Return to work and care use by long-COVID patients on Bonaire, Caribbean Netherlands: Are patients their needs met?

Abstract

ABSTRACTBackgroundSymptoms persisting ≥ 4 weeks after an acute SARS-CoV-2 infection (post-COVID condition, PCC) can have substantial consequences for the daily functioning and labor force participation of working age patients. We examined care consultations during PCC among patients on Bonaire, Caribbean Netherlands, identified activity limitations among patients who returned to work (RTW), and described the support that these patients indicated has or would have facilitated them in recovering and re-integrating.MethodsBivariate logistic regression was used to examine correlates of care consultations during PCC among 157 PCC patients on Bonaire, and to identify factors related to RTW among a subgroup of working age PCC patients with pre-pandemic employment (n=129). We applied in-depth qualitative analyses to assess patients’ lived experiences related to RTW and care during PCC.ResultsWe found 37% of PCC patients consulted at least one (para)medical professional during PCC, of whom one in three consulted multiple professionals. 26% of patients recovered within one month since their acute infection; for patients unrecovered at time of interview, median time since infection was 249 days (IQR 30). Patients with comorbidity (OR=2.90, p<0.01, 95% CI [1.40-5.53]), under care prior to the pandemic (OR=2.52, p<0.01, 95% CI [1.30-4.95]), who had been hospitalized during the acute phase (OR=9.16, p<0.01, 95% CI [3.41, 29.21]), and patients who were aware that their insurance covered certain medical costs related to COVID-19 (after)care (OR=3.99, p<0.01, 95% CI [1.87, 8.81]) were more likely to consult care during PCC. Of patients who RTW (81%), 13% were working reduced hours, 35% experienced worsening of their symptoms after carrying out any physical or cognitive activity, and 40% encountered situations where they were unable to carry out work activities since they had COVID-19. Outside of the workplace, about one in four patients faced issues in sports activities and maintaining social relations since having COVID-19.DiscussionOur findings highlight various factors related to care use during PCC by patients on Bonaire and patient identified needs related to support in the workplace and COVID-19 aftercare. Improving PCC related occupational and healthcare policies on Bonaire may prove beneficial for recovering patients their vitality and socio-economic vigor.