Peer Support for COVID-19 patients in the community

As of 15 June, the accumulated number of COVID-19 cases is 667,876, moving towards a million cases.  The health care workers have been working tirelessly caring for them while they are in the hospitals or quarantine centres.  However, once they are declared recovered and discharged home, they are left on their own except those with medical conditions that need to be followed up.   Based on the study by the Ministry of Health on stage 4 and 5 patients followed up in the hospitals post discharge, 66% of them reported to have post-COVID condition or Long COVID up to 12 weeks or more after infection.  While studies conducted in the UK and US among all COVID patients (with mild and serious symptoms), approximately 10 to 30% of them suffered from Long COVID.  How about our patients who are declared recovered from COVID and back in the community?  They may be still suffering from some of these symptoms but may not be aware of such symptoms or when to ask for medical assistance.

On the other hand, there are also patients with mild symptoms allowed to be home quarantined.  Although there are systems in place for these patients to report their symptoms, patients and carers not be well informed on what to observe or when to seek medical attention when their condition deteriorates.  Consequently, we noted that as at the end of May, Malaysia has recorded 10% (n=293) of the 2,796 Covid-19 deaths were brought in dead (BID). Other factors contributing to the increase of BID may be attitude of patients and carers who were ignorant or thought lightly of their symptoms, patients were not aware that they were infected with COVID-19 as they were not tested, the virus variant may be more virulent resulting rapid deterioration in the patient’s condition, medical facilities not readily accessible in remote areas such as in Sabah and Sarawak.

The health care workers are the most qualified personnel to care for the above two groups.  However, our health care workers are overwhelmed with the treatment of acute patients and in contact tracing, surveillance, isolation of close contacts etc.  They may be unable to cope with these large number of patients in the community.  Therefore, support from the community especially from the COVID-19 patients who have recovered fully may be very useful.  We are aware that there may be one or two private groups formed by the ex-COVID-19 patients. One of them is the Facebook group “COVID-19 Malaysian Stories” for members to share their stories.  These support groups could play a more active role in offering assistance to support patients who are on home quarantine and those suffering Long COVID.  The Ministry of Health may need to set up a formal group with clinicians involved as the resource person and to provide formal training to these volunteers.  They may need to be registered with the MOH before being allowed to offer their service.   With the training and registration system in place, they may be able to help prevent cases of BID if the deterioration of conditions is picked up early and medical treatment can be started earlier.  The support group can also provide advice to those suffering Long COVID when medical treatment is needed. 

Recovered COVID-19 patients acting as peer supporters also solve the issue of stigmatism on COVID-19 patients.  The patients may be reluctant to open up to volunteers who have not shared their experience and stressful conditions.   When both the peer supporters and patients have had the same experience, the sharing of knowledge or providing emotional support, social interaction or practical help may be better received.

The article was written by Professor Dr Moy Foong Ming and was first published in New Straits Times, Code Blue, The Sun Daily, Sin Chew and Sin Chew Daily (Chinese version).

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