Millions of us fully embraced the celebrations this Yuletide, after the pandemic put a stop to festivities for so many over the previous two Christmases.
However, Covid is still a nasty spanner in the works for many with latest figures revealing that around 2.2 million people – some 3.4% of the population – are experiencing self-reported symptoms of long Covid.
In our September cover feature, we explored the insidious condition and what is understood about its aetiology. GPs are sympathetic to their long Covid patients but are effectively going in blind when it comes to treatment and management.
Long Covid, for most people, manifests in vague though often-debilitating symptoms not unlike those of chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME), namely: fatigue, muscle aches, brain fog and shortness of breath.
And similar to CFS/ME, little is known of the whys and wherefores of long Covid, whether it’s down to microvascular dysfunction or inflammation markers, or perhaps even the virus hanging around in the gut or nervous system of infected people.
With GPs (and other medical professions) scratching their heads, hopes are high that the 90-or-so long Covid clinics across England might shed some light – and help relieve general practice of some of the load.
But, of the roughly 75,000 patients referred to the clinics more than 10% are rejected as clinically inappropriate. Huge numbers of those accepted face gruelling waits to be seen.
So, as happens with so many other medical specialisms, patients end up knocking on their GPs’ doors once again, all parties are left frustrated, and nobody is closer to an answer.
However, there is a positive. The more people reporting long Covid, the more appetite there is to plough money into research.
Investors include the National Institute for Health Research, which has funded studies exploring biological cause, diagnosis and treatments to the tune of more than £50 million.
Elsewhere, Belgian researchers concluded that long Covid is a multisystem disease and how severely people are affected is not linked to how unwell they were when they initially contracted the virus.
They point to several mechanisms underlying long Covid, including immune dysregulation, auto-immunity, endothelial dysfunction, occult viral persistence and coagulation activation.
Research continues globally, and the more we discover about the pathology of long Covid, the closer we edge towards potential treatments.
GPs, meanwhile, may offer some treatment for their long Covid patients’ symptoms, if not able to treat the cause.
The NICE guidance on managing long-term effects of Covid provides some pointers. And trials of medications like ivabradine for those with POTS and anecdotal evidence of the effects of high-dose antivirals show promise.
We are yet to see whether the ‘one-stop-shop’ approach alluded to in NHS England’s long Covid action plan, which would free patients from repeatedly going back to their GPs for multiple tests, will pan out. But hopefully, some good may come out of this awful pandemic and its aftermath.
READERS' COMMENTS [1]
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Suggest those wanting to understand ME and Long Covid might benefit from studying the historic diagnoses of Neurasthenia and Shell Shock.