Barriers to Long COVID Care in the U.S.: An Application of Levesque et al.’s Access Framework, 2026, Katherine F. Raymond et al

[Mij]

Abstract
Long COVID is a condition that arose during the COVID-19 pandemic in individuals who developed the multi-system chronic condition after a COVID-19 infection. During the pandemic in the United States (U.S.), these “COVID long-haulers” navigated a complex and overburdened health care system in pursuit of diagnoses and treatments. This qualitative secondary analysis used the 2013 Levesque et al. Conceptual Model of Healthcare Access to examine multidimensional health care access issues faced by 29 COVID long-haulers in the U.S.

Our analysis showed that long-haulers faced complementary issues from both individual and health systems perspectives related to the inability to get diagnoses or treatments, long waiting times for providers and difficulty reaching services, underinformed providers and biased interpersonal experiences, and struggles with the financial costs of treating the condition, which impacted care decisions. Interviewees also described relying on alternative medicine to provide symptom relief.

Overall, this study extends international research by offering a comprehensive examination of Long COVID health care access issues in the U.S. and identifying specific insights related to health care access that made obtaining Long COVID care difficult, such as the mismatch between individual expectations of what health care should look like and how it actually operates.

Our use of the full Conceptual Model of Healthcare Access provides new insights into the overlap across layers of access issues and offers suggestions for how public health and clinical health practitioners can collaborate to meet the needs of vulnerable populations such as these in future health emergencies.
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[Sean]

The fundamental problem being that there is no treatment. Difficult to access any when they don't exist.

 

[SNT Gatchaman]

A novel insight our interviewees described pertained to an expectation that the health care system they were encountering should have been well-organized and interdisciplinary, yet that is not how the U.S. health care system operates .

Our interviewees reported turning to complementary and alternative medicine (CAM), such as acupuncture, supplements, or chiropractic care, to relieve Long COVID symptoms, which has been studied in long-haulers in the U.K.. Despite a wariness about the pseudoscience of CAM, interviewees described turning to these services because they were readily available, relatively affordable, easier to navigate, and more effective at symptom relief, which aligns with other research exploring the acceptability of and engagement in this type of health service.

"Medicine: nul points."

 

[rvallee]

Our analysis showed that long-haulers faced complementary issues from both individual and health systems perspectives related to the inability to get diagnoses or treatments, long waiting times for providers and difficulty reaching services, underinformed providers and biased interpersonal experiences, and struggles with the financial costs of treating the condition, which impacted care decisions. Interviewees also described relying on alternative medicine to provide symptom relief.

Overall, this study extends international research by offering a comprehensive examination of Long COVID health care access issues in the U.S. and identifying specific insights related to health care access that made obtaining Long COVID care difficult, such as the mismatch between individual expectations of what health care should look like and how it actually operates.

Odd (bolded) past tense. Absolutely none of this has changed, a fact that is easy to find out. Things were also like that before, for decades, despite literal protests against it, a fact that is also easy to find out. I guess it makes things sound better when a disaster is put in the past tense, but that's a major reason why it's still a disaster in the present, and for the foreseeable future.

The quotes are really interesting. They describe a system in shambles. It's still very much the case, the excuses for "in the time of the pandemic" have long expired, and absolutely nothing has changed. As is tradition with chronic illness, everything is worse in context and the more context you add the worse it is. But the "context of the pandemic" is long gone, and literally every single criticism I have read quoted in the paper fully applies today.

There are reasons for that, those reasons are all decisions made by health care systems, institutions and professionals. They are the barriers, the gatekeepers who refuse us entry. It's genuinely hard to think of a more shameful example of professional failure than "those people you failed went instead to see quacks who don't know what they're doing either because they like them better despite literally doing nothing".

So, quite literally, the current state of health care when it comes to chronic illnesses: literally worse than nothing.

A novel insight our interviewees described pertained to an expectation that the health care system they were encountering should have been well-organized and interdisciplinary, yet that is not how the U.S. health care system operates .

People describing the most basic expectations out of professionals: "uh, what a novel insight". This is not how any health care system operates. Yet it literally describes the bare minimum.