Senior doctors are braced for up to a million people needing treatment for long Covid after the pandemic, putting huge extra pressure on an already overstretched NHS, the Guardian can reveal.
Long Covid is a significant problem affecting huge numbers of patients that will confront the NHS for many years to come, one of the service’s expert advisers on the fast-emerging condition said.
Signs are already emerging that the health service is having trouble keeping up with the demand for care created by the sheer number of patients who are still displaying symptoms such as exhaustion, brain fog, chest pains and breathing problems months after having Covid.
Doctors fear that staff shortages, the need to tackle the big backlog of surgery that has built up, and existing strain on lung and heart services will limit the care that the NHS can provide.
The boss of the hospital that set up the NHS’s first specialist clinic for long Covid admitted that it was struggling to give patients the speedy and high-quality help they needed. The head of the Royal College of GPs voiced concern that sufferers were facing long waits to get seen.
Prof Helen Stokes-Lampard, the chair of the Academy of Medical Royal Colleges, which professionally represents the UK’s 240,000 doctors, said: “The NHS knows this is a problem. It’s very concerned about this. Long Covid is going to be a very substantial new burden on the NHS. It’s working hard and setting up clinics. But there will be huge numbers of these cases and it’s clearly going to be dealing with this for years, absolutely for years.
“It’s going to be the next challenge that the NHS has to deal with whilst … recovering from the pandemic and whilst desperately trying to deal with the backlog [of diagnostic tests and surgery], with staff that are exhausted.
“People [in the NHS] are very fearful about how they’re going to be able to deliver [the care that long Covid patients need]. It’s going to be a bumpy ride.”
Stokes-Lampard is also a member of the taskforce that NHS England has set up to help it respond to long Covid.
The evidence so far shows that 20% of people who have had Covid still have some symptoms of it after four weeks and that 10% are still debilitated by it – sometimes very badly – after 12 weeks. While people who were ventilated in intensive care over the last year are the worst affected, some of those who never went to hospital are also having lingering symptoms.
One of Britain’s leading doctors, speaking on condition of anonymity, said: “Although officially about 4 million people have had Covid, in reality it’s about 8 million or 9 million. If 10% of those people have got something, then it could be almost a million people, and that’s enormous.”
Prof Martin Marshall, chair of the Royal College of GPs, said: “Right now there’s a lot of people in every GP practice that have got long Covid and who will develop long Covid. GPs are seeing growing numbers of people with post-Covid symptoms.” While about 300,000 people in the UK are thought to have long Covid, that is likely to rise, given the severity of the pandemic’s second wave, he said.
Some of the 40-50 patients with long Covid at his own practice in east London have been struggling to get an appointment at the first specialist clinic at University College London hospital, he said.
Prof Marcel Levi, UCLH’s chief executive, said: “It is fair to say that we are struggling to meet the demand of this patient group. We have a clear vision of the ideal pathway we would like to deliver. At the moment, we only have some of the components of that pathway in place, and it is something that needs rapid resource and focus to fill in the gaps.”
UCLH’s service, which opened in May, has already seen more than 1,300 patients. It expects about 1,000 new cases to present in the coming weeks. Access is restricted because of “workforce and resource constraints” and the team’s “significant backlog of other activity”, said Dr Melissa Heightman, the respiratory consultant who runs the clinic.
Stokes-Lampard and Marshall said that while NHS England’s creation of more than 60 specialist long Covid clinics was a good start, it would have to expand the care that was available.
Doctors are also worried that it is not yet clear how the NHS will be able to successfully treat those with long Covid, given its sheer array of symptoms and ongoing emergence as a condition.
Stokes-Lampard said: “It’s incredible that the NHS has set up and got going a network of new services in recent months. But the problem is that the services at the moment are only set up to assess people; there is no treatment known. It’s kind of still hitting a dead end because we don’t yet know how best to treat people. So we’re in a difficult situation as healthcare professionals.
“The diagnosis [of long Covid] is only part of the journey. It’s all about treatment and cure and actually we haven’t got many treatments and we haven’t got many cures. That is a concern.”
Long Covid poses a serious challenge for doctors to diagnose because so many of its symptoms, such as fatigue and pain, are also symptoms of so many other ailments, said Marshall.
Prof Andrew Goddard, president of the Royal College of Physicians, said: “It seems very likely that long Covid will place significant demands on the NHS moving forwards and given that many patients with long Covid did not get hospitalised and/or were relatively young, it shows the importance of vaccinating as much of the adult population as possible.”
NHS England said it planned to expand long Covid services this year and was still exploring what treatments worked best.
An NHS spokesperson said: “Long Covid is still a new condition, but dozens of NHS clinics across the country are rising to the challenge of understanding and treating it, bringing together expert clinicians to provide comprehensive assessments for thousands of patients, with more set to open over the coming months.
“We expect that there will need to be a substantial further expansion in support for long Covid patients during 2021. Covid and its long-term consequences are entirely new, but – through our network of clinics – the NHS is carrying out research and sharing learning about how best to treat and rehabilitate patients experiencing ongoing debilitating symptoms.”