Use of a Specialist Telephone Consultation Line for Long COVID in Primary Care in British Columbia: Retrospective Descriptive Quality Improvement Study
Bibliographic record
Abstract
Background: Long COVID (post-COVID-19 condition) continues to challenge primary care. To support family physicians in British Columbia, the general internal medicine (GIM) COVID-19 Rapid Access to Consultative Expertise (RACE) line was launched in August 2020 to provide real-time specialist advice. Objective: This quality improvement study aimed to evaluate the implementation and utilization of the GIM-COVID-19 Long-Term Sequelae RACE line in British Columbia. Specifically, it sought to characterize the demographics of patients involved in RACE consultations, identify the most common themes and clinical queries presented by primary care providers, and assess how usage patterns evolved over time during the COVID-19 pandemic. Methods: We conducted a retrospective descriptive analysis of 149 RACE line call summaries between August 2020 and June 2021. Six calls were excluded due to insufficient information, such as incomplete documentation or absence of a clear COVID-19-related question. Because the original extraction notes are no longer available, further details about these calls cannot be provided, leaving 143 eligible calls. Data extracted included patient age, sex, geographical location, symptom type, and timing of symptom onset post-COVID-19 infection. Calls were categorized by symptom duration (acute: <2 wk, subacute: 2-12 wk, chronic: >12 wk), thematic content (respiratory, fatigue, neurological, etc), and query type (symptom management, return-to-work, vaccination, etc). Data were coded independently by two reviewers using a standardized spreadsheet and predefined codebook. Discrepancies were resolved through discussion. Descriptive statistics summarized the findings. Results: Many calls involved female patients (91/143, 64%), with the most common age group being 40-49 years (32/113, 28%). Most calls came from Greater Vancouver (35/83, 42%) and the Fraser Valley (29/83, 35%). Subacute symptoms (52/149, 35%) and vaccination-related concerns (29/149, 19%) were the most common inquiry types. Symptom-related inquiries accounted for 92 of 143 calls (64%), with 253 symptoms documented overall. Respiratory symptoms were most common (100/253, 40%), especially shortness of breath (35 calls), cough (26), and fatigue (23). Call volumes peaked from January to June 2021, coinciding with the provincial vaccine rollout. Conclusions: The GIM-COVID-19 Long-Term Sequelae RACE line served as a critical early support system for primary care providers as the long COVID landscape evolved. This quality improvement study emphasizes the value of rapid access and specialist-informed consultation tools during emerging public health challenges. The trends ascertained may inform future health system responses, particularly when designing more scalable, interdisciplinary models to support primary care in managing complex chronic conditions.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".