Long COVID: What New Zealand should be doing to prepare for potential wave of illness

Tens of thousands of Kiwis could be effected by long COVID.
Tens of thousands of Kiwis could be effected by long COVID. Photo credit: Getty Images

After a week locked up at home, you may think your battle with COVID is over - but months later the effects of the virus could still loom.

Health experts say that while the focus to date has rightly been on the pandemic and vaccinations, it is now time to turn attention to the long-term health effects.

Long COVID is the term used to describe the effects of coronavirus that continue or develop for at least three months after initial infection. Patients can experience a range of debilitating symptoms, including chronic fatigue, brain fog, chest pain and even shrinking of the brain.

Physiotherapy New Zealand's Cardio-Respiratory Special Interest Group secretary Sarah Rhodes says some patients living with long COVID are unable to manage simple tasks such as showering without feeling wiped out for the day.

She says long COVID is the "elephant in the room" that needs to be addressed.

With Omicron surging through the country, this invisible illness could infect tens of thousands of Kiwis.

The World Health Organisation estimates around 10 to 20 percent of people that have had the virus will develop long COVID. But some researchers say that percentage could be a lot higher, with studies finding up to half of COVID patients developing long-term symptoms.

At the time of publication, world data shows that New Zealand has had over 400,000 cases of COVID. That's at least 40,000 people currently estimated to have long COVID.

"There is an urgency to develop treatment pathways and provide funding to support this currently unmet need," Dr Rhodes says.

Long COVID clinics

New Zealand has watched as overseas countries battled COVID outbreaks and the long-term health effects that came with it, but now that Omicron has inevitably broken through our border it is time to implement long COVID clinics.

"Overseas we have seen the impact of this sting in the tail of COVID and watched those affected fight for recognition and treatment of their ongoing symptoms. New Zealand has the opportunity to act decisively now to fund and introduce clear pathways of treatment like long COVID clinics," said Dr Rhodes.

By definition, the first cases of long COVID from Omicron will start to appear now as the variant has been in the community for just over three months - so why have we not got long COVID clinics ready for the predicted wave of patients?

Long COVID clinics are now operating around the world, but not yet in New Zealand.

University of Otago emeritus professor Warren Tate says the Waitematā District Health Board is currently setting up a long COVID clinic. But experts have been calling for clinics since the Delta outbreak in August 2021.

Dr Rhodes says due to New Zealand's initial elimination strategy, the impact of long COVID has been delayed - but she warns it is coming.

"We could have been more proactive but it is not too late," Dr Rhodes says. "Now is the time to prioritise a long COVID service."

She says physiotherapists in New Zealand have been learning from international colleagues' experiences of long COVID to prepare and are already supporting lots of people with the condition, but more awareness of the role is needed.

"To date, there has been little recognition of the role of physiotherapists in the management of long COVID and little funding for physiotherapy provision to manage these patients, so physiotherapy services may be stretched."

Dr Rhodes said physiotherapists have helped get pathways and policies in place to help with support and are developing a national guidance for the measure of long COVID.

Professor Warren Tate told the Science Media Centre there needs to be education in the medical schools to ensure graduating doctors have an understanding of the illness and how best to care for patients.

One of New Zealand's first earliest cases of COVID-19, Jenene Crossman, who is also a long COVID sufferer, has been campaigning for recognition of the condition.

She posted on Twitter that she often gets rung by doctors wanting advice on how to treat long COVID patients, despite having no medical training.

Prof Tate says there is "virtually no messaging reminding people of long COVID" despite New Zealand facing more cases than we have ever had, and the effect that could have in terms of a future health burden to individuals, families, communities, and our health system.

"This is not a call for fear-mongering but there is a need to remind all to take personal measures to minimise infection - so we not only mitigate immediate problems for our hospital system but future burdens on our health system as a whole."

What you can do to avoid long COVID

While New Zealand starts to implement support and care systems for long COVID, there are a few things you can do to prevent getting the condition.

The obvious way to avoid long COVID is of course not to catch the virus at all - but in the event that you do, experts say the key is rest.

"The best advice if you test positive for COVID-19 is to allow yourself time to rest both physically and mentally, to optimise your chance of a full recovery," Dr Rhodes said.

She says even if your symptoms are mild, resting is a priority.

It is still unknown what causes long COVID, but researchers have found that it has occurred in patients with both mild and severe symptoms.

People are urged to reach out to their local GP, physiotherapist or exercise physiologist if they need advice on how to get back into the activities they love.