As we start to see lockdown measures easing across the country I thought I would share with you some of my experiences over the past year and my thoughts on what our post-Covid health services may have to look like.
I caught Covid early on in the pandemic. I was very fortunate because my NHS employer spotted very quickly that I wasn’t recovering from Covid as I should. When, four months after being diagnosed, I was still suffering from significant breathlessness and fatigue they arranged a series of tests for me. The virus had attacked my heart and I couldn’t breathe because half of my heart wasn’t functioning. Believe it or not that wasn’t terribly bad news. Two types of medication later and my heart is back to normal functioning although I’ll probably have to keep taking the meds for the rest of my life.
Just as important was the help I received from Barking and Dagenham IAPT Talking Therapies (Cognitive Behaviour Therapy). CBT is about changing the way we think about our problems and consequent behaviour. Speaking to someone in 30-minute sessions who challenges you to break down your issues into smaller parts that can be tackled one at a time is enlightening. I needed to get to grips with the fact that my ‘new normal’ was not going to be a return to my previous life. I wasn’t super fit but I did used to go to the gym 3 times a week and walk between 3 and 5 miles every day and recovering that level of fitness was going to take a very long time, in all likelihood years! I had to think about the lifestyle I had lost and thinking about what I’d be able to do in my new life was key to identifying the small steps that I needed to take to be happy with my new normal.
Not only did Barking & Dagenham IAPT give me a therapist for 8 sessions they also set me up (over zoom) with a Physical Activity Co-Ordinator. His role was to assess what I was still able to do in terms of physical activity and work with me and teach me the sort of exercises that I could do without straining my heart, he helped me to find a way to start getting fit again without endangering my new and fragile health. The wellbeing and sense of achievement I have gained by getting involved with this programme has been immense. Accepting my limitations/new capabilities and embracing a new way of life has enabled me to say quite positively I’m looking forward to the future. Thank you Barking and Dagenham Talking Therapies!
My experiences have convinced me that the NHS ‘offer’ has to change to meet these new demands. In the same way that some community and hospital services have had to be ‘re-tooled’ to deal with the surge in Diabetes diagnosis it will have to offer something new to cope with a society that will feel the effects of Covid for decades. Covid 19 wasn’t a binary illness – you didn’t die or recover. A significant number of survivors have Long Covid.
The range of symptoms being experienced as Long Covid range from breathlessness, fatigue, problems concentrating (Brain Fog), heart palpitations, pins and needles, persistent cough – the list goes on. A health service that doesn’t recognise and deal with these symptoms and their corrosive effect on people’s mental health swiftly risks descending into a service that ends up firefighting new sorts of emergency care problems. If you take me as an example, had I not been diagnosed with heart insufficiency as quickly as I was one can only imagine that over time the stress and strain on my heart could have proved fatal, if not so debilitating I would have had to give up work.
It’s also fairly obvious to see that if people continue to suffer from breathlessness or fatigue or brain fog etc they will stop living the lives they’re used to and could instead become deconditioned, isolated and despondent. The chances of them suffering further physical problems escalates exponentially until Emergency Blue Light admission to hospital is the solution.
We have a problem in this country because Government completely fouled up mass testing from the very beginning. If a person with symptoms could access a proper Covid test from the beginning the NHS would have been better placed to set up a system where people could refer themselves for help with their Long Covid problems rather than waiting for a GPs support to refer. Barking and Dagenham Talking Therapies (and other North East London areas) offer a self-referral service. The recognition that it isn’t always desirable or appropriate to wait for a GP appointment/approval/support to refer has been invaluable to so many of our residents in getting them the help they need quickly.
Sadly, because Johnson followed an ill-informed unscientific herd immunity strategy we have a big hole in the data that could have helped the NHS build a complimentary system like IAPT for Long Covid sufferers. However, we are where we are. The government has trumpeted its investment in Long Covid clinics but not been so open about the fact that sufferers can only access them if a GP or other health professional refers them. Wow, more bureaucracy, just what the NHS needs.
Even if the NHS vaccination programme is a total success and Covid never returns (highly unlikely) we’re still going to have to manage the physical and mental health of Long Covid sufferers. Medicine is evolving all the time and there are some symptoms post covid that we don’t know how to manage totally but there are some (like a weakened heart) that we can, but we must see those patients as soon as we can and not let them get trapped in referral hell.
A self-referral system for established Covid sufferers would by necessity be heavily dependent on diagnostic tools rather than face to face doctor time and it is this part of the NHS that really needs urgent funding. There are already huge back logs for Echo Cardiograms (there were before Covid) but targeted funding and training to upskill technicians would not only clear the ‘regular’ backlog but will also lighten any additional wait list burden caused by Covid patients. In the 2020’s there are so many interventions and drugs that can either cure people or allow them to live full and active lives it seems criminal that we aren’t doing this. For a healthy nation going forward there has to be a massive investment in all available diagnostic tools as early as possible to avoid a future workforce carrying the burden of undiagnosed heart problems, lung congestion and so on. We can cure it we just need to know what it is.
Julia Offord Pearman – Vice Chair of Dagenham and Rainham Labour Party