Long COVID is keeping people from their jobs and their lives, and as COVID cases continue, it is unclear whether the rate of new long COVID cases is increasing faster than the old cases recover.
As the report of the committee into long COVID says, long COVID causes “lost earnings, impacts on household finances, and, in some cases, an inability to work or to extend care to family members including children”.
We need to be clear about what long COVID is and how long it lasts.
If a cough four weeks after infection onset counts, long COVID is common; if you need to be severely debilitated 12 months later, long COVID is less common.
The big difference between long COVID and AIDS is that long COVID is not infectious after the acute infection.
Many children in the current generation are growing up with either their parents or themselves confined to bed. Three months after catching COVID, an estimated 20% of Australians, primarily women but also men and children, are affected, according to an ANU study. Many people will be ill for a long time during the current COVID wave.
People are missing work and their lives due to long COVID, and it’s unclear if the number of new cases is rising more quickly than the rate at which older cases are recovering as COVID cases persist.
Persistent symptoms are the outcome of infection. Suffering is the outcome of chronic symptoms. “Lost earnings, impacts on household finances, and, in some cases, an inability to work or to extend care to family members including children” are the consequences of long COVID, according to the committee’s report on the disease.
The impact is evident in the United States, where, as a result of low vaccination rates and widespread infectious disease, disability has rapidly increased since 2020.
As the following chart illustrates, the pattern is less obvious in Australian data. The percentage of people who say they are unable to work because of their disability is greatly impacted by shifts in the relative rates of the disability support pension and the JobSeeker payment.
However, we observe a general increase in the number of people who are disabled and unable to work, which is contrary to what we would anticipate during a period of low unemployment. Those in their prime working years, 35 to 44, have the strongest signal.
According to a new study that was published in The Medical Journal of Australia, hundreds of thousands of Australians would be impacted by the $9.6 billion in lost labor that would result from a single round of infections in 2022.
It is important to clarify the duration and nature of COVID-19. Although the clinical course of the disease is still being discovered and the disease is not well studied, the following can be said.
Long COVID can be separated into several categories. One group consists of people with persistent coughs and those with lung damage from severe illnesses. Then there are those whose sense of smell is slow to return. That is a different group.
Even if they didn’t initially have a severe case of COVID, the most significant group is the one with enigmatic persistent symptoms. This is the group where we find people who do not recover, and it has been a mystery to science.
This category includes those who suffer from chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME), a mysterious post-infection illness that impairs people, primarily women, and causes symptoms in a variety of areas, including the neurological, blood pressure, immune system, and pain.
According to the NSW Agency for Clinical Innovation, estimates of the prevalence of long-term COVID-19 range from 0.09% to 1%. How you define long-term COVID and when you inquire about symptoms are two factors that influence this. Long COVID is more common if you cough four weeks after the infection started; it is less common if you need to be seriously incapacitated a year later.
The fact that many people recover appears to be accurate. There are many recovery stories on online forums for long-term COVID, some of which are unplanned and others that are ascribed to different steps the person took. Even though there are numerous trials in progress, science remains silent on what could result in recovery.
Stories about people who have not improved and many who have gotten worse over time abound in those same forums. As a person’s illness worsens, the likelihood of a spontaneous recovery appears to decrease. Long-term COVID illness affects many people for less than six months, some for a year, some for a few years, and an unfortunate few continue to suffer for a longer period of time.
Given that the virus was nearly exclusively infecting pangolins or possibly bats five years ago, it is evident that there are no long-lasting COVID cases in the world that have lasted longer than five years. However, the course of ME/CFS indicates that some patients may experience symptoms for decades.
The delta virus was the most frequent cause of long COVID. Although it does not occur as frequently, the more recent Omicron virus can still cause long COVID. This supports the conclusion that longer COVID is less likely to result from less severe illness. Immunization also seems to lower the risk of contracting a long-lived COVID.
One of the top Australian institutions researching long COVID is the Burnet Institute. According to its most recent research, long-term COVID is brought on by viruses that linger in the body. This is one of two fundamental theories; the other is the “hit-and-run” theory, which holds that the virus has been eliminated but that a critical system—likely the immune system—has been disrupted.
The Burnet Institute’s claim that viruses are persistent has some merit. Recently, an unpublished French team hinted at some brand-new discoveries, claiming to have discovered the virus’s hiding place. The French National Centre for Scientific Research research team discovered SARS-Cov-2 concealed in megakaryocytes, a unique kind of immune cell. These cells create platelets, which are tiny clotting factors in blood, and they have the ability to seed viruses into them, according to the French team. Fatigue and brain fog are just two of the issues that could be explained if that results in blood flow issues.
There is undoubtedly evidence that a virus can persist in immune cells following an acute infection. The human immune virus (HIV) infects T-cells in this way. If antiviral medications are not taken to control the infection, it results in AIDS, a much more serious post-infectious immune disorder that is lethal.
Long COVID is not contagious after an acute infection, which is a major distinction between it and AIDS. In that regard, the post-infectious phase is more comparable to the case of polio, in which a small percentage of patients maintain symptoms for a long time following an acute illness. The virus that causes polio attacks nerves, leading to post-polio syndrome.
Until recently, the notion that infections can lead to illness after their acute phase was out of style. Despite being widely understood, HIV/AIDS has historically been regarded as an uncommon situation. People were believed to recover from infections and move on. Large-scale, impactful research on the causes of chronic illness is challenging that way of thinking.
A number of other viruses also appear to be connected to the development of “other” illnesses. It is clear that the human papillomavirus causes cervical cancer to develop. The Epstein-Barr virus was most famously identified as a necessary trigger for the development of multiple sclerosis. That discovery was revolutionary and resulted from a very thorough analysis of 10 million US military personnel.
Of course, two Australians were awarded the Nobel Prize for demonstrating that bacteria, not stress, were the cause of stomach ulcers.
If viral persistence is proven to be the cause of long-term COVID, then strategies that have been used to combat viruses in other situations could be used in this one as well. To get many people—children and their parents alike—out of a tangle of misery and back into life, that would be an essential first step.
