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 Early in the pandemic, Klinik Wald, built in Zurich's highlands in
1898 for low income victims of the lung disease, took on many
patients straight from intensive care.
Now, more so-called "long COVID" victims are coming for
rehabilitation and fill 5-10% of its 158 beds, Dr. Marc Spielmanns,
its medical director, said.
It is part of a long evolution for 19th- and early 20th-century
Swiss sanatoriums, a dozen of which became modern rehab hospitals in
their ongoing fight to stay relevant.
Spielmanns said proper rehabilitation can succeed anywhere, but that
Klinik Wald's remote setting overlooking Lake Zurich and the Alps,
may offer extra respite. Patients recuperate from COVID-19 on
sun-soaked balconies where tuberculosis (TB) patients rested decades
ago.
"They are really fatigued," Spielmanns said. "This environment...
helps them to get on the way back to normality."
Long COVID includes not just respiratory difficulties and fatigue,
but also anxiety and depression. The World Health Organization fears
it may burden health systems for years to come.
The United States and Britain rely largely on out-patient therapy
for their long COVID rehab.
While Switzerland and neighbouring Germany offer similar outpatient
programmes, they also send some long COVID patients for weeks-long
residential therapy, sometimes in cure centres like Wald founded
more than a century ago.
A four- to six-week stay at Klinik Wald costs about 17,000-25,000
Swiss francs ($27,833). Switzerland's private health insurance
system in most instances covers the bill, the Federal Health
Ministry said, adding "services must be effective, appropriate and
economical".
'COME BACK TO YOURSELF'
In April, a Swiss Army officer checked into the 120-year-old
Hochgebirgsklinik, a former TB sanatorium in the Swiss mountain town
of Davos. The "cognitive fog" that accompanied long COVID left him
unable to work, he said.
"COVID took a little part of my lungs, and a big part of my brain,"
said the 56-year-old officer, who asked that his name not be used.
After six weeks of treatment, for his lungs and his psyche, he is
preparing to return home. "You need this time to be out of the
system...to come back to yourself," the officer said.
Since the SARS-CoV-2 virus attacks multiple organs, Prof. Dr.
Hans-Werner Duchna, the Hochgebirgsklinik's chief pulmonologist,
said cardiologists, occupational therapists and psychologists work
together with one simple aim.
"We try to bring the patient back to his or her daily life."
HOW OTHERS DO IT
In the Italian Alps, a giant 3,000-bed TB sanatorium-turned-hospital
in Sondalo, built in 1932 by dictator Benito Mussolini to rival
Davos's sanatorium industry, has provided long COVID care for 100
patients, doctors there said.
In Germany, COVID "Long Haulers" may go to rehab retreats like the
Median Klinik in Heiligendamm, a 230-year-old Baltic Sea spa once
popular with European nobility. Stays run 3-5 weeks, a spokeswoman
said, with insurance usually picking up the tab.
[to top of second column] |
 Britain, meanwhile, set aside
34 million pounds ($48 million) to start 83 long
COVID clinics for "community-based therapy
services", delivering help for fatigue or
respiratory complaints.
Dr. Melissa Heightman, an NHS England Long Covid
Task Force member, said residential therapy
"would not be an affordable model", with
hundreds of thousands of U.K. long COVID
sufferers potentially needing help.
Similarly, Dr. Alberto Esquenazi, board member
of the American Medical Rehabilitation Providers
Association (AMRPA), with 650 member facilities,
said U.S. long COVID rehab patients can expect
outpatient therapy. Results have
been encouraging, so far, he said.
"With this intervention, working on strength, endurance, balance and
concentration, they tend to do well," Esquenazi, chief medical
officer at Philadelphia-based rehab facility MossRehab, said.
REINVENTING REHAB
Mile-high Davos once boasted 40 tuberculosis sanatoriums for wealthy
Europeans whose long stays were romanticized in German author Thomas
Mann's novel "The Magic Mountain".
But when antibiotics tamed TB in the 1950s, some Swiss sanatoriums
like the famed Schatzalp became hotels. Many others failed. The
handful that have survived developed new rehab programmes for
cancer, asthma or chronic disease, said Flurin Condrau, a University
of Zurich expert on historic sanatoriums.
Still, it hasn't been easy: Klinik Wald was nearly abandoned in
2012, while German shipping billionaire Klaus-Michael Kuehne saved
Davos's Hochgebirgsklinik from insolvency two years later.
"All of them say, 'If we don't compete for patients and others do,
we lose,'" Condrau said, of clinics' efforts to re-invent
themselves. "That is responsible for them being quick out of the
gate in identifying long COVID as an opportunity."
For instance, 112-year-old Rehazentrum Walenstadtberg, atop a
winding, one-lane road beneath Switzerland's jagged Churfirsten
mountains, admitted its first non-TB patient in 1965 before adding a
multiple sclerosis wing in 1978.
It kept its lung programmes, which chief doctor Bjoern Janssen said
proved a lifesaver this year: Walenstadtberg has treated 500 acute
and post-intensive care COVID-19 patients, while referring long
COVID cases to a sister clinic nearby.
"That has a connection to our roots as a tuberculosis clinic,"
Janssen said. "This tradition has always continued."
($1 = 0.7090 pounds)
($1 = 0.8979 Swiss francs)
(Reporting by John Miller in Zurich and Emilio Parodi in Milan;
editing by Philippa Fletcher)
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