Long COVID Information Guide

Long COVID Information

There is still very limited information and research available for those people who live with long COVID. Diagnosis of long COVID can be difficult in the absence of antibody testing and even when this is available, a negative result can leave individuals in limbo and without any diagnosis.

We recognise that we have colleagues who are sadly living with long COVID so we have created this information pack to support you and to provide you with some useful exercises and resources.

There appears to be a stigma attached to long COVID still and not all colleagues want to speak openly about their experience, which is why we are keen to provide a robust package of support. It is important that colleagues with long COVID feel able to speak about their experiences and that we all take the time to learn about this new condition.

Many staff are reporting that prior to becoming unwell with long COVID they never had any absence from work for sickness reasons and as a result feel too guilty to ask for rest time and request flexible working. Many managers are unaware or not fully sighted on the long COVID condition and how it presents itself. It doesn’t help that the symptoms can differ from person to person and day to day.

What is long COVID?

For some people, COVID-19 can cause symptoms that last weeks or months after the infection has gone. This is sometimes called” long Covid” or “post-COVID syndrome”.

Recovery from COVID-19 may take time. The length of time needed will vary from person to person. Many people feel better in a few days or weeks and most will make a full recovery within 12 weeks. But for some people, symptoms can last much longer. It is important not to compare yourself to others.

Long Covid symptoms could include:

= Extreme tiredness (fatigue) and lack of energy = Problems with memory and concentration (“brain fog”)

= Shortness of breath and chest pains = Difficulty sleeping (insomnia) and nightmares

= Muscle weakness, joint stiffness

Pins and needles in hands and feet = Loss of appetite, weight loss and swallowing difficulties

= A persistent cough and headache =

Changes in mood, or anxiety or depression

This leaflet gives some helpful techniques to manage some of your symptoms as well as further support.

Positions to ease breathlessness

Following COVID-19 you may find you have continued breathlessness. You should monitor this and if it gets worse seek further review from your GP or NHS111. These positions can help ease your breathlessness and can be used when resting or when mobilising.

Exercises to help to manage your breathing

Breathing exercises can help you manage your breathlessness and reduce its impact on your everyday activities.

Breathing control

• Take a slow breath in through your nose

• Try to relax your shoulders and neck

• Allow the air to fill up from the bottom of your lungs to the top of your chest

• Breathe gently out through pursed lips (as if you were going to make a candle flicker) to create space for the next breath in

Breathing control while walking

This will help you walk on the flat, climb stairs and negotiate slopes. Try to keep your shoulders and upper chest relaxed and use your breathing control. Time your breathing with your stepping.

• Breathe in - 1 step

• Breathe out - 1 or 2 steps

Keep cool

Make sure you have good air circulation in the room by opening a window or door. Use a wet flannel to cool the area around your nose and mouth. This can help reduce the sensation of breathlessness.

Managing your cough

A dry cough is one of the most commonly reported symptoms for COVID-19 however in some cases it may be productive of phlegm (chesty).

Dealing with a dry cough

• Stay well hydrated

• Sipping a soft drink - take small sips, one after the other, avoid taking large sips

• Steam inhalation - pour hot water into a bowl and put your head over the bowl. If comfortable, cover your head and bowl with a towel. Do not use boiling water with small children to avoid the risk of scolding

• Drink warm honey and lemon or another warm drink - this can help to soothe the throat

• If you do not have a drink to hand, but need to cough, try swallowing repeatedly. This can work in a similar way to sipping water

Dealing with a productive (wet or chesty) cough

• Keep well hydrated

• Steam inhalation

• Try lying on either side, as flat as you can. This can help drain the phlegm

• Try moving around; this will help to move the phlegm so that you can cough it out

Exercises to help clear your chest

Following COVID-19 you may find that you have a cough and phlegm on your chest. These exercises and positions can help clear your chest and may be recommended by your physiotherapist or nurse.

Active Cycle of Breathing Technique (ACBT) exercise consists of three breathing exercises that together help to clear your chest.

Breathing Control

• Breathe in and out gently through your nose if possible

• Try to make the breaths slower

• Take as long as you need for your breathing to become comfortable

Deep breathing

• Take a slow breath in through your nose if you can

• Try to hold your breath for 2-3 seconds before you breathe out

• Breathe out gently, like a sigh

• Don’t exceed 3 -5 deep breaths in a row as it may make you feel light - headed or dizzy

• Return to breathing control

Small-Long Huff

This huff is to move phlegm from lower down in your chest to higher up. Take a medium breath in and then huff out through an open mouth as though you’re trying to mist up a mirror.

Big-Short Huff

This huff is to move phlegm from higher up in your lungs.

Take a deep breath in and then huff out quickly. This should clear your phlegm without needing to cough.

If huffing doesn’t clear your phlegm, then you may need to cough. Avoid long coughing fits as they can be tiring, give you a sore throat and make you feel breathless.

Clearing your chest should be done regularly. You may only need to do it once or twice a day. If you’re producing more phlegm, you may need shorter but more frequent sessions.

Remember to drink plenty of fluids - this will make it easier to cough up the phlegm

Exercises to help with concentration

It’s not yet known if the concentration problems associated with long COVID, are down to fatigue, depression or memory problems. However the treatment would be the same and that is to build up your concentration slowly over a period of time.

Measure your current level of concentration, for example how long in minutes can you watch the TV or how many pages of a book can you read? Build on this baseline day-by-day. Set a timer; if your baseline was watching TV with full concentration for five minutes (or reading one page of a book) then do this on day one and on day two watch six minutes of TV (stop when the timer goes off) or read one and a half pages of the book. Build up by a minute or half a page a day. Always stop when you have met that days target, and if you struggle, keep the same target for a number of day’s. Work towards 45 minutes of TV or a chapter of your book.

To maintain your memory

Cognitive Stimulation is key to maintaining memory. You need to be as socially active as you can be; virtually or face-to-face - group conversations make your brain work harder). You need to be as physically active as you can be; short walks, even if it is to the end of the drive and back will help stimulate your brain. You also need to be as mentally active as you can be; puzzles, crosswords, sudoku, TV quizzes. All these things help stimulate your memory pathways.

One of the best things you can do is learn a new task. We do a lot of daily tasks on automatic pilot and therefore our memory pathways aren’t challenged. Try and do something every day that you have to think about that you can’t do on autopilot. For example learn to play an instrument, speak a new language, learn to knit, follow a difficult recipe. The task doesn’t matter, as long as it requires our full attention to do it.

Memory joggers

We all need a helping hand with our memory every now and again and simple techniques such as using a calendar, setting an alarm, writing in a diary, making a list can be essential in reminding us what needs doing.

The Recovery Phase

As you recover from COVID-19 you might be experiencing symptoms such as fatigue and breathlessness or changes in your mood and thinking. These symptoms are common after a serious illness, especially if you have received hospital treatment. You might find that these symptoms affect your ability to complete everyday activities, such as getting washed and dressed, and doing tasks around the home. Activities that are usually simple might seem like hard work, and you may feel that you have less energy than usual. Try following the 3 P’s Principle - Pace, Plan and Prioritise - to conserve your energy when going about your daily activities.

Pace

• Give yourself permission to slow down. Don’t expect to be able to do everything at once, or at the pace you used to do. Do less than you think you can.

• Break activities into smaller tasks and spread them throughout the day. You’ll recover faster if you work on a task until you are tired, rather than completely exhausted.

• Build rests into your tasks and plan 30-40 minutes of rest breaks between activities. Resting is key to recharging your energy.

Plan

• Look at the activities you normally do on a daily and weekly basis; develop a plan to spread these evenly across the week.

• Think about which activities you find most tiring and make sure you spread these out, with plenty of time to rest in between.

• Don’t try to complete several activities all in one go. This will drain your energy, and you will need more time to recover afterwards.

• If you find that your energy is lower or concentrating is harder at certain times of day, plan to avoid tiring activities at these times.

• Think about ways you can do activities differently to make it easier and less tiring. For example, you could sit down during tasks like washing and getting dressed. Rather than lifting and carrying items when cooking, try pushing and sliding them across the work surface instead.

• Rearrange rooms like the kitchen so the items you use most are easy to reach.

Prioritise

• Some daily activities are necessary but others aren’t. There might be some tasks that you usually do that you can stop altogether, do less often or ask someone else to do for you.

• When prioritising activities make sure you have a balance of things you need to do, like washing and dressing and things you want to do for fun and enjoyment.

• Start the day by asking:

Relaxation techniques

Relaxation is an important part of energy conservation. It can also help you to control your anxiety, improve the quality of your life and reduce pain and discomfort. Below are two relaxation techniques you can use to manage anxiety and help you relax.

Grounding techniques for when you feel anxious

Take a few slow breaths and ask yourself:

• What are five things I can see?

• What are four things I can feel?

• What are three things I can hear?

• What are two things I can smell?

• What is one thing I can taste?

Think of these answers to yourself slowly, one sense at a time spending at least 10 seconds focusing on each sense.

Picture yourself somewhere calm

Think of somewhere relaxing and peaceful. It could be a memory of somewhere you’ve been or a

What do I need to do; what do I want to do today?

What can I put off until another day?

What can I ask someone else to do for me?

made up place. Close your eyes, and think about the details of this place.

What does it look like:

• What colour and shapes can you see?

• Can you hear any sounds?

• Is it warm or cool?

• What does the ground feel like?

Spend some time imagining each of these.

Support for colleagues and managers

Long COVID-19 Support Group

The purpose of the forum is to provide peer-to-peer support, listening as well as identifying what more we can do for our colleagues. This forum is a place where colleagues can talk to someone who’s been through it and can relate to what they may be experiencing. If you are keen to be involved please contact sath.ahealthieryou@nhs.net.

Optima Health

Optima Health provide individuals and managers with advice, guidance and recommendations on physical and mental health concerns following a management referral and employee consultation, sometimes involving other Healthcare professionals. Management referrals are made via the Occupational Health portal. Telephone: 01327 810777 Email: team1@optimahealth.co.uk.

Supporting your recovery after COVID-19

https://www.yourcovidrecovery.nhs.uk/

Long COVID Clinic

Shropcom have set up a long Covid Clinic to support individuals who are suffering with long COVID symptoms. Individuals are assessed and then referred to rehabilitation teams for advice on respiratory, fatigue and mental health issues. The service is happy to see members of staff who have symptoms for 12 weeks or more and should contact their GP who can refer into the service.

People Advisory Team

If you need to speak to a member of the People Advisory Team we are available on 01952 641 222 ext 2891 (Monday to Friday 9am until 5pm). Mobile numbers for the HR Advisory Team are available on the Intranet Phone book (please take into consideration that our team work a variety of work patterns and may not respond immediately to your call). Email: sath.hradvice@nhs.net

Health and Wellbeing Support Pack Managers Resources

Further information and resources on topics such as flexible working, COVID home working and managing attendance and wellbeing can be found in Corporate Projects: X:/Workforce/ManagersResources

If you do not have access to this folder, please email sath.hradvice@nhs.net.