Long Covid clinics finally open - what help can actually provide?

A multi-disciplinary approach dealing with respiratory distress to the psychological impact of the condition aims to assist patients

There are an estimated 22,000 people in Northern Ireland suffering from the manifold symptoms of long Covid which can be so severe as to constitute a disability. Northern Ireland has lagged behind the rest of the UK on long Covid clinic provision - until now
There are an estimated 22,000 people in Northern Ireland suffering from the manifold symptoms of long Covid which can be so severe as to constitute a disability. Northern Ireland has lagged behind the rest of the UK on long Covid clinic provision - until now

There are an estimated 22,000 people suffering from the panoply of symptoms known as long Covid or post-Covid syndrome here in Northern Ireland.

The condition, which can impact even those who only suffered a mild case of Covid infection that did not lead to hospitalisation, can range in severity, but the most dominant symptoms include brain fog, extreme fatigue, memory problems, anxiety, depression, joint pain, organ damage, breathlessness, heart, gut and pulmonary problems and for those admitted to ICU, post traumatic stress disorder; in fact according to Independent SAGE, a collective of scientists who have been largely critical of the British government’s Covid response strategy, the illness, likely to develop 12 weeks after infection, “can involve up to 200 reported symptoms and in some cases amounts to a long-term disability”.

According to the ONS an estimated one million Britons have been left grappling with long Covid symptoms, many of whom have lost jobs, relationships and their homes because of the debilitating nature of the syndrome that is still only embryonically understood by scientists and medics. It affirmed that one in five who contract Covid will go on to develop longer term symptoms of varying severity.

Zoe McNulty, 27, from Londonderry, has suffered with long Covid and a panoply of distressing symptoms since contracting the virus in March 2020. She hopes the new long Covid clinics will be able to help her

In England, long Covid clinics were opened at over 60 sites in November 2020 at a cost of £10m, but here in Northern Ireland such clinics have only opened this week with 1m invested by the Department of Health into their development.

The new multi-disciplinary assessment services which are set to be rolled out across all five health trusts and are open to referrals from both primary and secondary care, were announced by Health Minister Robin Swann on Monday (November 1).

Zoe McNulty, 27, from Londonderry has been affected by a litany of long Covid symptoms ranging from brain fog to headaches, dizziness and heart pains, that still make everyday life an exhausting exercise some 16 months on from her initial illness, which she contracted in March 2020.

Zoe welcomed the announcement of the opening of long Covid clinics here, and hopes that her GP may refer her to one in the near future.

“I’ve been asking about access to long Covid clinics for some time, but I haven’t yet heard about how I could be referred to one. I’m not sure how they will work yet or what services they will provide.

“The idea that clinics might be able to refer you to other services or specialists depending on the symptoms you are suffering from would certainly be very helpful.

“Breathing courses would help me, breathing techniques, and psychological support like CBT perhaps would be useful. I know that my symptoms are largely physical but there is also the mental exhaustion and low mood that I have experienced as a result of this. Long Covid is like a trauma and I think it should be treated as such.

“I am so happy that they are finally opening long Covid clinics here and I am certainly interested in what they may be able to do to help me.”

Previously Zoe did receive help from Northern Ireland Chest Heart & Stroke’s Breathe Better programme for long Covid sufferers which she completed in April.

It helped her with nutrition, sleep hygiene, how to pace yourself while living with fatigue and how to communicate better with health professionals about the symptoms that are most troubling you.

“The breathing techniques and distraction techniques that they recommended to me during the six-week course were helpful, as well as the idea of engaging in bouts of light exercise in order to increase stamina also helped, and just as I hope the new long Covid clinics will do, NI Chest Heart & Stroke did put me in touch with other people with long Covid who I do still engage with via a Whatsapp group. If these new clinics can give long Covid patients some sense of community with others who are going through the same thing then they are certainly to be recommended. And if they give people hope of recovery that’s invaluable.”

Of new the clinics Robin Swan has said: “Covid-19 has presented many challenges, not least for our health service. And whilst we will continue to live with Covid-19 for some time yet, we need to focus on rebuilding our services in a post-Covid era. That is a challenge. That is the legacy of Covid-19. We need to build back better and stronger than before and to deal with the issues coming our way post-pandemic.

“Providing appropriate assessments and treatments for patients who are experiencing long-term effects of Covid-19 is an essential part of building back services.

“The new services will offer dedicated support for the assessment and treatment of post-Covid-19 syndrome over the short and medium term. The proposed model will also strengthen core services for psychology and post-critical care recovery in the long term including follow-up services for patients.”

Long Covid clinics will offer bespoke pulmonary rehabilitation and a dysfunctional breathing service for patients with significant respiratory symptoms post Covid infection; psychological support; as well as signposting access to self-management resources.

The clinics will refer patients on to other services where necessary and will give patients advice on how to manage the condition to aid in their recovery.

The Health Minister listed the services on offer across multiple disciplines including physiotherapy, occupational therapy and nursing.

He added: “The clinics will allow people to have a comprehensive assessment of their condition and will help them access the services and expert advice they need to support them in their recovery.

“The multidisciplinary clinics are one element of a suite of services being established for post Covid-19 patients.

“Work is well advanced on other services including a dysfunctional breathing service for patients with significant respiratory symptoms post Covid-19.

“I will continue to review services on an ongoing basis to ensure the best possible help and advice is available from those suffering from post Covid-19 symptoms.”

Patients can access services if they are referred by a GP or another healthcare professional. If a patient’s GP considers their symptoms to be a result of long Covid it will not matter whether or not they have previously tested positive for the virus.

However, Joseph Carter of the British Lung Foundation released a statement saying that the £1m allocated for long Covid clinics here was simply “not enough to provide the care needed for patients across all five health trusts. Somewhere in the region of £3m would be more adequate and we also want to see respiratory care made a priority at these clinics”.

Alliance Health Spokesperson Paula Bradshaw welcomed the beginning of referrals for long Covid clinics here but cautioned that a lot of work is to be done to catch up on support and treatment for people living with it.

The MLA stated: “I welcome that referrals to long Covid clinics can now be made, but we do have to note that we are now a long way behind on this. There remains considerable concern for thousands of people across Northern Ireland about the impact long Covid is having. This concern is particularly keenly felt by those who were deemed clinically vulnerable to Covid in the first place. For example, people with underlying conditions are concerned about the impact on their treatment for that condition, as well as the general symptoms of long Covid.

“I will continue to push for a rounded service of treatment and support, with an added focus on the need to ensure those with other underlying conditions are assessed and supported.”