern, Switzerland, to advance recognition of long COVID as a disease, research for clinical treatments and to provide support to those affected. - Altea, the Long COVID Network (in English)
France:
- Association Aprèsj20
French association working to provide information for all audiences, support patients and ensure the joint creation of suitable and consolidated care pathways by health actors and patient partners under #CovidLong and #AvecEtPourLesPatients
United Kingdom:
- Long Covid Kids (mainly in English)
Return to school
Returning to school with post-COVID symptoms
Post-COVID symptoms may persist for weeks or even months, affecting an individual’s functional capacity and school attendance.
Before planning a return to school, you should discuss this with your paediatrician or primary care physician and make sure that you are medically capable of resuming school activity. Returning to school can be difficult and cause worry and anxiety after a long absence or in people who are still symptomatic. You should discuss it in detail with your paediatrician or primary care physician and the school to make sure that they are made aware of your state of health and you can work together on the best possible return-to-school plan. We recommend regular return-to-school meetings when you are ready to go back to school.
It is important to contact the school administration to agree on an appropriate solution to avoid relapses and potentially long-term functional impairment. This may involve a shorter school day or a later start in the morning. The issue should be discussed with the school doctors and the school administration.
People with post-COVID symptoms most often have intense fatigue, defined as asthenia. They may wake up tired and spend most of their day with extremely low energy levels. Although they have so little energy and sometimes hardly any at all, that is what they have to use for their daily activities and every aspect of their personal, professional and social lives. If they are overstretched, they may experience post-exertional malaise and need several days to recover. Patients can generally identify a time of day when they have more energy than at other times. It is important to inform the school authorities about these problems so as to take advantage of the time of day when the student feels most capable of working. Post-COVID symptoms can also fluctuate and, ideally, the school should review the workload on days when the child has relapses or has major symptoms. In general, symptoms improve over time if the framework allows the child to return to school gradually, which will ensure a better recovery. A daily energy diary is available as a tool for patients to monitor their energy levels, examine any improvement and determine when they feel better and which activities use up the most energy.
Individuals with post-COVID symptoms may also have difficulties in concentrating, often described as “brain fog”. They have trouble doing more than one thing at a time or concentrating for long periods, and they may be error-prone.
Organization and monotasking can help improve their concentration and their ability to complete their work. There is currently no medication available for post-COVID concentration difficulties. Occupational therapy (ergotherapy) can help manage the daily activities and give advice and coaching on how to manage tasks.
People suffering from post-COVID symptoms may also experience shortness of breath, chest pain or heart palpitations. These symptoms may occur at rest but are most often limiting for activities involving physical exertion, which must be taken into account in adapting the child’s school programme (sports classes, timetable adjustments, etc.) to reduce the symptoms as much as possible (activity involving low physical effort, more sedentary work).
The return should be gradual, after realistic short-term goals have been set by agreement with the school. It should preferably begin with half-days or a few hours a day at the time of day when the child has most energy. The back-to-school arrangements should allow them to attend their medical appointments and rehabilitation programmes to increase the chances of long-term improvement in their symptoms.
Symptoms generally improve over time after an often-slow recovery process. Unfortunately, a small proportion of patients with post-COVID symptoms may not recover enough to be able to return to school for long periods of time, and cannot complete their school year. In these cases, solutions should be discussed with the Education Department to allow them to return to their studies.
Online resources containing pacing, breathing, mindfulness, hypnosis and tai chi exercises can improve well-being and manage post-COVID symptoms.
