As hospitalizations and new cases of COVID-19 decline around the country, we now have the opportunity to focus on the long-term challenge that long COVID poses and will pose to many people. It is a confounding syndrome, and one that has affected the work and income of nearly 75% of long COVID patients. Meeting and managing this challenge requires the combined efforts of researchers and clinicians worldwide.

On February 22, 2022, U.S. News and World Report Live hosted a panel discussion between leading health and infectious disease experts to explore the scope and causes of the ongoing long COVID crisis, along with the latest management techniques and treatments.

Scope and Symptoms

Currently, about 30% of people infected with the SARS-CoV-2 virus go on to experience long COVID, or PASC, defined as “new, returning, or ongoing symptoms that last more than 28 days after the patient’s initial acute diagnosis of COVID,” said Dr. Kristin Englund, an infectious disease specialist who is the founder and director of Cleveland Clinic’s post-COVID reCOVer clinic.

Breathing difficulties and extreme fatigue are among the most common symptoms that send people who think they may have long COVID to seek medical care. “We treat them before we know the causes,” Englund said, because if someone comes in with a serious symptom like a high fever, “you can’t wait.”

Treatments for Long COVID

Once antivirals and other treatments for acute infections are done, those left with troubling symptoms have responded well to:

• Physical therapy 
• Occupational therapy
• Speech therapy, which includes memory re-training 
• Diet changes
• Exercise

All the panelists have found that simply receiving validation that they and their symptoms are being taken seriously can give patients a healing sense of relief, and reduce their anxiety, frustration, and overall stress.

Barriers to Effective Care

Unfortunately, while care is available, it’s not always accessible to many of those who need it. Some patients simply don’t know where to start, and they wind up doing nothing. Many in rural areas have to travel 60 miles or more to reach the nearest clinic. Many of those who did get to clinics were not taken seriously, at first, which discouraged them from seeking further help. This has especially been true for women.

Racial and ethnic minorities in both rural and urban centers are also not receiving culturally sensitive outreach, said Dr. Bonnie Maldonado, professor of Global Health and Infectious Diseases at Stanford University. That’s a major problem in research, as well, agreed Dr. Priya Duggal, a professor and vice chair of epidemiology at Johns Hopkins Bloomberg School of Public Health. “We need to partner with community leaders.” 

Given the complexity of long COVID, treatment often requires multiple specialty areas, and a large number of patients have no one to help coordinate care. “Up to 25% of Americans don’t have access to primary care,” said Dr. Philip Chan, MD, an associate professor at Brown University, and medical director of the Rhode Island Department of Health. 

Primary care physicians can also help rule out conditions that may be masquerading as long COVID, and they can refer patients to specialists as necessary. Since the beginning of the pandemic, however, the healthcare workforce in the U.S. has been significantly reduced–by about 124,000 providers–as a result of burnout.

Advice from the Experts

Fortunately, all is not lost. Dr. Chan emphasized that the increased use of telemedicine is one of the positive effects to come out of the pandemic, and Dr. Maldonado pointed out that streamlined care for complex, multi-specialty conditions has already been successfully modeled for decades by the patient “care hubs” established during the HIV/AIDS crisis. It’s a model that should be easily adaptable for long COVID care.

The expert panelists closed with words of advice for patients, providers, and the U.S. healthcare system overall. Collectively, they recommended:

• “Shoring up” the primary care workforce
• Making better use of the academic workforce to ensure that the next generation is optimally trained to take on these challenges
• Improving outreach into underserved communities, including racial and ethnic minorities, women, and caregivers
• Placing more stock in validating patients’ symptoms and concerns
• Continuing telemedicine usage and support, and improving access to care for everyone, regardless of location
• That patients get a primary care physician, so that their symptoms are documented and referrals can be provided to any necessary specialists 

Lastly, they encouraged health and research professionals to work more collaboratively and share information, for the good of all. It’s the only way to move forward, said Englund. “We shouldn’t be standing on an island, trying to do this ourselves.” 

*U.S. News Live Team. (2022, Feb. 22). Webinar: The Looming Crisis of Long COVID. U.S. News and World Report Live. https://www.usnews.com/news/live-events/webinar-the-looming-crisis-of-long-covid