Long COVID patients ‘devastated’ by impending changes to virtual care access in B.C.

Seven years ago, Vancouver resident Katy McLean was juggling a full-time job as an urban planner, a busy social calendar, and an active outdoor lifestyle.

Nowadays, even basic chores are a challenge.

“It’s my dream just to be able to go for a walk,” she said.

“I can walk around the block. But if I want to go farther, like to a big grocery store, I need to use a mobility scooter.”

McLean is one of more than 300,000 British Columbians living with long COVID.

She has a total of 13 diagnoses, including chronic fatigue syndrome, postural orthostatic tachycardia syndrome (POTS), fibromyalgia and mast cell activation syndrome.

“To find a doctor or health-care provider that is knowledgeable and can help you navigate these diseases is so difficult,” she said.

In recent years, McLean has seen some improvement with the help of a clinic specializing in chronic, post-viral illness — the B.C. Centre for Long COVID, ME/CFS, & Fibromyalgia (BC-CLMF).

The clinic, which provides virtual care to people across the province, has more than 8,500 patients.

But managers there have warned that impending changes to the province’s Medical Services Plan are going to make it harder for patients to access care.

From Nov. 1, the number of patients allowed to participate in virtual group appointments — which is currently not subject to any limit — will be capped at 30.

The per-patient reimbursement fee paid to service providers is also being reduced from $14.71 to $11.42.

McLean says being able to participate in virtual group sessions with allied health-care specialists has been hugely beneficial and improved her quality of life. (Tom Coule/CBC News)

No more virtual allied health care

The BC-CLMF routinely runs virtual sessions in groups of up to 50 patients.

Many of them feature conversations with allied specialists like occupational therapists, physiotherapists and psychologists.

“Learning about mobility aids and adaptive behaviors and devices and stuff like that has been so helpful to me,” McLean said.

“That multidisciplinary piece has made such a huge difference.”

But clinic co-founder and treating doctor Jane McKay said the new cap and changes to fees mean allied health will no longer be available in virtual group settings.

“The changes that were made to the fee code are such that we are no longer able to pay the providers we’ve curated that help us with this work,” she said.

“Try to tell 8,500 patients that the care that they had received that was making a difference is not going to be there. It’s pretty hard.”

The clinic has also warned patients to expect longer wait times.

“We, as the physicians, will continue with the fee code limits that have been set out. We’ll do the best that we can, but we know from the literature what we will be doing is not what is needed,” McKay said.

New guidelines stress importance of virtual care

National guidelines for delivering virtual long-COVID care were recently published by Simon Fraser University.

Kayli Jamieson, the lead researcher and a long COVID patient herself, says the MSP changes are completely at odds with best practice.

“This recent news is really disheartening because it’s going against all the recommendations that we’ve learned from patients,” she said.

“The reality is there is a lack of specialized services available and there’s a huge wait list.

“In order to deal with the huge patient population and a lack of clinical services available, the group care has been an efficient and effective way of serving as many people as possible.”

National guidelines for delivering virtual long-COVID care were recently published by Simon Fraser University. (Simon Fraser University)

Dr. McKay says in a health system under strain, service providers need to be given the opportunity to be flexible.

“A significant portion of this patient population is suffering to the point that they cannot access care in their own community, partly because they are their bed-bound or house-bound,” she said.

“We don’t have enough family doctors. We don’t have enough nurse practitioners. Our emergency rooms are overflowing.

“We have to look at how we deliver health care differently.”

The changes were signed off by the Medical Services Commission, an independent government-appointed body, on Sept. 24, two days after the B.C. election was called.

B.C. NDP campaign spokesperson Bhinder Sajan said in a statement to the CBC that if re-elected, the party would look into the impact of the decision to ensure nobody was denied access to care.

“I hope it will be reconsidered. I really hope so,” McLean said.