First of its Kind Grant Expands Access to Care for People with Long COVID

Drs Hector Bonilla and Linda Geng consult with a patient. Image courtesy of Steve Fisch Photography, 2022.

September 26, 2023 - By Sarah Paris

Stanford Medicine is among nine organizations that received major funding to expand access to care for underserved, rural, vulnerable, and minority populations disproportionately impacted by the effects of the pandemic.  The Stanford project, named Long COVID Care REACH (Long COVID Care Resources and Education for Advancing Community Health) is co-led by three Department of Medicine investigators: Upinder Singh, MD; Linda Geng, MD, PhD; and Hector Bonilla, MD.

Long COVID is a complex and poorly understood condition, impacting millions of people. Low-income populations and communities of color are disproportionately affected – the same people who experience financial, linguistic, and cultural barriers to healthcare access in general.

Long COVID Care REACH will be addressing this critical problem via its network of community partnerships, including two sub-awardees of the grant, the San Mateo Medical Center (SMMC) and the Community Health Center Network (CHCN.) Collectively, these serve around 400,000 low-income and vulnerable patients annually across six large counties in Northern California.

“Our goal is to improve clinical capacity and support primary care by empowering those who serve patients with added expertise. Patient will benefit from care with clinicians they trust who speak their language,” said Hector Bonilla, MD, a clinical associate professor of Medicine and Infectious Diseases, who is a co-director of the Stanford Post-Acute COVID-19 Syndrome Clinic.

Beyond addressing the urgent need of Long COVID care expansion, this academic-community partnership model serves as a scalable template to disseminate timely, vital information to clinicians and patients alike.

In their announcement, AHRQ described the grants as "a first of their kind," designed to expand access and care, develop and implement new or improved care delivery models, foster best practices for Long COVID management, and support the primary care community in Long COVID education and management. 

“This type of grant is designed to create a national learning community to determine how we can better deliver Long COVID care that is patient-centered, comprehensive, and accessible. This is a federal priority and will hopefully help guide policy and practice changes on a larger scale that translates to the whole country,” said Linda Geng, MD, PhD, a clinical associate professor of primary care and population health and the other co-director of the Stanford Post-Acute COVID-19 Syndrome Clinic.

The project also involves a number of outreach partners who will help facilitate deeper reach and dissemination of resources into diverse communities. They include the Santa Clara Public Health Department; the California Primary Care Association; Roots Family Health Center; and the Center for Independence of Individuals with Disabilities.

“In this endemic COVID phase, this collaboration assures that promising long COVID prevention and treatment approaches reach safety net health systems in a timely way. Patient education resources and treatment protocols developed through this collaboration can be adapted by other California and US safety net health systems,” said Vivian Levy, MD, San Mateo Medical Center chief of Infectious Diseases, and a REACH investigator. 

A Win for Team Science

The Stanford team for this project spans multiple divisions and specialties within the Department of Medicine, as well as including experts from Neurology, ENT, Sleep Medicine, Psychiatry, Psychology, and Rehabilitation Therapy. The initiative also merges collaborative expertise and resources from the Stanford Center for Continuing Medical Education, Office of Community Engagement, and Evaluation Sciences Unit.

“This represents yet another win for team science by validating an interdisciplinary, inclusive, and collaborative approach, led by diverse investigators, to address a major public health crisis,” said Upinder Singh, MD, a professor and chief of infectious disease and geographical medicine, and a professor of microbiology and immunology.

The funding is provided by the U.S. Department of Health and Human Services (HHS), through the Agency for Healthcare Research and Quality (AHRQ.) Other institutions receiving funding under this new grant mechanism were the University of Pittsburgh, the University of Texas Health Science Center, the University of Washington, the Icahn School of Medicine at Mount Sinai, Emory University, the University of Colorado Denver, Washington University in St. Louis, and the Kennedy Krieger Institute.

AHRQ also awarded a complementary contract to promote success and peer-to-peer learning of grantees through a learning community, evaluate overall success of the Long COVID initiative across grantees, and share initiative findings.