United Kingdom: Bath paediatric CFS/Fatigue clinic - Esther Crawley; Phil Hammond

The sign of a true expert. Wait, no, the other way around.

 

If I were a betting man I'd say he wants to stay on our good side so he can keep "treating" us if the guideline gets published in full. I don't know this Prof Garner, did he/she have a vested interest in treating us?

 

Ha! I wondered if that was the case.

A subtle difference from the Nov 2020 version:

 

Oops!

 

Interesting MD column from him in Private Eye today. Mostly positive, but with at least a toe in the Bacme/BPS camp.

For instance, in the section "The need for holism", he says,

 

No. Just in print.

It is curious, because it does seem to be a nod to the ridiculousness of the dualism arguments.

 

https://twitter.com/user/status/1432961233389555714

 

Someone on Twitter shared pics of the article. Not that easy to read as text is small, but possible.

 

It literally does, though. Or more likely it's not something that is relevant, as a virus doesn't "know" anything, let alone distinguishes anything, and only ever affects cells, which are definitely more of the bodily kind. What a ridiculous comment.

I really can't separate this kind of thinking from religious thinking. And can't comment on that without likely being offensive to religious belief. This is the exact same mechanism behind religious belief, it's a mantra that has to be repeated, has to be stated as true, and no ifs and buts, it just has to, just is.

(We're definitely the "dualists", though, ugh)

 

Ignoring the mind/body dualism, I think the last sentence is intended to be a joke – ie it would be convenient for the government if lots of people suffer from brain fog and memory problems as they might forget about how the pandemic has been handled.

Note to mods: I’m aware that we can’t discuss non-ME politics. I’m just trying to explain my understanding of what Hammond was trying to say.

I’ve been very critical of Hammond in the past, but this article was much better than I expected.

One error in my view was the suggestion that more doctors have LC because they were repeatedly exposed to high doses of the virus at close range and were under pressure to go back to work. I’m not aware of any evidence that people who are repeatedly exposed to high doses are more likely to get LC. I think a lot of doctors have LC because a lot of doctors have had covid, and when doctors get LC they are much more likely to make themselves heard than non-doctors.

For me, the main thing that was missing from the article was an apology. Hammond rightly apologised for getting it completely wrong about covid-19 at the beginning on the pandemic. I hope he will have the humility to admit that he was wrong to promote/prescribe GET, CBT and LP as treatments for ME/CFS. His implication that his type of GET isn’t the same as the GET that is described in the PACE manual for therapists or by the RCGP is feeble and disingenuous in my view.

[edit: typo]

 

It would be interesting to know when he decided that the GET he does is not GET as he hears about it. Since that is the GET that is described in PACE, it would be interested if he has ever previoulsy said that PACE GET didn't represent what he thinks of as GET. Or has he actually cited PACE as evidence for GET? That would seem to contradict his point here.

 

Got my copy of Private Eye through the post and it's... not bad? Or at least progress.

 

This is a better article than I expected, and pretty useful information for those who don’t know much at all about Long Covid or ME/CFS, or have erroneous preconceptions, despite its hand wavy mind/body mention and a bit of fudging around GET. He does say that those newly experiencing problems with Long Covid (or ME/CFS) should be resting and avoid post exertional symptom exacerbation and take care with activity.

I would think some could find this article useful with their families and others who are being unsupportive and think they should just ‘get on with it’ and ‘stop malingering’. I also appreciated the section about post-viral conditions not being new. This is better than some of the other articles I’ve seen about Long Covid.

 

Also:
https://twitter.com/user/status/1433387466132709380

 

it is interesting to see that comment "hurt does not equal harm". That was a prominent feature of the illness behaviour model described by Cott in 1985.(published 1986). Within the literature for ME I have never found a citation of Cott's work. I am unable to understand why that should be.

 

Especially given that PACE remains the most commonly-cited "evidence" for GET. So if it's not the same, how can it be evidence? Makes as much sense as using a drug because a trial found another drug was useful. What kind of twisted logic is that and how does anyone say something this clueless without realizing the blatant self-contradiction?

 

Ah, no, only physicians work hard. No one else does hard work, apparently. At least according to common arguments.