Thousands of Scots are thought to be experiencing so-called Long Covid with no prospect of treatment – with one GP describing the situation as a “slow motion car crash."
An investigation by BBC Scotland found that none of Scotland's 14 health boards currently offer dedicated Long Covid clinics, despite calls to follow NHS England’s £10m pledge for such facilities.
Estimates suggest as many as 6,000 people in Scotland could develop the condition – though experts are wary of the lack of data available and warn it is too early to accurately track the condition.
Amy Small, a GP in Edinburgh who has experienced symptoms for seven months, has reiterated calls to launch multi-disciplinary clinics.
She is now on medication that has helped her feel better in the last few weeks, has taken on the role of locum GP and is easing herself back into work.
She told BBC Scotland: “Seeing the second wave develop is a bit like watching a car crash in slow motion.
“We’ve seen in England they’ve had £10m put into the development of Long Covid clinics which we haven’t yet seen here in Scotland.
"GPs are getting frustrated because they’re seeing people with lots of different symptoms – breathlessness headaches, dizziness. People need to have a one-stop shop.”
Dr Alasdair Forbes, deputy chair of policy at the Royal College of General Practitioners Scotland, said: “We don’t have any guidelines published as yet and we do not have structured services.
“There is hope that many people will get better in time however there will be people who will need more specialist input.
“I would not be surprised that in the future we have specific clinics set up for this because if the number of cases keeps rising, there are going to be many many hundreds of people who are going to have Long Covid.”
Doctors who recently defined the condition as Post-Covid Syndrome have promised new treatment guidelines by the end of the year, but so far Scotland’s health boards have been using existing services such as physiotherapy - with only two working on long-term strategies for Post Covid Syndrome.
In NHS Greater Glasgow and Clyde, research studies are being carried out on patients with Long Covid at the Glasgow Clinical Research Facility to establish the main issues that affect them.
Meanwhile, NHS Lanarkshire’s occupational therapy service is trialling a new model of primary care where staff help patients to manage their symptoms at an earlier stage.
NHS Fife told the BBC it was “working through” recommendations from a report from Dr Nadine Cossette to the Scottish government in October.
Among several recommendations, Dr Cossette called for the “strengthening” of multidisciplinary Covid rehab teams with “a single point of access”.
NHS Tayside launched a rehab phone service in July for adults with on-going symptoms.
The remaining 10 health boards rely on existing pathways through the health service – namely community rehab, GP support and web advice.
Last month King’s College London published data on Long Covid which was collected through an app – researchers had identified risk factors including excess weight, old age, being female and having many different symptoms at the outset.
The data suggested that 60,000 people in the UK would go on to experience Covid symptoms for three months or more – a broad calculation based on population means this figure in Scotland is up to 6,000.
Microbiologist Prof Tom Evans, part of the team in Scotland working on the UK-wide guidelines, said the data is not yet reliable.
He said: “The data is not that great. Those who are still suffering symptoms after three months is roughly about 2% of respondents – but that is only an estimate and we’re very keen to explore those who are probably under-represented in those surveys, particularly older people, those from different ethnic groups and also from deprived communities.”
A Scottish Government spokesperson said: ‘On 5th October the Chief Scientist Office launched a call for Scottish-led research into Long Covid to help us better understand the longer term effects of COVID-19 infection on physical and mental health and wellbeing in Scotland, and/or research with the aim of developing effective clinical interventions to support recovery and rehabilitation from COVID-19 infection.
‘This is in addition to the £5m we recently awarded to 15 Scottish research institutions to better understand the effects of infection and inform treatment and management of the virus.
‘We are already taking action to support those experiencing the longer physical and mental health impacts of COVID and recognise that rehabilitation, clinical input and research are all critical to understanding and supporting recovery.
‘Our NHS Research Scotland infrastructure funding supports Scottish participation in the key large UK-wide COVID-19 platform studies. This includes the Post-hospitalisation COVID-19 study (PHOSP-COVID) that is looking at how different patients recover from COVID-19 following hospitalisation for the illness.
‘We have also published a Framework for supporting people through Recovery and Rehabilitation during and after the COVID-19 Pandemic, which puts in place clear principles, priorities and objectives to support planning to meet increasing demand and to provide high quality person-centred rehabilitation in different settings.’
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