Long COVID: the ‘Post-Pandemic’ Pandemic

We’re well into our third year of the COVID pandemic by now. While we all remember the months of harsh lockdowns and movement restrictions, I know most of those around me think of December 2021 as the most frantic of Australia’s outbreaks. Seeing case numbers climb by thousands every week, when we’d previously been locked down at just one hundred, was terrifying.

Now, despite having tens of thousands of cases every day, we’re relaxed. There are barely any restrictions left, and governments have pushed COVID way, way down on the to-do list. This attitude seems to trace back to that very December, when despite thousands of cases, deaths and hospitalisations remained comfortingly low.

The uproar around COVID in vulnerable settings, like aged-care homes, has died down recently, despite their situation worsening.

You might think that hasn’t changed; but you’d be wrong – just in this past week, Australia has recorded 656 COVID deaths. Hospitals are nearing breaking point. And as we get further into the ‘post-pandemic’ era, it’s not just the disease we should worry about, but its longer-term consequences.

Reinfection is becoming more and more common; most of us now know at least one person who’s had COVID twice. With increasing reinfection comes a higher risk of Long COVID.

Post-COVID syndrome and its risks are not news. Experts have been urging officials to prepare for tens of thousands of post-COVID patients for over a year. Researchers from Deakin University wrote a brief back in May of 2021, examining how our healthcare system needed to prepare for the strain of Long COVID.

“[W]e called for Australian policy makers to prepare for Long COVID, and to seize the opportunity Long COVID offers to trial and implement new approaches,” wrote Martin Hensher and Mary Rose Angeles in December. “It is not clear that much progress has been made in this regard in the months since the [May] Brief was published.”

Risk factors

Not enough is known yet about how age, sex, health, and other factors affect Long COVID risk. An English study reported females and older individuals experienced Long COVID more acutely, and obesity and smoking/vaping also increased risk. But even young children are at risk, losing their ability to concentrate in school and participate in hobbies.

Long COVID was also found more commonly among 65+ year-olds in a US study, which reported one in four COVID survivors over 65 experienced at least one long-term symptom. Still, 18-64 year-olds aren’t far behind, with one in four COVID survivors experiencing post-COVID symptoms.

That same study reported individuals aged 18-64 were more likely than their older counterparts to experience cardiac dysrhythmia and musculoskeletal pain post-COVID.

What is known definitively is that vaccination reduces risk of Long COVID, while reinfection increases it.

Public health epidemiologist and former university researcher, David Steadson, recently tweeted his concern over Long COVID risk data. His research compares the cumulative probability of getting Long COVID based on different reinfection risk estimates.

The CDC estimates the risk of getting Long COVID each time you get COVID is 20%, but even if the risk is 1%, says Steadson, there is cause for concern. If the risk of getting Long COVID is 1%, after ten infections, the accumulated risk is 10%. If it’s 10%, by the seventh infection your accumulated risk is more than 50%.

Steadson concludes that the vast majority of people should expect to suffer from Long COVID over the coming 2-3 years. “Given what we know now, the more times you get infected, the greater the accumulated likelihood you get Long Covid sooner or later,” he says. “This should be intuitively obvious, but is being ignored by the majority of people and policy makers.”

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