With daily COVID-19 case numbers climbing, there is mounting concern from health workers about the strain that could be put on ICU capacity. But it's not just the immediate hospitalisations that are a cause for worry, said Massey University Professor John Potter.
Potter, a professor at Massey's Research Centre for Hauora and Health who was Chief Science Advisor to the New Zealand Ministry of Health from 2016-2019, said if COVID-19 becomes endemic to New Zealand it could cause massive wider problems for the health system.
According to a new study from Oxford University, 37 percent of infected had at least one long COVID symptom diagnosed.
"Two hundred and seventy thousand COVID survivors, and they followed them, and between a third and a half had symptoms three to six months later," Potter said speaking today to Saturday Morning.
"And those are a wide variety of symptoms that are indicative of the fact that this particular virus infects a lot of different parts of us. It's not just a respiratory virus."
"It's a virus that gets into lots of organs and has downstream consequences that are really nasty for a lot of people."
Long COVID symptoms can include breathing problems, abdominal symptoms, fatigue, pain, anxiety and depression.
Victims can have myalgia, pain in the muscles, which can present similar to chronic fatigue syndrome.
"Abnormal breathing persists in a decent percentage of people almost 20 percent of people because of damage to the lungs," Potter said.
"Some people have headaches and cognitive symptoms which tells us that it does damage to the brain."
More than 10 percent end up with pain in various places of the body, and anxiety and depression were found in almost a quarter of people in the long COVID study.
"People also get something a little like what people have called chemo brain where you've got symptoms where your brain is fuzzy, it's not functioning at the level you're used to having it function."
The symptoms are very different than the ordinary influenza, Potter said.
"Flu has - occasionally you get a post-viral malaise. The flu people generally get, it's vile, it's lousy, it kills people ... but generally people recover fully after flu."
Long COVID symptoms were first described more than a year ago by ordinary people getting together in groups on social media and elsewhere.
"It was first picked up more than a year ago by a really good article in The Washington Post," he said.
The new UK study is a "really important contribution to our understanding", Potter said.
"But there's still an awful lot to understand. We don't know how long this persists."
"It's clearly different from anything like the flu."
Similarities to COVID-19 can be found in the respiratory illnesses of the 2002-2004 SARS outbreak in China and MERS in 2012 in the Middle East.
"These are both coronaviruses and our COVID ... this is the third that we know we've encountered with this kind of nastiness.
"But coronaviruses are also part of our common cold sources. There are lots of different viruses that cause cold."
The Delta variant mutation of COVID-19 has led to new waves and spread throughout the world, including New Zealand. Potter said nobody knows for sure if COVID-19 will mutate further, but there are concerns.
"Here's a very good reason why it won't become more benign. This particular version of this particular coronavirus, the Delta variant, has an R1 (reproduction rate) of about 6. That means that the numbers go up very rapidly. It spreads itself really, really rapidly. And that's our problem with it.
"For any virus variant to replace this one, it's got to be even more infectious than this one."
"If it mutates away from being infectious it won't compete with this one, so this will be the dominant one continuously."
"We should not give up," he said.
"If you want a comparison, malaria is endemic in tropical parts of the world. Every year there are more than 200 million cases of malaria, and over 400,000 deaths and two-thirds of those are in children under 5. So there are 750 deaths a day from children under 5 from malaria. And malaria is endemic."
"Germany and the UK are currently more than 80 percent vaxxed and yet the UK has got about 30,000-plus cases a day and 130 deaths. Germany has done better, bigger population, it's got 8000 cases a day and about 60 deaths.
"That would translate into New Zealand terms, at 80 percent vaccination, somewhere between 500 and 2500 a day and 5 to 10 deaths a day.
"This isn't formal modelling," Potter noted. "This is just saying if we compare ourselves to Germany and the UK that's the kind of numbers we're going to face."
Long-term, Potter said that if we don't penetrate all communities equally with vaccines we're going to face ongoing problems.
"We're going to end up with a new kind of inequity that I've begun to think of as the jabs and the jab-nots. We are going to be in trouble because this will spread rapidly in areas where there is no vaccination."
A new experimental drug, molnupiravir, is being developed to treat COVID-19 symptoms.
"It's certainly not a replacement for vaccination and it's not a cure," Potter said. "All it does is it stomps on the virus hard enough that you don't get such a big viral load."
However, it's not all doom and gloom, Potter said.
"I don't think we're going on forever. The good news is again ... the general response from the population is massive. More than 80 percent of the eligibles at the moment have taken their first jab. A huge proportion of those will take their second jab.
"We've got four-fifths of the population already voting with their feet. A lot of them doing it for the common good, for the family good, for the whānau good.
"All of that's just fabulous, and it speaks to us. The PM was absolutely right about the team of 5 million. Yes, we've got a few people who don't want to play the game, but generally, people are right on side and really doing everything they can to make this work properly."
"We're the country that other people look to to give them hope," Potter said, despite recent setbacks.
"I think one wheel is wobbling. I remain optimistic because the general sense is that we can still ring-fence this.
"If we have to crank the levels back up, fine. I appreciate that means pain and misery for some people. But it's mostly mental pain and misery, it's not gonna be the physical disease of COVID-19.
"That's the reason for everybody to go out and get vaccinated ASAP."