RACGP to advocate for more support at long COVID inquiry

The Parliamentary Inquiry into long COVID and repeated COVID infections has begun its latest round of public hearings, with the RACGP set to present its submission to the Standing Committee on Health, Aged Care and Sport on Monday.

While much is still unknown about long COVID and its associated clinical impacts, GPs are nonetheless already taking on much of the care in the community, the incidence of which is likely increasing following a record year of cases in 2022.

It is why Professor Mark Morgan, Chair of RACGP Expert Committee – Quality Care, told newsGP he will push for more clinical and professional support for GPs during his 40-minute appearance on Monday morning.

‘GPs need to be supported to coordinate services for patients and to provide affordable long appointments for these complex presentations,’ he said.

‘I am also very keen to make it clear that Australia needs an independent, trusted source of evidence synthesis and clinical practice guidelines. 

‘Without this, people will be exposed to best-guess treatments and even quack treatments, which are likely to be harmful and expensive.’ 

Professor Morgan will be joined at the hearing by other peak body representatives, medical researchers and ventilation experts, all of whom will discuss the effects of long COVID and repeated COVID infections on patients, health workers and schools.

The Committee’s Chair, Labor MP Dr Mike Freelander, said he is looking forward to gaining the perspectives of organisations and researchers who have played ‘central roles’ throughout the pandemic.

‘The Committee is interested in hearing about how we may be able to reduce the risk of COVID in highly social settings such as schools, including by investigating the role of ventilation,’ he said. 

‘We are also looking forward to speaking to peak bodies to better understand how long COVID and repeated COVID infections are impacting Australia’s primary care capability.’

To date, long COVID has been managed by a combination of standard GP-led community care, hospital-based clinics, and specially formed general practice long COVID centres.

But going forwards, Professor Morgan believes primary care should be ‘strongly supported’ to provide most long COVID treatment and care coordination, with only people who have high end and disabling symptoms treated in specialist centres.

‘A few specialist centres that get really good at managing complex long COVID would be helpful, but not as the mainstay of treatment for the majority of the population,’ he said.

‘History has told us they will otherwise be flooded and not able to cope with demand. Look at pain clinics, or sleep clinics – they’re few and far between with long waiting lists, and quite tight entry requirements.’

Aside from improving access to treatment, Professor Morgan says GPs are also well placed to help manage and coordinate the care of patients with long COVID.

‘GPs are the backbone of the health system in Australia,’ he said. 

‘Our patients come to see us with distressing symptoms and signs, often with no diagnosis, and part of our job is to help form a diagnosis or at least a plan to help our patients recover.

‘Long COVID has multisystem impacts and therefore lends itself to generalist management by GPs rather than subspecialist management. It can also have biopsychosocial impacts that GPs are well used to addressing.’

However, in order to do so effectively, he said GPs will need the support of a trusted organisation dedicated to constantly reviewing the latest research and clinical trials.

‘Australia currently has the National Clinical Evidence Taskforce that came together at the start of the pandemic to produce and maintain a living guideline with the support of 35 peak bodies – including the RACGP and more than 200 volunteer clinicians,’ Professor Morgan said. 

‘I co-Chair the COVID-19 Primary and Chronic Care Panel, but the modest Federal Government funding has not been continued with the thought that the Therapeutic Goods Administration and Pharmaceutical Benefits Advisory Council could take over the role of assessing pharmaceutical treatments. 

‘This is inadequate, because for long COVID rehabilitation is much more than just drug treatments. 

‘There are hundreds of current trials worldwide exploring what works and what doesn’t work. Some system is needed to make sense of all that information because clinicians cannot individually keep up.’

And while the current hearings are focused exclusively on long COVID, Professor Morgan is hopeful that its outcomes and findings extend to other post-viral conditions.

‘There’s been an ignored urgency to have a strategic response to post-virus syndromes in general,’ he said. 

‘People who have chronic fatigue syndrome and other post-viral symptoms get quite a raw deal in the current environment, because there’s not enough information and not enough coordination or support for them.

‘The recommendations of this inquiry should not be ring fenced around just long COVID, but actually help all people with associated symptoms that overlap with long COVID.’

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