Long COVID—ACOEM Guidance Statement Stave, Gregg M.;Nabeel, Ismail;Durand-Moreau, Quentin Persistent symptoms are common after acute COVID-19, often referred to as long COVID. Long COVID may affect the ability to perform activities of daily living, including work. Long COVID occurs more frequently in those with severe acute COVID-19. This guidance statement reviews the pathophysiology of severe acute COVID-19 and long COVID and provides pragmatic approaches to long COVID symptoms, syndromes, and conditions in the occupational setting. Disability laws and workers’ compensation are also addressed. Link | Open Access (Journal of Occupational and Environmental Medicine)
Statement from the Association of Occupational and Environmental Medicine. Good coverage of the themes in LC research, focusing on physiological factors. References ME/CFS and POTS. Covers BPS with the following paragraph. In the section on ME/CFS, the statement promotes the IOM criteria and continues with — That last paragraph links to https://askjan.org/disabilities/Myalgic-Encephalomyelitis-Chronic-Fatigue-Syndrome.cfm
The reference is to Multidisciplinary collaborative consensus guidance statement on the assessment and treatment of fatigue in postacute sequelae of SARS-CoV-2 infection PASC patients (2021, PM&R) It's not graded, but symptom-dependent and they are aware of PEM, but yes there is a lot of enthusiasm for the idea that rehabilitation will inevitably help people. Also, that one might reliably engage in some form of sub-threshold exercise without inducing PEM over the cumulative. (I recall from Twitter days that one of the authors of this 2021 consensus paper had LC with POTS/PEM, though perhaps has fully recovered subsequently).
(1) an individualized and structured, titrated return to activity program; And the evidence for benefit from that is...? (3) a healthy diet and hydration, Because patients don't know how to eat food and drink water.
Critics of this model are correct and are speaking to our own experience. This is literally what happened from day 1: gaslighting, dismissal, denial. But, hey, if you ignore that, it should lead to more holistic care. Assuming that more holistic care is a desired objective, and it seems here to be a stand-in for better care, which it simply never is. Ain't no True Scotsman in the whole of Scotland. They mostly could have left it to the usual "you do you, we ain't got shit", which I guess is where medicine is all heading now. If you recover naturally, they'll take all the credit because it was all biopsychosocial, or whatever, and if you don't you get all the blame. It's the most perfect system of negligence ever put together.
I had some of this at work, there was always an underlying assumption that things will gradually get better. Of course for some people with LC things do tend to improve with time, but managers seem baffled when they don't. They can't conceive of not being able to control it and manage it and subject it to a timetable.
