The Royal Australian College of General Practitioners (RACGP) has released new guidelines to help GPs and their teams care for patients with post-COVID-19 conditions, commonly called 'long COVID'.
The condition of long COVID, now officially recognised by the World Health Organization, refers to a range of symptoms that can last for months after the initial COVID-19 illness. The ongoing effects remain unknown, and prolonged illness could potentially last for years. The symptoms can be very debilitating and include fatigue, breathlessness, anxiety and depression, chest pain, 'brain fog' as well as changes to taste and smell.
The Caring for patients with post-COVID-19 conditions resource provides advice and support to GPs and their teams on caring for patients with post-COVID conditions, and to encourage the development of individualised plans for their ongoing management. It includes information on:
· identifying patients at higher risk of post-COVID-19 conditions including those who have experienced severe illness during their acute COVID-19 illness
· arranging a time with the patient to discuss how to monitor and manage their symptoms at home
· escalating care for "red flag" symptoms such as unexplained chest pain
· accessing multidisciplinary care and patient support services in the community.
RACGP President Dr Karen Price said that long COVID needed to be taken extremely seriously.
"Unfortunately, post-COVID-19 conditions have flown under the radar," she said.
"Just because you recover from the initial illness, that does not mean you are out of the woods. As I have been saying for many months, it might not be the end of your COVID-19 story – it could just be the beginning.
"Throughout 2021, there was so much media attention paid to the very rare risks of thrombosis with thrombocytopenia syndrome, or TTS, as well as myocarditis and pericarditis following COVID-19 vaccination. However, many people are not aware that long COVID can severely disrupt your quality of life, your job or study, your relationships and your long-term health and wellbeing. Some people with long COVID are struggling to walk up a flight of stairs months after having the virus.
"This should act as an extra impetus for all eligible people to get vaccinated right away. If you are still weighing up whether to be vaccinated or not remember that if you contract the virus, you may also suffer from long COVID symptoms for weeks or even months post illness. This isn't just a rare problem for older people too, young people can also experience long COVID.
"One United Kingdom study of 20,000 people who had tested positive to COVID-19 found 13.7% reported having symptoms 12 weeks after acute infection. Studies indicate that the risk of post-COVID symptoms in people who contract the virus after their second dose of a COVID-19 vaccine is approximately halved.
"So please, if you haven't already, get vaccinated and encourage your friends and family to do the same. The ramifications of not doing so could prove disastrous for your long-term health."
Dr Price said that the guidelines were a useful resource for the nation's practices caring for patients with long COVID.
"The guide provides key information on assessing patients for long COVID after their initial illness, providing education on symptom monitoring and management and linking patients to appropriate multidisciplinary services, allied health and support services," she said.
"It also addresses considerations when providing care for specific groups recovering from COVID-19 including patients who have had severe COVID-19 illness requiring hospitalisation, older patients, people with disability, people from culturally and linguistically diverse communities, Aboriginal and Torres Strait Islander patients, children and babies.
"As is always the role of the GP, caring for patients with long COVID is not just about managing the physical symptoms. We also support the mental health and wellbeing of patients, and the guide includes information on the mental health impacts of the acute illness, addressing stigmatisation post COVID-19 infection and acknowledging and validating the patient's experiences.
"So, there is a lot for GPs and their teams to consider; however, I am confident that practices will continue doing an extraordinary job supporting patients during the pandemic."
The RACGP President also warned that many practices were under enormous pressure helping patients during the pandemic.
"General practices are the backbone of the vaccine rollout, and we are also busy helping those affected by COVID-19, including patients with long COVID," she said.
"Many GPs and their teams are feeling understandably exhausted, and we are set to shoulder an even heavier load with so many pharmacies pulling out of the vaccine rollout.
"The additional financial pressures placed on practices during the pandemic have been very difficult for many to manage. As I have stressed recently, the $25 item number to see COVID-19 patients face-to-face is inadequate to cover costs of this sort of highly personalised care. We are working hard to keep up world-class care during the pandemic and it has been very challenging with many patients delaying or avoiding screenings and consultations.
"So, to take on an even more significant role in the vaccine rollout, including vaccines for children and booster jabs, care for those with long COVID as well as provide our usual day-to-day care - we really need more support from government. We are burning the candle at both ends after an extraordinarily difficult two years.
"To all GPs, practice managers, nurses, receptionists and administrative workers my message remains the same – thank you and keep up the great work. Your communities have never needed you more."
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