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Supporting Staff: the emergence of ‘long-covid’

 

Blog headlines

  • Structuring a PCN Social Prescribing Service for the post COVID world
    25 February 2021

    This week we have a blog by Nick Sharples.

  • Community-Oriented Integrated Care
    18 February 2021

    The blog this week is a short extract from a paper considering an approach primary care networks could use to move towards community-oriented integrated care.

  • Strategy Unit releases opensource model for planning vaccine centre capacity
    11 February 2021

    This week's blog is from The Strategy Unit who are sharing an opensource model to help with vaccine centre capacity planning.

  • Time to talk day
    4 February 2021

    A small conversation about mental health has the power to make a big difference.

  • Supporting Staff: the emergence of ‘long-covid’
    28 January 2021

    As we are now well into a second, or is it now the third, wave of Covid-19 it is becoming apparent that Covid is something we have not experienced before and it has unique implications for staff management. It is not just the possibility that staff may become acutely ill with the virus, but that for some they may go on to develop persistent debilitating symptoms that will affect their ability to go back to work. This article looks at the implications of long-covid for HR and service managers when looking to support health care professionals (HCPs) return to work.

  • Link of the week: Clinically-Led workforce and Activity Redesign (CLEAR)
    21 January 2021

    This week we are sharing a link to the Clinically-Led workforce and Activity Redesign (CLEAR) site that is funded by Health Education England.

  • So much more than an extra pair of hands
    14 January 2021

    The introduction of the additional roles reimbursement scheme for primary care networks has started to grow capacity in general practice to address the unsustainably high workload that has put so much pressure on GPs.

  • Primary Care Networks – how did we get here?
    7 January 2021

    This week we are sharing a blog by PCC’s chairman David Colin-Thomé.

  • A year like no other
    17 December 2020

    On 5 July 1948 the NHS was born, over the last 72 years challenges and changes have been remarkable but the service has probably never been tested as much as in the last nine months. There have previously been numerous re-organisations, multiple changes to hospitals, mental health services and a shift from the family doctor towards more integrated primary care services delivered by a range of professionals. However, rapid transformation of services to embrace digital technologies, and a shift change to work differently has been forced upon all areas of the health service this year.

  • Guest blog: David Hotchin
    11 December 2020

    This week we have a guest blog that was submitted to us by David Hotchin, written by a retired friend....obviously, he's used a little poetic licence.

  • What now for commissioning?
    3 December 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • What White people don’t see
    26 November 2020

    This year’s Black History Month (BHM) has, unfortunately, in its shadow another example of why campaigns like this exist.

  • Primary Care: Why don’t we talk about Racism?
    20 November 2020

    Rita Symons is an ex NHS leader who is now a leadership consultant, coach and facilitator. Her work is mainly in the NHS and she is an associate for PCC offering facilitation, coaching, strategy development and team development activities. She is a concerned but hopeful world citizen and combines work in the NHS with a board role in a non for profit organisation and an interest in writing.

  • Primary Care and the Health of the Public
    12 November 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • What now for primary care
    4 November 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • Boosting your resilience
    30 October 2020

    The last year has been a difficult one, who would have imagined last Christmas that we would have been in lockdown, with the NHS seriously tested by a global pandemic. So much change has happened and the resilience of people working in and with health and care services has been seriously tested. Resilience is our ability to deal with, find strengths in and/or recover from difficult situations. Its sometimes referred to as “bounceabiliy” – but bouncing in what way?

  • Link of the week: National Cholesterol Month
    23 October 2020

    Every month or week of the year seems to be an awareness week, October has more than its fair share.

  • New redeployment service offers talent pool of motivated, work-ready individuals
    15 October 2020

    People 1st International have shared some of the work they are doing to support people displaced from industries due to the Covid-19 pandemic. There is an opportunity for health and care services to benefit from this workforce.

  • Link of the week
    9 October 2020

    Article published in the BMJ looking at the ability of the health service to quickly bounce back to pre-Covid levels of activity and considers if it is desirable.

  • Virtual Consultations– the patient perspective
    2 October 2020

    This week Jessie Cunnett, director of health and social care at Transverse has shared this article.

 
 
Thursday, 28 January 2021

Supporting Staff: the emergence of ‘long-covid’

As we are now well into a second, or is it now the third, wave of Covid-19 it is becoming apparent that Covid is something we have not experienced before and it has unique implications for staff management. It is not just the possibility that staff may become acutely ill with the virus, but that for some they may go on to develop persistent debilitating symptoms that will affect their ability to go back to work. This article looks at the implications of long-covid for HR and service managers when looking to support health care professionals (HCPs) return to work.

It is becoming apparent that Covid is not just a mild infection that goes away after two weeks but can leave sufferers with persist health problems for weeks and months.  Data collected by ONS for the Coronavirus (COVID-19) Infection Survey is beginning to show the incidence of long term illness following Covid infection.  They estimate that around 1 in 5 people testing positive for Covid will show post infection symptoms for 5 weeks or longer, whilst around 1 in 10 people will still show post infection symptoms at 12 weeks or longer.

Like SARS, Covid is leaving some people with significant and persistent physical symptoms characteristic of chronic fatigue syndrome. Sufferers report symptoms like muscle and joint aches, brain fog, memory problems, post exertion fatigue, shortness of breath and these symptoms do not appear to be linked to the severity of the initial infection experienced by people. 

People who have experienced mild symptoms, who may not have been to hospital may not have a diagnosis but develop debilitating post-viral symptoms.  This long-tail end of Covid is likely to present new challenges for managers endeavouring to maintain patient services over the next phase of the pandemic and beyond.

Data from the Covid Symptoms Study App show that patients can have these debilitating symptoms for many months. Clinicians are now describing this pattern of post infection symptoms after ‘mild’ Covid as ‘long-Covid’ because these symptoms can persist for months (possibly years) after infection.  

“We don’t know about corona, but I think it will lead to many, many cases of post-infective fatigue syndrome.”

 Simon Wessely, former president of the Royal College of Psychiatrists

The longer-term health after mild (non-hospitalised) Covid infection is 'frighteningly poor' says Michael Rutgers, the Director of Longfonds, the Dutch Lung Foundation; a charity dedicated to reducing lung disease. Longfonds conducted a survey of 1600 people with Covid-like symptoms. The average age of those who participated was 53 years and over 85% reported having good health before Covid.  After their illness only six percent said they felt well.  More starkly half of the respondents reported that they were no longer able to exercise with more than 6 in 10 of those surveyed reporting they have difficulty walking and 95 percent reporting problems with simple daily activities. Ninety one percent of respondents reported that they had never visited or been admitted to hospital, and four in ten did not get diagnosed by a doctor. They are effectively invisible. 

Without a label there is the worry that their condition is not taken seriously, or they will not be believed. Reports from sufferers also suggest that the symptoms they experience are fluctuating, relapsing and remitting. This makes planning to go back to work difficult as they don’t know when they are going to ‘get better’ and get back to normal.

There is evidence of long-term employment consequences for people who contracted SARS and developed post-SARS symptoms (sleep disturbance, physical, and psychological symptoms).  A Toronto study found that those affected by post SARS symptoms were experiencing fatigue, muscle weakness and sleep problems up to three years later and were unable to return to their former occupation.

Currently there is no clinical definition of ‘long Covid’ and no way of recording this on the GP record via Read Coding.  Why is this important?  Many sufferers of ‘long Covid’ may struggle to convince their employers, line manager or colleagues that they are too ill to return to work.  There is also uncertainty about what will be recorded as the reason for their sickness absence. Like SARS healthcare workers are at a higher risk of contracting Covid and although they may not have developed a severe form of the illness the residual physical symptoms are likely to have a noticeable impact on the workforce.

HR and OD professionals can support their organisations to be better able to manage this potential loss of productivity and key employees by

  • recognising this complex picture and communicate this to the wider organisation.
  • have practical advice for employees and their managers about returning to work and be aware that not all ‘long-Covid’ sufferers will have had a diagnosis.   
  • develop policies for flexible working arrangements to enable employees to have a phased return to work
  • be proactive after return to work to check how the employee is coping
  • recognise that employees may also be suffering psychological symptoms and introduce initiatives to support staff and raise awareness e.g. Mental Health First Aid.
  • recognise that staff maybe suffering from brain fog, poor ability to concentrate and poor memory as a result of long-Covid and discuss ways to manage this.
  • develop employee’s psychological resilience through skills training aimed at increasing psychological flexibility.
  • Proactively monitor sickness, unexplained absences, accidents and mistakes as potential indicators that employees are continuing to be affected by ‘long-Covid’.
  • Recognise that psychological symptoms amongst employees who perceive they are affected by Covid can create conflict and grievances.

There are resources that organisations can use to help support staff from British Association for CFS/ME (BACME) and the ME Association.

Valerie Amies is a PCC associate. Valerie has published articles on the impact of Covid on healthcare workers and runs psychological skills training for resilience workshops for PCC.  For more information please contact enquiries@pcc-cic.org.uk

 
mark peters
mark peters says:
Jan 29, 2021 06:12 PM

this is really interesting thank you. I manage the Networks tai chi site and believe Tai Chi and qigong (breath exercise) would really help long-covid as it does COPD CFS/ME etc
https://www.networks.nhs.uk/nhs-networks/tai-chi-chi-kung-for-rehabilitation

Sue Gerrard
Sue Gerrard says:
Feb 01, 2021 09:40 AM

Not unique at all. Plenty of evidence of long-term effects of viral infections, but often treated, regrettably, as 'psychosomatic' or the equivalent.