As of: March 15, 2024, 9:30 a.m
By: Jana Stabener
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Who cares about people who suffer from the long-term consequences of a corona infection?
Hardly anyone.
The reasons are obvious.
“Sometimes I just want to throw down and cry,” says Conny Werner
to BuzzFeed News Germany
, a portal from
IPPEN.MEDIA
.
The general practitioner from near Ulm looks tired.
She is one of the few family doctors with health insurance approval who treats patients with post-Covid syndrome.
She needs “easily 1.5 hours of preparation time” for each patient, which she doesn’t get paid for by the health insurance companies.
The only thing she can charge for are calls, says Werner.
Even on the second Long Covid Awareness Day on March 15th, there is still no specific treatment for the disease ME/CFS due to Long Covid.
Doctors therefore face hurdles when it comes to billing for treatment.
Long Covid, Post-Covid Syndrome, Post-Vac Syndrome and ME/CFS
Long Covid
is the umbrella term for symptoms after a corona infection that continue to occur more than four weeks after the infection.
Post
-Covid syndrome
refers to complaints that are still present more than twelve weeks after the start of the SARS-CoV-2 infection and cannot be explained in any other way.
Late effects after a corona vaccination are known
as
post-vac syndrome .
However, they occur much less frequently than Long Covid.
As a result of a corona infection, some of those affected develop a clinical picture that is similar to chronic fatigue syndrome
(ME/CFS)
.
It is currently unclear how large the proportion of people with ME/CFS are after a SARS-CoV-2 infection.
According to the Robert Koch Institute (RKI), however, an increase in ME/CFS cases can be expected in the next few years as the pandemic progresses.
As early as 2022, the Long Covid Initiative warned Germany not to “ignore Post Covid as collateral damage”.
Long Covid: General practitioner association calls for “significant upgrade of consultation services”
“The diagnosis of Long Covid is complex,” says the General Practitioners Association (HAEV)
BuzzFeed News Germany
.
“The differential diagnosis therefore requires comprehensive discussions, which of course take time.” The fact that there is hardly any money from the health insurance companies for these discussions is unacceptable.
“There needs to be a significant upgrade in conversation services.
This is a demand that we have been making for a very long time and which of course plays a special role in the context of Long Covid diseases,” said the HAEV.
The Long Covid patients who come to Werner's practice are not decreasing.
After the Delta wave in 2022, three to four new cases were added per day among her existing patients alone, she says.
“Since then it has been a little less at a stable level.
But the influx is not decreasing.
Our waiting list is one A4 page long,” says the internist.
According to the RKI, there is no reliable data on Long Covid cases.
However, various studies assume that six to 13 percent of the population are affected.
“I can’t leave her alone,” says Werner.
In addition to her own patients, she also treats those affected by Long Covid who are not taken seriously by their doctor.
However, she can only take them on as a self-payer, otherwise she would no longer be able to run her practice economically.
Family doctor Conny Werner in her practice in Erbach an der Donau near Ulm.
© Conny Werner
More on the topic: This is what happens in your body if you become infected with Corona several times.
Family doctor: “An off-label list would be a massive improvement”
The new LongCOV directive, which was adopted in December 2023, is intended to provide a remedy.
It sees the family doctor as the “coordinator and first point of contact” and wants to enable “cross-professional, coordinated and structured care for those with statutory health insurance”.
The problem: The directive is currently still being examined by the Federal Ministry of Health.
Only when it comes into force will it be possible to negotiate with the health insurance companies about the reimbursement of services, says the National Association of Statutory Health Insurance Physicians (KBV)
BuzzFeed News Germany
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What the directive cannot regulate is the handling of off-label drugs, i.e. drugs that are actually intended for other diseases but that doctors can also use for other complaints within the scope of freedom of treatment.
With the help of a group of experts, the Federal Institute for Medicines (BfArM) is currently developing a list of off-label medications against Long Covid.
They should also be prescribed outside of the approval and paid for by the health insurance companies, Karl Lauterbach decided at a round table on Long Covid in September 2023. “A massive improvement,” says Werner.
The KBV and the General Practitioners Association also support such a list.
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Care for those affected by Long Covid – “terrible condition”
The BfArM writes to
BuzzFeed News Germany
that they are currently evaluating information and scientific studies.
“Against the background of this ongoing evaluation process,” it is not possible to say when the off-label list will appear.
“Such a list can only help patients if it is based on a solid scientific basis,” said a BfArM spokesman.
Werner sees it differently.
After all, family doctors constantly use off-label medications in everyday life, including for other illnesses.
In order to prevent so much valuable data from being lost, it would, in her opinion, make more sense to test the evidence of off-label drugs in practice.
“The patients really want this!
They are explained in detail, known active ingredients are used in minimal doses and we know the manageable side effects.
I find it more unethical to withhold an improvement in quality of life from patients,” she says.
A family doctor complains about the situation in the treatment of Long Covid patients in Germany.
(Symbolic image) © Liesa Johannssen/photothek/IMAGO
Mainly because the current use of off-label medications divides patients into two classes.
“Long Covid patients with enough money have a significantly greater chance of stabilizing,” says Werner.
For example, there is a promising anti-viral drug; a packet for five days costs over 1,200 euros.
If you take it for 15 days you can calculate how much it costs.
Most patients simply could not afford such a drug.
Or would have to put it down because they can no longer pay for it.
“A terrible condition,” says the internist.
More on the topic: Researchers discover previously unknown long-term consequences of Corona.