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Health systems stumble on ‘Long COVID’ as crisis grows

https://www.politico.eu/article/health-systems-stumble-on-long-covid-as-crisis-grows/

With "long COVID," doctors, scientists, politicians and regulatory bodies are facing an amorphous beast: Many people are battling with debilitating symptoms months after the virus is gone. Often these maladies are dismissed as anxiety, a recurrence of previous illness or even menopause.
Robin Gorna is a campaigner involved with the U.K. LongCovid.org group, who has worked as an activist and adviser on HIV for over 20 years. She suffers from deteriorating eyesight (something some other long COVID patients also complain about) but her optician refused to see her. “This is exactly what we saw in HIV, people just misunderstanding,” said Gorna.
This framing is important because last year (or the one before?) there was a commemoration of some milestone with the AIDS crisis, the 30th anniversary I think, and here we see that absolutely nothing was learned from it, medicine is still committing the exact same mistakes as before.
The need to get information out to family doctors is something that Charles Shepherd, medical adviser to the ME Association, is campaigning for. It’s also one of the recommendations he gave to British Health Secretary Matt Hancock’s office recently.

In fact, the long-term effects of COVID-19 came as no surprise to Shepherd, who has spent 40 years studying post-viral fatigue syndromes.

He worries that people with long COVID are falling into the same situation as those with myalgic encephalomyelitis (ME) or chronic fatigue syndrome, because "doctors don't know what to do with them." For years ME has been misdiagnosed, dismissed as not a real illness and under-researched — something that Shepherd doesn’t want to see on a wider scale.
But she worries about the second wave that is tearing through Europe, and what effect it could have on care for long COVID patients if health systems are overwhelmed.

"That's a really big danger," she warned.
The bonus here is that we already know what will happen, how disastrous it will be, because it already is, it already was before this latest iteration of the same old failure began.
 
Medscape article from October 7th
Long-hauler COVID Clinics Are Open, Skepticism Lingers

People have talked about long haulers having nonspecific symptoms of fatigue as well as discomfort despite having tested negative for lung and heart disease. It seems the symptoms are more related to an inflammatory process, and there are similarities with chronic fatigue syndrome.

This clearly could be part of an overlap of what we're describing as long haulers. We know that these are nonspecific symptoms, but an entity has been identified as a real disease with chronic fatigue.

ETA: Interesting discussion in the comments.
 
From the NIH:
https://www.covid19treatmentguidelines.nih.gov/whats-new/

The Coronavirus Disease 2019 (COVID-19) Treatment Guidelines
https://www.covid19treatmentguidelines.nih.gov/whats-new/
[..]
Key Updates to the Guidelines
Clinical Presentation of People with SARS-CoV-2 Infection
A new subsection entitled Persistent Symptoms or Illnesses After Recovery from Acute COVID-19 was added to this section to describe the emerging data on these symptoms. The Panel notes that more research is needed to better understand the pathophysiology and clinical course of these post-infection sequelae and to identify management strategies for patients.

https://www.covid19treatmentguidelines.nih.gov/overview/clinical-presentation/

Persistent Symptoms or Illnesses After Recovery from Acute COVID-19
There have been an increasing number of reports of patients who experience persistent symptoms after recovering from acute COVID-19. At this time, there is limited information on the prevalence, duration, underlying causes, and effective management strategies for these lingering signs and symptoms.12 Some of the symptoms overlap with the post-intensive care syndrome that has been described in patients without COVID-19, but prolonged symptoms and disabilities after COVID-19 have also been reported in patients with milder illness, including outpatients.13,14

Some of the persistent symptoms that have been reported include fatigue, joint pain, chest pain, palpitations, shortness of breath, and worsened quality of life.15,16 One study from China found that pulmonary function was still impaired 1 month after hospital discharge.17 A study from the United Kingdom reported that among 100 hospitalized patients (32 received care in the ICU and 68 received care in hospital wards only), 72% of the ICU patients and 60% of the ward patients experienced fatigue and breathlessness at 4 to 8 weeks after hospital discharge. The authors of the study suggest that post-hospital rehabilitation may be necessary for some of these patients.15

Neurologic and psychiatric symptoms have also been reported among patients who have recovered from acute COVID-19. High rates of anxiety and depression have been reported in some patients using self-report scales for psychiatric distress.16,18 Younger patients have been reported to experience more psychiatric symptoms than patients aged >60 years.15,16

Patients may continue to experience headaches, vision changes, hearing loss, loss of taste or smell, impaired mobility, numbness in extremities, tremors, myalgia, memory loss, cognitive impairment, and mood changes for up to 3 months after diagnosis of COVID-19.19,20 More research is needed to better understand the pathophysiology and clinical course of these post-infection sequelae and to identify management strategies for patients.

 
Total hot air from Greenhalgh plus the multidisciplinary rehab mantra again (with no evidence yet evidence based).

The clanging of empty tin pots is getting deafening.
It's a bit on the nose to promote evidence-based medicine when there still is no evidence whatsoever about what to do or what the nature of the problem is. This working-from-conclusions-first approach is very lousy and unimpressive, but it says a lot about how much weight evidence actually carries in this paradigm: very little.
 
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