Long COVID clinics likely to be required across the country

Tens of thousands of people are expected to benefit from dedicated long COVID clinics that have opened at four hospitals across Adelaide, following a surge in infection to start the year.
 
The state has recorded more than 433,000 cases so far in 2022 – compared to 11,078 across 2020–21 – and with between 5–10% projected to experience some form of symptoms four weeks post-infection, referrals are expected to continue to increase.
 
RACGP SA Chair Dr Danny Byrne told newsGP there will be a ‘definite’ ongoing need for the dedicated clinics, which he anticipates will eventually be set up across the country to deal with skyrocketing patient demand.
 
‘We’ve got patients who haven’t quite met the technical definition [required for referral] of 12 weeks, but there are plenty of people with symptoms of long COVID,’ he said.
 
‘As soon as they hit that 12-week mark, there’ll be plenty of people being referred to these clinics.’
 
And with GPs set to be intimately involved with referring patients, Dr Byrne said it is vital that they are familiar with a condition that can sometimes be difficult to diagnose.
 
‘The GP’s role is very important to rule out other conditions,’ he said.
 
‘You want to make sure it’s not a thyroid or anaemia, or some other pathology that’s mimicking long COVID.
 
‘Also, GPs are important for psychological support, and for interpreting the findings and specialist letters from the hospital with plain language for the patient.’
 
South Australia has become the fourth state or territory to set up dedicated long COVID clinics, following NSW, Victoria and the ACT, and Dr Byrne believes it is inevitable that other jurisdictions will follow suit.
 
Already, there are calls in Queensland for long COVID clinics to meet a growing demand.
 
RACGP Vice President and Queensland Chair Dr Bruce Willett recently told the ABC that the time it can take for patients to develop long COVID means state health authorities are only now starting to recognise a rise in cases.
 
‘We’re currently at the height of the pandemic,’ he said.
 
‘We’re seeing the most cases that we’ve seen in Queensland, so I think we can expect those cases [of long COVID] to really ramp up over the next 2–3 months.’
 
But fellow GP and Queensland resident Dr Maria Boulton told the same publication that there is already a ‘definite’ need for the clinics, including in rural and remote areas.
 
‘These clinics should have already been established – we knew that COVID was going to hit our shores,’ she said.
 
‘We know from the experience overseas that people were going to get long COVID, and we believe that now we’re playing catch up and it’s important that those clinics get established urgently.’
 
And, given the breadth of care that is sometimes required for these patients, Dr Willett says it would be ‘prudent’ for authorities to start planning multidisciplinary clinics in jurisdictions where they are not currently established.
 
It is also why Dr Byrne believes public hospitals are best-placed to deliver long COVID care – with the assistance of GPs.
 
‘You’ve got to have access to different specialists, like respiratory, rheumatology, infectious diseases, cardiology, and general physicians,’ he said.
 
‘Then you’ve got to have allied health, physios, dietitians, exercise physiology – it’s a very difficult model to fund in a private system.
 
‘It’ll be too much workload for a hospital clinic to do everything. But they’ll do the assessment and the plan, and then it’ll be up to the community primary care teams to implement as best we can, with the funding that we have.’
 
Aside from providing care, Dr Byrne says these clinics will also be able to collect data and perform research to help refine treatment for long COVID as more is discovered about the novel condition.
 
He is also hopeful that referrals to the clinics will eventually be expanded to incorporate patients with chronic fatigue syndrome.
 
 
 
‘We know there are plenty of patients with this syndrome who haven’t had COVID but have got the same symptoms,’ Dr Byrne said.
 
‘It’ll be interesting to see if efforts on data, research and treatment strategies come out that can help our other long-term chronic fatigue patients post-viral infection.’
 
Australia has recorded 6.391 million cases as of 11 May, 5.996 million of which have occurred in 2022. Should 5% of these go on to contract the condition, at least 300,000 will require assistance.
 
But given nationwide daily cases have not dipped below 17,000 so far this year – at an average of more than 46,000 – that number is only going to continue to grow.
 
The RACGP’s long COVID guidelines are available on the college website.
 
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