An anonymous Doctor has written on the BMJ website about how support from the NHS is lacking for those who contracted Long Covid after working in hospitals during the pandemic. Dr Charles Shepherd has written a reply to the article talking about the importance of convalescence for those experiencing post-viral symptoms. The article can be read from the link below and Dr Shepherd's reply is reproduced in full after extracts from the article.
Extracts
Within a few weeks of working during the first wave of the pandemic, I was sick and stuck in bed, my oxygen levels dropping whenever I stood or walked.
Initially, I carried on working, struggling to manage a few hours here and there. One key feature of everyone I know with long covid is that we “pushed through” the initial stages of our illness, believing that we could get better by carrying on and ignoring our bodies. As a doctor, the system I worked in and the martyr complex instilled by medical culture enabled that view. In medicine, being ill, being human, and looking after ourselves is still too often seen as a kind of failure or weakness.
Staff with long covid still have a lot to contribute to the NHS, which is beset by workforce shortages, but they need compassion and understanding. Many workers with long covid are desperately trying to return to work, but they must be met with flexibility and support. Instead of setting rigid time frames, NHS trusts should work with us to use our skills. This will mean making reasonable adjustments where they can, such as offering reduced duties, shorter hours, or the opportunity to work from home where possible.
Dr Charles Shepherd's reply
Dear Editor
Long Covid has a lot of clinical and pathological similarities with ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) 1.
The history surrounding the onset of Long Covid given by this anonymous doctor, along with the failure to take a proper period of rest and convalescence, will be depressingly familiar to many people who have ME/CFS and other post viral diseases.
So it is disappointing to see that the lessons we have learnt about the importance of good early management of post-viral disease, especially activity and energy management aimed at preventing post-exertional symptom exacerbation, are still not being applied to people with Long Covid.
On a personal basis, I developed a severe post-viral syndrome with an encephalitic component following chickenpox over forty years ago.
Like this doctor I caught the infection from one of my hospital patients.
In those days some doctors, including myself, were working 1 in 2 rotas – in other words being on duty Monday to Friday (with a half day off) as well as being on call every second evening, night and weekend.
This could be a very stressful existence – both physically and mentally – and doctors weren’t really allowed to go off sick…
So I returned to full time work on a busy hospital ward far too early, still feeling very unwell, and went through a cycle of working, being off sick and working till I finally could no longer carry on.
One of the most powerful lessons I have learnt about the management of ME/CFS (and Long Covid) is to the need for rest and convalescence during the very early post-infectious stage and negotiating a carefully staged return to work when/if improvement is occurring.
Failure to do so is likely to have a very adverse effect on long term prognosis.
Dr Charles Shepherd
Reference:
Shepherd C. Long Covid and ME/CFS
Are they the same? ME Association 2022