Long Covid is one of the most controversial topics remaining about the pandemic. Depending on who you ask, this is either a real and present threat to the health of the world, or a relatively minor issue that we need to pay little attention to in the future. It’s hard to weigh in on the topic without passionate advocates challenging the things you say, which is true of many of the conversations we’ve had over the course of the pandemic.
A recent study from Queensland has injected further discord into this already complicated space. The Press release about the study says that, in a large observational study, people who tested positive for Covid-19 when the Omicron variant was spreading were no more likely to report ongoing symptoms or serious problems in their daily lives than people who tested negative tested positive for influenza. It follows similar previous work by the same team showing almost identical results. According to Dr John Gerrard, one of the authors of the paper and Queensland’s chief health officer, the findings call into question the entire conceptualization of long Covid, arguing that it is possible “time to stop using terms like ‘long Covid'”.
This caused a number of articles arguing that long Covid causes unnecessary fear, because of little difference between long-term symptoms caused by Covid-19 and other common viral infections.
The first problem here is that it’s hard to know what to make of the research. The results reported are an early news release about a presentation going to happen at the European Congress of Clinical Microbiology and Infectious Diseases in April. In other words, we have no idea how robust this paper is, nor how useful the data might be. The fact that there are so many news reports about this unpublished, unproven finding is in itself somewhat of a problem.
However, the reports on these findings are consistent with a series of other articles published on Covid-19 in recent years. We know that the risk of prolonged Covid strongly related on how bad initial infections are. In 2020, when Covid-19 was many times more problematic than influenza, Covid was quite common for a long time, but after successful vaccination campaigns, effective new medications and large-scale infection, the risk of a Covid-19 infection has decreased significantly. The risk of getting long Covid from an infection is now somewhere around 10 times less common than it was in 2020. Given the decline in severity of Covid-19, it is not unlikely that rates of prolonged symptoms will be similar between Covid-19 and influenza in 2024. Like I said for yearsa lot of this comes down to how we define long Covid, and how we know what long-term symptoms are actually caused by Covid-19.
In other words, you could reasonably argue that Dr Gerrard is correct. However, the problem is that many people were infected in 2020 and 2021, before we had vaccines and treatments to reduce the severity of the disease. There is no doubt that a large group of people are still experiencing serious problems from their initial Covid-19 infection, many of them years after they first became ill. Australia does not have a national estimate of how many, but data from the United Kingdom suggests that approx 0.5% of the country may fall into this group. While that’s not a huge percentage, it’s still a lot of people – a similar rate in Australia would mean around 100,000 Aussies suffer similarly. These people have been largely left without hope because we still don’t really know why they have Covid for so long, and have no effective interventions to treat their disease.
And therein lies the problem with long Covid discussions. There are two separate conversations going on at the same time. We can talk about the future, which looks a little brighter – long-term Covid rates are down drastically, and people who get infected with Covid-19 now are about as likely to experience serious, long-term problems as people who got it in 2019 But we must also acknowledge the large number of people seriously injured by Covid-19 in the early stages of the pandemic who may never recover.
There may be nothing unique about long Covid in the future – even without this new report, the evidence is strong that Covid-19 is now quite similar in risk to influenza per infection – and perhaps we should start talking more about post-viral conditions than a category rather than focusing on the symptoms caused by Covid-19 alone. But if we do, it’s important that we don’t leave behind the many people who are facing seemingly endless problems caused by Covid-19 years ago.
