"....Long Covid is a multi-system condition with many different patterns of symptoms perhaps indicating different syndromes (NIHR CED, 2021). There is increasing evidence that symptoms change over time and it is clear that, for many, rehabilitation is not the answer. There is a clear need for systems of care for Long Covid with holism as it is a fundamental design feature. This includes the skills of a practitioner experienced in managing uncertainty and long-term conditions and who can co-produce personal coping strategies as potential treatments change over time. Nurses are pivotal to this." Open access, https://journals.sagepub.com/doi/10.1177/17449871211037473
One issue for Long Covid and many other illnesses is that convalescence has become a dirty word in medicine and medical care generally. For many decades now people have grown up expecting to get better far too quickly from all sorts of illnesses, accidents and surgery. I used to get tonsillitis extremely badly as a child. I would stay off school for 4 - 5 days before being sent back. I have discovered quite recently that in the US children with similar problems today are expected to go to school even though they are ill. They get no time to recover and recuperate at all. I used to get fevers of 103F - 104F (39.4C - 40C) and could barely walk and think. I'm sure modern children are no different. How many of them stay permanently ill?
It entirely depends on what one means by holism, because the current psychosocial model that deals with chronic illness and applies to Long Covid constantly boasts about being holistic. Mostly because it's just a marketing buzzword that can mean anything, or nothing, and in itself isn't a desirable feature, since by definition it's not possible to take everything into account, decisions are always made about which parts to ignore, no matter what the current fashionable keywords are. But, hey, being able to actually say that rehabilitation doesn't work is something. It's a very small something that has been known for decades. But it's something. At this pace we'll see real progress somewhere around the time when our solar system completes a full turn of the galaxy. For sure sustainable nuclear fusion will happen before then, the difference putting an effort makes.
Thanks for posting this editorial! I wish more health care professionals would see things this way. Health care professionals need to learn about PEM/PESE (post-exertional issues) and warn patients about trying to push through symptoms.
