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This Written Statement provides an update on action in Wales to support people experiencing longer term effects of COVID\-19\.


COVID\-19 infection is now a global topic of research, and as the pandemic continues, we are understanding more about the disease process and its longer term impact on patient health. Whilst initially it was thought that symptoms could last a few weeks and, once they subsided, the individual could return to their previous lifestyle, it is now becoming apparent that some people experience much longer term effects.


NHS Wales has developed and launched a COVID Recovery app with advice, tips and actions for patients to carry out themselves, in order to manage their own recovery. This app is free to download.  


Increasing evidence and testimony from people’s experiences shows that a small, but significant number of people who contract COVID\-19 are slow to recover from the effects of the virus, often months after initially falling ill. Some estimates suggest that approximately 1 in 5 people affected by COVID\-19 may still experience different groups of symptoms more than three weeks after infection; and 1 in 10 people could still be affected at three months, or longer, after initial infection.


The National Institute for Health and Care Excellence (NICE) has developed a clinical guideline, published on 18 December 2020\. 


This guideline covers identifying, assessing and managing the long\-term effects of COVID\-19, often described as ‘long COVID’. It makes recommendations about care in all healthcare settings for adults, children and young people who have new or ongoing symptoms four weeks or more after the start of acute COVID\-19\.


NICE uses the following clinical definitions for the initial illness and long COVID at different times:


* **Acute COVID\-19**: signs and symptoms of COVID\-19 for up to four weeks.
* **Ongoing symptomatic COVID\-19**: signs and symptoms of COVID\-19 from four to 12 weeks.
* **Post\-COVID\-19 syndrome**: signs and symptoms that develop during or after an infection consistent with COVID\-19, continue for more than 12 weeks and are not explained by an alternative diagnosis.


The profile of symptom range and severity for post COVID\-19 syndrome, that is 12 weeks or longer, is not yet fully understood. However, the evidence does suggest that people are experiencing significant medium and long\-term effects which are diverse in nature, and can affect any system in the body. Some of the most common things people describe are fatigue, feeling breathless, mood changes, brain fog and sensory changes.  Some people may need help to return to everyday activities.


In line with our vision in *A Healthier Wales, o*ur approach is founded on avoiding harm, promoting and supporting self management and value based, seamless care from the right health professionals or service, at or as close to home as possible and agreeing care tailored to each person’s specific needs.  


Using latest evidence, each health board is bringing together its GP practices and multi professional community services to put systems in place, making best use of the expertise of different health professionals and other resources, such as the new NHS Wales COVID Recovery app, to identify, assess and support people in their recovery. Some people with severe effects may need more specialist advice provided in acute hospital settings.


While services and access to these may be organised and communicated according to local needs and circumstances, the Welsh Government and NHS Wales have collaborated on an all Wales Community Pathway for post COVID syndrome to help ensure a consistent approach across all health boards in line with *A Healthier Wales.*


The skills of our Allied Health Professions and self care support for people so they can manage their own recovery is core to our approach. To help inform the local response to post COVID syndrome, we have updated our National Rehabilitation Framework and population specific planning guidance and patient scenarios, in light of NICE clinical guidelines and other research.


Health Education and Improvement Wales has developed a digital platform to create a single ‘landing page’ enabling easy access to a wide range of resources to support health and care professionals as they provide help and advice to people managing their recovery.


Health and Care Research Wales is creating a Wales COVID\-19 Evidence Centre to analyse the impact of coronavirus and use research\-based evidence to address new challenges as a result of the global pandemic. The dedicated team at the new Evidence Centre will work closely with the Welsh Government, the NHS and social care in Wales to provide the necessary evidence needed to make effective decisions to support people with their recovery.


As well as research, my officials will be engaging with patient support groups to hear their experiences at first hand, to discuss our approach in Wales and identify what further action is needed.


We will continue to adapt our response as we learn more.







Translation:


 
Mae’r Datganiad Ysgrifenedig hwn yn rhoi’r wybodaeth ddiweddaraf am gamau sy’n cael eu cymryd yng Nghymru i gefnogi pobl sy’n teimlo effeithiau hirdymor COVID\-19\.


Mae haint COVID\-19 nawr yn destun ymchwil ledled y byd, ac wrth i’r pandemig barhau, rydym yn dod i ddeall mwy am broses y clefyd a’i effaith fwy hirdymor ar iechyd y claf. Y gred i ddechrau oedd y gallai symptomau bara rai wythnosau ac y gallai’r unigolyn, ar ôl i’r symptomau gilio, fynd yn ôl at ei ffordd arferol o fyw, ond mae hi bellach yn dod i’r amlwg bod rhai pobl yn teimlo effeithiau llawer mwy hirdymor.


Mae GIG Cymru wedi datblygu a lansio ap Adferiad Covid/Covid Recovery sy’n cynnig cyngor, awgrymiadau a chamau i gleifion eu cymryd, er mwyn rheoli eu hadferiad eu hunain. Mae’r ap dwyieithog ar gael i’w lawrlwytho yn rhad ac am ddim. https://llyw.cymru/lansio\-ap\-yng\-nghymru\-i\-helpu\-i\-gefnogi\-pobl\-sydd\-symptomau\-covid\-hir


Mae tystiolaeth gynyddol o brofiadau pobl yn dangos bod nifer bach ond sylweddol o bobl sy’n dal COVID\-19 yn araf i adfer o effeithiau’r feirws, yn aml fisoedd ar ôl iddynt ddechrau teimlo’n sâl. Mae rhai amcangyfrifon yn awgrymu y gallai tua 1 o bob 5 o bobl sydd wedi dal COVID\-19 barhau i fod â rhai o’r symptomau dros dair wythnos ar ôl cael eu heintio; a gallai 1 o bob 10 o bobl deimlo effeithiau dri mis, neu fwy, ar ôl yr haint cychwynnol.


Mae’r Sefydliad Cenedlaethol dros Ragoriaeth mewn Iechyd a Gofal (NICE) wedi llunio canllawiau clinigol, a gyhoeddwyd ar 18 Rhagfyr 2020 https://www.nice.org.uk/guidance/NG188.


Mae’r canllawiau hyn yn ymdrin â nodi, asesu a rheoli effeithiau hirdymor COVID\-19, a elwir yn aml yn ‘COVID hir’. Mae’r canllawiau’n cynnwys argymhellion ynglŷn â gofal ym mhob lleoliad gofal iechyd ar gyfer oedolion, plant a phobl ifanc sy’n parhau i fod â symptomau, neu sydd â symptomau newydd, bedair wythnos neu ragor ar ôl dechrau COVID\-19 acíwt.


Mae NICE yn defnyddio’r diffiniadau clinigol canlynol ar gyfer y salwch cychwynnol a COVID hir ar wahanol adegau:


* **COVID\-19 acíwt**: arwyddion o COVID\-19 a symptomau am hyd at bedair wythnos.
* **COVID\-19 symptomatig parhaus**: arwyddion o COVID\-19 a symptomau am bedair i 12 wythnos.
* **Syndrom ôl\-****COVID\-19**: arwyddion a symptomau, sy’n datblygu yn ystod neu ar ôl haint sy’n gyson â COVID\-19, yn parhau am dros 12 wythnos ac nad ydynt yn cael eu hesbonio gan ddiagnosis arall.


Hyd yma, nid oes dealltwriaeth lawn o broffil syndrom ôl\-COVID\-19 – hynny yw, 12 wythnos neu fwy – o ran ystod a difrifoldeb y symptomau. Fodd bynnag, mae’r dystiolaeth yn awgrymu bod pobl yn teimlo effeithiau tymor canol a hirdymor sylweddol. Mae’r effeithiau hyn yn amrywiol eu natur ac yn gallu effeithio ar unrhyw system yn y corff. Blinder, diffyg anadl, newidiadau yn hwyliau’r unigolyn, anallu i feddwl yn glir a newidiadau i’r synhwyrau yw rhai o’r pethau mwyaf cyffredin y mae pobl yn eu disgrifio. Bydd ar rai pobl angen cymorth i ailddechrau gwneud pethau pob dydd.


Yn unol â gweledigaeth *Cymru Iachach*, mae ein dull gweithredu wedi’i seilio ar osgoi niwed, hyrwyddo a chefnogi hunanreoli a gofal di\-dor seiliedig ar werthoedd gan y gweithwyr iechyd proffesiynol neu’r gwasanaeth cywir, gartref neu mor agos â phosibl at gartref pobl, a chytuno ar ofal sydd wedi’i deilwra i anghenion penodol pob unigolyn.


Gan ddefnyddio’r dystiolaeth ddiweddaraf, mae pob bwrdd iechyd yn dod â meddygfeydd a gwasanaethau cymunedol amlbroffesiynol at ei gilydd er mwyn sefydlu systemau sy’n gwneud y defnydd gorau o arbenigedd gwahanol weithwyr iechyd proffesiynol ac adnoddau eraill, megis ap newydd GIG Cymru – Adferiad Covid/Covid Recovery – i nodi, asesu a chefnogi pobl yn eu hadferiad. Mae’n bosibl y bydd ar rai pobl sy’n teimlo effeithiau difrifol angen cyngor mwy arbenigol a ddarperir mewn lleoliadau ysbytai acíwt.


Er bod gwasanaethau a’r ffordd o’u defnyddio yn cael eu trefnu a’u hyrwyddo yn ôl anghenion ac amgylchiadau lleol, mae Llywodraeth Cymru a GIG Cymru wedi cydweithio ar Lwybr Cymunedol Cymru gyfan ar gyfer syndrom ôl\-COVID\-19 i helpu i sicrhau dull gweithredu cyson ar draws pob bwrdd iechyd yn unol â *Cymru Iachach*.


Mae sgiliau ein Gweithwyr Proffesiynol Perthynol i Iechyd wrth wraidd ein dull gweithredu, fel y mae cymorth hunanofal i bobl fel y gallant reoli eu hadferiad eu hunain. I helpu i lywio’r ymateb lleol i syndrom ôl\-COVID\-19, rydym wedi diweddaru ein Fframwaith Adsefydlu Cenedlaethol a chanllawiau cynllunio a senarios cleifion ar gyfer poblogaethau penodol, yn sgil canllawiau clinigol NICE a gwaith ymchwil arall.


Mae Addysg a Gwella Iechyd Cymru wedi datblygu platfform digidol i greu un ‘dudalen lanio’ i’w gwneud yn hawdd cael gafael ar ystod eang o adnoddau i gefnogi gweithwyr iechyd a gofal proffesiynol wrth iddynt roi cymorth a chyngor i bobl sy’n rheoli eu hadferiad eu hunain.


Mae Ymchwil Iechyd a Gofal Cymru yn creu Canolfan Dystiolaeth COVID\-19 Cymru i ddadansoddi effaith y coronafeirws a defnyddio tystiolaeth seiliedig ar ymchwil i fynd i’r afael â heriau newydd o ganlyniad i’r pandemig byd\-eang. Bydd y tîm penodedig yn y Ganolfan Dystiolaeth newydd yn gweithio’n agos gyda Llywodraeth Cymru, y GIG a gofal cymdeithasol yng Nghymru i ddarparu’r dystiolaeth angenrheidiol i wneud penderfyniadau effeithiol i gefnogi pobl yn eu hadferiad.


Yn ogystal ag ymchwil, bydd fy swyddogion yn gweithio gyda grwpiau cefnogi cleifion i glywed am eu profiadau yn uniongyrchol, trafod ein dull gweithredu yng Nghymru a nodi camau gweithredu angenrheidiol pellach.


Byddwn yn parhau i addasu ein hymateb wrth inni ddysgu mwy.