Still here
An update on the Covid pandemic from across the bridge
First of all, a quick reminder about the Westminster Hall debate on ME taking place this Wednesday. You can use our template here to write to your MP.
Today’s guest post is from Yanto Evans. Yanto has been living with Long Covid since April 2020. His background is in Finance and Economics. He lives in Wales and is also a Trustee for the Long Covid Support charity. A Welsh language version is available below.
Ask most people in Wales right now and they’d say Covid-19 is no longer anything to worry about. Government officials commonly refer to the Covid pandemic in the past tense. Once a staple of every daily news feed, any efforts to record community cases have long fallen by the wayside. Even when it comes to Long Covid, long-term sequelae resulting from Covid infections are often blamed on the vaccine – despite many developing the condition well before the first vaccine was even administered.
In December 2024, during a debate on Long Covid in the Senedd (Welsh Parliament), the Welsh Cabinet Secretary for Health and Social Care, Jeremy Miles, proclaimed the population was developing ‘natural immunity’ to Covid-19. This is misleading and dangerous. Numerous studies have shown repeat Covid infections actually increase the risks of long-term harm.
While there is no longer the same focus on Covid infections, the limited data that are available suggest Covid remains a tangible threat. I wrote to Jeremy Miles to request a meeting to address serious concerns. That request was unfortunately declined. What follows is a summary of the findings from recent and ongoing research.
Long Covid in Wales
According to the Office for National Statistics (ONS), mortality rates in Wales have still not recovered to pre-pandemic levels.
Deaths in Wales 2013–2024
Indeed – according to the National Survey for Wales – the general health of people in Wales is at its worst since records began.
In June 2021, the Welsh Government launched the Adferiad programme (Welsh for ‘Recovery’) of services to support those with Long Covid. As of March 2023, annual funding was increased to £8.3 million divided among the seven Health Boards and its remit was extended to support those with other chronic conditions, including ME. These services, by definition, aren’t clinics, and most are not able to prescribe medications. Instead, responsibility lies with each health board to determine those services it feels are appropriate. There is no overarching strategy regarding how best to diagnose or treat patients.
In January 2022, the then First Minister Mark Drakeford dismissed any notion of a specialist clinic in Wales. His preference was that primary care clinicians should be equipped to respond to patients within the community where possible. In January of this year, patients under the Cwm Taf Morgannwg Health Board received news that their local service was closing. This is despite the health board being in receipt of funding from the Welsh Government for that very purpose. The reason given for its closure cited low referral numbers. In a Freedom of Information request, it was determined that, of the £1.1 million of funding it received, less than half was spent on Long Covid patients. The remaining funding was redirected to other unrelated services within the health board.
In conversations with Long Covid patients in the area, they say that many GPs have little understanding of Long Covid. Similarly to ME, some patients claim their symptoms are still being dismissed or ignored. Where patients asked to be referred to their local Adferiad service, many GPs were unaware such a service existed. Consequently, patients recall being referred to a succession of specialists that had proven unproductive. A closer examination of GP referrals in recent years reveals a steep rise compared to pre-pandemic times. Referrals in the Betsi Cadwaladr Health Board have more than doubled, while in the Aneurin Bevan Health Board they’ve almost tripled.
Wales GP referrals 2010–2011 and 2021–2024
Impacts for the workforce and education
Due to continued exposure to airborne viruses (including SARS-CoV-2, which causes Covid-19), absence rates among healthcare workers have risen significantly since the start of the pandemic. This is demonstrated by recent data published by NHS Wales. Absence rates in NHS Wales – the nation’s largest employer – are now averaging 6.5% compared with the 2% UK national average. That equates to 1 in 15 NHS workers off sick every day.
Four key reasons for sickness 2018/19 to 2022/23
When it comes to children, initial theories suggested they were at minimal risk following a Covid-19 infection. However, subsequent papers have dismissed that notion; a recent study in the US suggested that Long Covid may have become the most common chronic condition in children, with more affected by it than by asthma.
Meanwhile, school absenteeism in Wales has still not recovered to pre-pandemic levels. The main reason attributed to these absences is illness.
Percentage of half-day sessions absent from school of secondary school-age pupils
Given the declining health of the workforce, it stands to reason this is impacting the Welsh economy. According to ONS data, more than 30,000 have become economically inactive due to long-term sickness since 2020.
Number of economically inactive people in Wales due to long-term sickness
There are currently no efforts to count those living with Long Covid (or indeed ME) in Wales. In the last Winter Covid Infection Study by the ONS in March 2024, Wales opted not to take part. Among the reasons that the Welsh government gave was that incidence was based on self-reporting of symptoms and misclassification by participants was possible. With a current lack of a diagnostic test, there is simply no alternative other than to count self-reported cases.
Research into the impact of chronic illnesses on the Welsh economy is sorely missing, yet consider the introduction of the 20mph speed limit in September 2023. In the face of fierce opposition, the Welsh government defended spending £32 million on its roll-out by claiming it served to ‘protect lives’, prevent co-morbidities and would save NHS Wales £92 million per year. In a 12-month period leading up to June 2023, the number of fatalities caused by road accidents was 89. By contrast, official figures for deaths caused by Covid-19 (which is likely to be an undercount) came to 1,486. This statistic alone indicates the profound impact that Covid-19, and indeed Long Covid, is likely to be having on NHS Wales and the wider economy.
‘Yma o hyd’
So, what now for those in Wales with Long Covid or ME? As attention turns towards the Senedd elections in May next year, there seems to be little appetite within government to prioritise the unfolding health crisis. A Special Purpose Committee set up to examine the role of the Welsh government’s response to the Covid pandemic was dissolved earlier this year. This followed a withdrawal from the committee of the Welsh Conservative party following Labour’s refusal to support witnesses providing evidence under oath. Meanwhile, Jeremy Miles has already declared his intention to step away from politics altogether at the next election.
‘Yma o hyd’ is a phrase embedded within Welsh culture. Pronounced ‘um-ah oh heed’, it means ‘still here’. Taken from a song by the musician and campaigner Dafydd Iwan, it serves as a reminder to his compatriots of the country’s long, tumultuous history and the resilience shown in the face of foreign invaders. Its chorus rings out with the rallying call – ‘Er gwaethaf pawb a phopeth, ry’n ni yma o hyd’, which translates as, ‘In spite of everyone and everything, we are still here’. In my eyes, it’s symbolic of the plight of so many, both here in Wales and further afield, whose lives have been devastated by Long Covid and ME.
Mae post gwadd heddiw yn dod gan Yanto Evans. Mae Yanto wedi bod yn byw gyda Covid Hir ers Ebrill 2020. Ei gefndir yw mewn Cyllid ac Economi. Mae’n byw yng Nghymru ac mae hefyd yn Ymddiriedolwr ar gyfer yr elusen, Long Covid Support. Mae fersiwn Cymraeg ar gael isod.
Gofynnwch i’r rhan fwyaf o bobl yng Nghymru ar hyn o bryd a byddent yn dweud nad oes unrhyw rheswm i boeni am Covid-19 mwyach. Mae swyddogion y llywodraeth yn cyfeirio’n aml at y pandemig Covid yn y gorffennol. Unwaith y prif bwnc mewn pob datganiad newyddion dyddiol, mae unrhyw ymdrechion i gofnodi achosion cymunedol wedi stopio. Hyd yn oed pan ddaw at Covid Hir, mae canlyniadau hirdymor o heintiau Covid yn aml yn cael eu bai ar y brechlyn – er gwaethaf y manylion o lawer yn datblygu’r cyflwr yn llawer cyn i’r brechlyn cyntaf gael ei roi.
Ym mis Rhagfyr 2024, yn ystod dadl am Covid Hir yn y Senedd, cyhoeddodd Ysgrifennydd Cabinet Cymru dros Iechyd a Gofal Cymdeithasol, Jeremy Miles, fod y boblogaeth yn datblygu ‘immunedd naturiol’ rhag Covid-19. Mae hyn yn gamarweiniol ac yn beryglus. Mae nifer o astudiaethau wedi dangos bod heintiau Covid ailadroddus yn cynyddu gwirioneddol y risg o niwed hirdymor.
Er nad oes yr un ffocws ar heintiau Covid mwyach, mae’r data cyfyngedig sydd ar gael yn awgrymu bod Covid yn dal i fod yn bygythiad ymarferol. Ysgrifennais at Jeremy Miles i ofyn am gyfarfod er mwyn ymdrin â phryderon difrifol. Gwrthodwyd y cais hwn yn anffodus. Y canlynol yw crynodeb o’r canfyddiadau o ymchwil ddiweddar a pharhaus.
Covid Hir yng Nghymru
Yn ôl Swyddfa Ystadegau Gwladol (SYG), nid yw cyfraddau marwolaeth yng Nghymru wedi adfer i lefelau cyn-pandemig eto.
Farwolaethau yng Nghymru 2013–2024
Yn wir – yn ôl Arolwg Cenedlaethol Cymru – mae iechyd cyffredinol pobl yng Nghymru ar ei waethaf ers i gofnodion ddechrau.
Ym mis Mehefin 2021, lansiodd Llywodraeth Cymru raglen Adferiad o wasanaethau i gefnogi’r rheini gyda Covid Hir. Hyd at Fawrth 2023, cynnyddodd ariannu blynyddol i £8.3 miliwn wedi’i rannu rhwng y saith Bwrdd Iechyd ac estynnwyd ei gylch gorchwyl i gefnogi’r rheini gyda chyflyrau cronig eraill, gan gynnwys ME. Nid clinigau yw’r gwasanaethau hyn, wrth eu diffiniad, ac nid yw’r mwyafrif yn gallu rhagnodi meddyginiaethau. Yn lle hynny, mae’r cyfrifoldeb gyda phob bwrdd iechyd i benderfynu pa wasanaethau y mae’n teimlo sydd yn addas. Nid oes strategaeth gyffredinol ynghylch y ffordd orau o ddiagnosio neu drin cleifion.
Ym mis Ionawr 2022, gwrthododd y Prif Weinidog ar y pryd Mark Drakeford unrhyw syniad o glinig arbenigol yng Nghymru. Ei ffefryn oedd y dylai clinigwyr gofal sylfaenol fod wedi’u harfogi i ymateb i gleifion o fewn y gymuned lle bo modd. Ym mis Ionawr eleni, derbyniodd cleifion o dan Bwrdd Iechyd Cwm Taf Morgannwg newyddion bod eu gwasanaeth lleol yn cau. Mae hyn er gwaethaf bod y bwrdd iechyd yn derbyn cyllid gan Lywodraeth Cymru at y diben hwnnw. Y rheswm a roddwyd am ei gau oedd nifer isel o gyfeiriadau. Mewn cais Rhyddid Gwybodaeth, penderfynwyd, o’r £1.1 miliwn o gyllid a dderbyniodd, y treuliodd llai na hanner ar gleifion Covid Hir. Ailgyfeiriwyd y cyllid aros i wasanaethau eraill nad oeddent yn gysylltiedig o fewn y bwrdd iechyd.
Mewn sgyrsiau gyda chleifion Covid Hir yn yr ardal, maent yn dweud bod llawer o Meddygon Teulu yn deall ychydig am Covid Hir. Yn debyg i ME, mae rhai cleifion yn honni bod eu symptomau yn dal i gael eu hanwybyddu neu eu gwrthod. Pan ofynnodd cleifion i gael eu cyfeirio at eu gwasanaeth Adferiad lleol, nid oedd llawer o Feddygon Teulu yn ymwybodol bod gwasanaeth o’r fath yn bodoli. Yn sgil hynny, mae cleifion yn cofio cael eu cyfeirio at gyfres o arbenigwyr a brofodd fod yn anfoddhaol. Mae archwiliad agosach o gyfeiriadau Meddygon Teulu yn y blynyddoedd diweddar yn datgelu cynnydd sydyn o gymharu â’r amseroedd cyn argyfwng y pandemig. Mae cyfeiriadau yn Bwrdd Iechyd Betsi Cadwaladr wedi mwy na dyblu, tra bod cyfeiriadau yn Bwrdd Iechyd Aneurin Bevan bron i drydeddau.
Cyfeiriadau Meddygon Teulu Cymru 2010–2011 a 2021–2024
Effaith ar y gweithlu a addysg
Oherwydd ymdreiddiad parhaus i firysau yn yr awyr (gan gynnwys SARS-CoV-2, sy’n achosi Covid-19), mae cyfraddau absenoldeb ymysg gweithwyr gofal iechyd wedi cynyddu’n sylweddol ers dechrau’r pandemig. Dengys data diweddar a gyhoeddwyd gan GIG Cymru hyn. Mae cyfraddau absenoldeb yn GIG Cymru – cyflogwr mwyaf y genedl – bellach yn cyfartalu 6.5% o gymharu â chyfartaledd cenedlaethol y DU o 2%. Mae hynny’n 1 o bob 15 gweithiwr GIG ar salwch bob dydd.
Pedwar rheswm allweddol dros salwch 2018/19 i 2022/23
Pan ddaw i blant, awgrymodd damcaniaethau cychwynnol eu bod mewn perygl isel ar ôl haint Covid-19. Fodd bynnag, mae papurau diweddarach wedi gwrthod y cysyniad hwnnw; awgrymodd astudiaeth ddiweddar yn yr UD y gallai Covid Hir fod wedi dod yn yr cyflwr cronig mwyaf cyffredin ymhlith plant, gyda mwy yn cael ei effeithio ganddo na chan asthma.
Yn y cyfamser, nid yw absenoldeb ysgolion yng Nghymru wedi adfer i lefelau cyn-pandemig eto. Prif reswm a roddir am y rhai hyn yw salwch.
Canran o sesiynau hanner diwrnod wedi colli ysgol gan ddisgyblion oed ysgol uwchradd
O gofio iechyd dirywiol y gweithlu, mae’n rhesymegol bod hyn yn effeithio ar economi Cymru. Yn ôl data ONS, mae mwy na 30,000 wedi dod yn anweithgar yn economaidd oherwydd salwch hirdymor ers 2020.
Nifer y bobl sydd yn economaidd anweithgar yng Nghymru oherwydd salwch hirdymor
Ar hyn o bryd nid oes unrhyw ymdrechion i gyfrif y rhai sy’n byw gyda Covid Hir (neu ME) yng Nghymru. Yn Astudiaeth Haer Cymdeithasol Covid y Gaeaf diwethaf gan yr ONS ym mis Mawrth 2024, dewisodd Cymru beidio â chymryd rhan. Ymhlith y rhesymau a roddodd llywodraeth Cymru oedd bod achosion yn seiliedig ar hunan-adrodd ar symptomau ac y gellid cam-ddosbarthu gan y cyfranogwyr. Heb brawf diagnosis presennol, nid oes dim dewis arall ond cyfrif yr achosion a adroddwyd yn hunan.
Mae ymchwil i effaith afiechydon cronig ar economi Cymru yn amlwg yn brin, ond ystyriwch gyflwyno’r terfyn cyflymder 20mph ym mis Medi 2023. Yn wyneb gwrthwynebiad ffyrnig, amddiffynnodd llywodraeth Cymru wario £32 miliwn ar ei gyflwyniad gan honni ei fod yn ‘diogelu bywydau’, atal anafiadau a byddai’n arbed £92 miliwn i’r GIG Cymru y flwyddyn. Mewn cyfnod o 12 mis cyn mis Mehefin 2023, y nifer o farwolaethau a achoswyd gan ddamweiniau ffyrdd oedd 89. Yn groes, ffigurau swyddogol ar gyfer marwolaethau a achoswyd gan Covid-19 (sydd yn debygol o fod yn gyfrif isel) oedd 1,486. Mae’r ystadegyn hwnnw’n unig yn dangos y dylanwad dwfn y mae Covid-19, a hefyd Covid Hir, yn debygol o fod yn ei chael ar GIG Cymru a’r economi ehangach.
‘Yma o hyd’
Felly, beth erbyn hyn i’r rheini yng Nghymru â Covid Hir neu ME? Wrth i’r sylw droi at etholiadau’r Senedd ym mis Mai y flwyddyn nesaf, ymddengys nad oes llawer o awydd yn y llywodraeth i roi blaenoriaeth i’r argyfwng iechyd sy’n datblygu. Daeth Pwyllgor Diben Arbennig a sefydlwyd i archwilio rôl ymateb llywodraeth Cymru i’r pandemig Covid i ben yn gynharach eleni. Dilynwyd hyn gan dynnu’n ôl o’r pwyllgor gan Blaid Geidwadol Cymru ar ôl i Lafur wrthod cefnogi tystion yn darparu tystiolaeth o dan addo. Yn y cyfamser, mae Jeremy Miles eisoes wedi datgan ei fwriad i adael gwleidyddiaeth yn llwyr yn yr etholiad nesaf.
‘Yma o hyd’ yw ymadrodd wedi’i osod o fewn diwylliant Cymreig. Yn deillio o gân gan y cerddor a’r ymgyrchydd Dafydd Iwan, mae’n gwasanaethu fel atgof i’w gyd-Gymry o hanes hir a chythryblus y wlad a’r ymwrthedd a ddangoswyd wynebwr goblygiadau tramor. Mae ei chorws yn canu gyda’r alwad uno – ‘Er gwaethaf pawb a phopeth, ry’n ni yma o hyd’. Ym marn i, mae’n eiconig o drasiedi cymaint, yma yng Nghymru ac ymhellach, lle mae eu bywydau wedi cael eu dinistrio gan Covid Hir a ME.
 | A guest post by
|