Melbourne GP Pallavi Sharma on the vexed issue of long COVID

Dr Pallavi Sharma is general practitioner (GP), a Cosmetic Physician and a staunch advocate for her patients. With Diploma in Obstetrics from India, she later completed her MBBS from the University of Queensland. After successfully qualifying as a Fellow of the Royal Australian College of General Practice (RACGP) in 2002, she further went on to do a Diploma in Aesthetic Medicine.

Dr Sharma was the face of the 2018 RACGP national campaign: “I’m not just a GP. I’m your specialist in life.” She says this emboldened her passion further as it signified the role of the “GP”, the primary health care physician in Australia.

In her long illustrous career, Dr Sharma has also enjoyed her roles as an Examiner and Quality Assessment Officer for the RACGP exams for the last 10 years. She has further accepted the challenge of being a Remote Clinical Examiner during these pandemic times. Teaching young doctors and seeking opportunity to learn from young brains is a professional gift, she says. In conversation with Dr Sharma on the vexed issue of long COVID as Australia grapples with it now.

What is long COVID?

Long COVID is defined as symptoms extending beyond 12 weeks from the onset of the infection. So, after three months, if patients come back with symptoms of tiredness, exhaustion, foggy brain, lack of concentration, memory, lack of energy, often feeling sad and run down, muscle cramps, shortness of breath on exertion and generally not being able to cope with life—all these are common symptoms of long COVID.

Are women more prone to long COVID?

Yes, the statistics definitely point to that. Females, usually in the age group of 40-50, are generally more prone according to the data. So there is a gender difference when it comes to long COVID and these symptoms developing in women.

What are the reasons?

We can say, yes, it’s a gender difference in hormones but one which also gives women a robust response initially to recover. So, they recover faster but because of the different immune system, they are, at the same time, more prone to it. This is what the data and research have shown until now.

Again, women are more integrated into families and into society than men. Their role as a daughter, mother, teacher, and so on make them more vulnerable to catching infections. A majority of them are also employed in the nursing and childcare sector, which exposes them further.

What is your advice for people living with long COVID?

As a GP, first of all, I always want my patients who have gone through a long list of symptoms (sometimes of course they might not have all the symptoms) to understand what long COVID means and go through the understanding of what they have approached and sought help for until now.

Once that is sorted, they have to get the right professional advice. You have to get your health check-up optimised with the GP because not everything is long COVID. You might have other medical conditions such as blood pressure issues, diabetes, etc., and it is important that everything is under control.

The good news is, there are long COVID clinics available. In Victoria, we have St Vincent’s Hospital, Monash Medical Centre, Epworth Healthcare – all offering multi-disciplinary COVID clinics. Sometimes patients will be happy to be referred there.

I also tell people to link up with other patients who have been suffering from long COVID and from social media they can learn from each other’s experiences. Also, they might need psychological support, not that they have a psychological problem. But because of the immense pressure they go through, a psychologist’s counselling will help.

With pains and joint pains, I offer them physiotherapy, hydrotherapy, meditation or yoga classes. All those support services are offered in different suburbs of Victoria in the different centres mentioned above. So, there are multiple resources which we really need to offer to our patients.

Sometimes, people lack income or financial support, so approaching Centrelink, Social Care Worker are other options. So, it’s quite a multidisciplinary approach.

The key thing I tell my patients is, ‘please budget with your health capacity’. Work within your comfort zone. Patience is the key to success to get over long COVID. It will improve over time, nobody can tell you when, but it is a long journey, so be prepared. Remember you have to not use your maximum capacity in day-to-day activities. Try to budget your energy levels, only work within those limitations and one day you will get over it. There is quite a lot of hope, it’s not a difficult path. Yes, initially the journey is hard but with all the support you will get through it.

How does one protect oneself from the next COVID infection?

First things first, you have to maintain a healthy lifestyle, have proper check-ups with your GP, make sure that all your health issues such as BP, diabetes, asthma, etc., are being managed thoroughly and are under control. If you have basic good health, you will be maintaining a good immune system.

The next important thing in the whole of pandemic that we have been learning is masking up with good quality masks that will protect you from  second COVID infections. Wearing a mask indoors is also a wise thing to do.

The next thing is vaccination. Make sure you are boosted enough around the winter time now, so you have enough antibodies to protect yourself from the current surge of infections. Then, definitely social distancing. If you can offer good ventilation, that’s an icing on the cake, so make sure ventilation is encouraged wherever you are.

Any closing thoughts?

If people are diabetic or have very poor immune system, the best thing that has happened are antivirals which are now available. You can reduce the risk of hospitalisation, ICU admissions and severity of the disease by taking antivirals. Antivirals are prescribed in the first five days once you have tested positive. You got to have a positive RTPCR test for your GP to prescribe you the antiviral. It is effective when taken in those first five days of infection, otherwise it is not that effective. And it can be procured through telehealth too.

Often a RAT test at home can give you false negative results and a false sense of security. Therefore, if you have all the symptoms, get an RTPCR test to be hundred per cent sure. Once you are positive, you approach through telehealth to get the earliest advice from your doctor.

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Dr Pallavi Sharma is general practitioner (GP), a Cosmetic Physician & a staunch advocate for her patients. In conversation with Dr Sharma on the vexed issue of #longCOVID as Australia grapples with it now. #TheIndianSun @indira_laisram https://t.co/M7fvavxmPh

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