As of 2 August 2021, in England there have been over 5.9 million cases of acute COVID-19 infection, and over 130 000 deaths.1 The Office for National Statistics (ONS) estimate that 962 000 people in England are experiencing long COVID symptoms at least 4 weeks post-infection, with almost a fifth reporting ‘a lot’ of day-to-day limitation2 — although there is uncertainty about the accuracy of these estimates.3 In addition to the health burden, there is potential for significant socioeconomic harm due to the increased prevalence among the working age population and those from deprived areas.2 Here, we look at the English health system’s response to date, and the challenges ahead.
PROGRESS TO DATE
In late 2020, a five-part package was announced by NHS England to support patients with long COVID:4
A rapid guideline was produced by a collaboration involving the National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guideline Network (SIGN), and Royal College of General Practitioners (RCGP).5 Strengths included a clear case definition: ‘ongoing symptomatic COVID-19’ (signs and symptoms 4–12 weeks post-infection), ‘post-COVID-19 syndrome’ (beyond 12 weeks), and ‘long COVID’ (umbrella term); and a review of patient experiences.
Multidisciplinary post-COVID-19 assessment clinics were established in each Integrated Care System (ICS), supported by a national £34 million investment.6
Self-management was thought to be appropriate for 30%–50% of patients7 leading to the launch of an interactive rehabilitation platform — ‘Your COVID Recovery’.8
The National Institute for Health Research published two comprehensive themed reviews on long COVID9 and jointly commissioned £18.5 million worth of new research to fill the identified evidence gap10 with studies on: mechanisms, patient pathways, and treatments for long COVID; as well as characterisation of long COVID in children and young people.
A Long COVID Taskforce was …
