Post-infectious conditions require knowledge management
The risk of long-term severe disability after covid-19 infection has not been sufficiently addressed in Sweden despite ongoing spread of infection. Postcovid, or with an international term PACS (post-acute covid-19 syndrome), is a global public health problem [1, 2]. Almost all age groups are affected, and current vaccines do not eliminate the risk of postcovid [3]. At the same time, centres of learning that have been built up in health care are being closed down [4], and the value of diagnostic and highly specialised care is being questioned [5-7].
The Parliament has recently approved a motion for the establishment of a national knowledge centre for ME/CFS, but a corresponding one for postcovid is rejected [8]. It is high time to give the knowledge management of these related post-infectious syndromes a much-needed collective boost. [...]
In the absence of evidence for pathophysiological processes, severe symptoms are still questioned as social contagion [2, 5, 6]. The Nobel celebrations remind us annually of all the knowledge that remains to be discovered. At the same time, the postcovid pandemic seems to be left in the somatoform limelight: why? Could it be, as the author of the article in the Läkartidningen argues [9], due to a non-constructive scepticism within the profession, and the complacency that exists in any knowledge society where the established is defended and the new is distrusted? If so, let us avoid this.
To claim that postcovid and dysautonomia cannot possibly have a somatic basis [6], by referring to the large number of reports of multifaceted symptoms (including anxiety), is as wrong as claiming that cancer cannot give rise to a varied symptom picture. Instead, as in cancer care, we need to use biomarker research and subgroup studies to chisel out subdiagnoses that have different genes, prognosis and treatment strategies.
Building evidence-based multidisciplinary care requires nationally coordinated professions. Here we can learn from history and be inspired by the progress of cancer care. Symptom focus, anxiety or disease identity can certainly be barriers for individuals to live as healthy a life as possible [10]. This also happens in cancer, but without us concluding that investigation makes people sicker or that research and patient support groups are a bad thing [6]. However, the risk of misdiagnosing post-covid should be considered in this context as small compared to the risk of not providing adequate care to seriously ill patients.
) I have no doubt children/young adults will get similar messages in sports.
