They are in their thirties, were healthy and fit, but after they were in the first wave sick at home, they are still tired, flabby and stuffy. It is estimated that there are 10,000 to 16,000 post-covid patients, some 30 percent of whom are between 20 and 40 years of age. Physiotherapy can help and since mid-July as paramedical recovery care is in the basic package, but after six months no longer for people with “nonspecific” complaints.
Esther (32) steps on a bicycle ergometer in the training room of her lung physiotherapist in Utrecht. Doeko Ellen from Center for Physiotherapy Colli measures the oxygen levels in her blood and her heart rate. “For now, no particulars.” Esther‘s starting to kick. A few minutes later, Ellen shows her two plastic A4. Esther points out the load scales of 1 to 10 how it is with her fatigue and tightness. “The intention is not to overload her and recover from the training within a reasonable period of time,” says Ellen.
Esther has come from a long way. In April, she couldn’t do anything but lie in bed for five weeks. She had to wake up when she woke up before she could walk to the bathroom. “After that, I had a pounding heart and had to rest again,” she says. “When I was able to do more, I started walking small pieces and I slowly built up everyday things.” On some days she did too much, and in the evening she could only lie on the couch while hearing her heartbeat in her head or a squeak in her ear. The six months she was reimbursed to recover are over. In order to be able to get reimbursed for more treatments, she has taken out an additional insurance.
The Royal Netherlands Society for Physiotherapy (KNGF) wants to make it easier for patients like Esther to spread the 50 sessions that are reimbursed in the basic package over a longer period than six months. Now this can not be done with complaints such as a lack of condition, muscle pain and fatigue. But only with specific long-term damage such as a lung deviation, and a referral by a medical specialist. Members complained about it to the professional association.
“ Getting such a referral takes time. In addition, try to make an appointment now. Medical specialists are very busy with other matters,” says KNGF spokesman Pieter Vonk. “The serious complaints of ex-coronation patients – difficulty breathing, loss of muscle mass and loss of confidence in their own bodies – must be treated for a long time. So you can not temporarily stop treatment, because a referral from a specialist is required.”
That is why the professional organisation at the Dutch Health Institute, which advises the ministry on what should be included in basic insurance, advocates a more flexible policy. But the institute expects that continuing treatment of these patients after six months will have no added value. “When it comes to good care, these patients also learn how to maintain their own condition in the six months,” says a spokesman. “And how best to deal with any lasting residual complaints.”
From the first wave, about 10,000 to 16,000 patients still have complaints, estimates the C-support foundation, which supports these patients. Why some people keep such a long and serious burden is the big question, also for former GP Alfons Olde Loohuis, who connects patients to therapists from C-support.
“ How is it that the immune system in these people has been ringing alarm bells for so long when the intruder has long gone? Why does the virus leave such havoc in a number of people with a blank history?” Olde Loohuis mentions muscle pain, neuralgia, lung problems, shortness of breath, chest pain, severe headaches and neurological problems such as mispronouncing words. “And that would have been in succession.”
Jochem (34) also suffers from the latter. He had all kinds of corona complaints in the spring, but could not be tested at that time. “My thinking level is sometimes still at 50 percent, conversations can be very difficult. I am then not sharp, do long about finding my words, can not finish sentences. It‘s a very strange sensation.”
Jochem’s living roommate Nanda (39) could not speak well for another reason: because of the stuffiness. She said that was one of the most difficult aspects of her illness period. “I needed support from my environment while I was in quarantine, but in this difficult time I could hardly talk to my loved ones.”
Nanda is still being treated by a physiotherapist and has requested an extension. If her pulmonologist doesn‘t refer her to that, she doesn’t know yet whether she will continue with it. “My physio says that in order to build strength, it is necessary to go twice a week. If it is not reimbursed, the costs are very much higher.” She hopes she can go throughgo with the treatments. “Because of the fragile balance between enough load to recover and overload, which causes me a relapse.”
After some rest, Esther continues with strength training in the training room. She and physiotherapist Ellen keep an eye on her not making too much effort. Then she leaves, on an electric bike. Because although she lives nearby, walking or just cycling is still too much for now.