Calculations of the impact of ‘long COVID’ as Australia opens up are worrying

Professor Hensher (now at UTAS) and Associate Research Fellow Angeles have also recently published updated modelling of long COVID numbers that reflect the Omicron wave and on the potential Disability Adjusted Life Years burden of long COVID and other long-term health consequences of COVID-19.

Recent research from Deakin Health Economics examines the shifting burden of COVID-19 disease as Australia opens up and as high vaccination rates reduce mortality and severe illness. Martin Hensher and Mary Rose Angeles report in an article in the Conversation how long COVID will increasingly drive the burden of COVID illness, even as death rates decline. They examined the 2021 Delta outbreaks in Victoria and New South Wales and estimated that by the end of October these outbreaks may have led to 9,450-19,800 people developing long COVID that could last 12 weeks after their COVID infection.

COVID-19 survivors can develop a range of longer-term symptoms now called “long COVID”. This includes people who did not have severe illness initially. Such longer-term symptoms can affect multiple systems in the body. This can result in ongoing, severe fatigue, pain, as well as breathing, neurological, sleep and mental health problems. The authors estimated long COVID prevalence using two sources. A large dataset from the UK found more than 13% of people had symptoms after 12 weeks. A much smaller study conducted in NSW found about 5% had symptoms over roughly the same period.

Their modelling found that in addition to those developing long COVID that could last 12 weeks after their initial infection, even more will have experienced long COVID symptoms for a shorter time: 34,000-44,500 people will likely have symptoms for at least three weeks after first becoming ill. They also estimated the likely consequences for long COVID if Australia followed the national re-opening plan. Associate Professor Hensher and Associate Research Fellow Angeles calculated that more limited relaxation of public health measures could generate 10,000-34,000 long COVID cases (people with symptoms lasting at least 12 weeks). More complete relaxation of public health measures could lead to 60,000-133,000 long COVID cases. Based on the longer-term UK data for long COVID prevalence, they calculated 2,000-11,000 people might still be sick a year after their initial infection.

Long COVID can be a debilitating and distressing health condition. It also has a number of economic impacts, for the health system and people’s ability to work. For instance, people with long COVID require coordinated care across a range of different health services and specialties. Data from the UK’s Office for National Statistics indicate that around 1.2 million people reported long COVID symptoms in the four weeks to the end of October. Indeed, attempts to provide long COVID care through specialised hospital-based clinics in the UK and elsewhere have led to long waiting times and uneven access.

Meeting the emerging needs of people with long COVID represents an additional burden on Australian health-care systems already stretched by COVID and rapidly rising backlogs of care for other conditions. If health-care workers are particularly at risk of long COVID, this will further stretch health systems as they take time out to recover or leave the workforce. The authors expect long COVID to be over-represented in the socially and economically disadvantaged populations already disproportionately affected by COVID-19.

Australia needs to focus urgently on identifying and counting long COVID. It also needs to establish mechanisms to coordinate care for long COVID by mobilising resources across the community and private sectors, not just public hospitals.