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Over 21,000 cases of long Covid diagnosed in Finland

The actual number of people suffering long-term effects from a coronavirus infection is unknown since physicians may use varying diagnostic criteria, and no population-level research is yet available.

Taija Rutanen, who has been diagnosed with long Covid, has contacts with other patients all over the country. "People don't get enough information and support from healthcare services," she says. Image: Juha Kivioja / Yle
Yle News

The World Health Organisation WHO estimates that at least 17 million people in Europe may have contracted long Covid during the first two years of the pandemic.

The number of people suffering from long-lasting symptoms caused by the coronavirus has clearly increased in Finland and so far more than 21,000 people have been diagnosed with long Covid.

It is impossible to know the actual number of patients suffering from the condition because doctors have been using widely varying diagnostic criteria, and as of yet no comprehensive research on the prevalence of long Covid has been carried out in Finland.

Yle's MOT investigative journalism programme looked at the prevalence of long Covid in Finland, and reported that patients diagnosed with the condition are receiving both a variety of treatments and a variety of support in dealing with the prolonged impact of the disease.

Treatment uncoordinated

Private occupational healthcare providers have reacted to the situation, and for example the private healthcare provider Terveystalo has established its own long Covid network. On the public side, the response appears to be mixed.

The Helsinki and Uusimaa Hospital District (HUS) has an outpatient clinic for long-term symptoms of coronavirus infections, but about half of the estimated 700 referrals have had to be turned away due a lack of resources. It is the only public clinic of its kind in the country.

A survey by MOT of the 21 new regional authorities that will be in charge of public healthcare from the beginning of next year found that only a few have a model in place for dealing with the treatment of long Covid patients.

Catherine Smallwood, senior emergencies officer with the World Health Organisation in Europe, told Yle that the situation does not sound ideal.

"Of course, what you want is that regardless of whether they live in Helsinki or up in Lapland in the bush, should they need health services, that they should be able to get it," said Smallwood.

She added that patients should also be treated as comprehensively as possible and not just for specific symptoms, because long Covid has such a broad effect on the body. Smallwood said that a number of countries are currently having difficulties in organising treatment for patients with long Covid. However, if the problem is not addressed, a significant portion of the population may be left with various physical and psychological problems from the long-lasting effects of the virus.

Disagreement among doctors

An extensive round of interviews conducted by Yle's MOT programme found a sharp division of opinion about long Covid within the Finnish medical community.

There is, for example, a debate among doctors about whether it is an actual physical disease or more of a functional disorder.

According to Turku University emeritus professor of neurology Risto O. Roine, this may be the main reason why treatment in the public sector is lacking in many places.

"In Finland, there has been a widespread perception that long Covid is a psychological or functional disorder, and that may have influenced how it is approached. It's possibly been considered that there is no need to develop treatment," he said.

Roine pointed out that in the light of scientific research it is already known that the mechanisms of long Covid are biological, and viewing it as a functional disorder is not enough to explain the symptoms.

The Helsinki and Uusimaa Hospital District (HUS) is currently leading an approximately 6.5 million euro EU-funded study examining the mechanisms of long-term symptoms caused by the coronavirus.

Helena Liira, chief physician at HUS's long Covid outpatient clinic, is involved in the research work.

She recognises features of a functional disorder in long Covid.

According to Liira, for example magnetic resonance imaging has shown hardly any abnormalities in cranial examinations of long Covid patients treated at the HUS clinic.

"There are no findings with conventional methods, but in this EU project we are using a few new research methods. It remains to be seen whether we will come up with any anomalous findings," she told MOT.

Diagnosis not enough

Taija Rutanen, who chairs an association of long Covid patients, says that some people with the condition have told their doctors that they are depressed or suffering from anxiety in order to get a diagnosis that qualifies them for sick leave or other benefits, since a long Covid diagnosis does not necessarily do so.

Doctors are also aware that a long Covid diagnosis may not qualify patients for benefits, and so may have a lower threshold for providing an alternative diagnosis.

The head of Terveystalo's long Covid network, neurologist Markku Partinen, says that he's heard about the problem and looked into the matter at his own workplace.

"It turned out that Terveystalo has not misrepresented these diagnoses, but there is talk on the grapevine. Where there's smoke, there's fire," Partinen pointed out.

In the case of pension applications made on the basis of a long Covid diagnosis, a positive decision has almost always been made only if the applicant has had other diseases, or health issues that significantly impair their ability to work.

Item continues after the photo.

Neurologist Markku Partinen thinks it doesn't make sense that, for example, a diagnosis of depression qualifies patients for benefits, but a diagnosis of long Covid does not. "This is wrong. A long Covid diagnosis should be enough. It is a real disease." Image: Juha Kivioja / Yle

The long form of Covid seems to be a relatively minor problem in light of the overall volume of sickness allowance and pension applications by people who contracted the virus.

Based on a register maintained by the Institute for Health and Welfare (THL), the number of "depressive state" diagnoses and "other anxiety disorders" diagnoses have increased significantly since 2020. It is impossible to say how many of these people are actually suffering from long Covid.

Minister of Family Affairs and Social Services Krista Kiuru (SDP) admits that the situation for long Covid patients in Finland is not good.

"We don't have an established, long-term plan of action, what to do in this situation when trying to help these people. This is being seen in the field," she said.

However, Kiuru pointed out that she is currently heading up an expert working group that will make recommendations for long Covid treatment before the end of this year.

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