COVID-19 has turned a spotlight on health inequities among Americans in both its acute viral phase and the extended symptoms and complications known as Long COVID. Now, healthcare providers are seeing this inequity manifest in lack of access to proper post-COVID care for non-White populations.*

White women the bulk of patients

Healthcare providers have noticed that, while Black and Hispanic men make up the majority of patients who are hospitalized for COVID-19, White women are more likely to visit post-COVID recovery clinics.

At Boston’s Brigham and Women’s Hospital, pulmonary and critical care physician Daniela Lamas, M.D. says that many COVID patients were Black and Hispanic, did not speak English, and were brought into the hospital’s intensive care unit from neighboring communities. 

• In contrast, Lamas says, most of the post-COVID patients Brigham and Women’s has seen at its COVID Recovery Center have been self-referred, non-hospitalized patients suffering from Long COVID rather than post-intensive care syndrome (PICS).
• Between April 2021 and April 2022, there were more than 1,200 patients treated at the hospital’s COVID Recovery Center. Of these patients, Lamas says, 80% were White and 70% were women.

Nisha Viswanathan, M.D. has noticed a similar trend at the University of California Los Angeles (UCLA). In UCLA’s Long COVID program, which she directs, Viswanathan said the majority of her patients have been financially well-resourced and experienced at making their way through the healthcare system.

Where are all the post-COVID patients going?

In an opinion piece in The New York Times, Lamas described how she and her colleagues originally intended to serve people suffering from PICS—the “unintended legacy of critical care.” Instead, they’ve witnessed an influx of self-referred, non-hospitalized people who are dealing with Long COVID and desperate for answers.

Lamas and the clinic have wondered what has happened to all the post-COVID Black and Hispanic patients who were admitted to intensive care. In her view, there are two issues.

• Finding the best way to serve people severely affected by COVID, but who do not have Long COVID, or if they do have it, aren’t showing up at recovery clinics.
• Determining whether minority populations are also experiencing the burden of Long COVID, but it’s not being addressed.

Asks Lamas, “How do we ensure that those who bore the brunt of this disease have the best chance to thrive afterward?” In an interview with Lamas, Viswanathan explained how some of her patients were able to arrange private flights to Los Angeles to secure appointments. “How do you provide care to the neediest individuals when you have this competing crowd?” This inequity can affect whether less-privileged patients seek care for PICS and Long COVID.

Another issue is that more treatment is needed for both Long COVID and PICS, but this can only happen with participants who represent the broad spectrum of those suffering.

Outreach needed

“Looking at the data,” says Elizabeth Gay, M.D., director of Brigham and Women’s COVID Recovery Center, “we know we’re not seeing the patients who bore the brunt of Covid hospitalizations.” She adds that clinics need to be very deliberate in reaching out to these underserved populations. The Boston clinic is making outreach efforts to address language, transportation, and other accessibility issues via partnerships they’ve created with various community organizations.

*Kayser, A. (2022, September 27). Viewpoint: Access to long-COVID care financially, racially disproportionate. Becker’s Hospital Review. https://www.beckershospitalreview.com/health-equity/viewpoint-access-to-long-covid-care-financially-racially-disproportionate.html