Recommendations

We’ve assembled high-leverage recommendations based on our interview synthesis and own expertise at the Patient-Led Research Collaborative. These recommendations are designed to work together in coordination between Indian government agencies, healthcare institutions, research organizations, and patient communities. In alignment with disability justice, we advocate for implementation efforts that center patient voices, ensuring those directly affected by Long COVID have meaningful influence over policies and programs designed to address their needs.

Clinical Care Priority Recommendations

India’s vast geographic, cultural, and socioeconomic diversity demands flexible, context-specific models for Long COVID care that align with local populations’ needs.

Integrated Care Models

Protocols must be developed that bridge allopathic and Ayush medicine in Long COVID care while creating quality standards for Ayush treatments. Long COVID Centers of Excellence should be established at institutions like AIIMS to coordinate research, registries, and specialist referrals while partnering with the private sector to expand reach. As Dr. Lancelot Pinto noted: “it would be very useful to have one umbrella place to send people with all sorts of complaints, to see if they fit into any particular syndrome, or they fit into any constellation of symptoms that you know people are researching to […] enroll them in studies or registries.”

Provider Training

Long COVID and IACC education must be mandated in medical curricula and incorporated into continuing education for recertification through the National Medical Commission and State Medical Councils. As Dr. Joyeeta emphasized: “The Indian Medical Association, ICMR, and the Ministry of Health need to hold seminars, update guidelines every three months, and engage with medical professionals.”

The need for such training approaches is globally recognized, as a consensus study involving 179 healthcare professionals in 28 countries found that few recommendations and no formal training exists for medical professionals to assist with clinical evaluation and management of patients with Long COVID, emphasizing the urgent need for comprehensive training programs (Ewing et al., 2025).

Sustainable Care Models

Hub-and-spoke care networks should connect district hospitals with rural primary health centers, enabling specialist consultation through teleconsultation. This model has proven successful in India (Devarakonda, 2016a), where smaller hospitals and clinics in outlying towns treat patients with straightforward needs and refer complex cases back to the hub or use telemedicine to consult with hub specialists, demonstrating that medical care can be provided to even the most rural areas at a much more nominal cost.

Mobile care must be integrated for rural access, with CHOs and ASHA workers trained to recognize Long COVID symptoms and traditional healers engaged as care partners. Dedicated funding mechanisms must be established for Long COVID care centers.

Priority Area	Key Recommendations	Key National Stakeholders
Integrated Care Models	• Develop protocols bridging allopathic and Ayush medicine in Long COVID care • Create quality standards for Ayush treatments • Establish Long COVID Centres of Excellence	AIIMS AYUSH practitioners ICMR Ministry of Health
Provider Training	• Mandate Long COVID and IACC education in medical curricula • Incorporate Long COVID and IACC into continuing education for recertification • Train providers in empathetic communication	National Medical Commission State Medical Councils AYUSH practitioners
Sustainable Care Models	• Create hub-and-spoke care networks • Integrate mobile care for rural access, combining cultural and infrastructure adaptation, and digital literacy • Establish dedicated funding mechanisms for care centres	AIIMS Ministry of Health Primary Care Providers ASHA workers

Public Health Policy Recommendations

Long COVID must be formally acknowledged within India’s healthcare system to drive clinical awareness, education, and direct public health policy. We advocate for government funded awareness campaigns, implementing policies that expand financial protection for patients, and investing in mobile health initiatives in rural regions.

Priority Area	Key Recommendations	Key National Stakeholders
National Recognition	• Develop comprehensive national guidelines • Create Long COVID surveillance systems • Standardize diagnostic criteria	Ministry of Health ICMR
Financial Protection	• Expand insurance coverage for Long COVID • Create disability support systems • Implement sliding fee scales	Government (general policy & support) Insurance Companies Ministry of Health
Long COVID and IACC Awareness Campaigns	• Launch anti-stigma education programs • Target workplace discrimination • Focus on prevention messaging	Ministry of Health (for public health education policy)
Equity Initiatives	• Expand rural and mobile health services • Develop gender-responsive care protocols	ASHA workers Ministry of Health (for policy oversight)

“It is time for Long COVID to be recognized as a real entity and for doctors to discuss it just like they discuss diabetes, heart attacks, or tuberculosis. We can’t ignore it—it needs to be included.”, Dr. Rajeev Jayadevan highlighted. Developing national protocols for Long COVID diagnosis and care integrated with clinical education strategies can strengthen surveillance efforts and support resource allocation. According to Dr. Joyeeta: “The Indian Medical Association, ICMR, and the Ministry of Health need to hold seminars, update guidelines every three months, and engage medical professionals. Nobody is talking to us.”

Dr. Jayadevan further argues the importance of Long COVID surveillance: ”[…] with testing going down, we simply have no way of counting the number of infections that person has. You can’t really count the number of scars on the skin […]. And with each reinfection the risk of long covid increases. That’s been confirmed.”

Research Priorities

To close the gap in Long COVID surveillance, diagnostics, care and treatment, India must prioritize sustained investment in research that can inform public health policy and policies in social support systems. We advocate to expand the pipeline of research opportunities to study Long COVID in India, not just from publicly funded research, but also philanthropic initiatives, academic.

Patient-Centered Research

As Dr. Anant Bhan highlights, understanding the range of symptoms and complaints unique to Indian patients is critical. Community-led research and patient involvement ensures that studies capture the diverse manifestations of Long COVID in India.

India-Specific Studies

India-specific research is essential to address the unique challenges posed by Long COVID in the region. India’s climate, culture and healthcare system differ from challenges observed in Western populations.

Dr. Anant Bhan spoke to its importance: “We need to understand better what is the range of symptoms and complaints which patients are coming with…because again, there might be some aspects which are unique to say an Indian patient population. It’s not the case that everything will necessarily be the same as what patients in the West might have.”

Longitudinal studies and investigations into Ayush medicine can provide evidence-based solutions tailored to India’s healthcare landscape, while reinfection studies can inform public health strategies to mitigate long-term impacts on the region to region basis. Dr. Rajeev Jayadevan emphasized the need for location-specific surveillance: “what I would like to know is how the Indian sub-continent and the regions around the area are responding to relentless infections.”

Diagnostic Research

Accurate and accessible diagnostics are critical for effective Long COVID management. As Dr. Bhan notes, “Even a small subset here is large enough for robust studies.” Leveraging India’s vast patient population through registries can yield insights that benefit both national and global efforts in Long COVID research. Due to the lack of Long-COVID clinics, research into cost-effective biomarker testing can improve care accessibility in rural and low-income communities.

LMIC Resource Networks for Research

An international network of patients, healthcare providers, clinical researchers, and policy makers from LMIC countries can exchange research capacities and facilitate grants for Long COVID. When we asked Dr. Anant Bhan, how research into Long COVID could be better funded, he advocated sector groups like the ICMR and philanthropy organization, and emphasized the importance of supporting practicing medical professionals to publish papers and case studies: “That is good if it happens from the government sector and especially bodies like ICMR. It can also be other groups of philanthropy organizations looking at this as something which is a good medical question to understand, it could sometimes be medical researchers by themselves, as they said, doing some academic studies to try to find out among patients with covid that they saw, whether there are complaints which could be part of what is currently described among the various manifestations under Long COVID”

Priority Area	Key Recommendations	Key National Stakeholders
Patient-Centered Research	• Fund community-led research initiatives • Integrate patient advisory groups • Support grassroots health organizations	ICMR Patient-Led Research Collaborative (PLRC) Jan Swasthya Abhiyan
India-Specific Studies	• Conduct longitudinal population studies • Research traditional medicine effectiveness • Study reinfection impacts	ICMR Philanthropic organizations Traditional medical practitioners (AYUSH system for research)
Diagnostic Research	• Develop biomarker discovery programs • Create cost-effective diagnostic tools • Establish patient registries	ICMR
LMIC Networks	• Build resource-appropriate research capacity • Share successful models between countries • Support local researcher training	Patients Healthcare providers Researchers Policymakers (as components of the network, from India and other LMICs)