News about Long Covid including its relationship to ME/CFS 2020 to 2021

The Guardian: How BBC's 'Dr Xand' learned surviving Covid isn't child's play

ME is not mentioned, but this:

His own experience of Covid has reminded him how vulnerable adults can be to new viruses. Children’s immune systems are designed to respond vigorously to viruses, but by the time we reach adulthood most of us have been exposed to the common ones so there’s less need for an all-out response; it’s why adults get chickenpox so much worse. “Some long-Covid symptoms will be specific to coronavirus but it is possible that some of what we’re talking about is the effect of new virus exposure in adults, something we’ve been aware of for a long time but which has been neglected by medicine,” he explains.

 

If we have been aware of this phenomenon in adults for a long time, it makes one wonder what the phenomenon Crawley sees in children might be.

 

I’m a first-responder and now, it seems, a covid-19 ‘long-hauler’

https://www.washingtonpost.com/business/2020/10/22/first-responder-covid-long-hauler/

That was the only true bit of success the grand BPS experiment had: delinking the illness from its trigger, so much so that some GPs will actually say it's probably not "CFS" because it's likely a direct result of a viral infection. I am very curious what that person thinks about mononucleosis.

Incredible level of dysfunction, maximum confusion.

 

No idea what she means by "the current mental health emergency", I assume she means her struggles with burnout, this seems very much about her own experience. I feel safe in assuming this is more or less what she believes chronic fatigue is, the language is very telling about physical recovery when talking about... I don't know... I guess this means burnout but it's very muddled.

 

Is there, in fact, a mental health emergency?

If so, why?

I hear people who've been primed going on about it, and quite a lot of people will be feeling stressed, about jobs, money, homes etc. - but...and this is important - this is a perfectly natural response to a stressful situation, albeit a prolonged one, for those who are not used to such things.

It is not IMO an indication of poor mental health, let alone a mental health emergency, at least not in the way these terms have been used for the last several decades.

The whole 'mental health emergency' strikes me as a preemptive cover story, and marketing.

 

@Wonko

What really strikes me as a possible over reaction is not being able to see family during the holidays as a 'crisis'. Perhaps I've had ME for too long or being social introvert is the reason, but I've never felt that my mental health was in an emergency crisis when I got sick. My goodness, it's only been less than a year with this pandemic.

 

Don't think it's so simple, covid kills adults but long covid seems to be targeting healthy young folk. Certainly m.e. went for a lot of kids and those of student age. Maybe their immune systems are too healthy.

 

Per usual a government apologist that doesn't link suffering to realities of: long hours, poor pay, lowering of professional authority/esteem; and dealing with a chronically underfunded system that stresses the hell out of everyone. She has played her part in supporting policies that contributed to the poor mental health of pysicians now i imagine she's selling back a halfbit cure.

 

Everyone else has to improve their " resilience" , or in other words it's your own fault if you can't cope. A get out clause for employer and workforce/ work dynamics.

This has been the buzzword/ favoured instigation for recent years.

 

An aside, but it applies to arts funding too. Started appearing about 12 years ago.

 

A really interesting article that could be posted in several threads but this one will do. Marvelous example of the cognitive dissonance between traditionally discriminated chronic illness and experiencing its reality as being nothing like medicine describes it. It's borderline "I was wrong all along", but the author seems unable to process Occam's razor, that this can't possibly be true, and so doesn't manage to get there, yet.


I have all the symptoms of a Covid-19 long-hauler — but I’m hesitant to identify myself as one

https://www.statnews.com/2020/10/26/hesitant-identify-myself-as-covid-long-hauler/

I had never heard of NOS, which seems to play the same role as MUS.

Not always, unfortunately, has been operationalized as never, hence the clusterfuck.

Better idea: let's actually do the work so we don't have a junk category of things where people go to die. Those "NOS conditions" are not imperfect, they are complete and total failure. "Heightens suffering" sure is a good euphemism for "doing harm" but when you are faced with reality you have to call it for what it is. This is, in fact, medicine doing harm. Sadly showing the Hippocratic oath ain't worth much in real life. A good feel-good slogan, but no more.

 

I have empathy for the author's suffering but I'm also really, really astonished.

Is it - really - so hard to believe that there are people with physical ilnnesses that are just yet unknown or undiagnosed? The author only understands when going through herself? That's not even a lack of empathy but a lack of...imagination.

"Not knowing" is a totally valid category in any other science. Why not in medicine? Is there an inherent conflict between the role of a doctor, that might come with so many responsibilities and expectations that are unbearable when you allow any doubt in your abilities to solve a problem in?

The author sounds traumatized, not by LongC but because it's shattering her fundamental beliefs.

Edit for pronouns/author

 

Interesting points. By the way, I googled the name and lots of photos of a woman came up so presume the author is female.

 

Oops, I knew an Iranian with the same name and then assumed the author was male even though I was surprised about the openness and self reflexion that I'd associate more with a female. So I was double biased myself ranting about biases Will edit.

 

Based on her information, this is she:

https://www.linkedin.com/in/pooja-yerramilli-4676413a

Young

 

The author is in the U.S. where ICD-10-CM is the mandatory version of ICD-10 and is used for morbidity coding, billing and records:

https://www.cdc.gov/nchs/data/icd/10cmguidelines-FY2021.pdf

ICD-10-CM Official Guidelines for Coding and Reporting FY 2021 (October 1, 2020 - September 30, 2021)


6. Abbreviations

a. Alphabetic Index abbreviations

NEC “Not elsewhere classifiable”

This abbreviation in the Alphabetic Index represents “other specified.” When a specific code is not available for a condition, the Alphabetic Index directs the coder to the “other specified” code in the Tabular List.


NOS “Not otherwise specified”

This abbreviation is the equivalent of unspecified.


b. Tabular List abbreviations

NEC “Not elsewhere classifiable”

This abbreviation in the Tabular List represents “other specified”. When a specific code is not available for a condition, the Tabular List includes an NEC entry under a code to identify the code as the “other specified” code.


NOS “Not otherwise specified”

This abbreviation is the equivalent of unspecified.

---------------


In the U.S.'s ICD-10-CM, Chronic fatigue syndrome is listed in the Symptoms, signs chapter as:


R53.82 Chronic fatigue, unspecified

Chronic fatigue syndrome NOS

(where "NOS" = "Not otherwise specified")



Many coded terms in ICD-10-CM also have a "NOS" version.

See ICD-10-CM Tabular List FY 2021 for further examples:

https://dxrevisionwatch.files.wordpress.com/2020/07/icd10cm-tabular-p-2021.pdf

 

Further explanation on use of "NOS" terms in ICD-10-CM:

https://www.findacode.com/articles/icd-10-cm-abbreviations-nec-nos-31650.html

ICD-10-CM Abbreviations: NEC, NOS
by Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
May 6th, 2015

The difference between NEC and NOS is very specific and not to be confused as they are two very different abbreviations.

NEC - When a specific code is not available for a condition, the Index directs the coder to the “other specified” code in the Tabular List. NEC is used to indicate the diagnosis is specific; however, the coding system is not specific enough.


Example: Alphabetical Index

Cataract

Specified NEC H26.8 Tabular List

H26.8 - Other specified cataract


NOS “Not otherwise specified”

This abbreviation is the equivalent of unspecified, indicating the documentation does not provide enough information to assign a more specific code.


Example: Tabular List

I50.9 - Heart failure, unspecified
Biventricular (heart) failure NOS
Cardiac, heart or myocardial failure NOS
Congestive heart disease
Congestive heart failure NOS
Right ventricular failure
(secondary to left heart failure)

 

So the term "NOS" (Not otherwise specified) is not a stand alone term in ICD-10, ICD-10-CM or ICD-10-CA, but a qualifier appearing at the end of a coded-for term, for which there are many examples in ICD-10 and in the national modifications of ICD-10.

So I question the author's understanding of the use of "NOS".

 

Just listening to the discussion on cognitive problems from Covid-19 on Times Radio. This may be relevant to other threads on the forum where 'brain fog' is discussed, but just linking the research here before I forget:

https://www.medrxiv.org/content/10.1101/2020.10.20.20215863v1

 

I agree. The author sounds very naive as a medical professional. But maybe hates not unusual!