Swiss Re: Expert Forum on secondary COVID-19 impacts, Feb 2021

Sly Saint

Sly Saint

Senior Member (Voting Rights)
Expert Forum on secondary COVID-19 impacts
Virtual Expert Forum with internal and external experts addressed the diagnosis, management, and prognosis of the most common lasting symptoms of COVID-19

14:10


Long-haulers and chronic fatigue


Trends in fatigue due to Secondary COVID Syndrome

Michael Sharpe, Professor of Psychological Medicine, University of Oxford

https://www.swissre.com/institute/conferences/expert-forum-on-secondary-covid-19-impacts.html


https://www.swissre.com/dam/jcr:788...vid19-impacts-presentation-michael-sharpe.pdf

See also this members only thread
 
Last edited by a moderator:
Sharpe lists support groups as one of the "social factors" that influence recovery -- included are Long Covid Support and ME Action's "Long Covid and ME - Understanding the connection" group.

He says that "At present the best treatment is psychologically informed rehabilitation", accompanied by slides showing improvement from GET and CBT in the PACE trial. Meanwhile, he puts the NICE ME/CFS draft guidelines under "Challenges in providing rehabilitation".

Admittedly, I didn't expect he would tell Paul Garner's story as a "Case study from the BMJ". But he did.
 
Including an interview with Sharpe:

https://www.swissre.com/institute/c...acts.html#interviewwithprofessormichaelsharpe

Swiss Re Institute: What can you tell us about the causes of Long-COVID?
Professor Sharpe: It is all-too easy to talk about post-COVID syndrome as if it were one thing, like lung cancer, for example. We must allow for the fact that it is heterogeneous and be wary of thinking in terms of a single cause. Based on our clinical experience, there are biological, psychological and social causal factors. Patients often have a lot of symptoms, as many as 20-30 – but we must remember that multi-symptom illness does not mean multi-symptom pathologies.

There are striking psychological factors, we might call it health anxiety. Some of our patients experience significant anxieties because of an understandable focus on their bodily symptoms, but about a third to half of our patients are negatively impacted by the media. Consumption of newspaper articles that proclaim 'Long-COVID could mean lifelong-COVID' and that 'the effects could be horrible,' can hinder patients' recovery. Another, perhaps surprising, social factor has to do with online support groups. These have proven to be of great benefit for many worried patients. However, people who recover tend to leave such groups, leaving the group with only people with poor prognosis. There's concern that such groups can then exacerbate pessimistic views of the illness and transfer those to vulnerable patients.
Click to expand...

Also, I found this being mentioned interesting:

In the absence of good data, physicians usually fall back on the rule of thirds.
Click to expand...

I'd long noticed that quacks would tend to claim that worthless treatments cured a third, got significant improvement in a third and left a third largely the same. This seemed common with homeopaths, immunological pseudo-science, mind-body training, etc. Alistair Miller seems the most committed to this ratio for ME/CFS and CBT/GET. I'd always assumed that reflected a combination of the way people perceive the effects of their own quackery and how much they think that can get away with. I hadn't realised it was an actual 'rule' people would refer to:

For much of the 20th century psychiatrists thought of recovery rates from schizophrenia in terms of what was known as the “rule of thirds”. According to this rule of thumb about one third of those diagnosed with schizophrenia would recovery completely, a further third would be improved over time, leaving the remaining third who would not show any improvement.
Click to expand...

https://livingwithschizophreniauk.org/information-sheets/can-you-recover-from-schizophrenia/
 
Last edited:
He's testing the waters, seeing how much psychologization he can get away with.

What he says about support groups is close to claiming mass hysteria, but expressed so that he can always deny this interpretation should he be attacked for it.
 
Yet again, this is the same claim being made for over two decades - that membership of support groups is a bad thing.

Two decades ago there weren't that many groups that were accessible, the world wide web wasn't even a shadow of what it is today and still people became chronically ill. They just did it in isolation.
 
When searching for the Sharpe talk I found a different swiss re thing

Podcast: Long COVID and implications for disability claims | Swiss Re

In the first L&H claims podcast for 2021, Lucy Hartley (Claims Service Manager, Swiss Re ANZ) and Monica Garcia (Health & Wellbeing Insurance Consultant, UK) discuss the long term health effects of COVID-19 and the resulting impact on the disability claims landscape. The podcast explores trends emerging in the UK, and provides claims assessors with strategies to identify and manage Long COVID disability claims.

Listen time: 27:30
Click to expand...

It's a discussion between Swiss Re's Lucy Hartley & Monica Garcia.

These are my rough notes, not precise quotes, in case anyone else is interested:

9:50 - 'reassurance that fatigue can be managed, I can share a case study I found from the compensation industry'.

14:50 - The importance of taking a biopsychosocial approach and putting in place a management plan.

18:45 - Compared/contrasted LC with ME/CFS. ME/CFS will tend to be only diagnosed after extensive investigation, not rapidly like with LC.

20:45 - Case study from their private 'fatigue' experts. [Vitality 360?] This patient was said to have become anxious about returning to work, needed help with boom & bust behaviour... but after 8 sessions had a good outcome.

25:15 - "We want to take an evidence based approach, and Monica's case report is just excellent". Mentions GET and pacing and, 'of course', return to work.
 
Invisible Woman said:
Yet again, this is the same claim being made for over two decades - that membership of support groups is a bad thing.

Two decades ago there weren't that many groups that were accessible, the world wide web wasn't even a shadow of what it is today and still people became chronically ill. They just did it in isolation.
Click to expand...

Excellent points. Decades ago, people in isolation, world wide, were developing ME, having never heard anything about it. Hmm....what a coincidence, eh?
 
Esther12 said:
20:45 - Case study from their private 'fatigue' experts. [Vitality 360?] This patient was said to have become anxious about returning to work, needed help with boom & bust behaviour... but after 8 sessions had a good outcome.
Click to expand...

But this tells us little to nothing. What precisely is a good outcome and a good outcome for who?

Here's the thing, from what I've been told it's fairly typical that once a person makes a return to the workplace (& it doesn't necessarily have to be a return to full time either) the clock starts ticking. Many group policies, those taken out by the employer, will time out at about the six month mark.

That is, if you have returned to work and managed to stay there for 6 months the claim is effectively ended. If you relapse after that point that is classed as a new claim.

Of course, by the time 6 months has elapsed the policy might now be with another insurer, & even if it's not, it may also be under a new policy with more restrictions on paying out.

So, even if they get you back into part time work, if you collapse in a heap unable to continue after 6 months, there's a chance you then become someone else's problem. Or the new policy won't pay out because it is more restrictive.

Note this information might be out of date by now.

Edit - removed rogue "?"
 
I also take issue that being a member of a support group gives you a more pessimistic view of the condition.

I don't believe this is true. It might give you a more realistic idea, certainly. Especially when we consider that it is still being claimed by some that the majority if ME patients recover in time though maybe not back to full function. There is no evidence to suggest or support this.

You could just as easily argue that "experts" like Sharpe, Wessely, Chalder and those running fatigue clinics have an unrealistically optimistic view of the condition. If they are seeing outpatients then by definition they are seeing patients at the milder/moderate end of the spectrum. Patients they aren't helping or are making worse will drop out. We know they don't record harms or long term follow ups.

If someone is given enough information to plan for the worst while they hope for the best then I would argue this gives them the greatest all round chance of adapting to their new situation. Adaptations aren't just about managing the illness but about organising support, financial planning and so on. Something you would think the BPS school woukd understand.

Also note that BPS proponents seem to hold a very static view of people's ability to adapt. Apart from being quick to adopt the sick role, they seem to have an unreasonable and inexplicable idea that, having become sick people then don't adapt to becoming well. Why?

Adapting to change is an inherent part of life. Sometimes it isn't easy but we all do it. We grow up, leave home, get sick & hopefully get well again, get made redundant & hopefully find employment again, have relationships & maybe a family, retire.

The one constant in over 20 years of the course of my illness? The desperately clinging on to absurd and irrational beliefs of the BPS crew. The core beliefs and understanding of this group never change, no matter what arguments or evidence to the contrary are presented. The field is unchanging, never moving forward and always seems aligned with benefits agencies, insurance industry. Ironic.
 
Last edited:
Milo said:
So what exactly is the relationship between sHarpe and Swiss re
Click to expand...
He is employed as a consultant by them.

Milo said:
why does Swiss re keeps on asking this one guy
Click to expand...
Presumably because they perceive value in what he tells them, that by using what he tells them they are able to increase revenues, or decreases costs, or both.

Milo said:
and why is a psychiatrist involved in long-Covid?
Click to expand...
My second answer probably covers that. Of course, the stated reason will be some biopsychosocial mumbo-jumbo, "we all know that the mind is intrinsically linked with, and influences, any illness", blah blah blah.

Part of David Tuller's initial writing on the PACE trial covers links between PACE trial authors and insurance companies, which includes work for Swiss Re, it might be a helpful overview, https://www.virology.ws/2015/11/17/...surance-companies-not-related-to-pace-really/
 
Andy said:
He is employed as a consultant by them.


Presumably because they perceive value in what he tells them, that by using what he tells them they are able to increase revenues, or decreases costs, or both.


My second answer probably covers that. Of course, the stated reason will be some biopsychosocial mumbo-jumbo, "we all know that the mind is intrinsically linked with, and influences, any illness", blah blah blah.

Part of David Tuller's initial writing on the PACE trial covers links between PACE trial authors and insurance companies, which includes work for Swiss Re, it might be a helpful overview, https://www.virology.ws/2015/11/17/...surance-companies-not-related-to-pace-really/
Click to expand...
I know all that @Andy, but thank you for the link. I am beyond frustrated that this keeps on happening, and it’s quite triggering to be honest.
 
Last edited:
You must log in or register to reply here.
Back
Top Bottom