Several weeks after Covid-19 first raised its ugly head, some people who had contracted the virus were finding that they were not getting better – some were getting worse. Now, several months later, numerous and increasing reports of what is typically referred to as long or chronic Covid detail instances of patients left with an overwhelming plethora of highly debilitating physical symptoms. Stories abound of previously super fit marathon runners finding that walking up the stairs takes every last drop of energy, whilst everyday tasks that were previously taken for granted result in prolonged enforced bedrest. And yet, many of these patients are being told by medical professionals that they are actually suffering from anxiety, or depression, or deconditioning, or perhaps all of these things. Some (mainly women) are told they are falling prey to mass hysteria. Some are offered psychotropic drugs, others are told to exercise, still others are told to go away and get a grip.
Why is this happening? Most people will be familiar with this as a dynamic of medical gaslighting, but less is written about what might be underpinning such systematic dismissal, minimisation and psychologisation of patients’ concerns. In this series of blogposts, I list and discuss factors which I believe are contributing to the current lack of care for Long Covid patients in the NHS. It goes without saying that chronic under-funding of the NHS is a significant factor, but I believe there are issues beyond this which relate to structural incompatibility of the NHS with chronic illness healthcare. These factors are equally pertinent to many other chronic illnesses, particularly medically contested illnesses such as ME/CFS (myalgic encephalomyelitis / chronic fatigue syndrome), fibromyalgia and chronic Lyme disease.
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