Former Swiss “Zauberberg” TB clinics treat COVID to stay relevant | Top news
WALD / DAVOS, Switzerland (Reuters) – Swiss mountain sanatoriums, whose fresh air and sun cures once attracted tuberculosis patients from all over Europe, are reinventing themselves for a new generation: patients suffering from the after-effects of COVID-19.
At the beginning of the pandemic, the Wald Clinic, which was built in the Zurich Oberland in 1898 for low-income lung patients, admitted many patients directly from the intensive care unit.
Now more so-called “long COVID” victims are coming to rehabilitation and filling 5-10% of the 158 beds, said Dr. Marc Spielmanns, the medical director.
It is part of a long development of 19th and early 20th century Swiss sanatoriums, a dozen of which became modern rehab clinics in their ongoing struggle for relevance.
Spielmanns said that adequate rehabilitation could be achieved anywhere, but the remote location of the Wald Clinic with a view of Lake Zurich and the Alps could offer additional relaxation. Patients recover from COVID-19 on sunlit balconies that tuberculosis (TB) patients rested on decades ago.
“You are really tired,” said Spielmanns. “This environment … helps them get back to normal.”
Long COVID not only includes difficulty breathing and fatigue, but also anxiety and depression. The World Health Organization fears that it could put a strain on health systems for years to come.
The United States and the UK rely largely on outpatient therapy for their long COVID rehab.
While Switzerland and neighboring Germany offer similar outpatient programs, they also send some long-term COVID patients for weeks of inpatient therapy, sometimes in spa centers like Wald, which were founded more than a century ago.
A four to six week stay at the Wald Clinic costs around 17,000-25,000 francs (27,833 US dollars). In most cases, the Swiss private health insurance pays the bill, according to the Federal Ministry of Health.
In April, an officer in the Swiss Army checked into the 120-year-old high mountain clinic, a former tuberculosis sanatorium in the Swiss mountain town of Davos. The “cognitive fog” that accompanied COVID for a long time made him unable to work, he said.
“COVID has taken a small part of my lungs and a large part of my brain,” said the 56-year-old official, who asked not to use his name.
After six weeks of treatment for his lungs and psyche, he is preparing for the journey home. “You need this time to get out of the system … to get back to yourself,” said the officer.
Since the SARS-CoV-2 virus affects several organs, cardiologists, occupational therapists and psychologists work according to Prof. Dr. Hans-Werner Duchna, chief pulmonologist at the Hochgebirgsklinik, with a simple goal.
“We try to bring the patient back to their everyday life.”
In the Italian Alps, a huge 3,000-bed TB sanatorium in Sondalo, built in 1932 by dictator Benito Mussolini to compete with the Davos sanatorium industry, has provided long COVID care for 100 patients in Sondalo, doctors there said .
In Germany, long-distance COVID drivers may go to rehab retreats such as the Median Klinik in Heiligendamm, a 230-year-old Baltic seaside resort that was once popular with the European nobility. Stays last 3-5 weeks, said a spokeswoman, with insurance usually taking care of the bill.
The UK, meanwhile, is setting aside £ 34 million ($ 48 million) to open 83 long COVID clinics for “community-based therapy services” to help with fatigue or respiratory problems.
Dr. Melissa Heightman, a member of the NHS England Long Covid Task Force, said inpatient therapy was “not an affordable model” as hundreds of thousands of people with COVID in the UK may need help.
Similarly, Dr. Alberto Esquenazi, board member of the American Medical Rehabilitation Providers Association (AMRPA) with 650 member institutions that US COVID rehab patients can count on outpatient therapy.
The results so far have been encouraging, he said.
“With this intervention, which works on strength, endurance, balance, and focus, they tend to work well,” said Esquenazi, chief medical officer for Philadelphia-based rehab facility MossRehab.
In the kilometer-high Davos there were once 40 tuberculosis sanatoriums for wealthy Europeans, whose long stays were romanticized in the novel “The Magic Mountain” by the German writer Thomas Mann.
But when antibiotics tamed tuberculosis in the 1950s, some Swiss sanatoriums, such as the famous Schatzalp, became hotels. Many others have failed. The handful that survived developed new rehabilitation programs for cancer, asthma or chronic diseases, said Flurin Condrau, an expert on historic sanatoriums at the University of Zurich.
But it was not easy: The Wald clinic was almost abandoned in 2012, and two years later the German shipowner billionaire Klaus-Michael Kühne saved the Davos High Mountain Clinic from bankruptcy.
“Everyone says, ‘If we don’t compete for patients and others do, we lose,'” said Condrau of the clinics’ efforts to reinvent themselves. “This is responsible for the fact that they quickly recognize COVID as an opportunity for a long time.”
The 112-year-old rehabilitation center Walenstadtberg, for example, admitted its first non-TB patient in 1965 on a winding, single-lane road under the rugged Churfirsten of Switzerland, before adding a multiple sclerosis ward in 1978.
It kept its lung programs, which Chief Physician Bjoern Janssen said had proven to be lifesavers this year: Walenstadtberg treated 500 acute and post-intensive COVID-19 patients while referring long COVID cases to a sister clinic nearby.
“That has a connection to our roots as a tuberculosis clinic,” said Janssen. “This tradition has always been carried on.”
($ 1 = 0.8979 Swiss Francs)
(Reporting by John Miller in Zurich and Emilio Parodi in Milan; Editing by Philippa Fletcher)
Copyright 2021 Thomson Reuters.