New statewide criteria for long COVID are now in effect across Victoria, making it easier for patients and GPs to navigate referrals to specialist hospital services for the small number of patients who may need specialist support.
GPs are being urged to check their local HealthPathways or care pathways website when considering a referral for a long COVID patient. This will ensure that patients receive timely access to the most appropriate hospital-level service, as close to where they live as possible.
While most patients diagnosed with long COVID can and will be managed in general practice and primary care, some patients require referral to hospital-based specialist clinics. From the data available, current prevalence estimates of long COVID (defined as symptoms lasting more than 12 weeks) in Australia range from 5 per cent to 10 cent of COVID-19 cases.
The criteria were developed by a team of GPs and hospital clinicians experienced in long COVID treatment. They are for single organ symptoms (such as cardiology and neurology), allied health, and multidisciplinary services (such as rehabilitation, cardiac rehabilitation, pulmonary rehabilitation or joint cardiopulmonary services). The criteria assume a probable or confirmed diagnosis of long COVID; patients should not be referred for diagnosis.
Richmond GP Dr Jeannie Knapp is a GP adviser at North Western Melbourne Primary Health Network. She says that general practice is well placed to manage long COVID but the clear, consistent criteria are welcome when she needs to refer to hospital-level support.
“GPs are experts in multisystem care, we are care coordinators, and we provide holistic support and education to our patients. We have access to most of the same diagnostic services as hospitals and can mobilise a multidisciplinary team.
“Victorian hospitals already provide these levels of communication for surgery, and most hospitals have this referral management in place. As a GP, it is reassuring that there is now a process of clear communication in place.”
Dr Louis Irving, a respiratory physician who leads services for long COVID patients at the Royal Melbourne Hospital, said that while they don’t expect a huge number of referrals for long COVID patients, some patients do require a specialist to work closely with them on their road to recovery.
“We are now in a phase of the COVID-19 pandemic where most people who contract the disease can self-manage their symptoms at home and recover fairly quickly. Those who do require care after 12 weeks can usually work with their GP and primary care team on a rehabilitation plan. While recovery can take some time, most patients gradually recover over time.
“However, some patients do need to be seen at a hospital clinic. Our specialists can assess symptoms such as ongoing fatigue, breathlessness, cognitive impairment, loss of smell and taste, and sleep issues and offer advice on a suitable management plan.
Dr Knapp’s recent article on reclaiming long COVID as a primary care issue is available here.