We are grateful for the opportunity to respond to the Correspondence from Joanne McPeake and colleagues, which highlights the socioeconomic challenges that survivors of critical illness face, particularly with respect to returning to work. As the authors describe, these difficulties are undoubtedly applicable to the post-COVID-19 cohort. Indeed, the COVID-19 pandemic has magnified existing social inequalities, which render the economically disadvantaged more vulnerable, including to COVID-19 exposure and mortality, and to adverse employment implications.1, 2
UK-based guidance addresses these issues and highlights the need for clinicians to evaluate the effects of financial stress and unemployment as part of a holistic post-COVID-19 assessment.3 Incorporation of occupational therapists to provide an occupation-focused approach to evaluating and directing patients to relevant sources of support, including advice for financial matters, employment, social care, and housing, is advocated.4 We thank the authors for drawing our attention to the feasible colocation of welfare services into primary care, and the beneficial effects this integration might have on improving housing circumstances, income, and mental health and wellbeing.
© 2021 John Birdsall Social Issues Photo Library/SPL
When we first developed and implemented our post-COVID-19 service, clinical resources were considerably stretched, and the medium-term and long-term physical and psychosocial effects of acute COVID-19 infection were unclear. With the emergence of national guidelines and prospective clinical data,3, 4, 5 we consequently adapted our service, which now includes vocational assessment to patients recovering from severe COVID-19 pneumonia or those with a diagnosis of post-COVID-19 syndrome.
Acknowledgments
We declare no competing interests. RFD has been awarded a National Institute for Health Research (NIHR) Doctoral Research Fellowship (DRF-2018-11-ST2-037). The NIHR were not involved in any element of writing or submitting this manuscript. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
References
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