Long COVID Response Spotty among Local Governments

The Yomiuri Shimbun

15:25 JST, February 19, 2023

Only about 40% of prefectural governments have publicly listed medical institutions capable of treating long COVID, according to a Yomiuri Shimbun survey that showed broad disparities in local governments’ ability to support patients with such symptoms.

Long COVID refers to symptoms that started at the time of infection with the novel coronavirus, developed after recovery from COVID-19, or where the cause is not clear.

Symptoms of long COVID vary widely and can include fatigue, a loss of taste or smell, an inability to think clearly, loss of strength, hair loss and depression. Such symptoms have been known to last for a year or more.

The precise cause of long COVID has not been identified, and treatments are generally limited to relieving symptoms.

Guidelines for treatment of long COVID prepared by the Health, Labor and Welfare Ministry recommend that affected individuals initially be treated by primary care doctors and then recommended to specialists as necessary.

However, many young people do not have primary care doctors. This leads to some individuals having difficulty in finding a place where they can receive proper treatment and visiting many medical facilities one after another.

The Yomiuri Shimbun conducted the survey for all 47 prefectures in January. Nineteen prefectural governments, including Tokyo, Kanagawa, Osaka and Fukuoka, publicly listed medical institutions capable of treating long COVID as primary care providers on their websites or elsewhere.

“We made it easier to find places as we had received numerous inquiries about facilities admitting long COVID cases,” said an official of the Tokyo metropolitan government.

According to the survey, 482 medical institutions were capable of treating long COVID in Tokyo, the highest of any prefecture, while Fukuoka Prefecture had 312 such institutions and Kanagawa Prefecture had 221.

Twenty-eight prefectures, including Hokkaido, did not publicly list medical institutions for long COVID sufferers. As reasons for not doing so, some said that it would put stress on particular institutions or that primary care doctors were handling such cases.

Local governments have consultation desks for inquiries about novel coronavirus-related issues, and five prefectural governments — Hokkaido, Fukushima, Tokushima, Saga and Okinawa — said in the survey that they introduce specific hospitals capable of treating long COVID in response to inquiries.

The four prefectural governments of Aomori, Ishikawa, Tottori and Yamaguchi only introduce medical institutions willing to accept long COVID sufferers if the individual has a letter from a primary care doctor.

On the other hand, 24 prefectural governments, including Ishikawa and Kyoto, have established systems for connecting long COVID patients unable to be treated by a primary care doctor with cooperating medical institutions able to offer specialized treatment.

The Kansai region stood out for how few prefectures had taken any measures, with Shiga, Hyogo and Wakayama prefectures not having publicly listed available medical institutions, introduced patients to medical institutions nor established systems for this purpose.

“Behind the lag in publicizing names of medical institutions and establishing systems seems to be the fact that, even if doctors can diagnose long COVID, all they can do for the most part is watch and wait,” said Prof. Akihito Yokoyama of Kochi University, an expert on respiratory medicine who served as the lead researcher for a long COVID study team under the health ministry. “But patients need to see doctors to check whether they have any other diseases. I want local governments to encourage medical institutions to join the care schemes and sharing lists of such institutions.”