UKC

Just tested positive again after a couple of days of feeling crap. Exactly a year since I last had it so yet again another lonely Xmas separate from family to protect vulnerable family members. Wondering if there has been a big upsurge in cases again!

Definitely plenty around again! Time of year maybe and weeks of grim weather....hope you can get by over Xmas, I've had 2 home alone Christmas's because of covid which on reflection I quite liked in a peculiar kind of way! Best wishes...

The gift that keeps on giving! I've felt 'slightly rough' a few times this winter but haven't tested myself. I've just put it down to the usual winter mix of general crapness. My last dose of covid was back in July.

Yes... a doubling to 1 in 24 in two weeks ( which is huge)  was reported in a few places, including these links:

https://www.theguardian.com/world/2023/dec/22/nhs-given-warning-about-infec...

https://www.theguardian.com/world/2023/dec/21/covid-infections-rising-again...

No doubt  the Christmas Spreading Event will bring a lot more covid cases.

I tested positive for the first time ever two days ago (I was beginning to think I was completely immune!). No worse than a mild cold for me so far but it's going to be Christmas on my own too to protect my very elderly parents.

So if it doubles again in two weeks, it will be about 1 in 12 at Christmas. And then the Christmas spread on top. 

Annoying to read in that article that there were millions of vaccine doses left over from the autumn that could easily have been given to younger people along with the flu one.

Yes once all priority groups had been offered the vaccine, why on earth didn't they open the door for youngsters to get one? No chance of herd immunity when most of the population is unvaccinated, and herd immunity is especially important with what they described as a disappointing uptake in vaccines by at risk groups.

Also to those of you imposing self quarantine over Christmas - THANKYOU, your sacrifice is appreciated.

Me feeling is, and I’m aware that I may be over generalising, is that ‘the younger people’ wouldn’t take the vaccine. A few would, but I reckon the vast majority wouldn’t. In fact, most folk I know haven’t had a jab in ages (middle aged to older adults), my young adult children and their friends - zero have had it. 

Maybe, but what I find galling is that I made a special trip to Perth to get my flu vaccine and, for a few extra seconds I could have been given the covid one which I would have got if I were just a few years older but which was probably effectively just binned instead.

I found out too late that if I had mentioned at the time that I had elderly vulnerable parents they would almost certainly have given me the covid one. 

I had the vaccine as I’m over 65 but my wife didn’t as she is only 64 and it wasn’t available to her. 

To be honest if you are already vaccinated and at your age or younger risks are low for severe illness. The bigger missed opportunity was public health action to keep all serious respiratory virus types in check this winter: continued proper monitoring and messaging; action on improved ventilation in public spaces; and clear messaging on the benefits of cheap FFP2 masks for individuals (especially for the clinically vulnerable or anti vax fools). 

Another source of recent info - https://coronavirus.data.gov.uk/

Dave

I dont know if ive had covid these past few weeks cos cant get lft anywhere, but 4weeks ago started what felt like a head cold continous runny nose so i carried on running but turned down the mileage, then a week later turned into a productive cough.Four weeks later im still coughing up phlegm  on and off headache and a blocked left ear and just feel beaten down, been to docs twice lungs are clear and puts it down to post nasal drip for which ive got a nasal spray, whatever it is its a b@stard.

I bought some from my local Sainsburys a couple of days ago. Pack of 5 for £8.50.

I'm not so worried about myself as minimising risk to my parents.

Thx robert,ive only been trying chemists.

Vaccination only slightly reduces probability of infection and transmission. Best thing to do is self isolate for a few days to a week with no symptoms and self test before a visit.

Down votes? Perhaps because you didn’t wish everyone a merry Xmas or maybe they’re of the opinion that you should happily spread covid to as many vulnerable family members as possible?

I just got it

I got some tests from Boots, I’d actually been feeling a bit crap for a couple of weeks with muscle and joint aches plus a bit of a cough I thought was old age and acid reflux. Then woke up at night earlier this week and felt I was drowning in phlegm.. so did lft and it was positive!

Apart from long covid, of course, which can have life changing effects and is really not that rare an outcome. 

I got it last week, for the first time, at my work Xmas party. Had my 5th jab a month ago and was beginning to think I was immune. 

It seems like everyone has it. It's very mild though, I've had far worse colds.

I had it two weeks ago, a very distinct set of symptoms, and not like a cold, more mild flu with short episodes of extreme fatigue for a week after. Daughter too with identical symptoms.

My interpretation of the lft taken over four days was of a very strong antigen reaction which reduced quite quickly. I've had all the vaccines I was eligible for and they seem to have done the job of priming my immune system. Only my impression and not science at all.

My first test two days ago (which I only took because a friend I had seen went down with it and I felt very mildly ill) gave a very weak line which appeared very slowly. Next day I felt much the same but the line appeared instantly and strongly. As I understand it the test is for antigens, so does this mean I've had a good strong immune response? Feel the same today but not tested having already written off Christmas anyway!

Yes I've had far worse colds.

But not ones that have left me unable to hold down a job almost there years later!

Sure... but again extra vaccination doesn't seem to help long covid so we need those public health measures again to keep infection levels down: national testing and messaging when infection levels are high; test if potentially infected and isolate if infected; improve ventilation in public places, wear well fitted FFP2 masks if particularly vulnerable. From the main news one might think covid is now a minor annoyance when in fact it's making a lot of people ill and hitting UK productivity and contributing to too many hospitals being under emergency measures, or close to that.

The test is only for the presence of virus (or rather, for bits of virus, the antigen), it's not testing your antibody levels, so there's little inference you can draw about your response to the infection, I'm afraid. If you were will to blow your remaining tests, you could see how the strength of the line (hopefully) diminishes in the next few days, but probably best to save them for pre-visit testing!

What’s your evidence for this? Certainly a majority of covid experts I’ve seen seem to recommend keeping up to date with vaccinations if at all possible, but maybe I’m misremembering or misreading that. 
 

I still think to characterise the risks as “low” is mistaken. 

Oh yes, absolutely. There’s some evidence (but it’s far from conclusive) that simple reinfection puts one at greater risk of long covid, so more mask wearing might well be a very sensible idea. Of course it’s absolutely not going to happen and more people will continue to get a very serious illness >insert shrug emoji<.

The problem with relying on testing though is that many are now getting it so mildly that it doesn't show in a test. I have had a couple of "colds" or sore throats which have coincided with close contacts with covid. I am pretty sure they were covid, but tests negative. Presumably because of mildness. I think that's probably not uncommon in younger people. So relying on testing is not so effective now. 

Sorry I thought I was clear that I was talking about those fully vaccinated like Robert. If risks reduced significantly JVCI advice would have been to get other age groups jabbed again this autumn. Vaccination does seem to have reduced the long covid type of serious illness.

I think the other measures are more important than masks now, except for the most vulnerable (obviously including those who refused vaccination for no good reason)

Sure... that's why the wider collection of public health measures should have been put in place. It seems nuts this didn't happen.

The ONS tests were PCR type so did give accurate levels of population infection with some useful geographical and age information. It also seemed nuts to ditch such a cheap research measure. 

Ok, Thanks. I was confusing antigens with antibodies.

I'm not sure this is fair. I'm 35 and not in a risk category (asthmatic, but not enough) but I've had a series of chest infections and other illnesses this year and would quite fancy not having COVID yet again. The weeks of poor chest after the last time, while not serious, weren't fun - a few weeks before I could walk any distance or do any cardio etc.

Besides we only seem to be reliably treating people for Long COVID who had a positive test. There were plenty of us who had COVID before the testing was brought out, with no advice on the effect (I strongly suspect it's been the cause of developing chronic migraines for me).

Only issues for me are a) taking time off to actually get the vaccine and b) it potentially making you sick for a few days after. The Christmas we were eligible, I had it, and then felt horribly unwell for a few days making the drive home horrific. (Ironically I've not had the flu jab this year as I've spent too much time unwell.) I'd assume a lot of people in my age bracket might not find it so easy to take a few days out as those who are retired. I suppose there's also an argument that the effects on menstruating women were shamefully ignored by the medical community at the time, so could be a reason for a few to baulk at it.

On balance I'd definitely like to be asked, though - surely they could at least open it up to everyone who's eligible for the flu jab-? I'm not entirely sure COVID has had less of an effect on my health than flu. We offer it to everyone with coeliac disease, for instance, for good reason, but wouldn't people with a history of chest infections or similar be worth considering-? 

It does, but to what? An overview on long covid published in January 2023 in Nature said:

"The impact of vaccination on the incidence of long COVID differs across studies, in part because of differing study methods, time since vaccination and definitions of long COVID. One study indicated no significant difference in the development of long COVID between vaccinated individuals and unvaccinated individuals; other studies indicate that vaccines provide partial protection, with a reduced risk of long COVID between 15% and 41%, with long COVID continuing to impact 9% of people with COVID-19...

"Reinfections are increasingly common. The impact of multiple instances of COVID-19, including the rate of long COVID in those who recovered from a first infection but developed long COVID following reinfection, and the impact of reinfection on those with pre-existing long COVID is crucial to understand to inform future policy decisions. Early research shows an increasing risk of long COVID sequelae after the second and third infection, even in double-vaccinated and triple-vaccinated people."

https://www.nature.com/articles/s41579-022-00846-2#Sec13

So in short, we don't really know. I personally would have preferred a much more cautionary approach to covid vaccination but, given that even the most optistic study included in the Nature review still saw 9% of double vaccinated participants reporting long covid symptoms, we shouldn't be relying entirely on vaccination.

Do we have any sense of which of the many estimates of long covid prevalence and impact the JVCI used, given those estimates are really wide? And as a general point should we have confidence in how our medical establishment treats post-viral illness given the really poor response to those illnesses, both the pre- and post-pandemic? We currently don't even count how many people have long covid (we did, but we stopped counting) and I haven't seen much on the economic impact of the disease, which would be a part of any cost-benefit scenario planning. So we've got a disease of a type which is massively under-counted (it typically takes years to obtain an ME diagnosis), generally ignored or downplayed by doctors, and which we've got very little good data on. Maybe they made a solid, informed decision, or maybe not - I suspect we won't know that for many years.

Again, what's the factual basis for this argument? For example, how can we really ensure filtered air on buses, trains or planes? Is it realistic to expect widespread uptake of air filters by businesses, or to expect individuals to do frequent self-testing given that there are no longer free tests and many households are facing serious financial pressures? Many covid experts I read recommend mask wearing in some situations. Surely even just a new social norm of masking on the bus would make an impact...

me too 😀

 As you were.

Hi Tringa, that covid dashboard is no longer being updated. It's been replaced by this - https://ukhsa-dashboard.data.gov.uk/ - which is a good deal less informative & transparent.

Offwidth: I agree completely about all the missed opportunities, but not on the risk. I know we've all been subject to a year of soothingly reassuring noises from UK Gov, UKHSA, DHSC, and the press parroting those noises, but those noises are as misleadingly poor as our public messaging.

Owing to the way our data has been pruned of utility it's hard to give a UK-based picture of what's going on stratified by age, but it's possible to do it for other countries who are producing higher-quality open data. The pressure is telling on hospitalizations across Europe: Germany's a reasonable comparator as it also failed to offer the vaccine to working-age adults (though it wasn't as parsimonious as the UK) so they too have a significant population who are over a year out from their last booster. 40% of people in ICU are under 70. JCVI shouldn't have had their hands tied by Sunak's ludicrous cost-benefit analysis in the first place but, given that, to incinerate the doses we've already paid for indicates in what bad faith that analysis was done.

But even that is missing the important point, I feel, which is that the initial acute symptoms are not the real danger any more except for the very frail: the sequelae are the real kicker and the bigger cost. Yet we have a population who think their experience of a mild dose of flu is all there is to it, failing to understand both that there's a spectrum of acute initial reaction from 40% completely asymptomatic through mild symptoms to ICU admission, and that none of thieir initial symptoms are a good predictor of sequelae.

All fair enough but I guess my main concern is the lack of public health work to reduce respiratory disease risks and learn more about long covid, in times when the NHS is really on the edge. I'd say the government are effectively gaslighting the population and the NHS are somewhat complicit partly due to costs.

I would be interested in the percentage of that German ICU population under 70 who are unvaccinated but had still been careful until after the 4th wave, due to communications like this:

https://www.nature.com/articles/s43856-022-00176-7

For Sean I'm going from memory on various data sources posted by wintertree et al during the many covid threads (including LSRH putting up info after being challenged on his 'flimsy facepants' jokes). I could be misremembering or new variants might change results. I'd still maintain FFP2 masks are maybe the best value for money in cutting population  risk. I think it's in the interest of many organisations to have good ventilation to cut respiratory illness absenteeism. Whatever, mass mask use simply won't happen unless a really nasty variant or new virus arrives to scare people (mainly because of government), nor will other useful measures for the same reasons. So I sympathise with your arguments. If you have data that new infections are giving worst long covid outcomes I'd like to see that but by definition that will only be from early 2023 at best, so we don't know. However,  I don't get the sense the numbers are growing as rapidly as they did from earlier waves, from those I know on large self help groups. The number was nearly 2 million self reported with long covid in the last ONS data published this March: a huge public health impact.

Aren't we saying something broadly identical? Forgive me if I'm missing something.

I was using Germany just as one example as they have good data, but the same is being seen across Europe. For vax in Germany stats are here - https://impfdashboard.de/en/ - and you can see how reluctance is a problem in the old GDR rather than Berlin and the west; alas ICU problems are not confined to the old GDR.

Prevalence of LC is difficult with the ONS ending their survey in March, just as it was showing a decline. Later data (e.g. the NHS GP-patient survey in July) showed a large increase but went unreported on. At the moment UK prevalence is so high that even a much reduced % of LC will amount to a massive burden.

Oops, seems I have just disproved my theory there. My slight niggly cough has just brought up a positive on a covid test. I only tested just as a slight whim. My mum had looked out tests we had as we all need to test before NY day to see the in-laws due to father in law going through complicated treatment. She noticed they were close to being out of date, and we were due to go to a watchnight service. I have had a niggly cough for about a week, and did test earlier in the week before going to work, so was sure I was fine. But it came up as a strong positive on the test tonight. So that's a thing! A night at home for us instead. 

My cough has pretty much gone. 

Last time I tested positive it was a similar situation, where the positive test came when symptoms had stopped. 

Stepping aside from covid for a moment, let me introduce norovirus. That's just appeared and blown up the big family Christmas due to isolation to protect the elderlies. Gonna be quiet tomorrow, I shall catch up on diy stuff. Festive shed wiring! 

I work in the manufacturing industry and if the place I work is typical of other sites (which I suspect it is), then I will say that Covid has had zero impact for at least a year.
Looking further afield, then I also see no impact on other sectors such as retail and construction.
From what I can see, Covid is no longer an issue to the vast majority of the UK population and to the point that people have totally forgotten about it and have just returned to normal life.
Fair enough, there might be a minority still potentially effected by Covid, but as a country, we really have to move on and designate Covid 19 to the history books.  

My understanding about the hit to productivity is that it's the number of people across the country who can't work due to long Covid. We have many sectors who are desperately short of staff, in particular health and social care. Coincidentally (!), the people in these professions were some of the worst hit by Covid. Obviously, these sectors are also badly hit by brexit, so they have had a doubly whammy. It will be hard to quantify how much effect each has had, but I suspect if you speak to people working in a hospital, they will all have a tale of someone who has had to stop working due to LC

You could say the same about flu or pneumonia or smoking or seatbelt use. It's an idiotic attitude bordering on eugenic foolishness that will further damage the NHS and cause poorer health outcomes for millions, especially the clinical vulnerable. Public Health measures save money in the NHS and helps people live longer happier lives.

More likely he is clueless. Here is a US example of serious concerns of the impact of long covid.

https://www.powderbulksolids.com/business/how-long-covid-impacts-the-manufa...

I would assume (based on nothing more than my own prejudice!), that long Covid effects are worse in the US, as US health care will be unaccessible to many who have it, making it harder to get any help to get back to work with whatever symptoms people have. Of course, it is still definitely going to be having an effect here too, I am in no way playing down the seriousness of it here, but I just wonder how accurate US figures are for us given the difference in healthcare availability.

I am spending Xmas without family for just this reason. Tested positive Wednesday. My wife had it earlier and has cleared so she's taken her mother (who was meant to be staying with us up to her nieces). On the plus side I don't have to drive through all the traffic and some friends and i who have already had/still got Covid are having a Plague Xmas together.

Healthcare for Long Covid Sufferers is pretty much non existent in the UK, there is also no financial or welfare support as it's not classed as a disability.

My friend with long covid has had some sort of help. It's not very extensive, I guess not enough known yet, but they have been trying various things with her and some things have help a bit. Maybe it's a bit of a lottery with who your GP is.

Yes as always NHS care something of a postcode lottery, also depends on your LC symptoms.

GP is happy to sign sick notes and run blood tests but that's it, fed up with being told to give it time (35 months tomorrow from when I tested positive).

LC clinic is a box ticking exercise, did an hour's group zoom session on fatigue and all it taught me was that hour long meetings now trigger a three day crash.

Exactly what healthcare for long covid is available here that isn’t available in the US? If anything, it’s the other way around - Americans with health coverage (which is still the majority) can often access drugs that the NHS won’t allow doctors to prescribe.

Quite a lot is known, there are thousands of papers on long covid, but most GPs seem clueless still. There’s a failure of information sharing and transmitting best practice. 

In my estimation, GP's are not interested in using their own time to do CPD to stay up to date with information.

Meantime, is it not the case that we need to do some more precise analysis of what goes on in the mitochondria of those with long covid? I also am ignorant of what techniques can be used to target gene manipulation of mitochondria.

In my estimation, that's a grossly unfair thing to write after the past few years, regardless of the thread topic.

Worth speaking to some long covid patients and seeing what their experience of the medical profession is. You might find your estimation altering somewhat.

This is the same veteye who was pontificating on that other thread not so long ago about how first responders probably just prescribe ketamine to their patients willy nilly to their patients without knowing what they're doing.  (Unlike vets, who are much more tightly regulated than clinicians who treat humans apparently.)  There's a big ol' chip on that shoulder for some reason.

You don't need to limit yourself to long covid patients if you want to talk to someone who's having a miserable time of it trying to get adequate treatment from the NHS at the moment.  The suggestion that individual doctors half-arsing their jobs is the cause of that though - wow, what absolutely mind-boggling ignorance!

I’m afraid you’re talking about two separate things here. Yes, there are huge issues with NHS services due to underspending for 13 years. And at the same time, yes, some doctors do a terrible job caring for some patients, including gaslighting them and abusing them. If you don’t believe that later, then look into how women get treated, eg having their symptoms explained away as “anxiety” and being refused tests, etc, which  later go on to reveal actual issues. Some doctors absolutely do half arse their jobs! 
 

Of course the thought that one might get sick and the people one turns to for help behave unpleasantly is an uncomfortable one; perhaps too uncomfortable to be taken seriously.

Despite some bad eggs (that you can find in any profession), I sympathise with most GPs... way too much to do with way too few numbers on average and more are leaving than joining the profession every year whilst the population grows and average health declines. Long covid makes things worse and funding and producing the majority of the research base to enable the best primary care responses isn't the responsibility of GPs.

A half arsed argument.

Service quality always declines when numbers of patients and average health issues per person increase when GP numbers are declining; and their ability to deliver as efficiently as possible reduces when under significant stress. The situation is far from binary.

Fundamentally we need a massively improved investment in public health and legislation to help public health (rather than the current backpeddling on food legislation and smoking) and emergency funding in primary care until the influence of that public health investment filters through. I'd also like to see increasing investment in NHS employed primary care practitioners. Will any of this happen any time soon? No chance.

Some humans half-arse their jobs, and some behave unpleasantly.  Doctors are humans.  It's the generalisation that's offensive, and offensively stupid.  My experience of doctors, paramedics, nurses and other clinicians is that they're generally more compassionate and more competent than most other professionals I deal with from day to day.

However eloquently one words it, one's argument is moronic.  Good day sir.

The problem is that you’re ignoring the actual experience of a large cohort of patients who have real problems getting heard by doctors. 

I’m afraid the medical profession is both systemically and personally weak when it comes to post-vital patients, ie doctors aren’t taught much about the disease but even given that there is a large variation in doctors showing qualities such as respect, curiosity, willingness to learn (or even admitting they don’t know). This goes back much further than the current NHS crisis, although that doesn’t help.

For example, the following is from the current NICE guidelines on ME, an illness with many similarities with long covid: 

“Recognise that people with ME/CFS may have experienced prejudice and disbelief and could feel stigmatised by people (including family, friends, health and social care professionals, and teachers) who do not understand their illness.” 

I’m sorry that patient experience strikes you as “half-arsed”; your post strikes me as disrespectful and closed minded. 

My experience is quite different. 

If my argument from experience is moronic, then so is yours. I’m sorry that my experience is so threatening to you that you need to resort to abusive language, and at Christmas too! 

I think it’s important for people to feel safe and secure, and the awareness doctors will treat them if they become sick is part of that. To hear it isn’t always the case is extremely concerning, and it must be pushed away, or excuses found. The thought that they might not be treated because of “prejudice” (NICE’s word, not mine) is, for a white male in the U.K., very difficult to deal with. 

On the productivity question, published today: https://link.springer.com/article/10.1007/s10198-023-01653-z

Worth paying a bit of attention to the outlined study limitations: it's likely underrepresentative of the demographics hit hardest, and therefore an underestimate. But also illuminating is the statement about friction costing. It might suggest how someone in manufacturing, with still an ample supply of easily-replaceable workers, might be able to go through a whole year maintaining ignorance - whereas those of us in fields where few workers are easily replaceable are acutely aware of just how often this last year has seen services collapse.

It’s not going to be known.  Only really hospital admissions where you can guarantee a test. Not enough data to reliability report an estimate at population level.  I think it’s harder to tell this year as well, as it’s no longer a novel virus and for many the symptoms won’t be different to other respiratory infections.

But since all respiratory illnesses increases this time of year, you can expect cases will have increased. 

Ah yes I'd forgotten about that. Ha.

Just the opposite. I've many friends who faced poor response from a GP with such conditions. I just don't usually blame the GP when the advice they as GPs are given on dealing with such situations has been so crap and I recognise the pressure on time allocations can lead to some inappropriate behaviour. I've also known of several genuinely shit GPs (from those who worked with loads of them) and a lovely GP when I was a child scarily called Dr Paine (works better as a verbal joke).

This is true in part, but the level of gaslighting, aggressive behaviour and general unpleasantness is absolutely a cultural problem and intellectual failure that goes way beyond “we aren’t given enough information”. Every individual GP faces a choice over how to deal with such patients that is independent of being given poor advice. 
 

Worth pointing out that doctors with a very poor attitude to post-viral patients isn’t just a British thing, ie it’s not caused by the current NHS problems (even if it’s exacerbated by them). 
 

That’s simply giving fellow middle class professionals a degree of latitude that they don’t deserve. “I recognise that police officers are busy so they don’t investigate rapes” or “I recognise that police officers are busy so they stop a lot of black kids because it’s just easier” would be the equivalent in a rather more working class/lower middle class public service, except of course in situations where we know there is a structural problem. 

It's difficult to express how frustrating it is when you're literally years into a chronic illness and have had zero actual help from your GP. I'm  lucky that unlike many my GP has never gaslighted me, but that doesn't mean I haven't had to FIGHT to get them to consider non-COVID related causes of my symptoms.

November 2021 the Lancet reported on the overlap between many common long covid symptoms and perimenopause, and also that women under 50 (the average age of menopause in the UK is 51) are disproportionately susceptable to long covid.

https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(21)00228-3/...

It specifically states that "Failure to recognise this overlap misses an opportunity to treat many debilitating symptoms affecting both physical and mental health, but also to reduce some women's risk of cardiovascular disease, type 2 diabetes, osteoporosis, obesity and possibly dementia"

I first discussed perimenopause with my GP on November 2021 and have raised the subject several times with other GPs, all of whom have dismissed my concerns. As Sean says it's not the patients job to be researching two year old papers for recommendations on cheap and safe treatments that "may," offer substantial relief to our symptoms.

Is this a failure of the individual GPs to research new syndromes, or of the greater NHS for failing to update best practice and keep doctors informed of those changes? Well given that even the long covid clinic staff (supposed experts) were also vague and non committal about the impact of HRT on long covid symptoms for ladies of my age I suspect the latter, but it's still a critical failure for tens of thousands of British women.

I've a dad with GBS, a father in law peg fed and nearly immobile post strokes (home cared), various family members with various auto immune conditions, an ex lodger with ME and pals with Malaria, Denge, Lyme and long covid (a few for over a year). Few criticise most or all GPs despite the occasional disappointment on sevice levels and sometimes significant frustration. In the end it's a system failure arising from decades of underinvestment in public health and research (that would save money in treatment in the long run) and declining investment in primary and secondary care per capita weighted for numbers with medical conditions.

On woman's hour today training on the benefits of vaginal oestrogen being overbooked by primary care staff was a great example of what can happen when an easy safe solution is available to common medical problems. In the meantime, there is a growing crisis in primary care in particular in England with departures exceeding recruitment. Last year a BMJ survey reported 1/3 of GPs are looking to leave or retire in the next 5 years, including 2/3rds of the over 50s...so it may get worse very quickly.

As for women....aspects of their gender linked medical treatment has been dreadful for too long (more of that on woman's hour today!), as with pension treatment (waspie women in particular) professional pay gaps (even for those with no kids), percentages in senior positions... the list goes on and on. 

Speaking as someone with a close family memebr who has suffered from ME/CFS for over 30 years the sudden concern about long covid seems a little false.

Yes the ME/CFS community had been long overlooked and there are undoubtedly many parallels with LC.

Hopefully the demand for LC research will lead to improvements in the understanding of ME.

Or maybe an opportunity for sufferers?  It's generally seen to be post-viral isn't it?

Viruses do odd things.  One gave me asthma in my mid 30s for example.

So a sample of what, ten or fewer? Such a small sample size should lead to a low confidence in any conclusion you draw from it, no? A cynic might even call it anecdata… 

It's around 20 and obviously more than 10 from the list. I forgot I could add the same again from work casework. Enough to see GPs get blamed when they have genuinely done something wrong but usually they are just recognised as stuck in a faulty system. Where are all the new post viral condition consultants and their research grants? Where is the public health support? Why are GP numbers declining when population numbers are up and we are on average unhealthier than ever in recent times?

I'll still forgive you for your accusation of fellow professional nepotism as anyone genuinely suffering from poor practice from a well payed professional and can easily end up overblaming.

You’re also assuming that the people you’re talking to are telling you the full extent of their feelings about their healthcare experiences. My knowledge of people with chronic illness is that you probably shouldn’t assume this. 

I don’t deny all that and made clear that these are all serious problems; I’m saying that there’s an extra layer of bad behaviour on top of those problems. I’ve pointed out that you’ll hear similar complaints from these patients outside of the U.K. - how does you argument deal with that given other nations’ health systems are much better funded?

The NICE guidance I quoted above talks of “prejudice” towards patients by healthcare professionals. Prejudice by doctors against people who’ve got sick - surely there is something troubling there that goes beyond a lack of research or knowledge? One doesn’t need to have knowledge to treat patients with respect, yet this often doesn’t happen, at least according to the body tasked with providing guidelines for doctors. There are plenty of research papers that talk in similar terms, in contexts away from the NHS as well as within it.

Not nepotism, but rather extending a certain credulity to people who “look like us”, always the hardest people to see wrongdoing in. Remember that white, able bodied, middle class males have always, in our societies, been the last group to become aware of prejudice against others, and in fact have a history of downplaying or ignoring such behaviour.

As for your “oveblaming” comment - you have absolutely no idea of my experience in this regard, but you’ve always made your mind up as to what’s happened and where the problem lies. Almost literal proof of the point I made in the previous paragraph (as well as being patronising to boot). If this is your attitude I can assure you that the interlocutors from whom you draw your conclusions are absolutely holding something back. 

I've dealt with and heard of a few awful cases in my time and thought I was indicatiing you may be one of them and that's horrible if so. The overblaming point is when someone in that position is extrapolating such experiences to most GPs. Where is your evidence of that most GPs are doing this unprofessionally rather than through exhaustion or lack of time?

Im pretty sure there are analyses out there showing that the main issue with GP complaints is most people inquire after bad treatment but the majority of those don't formally submit a complaint (I'm pretty sure that was related to Citizens' Advice, from a friend who worked there). Another problem is the BMA are powerful and overprotective of those receiving complaints. Also, complaint data isn't easy to find over the Primary Care sector, another structural fault.

You only need to engage with the Long Covid community to realise that patients worldwide are being let down (and in many cases gaslighted) by medical professionals. I say worldwide, but this is very much a case in the UK as well.

I think it's fair to say that gaslighting patients is professional negligence, and whilst the UK is better than many countries in this respect, yes British NHS doctors are still gaslighting Long Covid patients.

The trouble with long covid is that aside from the organ damage and similar, there isn't any NHS recognised/approved treatment available to patients. A handful of NHS doctors are looking outside the box and supporting sufferers to experiment with treatments that have been shown elsewhere to have positive results, but most (including mine) aren't even open to discussing such things* never mind doing their own research.

* See my earlier post about accessing HRT

Personally I feel this is a failing of both the government and NHS, as given the number of LC patients (many of whom have been forced out of the workforce) I believe that the government should be pushing/supporting the NHS to ensure that GPs are getting guidance on how to actively support LC patients in their return to work. 

I think Sean sees things from a slightly different perspective, but my personal experience has been of neglect rather than negligence. "Yes you have long covid, what do you expect me to do about it? I'll order another set of bloods tests and give you a further months sick note." What we do share is a frustration that our lives are on hold, with no end in sight and negligible support from our healthcare providers.

My view is the neglect is at NHS system level and government: it's a national scandal. There are just too many long covid patients and not enough investment to be able to rely on most GPs (who are under growing pressure across the board) to be constructively 'going the extra mile'. Where is the extensive new research information and specialist support going to come from? In the NHS, most complex medical issues rely on referral to specialists, and although this was announced in 2020 for long covid there are still huge gaps (and my guess is those services that do exist will be very busy).

https://www.england.nhs.uk/coronavirus/post-covid-syndrome-long-covid/

My friends with long covid used self help groups which are worldwide, they mainly bypassed the NHS because they knew it just couldn't deliver (other than providing respectful sympathy and fit notes). 

I agree HRT services can be patchy (couldn't resist ) but other areas of NHS provision are plain terrible and some have been for years, notably children's mental health crisis services.

I agree gaslighting patients is a form of professional negligence. Patients should warn GP's if they are treated this way and if they continue a formal complaint should be made (Citizens Advice can help those who struggle to navigate the complaints system).