‘Never seen it this bad’: new long COVID clinic opens in Victoria, as emergency rooms fill up

A new clinic for people who suffer from long COVID symptoms has opened at the Royal Jubilee Hospital in Victoria and is taking referrals as of this week.

A statement posted on Island Health’s website for medical staff on April 12  announced the opening of the ‘Post COVID-19 Recovery Clinic at RJH,’ making it the fifth long COVID clinic site in BC—the first outside of the Lower Mainland.

According to the statement, the program is designed to help each patient for 18 months, with sessions designed to be accessible virtually and in person. The Jubilee long COVID clinic is taking patients from across Vancouver Island and, the website stresses, “A positive COVID test is NOT required for a referral.”

In a statement to Capital Daily, an Island Health spokesperson said the clinic was opened on March 1, and there have been 60 patients referred since then. Patients can be referred to the clinic by a doctor or a nurse practitioner.

Dr. Jeff Unger, an ER physician who has been working in Victoria for 22 years, said Tuesday, April 12 was the first he’d heard of the clinic starting to take referrals. Its arrival, he said, was not a moment too soon, as more and more patients suffering from long COVID have started to show up in the emergency room.

“Most of the time, [patients] are coming in because they’ve got some complication of COVID or they’re getting sicker,” Unger told Capital Daily. “Only just recently in Victoria, the long COVID clinic opened… so we've got somewhere to actually refer those people. Previously, we were trying to do that with testing and follow-up referrals as best we could.”

Unger says emergency departments at Saanich Peninsula, Royal Jubilee, and Victoria General hospitals have been serving as primary care sites for a number of patients with long COVID symptoms who have not been able to get into a walk-in clinic and don’t have a family physician.

There are now fewer patients showing up at the emergency room than at the peak of the Omicron wave in January. Unger says part of this is because far fewer people are trying to get COVID tests at hospitals now that at-home rapid test kits are more widely available. But that doesn’t mean the danger has passed: with the decline of the fifth wave, Unger says COVID-related hospital visits had started to drop last month, but have slowly picked back up again, to the point where patients are waiting up to eight hours and being treated in hallways and closets.

Unattached

A lot of what Unger does these days involves making up for a lack of available primary care on the Island, amid a surge of patients with post-COVID complications. That reality is acknowledged in a statement distributed on Island Health’s medical staff website.

“[P]atients do not need to be attached to be accepted,” the statement reads.

Unger says not having access to family doctors has added to the difficulty for patients seeking post-COVID care.

“Patients [are] coming in more than three months after COVID with ongoing symptoms [like] insomnia, shortness of breath, chronic cough, fatigue, muscle and joint pains, those kinds of things,” he said.

They are then treated on a case-by-case basis. The doctor might check for complications like signs of myocarditis (inflammation of the heart muscle) or order lab tests and ultrasounds. Before Victoria’s long COVID clinic was set up earlier this week, there was nowhere to refer unattached patients. This forced ER physicians to follow up on every case themselves and take on primary care duties they’re ill-equipped to do.

“We're still figuring out all about long COVID and what those treatments are, which is why having a specialized clinic nearby is going to be a great option for people,” Unger said.

Advocates predicted this rise in the number of people who suffer from post-COVID complications after the Omicron wave. As cases start to rise, with or without the province sharing this data, the sixth wave poses the risk of even more people developing these still-mysterious symptoms.

Even without the virus or post-COVID cases, Unger says ER physicians already have their hands full with patients who’ve gotten more and more sick without access to in-person, physical doctor visits over the course of the pandemic.

He diagnoses new cancers almost every shift that are “almost certainly a result of lack of preventative care, screening care, patients being able to access in person care for an actual physical exam over the last two and a bit years.”

Unger described one recent case of a patient with a tumour on the side of her face who hadn’t been diagnosed for over a year and a half because the only doctors’ appointments she’d had in that time were virtual. All he had to do to find the cancer was examine her and feel the mass in her cheek.

Though wait times at the ER often average six to eight hours, Unger said patients feel it’s worth it to wait because the only other option is urgent care clinics, which often reach full capacity minutes after opening in the morning.

“I’ve never seen it this bad in the 22 years I’ve been working in Victoria,” Unger said.

The province and health authorities have tried to help ease the burden on emergency rooms by providing COVID surge funding to hire extra physicians; this boost is guaranteed until June 30, according to Unger. But like nurses and other healthcare workers, he says those extra physician hours were needed at least 10 years ago. In fact, a decade ago, the BC Medical Journal was already writing about an ongoing, worsening doctor shortage across the province, while Victoria emergency room doctors were complaining of understaffing even before that.

Measures like opening urgent primary care centres—the province’s current method of trying to renew access to healthcare—are failing, according to Unger.

“This government and multiple governments before that have failed,” Unger said. “They like to talk about…the 27 Urgent Care [centres opened] since 2017 [seeing] over a million urgent care visits. But there are almost certainly two [to] four times that many visits that needed to be seen and they've been an absolute failure on attaching any patients for longitudinal care.”

On Thursday, the Times Colonist reported that yet another walk-in clinic will be closing in June, making it the fifth walk-in clinic in Greater Victoria to shut down this year. The provincial health ministry has responded to this spate of clinic closures by announcing stabilization funding of $3.46 million to keep the doors of Esquimalt Medical Clinic, Shoreline Medical clinics in Brentwood Bay and Sidney, West Coast Family Medical Clinic in Sooke, and West Saanich Medical Clinic open.

This announcement, like the COVID surge funding, offers a short-term, stopgap solution to a rapidly escalating crisis. For his and other emergency departments, what Unger says physicians and nurses need most is more long-term funding for staff.