The story of Alberta's rural long COVID program that never was

Positive, left, and negative COVID-19 antigen rapid tests are pictured in Calgary, Alta., Tuesday, Jan. 4, 2022. (Jeff McIntosh / The Canadian Press)

As better diagnosis and symptom management emerged for people with long COVID, researchers in Alberta set to work creating a program that could remotely connect urban specialists and rural patients. Between development and clinical implementation, the project was shelved.

With the province closing its clinics dedicated to treating people with long COVID, the story of Alberta’s innovative rural outreach program appears destined to remain incomplete.

Long COVID, or post COVID syndrome, refers to patients who are still experiencing symptoms twelve weeks after the initial infection. According to Health Canada, the condition affects about 1 in 9 adults who have had COVID.

Martin Ferguson-Pell said the University of Alberta’s Rehabilitation Robotics Lab was approached by Alberta Health Services to find a way to help assess rural patients for two common symptoms: breathlessness and fatigue.

“What we did, because of the challenges that people who are in rural areas have in getting access to specialist assessments, was to look at the feasibility of doing this remotely,” Ferguson-Pell.

The rehabilitative medicine team has over several years designed a clinic-to-clinic model using the ProMote system. A combination of video conferencing and telerobotics equipment, the platform allows patients to be remotely assessed by an expert from their local health centre.

“The idea was that we would make sure that rural health centres had the means to be able to support these patients and help with the assessment and monitoring of their symptoms after COVID, with the focus in our case on measuring breathing and respiration,” he said.

Over the course of about five months, Ferguson-Pell said they developed the specific tools needed to ready the ProMote platform for long COVID care.

“That was finding the right kind of stethoscope that we could use remotely. Producing a means to be able to measure breathing rate and, ideally, depth of breathing,” and communicating the information from the rural site to a specialist who could interpret what was happening in real time.

Ferguson-Pell said the team achieved their goal, and delivered the technological solutions needed to adapt ProMote to long COVID patients. But as the clinical implementation phase approached, AHS’ interest in the project shifted, and funding for it dried up.

“We did step one, and we got everything set up and ready to go. Step two, the funding was not provided. In other words, they decided not to go forward with the implementation. And that was nothing to do with the quality of our work. It was a strategy decision that was made by AHS. This was during the latter stages of COVID,” he explained.

A spokesperson for AHS said there are no plans to put the clinic-to-clinic assessment tools to use for long COVID patients.

“This research program relied on in-kind contributions and shared general research grant dollars, which were exhausted. The long COVID aspect of the ProMote program was discontinued in July 2023.

“While AHS has no plans for clinic-to-clinic assessments of long COVID symptoms using the developed tools, the telerobotic technologies and tools under the Promote program (which were not limited to long COVID) continue to enhance assessment and treatment across various practice areas, including orthopedics, neuro rehab, vestibular care, and more.”

Jennifer Kendall is one of many in the province with enduring health problems that followed a COVID infection. Originally from Lacombe, Kendall sold her house and moved in with family in St. Albert, both to be closer to her specialist in Edmonton and because she was no longer able to care for herself due to long COVID symptoms.

Kendall said initiatives like the remote long COVID program could still be of use, and help fill the void created by the shuttering of the specialized clinics in Edmonton and Calgary, which left many patients without a doctor who really understands the condition.

“Anything is better than nothing for us. Absolutely I think that (program) would be beneficial,” she said.