Opinion | Where Are All Our Post-Covid Patients? - By Daniela J. Lamas
The New York Times
Dr. Lamas is a pulmonary and critical-care physician at Brigham and Women’s Hospital in Boston.
At the University of California, Los Angeles, Dr. Nisha Viswanathan finds that she disproportionately sees long Covid patients in her post-Covid clinic who are well off and adept at navigating the health care system and — in a few cases — can even arrange a private jet to fly from their home to Los Angeles. If coronavirus was a disease of the vulnerable, Covid-19 follow-up has become a luxury of the well resourced. These are patients who can call the clinic repeatedly, waiting for a spot to open, who can afford to take days off work for pulmonary rehab and other appointments. “How do you provide care to the neediest individuals when you have this competing crowd?” Dr. Viswanathan asked.
This is particularly troubling given the data from her own institution, surveying Covid patients after their hospital discharge, which found that Black and Hispanic patients had lingering symptoms such as fatigue and shortness of breath at similar rates as their white peers. While expectations of the health care system and the experience of illness are different across cultures, inequities in health care access could have an effect on whether patients seek care. The suffering is out there.
Indeed, at the Covid-19 Recovery Clinic at Montefiore Medical Center in New York City, long Covid is not a disease of the privileged. At the clinic, in the Bronx, the population reflects the diversity of their surrounding community: About half of the patients are Hispanic, a quarter Black and about 15 percent Caucasian. Thanks to doctors who are familiar with the challenges of navigating Medicaid, these patients receive referrals to physical therapy and sub-specialists that they’re able to access.
(...) “These patients are young and are extremely debilitated, and they are coming to me six months too late — because we don’t have the resources to follow them and schedule them, so they fall through the cracks,”
(...) At every turn, Covid-19 has revealed the fault lines in our health care system and society. It should come as little surprise that the care delivered in the wake of this virus threatens to further entrench pre-existing disparities.