Abstract Background Individuals of all ages and with all degrees of severity of the coronavirus disease (COVID) can suffer from persisting or reappearing symptoms called long COVID. Long COVID involves various symptoms, such as shortness of breath, fatigue, or organ damage. The growing number of long COVID cases places a burden on the patients and the broader economy and, hence, has gained more weight in political decisions. This scoping review aimed to give an overview of recommendations about possible long COVID healthcare pathways and requirements regarding decision-making and communication for healthcare professionals. Methods A systematic search in four databases and biweekly update-hand searches were conducted. In addition to guidelines and reviews, expert opinions in consensus statements or clinical perspectives were also considered. Data were systematically extracted and subsequently narratively and graphically summarised. Results Fourteen references, five guidelines, four reviews, one consensus paper, and four clinical perspectives were included. The evidence recommended that most long COVID-related healthcare should be in primary care. Patients with complex symptoms should be referred to specialized long COVID outpatient assessment clinics. In contrast, patients with one dominant symptom should be directed to the respective specialist for a second assessment. Depending on the patients’ needs, further referral options include, e.g. rehabilitation or non-medical health services. Self-management and good communication between healthcare professionals and patients are crucial aspects of the long COVID management recommendations. Conclusions The quality of the included guidelines and reviews is limited in the methods applied due to the novelty of this topic and the associated urgency for research. Hence, an update review with more rigorous data is recommended. Furthermore, the systematic collection of real-world data on long COVID surveillance needs to be set up soon to gather further information on the duration and severity of long COVID and thereby facilitate long COVID care planning. Open access, https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-022-08384-6
It's very difficult for experts to make any progress when they don't understand what the words mean and clearly don't bother trying to understand. I don't think they can, frankly, it's hard to otherwise explain the scale of the failure here. Really doesn't understand what pacing is, seems to think it's like being on a minimum wage budget, easily doable as long as you're careful. And although they acknowledge some limits about rehabilitation, they miss the mark entirely about the issue being fixed increments. It's so extremely naïve, the professionals are still barely where the LC community was in mid-2020. They are basically pointing to things that don't exist. Talk about GPs managing most of the care, specialized clinics, etc. As if the last 2.5 years didn't happen, or as if it wasn't the general average that 1/4 people don't even have a GP, healthcare systems were already not capable of meeting basic demands before, that's why they completely neglected us. It's maddening. If reviews like this represent the sum of what's been accomplished so far there's no point in that because the information they are getting is misleading, inappropriate or flat out wrong, and almost all the good advice came from the patient community, is not expert knowledge, it's literally folk knowledge. There is a lot of emphasis on self-management, as if self-management is not itself the product of medicine's failure. Patients have to self-manage because the profession is falling on its own hubris. That's not a good thing, in fact it's explicitly terrible. Again, solutions that are entirely about the burden on healthcare services and represent the failure of the entire system to provide effective care: What good could that possibly do when it has obviously been shown to be entirely pointless? This is what the clinics are based on and they are useless. This being the sum of 2.5 years is absolutely pathetic. What's worse is there is no interest or will to even improve on any of this, hence why it's universally mediocre. Hubris-based systemic paralysis and dysfunction.
You really would think it might have occurred to someone to do this as soon as it became clear that it's a widespread phenomenon, wouldn't you.
