Are we using the same terminology here?
When you "edit" a profile, you are in the Profile Editor view which shows a list of commands, from there, you can select a command to view the Command Editor window. There should be zero reasons to simultaneously edit more than one profile and its command(s) at the same time independently and also with each of these as 'active' profiles.
I can't imagine a scenario where you would be editing profiles while using them. What you seem to describe is that you need multiple active profiles, one for Blender, one for a game, one for controlling streaming software, a spreadsheet editor, and ithoughts. For this, you merely need to manage your profiles and possibly modify them so that they do not need to be the currently selected profile in order to function, so that they can be global profiles in the background all active at the same time.
So long as there is no command overlap (same voice commands in multiple profiles), this should work just fine. I presently have my default profile loaded, which works for several games depending on if they are running, but also globally I have my voice calculator, my sensors & weather profile, and my openai/chatgpt profile all waiting for commands as well - each of these are separate profiles with specialized purposes, similar to what you describe in your use case scenario.
When a profile is included as a global profile, that profile's command phrases are loaded (globally) when VoiceAttack starts up - no need to switch to the profile(s). But if any of your profiles have 'initialization' or 'start-up' commands which need to fire at least once before using the profile, you may consider means to merge these somehow so that they occur after VoiceAttack is loaded so that you can use other profiles as global or included profiles all at the same time without switching between them in order to use their commands.