Doctors overwhelmed with high demand of Long COVID patients call for support

By CHRISTINE LAI

Long COVID clinics across the country have been long under resourced and are struggling to meet the demand of patients seeking treatment as the health system continues to bear the pressure of high requests for those struggling with symptoms.

In October this year, Dr Irani Thevarajan, an infectious diseases physician at the Peter Doherty Institute for Infection and Immunity appeared at the first public hearing of the Inquiry into Long COVID and repeated infections to express the view that establishing a large population study specific to Australia was “critical” to “appreciating the burden of long COVID”.

As reported by the Royal Australian College of General Practitioners (RACGP), Dr Thevarajan said that there was an increasing body of international evidence for the risk factors involved in long COVID, including its greater prevalence among women, those with certain comorbidities, as well as patients from poorer socio-economic backgrounds.

Following the release of an issues paper by the House of Representative Health Committee, the RACGP have made a submission with recommendations that include increased attention on the difficulties doctors have to undertake while treating patients with long COVID.

In the submission, the RACGP outlined the vital role of General practitioners (GPs) during Australia’s COVID 19 responses, where they have provided care for COVID positive patients, administered over 50% of the nation’s COVID-19 vaccines and are now responding to the longer-term effects of the pandemic including “long COVID, repeated COVID-19 infections, follow up care missed during lockdowns and increased mental health presentations.”

The RACGP notes that the unprecedented nature of the pandemic means that evidence and responses to the spectrum of post-COVID-19 illnesses is dynamic and continually evolving. However, they have also stated that it is vital for “appropriate investments” to be made and “lessons from this pandemic” are used to help inform doctors’ management of ongoing health and societal impacts, in addition to the country’s response to future infectious disease outbreaks.

Personal and professional impacts on medical professionals 

In the submission, the impacts of long COVID were reported to be felt by both the patient and by the healthcare team supporting them.

The time burden in supporting patients with long COVID has impacted GP workload, their ability to take on new patients, and the financial viability of practices.

While responding to rapid changes in the early days of the COVID-19 pandemic, time-poor GPs have been forced to deal with competing demands including navigating emerging evidence, assessment and treatment options and inconsistent referral pathways which have been detrimental for the health system.

Burden of care of long COVID and repeated Covid infections 

The House of Representative Health Committee has said that it anticipates the greatest burden of care relating to long COVID and repeated COVID infections will fall on primary care providers, including GPs.

RACGP President Dr Nicole Higgins said this submission highlighted the need for GPs to be supported to care for patients with long COVID.

“Across Australia, long COVID is affecting people, with symptoms ranging from fatigue, breathlessness, anxiety and depression, chest pain, “brain fog” and changes to taste and smell which can last for weeks or months after the initial illness.

The Committee’s issues paper has identified key themes emerging from the evidence to date, including that the greatest burden of care relating to long COVID and repeated COVID infections will fall to GPs”, she said.

Dr Higgins spoke on the issues paper highlighting the need for greater investment in data collection and research into long COVID, which aligned with what the RACGP has long been calling for.

“These patients require complex care, and this takes time. But the current patient rebate structure disincentives GPs to spend more time with patients with multiple, complex conditions, including those with long COVID.

While we may want to move on from the COVID-19 pandemic, the reality is that this virus is here to stay. And we need a long-term plan to deal with COVID-19 and long COVID in the years ahead. Access to evidence-based medical care and support is essential to ensure long COVID sufferers have the best chance of recovering and moving on with their lives”, Dr Higgins said.