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NICE’s long Covid guidance is woollier than a festive jumper



Well done NICE. With its just-published long Covid guidance, it has clearly taken on board previous criticism that its guidelines are crazily unrealistic and overly prescriptive. So now we have the opposite problem. This latest guidance is so woolly that I intend to recycle it as a Christmas jumper.

If you do fancy a seasonal flurry of fluff, though, here, from the pages of NG188 itself, are some NICE tips on managing long Covid. Use ‘clinical assessment’  and ‘support access to assessment and care’. Use a ‘holistic, person-centred approach’. Include a ‘comprehensive clinical history and appropriate examination’. ‘Listen to their concerns with empathy’. ‘Offer tests and investigations’ (tests and investigations?!). ‘Consider referring people to an integrated multidisciplinary assessment service if available’ (tip from me: if not available, don’t). ‘Agree with the person how often follow-up and monitoring are needed’.

And so it goes on, this litany of the non-specific and the bleedin’ obvious,  until you’re struck with the inevitable conclusion that what they’re actually trying to say is, look, just carry on being a GP with these patients, would you, we have nothing further to add?

Which is fine, except for the opportunity cost. You have quite possibly noticed that we are currently suffering a plandemic, with guidance, SOPs, diktats, protocols, webinars, bulletins, updates et al arriving faster than we can keep up.

It’s utterly addling. For example, I’m pretty sure I read somewhere that setting up a Covid vaccination centre involves 5,000 separate things coming together. The point is, I can’t remember whether I really did read this, or I dreamt it, because when I’m not reading all this stuff, I’m asleep, dreaming that I’m reading all this stuff. And if I’m distracted ploughing through vacuous nonsense like the latest NICE guidance, there’s a danger I’ll overlook something more important, like a document reminding me which end of the Covid vaccine to stick in people.

So look, NICE, I understand the pressure to be seen to be doing something. But when we really need signal rather than noise, it would probably be best, if you have nothing to say, to say nothing. Covid has already been long enough without this.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield

READERS' COMMENTS [10]

Michael Mullineux 21 December, 2020 9:16 pm

Spot on as always.

James Cuthbertson 22 December, 2020 1:42 pm

What can actually be done for long covid? Assuming they have no reversible pathologies based on examination/investigation…..

Scottish GP 23 December, 2020 12:57 pm

They can get holistic multidisciplinary assessment and targeted personalised care in the form of a prescription for duloxoprebabapentin.

John Graham Munro 24 December, 2020 9:14 am

ALL SINGING, ALL DANCING ALGORITHM === N.I.C.E.

Abigail Beastall 26 December, 2020 10:18 pm

Apparently there are myriad interventions and investigations for long covid – some.angry GPs on Facebook told me so….

Merlin Wyltt 26 December, 2020 10:22 pm

“Plandemic”—I like that!
“demic” seems to have replaced “gate”. I haven’t seen “Brexitgate” “Covidgate” “Bill Gates-gate” etc

Patrufini Duffy 29 December, 2020 5:26 pm

Poignant. Nanny guidelines. This country wants to run before it can walk. Good business though. Keep the system churning.

Turn out The lights 30 December, 2020 5:02 pm

Long covid excellent a9 month wait for respiratory physio locally.More moonsh@t from bs Boris and co.

Kevlar Cardie 31 December, 2020 2:18 pm

Will we be able to get a Bill Gates’ microchip Windows upgrade at Long CoVid clinic ?

Mark Heneghan 2 January, 2021 10:30 am

Hilarious. They’ve made a specialist case out of post covid, as if it is something different from any other post viral condition, even though, just like all the others, there is no easy way to diagnose it, or, for that matter, treat it. It will, of course, generate the twin evils of increased demand and decreased trust, when we try to discourage consultation for it because we can’t do anything for it except ‘validating’ patient concerns and referring to secondary care. Before long, as with fibromyalgia, secondary care will refuse to manage it, and bounce patients back to us, with advice to follow the advice on the Long Covid web page. There will be Long Covid self help groups that spend most of their time complaining about how their GP doesn’t listen, and soon a GP will sued, not for the money, but to make sure that nobody else has to go through what the patient went through. I am going to advise them all to take plenty of vitamin d and exercise, and to eat a low carbohydrate diet.