COVID-19 FEATURE
But while some Scottish COVID-19 treatment pathways and dedicated services have been developed , they are not universally available nor supported with additional funding . As a result , many health professionals and people with Long COVID appear unaware of what services are available .
Anecdotal evidence suggests that referrals for Long COVID rehabilitation in several Scottish health boards are lower than anticipated .
What can be done ? UK-wide guidelines on managing the long-term effects of COVID-19 recommend that multidisciplinary rehabilitation teams should support people ’ s recovery ( SIGN 2020 ). But rehabilitation services have often been perceived as neglected and sometimes disjointed .
Long COVID has highlighted some of the limitations of these preexisting systems . The latest Scottish government figures estimate that between 46,000 ( 0.7 per cent of the population ) and 110,000 ( 1.9 per cent ) people were estimated to experience Long COVID in Scotland .
Even if only a small proportion of these people were referred to existing rehabilitation services as currently funded , these services would quickly become overwhelmed . Additional funding is required to support the foreseeable surge in demand and the training required to upskill staff .
The jury is out as to whether specialist clinics or integration within existing services will prove to be most effective for people requiring Long COVID rehabilitation . But , as has been argued elsewhere : ‘ In the face of a pandemic the search for perfect evidence may be the enemy of good policy ’ ( Greenhalgh et al 2020 ).
In other words , in situations such as this , it is best not to wait for the highest levels of evidence about ‘ what works ’ before intervening – especially in cases such as Long COVID where some forms of rehabilitation already exist for people who present with similar symptoms .
This approach is known as the ‘ precautionary principle ’. In these circumstances , research – which remains essential – and practice best proceed hand in hand .
It is time for Scotland to embrace the precautionary principle in Long COVID rehabilitation and act – even without definitive evidence of what is best . Investment to scale up and publicise existing specialist and integrated Long COVID rehabilitation would enable people to receive much-needed help and support .
Researchers like us – working in close collaboration with health and social care services and people living with Long COVID – are well placed to evaluate these different forms of rehabilitation as they are made available , and we can develop and recommend how best to implement these services as they emerge .
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References
Duncan E , Cooper K , Cowie J et al . ( 2021 ) A national survey of community rehabilitation service provision for people with long Covid in Scotland [ version 2 ; peer review : 2 approved ]. F1000Research 2021 , 9:1416 . DOI :
https :// doi . org / 10.12688 / f1000research . 27894.2
Greenhalgh T , Schmid MB , Czypionka T , Bassler D , Gruer L ( 2020 ) Face masks for the public during the covid-19 crisis . BMJ 2020 ; 369 : m1435 DOI : 10.1136 / bmj . m1435
Scottish Intercollegiate Guidelines Network ( SIGN ) ( 2020 ) Managing the long-term effects of COVID-19 . Edinburgh : SIGN . ( SIGN publication no . 161 ). [ December 2020 ]. Available online at :
http :// www . sign . ac . uk . [ accessed 2 August 2021 ]
Edward Duncan , professor of applied health research , University of Stirling , Jenny Preston , honorary associate professor , Nursing , Midwifery and Allied Health Professionals Research Unit , University of Stirling , and Kay Cooper , clinical professor allied health professions , Robert Gordon University
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