Introduction

Long COVID, sometimes also called long-haul COVID, chronic COVID or post-acute sequelae of SARS-CoV-2 infection,¹ presents a complex and evolving challenge for health care systems and providers, particularly for primary care physicians. As millions of individuals experience ongoing symptoms long after recovering from the acute phase of COVID-19, family physicians can play a critical role in addressing the multifaceted needs of these patients. This supplement highlights the importance of advocacy, equity and resource access in managing long COVID, focusing on underserved and marginalized communities to ensure all patients receive comprehensive and equitable care. It can accompany a previous FPM supplement, Understanding Long COVID: Implications for Family Physicians.

Advocacy for Long COVID Care

Advocating for improved recognition and resources for patients with long COVID is essential to ensuring they receive the care they need. Family physicians should make their voices heard in efforts to secure funding for research, education and patient support services in the following ways:

• Raising Awareness: Advocacy efforts should aim to increase awareness among policymakers, public health officials and the public about the widespread and long-term impacts of long COVID. Family physicians are well-positioned to amplify patient voices and push for systemic changes.

• Securing Funding and Support: Family physicians can help advocate for increased funding directed at long COVID research, particularly in areas that focus on disparities in care and outcomes. Collaborative efforts can ensure that health care systems are adequately equipped to address the needs of these patients, especially those in economically disadvantaged areas.

• Policy and Insurance Reform: Family physicians can influence health policies that promote equitable access to care, such as advocating for insurance coverage that facilitates comprehensive, multidisciplinary care. Policies should address patients' barriers to accessing necessary long COVID services, particularly in underserved communities.

Health Equity and Long COVID

Disparities in long COVID outcomes are stark, with under-resourced and underserved communities disproportionately affected by both the virus and its long-term effects.² Addressing these inequities requires a multifaceted approach, including the following:

• Recognizing the Impact on Certain Populations: Studies show that individuals from racial and ethnic minority backgrounds, individuals living in rural areas, and individuals with low income and disabilities all face greater risks of developing long COVID and encounter more barriers to access care.^2,3,4 Structural racism and social determinants of health contribute to these disparities, making it imperative for family physicians to understand and address these factors within their practices.

• Improving Access to Care: Family physicians should advocate for expanded access to care for these populations, including increasing the availability of testing, vaccinations and post-COVID care in underserved areas.^5,6 Telemedicine has emerged as a crucial tool, but disparities in digital access must also be addressed to ensure equitable care.⁶

• Community-based Approaches: Family physicians should engage in community-based efforts to promote education and support for individuals suffering from long COVID. This can include collaborating with local health departments, advocacy groups and other health care professionals to ensure patients receive comprehensive care.

Addressing the Social Determinants of Health

SDOH significantly affects both the prevalence and outcomes of long COVID.⁷ Family physicians should incorporate an understanding of SDOH into their care strategies to include assessing the following:

• Economic Barriers: Many patients with long COVID face economic hardships that complicate their ability to access care.⁸ Family physicians should advocate for policies that provide financial support for patients unable to work due to long-term illness and ensure access to affordable treatments.

• Access to Food, Health Care and Housing: SDOH, including food insecurity and access to health care and housing, can exacerbate the effects of COVID.⁹ Family physicians should assess these factors and collaborate with social workers and community organizations to connect patients to necessary resources.

• Behavioral Health Support: Long COVID often has significant mental health implications, including anxiety, depression and cognitive dysfunction.¹⁰ Family physicians should advocate for integrated behavioral health services and resources to address these needs within the context of long COVID care.

Navigating Resources for Long COVID Care

Effective care for long COVID requires a coordinated, multidisciplinary approach, including the following:

• Multidisciplinary Care Teams: Long COVID affects multiple organ systems, often requiring input from various specialists.^11,12 Family physicians should work with pulmonologists, neurologists, cardiologists and mental health professionals to create individualized care plans.

• Telehealth and Remote Care: As many patients with long COVID are unable to access in-person care due to mobility issues, telehealth can be an essential tool for monitoring symptoms and providing care.^6,13 Family physicians should advocate for reimbursement parity for telehealth services to ensure continued access.

• Patient Advocacy and Education: Educating patients about long COVID is vital. Family physicians should provide resources about symptom management and available treatments and emphasize the importance of seeking timely care.¹⁴ They can also assist patients in navigating complex disability claims and provide referrals to advocacy organizations.

Call to Action

Family physicians are pivotal in advocating for patients with long COVID, ensuring equitable care and improving access to necessary resources. By working collaboratively with other specialists, advocating for policy reform and addressing the unique needs of underserved communities, family physicians can help mitigate the impact of long COVID and improve the quality of life for those affected. Continued education, research and advocacy efforts are critical to long COVID care and management success.