WHO have stated globally its approach to rehabilitation as it is to be applied to post COVID-19. The 2020 version is not so detailed on post COVID-19 rehabilitation as this 2023 one is. It cites the Cochrane review as the basis for some of it's decisions. WHO are therefore, the higher authority.
It is for the Nation states to take their own view and approach regarding post COVID-19 rehabilitation, as a result in light of WHO guidance. If you consider the various closing of borders etc, and differing applications of lock down in nation state during the pandemic, but the global uniform wearing of masks, you can see the principle at work.
For example, I noticed in a long covid podcast which
@Dolphin posted on a thread last weekend, can't remember which thread, that one of the UK podcaster's was talking about a referral she'd had to haematology, just before they interviewed Nancy Klimas. In the UK we are banned from blood donation as now are Long Covid patients.
Now in the UK MDT long covid clinics that's how it's supposed to work, as per this WHO clinical management 'Living' guidance and that's how it is working.
Whereas in the UK, ME/CFS clinics such as there are, are limited to occupational therapists and physios. Behavioural rehabilitation only.
But it got me thinking about what I'd already discovered about 2004 and the WHO patient safety alliance, and various events in 2023 in the process of preparing my timeline for this illness. So I went in further search and found this document a couple of days ago. It's taken me this long to skim through it. Didn't realise there was another on thread on WHO stuff, sorry.
Here in the UK Nation states, it is for the states individually i.e. Wales, Scotland, Northern Ireland and England, and the UK government as a whole, to apply WHO guidance as it sees fit. For example, we know how loosely successive UK governments have applied the 1969 definition of ME ever since it's inclusion in the ICD.
NICE already stated it's similar approach to the quality of evidence to support CBT and GET as low or moderate GRADE in 2021, and that harm has been reported. They stood by that decision in their robust reply to the 10 July 2023 'Anomalies' paper, which was not published until earlier this year.
2023 was a significant year for global discussions regarding patient safety in general, and in particular in the UK. I've called it the year of broken trust in my timeline. I'm splitting out 20023/24 as a sample of the timeline which I hope to be well enough to complete, and publish by the end of this week and you'll see what I mean. This is an example:
10 July 2023
Anomalies paper
18 August 2023
WHO Clinical Management of COVID-19: Living guideline
4 September 2023
'My Reality' consultation on the interim ME/CFS implementation and delivery plan. UK gov't consultation process, acknowledging stigma, a need for a change of attitude etc. so long after the then SoS for DHSC Sajid Javid's announcement in early 2022. He even questioned the delay in relation to his announcement when he was SoS, during the Westminster Hall debate on 1 May.
We were all so grateful (with an experienced degree of caution) for the fact that these things had finally been publicly acknowledged in the interim delivery plan, after 67 years, that perhaps the landscape in which that process was suddenly launched, went un-noticed, representing as it does a seizmic shift in UK approach, because it will become a government policy document.
So in answer to
@Caroline Struthers question, who are the "higher [expert] authorities" advising in the UK government and by extension the NHS, on the question of rehabilitation for post-COVID 19 (WHO style) which is very different from rehabilitation in ME/CFS despite the similarity is post viral disease presentation.
There are no checks and balances on the question of 'conditional' referral for rehabilitation, recognising 'red flags' such as PEM and OI which in ME/CFS, drastically limits the nature of such rehabilitation techniques = health inequality.
