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From diagnosis to services and support: how Australia’s long COVID response is falling short

Around in Australia experience symptoms for more than three months after a COVID infection, termed long COVID.

Authors


  • Zhen Zheng

    Associate Professor, STEM | Health and Biomedical Sciences, RMIT University


  • Catherine Itsiopoulos

    Professor and Dean, School of Health and Biomedical Sciences, RMIT University


  • Magdalena Plebanski

    Professor of Immunology, RMIT University


  • Rose (Shiqi) Luo

    Early career researcher, RMIT University

So far, more than have been recorded, ranging from shortness of breath to fatigue and brain fog. The effects are far-reaching for those with the condition, often affecting their capacity to work and their quality of life for many months or even years.

With this in mind, we set out to examine Australia’s long COVID guidelines, services and public health information.

Our found that compared to international standards, Australia is generally slow to recognise and investigate possible cases of long COVID. We also found the availability of multidisciplinary long COVID services was lacking in Australia, as was accessibility of trustworthy public health information.

From COVID to long COVID

Even with all the advancements in medical science, there’s not yet any simple blood test or scan that can definitively tell you if you have long COVID. A diagnosis is based on how long you’ve been dealing with symptoms. But the point at which you’ll receive that diagnosis can vary depending on where you live.

In our , we examined international guidelines from the as well as national guidelines in the , the , and .

Most countries, including Australia, wait 12 weeks after the initial infection to officially diagnose long COVID. The US, however, determines a person has long COVID after just four weeks of continued symptoms. This discrepancy can have significant implications for how much support the person will get from the health system.

Guidelines in Australia, the UK and the US do advocate for further investigation if symptoms persist for four weeks after contracting COVID. But we discovered this approach of early investigation is not consistently implemented in Australia.

On reviewing the eligibility criteria for long COVID services in Australia, we found that most of these services require a person to have had symptoms for 12 weeks or more to qualify for care.

Get help early

If your for four weeks or more after catching COVID, it’s important to act early by contacting your GP. They can investigate further and help you manage your symptoms.

Unfortunately not all GPs and health-care professionals are up to speed on long COVID. The Royal Australian College of General Practitioners has called for .

All health-care professionals, especially those working in the community, should be educated about how to spot long COVID early. This will enable them to refer patients for specialised care when required.

Australian long COVID services cannot meet demand

Long COVID is a complicated health issue that can affect of the body, and right now there are for the condition as a whole.

However, a mix of supports and services can help. This might include care from a cardiologist, neurologist and physiotherapist for different symptoms. Research has shown that a personalised, can have long-term benefits for people with long COVID. Long COVID clinics offer these sorts of programs.

When we conducted our research, we identified just 16 specialised long COVID clinics in Australia.

The vast majority of the Australian population has had COVID at least once. The current best estimate is . If we do a conservative calculation and say out of 80% of Australians who have had COVID, 5% ended up with long COVID, that’s at least one million people.

Each long COVID clinic is then essentially tasked with serving more than 60,000 people. Even if we assume and don’t need these services, it’s still an impossible task.

So it’s not surprising reports suggest people have had to wait to access these services.

Further, all of the 16 clinics were in big cities, and none in rural areas. There were also no long COVID clinics catering specifically to the unique needs of children, elderly people in aged care, or those with a disability.

Another gap we identified is that trustworthy public health information on long COVID, such as online resources, is either not readily available or not advertised. Where these resources exist, they are primarily in English, disadvantaging people with low health literacy or from non-English-speaking backgrounds.

Integrating advice in multiple languages on diet, movement, energy conservation and mental health with clinical support will be of great value to many people who are on the wait list for long COVID clinics.

If your COVID symptoms last more than four weeks, or if new symptoms appear during that first month, affecting your life or work, you might be in for the long haul. Our key message is act early. Book yourself in with your GP or a GP-led specialist clinic.

With COVID cases , more and more people will find themselves with long COVID. As a society, we need to fast-track better services and work towards a deeper understanding of the condition.

The Conversation

Zhen Zheng is a member of Australian Acupuncture and Chinese Medicine Association

Zhen Zheng co-leads a research program “Eat, Move, Heal for Long COVID” at RMIT University, aiming to improve education of the public and healthcare professionals about long COVID.

Catherine Itsiopoulos has received funding from NHMRC for other research. She is a member of professional bodies including Dietitians Australia and The Australasian Society of Lifestyle Medicine.

Member of RMIT University ‘Eat, Move Heal Network’ researching to develop tools to support patients with long COVID19 at home. Director of Biomedical and Health Innovation Enabling Impact Platform supporting multidisciplinary research within RMIT University. Unrelated research into ovarian cancer, one of our cancer human clinical trials receives partly support from Astrazeneca and ANZGOG.

Rose (Shiqi) Luo does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

/Courtesy of The Conversation. View in full .