Call for more investment in long COVID treatment

Funding for more multidisciplinary clinics with virtual access and living guidelines is needed to help deal with the growing burden of long COVID, according to the Royal Australasian College of Physicians (RACP).
 
The organisation has also raised concerns about the closure of long COVID clinics, saying more government funding is required in spite of a detailed public inquiry held by the Standing Committee on Health, Aged Care and Sport, which reported in April this year.
 
This week, the ABC reported that five of 23 long COVID clinics in Australia has either been scaled back or closed.
 
Among its suggestions, the RACP said more multidisciplinary clinics with virtual access, including to patients in rural areas and those managed in Aboriginal and Torres Strait Islander health services, are needed.
 
It is also advocating for referral pathways to improve the way rehabilitation and respiratory doctors work together, and the development of evidence-based living guidelines for GPs and other health professionals.
 
Dr Kate Graham, a GP in rural western Victoria who co-wrote the first national long COVID HealthPathway, said there is strong evidence multidisciplinary care works in the treatment of the condition, which is known for its many, varied symptoms – but said there are significant challenges.
 
‘While general practice is capable of coordinating and managing complexity in chronic conditions such as long COVID, it is extremely difficult to achieve this in the current chronic-disease-management, referral, waitlist and funding environment, especially for long COVID patients with limited financial resources,’ Dr Graham told newsGP.  
 
‘It would be good to see future health funding recognise the individual and economic impact of long COVID and proactively fund multidisciplinary models of care that have evidence of benefit, as the closure of clinics was challenging for those in areas where they were accessible.
 
‘Even when they were open, the wait times and limited options meant that they were not able to meet the needs of the long COVID population.’
 
The RACGP suggested in its submission to the inquiry that chronic disease GP Management Plans (GPMPs) could be used to help manage long COVID but said the stipulation that a condition needs to be present for six months is ‘causing hesitancy’.
 
The Parliamentary report indicated that most support for the condition is falling on primary care – and GPs in particular – a finding that corresponds to Dr Graham’s own experience.
 
‘Current successful GP-led clinic models are privately-run and involve an out-of-pocket cost for patients but provide a blueprint for how GP-led care in the community could be achieved if funding structures differed,’ she said.
 
Dr Graham also noted particular pressures on more remote areas.
 
‘Given the challenges with fatigue and travel, it is essential that any future models consider the patient impact of attending multiple appointments at a distance from home,’ she said.
 
According to Dr Graham, funding should also be reallocated to ensure up-to-date evidence is used.
 
‘In order for GPs to remain up-to date with evidence-based care, it is essential to have easy-to-access, relevant pathways, resources and guidelines,’ she said.
 
‘Healthpathways on long COVID have been one way that we have translated guidelines into a point-of-care resource.
 
‘We would like to see that organisations such as the National Clinical Evidence Taskforce have funding re-established to be able to look at and analyse the emerging research taking place in this space to ensure that the guidance we provide for our patients aligns with best care.’
 
The Federal Government ceased funding the Taskforce at the end of last year. While the COVID-19 and MPX guidelines are still accessible, they stopped being updated at the end of July 2023.
 
The Parliamentary inquiry report also recommended that education for GPs to help diagnose and treat long COVID should form part of Continuing Professional Development (CPD).
 
After the report was published, Federl Health and Aged Care Minister Mark Butler announced $50 million for long COVID research via the Medical Research Future Fund (MRFF).   
 
According to a study published in October by the Australian National University, almost 5% of Australian adults who have had COVID had symptoms lasting three or more months.
 
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