As the COVID-19 pandemic continues to evolve, many individuals are experiencing lingering and prolonged symptoms long after their initial infection has cleared. This phenomenon, known as “long-COVID,” or “post-acute sequelae of SARS-CoV-2 infection” (PASC), has been garnering increased attention from researchers and healthcare professionals alike.

Long-COVID is a condition where individuals experience a wide range of symptoms that last for weeks or even months after recovering from the acute phase of COVID-19. While the exact causes of long-COVID are not yet fully understood, it is believed to be the result of the body’s immune response to the virus, persistent inflammation, or the virus itself causing ongoing damage to the body.

Below, we examine the common and uncommon symptoms of long-COVID, and what researchers and healthcare professionals know about the condition so far.

Common Symptoms of Long-COVID

Fatigue: One of the most commonly reported symptoms of long-COVID is fatigue, which is often described as an overwhelming lack of energy and difficulty in performing daily tasks. This fatigue can be particularly severe and debilitating, affecting the individual’s ability to work, exercise, and socialize.

Breathlessness: Many individuals with long-COVID experience breathlessness or difficulty breathing. This symptom may be accompanied by a persistent cough and chest pain.

Brain fog: A significant number of long-COVID patients report experiencing brain fog, which can manifest as difficulty concentrating, memory problems, and confusion. This can interfere with a person’s ability to function at work or in social situations.

Joint and muscle pain: Muscle pain and joint pain are common symptoms of long-COVID. These symptoms can be widespread, affecting multiple areas of the body, or localized to specific regions.

Headaches: Persistent headaches are another commonly reported symptom of long-COVID, ranging from mild to severe in intensity.

Anxiety and depression: Many individuals with long-COVID experience anxiety, depression, or mood swings, which may be related to the physical symptoms, ongoing health concerns, or the impact of the condition on their daily lives.

Less Common Symptoms of Long-COVID

Heart palpitations: Some individuals with long-COVID report heart palpitations or irregular heart rhythms, which can be accompanied by chest pain and shortness of breath.

Digestive problems: Digestive issues such as nausea, diarrhea, and loss of appetite are less common but still reported symptoms of long-COVID.

Skin issues: Some long-COVID patients experience skin issues, including rashes, hives, or redness.

Loss of taste and smell: A small percentage of long-COVID patients continue to experience a loss of taste or smell for weeks or months after their initial infection.

Ongoing Research

Researchers and healthcare professionals are actively investigating the causes, risk factors, and treatment options for long-COVID. Some studies suggest that the severity of the initial COVID-19 infection may be associated with the risk of developing long-COVID. However, long-COVID can also occur in individuals who had mild or even asymptomatic COVID-19 cases. Factors such as age, sex, and pre-existing health conditions may also play a role in the development of long-COVID.

Research is also focused on understanding the mechanisms underlying long-COVID symptoms. It is currently believed that long-COVID may be the result of a combination of factors, including ongoing viral activity, immune system dysfunction, and inflammation.

Treatment and Support

While there is no specific treatment for long-COVID, healthcare providers may offer symptom-based management, including pain relief, breathing exercises, and lifestyle modifications. Individuals with long-COVID may benefit from physical therapy, occupational therapy, or mental health support.

As the pandemic continues, it is crucial to continue studying and addressing the needs of individuals affected by long-COVID. This requires ongoing research, patient advocacy, and support for those living with persistent symptoms.

Earlier this week, the B.C. Government announced that COVID-19 restrictions would be easing – beginning with the mask mandate, which has now been lifted. While you will still be required to wear a mask in certain settings, such as healthcare facilities (i.e., doctors’ offices), it is now up to British Columbians to decide, based on their own comfort level, whether they want to continue wearing a mask in other settings. For those who are not ready to stop wearing a face mask, or for individuals who are at high-risk of contracting COVID-19 (for example, if you are clinically extremely vulnerable/immunocompromised), the recommendation is that you continue to wear a mask – especially in indoor public settings – if you feel more comfortable doing. Masks are also still encouraged, but not mandatory, on public transit (such as buses and ferries.)

On April 8th, further restrictions will be lifted. This includes proof of vaccination no longer being required under public health order to access certain services, businesses, or events, as well as no longer being required for post-secondary student campus-housing. That being said, individual businesses and event organizers can choose to continue to require proof of vaccination for entry. Proof of vaccination will also continue to be required for federally regulated travel, such as air travel. You can find more about the federal regulations for COVID-19 by clicking here.

When it comes to business safety plans, these will also no longer be required effective April 8th. However, all businesses must continue to follow guidance for communicable diseases from WorkSafe BC. As part of this plan, employers must understand the risks for their employees – whether those risks are specific to their workplace, or certain employees who may be at higher risk than others, as well as be prepared to implement further measures when required to do so by public health. Employers must also continue to implement policies that ensure their workers are aware of any measures in place, have supports in place for employers working from home, and post any necessary signage in the workplace to explain the policies of your business.

Undoubtedly, the easing of these restrictions has left some British Columbians feeling quite anxious. If you are feeling stressed or overwhelmed, it’s important to find healthy ways to cope with those emotions, such as talking to a trusted individual, or doing other healthy activities like getting regular exercise, meditation, and even eating healthy, well-balanced meals as all of this can help improve the mood. As social media and television are two of the most common ways people get their news, overexposure can also lead to increased feelings of stress and anxiousness, so it is recommended that you consider scheduling TV and social media “blackout” times throughout the day to give yourself a bit of a break. Remember, prioritizing your mental health is just as important as prioritizing all other aspects of your health. For tips on how to better manage anxiety, visit www.anxietycanada.com.

As we’ve seen with COVID-19, there have been several variants of the virus that have emerged since the start of the pandemic. It is not uncommon for viruses (such as influenza, for example), to change over time – while some viruses will remain the same. When viruses like COVID-19 do change and mutate, they are closely monitored by public health officials.

Among the most talked about variants of COVID-19 are the Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1) and Delta (B.1.617.2) variants – with the Delta variant currently accounting for the majority of COVID-19 cases in British Columbia and around the world.

A variant of COVID-19 is deemed a VOC (Variant of Concern) by the World Health Organization when it meets the following criteria:

• Increase in transmissibility or detrimental change in COVID-19 epidemiology; OR
• Increase in virulence or change in clinical disease presentation; OR
• Decrease in effectiveness of public health and social measure or available diagnostics, vaccines, therapeutics.

Omicron (B.1.1.529) – the most recent COVID-19 variant to emerge – was first documented in South Africa in mid-November and has since been detected in over 30 countries – including right here in Canada. The Omicron variant has up to 32 mutations on spike protein and as many as 10 mutations on the receptor binding domains. The more mutations there are of a variant, the easier it is to transmit from person to person on a much more rapid scale; and while scientists say that there is reason for concern pertaining to the transmissibility of the variant as well as a spike in re-infection of COVID-19 according to one South African study – there is also much we don’t know. For example, whether or not the Omicron variant can lead to more severe illness compared to other variants, if the severity of the Omicron variant is equal to other variants or less severe, or if vaccines will work against it – data that could take several weeks to learn.

While health officials await new data on this variant, important temporary precautions have been taken to help prevent the spread of COVID-19 and the Omicron variant – particularly around travel, with many countries reverting back to old measures. In Canada, any traveller who has been in South Africa, Mozambique, Namibia, Zimbabwe, Botswana, Lesotho and/or Eswatini from November 12th onwards will be barred from entering the country. If you are a Canadian citizen or a permanent resident and have been to any of the aforementioned countries, you will be allowed to return home – however, you must have a negative PCR test prior to boarding your flight to Canada, must take an additional test upon your arrival to Canada, and must quarantine in a hotel until your test has a confirmed negative result followed by quarantining at your home for an additional 14 days thereafter.

Along with using all layers of protection – such as staying home when you’re feeling sick, washing your hands frequently, physically distancing yourself from others, working from home, as well as wearing a face mask, the next best thing you can do to protect yourself and those around you is to get vaccinated. If you haven’t yet received your first or second COVID-19 vaccine, it’s important you do so. Booster vaccines are also being made available to those 18 years of age or older.

Along with other layers of protection such as physical distancing, good hand hygiene, staying home when sick, and mask-wearing, getting vaccinated against COVID-19 is one of the best measures in fighting this pandemic. If you’ve received two doses of an mRNA vaccine, it is highly recommended that you get a booster vaccine. Getting a COVID-19 booster vaccine can help maintain and lengthen your protection against the virus.

“Why do I need a booster vaccine?”

While vaccines are highly protective against the development of serious illness (or even death) as a result of COVID-19, studies have shown some waning of vaccine effectiveness over time – with an increase in susceptibility in individuals who are older or severely immunocompromised. Getting a booster vaccine is also crucial as new variants (such as the highly transmissible Delta variant) of the virus emerge and transmit in the community.

“Who is eligible to receive a COVID-19 booster vaccine?”

Everyone in British Columbia who is 18 or older will be eligible to receive a booster vaccine, starting with those who are most at risk. While getting a booster vaccine is optional, it is highly recommended – especially for those who are considered CEV (clinically extremely vulnerable.)

“When will I get my invitation for the booster vaccine?”

From November 2021 until January 2022, invistations will be sent out based on age group (starting from oldest to youngest) and the date of your second dose. Everyone will be eligible, and you will not miss your opportunity to receive a booster vaccine. In order for you to receive your invitation, you must be registered with British Columbia’s Get Vaccinated system. If you have not yet registered, you can do so by visiting www.gov.bc.ca/getvaccinated and may register online. Alternatively, you can also register by calling 1-833-838-2323. This number is available 7 days per week, from 7 AM to 7 PM PDT.

“What type of vaccine will I receive for the booster dose?”

All booster doses will be an mRNA vaccine – such as Pfizer or Moderna. If you happened to receive the AstraZeneca vaccine for your first or second dose, you will receive either Pfizer or Moderna for your booster dose.

“Will I develop more side effects from a booster vaccine?”

Everyone’s body reacts differently. While some individuals may not develop any noticeable side-effects from the COVID-19 vaccines, others can. Regardless of whether you receive one, two, or three vaccines, it’s still possible to develop side-effects. The most common side-effects that are reported following COVID-19 vaccines include flu-like symptoms such as headache, nausea, and fever, in addition to pain, redness and/or swelling at the site of injection. Typically, these side-effects will be mild and dissipate after a few days. If you’re still experiencing these symptoms after one week, you should speak with your physician by telephone for further consultation.

“Will a booster vaccine protect against influenza?”

Receiving a COVID-19 vaccine does not protect against the flu, which is why it’s also strongly recommended that everyone aged 6 months or older get the flu vaccine in addition to the COVID-19 vaccine (although at separate times.) Developing both the flu and COVID-19 could put you at even greater risk of significant complications, so it is important to protect yourself from both of these illnesses. For more information on influenza and the flu vaccine, visit www.immunizebc.ca/influenza.

For almost two years, British Columbians have had to take certain measures to keep themselves, their families, and their communities safe from COVID-19 – including testing, physical distancing, limiting or avoiding non-essential services and travel, mask-wearing, and most recently, vaccines. Now, another layer of protection will soon be coming into effect. Starting September 13th, and by order of Provincial Health Officer Dr. Bonnie Henry, British Columbians aged 12 and older will be required to show proof of at least one dose of COVID-19 vaccination (two doses by October 24th) if they want to access certain services, businesses, and events.

“Where will I be required to show proof of vaccination?”
You will need to show proof of vaccination if you want to access the following:

• Indoor ticketed sporting events, concerts, theatre, dance and symphony performances
• Indoor and outdoor dining at restaurants, bars and pubs
• Nightclubs and casinos
• Movie theatres
• Gyms (including high-intensity group exercise), recreation facilities and pools
• Indoor organized recreational classes and activities
• Indoor organized gatherings (i.e., weddings, funerals, parties, meetings, workshops)
• Post-secondary on-campus student housing

“How will I be able to access my vaccine card?”
Starting September 13th, British Columbians will be able to visit a secure website to access their vaccine card. From there, you will be able to save your vaccine to your smartphone for easy access and show it when accessing any of the aforementioned services, businesses, or events. If you do not have access to a smartphone, British Columbians will also have the option of receiving a paper copy of their vaccine card. In order to access your vaccine card, you will need to provide proof of identity – including your name, date of birth, and personal health number. To prepare and confirm your immunization records, it is recommended that you register for Health Gateway. (This secure website also provides you with information on healthcare visits and recently filled prescriptions.) If you believe any of your information on Health Gateway is incorrect, you should call 1-833-838-2323 (available 7 days a week from 7 AM to 7 PM PST.)

“Do I still need to show proof of vaccination if I’m visiting from outside of British Columbia?”
If you are visiting British Columbia from another province or territory, you will be required to show valid government identification from that province or territory in addition to an officially recognized vaccination record. If you are an international visitor, you will need to show proof of vaccination used to enter Canada, in addition to showing your passport.

“What if I cannot get (or am not yet fully) vaccinated, or do not want a vaccine?”
Because this is a temporary measure to help British Columbians get through this risky period of COVID-19 – particularly with the highly contagious and rapidly spreading Delta variant – Dr. Bonnie Henry has stated that there are no plans at this time for exemptions to be made for unvaccinated individuals who want to access discretionary services, businesses or events where the vaccine card will be required.

“If I’m not yet vaccinated but want to get a vaccine, where do I go?”
British Columbians who are not yet vaccinated (or not yet fully vaccinated) and want to be, can register for their vaccine by clicking here.

“Will I need to show proof of vaccination each and every time I want to access these things?”
For the time being, yes, you will be required to show your vaccine card when wanting to access discretionary services, business or events. The vaccine card program is set to expire on January 31st, 2022; however, it is subject to extension depending on where things are with COVID-19 in our province at that time.

When it comes to COVID-19, it is a virus that can affect individuals of all walks of life – regardless of age, gender, or where they live in the world. However, what we’ve also learned since living with this virus for the past 18 months is that there are certain individuals who may be at increased susceptibility for COVID-19 than others. While age is something that certainly plays a role (with those over the age of 60 being the most impacted by this virus with severe illness, hospitalization and death), we also know that individuals with certain pre-existing medical conditions are also more likely to contract COVID-19 and develop severe illness as a result – including the following:

• Those who have cancer or are receiving cancer treatment
• Chronic kidney disease
• Chronic lung disease (i.e., asthma, COPD)
• Diabetes (type 1 or type 2)
• Neurological conditions (i.e., dementia)
• Heart conditions (i.e., heart failure, coronary artery disease, hypertension)
• Liver disease
• HIV infection
• Pregnancy
• Those who are immunocompromised
• Blood disorders (i.e., sickle cell disease, thalassemia)
• Obesity
• Those who are smokers (current or in the past)

To mitigate the spread of the virus, measures were put in place early on in effort to help decrease the spread of COVID-19 – such as physical distancing guidelines, limiting or closing non-essential services (including limiting the number of people allowed inside a business), mask mandates, and more. However, with vaccines now in the mix, this has allowed many of these restrictions to be loosened, businesses to reopen, and life to go back to a certain degree of normalcy – and while some individuals may feel comfortable going back to living their lives the way they did prior to this pandemic, not everyone may feel comfortable doing so just yet. For example, a friend or family member might invite you out to eat at a restaurant while you might instead prefer ordering in; or, you may have been working remotely through the pandemic and are now being pressured by co-workers to return to in-office work; or people may ask why you’re still wearing a mask despite being fully vaccinated. In cases such as these, it may be surprising to some to learn you aren’t taking the exact same measures as them when re-introducing yourself to what’s known as a “post-pandemic” world (despite the pandemic still very much being a significant factor – particularly with numbers on the rise again due to the highly transmissible Delta variant.)

In any event, what’s comfortable for one person may not be comfortable for someone else, and it is both important to not only set your own personal boundaries – but, in turn, also be respectful of the personal boundaries that individuals may set for themselves due to their own personal risk profile – especially if they do not align with your own; also taking into account that someone may have certain comorbidities that you are not aware of, which may lead to some hesitancy in things like not wearing masks, etcetera.

For some, setting boundaries can be difficult, but it’s important to note that any decision you make for yourself is the right one as you’re doing what you need to do to not only protect yourself, but protect those around you, and you should not feel guilty about wanting to ensure your own optimal health as well as the health of others. While one’s risk of developing COVID-19 decreases if they are fully vaccinated, the fact remains that vaccines are not considered 100% effective – there is still the potential for breakthrough cases – and one’s personal risk factor still needs to be considered. When being invited to a social gathering, the likelihood is that your friends and family miss you; but as you turn them down, they may feel as though you’re trying to intentionally avoid them which could lead to hurt feelings. This is why it’s also important to have a conversation about why you’re setting personal boundaries, and find other ways to continue to prioritize those friendships by offering alternative ways of socializing – such as having regular group video chats, as keeping those social connections are important – particularly for our mental wellbeing.