A national survey of community rehabilitation service provision for people with long Covid in Scotland, 2021, Duncan et al

Abstract

Background: Over 50 million cases of COVID-19 have been confirmed globally as of November 2020. Evidence is rapidly emerging on the epidemiology of COVID-19, and its impact on individuals and potential burden on health services and society. Between 10–35% of people with COVID-19 may experience post-acute long Covid. This currently equates to between 8,129 and 28,453 people in Scotland. Some of these people will require rehabilitation to support their recovery. Currently, we do not know how to optimally configure community rehabilitation services for people with long Covid.

Methods: This national survey aimed to provide a detailed description of current community rehabilitation provision for people with long Covid in Scotland. We developed, piloted, and conducted a national electronic survey of current community rehabilitation service provision for people presenting with long Covid symptomatology. Our sample were the Allied Health Professions Directors of all 14 territorial NHS Health Boards in Scotland. Fixed response and narrative data were analysed descriptively.

Results: Responses were received from all respondents (14/14), enabling a national picture to be gained. Almost all Health Boards (13/14) currently deliver rehabilitation for people with long Covid within pre-existing services. Fatigue (11/14) and respiratory conditions (9/14) were the two most common presenting problems of patients. Most long Covid community rehabilitation services are delivered through a combination of face-to-face and digital contact (13/14).

Conclusions: Community rehabilitation for people with long Covid is an emerging reality. This survey provides a national picture of current community rehabilitation for people with long Covid. We do not know how community rehabilitation can be optimally delivered for this population. This is vital as community rehabilitation services were already under pressure prior to the emergence of COVID-19. Further research is urgently required to investigate the implementation, outcomes and cost-effectiveness of differing models of community rehabilitation for this patient population.

Open access, https://f1000research.com/articles/9-1416/v2

 

We do these things, not because they work, but because those are the things we know how to do.

There is still exactly zero evidence that rehabilitation plays any role whatsoever or even improves odds of anything beyond correcting for the bad assumptions in medicine that advise to exercise and ignore symptoms. A problem that is obviously better fixed by not creating the problem in the first place.

There is still no serious research happening and none of those clinics are involved in understanding anything, all they do is deliver a supply of things that suppliers have in stock, not because it meets demand but simply because that supply is available. If the measure of success is checking whether people are doing something for the sake of doing something, all you have to do is show up, and even then that's entirely optional.

All those could be astrological services and it's likely that the outcomes would be the same. But the measure of success is that they are doing something and so that ends any chance of ever doing something useful. Brilliant. Because if we know anything about health care is that people have so little work to do that it's fine to have an actual busywork program for people who apparently can't figure out the difference between useful work and just being there. Opportunity cost is just some alien thing for other people, I guess.

I shall dub this Gardner Medicine: it's "medicine" by simple virtue of Being There and having only positive outcomes attributed to Being There while not counting bad outcomes. You can substitute with a potted plant and get the same outcomes, the counting is a sham anyway and nobody seems to care, nature does most of the work anyway and odds are 90% so the house always wins. Wins at what? At Being There.