Post-Acute Sequelae of SARS-CoV-2 infection (PASC) - Lessons Learned From a Coordinated Health Systems Response, 2022, Ganesh et al

[Andy]

Abstract

Objective: To outline a consensus designed process for triaging and managing patients with Post COVID syndrome at the Mayo Clinic.

Patients and methods: We convened a central multidisciplinary team including members from General Internal Medicine, Occupational Medicine, Physical Medicine & Rehabilitation, Psychology, Allergy and Immunology, Infectious Disease, Pulmonology, Neurology, Cardiology, Pediatrics and Otorhinolaryngology, with membership from all the Mayo Clinic sites in Arizona, Florida, Iowa, Minnesota, and Wisconsin.

Results: Consensus recommendations were made for best practice guidelines on triaging and managing patients. Several innovations were agreed upon including a PASC specific appointment request form for data collection, a bio-registry, a bio-repository, and a PASC specific treatment program.

Conclusions: Given that each clinical site had individual clinical practices, these recommendations were implemented using different models, which may provide broad applicability to other clinical settings.

PubMed listing, https://pubmed.ncbi.nlm.nih.gov/35669936/
Full paper, https://www.mcpiqojournal.org/article/S2542-4548(22)00033-9/pdf

 

[rvallee]

I skimmed the paper and frankly can't find any substance at all, certainly no lessons there. They're describing what they're doing, that's all there is. Looks like a paper published for the sake of publishing papers, one that doesn't show any professional-level progress, merely a description of continuing the same old that's unfit for this purpose.

There is a passing mention to CFS and other chronic illnesses, with either no awareness of how awful Mayo is at those, how the entire association with infectious disease is completely lacking from how they deal with it, essentially making LC exceptional, just nothing to do with the disease or the patients, but rather how they frame it.

There is a section on "central sensitization" and how they deal with those with exercise programs and CBT, health coaching and "paced rehabilitation", so they literally learned nothing here and don't even understand the words or what they mean. This is medical practice in its true sense, it's a practiced thing, people are doing things they're taught to do because those teaching them were taught this is good and taught them, they're merely executing scripts without any care why or whether it's appropriate.

So this is mostly a paper about how Mayo are doing and how many acronyms they added, with not a single actual lesson learned anywhere, the textbook version of every article that mentions how CBT is used to treat CFS and brain fog. That's a true statement, even if it doesn't actually treat anything, it is, indeed, used to treat it. Just as true to say that some people treat cancer with homeopathy. They sure do. That it doesn't work any better than healing crystals clearly doesn't bother anyone and this trend continues here.

Frankly this would be sad in itself, if this infinite tolerance for failure and inability to learn from experience weren't responsible for disastrous real-life outcomes.