Hundreds seek treatment for long Covid at specialised clinics

By Tara O’Connor, local democracy reporter

Hundreds of Londoners are suffering the after effects of coronavirus and are seeking treatment at long Covid clinics set up across the capital.

In Croydon alone, more than 600 people are being seen with at least another 600 waiting or expected to come forward for appointments.

Dr Yogini Raste is a consultant respiratory doctor who has looked after some of the sickest Covid patients at Croydon University Hospital.

General medical and respiratory wards were converted into Covid wards – during the worst phase of the pandemic and there were three extra wards to deal with an influx of patients.

She has been involved in a long Covid clinic at the hospital. There are now more than 60 of them across the country and at least 10 in London alone.

Dr Raste says that even patients who had mild coronavirus symptoms can be hit with long-lasting effects.

The 43-year-old said: “Some people make a full recovery, even if they’ve been in intensive care, then others have ongoing breathlessness and fatigue several weeks after.

“Some patients have been really debilitated by these symptoms for months.”

The patients are treated with graduated physiotherapy exercises and offered psychological support as some are suffering from PTSD and depression.

“We have a really good rehab service as part of our post Covid outpatients, we had to get this service up and running from scratch,” she said.

“We had seen post viral syndrome before but quite rarely.”

She thinks that one in 10 people with the virus are suffering with the after effects of Covid-19 for weeks or months.

“We didn’t envisage that, and the frustrating thing is we don’t know what is driving it so can’t offer treatments,” said the consultant.

“It is about symptom management so they can get through the day.”

‘Come forward for treatment’

Dr Raste, who has been a doctor for 20 years, is also concerned that people have not been visiting their doctors with serious health conditions throughout the pandemic.

“We are experiencing an increase in lung cancer referrals with people deferring coming into hospital and when they do come they are sicker,” she said.

“In the lull over the summer we saw cancer patients presenting much later and quite a few tuberculosis patients who came in.

“In general tuberculosis is falling, we do get the odd case but the severity and the number of patients has been higher.

“It worries me, it shows that people are worried about coming to hospital. The message is still that the NHS is for everybody, we will make maximum efforts to keep them away from Covid zones.”

To keep non-Covid patients safe, Croydon University Hospital created a ‘hospital within a hospital’ in the elective centre, meaning those coming in for planned care are treated in a protected area away from coronavirus patients.

Locals are being advised to talk to their GP or call NHS 111 when they feel unwell and not wait until it gets worse.

‘It’s been like five years in one’

This year has been incredibly challenging for NHS staff and Dr Raste says the second wave of the pandemic has been more intense.

There are still around 100 Covid patients in the hospital and she thinks it will be another month until the hospital begins to get back to normal service.

“I clearly remember when we got the first confirmed positive case in Croydon, it was in a care home,” she said, “that was in mid-march, that made me realise that the patient had got infected by somebody who had gone into the care home so it was in the community.

“That was a scary moment, it made me realise that the number of cases was going to be huge. From there it ramped up really quickly, within a few weeks we were full.

“It was terrible, we felt helpless because we didn’t have much in the way of treatments, we didn’t have time to draw breath before we’d get another patient who would become sick. It was really harrowing for everyone.

“When we came through April and May we didn’t think we could sum up all our strength to do that again.”

When the hospital was thrown into that position again at the end of 2020, Dr Raste says they were more confident at looking after Covid patients and they had more treatments at hand.

“We were not prepared to see those numbers again, patients felt a bit younger and there has been more pressure for a longer period of time,” she said.

Dr Raste was instrumental in putting in place new ways of dealing with coronavirus patients in the second wave of the pandemic.

This included more use of continuous positive airway pressure (CPAP) machines which is a non-invasive way of giving patients oxygen through a mask. It means that patients do not have to be admitted to intensive care.

Like many doctors, the mum of three had to cancel time off and work extra shifts this year.

She added: “I’ve learnt a lot about myself, being resilient, being strong in the face of something that is completely unknown.