Long COVID Insight Survey - Residents

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Cheshire West and Chester Council is interested in hearing the views and experiences of residents who have been diagnosed or have suspected (but undiagnosed) 'long COVID'. Your input will help us to make sure that as a council we offer appropriate services and support, and that residents are able to access the information they need.

We are also interested in hearing from close family members/friends of those who have been affected by 'long COVID'.

'Long COVID', also known as post-Covid-19 fatigue syndrome, is a long-term condition that some people suffer after contracting Covid-19. Symptoms vary but usually include fatigue, persisting high temperature, breathlessness, cognitive impairment (such as memory loss), generalised pain, and mental health problems.

NICE (National Institute of Clinical Excellence) defines 'long COVID' (or post COVID-19 syndrome) as signs and symptoms that develop during or following an infection consistent with Covid-19, continue for more than 12 weeks and are not explained by an alternative diagnosis. 

The survey should take around 5-10 minutes to complete.

Please note, survey responses will not be monitored daily, therefore please contact your GP with any immediate concerns regarding your health and wellbeing.
You can also find support and advice at www.livewell.cheshirewestandchester.gov.uk.

How to complete this questionnaire
If there are any questions that you do not wish to answer, please feel free to leave them blank.
To ensure that your response is submitted, please press the ‘Finish survey’ button at the end of the questionnaire.
Completing the questionnaire is voluntary and all the information you provide will be treated in the strictest of confidence. No information will be released that could identify an individual, household or organisation. If you would like to know more about how we use and store the information you give us please read our privacy notice.

Council information is also available in audio, Braille, large print or other formats. If you would like a copy in a different format, in another language or require a BSL interpreter, please email equalities@cheshirewestandchester.gov.uk, telephone 0300 123 8 123 or textphone 18001 01606 275 757.

1. Have you or a close family member/ friend been affected by 'long COVID'?

 

2. How long have you or your close family member/ friend been affected by 'long COVID'?

 

3. Has having ‘long COVID’ negatively affected any of the following aspects of your life?
Please tick all that apply.

 

4. The symptoms associated with 'long COVID' vary significantly. Please tick which of the main symptoms listed below you have experienced. If you have experienced a symptom not listed, please add this to the comment box.

Previously had these symptomsCurrently have these symptomsNever had these symptoms
Respiratory symptoms (breathlessness, cough)
Cardiovascular symptoms (chest tightness, chest pain, palpitations)
Generalised symptoms (fatigue, fever, pain)
Neurological symptoms (cognitive impairment - 'brain fog', loss of concentration or memory issues, headache, sleep disturbance)
Peripheral neuropathy symptoms (pins and needles and numbness, dizziness, delirium)
Gastrointestinal symptoms (abdominal pain, nausea, diarrhoea, reduced appetite)
Musculoskeletal symptoms (joint pain, muscle pain)
Psychological/ mental health (symptoms of depression, symptoms of anxiety)
Ear, nose and throat symptoms (tinnitus, earache sore throat, dizziness, loss of taste and/or smell)
Dermatological (skin rashes)
 

5. Have you (or close family member/ friend) been supported to manage the symptoms of 'long COVID'?

 

6. How have you (or close family member/ friend) been supported to manage the symptoms of 'long COVID'?
Please tick all that apply.

 

7. Thinking about recovery and rehabilitation, have you (or close family member/ friend) been able to access support for 'long COVID'?

By 'recovery and rehabilitation' we refer to virtual or face-to-face support to improve your condition (this can be 'physical' e.g. exercise classes or breathing classes, 'emotional' or support for your 'mental wellbeing')

 

8. What services (if any) do you think are missing to support residents with 'long COVID' recovery and rehabilitation?

 

9. Have you (or close family member/ friend) faced any challenges in accessing support for 'long COVID' locally?

 

10. If currently in employment do you (or close family member/ friend) feel supported by your employer to help you manage 'long COVID'?

 

11. Is there anything you would like to tell us about the support you have received for 'long COVID'?

 

12. Is there anything you would like to tell us about how 'long COVID' has impacted on your quality of life?

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