Posted on 01/28/2021
5 min read
Almost a year after the arrival of the epidemic, many patients still have the sequelae of Covid-19, even for the less severe forms of the disease. Symptoms that can be treated with thermal medicine. Explanations with Professor Christian-François Roques, President of the Scientific Council of the French Association for Thermal Research (AFRETh).
How can hydrotherapy be beneficial to people who suffer from the after-effects of Covid-19?
Thermal medicine is a good answer for certain after-effects of Covid-19 because it is already capable, in terms of both equipment and personnel, of meeting many of these expectations. And this can concern several cases. There are in particular patients who were unable to receive the care they needed due to the invasion of follow-up care structures by Covid-19 patients. In this case, the thermal world can offer a relevant answer in terms of rehabilitation. And there is of course the care to be given to patients who have been infected by Covid-19.
What types of physical sequelae could be relieved / treated in thermal cures?
There are several types of sequelae, and this question has been well studied for a year because at the beginning we may have been surprised by certain symptoms. This was not the case for patients who had prolonged resuscitation, because post-resuscitation syndrome has been known for a long time. But it must be said that it is particularly marked in the case of Covid-19 because the duration of hospitalization in intensive respiratory care, which is usually one week, has increased to three weeks on average. In this case, the syndrome is not only more common, but also leads to heavier manifestations. There are also respiratory consequences. Covid-19 has resulted in extremely destructive damage to the respiratory system, which results in pulmonary fibrosis. And if we can’t do anything about the lesion, which is definitive, we will be able to work on the consequences. This will include improving the autonomy of patients by allowing them to make more intense efforts, or of a low to moderate intensity but for longer periods. The initial management phases of these post-Covid complications are the responsibility of specialized rehabilitation units, particularly respiratory units. But it is not excluded that subsequently, when the patients are stabilized, they can benefit from appropriate thermal treatments with a view to a complement or, later, a maintenance.
You talk about serious after-effects. What about other symptoms?
This care can actually also concern patients who have been affected by the less severe forms of Covid-19. And I’m talking about people who have not necessarily had clinical signs. These are patients who are tired, are incapable of the slightest effort, have memory problems, difficulty concentrating, who sleep poorly, whose heart rate accelerates with the slightest effort, or who have pain. in the joints or muscles. At first, we were surprised by the existence of these symptoms of Covid-19, especially for patients who did not even know they had had the disease. These symptoms seem to last a long time and management is difficult. These are patients for whom it is obvious that the spa environment can provide answers because it knows how to take charge of these different symptoms, and this in an atmosphere which is at the same time reassuring, because they meet a lot of health professionals. healthy, and calming.
Can this also concern psychic sequelae?
Yes quite. You should know that Covid-19 places a major burden on both patients and health personnel, both emotional and physical, and that the epidemic is far from over. This is a situation that causes many professionals to experience a syndrome of physical and emotional exhaustion, which is also called burn out. These are people who must absolutely be taken into account. This is a problem that we have been interested in for several years, and it has obviously accelerated with the crisis. The spa treatment offers the advantage of treatments which are known to be anxiolytic, which allow them to regain a better general condition, and which represent a break with the usual living conditions while remaining a socialized way of life. For these health personnel, the thermal world, through its know-how in the psychosomatic field, offers interesting resources which it would be regrettable to deprive oneself of.
Apart from health personnel, could patients who have been infected with Covid-19 be treated in the event of psychological sequelae?
Yes absolutely, the thermal world knows very well how to deal with serious anxiety disorders, mild depression, burnout, or chronic fatigue syndrome. There are indeed sequelae which will be more on the psychological side which must lead patients to psychosomatic stations. But other people will be more bothered by muscle fatigue, loss of strength, or joint pain, it will be more of the locomotor side which can be taken care of in rheumatological type stations. Everything ultimately depends on the dominant symptomatology.
In short, the site devoted to thermal medicine * is very well done, and patients will be able to find all the information that will come out as and when. However, if we had broached this subject on December 22, for example, my speech would have been reassuring because we could have counted on the opening of thermal establishments in March or April, with the feeling that the second confinement had indeed broken the epidemic curve. . There we see the appearance of variants of the virus, more contagious, all over the world, and that is very problematic. Mathematically, we should see an increase in the number of cases, therefore of people to be taken care of, and the physical distancing measures will have to be more severe. It is therefore very difficult to know if we will be able to afford to reopen the thermal establishments in three months.
You have no information on a potential reopening at the start of the season?
Absolutely not. It should be very difficult in the coming weeks to have a realistic idea of a possible opening date for establishments. The latter are facing a serious economic challenge because they cannot operate at a loss for long. This was the case last year. It is not excluded that some, this year, will perhaps choose not to reopen if the prospects of activity are not sufficient.
In order to accommodate patients who are generally elderly and necessarily vulnerable, will a specific protocol be put in place?
A certain number of treatments have already been deleted, and there are treatments for which the security measures have been reinforced. This particularly concerns mud protocols. It is a question of heating the sludge so as to be sure that those which could have been contaminated are sterilized. Facilities have also been imposed on physical distance measures in care; which obviously considerably reduced their reception capacity. So there were fewer people in the pools, and fewer people in the treatment rooms, walkways, and waiting times. And of course, wearing a mask was compulsory, as was the use of hydroalcoholic solutions, washing hands, providing linen and cleaning it according to strict standards, etc. It was worked a lot to end up with something very structured.
Will patients with Covid-19 sequelae be treated as a priority?
This is something that is being negotiated with health insurance. If it puts the means so that the thermal world can take care of these patients, it should be able, if it wishes, to demand a priority. Otherwise, it will be more complicated. What is certain is that thermal establishments are very keen to make their contribution to the fight against the pandemic, and to show that thermal medicine is an integral part of the country’s health system.
* site: Medecinethermale.fr.
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