Post COVID Demand Curve: A New Normal for Lungs

The COVID-19 pandemic was not just a short term public health crisis, it fundamentally reshaped the landscape of respiratory care in the U.S. and globally. At the epicenter of this transformation stands the Respiratory Therapist (RT), once seen primarily as a hospital-based ICU specialist. Today, RTs are increasingly central to outpatient care, long term pulmonary rehabilitation, and even in home ventilation programs.

One of the clearest catalysts for this shift has been the emergence of Post Acute Sequelae of SARS CoV-2 infection (PASC), better known as long COVID. According to the Centers for Disease Control and Prevention (CDC), an estimated 6.8% of American adults currently report symptoms of long COVID, which can include persistent shortness of breath, fatigue, and reduced lung function, conditions that often require sustained respiratory therapy interventions. Source: CDC Long COVID Data

Moreover, a 2024 study by Respiratory-Therapy.com tracking over 12,000 patients across four years concluded that patients who had multiple COVID-19 infections were nearly three times more likely to develop chronic respiratory symptoms requiring pulmonary rehabilitation. Source: Respiratory-Therapy.com Study on Repeat Infections

The consequence?

A surge in referrals to pulmonary rehab programs. Clinics that once catered mostly to seniors with COPD are now expanding to manage a younger demographic suffering post-viral syndromes. And they’re calling in more RTs than ever before to do it.

Beyond the Hospital Walls: The Expanding Role of RTs

Once largely confined to ICUs, neonatal units, and surgical wards, RTs are now mobile, community embedded, and digitally connected. New roles have emerged at the intersection of telehealth, chronic care management, and population health.

Tele pulmonology, once a niche service, has grown into a mainstream solution. RTs now assist pulmonologists via remote monitoring technologies to oversee chronic patients tracking oxygen saturation, ventilator settings, and breathing patterns from afar. The American Telemedicine Association reports a 48% increase in home based spirometry usage since 2022, often supervised virtually by RTs.

Similarly, home ventilator programs have expanded dramatically. These programs allow patients with neuromuscular disorders, advanced COPD, or long COVID to live independently while receiving daily respiratory support. RTs are the technical and clinical coordinators for these efforts, configuring machines, educating families, and responding to alerts.

Home health agencies report that demand for RT home visits has risen by 32% since 2021. Source: Vivian Health 2023 Workforce Trends Report

RTs are also playing a key role in population health initiatives. In underserved urban and rural communities, RTs have been deployed to run asthma education sessions, smoking cessation programs, and mobile lung-function screenings. These preventive efforts have become integral to Medicaid accountable care models and have shown promising results in reducing emergency room visits.

Workforce Crunch: Supply Struggles to Meet Demand

With the expanding role and rising caseloads of RTs comes a major challenge: there simply aren’t enough of them.According to the U.S. Bureau of Labor Statistics (BLS), the demand for respiratory therapists is projected to grow by 13% from 2022 to 2032, significantly faster than the average for all occupations. This translates to an estimated 8,200 job openings every year, driven both by growth and replacement needs. Source: BLS Occupational Outlook for Respiratory Therapists (May 2025)

A trifecta of issues is driving the crunch:

• Burnout: The pandemic took a steep toll on the RT workforce. A 2023 survey by the American Association for Respiratory Care (AARC) found that 42% of RTs reported moderate to high burnout, citing stress, under recognition, and overtime as key factors.

• Retirement Wave: The field is aging. Nearly one third of current RTs are over 50, with many set to retire within the next decade. Training pipelines are struggling to fill the gap.

• Geographic Maldistribution: RT shortages are especially acute in rural areas and low-income urban zones. For example, Arkansas and Mississippi report fewer than 25 RTs per 100,000 residents, compared to more than 50 per 100,000 in Massachusetts and California. This inequality exacerbates care gaps for vulnerable populations.

  
  

Despite increasing enrollments in accredited RT programs, bottlenecks in clinical placements and instructor availability have slowed the pace of new graduates entering the field.

Upskilling & Retention: Building a Sustainable RT Workforce

Addressing the growing workforce gap in respiratory therapy (RT) requires more than just recruitment efforts. With demand for respiratory therapists rising and burnout rates posing a persistent threat to retention, health systems must adopt a more holistic and sustainable strategy, one that combines upskilling, retention-focused incentives, and robust mental health support.

Cross Training and Multidisciplinary Support

One of the most immediate solutions being deployed is cross training existing healthcare personnel, particularly Licensed Practical Nurses (LPNs) and Registered Nurses (RNs), in basic respiratory care interventions. This model not only optimizes the use of available staff during times of high patient volume but also helps alleviate pressure on certified RTs.

Health systems are increasingly introducing short form certification programs that focus on essential respiratory procedures such as oxygen delivery, pulse oximetry, and CPAP (Continuous Positive Airway Pressure) setup and monitoring. These programs often delivered through online modules or brief in person workshops, equip non RT professionals with the competencies needed to handle routine respiratory support tasks safely and effectively. The result is a more agile care team that can step in during peak times or staff shortages without compromising quality of care.

Additionally, this multidisciplinary model encourages greater collaboration between RTs, nurses, and physicians, fostering a team-based culture that enhances both patient outcomes and employee satisfaction.

Career Ladder Scholarships and Workforce Diversification

Long term workforce sustainability also hinges on expanding the pipeline of qualified respiratory therapists, particularly from underrepresented communities and mid career healthcare workers. To this end, organizations such as the National Board for Respiratory Care (NBRC) are spearheading career ladder scholarship programs designed to remove financial barriers for aspiring RTs.

These scholarships and tuition assistance programs target individuals already working in healthcare, such as medical assistants or patient care technicians who are looking to advance into more specialized roles. By offering both financial aid and mentorship, these initiatives open up upward mobility pathways and foster diversity within the RT profession.

Moreover, such programs contribute to stronger retention overall. Employees who are supported in their professional growth are more likely to remain loyal to the institutions that invested in them. This "grow-your-own" model helps address regional shortages while also improving cultural competency in patient care, particularly in underserved communities.

Mental Health, Wellbeing, and Leadership Pathways

The COVID-19 pandemic laid bare the mental and emotional toll that frontline healthcare work takes on RTs and other professionals. In response, hospitals are investing in mental health and wellness initiatives aimed at reducing burnout and promoting long term job satisfaction.

Peer support groups, flexible scheduling, mental health days, and on site counseling have become core components of employee wellness programs. One notable example is the Cleveland Clinic’s RT Wellness Program, which offers one on one counseling, resiliency workshops, and mindfulness training tailored specifically for respiratory therapists. Since its implementation, the program has contributed to a 24% reduction in RT turnover within just 12 months.

Retention incentives are also evolving beyond financial bonuses. Many health systems are developing leadership tracks and specialized roles for experienced RTs. Positions such as Pulmonary Rehab Director, Clinical Educator, or Telehealth Respiratory Supervisor offer clear progression pathways, giving seasoned RTs opportunities to mentor, innovate, and lead without leaving the profession.

These new roles not only boost morale and institutional loyalty but also ensure that institutional knowledge is retained and shared. By adding both prestige and purpose to long term service, such pathways can transform respiratory therapy from a job into a fulfilling career.

Outcomes Spotlight: When RTs Lead, Patients Thrive

In the evolving landscape of healthcare, especially in a post pandemic world, Respiratory Therapists (RTs) are proving to be not just supportive players but key drivers of positive patient outcomes. Their clinical expertise, combined with patient education and long term engagement strategies, is delivering measurable, data backed results across multiple care settings from hospitals to homes.

One of the most compelling examples comes from North Carolina, where a post COVID recovery clinic staffed by just three RTs and one pulmonologist managed to reduce hospital readmissions by 29% over a 12 month period. This outcome wasn’t achieved through high cost technologies or aggressive pharmaceutical regimens, but through consistent, human centered care: daily telehealth check ins, guided breathing exercises, home spirometry usage, and early identification of exacerbation signs. Patients recovering from long COVID or post ICU respiratory distress were monitored closely, not just medically but emotionally, helping them regain confidence in their breathing and functional ability.

Similar success stories are being replicated on a larger scale. At Kaiser Permanente in California, RTs were integrated into primary care teams specifically for patients with Chronic Obstructive Pulmonary Disease (COPD). The results were both impressive and clinically significant:

• 40% reduction in emergency room visits: By providing patients with education on inhaler technique, recognizing early warning signs, and optimizing oxygen therapy, RTs were able to intercept deterioration early and prevent emergency situations.

• 27% improvement in patient-reported quality of life: Through structured breathing programs, support groups led by RTs, and more frequent touchpoints, patients reported feeling more in control of their health and less anxious about breathlessness episodes.

• 22% increase in medication adherence: One of the lesser known but critical factors in chronic respiratory disease management is proper medication use. RTs conducted hands on training in correct inhaler use, dosage timing, and device maintenance resulting in better adherence and more stable clinical outcomes.

Even more broadly, data from the 2024 American Association for Respiratory Care (AARC) Outcomes Report underscores the power of RT led interventions. The report highlighted that RT managed COPD education programs, when paired with at home oxygen therapy and inhaler technique training, led to a reduction in hospital admissions by over 30%. These education based models not only improved patient outcomes but also reduced per patient healthcare spending by thousands of dollars annually by avoiding complications and costly interventions.

These are not isolated or experimental results. They reflect a systemic shift toward value based care, where health systems are rewarded not for the volume of procedures, but for improved patient outcomes and reduced readmissions. In this environment, RTs are excelling. Their ability to combine technical precision such as ventilator settings, pulse oximetry interpretation, and spirometry with empathetic, one on one patient coaching is transforming what respiratory care looks like.

In a healthcare system grappling with workforce shortages, rising chronic disease burdens, and an urgent need for cost control, Respiratory Therapists are proving to be both a clinical asset and a strategic solution. When RTs lead, patients breathe better, live better, and stay out of the hospital longer.

Community Integration: RTs in Public Health Infrastructure

As the healthcare ecosystem moves from acute intervention to long term disease management and prevention, Respiratory Therapists (RTs) are increasingly embedded within community health frameworks. Their value now extends beyond individual patient outcomes to population level respiratory health.

In cities like Cleveland, Ohio, RTs have joined public health task forces to assist in environmental asthma control programs. Working in collaboration with school nurses, housing inspectors, and local clinics, RTs assess indoor air quality, provide spirometry screenings for school aged children, and offer parental education on managing asthma triggers. Since 2022, Cleveland’s pediatric asthma emergency visits have dropped by 18%, correlating with these integrated efforts.

In rural Montana, where specialist access is limited, RTs have been mobilized as part of community paramedicine units. These programs designed to prevent avoidable hospitalizations allow RTs to conduct in home pulmonary assessments, nebulizer education, and post COPD discharge follow ups. Early data from St. Peter’s Health in Helena show a 26% reduction in COPD readmissions for participants in the first 10 months.

Moreover, many local public health departments now include RT roles in pandemic preparedness plans. The experience of COVID-19 emphasized the need for rapid deployment of respiratory care, oxygen support, and ventilator triage expertise. RTs are now seen as vital to community resilience in future viral outbreaks or environmental crises like wildfires and pollution surges.

Innovation & Tech: The Digital RT Era

Technology is rapidly expanding the scope and efficiency of respiratory therapy. From wearable devices to AI driven pulmonary analytics, the RT of today must also be digitally fluent.

Remote Patient Monitoring (RPM)

Remote patient monitoring platforms are increasingly common in chronic disease management, and RTs are often the human interface behind them. Platforms like Propeller Health and ResMed’s AirView allow real time tracking of medication usage, inhaler technique, and airflow resistance.

For example, a 2023 pilot in St. Louis, Missouri embedded RTs to monitor patients using Propeller inhaler sensors. They reached out within 12 hours if irregular usage was detected. The program led to a 31% decrease in asthma related ER visits and high patient satisfaction scores. Source: Propeller Health Clinical Outcomes

Artificial Intelligence in Spirometry

New AI enabled spirometers can detect early signs of disease progression, even when patients feel asymptomatic. Companies like NuvoAir and MIR are producing handheld diagnostic tools that sync data to the cloud, where RTs interpret and respond with clinical recommendations.

These tools are especially important for underserved populations, such as tribal health centers or inner city clinics, where traditional lab based spirometry may be inaccessible. RTs are trained to operate these devices, interpret data, and escalate cases to pulmonologists as needed.

Virtual Reality in Training and Therapy

Virtual reality (VR) platforms are now being piloted in respiratory therapy both for training RTs and for patient rehab. The University of Illinois at Chicago developed a VR training module simulating high pressure ventilator adjustments in ICU settings reducing student error rates by 45%.

On the patient side, immersive VR experiences are used in some rehab centers to help COPD and long COVID patients perform breathing exercises in a calming virtual environment. These environments have improved patient engagement, reduced anxiety, and enhanced therapy adherence.

Advocacy & Policy: Securing the RT Pipeline

Despite their vital role, RTs have historically been underrepresented in federal policy discussions, reimbursement models, and health education funding. That’s beginning to change.

Legislation to Watch

The Allied Health Workforce Diversity Act, reintroduced in Congress in 2024, aims to allocate funding to diversify and expand allied health training programs, including respiratory therapy. If passed, it could fund scholarships, loan repayment, and clinical site expansion, especially in underserved communities.

Another key policy push is the Telehealth Expansion for Respiratory Therapists Act, supported by the American Association for Respiratory Care (AARC). It would allow RTs to bill Medicare directly for remote services a game changer for both patients and professionals.

Currently, Medicare does not allow independent billing by RTs, limiting their ability to provide reimbursable care outside of physician offices or hospitals. Fixing this could unleash a wave of entrepreneurial and home based care models, empowering RTs to run their own mobile practices or virtual clinics.

Source: AARC Advocacy Page Policy Tracker

Education and Credentialing Expansion

As the demand rises, states are rethinking their credentialing timelines. Some, like Florida and Texas, are piloting fast track RT programs for veterans and mid career health professionals, cutting down licensure time by 20-30% without sacrificing clinical rigor.

Additionally, there’s increasing pressure to integrate RT curriculum into broader health science pathways rom high school career academies to community college associate degrees. These pathways can feed talent into the pipeline earlier and widen access, especially for students in low income areas.

Inclusion in Value Based Payment Models

The shift to value based care where outcomes, not procedures, drive reimbursement puts RTs in a powerful position. Their work directly affects readmissions, oxygen use, ER visits, and long term disease control.

Several Accountable Care Organizations (ACOs) have begun tracking RT interventions as part of their quality measures dashboards, linking them to Medicare Shared Savings Programs. In Illinois, one such ACO found that incorporating RT consultations in COPD management reduced costs per patient by $1,840 annually, largely by cutting ER visits and improving inhaler adherence.

The Rural and Equity Gap: Where Help is Most Needed

While the profession is growing, it’s not growing equally everywhere. A central challenge facing the U.S. healthcare system is the maldistribution of RTs, especially in rural, tribal, and economically marginalized communities.

The Health Resources and Services Administration (HRSA) classifies over 3,100 counties as respiratory health shortage areas, where pulmonology and RT services are insufficient for the population need.

One innovative model addressing this is the “Grow Your Own RT” program in Appalachia, which funds students from rural towns to become RTs and guarantees clinical placements within their home regions. Since 2020, the program has graduated over 80 RTs, most of whom remain in underserved counties.

Similarly, the Indian Health Service has partnered with community colleges to deploy RT interns across Navajo and Cherokee nations, combining cultural competence with clinical skill. These efforts are slowly closing the access gap but much more is needed.

Final Thoughts: Respiratory Therapists as a Linchpin of Post Pandemic Healthcare

The trajectory of modern healthcare has shifted decisively toward a model that is community centered, digitally connected, and outcomes driven. In this new paradigm, Respiratory Therapists (RTs) are emerging not just as support personnel in critical care units but as essential pillars of the broader care continuum. From ICUs and long COVID clinics to telehealth platforms and home based care, RTs are now vital to ensuring respiratory wellness across diverse populations.

Their unique ability to bridge high level clinical expertise with compassionate, ongoing patient interaction makes them particularly well suited to tackle the persistent challenges of post COVID respiratory disease, chronic conditions like COPD and asthma, and rising environmental respiratory hazards. RTs are also playing a central role in managing remote care technologies, conducting virtual consultations, and delivering culturally competent education skills increasingly critical in rural, low income, and aging communities.

Failure to act risks deepening the current respiratory care gap and losing skilled professionals at a time when they are needed most. But if we invest thoughtfully and systemically the respiratory therapy workforce could emerge as one of the greatest public health success stories of the decade, leading not just recovery, but transformation.

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