Here are the relevant bits from the very long article quoted in the original post:
How is long Covid treated?
Treatment is a thorny area when it comes to conditions where biological causes are undetermined. For ME/CFS and PVFS, it’s the reason there can be so much misunderstanding among the general public. Because for the most part, treatment is psychological in nature.
“There is no tablet or injection we can give people to cure them,” says Vickers. “So it becomes about managing the symptoms, about helping people get on productively with their life despite those symptoms.”
Jo Daniels, senior lecturer at the University of Bath and a specialist clinical psychologist, is one of the leading experts in the treatment of ME/CFS and PVFS in the UK and sits on the NICE guidelines panel for ME/CFS. She believes the use of psychological treatment in medical conditions is widely misunderstood.
“We need to debunk the myths that are out there,” she says. “Psychological therapy is useful for a range of medical conditions, with a strong underpinning evidence-base supporting its use.
“The use of psychological therapy does not by any means infer a psychological or psychiatric root cause, but rather an acknowledgement of the fact that living with a long-term condition is very distressing and very disabling.”
Key among the strategies used for ME/CFS patients is cognitive behavioural therapy (CBT).
“Psychologically based therapies such as CBT have a strong evidence base for supporting people with medical conditions to adapt to and manage their health,” Daniels explains. “Psychological therapy does not infer that a physical experience is psychological, it suggests that physical health problems can be distressing.
“The point of CBT is to improve quality of life and reduce psychological distress. The main focus isn’t to ameliorate physical health symptoms, although this is a common misunderstanding. We do see improvements in symptoms, but this is not the primary target.”
She believes CBT may be a useful treatment for symptoms associated with long Covid, too.
“I would expect to see anxiety and depression emerging in those with long-haul Covid; that would be a very understandable response to suffering a very unpleasant illness and then living with protracted symptoms of unknown duration. CBT is likely to be useful in Covid-19 long haul as it would be in other medical conditions.”
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Thirdly, Daniels feels schools really need to try to understand the individual pathway these teachers will be on.
“Long-haul Covid appears to be taking different forms so a one-size-fits-all approach is unlikely to work well,” she says. “What’s really very important is that heads view every teacher who has long Covid on an individual level and case-by-case basis, and that they ensure the relevant services are involved. Occupational health involvement can be very useful, as can GP input.”
She says that heads should be particularly cautious around return to work plans.
“We have seen in other post-viral syndromes that a premature return to work is often problematic,” says Daniels. “We should resist blanket timeframes as a school or comparing individual teachers progress and assuming recovery from long Covid will be anything like what we have seen before. We just don’t know enough yet.
“What is important is that people are empowered to make decisions about their own bodies and behaviour; while we are learning about this new condition, those suffering need support, understanding and validation if they are to achieve whatever recovery is possible.”
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Daniels agrees that schools mistaking post-viral conditions to be school refusal is a real issue.
“We hear a lot that children are often mistaken for school refusers, with not enough time taken to consider what the underlying problem may be,” she says. “Depending on their cognitive and emotional developmental stage, some children may find it difficult to articulate their internal world, what is happening in their bodies and their emotional experiences. Which means it is harder to immediately establish what is going on for that child.
“What we can sometimes see in fatigue is that children can appear to become withdrawn, they may seem like they're being difficult by refusing to engage in activities such as PE for example, or in the classroom. Whereas they may actually be experiencing fatigue, and a range of symptoms that they have no words for.
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“Children may often complain of feeling tired or having tummy ache, so it can be a challenge to differentiate what is normal childhood bodily variations, mood related or physical.
“Looking out for a definite ‘change’ in behaviour can be a helpful clue, particularly post virus. Active monitoring is important, particularly as we don't know yet how/if children will be affected by Covid in a long-haul way as adults are.
“We must be vigilant to signs of ongoing illness in some form or other and consider the possibility that they may be developing Covid long haul. Involvement with other services such as the GP or paediatrician should be considered if ongoing physical symptoms are present.”
