Long COVID: sustained and multiplied disadvantage, 2022, de Leeuw et al

[Andy]

Policy and institutional preparedness for the coronavirus disease 2019 (COVID-19) pandemic recovery is essential1 because the roots of the pandemic and its resolution are deeply systemic.2 The COVID-19 pandemic disproportionately affects certain groups and populations. Generally, they are labelled as “vulnerable”, “marginalised” or “disadvantaged”, and these groups may be considered at risk from a medical perspective and/or from the perspective of their opportunities to function and participate in the community.3 But there is great and refined differentiation within these populations, whereby the varying waves have highlighted various inequitable and devastating effects. We followed recent guidance by Dahlgren and Whitehead4 for our understanding of differential effects of the COVID-19 pandemic and one of its expressions (“long COVID”) across Australian populations, and the long term impacts on health, wellbeing and economic resilience.

Open access, https://onlinelibrary.wiley.com/doi/10.5694/mja2.51435

 

[Hutan]

However, to make a reliable and lasting impact on the prevention of entangled disadvantage, Australia should also focus on working in collaboration with equity-seeking populations and communities most affected to understand lived realities and potential solutions. Policy and its development (or lack thereof) in response to long COVID is also key, as will be its integration into a nationally consistent and regionally administered patient-centred health and social response.21 We must consider how structural inequities, such as housing availability and affordability, lack of adequate social protection, and marginalisation from health systems, may further entrench disadvantage in the face of long COVID.

This brief commentary is light on detail. It does note that the impact of Long Covid will be very different in affluent communities versus those communities that don't have easy access to quality health care, intergenerational wealth and affordable housing. Specifically, it mentions indigenous Australian communities as likely to be highly impacted.

I share the concern. I'd like to see more ideas about what to do about it. I think one first step is collaborative research in these communities on the incidence of post-Covid-19 symptoms, the awareness of community health care providers, and on the types of patient support that are likely to be useful.