Dear Sir/Madam, 

This is a submission to the Inquiry into the impact of the Covid-19 outbreak, and its management, on health and social care in Wales by me, xxxx, a xxxx year old stay at home mum from Carmarthenshire. 

The outbreak, management and messaging have all had both direct and indirect effects on my health and health care over the last year.

First of all, I was already under the care of the physiotherapy and occupational therapy department of the plastic surgery unit at xxxx Hospital when the pandemic was declared, following an accident and skin graft towards the end of xxxx. I had regular appointments at the hospital until lockdown after which all of my appointments were moved online as video calls. I found these very convenient and useful, saving me having to travel some distance to the hospital. There have been some slight issues with technology but generally my appointments have been successful.

Secondly, I was diagnosed with fibroids in February xxxx and referred to the gynaecology department at xxxx Hospital. Unfortunately, due to the Covid-19 outbreak, I have yet to hear anything about an appointment with the department and don't expect to for some considerable time to come, considering how busy hospitals are with Covid-19 and the rates of the disease in the country. My symptoms have not improved over this period and have been aggravated by other factors and symptoms so that I feel my need to be seen may well be substantially more urgent by the time I  am given an appointment.

Thirdly, I have a number of diagnoses relating to mental health - autism, ADHD and chronic depression - and also suffer from anxiety. I had already found it very hard to access mental health care provision prior to the pandemic through not being considered ill enough (compared with others) and issues of who should be responsible for my care between mental health and autism provision. I am hearing constantly about the huge mental health impacts of the pandemic and what will need to be done to support people newly suffering with mental health issues due to Covid-19 but I have heard nothing about support for those of us who already had such issues prior to the outbreak. I am very concerned that the already over-burdened mental health services will be overwhelmed by new patients while people like myself continue to have our needs unmet.

Fourthly, I may have Long Covid without ever having been tested for Covid-19, being diagnosed with it or going to hospital for it. My case is a little unusual in that certain key symptoms of Covid-19 were actually symptoms I already experienced for other reasons - a long term severe cough (due to post-nasal drip and asthma), changes in my sense of taste following hospitalisation, several surgeries and several weeks of antibiotics in late xxxx (including the skin graft mentioned above) and sometimes slightly raised temperature (due to hormonal variations related to the fibroids mentioned above and perimenopause). From the start, this caused me concern as I constantly worried about whether I might have Covid-19. It was only much later that messaging came out that other symptoms such as abdominal and gastrointestinal symptoms were also possible with Covid-19, some time after I had experienced such symptoms myself (about May xxxx). After having these symptoms, I began to suffer from fatigue, breathlessness and worsening back pain when walking and discomfort in my throat and difficulty swallowing when lying in bed at night. I also later discovered that I now have high blood pressure, which wasn't the case at the time 9f my hospitalisation and surgeries (Oct and Nov xxxx) or at other times in my life and also a higher pulse rate than previously. These I understand to be some of the symptoms associated with long covid. I have no idea whether I have actually had Covid-19 or now have long covid since, throughout the first months, the messaging seemed to be that we should keep away from medical settings as much as possible, that we should call 111 only if we had definite recognised symptoms (and even then, according to the media, 111 was telling most people to stay at home anyway and people with severe symptoms were being turned away from A&E departments), plus my own anxiety about myself or my family catching Covid and putting more pressure on health care workers. By the time I became aware I had experienced some symptoms associated with Covid, it was too late to be tested even if testing was available and I still have no idea whether I would qualify for an antibody test, how I to go about having one done or whether it would show anything. And I have no idea whether my GP would be able to recognise long covid, if I do have it.

The big issue for me, regarding health care in Wales through all this, is that I already had a number of health conditions and issues for which I was struggling to get care and support before the pandemic. I still have all of those and now have a collection of new symptoms which may be connected to those, to covid or to something else and I don't know if or when I will ever get help with them or alleviation from them. I am now functionally disabled and struggling just to keep going. Our already overwhelmed National Health Service is going to need to be on life support for a long time to come, even after this current covid wave dies down, despite the best efforts of its excellent (and much appreciated) workforce.

Yours truly,

xxxx