Official websites use. Share sensitive information only on official, secure websites. Primary care providers are in a unique position to provide and coordinate care for vulnerable patients with long COVID. Policy measures should include strengthening primary care, optimizing data quality, and addressing the multiple nested domains of inequity. It occurs in adults who were hospitalized and those who were not 6 , 7 , 8 and more rarely in children.
The natural history of long COVID appears to be gradual improvement over time in most cases, though recovery is typically measured in months. Patients without concerning symptoms should be supported but spared overinvestigation and overmedicalization. Adapted from an original diagram by Bentley 2 under Creative Commons License. We will consider these approaches in turn. The first is medical expenses. For many patients, this cost would be a deterrent from screening or, for those without health insurance coverage, seeking advanced care.
Postacute care ranges from skilled nursing facilities to inpatient rehabilitation to home health agencies. As noted earlier, this affects the costs of testing and the resultant willingness to be tested. The second economic barrier is that debilitating and disabling symptoms interfere with people's ability to work and hence to generate income for themselves and their dependents.
The vulnerable in society have less job security, less flexibility in their roles, and less entitlement to sick pay and occupational health services. People living in medically underserved areas, who include disproportionate numbers of Black and minority ethnic groups, may have inadequate access to primary care. Residential segregation underlies and exacerbates health disparities.
Vulnerable groups are disproportionately represented among essential workers e. The effective management of long COVID requires, first and foremost, recognition of the condition and empathic validation of the patient's experience. It also requires a skilled, generalist assessment of the multisystem disorder which may affect virtually every organ in the body and judicious referral to cardiology, respiratory, neurological, mental health, or other specialist colleagues as appropriate. A comprehensive training program for generalist clinicians, along with care pathways, guidance, and criteria to which patients should be referred, must underpin a primary careβled long COVID response.
