Long COVID, what we know and what we don’t know

by David Bailey

The legacy of COVID-19 paints a complex picture of care for long COVID patients in Wales

Location: Wales
Published: Monday 5 July 2021
david bailey

Despite a recent rise in COVID-19 infections, we’re now providing significantly less acute care to COVID patients in our hospitals and in particular our intensive care units. This is largely thanks to the enormous success of the vaccination programme here in Wales.

This is not to say the virus’s grip on the health service has relinquished, in fact it has left an indelible mark on healthcare and society and continues to place an enormous burden on an already overwhelmed NHS.

While tired staff pick up the pieces by tackling record high waiting lists, a reported two million patients in the UK will require varying degrees of care for the long and lasting effects of COVID-19 known as long COVID.

Patients with the condition have symptoms ranging from more commonly seen post-viral complaints such as fatigue, brain fog and depression to more immediately life-threatening symptoms such as prolonged respiratory problems, blood clots and new cardiac conditions, which appear to be unique to the COVID-19 virus.

The number of people experiencing more severe long COVID symptoms will require continuing care from a range of doctors including GPs, cardiologists and respiratory consultants, and undergo physiotherapy to address the effects of prolonged periods in intensive care.

The much larger proportion of patients suffering with more common post-viral symptoms such as chronic fatigue, muscle weakness, and concentration difficulties will require the care of general practice along with support from other healthcare professionals in the community.

We are working in consultation with the Welsh Government, advising on how to best care for and treat these patients in the context of an already overwhelmed GP service across Wales.

The recently announced £5 million investment for the Adferiad (Recover) programme designed to treat long COVID patients will initially go some way to help us provide this care with appropriate specialist support.

We do, however, expect there to be a rising demand for this support and foresee a further need for investment as the picture of long COVID care evolves in Wales. Some of these patients are NHS colleagues who have remained vulnerable to the virus and its harmful effects.

Staff sickness from COVID-19 has placed additional pressure on our ability to deliver care for our patients and we want to see greater investment and access to occupational health services for doctors in primary and secondary care.

This will form a crucial part of ensuring talented NHS staff are able to get the help they need to stay in their jobs and continue to deliver the care to their patients.

As with any new illness there is a lot, we are still learning about COVID-19 and its lasting effects and so we anticipate patient numbers and levels of care to evolve in time.

Lastly, to stabilise demand for services and deliver world class care to those who need it most we need to create a healthier Wales, and this can only be done by addressing and investing in the significant health inequalities that exist across Wales.

As we learn more about the pandemic, we hope there will be an emphasis placed on learning lessons from the pandemic about how to better protect healthcare staff to avoid this happening in future.

David Bailey is chair of BMA Cymru Wales