Hierarchy of Covid Needs

Someone asked me if I had tried anti-virals for long covid yet.

And I just laughed like a banshee on PCP.

If you are person with a lot of medical issues, long covid may not even be your biggest problem.

If you are a parent with long covid who has children with health issues and long covid, you don't come first.

In any given family, there are only so many resources for doctor's appointments. Only so much time available to go to the doctor. Only so much money.  And very high deductibles and soooo very many other competing priorities.

Forget money, forget insurance, just time is problem. In a family with a lot of medical issues and long covid, there's no time to help everyone. Someone has to sit it out. This is a hidden problem when it comes to the aftermath of covid. I can't be the only parent taking the backseat on this.

Also, because we don't know what we're doing with long covid, we're locking what treatment we do have away in these tiny long haul covid clinics who are all doing their own thing. Some are busy treating long haul as a psych issue. Some are treating it as chronic fatigue. There are literally not enough appointments for the number of patients affected. 

Do people even understand that? There's not enough supply for demand. And God only knows what model of care you're going to get when you do see someone.

No capacity. No model of care. Only guesses and chances. 

The math doesn't work. No one does the math. No one talks about the math. But it's real. Silence doesn't invalidate the numbers. Silence doesn't mean everything's fine.

So care is difficult to access and it's not turnkey. Nor is there any push to improve access faster. It's kind of fascinating to me that we know the most vulnerable to long covid are often the ones already dealing with health issues and there's just no sense that we need to make access simpler and easier otherwise they may never get help. The system doesn't care. The specialists are so siloed, they're not going to lift a finger, it's outside their purview and they've been trained very well to be very myopic.

But covid doesn't care about Ivory Silos. It's transgressive. It has no boundaries.

We need integrated care. When you see the neurologist for your whatever, there needs to be a long covid provider that's part of the visit or something equivalent. In reality, it should be the same for PCP appointments too. (I just met a 28 year old kid who had a covid related stroke. Where's their preventative screening? It doesn't exist.) Don't forget dialysis. Cancer care. 

Anything requiring infusions or lots of regular appointments FOLD LONG COVID CARE INTO CARE THAT'S ALREADY HAPPENING. 

Give patients some quality of life. No one wants to live at the doctor's office. We're busy. We're tired. Very likely we're not the only ones at home with long covid. Very likely covid is impacting the conditions we see the specialists for and we need them to incorporate it all into our care. Help us.

Like, how much time does medicine think people have? They really seem to think riding a full-time medical merry-go-round is fine. 

Here's what long haul treatment in the mix with other issues looks like in 2023: Drive an hour this way for an infusion. An hour that way for PT. And hour another direction for therapy. Multiple multi-specialty follow up appointments for the long haul clinic...anther hour drive. Each. Then all the usual non covid specialists also an hour drive away. 

Drive drive drive. Time time time.

One appointment easily turns in a four hour odyssey. PEOPLE DON'T HAVE TIME FOR THIS. On what planet does anyone think they do?

If it's not turn key, it's going to be the last thing on the list for me. I don't have time for it. I have to babysit the tumors because they are changing and my kid has to come first beyond that. Ergo, other things languish. I can only do so much. 

So no. I haven't tried anti-virals for long covid. I'd like to (although I'm not optimistic as my biggest battle is the way covid triggered all these nerve issues and that seems to be a less common problem lol lol lol why be normal hahaaaaaaaaa), but no one's prescribing it without a six month wait to get into a clinic*. A clinic with no guarantees they'll do anything anyway.

So tell me. How the fuck am I supposed to put that at the top of the list for me? I can't justify it. Can you?

*I mean, I could lie my ass off at a telehealth appointment and score some paxlovid that way, which to be clear, I would have no issue doing if I knew my shit** BUT we barely know anything about covid and I'm a little leery of going off the map with it right now. 

**Yeah. Welcome to modern health care. Where patients work the system to get what they need. And yep, probably people abuse this option, but they're not the root cause. Don't get twisted on what the root cause really is here. It's the system, not the people. Patients are just trying to survive a dysfunctional system that blames them and overcharges them for everything. 

I have no compunction about doing what I need to do to get care out of this craptastic system that passes for healthcare in this civilization. That said, fortunately, it's not something I've had to resort to all that much. I'm not over here rolling in meds obtained under suspicious circumstances. But if I'm ever properly prescribed Paxlovid, and learn its ins and outs...hell yes, I'd leverage telehealth to get some in the future if I needed it and couldn't get the system to function on my behalf otherwise.

But at the rate Covid is outpacing treatments, this is all going to be moot soon anyway. Soon we'll have nothing at all that helps.