(Image: AP/Mary Altaffer)

I knew people could die of COVID. But I learnt this week you can die of long COVID too.

In the first six months of 2022, 98 Australians had long COVID on their death certificates: 15 each month until the end of April; 17 in May; 21 in June. The toll is mounting.

As Australians get vaccinated, rates of long COVID fall. The best estimate from the UK is that getting vaccinated reduces your risk of long COVID from 15% to 9%. Furthermore, as the virus becomes less dangerous in its infectious phase, rates of long COVID fall.

But when the sheer numbers of people contracting COVID balloon, rates are not the only thing that matters.

If we’re having 10,000 COVID cases a day rather than 100, the result is hundreds more people each day will endure long-lasting symptoms, which can include muscle weakness, fatigue, cognitive effects and cough — among many others.

Australian researchers set out last year to estimate the total burden of those symptoms in the four months from December 2021 to April 2022, a period encompassing 4.87 million COVID infections. Their work is now available as a pre-print and what they found is concerning: much of the harm is now done by long COVID.

“Long COVID contributes to almost three-quarters of the non-fatal health loss resulting from Omicron variant infections, and should therefore be more explicitly considered in future pandemic policymaking,” argue Samantha Howe, Joshua Szanyi and Tony Blakely from the University of Melbourne.

How bad is it?

In the US, the latest data from a regular survey by the Centers for Disease Control and Prevention finds 7% of Americans are experiencing long COVID. That is 15% of people who ever had COVID. Prevalence is higher among women. Most of the long COVID group report the symptoms give them “limitations”. The share of the American population currently limited by long COVID is 5.9%.

Among that group is 1.8% of Americans who have “significant activity limitations”. That is 25% of those who have long COVID. Prevalence of significant limitations is higher among men. Of course, the term “significant activity limitations” is broad enough that it might be used both by those who can no longer play baseball, and those who cannot get out of bed. Still, the figures are concerning.

If Australia has 5000 new COVID cases a day, and 15% of those go on to get long COVID, that’s 750 people a day. Then if 25% of those have significant limitations, that represents about 190 people being consigned each day to serious chronic disease. It makes you wonder if China knows something about long COVID we don’t.

What will be the long-run price we pay for these infections? Bear in mind long COVID doesn’t necessarily overlap with the elevated incidence of stroke and heart attacks among people who previously had COVID. That’s a whole separate issue.

The response

In Australia, the Standing Committee on Health, Aged Care and Sport is mounting an inquiry into long COVID. Submissions have begun to roll in, with tales of lives hemmed in by sudden symptoms.

“My family member’s quality of life has been very negatively impacted, with them spending most of their out-of-work time trying to recuperate and recover from long COVID symptoms that are exacerbated by the demands of their work,” says one. “They spend additional time sleeping, resting, and can no longer participate in the social activities that they did previously.”

Another says: “[I] was unable to drive or manage day-to-day tasks. Reading more than a page of text was exhausting and a phone call of more than a few minutes left me needing to lie down for an hour.”

Long COVID is a post-viral illness defined as new symptoms that last more than 12 weeks post-infection. After-effects from viral infections are common and can affect:

  • The immune system, as AIDS does after infection with the human immunodeficiency virus
  • The nervous system, like poliomyelitis after infection with the polio virus
  • A combination of systems.

The novel coronavirus damages organs during the acute phase of infection. But that’s not all. It also has more mysterious effects, more akin to the disease known as ME/CFS, sometimes known as chronic fatigue syndrome. What little is known about that disease — which is also post-viral — points to problems in immunity, circulation and metabolism. It can strike after even a mild infection, and so too can long COVID.

Research into long COVID is growing rapidly. There is certainly no shortage of patients to study. Micro-clots have been found in blood, for example, and viral reservoirs in tissues. Science is advancing. Given the mounting prevalence, a lot of Australians will be hoping the advance is rapid.

Has long COVID impacted you in any way? Let us know your thoughts by writing to letters@crikey.com.au. Please include your full name to be considered for publication. We reserve the right to edit for length and clarity.