In August, the prime minister, Scott Morrison, wrote: “This is what living with Covid is all about. The case numbers will likely rise when we soon begin to open up. That is inevitable. But our focus needs to be on the rate of people being hospitalised”.
Well, he was spot on with respect to case numbers rising. The trouble is, that they have risen much faster than expected.
The University of New South Wales recently reported modelling showing that 25,000 cases a day for NSW were possible by the end of January. With 12,226 cases for the state on Thursday, it not only looks very realistic, but is most likely an underestimate.
Even if Omicron is milder than Delta, with thousands of cases a day, hospitalisations and ICU admissions will inevitably rise. We are already seeing this in NSW.
And when he wrote about living with Covid, Morrison failed to mention that many infected people end up with long-term health problems, a condition we call long Covid (or post-Covid-19 condition).
Although most people infected with Covid-19 return to normal health after their infection, more than a third may still have health problems three to six months after recovery. Those most at risk of long Covid include people aged over 50, females, and those with chronic health conditions and obesity. Having a psychiatric or an immunosuppressive condition also increases your risk. There is some evidence that the severity of the initial Covid-19 infection doesn’t seem to affect the chance of you getting long Covid, although there are mixed findings on this.
If you are unfortunate to end up with long Covid, common symptoms include abnormal breathing, constant fatigue, malaise, sore chest, sore throat, heart abnormalities, headache, muscle pain, abdominal problems, nerve pain, insomnia, dizziness, brain fog, anxiety and depression. In fact, just about any organ in your body can be damaged by the virus. On a more cheerful note, at least one study has found that children are less likely to get long Covid.
We are still learning about long Covid and all of the studies referenced above have been on previous variants. Unfortunately, because Omicron has only been around a few weeks, it is too early to know whether the new variant will be just as bad for long Covid. The Australian Medical Research Future Fund is about to fund one or more major studies of long Covid in Australia, so more information will become available in the next two to three years.
Like Australia, many European countries have gone through the same route of reopening and trying to live with Covid-19. But Prof Martin McKee, a European public health expert at the London School of Hygiene & Tropical Medicine, is critical of the French and UK governments’ responses and disbanding of public health measures. He wants to return the focus to cases, and on bringing cases down to as low a level as possible, rather than simply trying to live with the virus.
This doesn’t necessarily mean lockdowns, although McKee points out that these have been very effective in Austria and the Netherlands, albeit for the Delta variant. He argues that the focus now should be on public health measures like improved air filtration and ventilation.
What a sensible idea. Unfortunately, the Australian government rarely learns from other countries.
Meanwhile, the elephant in the room called long Covid is still there, but quite invisible to our politicians.
Prof Adrian Esterman is chair of biostatistics and epidemiology at the University of South Australia. He previously worked for the World Health Organization in Geneva and Copenhagen