News from Austria and Switzerland

Austria - National Action Plan for Post-infection Syndromes
Merged

Health Minister Johannes Rauch (Greens) presented the National Action Plan on post-acute infection syndromes on Tuesday, which deals with diseases such as post-Covid, ME/CFS, POTS, fibromyalgia, reactive arthritis and chronic Epstein-Barr virus infections. It recommends better diagnostics, specialised contact points, improved social security, expert training, more research and better conditions for children and young people.

Summary
  • Health Minister Johannes Rauch presented the National Action Plan on Post-Acute Infectious Syndromes on Tuesday, which deals with diseases such as ME/CFS and POTS.
  • The plan provides for specialised contact points and multidisciplinary care to improve the care of those affected.
  • A national reference center has already been set up at the Medical University of Vienna to pool and disseminate knowledge.
  • Attention is drawn to the financial burden on those affected and better training of assessors is called for.
  • The implementation of the measures is scheduled to begin in December, with a kick-off event to mark the start.
LINK
 
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Swiss national radio had an 7 minute “investigation” that from the description seems good.

(translated from german):
Long Covid: Incorrect Treatment in Rehabilitation Clinics

Patients report that their condition worsens after staying in a rehabilitation clinic: Long Covid or other post-inflammatory illnesses are often treated incorrectly in clinics. SRF reporter Kathrin Winzenried reports on dramatic cases in the program “Espresso.”
https://www.srf.ch/audio/espresso/l...n?partId=47160787-17e0-4b64-9b25-83fe5d97d04c

Haven’t listened myself since I can’t tolerate sound, and Switzerland is terrible for accessibility so no subtitles or script was provided.
 
Swiss national radio had an 7 minute “investigation” that from the description seems good.

(translated from german):
Long Covid: Incorrect Treatment in Rehabilitation Clinics

Patients report that their condition worsens after staying in a rehabilitation clinic: Long Covid or other post-inflammatory illnesses are often treated incorrectly in clinics. SRF reporter Kathrin Winzenried reports on dramatic cases in the program “Espresso.”
https://www.srf.ch/audio/espresso/l...n?partId=47160787-17e0-4b64-9b25-83fe5d97d04c

Haven’t listened myself since I can’t tolerate sound, and Switzerland is terrible for accessibility so no subtitles or script was provided.

There was someone in my FB group who lives in Switzerland and she mentioned how great it is that there are rehabilitation clinics for long covid there and she even said there were some special programmes for people that present with ME/CFS type symptoms (so people who have PEM, I guess?). She made it sound like a retreat where people can take some time off to recover and healthcare workers probably somewhat understand what ME/CFS or PEM is. Still, "rehabilitation programme" was a red flag to me.

Eventually I had to remove this person from the group - for various reasons, eg. promoting Alex Howard's book, name-calling other people who failed to recover or anyone who "didn't understand the complexity of the disease" unlike her. I really hope that this about the LC rehab clinics gets enough coverage in Switzerland and reaches people like her too (as well as everyone).
 
There was someone in my FB group who lives in Switzerland and she mentioned how great it is that there are rehabilitation clinics for long covid there and she even said there were some special programmes for people that present with ME/CFS type symptoms (so people who have PEM, I guess?). She made it sound like a retreat where people can take some time off to recover and healthcare workers probably somewhat understand what ME/CFS or PEM is. Still, "rehabilitation programme" was a red flag to me.

Eventually I had to remove this person from the group - for various reasons, eg. promoting Alex Howard's book, name-calling other people who failed to recover or anyone who "didn't understand the complexity of the disease" unlike her. I really hope that this about the LC rehab clinics gets enough coverage in Switzerland and reaches people like her too (as well as everyone).
A lot of people in the local facebook groups seem to be convinced they will magically recover if they get send to a rehab clinic.

The psychotherapist I was going to visit until I became too severe was one of those people.

It seems that a couple of the first people who got Long COVID and loudest voices in these groups had a sort of 3-4 month illness trajectory, where their recovery coincided with going to one of these ridiculously expensive clinics.

And so atleast in the groups I was a member of, the “common knowledge” was that it would help you to go to a rehab clinic, and the admins shared that view.
 
A lot of people in the local facebook groups seem to be convinced they will magically recover if they get send to a rehab clinic.

The psychotherapist I was going to visit until I became too severe was one of those people.

It seems that a couple of the first people who got Long COVID and loudest voices in these groups had a sort of 3-4 month illness trajectory, where their recovery coincided with going to one of these ridiculously expensive clinics.

And so atleast in the groups I was a member of, the “common knowledge” was that it would help you to go to a rehab clinic, and the admins shared that view.
Rarity of those programs and a constant renewal of the LC population are very effective at amplifying this.

Once people have gone through the programs, if they recover naturally a few will retroactively attribute it to it if they wish, but for everyone who remains ill this hope dies very rapidly, and they often don't hesitate to say so to others. But no health care system has the resources for more than 10% of the patients out there, most not even 1%, so the vast majority will be in waiting/hoping mode.

Whereas if they were common enough that most would go through them, they would be revealed as a sham. But since 90%+ never will, may be waiting for it in hope that it helps them, it retains some force as a potential. Because really everything in biopsychosocial ideology is about potential. The potential that it could work, if it did, which it doesn't. That it may work for you. It doesn't, but (movie trailer voice) imagine a world in which it does.

I saw a lot of that in the LC subreddit in the first 2 years. No more. But it's a general forum, whereas closed forums can be more restrictive, new ones keep popping up as a few new long haulers start duplicating groups around them and their personal experience of it.

I think this is the plot to Logan's run. When people reach the age of 30, they think they go to some magical place, instead of getting shredded. But you can't know this until it happens to you. Similar to the movie The Island. May you win the ticket out of here, you will be so happy and tell everyone about it. Just like in the LP.
 
I saw a lot of that in the LC subreddit in the first 2 years.
Has it gotten better in the past couple months? I had to step away from it around 6 months ago because there was too much psychosomatic stuff, constant peddling of unproven treatments, and what seems to have been coined as “BioBS”, a bunch of people pretending they are the smartest person in the world and thus must know exactly what causes long COVID.
 
Swiss national radio had an 7 minute “investigation” that from the description seems good.

(translated from german):
Long Covid: Incorrect Treatment in Rehabilitation Clinics

Patients report that their condition worsens after staying in a rehabilitation clinic: Long Covid or other post-inflammatory illnesses are often treated incorrectly in clinics. SRF reporter Kathrin Winzenried reports on dramatic cases in the program “Espresso.”
https://www.srf.ch/audio/espresso/l...n?partId=47160787-17e0-4b64-9b25-83fe5d97d04c
Now published as an Article in German.
https://www.srf.ch/sendungen/kassen...-me-cfs-falsche-behandlungen-in-reha-kliniken

Article is really good, multiple mentions of ME/CFS, and mentions a n>800 survey done by the local long COVID charity, rehabilitation made 50% of people worse and only improved 17%.

Also contains bits of the really sad story of one individual who was forced into rehabilitation as a condition for disability insurance, and deteriorated so much she’s now seeking assisted dying.

Translated Article: (For context EXIT is a euthanasia foundation.)

Incorrect Treatments in Rehabilitation Clinics

Rehabilitation stays are harmful for many people with severe Long Covid and ME/CFS, as shown by a recent survey.


Author:

Kathrin Winzenried

Today, 18:02


“When I came back from rehab, I signed up with Exit.”

This is the alarming statement of Jessica Aebi. The 39-year-old is seriously ill. She has been diagnosed with Long Covid/ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome), a complex neuroimmunological disease.


Medically Prescribed Rehabilitation


In the spring, doctors and the disability insurance agency pushed Jessica Aebi to attend a rehab clinic. Hoping for improvement, she endured the challenges of a rehabilitation stay.


However, after only a few days, she realized that the clinic’s environment did not meet her needs at all.


Exceeding Limits


The therapy program was one issue, Aebi says, but the environment was another. “Even eating in the dining hall with a hundred other people pushed me to my limits,” she says.


During her stay at the Gais Clinic, the sick woman experienced multiple “crashes” — collapses that occur one to two days after overexertion. The discharge report stated: “Due to the accumulating overexertion, the patient’s functionality deteriorated.”


Support Instead of Activation


According to Gregory Fretz, head of the ME/CFS outpatient clinic at the Cantonal Hospital Graubünden, people with this condition are often overwhelmed by the rehab environment. “The hallmark symptom of this illness, called PEM (Post-Exertional Malaise) or exertion intolerance, can cause irreversible damage if physical or cognitive exertion exceeds individual limits.”


50 Percent Worse After Rehabilitation


For the first time, a non-representative survey by the patient organizations Long Covid and ME/CFS illustrates the extent of damage caused by rehabilitation therapies for individuals with this condition.


Rehabilitation for Long Covid and ME/CFS


Non-representative survey of 854 individuals with ME/CFS and Long Covid:

• 50% experienced deterioration

• 33% saw stabilization/no change

• 17% experienced improvement


Source: Long Covid Switzerland, ME/CFS Switzerland, Swiss Society for ME&CFS


Shocking conclusion: Of over 800 respondents, half said the rehab worsened their health. For 17%, it led to improvement, while 33% reported no change. “It is unacceptable that a therapy often prescribed worsens the health of 50 percent of affected individuals,” says Manuela Bieri of the Long Covid association.


Rehabilitation Clinics Respond


Specialized Departments Could Be the Solution

“The structure of rehabilitation clinics is not equipped to meet the needs of these patients and their condition,” says Dr. Gregory Fretz. To avoid incorrect treatments, specialized clinics and departments dedicated to this patient group are needed.


Jessica Aebi has not recovered even six months after her stay in the clinic. Her condition remains worse than before, and she is still registered with Exit.
 
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New Documentary on Austrian National Television (45min) (In German)

Much Suffering, Little Help – The Illness ME/CFS

Trapped in an Invisible Cage – that’s how life feels for many people affected by ME/CFS. This illness, with the complex name Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, turns even the simplest actions, like getting out of bed or brushing one’s teeth, into an ordeal.

Each day is an unrelenting battle against exhaustion unimaginable to healthy individuals, against pain, and against a healthcare system unprepared for their needs.


https://on.orf.at/video/14253831/15...k-1-viel-leid-wenig-hilfe-die-krankheit-mecfs
 
Has it gotten better in the past couple months? I had to step away from it around 6 months ago because there was too much psychosomatic stuff, constant peddling of unproven treatments, and what seems to have been coined as “BioBS”, a bunch of people pretending they are the smartest person in the world and thus must know exactly what causes long COVID.
Almost none anymore and for a while.
 
Now published as an Article in German.
https://www.srf.ch/sendungen/kassen...-me-cfs-falsche-behandlungen-in-reha-kliniken

Article is really good, multiple mentions of ME/CFS, and mentions a n>800 survey done by the local long COVID charity, rehabilitation made 50% of people worse and only improved 17%.

Also contains bits of the really sad story of one individual who was forced into rehabilitation as a condition for disability insurance, and deteriorated so much she’s now seeking assisted dying.

Translated Article: (For context EXIT is a euthanasia foundation.)
“The structure of rehabilitation clinics is not equipped to meet the needs of these patients and their condition,” says Dr. Gregory Fretz. To avoid incorrect treatments, specialized clinics and departments dedicated to this patient group are needed.
Pretty absurd to say this, as this is exactly what they claim. Why else would they be referred those patients? But of course the problem is that there is no such thing as a clinic specialized in rehabilitating this kind of chronic illness, since it's not possible to do so.

But if they are not that, then what are they? Generic rehabilitation clinics? Of what use is that? And to whom? Because there is no evidence they provide any benefits to any type or combination of symptoms here. Whether it's chronic cough or loss of smell, none of this can be addressed generically.

But this is the nonsense that this industry has been building over decades, that they don't have to know or care what the cause of symptoms are, they can simply treat them generically. The scam only works when they can abuse the fact that they can't even tell the difference, that lots of people recover naturally, and that in LC many of those symptoms are bothersome but not disabling, which are basically used as freebies since no one can tell the difference besides the patients anyway, and this is exactly what they aim to manipulate just enough to get a false blip of a signal.
 
Article in Swiss state news about people with Long COVID (and PEM) going bankrupt because of disability waiting times.

(translated from french):
Completely incapacitated, people with long COVID face delays of more than two years to determine whether they are entitled to a disability pension. Unable to work, some end up financially ruined.


For most of us, COVID-19 is now just a distant memory. But for those unfortunate enough to suffer from long COVID, it remains a burden that can be nearly insurmountable. The stakes are high: long COVID is estimated to affect hundreds of thousands of people in Switzerland, often severely, with women being three times more at risk than men.


“From the moment I wake up in the morning, I’m utterly exhausted, unable to get out of bed,” says Nicole Spychiger on RTS’s programme A Bon Entendeur. This mother of two contracted COVID in October 2021. According to the disability insurance (AI), rehabilitation is not possible for her. Since December 2023, her income-loss insurance has stopped providing benefits. She has since lost her job. Because of her illness, she is unable to visit the unemployment office and therefore does not receive unemployment benefits. AI has advised her to apply for social assistance.


Crowdfunding for Survival


Over time, Nicole Spychiger and her family exhausted their savings before even receiving a decision on whether she would be granted a pension. They are surviving thanks to a crowdfunding campaign organised by a friend.


“This crowdfunding is really an act of desperation for us because we didn’t know how to pay the bills, home care, or even fill the fridge,” she laments. “And to think that we’re in Switzerland, relying on financial help from friends and even strangers just to keep our heads above water!”


Similar Stories of Struggle


Her story resonates with others, like that of Sophie Verniers, a former nurse at Geneva University Hospitals (HUG). In November 2020, she contracted COVID while caring for patients and has not recovered. Since then, she has experienced profound fatigue and mental fog.


“Last week, I got lost in my own neighbourhood, where I’ve lived for six years! I can’t even remember my food preferences. I taste things, but I don’t know if I like them or not,” she shares.


Chronic Fatigue and Recovery


Dr. Mayssam Nehme, head of the post-COVID consultation at HUG, highlights the debilitating nature of the condition: “The most common symptom is what we call fatigue, but in reality, it’s more about post-exertion malaise or crashes. A person with long COVID may attempt minimal physical or mental effort and feel utterly drained, requiring days to recover.”


This makes working impossible for many, including Sophie Verniers, who is also financially strained: “Today, we’re left with nothing, as if we’re being abandoned to starve. I no longer receive family allowances because I don’t have an employer. Luckily, I had savings to keep my apartment and feed my children. Otherwise, what would I do? I’m only asking for what I’m entitled to.”


Lengthy Processes and Low Pension Approval Rates


Florian Steinbacher, deputy director of the Federal Office for Social Insurance, acknowledges the challenges: “We have long procedures because we must first explore all possibilities for reintegration. Sometimes, we require medical expertise, but experts are rare, leading to delays.”


The average processing time for disability claims is nearly two years, but cases involving long COVID tend to take even longer due to its complexity. By the end of 2023, about 12% of long COVID applicants had been granted a pension. Steinbacher notes that an upcoming study may shed more light on the issue, with early indications suggesting a higher approval rate for long COVID cases compared to other conditions.

https://www.rts.ch/info/suisse/2024...s-la-precarite-28723610.html?rts_source=rss_t

Except for the lack of acknowledgment of severe people and the focus on fatigue, I found it to be a good article.
 
Thanks for sharing that @Yann04, things sound terrible. It's amazing that even a nurse who could demonstrate that she got Covid-19 relatively early on at work has no way of getting financial support.

Contrast that with the benefits available to Swiss soldiers incapacitated at work:
The list of monetary benefits offered by military insurance is more extensive than those of other social insurance schemes, and the payments made are more generous.

Daily allowances
Persons who are wholly or partly unfit for work as a result of an accident or illness covered by military insurance are entitled to receive a daily allowance. It is payable from the day after they become unfit for work and amounts to 80% of their expected loss of income. The maximum annual income currently applicable is CHF 152,276.

The entitlement to a daily allowance ends when the person regains full capacity for work, is granted a disability pension, or dies.

During occupational rehabilitation, insured persons receive a daily allowance or retraining benefit.

Disability and old-age pensions
Persons covered by military insurance are entitled to receive a disability pension if they have become disabled as a result of an accident or illness and their complete or partial incapacity for work is presumed to be permanent or long-term.
This entitlement starts as soon as it becomes clear that no significant improvement in health can be expected from continued medical treatment, and any rehabilitation measures have been ineffective.

The entitlement to a pension ends when the person concerned regains full capacity for work, reaches AHV retirement age, or dies.

When the insured person reaches AHV retirement age, the disability pension is replaced by a military insurance old-age pension, which amounts to half of the disability pension previously received. It is payable until the insured person’s death and is not subject to revision.
 
And this is in a country that is so wealthy. It could ensure that all of its citizens have a reasonable quality of life. It absolutely could be resourcing the system so people are assessed quickly, if the decision-makers wanted to. It certainly should be looking after the people who put themselves in harms way to care for others and became disabled as a result.
 
https://www.beobachter.ch/magazin/gesundheit/kinderspital-stellt-long-covid-sprechstunde-ein-815310

(Translated)

Children's Hospital Zurich closes long-Covid consultation

The subject of the announcement had in fact long been completed: The hospital had tacitly let its long Covid consultation for children and adolescents expire and no longer offered it. The specialized contact point existed since April 2022, the patient demand was high.

The hospital justifies the discontinuation of the offer by the fact that the reasons for allocation have changed over time - increasingly away from a Covid disease, the original purpose. "In the beginning, Covid and lack of recovery were actually in the foreground, in the end school absenteeism and an overwhelmed system, but this often without a direct connection to an infection," says Lara Gamper, head of the general pediatrics department at Kispi.

According to Gamper, if ME/CFS disease is present, this requires an interdisciplinary approach to assessment and treatment. Established pediatricians would know the sick children and their families as well as the therapeutic environment much better than a central hospital."

However, the Kispi does not want to withdraw completely, emphasizes Lara Gamper. As a follow-up offer, the hospital plans to set up a psychosomatic consultation hour for the holistic clarification and monitoring of complex cases in the coming years.
 
Urgh. That’s the same hospital they have the only “CFS” clinic in the country which is psychosomatic as well.

Their “chronic fatigue” page tells the story [that they have no idea what they are talking about] pretty well..
In severe cases, those affected can no longer cope with work.
Psychotherapy often helps. In the process, patients learn to replace negative thoughts with positive ones, to reshape entrenched thought patterns, and to use their remaining energies sparingly.
https://www.usz.ch/en/disease/chronic-fatigue/
[The only silver lining is they don’t seem to recommend GET]
 
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