The public health system launched a $114 million effort to build three centers of excellence, located in the Bronx, Brooklyn and Queens.
“We based our centers around evidence of what we’re finding in terms of prevalence of symptoms,” Long said. That includes breathing problems, heart issues and fatigue. Primary-care doctors screen patients for the symptoms before referring them to on-site pulmonologists, cardiologists and mental health specialists, he said.
Continued care can be necessary for patients who were hospitalized due to the coronavirus, said Dr. Marjan Islam, co-medical director of Montefiore’s COVID-19 Recovery Clinic, located at the Albert Einstein College of Medicine in the Bronx. The health system saw that patients who had been discharged were experiencing complications that required a different level of expertise from the typical long-COVID patients, Islam said.
Larger health systems such as New York–Presbyterian have included a post-ICU component to their clinics. Long noted that Health + Hospitals centers have treated thousands of patients since they opened. Islam said Montefiore’s clinic has seen about 500.
What is understood about long COVID is continuously changing, and health systems need to adapt their protocols accordingly, experts said.
“There are reports of new symptoms all the time,” Long said. “Even though our clinics are set up to address the most common ones, patients can be readily transferred to our hospitals for the less common ones.”
An interconnected, multidisciplinary team working together is key, Islam said. Each division at Montefiore has someone tapped to be a COVID-19 specialist, and the specialist provides the primary-care doctors interacting with long-COVID patients with updates on what to screen for, he said. Rehabilitation specialists were brought in from the health system’s Burke Hospital in White Plains to assist in treatment, as the clinic lacked such capabilities, he added.
Also critical to the clinics’ success is outreach, Long said.
“A lot of people haven’t seen a doctor in the last year,” he said, “and they might not be aware they’re suffering from long COVID.”
The city’s Test and Trace Corps reaches out to patients who have interacted with its contact-tracing system four weeks after completing intake, referring them to their centers as needed, he added.
As the pandemic rolls on, the necessity of such clinics could endure.
“We still have a wave of patients to go in terms of our recovery,” Long said.
As COVID-19 cases continue to fall and vaccination rates increase, however, the clinics’ role might change.
“Our centers can transition into places for health care maintenance and comprehensive primary care,” Long said, adding that the centers of excellence already offer mammograms, dental services or optometry.
Montefiore’s specialized post-ICU clinic can make that transition as well, Islam said. Its referral and evaluation system, set up specifically for COVID-19 patients, can be adapted by any surgical unit for post-ICU support, he said.
“Our work with providing care for patients after they’ve been discharged doesn’t have to stop with COVID-19,” Islam said.