The closure of a North Carolina long-COVID clinic underscores the precarious outlook facing other COVID rehabilitation facilities across the US and elsewhere. Many clinics are still experiencing waitlists and backlogs, doctors say, even as burned-out staff grapple with worries over the future of its operations.

Since 2021, the UNC COVID Recovery Clinic served thousands of patients struggling with post-COVID symptoms. But the loss of multiple funding sources forced it to shutter its doors for good this summer. 

Directors of other long-COVID clinics say they may be next, with federal officials drastically cutting funding for health programs, including long COVID.

“Clinics around the country are closing or slowing down for sure,” according to Monica Verduzco-Gutierrez, MD, who directs the COVID Recovery Clinic at UT Health San Antonio. In addition to the UNC clinic closure, she said a clinic affiliated with another Texas school is not funded and struggling. She noted that patients from that clinic were trying to get into the San Antonio facility, which already has a long waitlist.

“The feeling is that we live day to day,” said Verduzco-Gutierrez, who chairs the UT Department of Rehabilitation Medicine and was also appointed to the US Department of Health and Human Services (HHS) Advisory Committee on Long COVID in January before it was disbanded by the Trump administration. “It was a shot to the heart to many on the committee. We truly love the work and will continue to do it with or without the HHS.”

Struggling for Continuity in Care

Unlike the UNC clinic, the clinic at UT Health San Antonio is among nine COVID rehab facilities awarded a multimillion-dollar grant in 2024 by HHS' Agency for Healthcare Research and Quality (AHRQ). That funding appears intact for now, according to several recipients of the grant. But unease over the future remains, given the massive health cuts expected.

“Fortunately, we have not had a change in funding (yet), although AHRQ, the funding agency, has largely been dismantled, so we are continuing to forge ahead with our plans,” said Janna Friedly, MD, MPH, who directs the University of Washington School of Medicine’s Post-COVID Rehabilitation and Recovery Clinic and heads the Department of Rehabilitation Medicine.

In the wake of the UNC clinic’s closure, a UNC spokesperson said care for long-COVID patients would be shifted to an existing practice within the Department of Physical Medicine & Rehabilitation.

“They are receiving the same excellent care from their current medical providers. We are committed to ensuring that all patients suffering from long COVID continue to have access to much-needed treatment with minimal disruption,” Alan Wolf, a spokesperson for UNC Health, said. 

Despite the continuity in care, some services will no longer be available due to limited clinic resources, including access to a dedicated social worker and referrals to specialists outside the UNC Health system.

Also no longer available: help completing paperwork for insurance prior authorizations, medical leave, and disability. For long-COVID patients struggling with debilitating brain fog and fatigue, filling out complicated administrative forms and managing their day-to-day care can be exhausting and challenging in itself; the loss of thoughtful, integrated care deals another major blow.

COVID Cuts Part of Federal Health, Job Cutbacks

In his first few months in office, President Donald Trump and his administration have slashed tens of thousands of jobs and are shuttering units across multiple federal health agencies, including the AHRQ and the Office for Long COVID Research and Practice. 

Officials have attempted to claw back more than $11 billion in COVID-related public health funding, including RECOVER grants for dozens of long-COVID studies and projects. Nearly half a billion dollars in mRNA vaccine development was also terminated in May. 

The HHS said it would “no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago.” Nearly two dozen states and the District of Columbia sued the government agency and was granted a preliminary injunction that temporarily prevented the HHS from moving forward with its plans, but the government is appealing that decision. 

Amid this backdrop, clinicians are worried about the impact of the cuts and what could be next.

“Things at the clinic have been rocky. We still have our grant from AHRQ, though there were months spent trying to figure out if they are going to pull it or not,” said Alexander Truong, MD, a director of Emory University’s Executive Park Post-COVID Clinic.

In anticipation of potential cuts, the Emory clinic streamlined some of its services, letting go of its social worker and changing its nurse practitioner’s workload, he said.

“I continue to be very concerned about the future of the grant, and research in general. With the current administration shutting down the long-COVID office and pulling research funding, we will continue to lack evidence-based information from which to make decisions,” said Truong, an assistant professor in the Department of Medicine. 

Despite the HHS’ assertion that Americans have “moved on,” long-COVID clinics tell a different story. Like the waitlist at UT Health, the Emory clinic remains booked 3-4 months ahead, and these clinics are not alone.

Hanging on in the US and Elsewhere

The Stanford Post-Acute COVID-19 Syndrome Clinic is a busy center that continues to take on new patients. The clinic, another AHRQ grant recipient, is also working to expand its reach and improve access to long-COVID care, especially in communities affected by the condition, said Linda Geng, MD, co-director of the Stanford Long COVID Collaborative, which includes the long-COVID clinic. 

She noted that some clinics had to close even earlier. “These programs are difficult to sustain without funding, staffing, and resources,” she explained.

Clinics in other parts of the world, including the UK and Canada, are also facing similar uncertainties. 

According to Long COVID Support, a UK advocacy group, 24 clinics in the UK have closed or are set to close, and another 31 are under review. At its peak, more than 120 long-COVID services were available in the UK.

In Canada, where more than a million people are estimated to have the condition, access to specialized care is also shrinking. A program that opened in July 2021 in the nation’s capital shut down in May, while another clinic in British Columbia warned patients it may have to partially close if changes to the province’s medical services plans move forward. Last year, the province of Alberta told doctors and patients its Long-COVID Inter-Professional Outpatient Program was no longer being funded. The province's long-COVID clinics closed their doors as a result, leaving patients on the waitlist in limbo and existing patients forced to transition elsewhere.

Back in the US, the future of Washington University’s Care and Recovery After COVID-19 clinic in St. Louis, Missouri, looked bleak following the departure of its medical director to a new position out of state. The clinic, which opened in 2020 and is also an AHRQ recipient, announced plans to close its doors in July. But administrators have since reversed course, saying they are working on a transition plan.

Some clinics are faring better, in part because they are less reliant on federal funding. The long-COVID clinic at UCLA Health, for example, has not had to cut staff because it is insurance-based, according to its director, Nisha Viswanathan, MD.

While the clinic remains busy, staff are able to see most referrals within 4-6 weeks, said Viswanathan, an assistant clinical professor of medicine with the UCLA David Geffen School of Medicine. But the looming threat of HHS cuts probably will have tangible repercussions in other ways, especially in research and patient outreach. 

“There still remains a lot of uncertainty with the dynamic changes. Work in long COVID has and will be impacted by these changes, but we need to continue to push forward and figure out best ways to care for the patients in need,” said Geng about the fallout from the Trump administration cutbacks.

“These are uncertain times,” she said, “but I am hopeful that we will find ways to help the millions of people with long COVID and continue to provide care to those in need.”