24 ANALYSIS
Primary care nursing ’ s ‘ huge role ’ in long Covid
Nurses have an important role in supporting patients with long Covid and can use their existing knowledge and skills in relation to long-term conditions to help individuals with this new condition , reports Kathy Oxtoby
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urses in primary care are currently facing unprecedented pressures : coping with the pandemic , dealing with a backlog of care , supporting the Covid booster and flu vaccination programmes , and struggling with staff shortages . On top of this comes the growing number of patients presenting with long Covid .
The addition of this new and complex condition to existing workload pressures amounts to ‘ a perfect storm – and it ’ s going to come and hit us ’, warns Dr Elaine Maxwell , nurse academic , former scientific advisor to the National Institute for Health Research . Dr Maxwell is the author of the NIHR ’ s ongoing long Covid review , 1 and trustee of patient advocacy group Long Covid Support .
The Office for National Statistics ( ONS ) estimates that , as of the start of October , 1.2 million people in the UK were experiencing long Covid symptoms 2 – an increase of 100,000 on its September figure .
Despite the pressures , nurses working in general practice and the community have a ‘ huge role ’ to play in supporting patients with long Covid , Dr Maxwell says . ‘ These nurses have a lot of experience in managing long-term conditions . This is exactly where nurses excel .’ And she believes these skills and knowledge can be transferred to help people with long Covid manage this multisystem condition .
Understanding long Covid
Because long Covid is a new condition , understanding of its symptoms and impact on individuals is evolving .
NICE ’ s rapid guideline , 3 published last December , divides it into ‘ ongoing symptomatic Covid-19 ’ with symptoms lasting from four to 12 weeks , and ‘ post Covid-19 syndrome ’, where symptoms continue beyond 12 weeks .
The NHS advises that common long Covid symptoms currently include : fatigue , shortness of breath , chest pain , problems with memory and concentration , insomnia , heart palpitations , joint pain , depression and stomach ache 4 ( see box , page 24 ).
Initially seen as an adult condition , it is now clear children can also have long Covid . The Children and Young People with Long Covid ( CLoCk ) study , a large study of children and young people who caught Covid-19 , has found that up to 14 % may still have symptoms 15 weeks later . 5
And worryingly for workforce pressures , the prevalence of self-reported long Covid is greatest among those working in health or social care compared with other industries , according to ONS data published this September . 2
As for its impact , long Covid can be ‘ very debilitating and some people need help with personal care months after the initial infection ’, according to NIHR ’ s second review on living with Covid-19 . 1
Not surprisingly , nurses say long Covid is having an impact on the workload of staff in general practice and the community . Practitioners have told Nursing in Practice they are seeing more and more patients with enduring symptoms and multiple health conditions .
There is also a great deal that remains unknown , nurses say , pointing in particular to the absence of a clear definition of what long Covid actually is . ‘ I ’ ve had a few patients who sound like they have long Covid from the symptoms , but without a clear definition it is still vague and open to interpretation ,’ says Jenny Aston , an ANP for Granta Medical Practices in Cambridge .
Long Covid can be managed in specialist clinics , where available . But the pathway lacks the resources to support the hundreds of thousands struggling with symptoms – an issue highlighted this September at a Commons Health and Social Care Committee inquiry into the backlog caused by the pandemic . 6 Relatively few patients are managed in long Covid clinics – between 5 July and 1 August , just 5,737 referrals were made , according to a report in the Independent . 7
Adding long Covid to existing pressures amounts to a perfect storm – and it ’ s going to come and hit us
SCIENCE PHOTO LIBRARY nursinginpractice . com Winter 2021