Australia: Guideline: Caring for patients with post–COVID-19 conditions

Andy

Senior Member (Voting rights)
"This guide contains information for general practitioners (GPs) and their teams, who are providing care for patients who have previously tested positive to COVID-19 or have a history suggestive of undiagnosed COVID-19 and have – or are at risk of – post–COVID-19 conditions at any point after the initial acute infection."

https://www.racgp.org.au/clinical-r...ng-for-patients-with-post-covid-19-conditions
 
"Long COVID guidelines updated ahead of expected ‘influx’

Experts are warning that the long-term effects of having COVID-19 need to be more closely monitored, with an estimated one in three people experiencing at least one symptom 3–6 months after their initial diagnosis.

With the World Health Organization officially recognising ‘post-COVID-19’ as a clinical condition in October, GPs and other frontline healthcare workers are being warned of an ‘influx’ of patients with the condition following infection.

‘Unfortunately, post-COVID-19 conditions have flown under the radar,’ RACGP President Dr Karen Price said.

‘Just because you recover from the initial illness, that does not mean you are out of the woods.

‘As I have been saying for many months, it might not be the end of your COVID-19 story – it could just be the beginning.’"

https://www1.racgp.org.au/newsgp/clinical/long-covid-guidelines-updated-ahead-of-expected-in
 
management of 'common symptoms' said:
Fatigue:2,9,19
• Maximise self-care, sleep, relaxation and nutrition
• Recommend that patients pace and be selective when prioritising daily activities
• Recommend caution with return to exercise (reduce if there is any increase in symptoms)
• A monitored return to exercise can be supported by an exercise physiology, physiotherapy
or rehabilitation referral

• If fatigue is causing difficulty with activities of daily living (ADLs), recommend
energy conservation techniques and home visits by an occupational therapist or
rehabilitation service

Recommendations for patients discharged following severe COVID-19 include said:
• Patients should be encouraged to do regular daily activities and low-to-moderate
physical exercise (but not high-intensity exercise) in the first 6–8 weeks
post-discharge.
• Patients should have a formal assessment of physical and emotional functioning
at 6–8 weeks post-discharge, including measurement of respiratory function and
exercise capacity, and referral to appropriate services where indicated. These
might include:
– comprehensive rehabilitation service if there are multiple treatable concerns
– exercise physiology to facilitate a graded increase in activity tolerance if fatigue is
preventing completion of pre–COVID-19 activities

– pulmonary rehabilitation if there is pre-existing or ongoing lung function impairment
– strengthening exercise and nutritional support programs, if there is loss of strength
or muscle mass
– formal psychological assessment.
 
That seems to self contradictory. It does recomment pacing, and specify cutting back if symptoms worsen, but also recommends what sounds like GET.

There seems to be a fundamental gap in the theoretical underpinnings of much rehabilitation, it takes the idea that if you have a broken leg you stimulate muscle recovery and return to normal activity by physical activity and generalises it to other unrelated conditions, without asking why.

For me this can become dangerously akin to the ‘principle of similars’ in homeopathy. You treat people with adverse responses to activity with controlled doses of activity in the hope this will result in a magic cure, with actually knowing what you are trying to treat.
 
That seems to self contradictory. It does recomment pacing, and specify cutting back if symptoms worsen, but also recommends what sounds like GET.
They just don't understand any of it, it only speaks of "if fatigue". They're stuck at this phase and can't unhook from it, simply refuse to acknowledge the breadth of symptoms, especially neurological, and PEM.

The patient community had most of this nailed down within a few months. Medicine hasn't even caught up to the basics yet. Clearly shows that yet again the standard is everything about us in secret behind closed doors, take it or leave it. It's obvious that patients were not involved in any step of this process, this is purely top-down.

I don't even know what a "formal psychological assessment" is supposed to mean. That's not a thing, there is no process that will conclude with a "no psychological issues", it's all performative. We all know this means an infinite loop that never ends because the other side of the coin is, somehow, not applicable: that if they can't tell whether psychological issues are not significant, they sure as hell can't tell if they are. The magic only works in one direction, the one that says "I decide what reality is".

"Has flown under the radar", says the radar operator who refused to point the dish where things were happening. Pffft. The complete lack of accountability is shocking, though completely unsurprising.
 
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