Vaughan Gething, Minister for Health and Social Services
This Written Statement provides an update on action in Wales to support people experiencing longer term effects of COVID 19.
COVID-19 infection is now a global topic of research, and as the pandemic continues, we are understanding more about the disease process and its longer term impact on patient health. Whilst initially it was thought that symptoms could last a few weeks and, once they subsided, the individual could return to their previous lifestyle, it is now becoming apparent that some people experience much longer term effects.
NHS Wales has developed and launched a Covid Recovery app with advice, tips and actions for patients to carry out themselves, in order to manage their own recovery. This app is free to download. https://gov.wales/recovery-app-launched-wales-help-support-people-long-covid
Increasing evidence and testimony from people’s experiences shows that a small, but significant number of people who contract COVID-19 are slow to recover from the effects of the virus, often months after initially falling ill. Some estimates suggest that approximately 1 in 5 people affected by COVID-19 may still experience different groups of symptoms more than three weeks after infection; and 1 in 10 people could still be affected at three months, or longer, after initial infection.
The National Institute for Health and Care Excellence (NICE) has developed a clinical guideline, published on 18 December 2020 https://www.nice.org.uk/guidance/NG188
This guideline covers identifying, assessing and managing the long-term effects of COVID-19, often described as ‘long COVID’. It makes recommendations about care in all healthcare settings for adults, children and young people who have new or ongoing symptoms four weeks or more after the start of acute COVID-19.
NICE uses the following clinical definitions for the initial illness and long COVID at different times:
- Acute COVID-19: signs and symptoms of COVID-19 for up to four weeks.
- Ongoing symptomatic COVID-19: signs and symptoms of COVID-19 from four to 12 weeks.
- Post-COVID-19 syndrome: signs and symptoms that develop during or after an infection consistent with COVID-19, continue for more than 12 weeks and are not explained by an alternative diagnosis.
The profile of symptom range and severity for post COVID-19 syndrome - that is 12 weeks or longer - is not yet fully understood. However, the evidence does suggest that people are experiencing significant medium and long-term effects which are diverse in nature, and can affect any system in the body. Some of the most common things people describe are fatigue, feeling breathless, mood changes, brain fog and sensory changes. Some people may need help to return to everyday activities.
In line with our vision in A Healthier Wales, our approach is founded on avoiding harm, promoting and supporting self management and value based, seamless care from the right health professionals or service, at or as close to home as possible and agreeing care tailored to each person’s specific needs.
Using latest evidence, each health board is bringing together its GP practices and multi professional community services to put systems in place, making best use of the expertise of different health professionals and other resources, such as the new NHS Wales Covid Recovery app, to identify, assess and support people in their recovery. Some people with severe effects may need more specialist advice provided in acute hospital settings.
While services and access to these may be organised and communicated according to local needs and circumstances, the Welsh Government and NHS Wales have collaborated on an all Wales Community Pathway for post COVID syndrome to help ensure a consistent approach across all health boards in line with A Healthier Wales.
The skills of our Allied Health Professions and self care support for people so they can manage their own recovery is core to our approach. To help inform the local response to post COVID syndrome, we have updated our National Rehabilitation Framework and population specific planning guidance and patient scenarios, in light of NICE clinical guidelines and other research.
Health Education and Improvement Wales has developed a digital platform to create a single ‘landing page’ enabling easy access to a wide range of resources to support health and care professionals as they provide help and advice to people managing their recovery.
Health and Care Research Wales is creating a Wales COVID-19 Evidence Centre to analyse the impact of coronavirus and use research-based evidence to address new challenges as a result of the global pandemic. The dedicated team at the new Evidence Centre will work closely with the Welsh Government, the NHS and social care in Wales to provide the necessary evidence needed to make effective decisions to support people with their recovery.
As well as research, my officials will be engaging with patient support groups to hear their experiences at first hand, to discuss our approach in Wales and identify what further action is needed.
We will continue to adapt our response as we learn more.