The Australian Medical Association has blasted “weak political leadership” in the current response to the coronavirus pandemic, saying governments should reconsider mask mandates to address a feared rise in long Covid cases.
The peak doctor’s body has called for more funding into research and treatment of the long-term lingering symptoms of Covid, claiming the nation’s health system is not equipped to manage chronic conditions on a large scale. One expert warned 1 million Australians could experience long Covid by 2023.
“It is ambitious to make predictive statements of the specific impact of long Covid and further repeat infections on the health system as we do not yet know the scale of long Covid infections,” the AMA said in a submission to a federal parliament inquiry into the issue.
“However, we know that right now our health system is not prepared and is failing to deliver the level of care that Australians expect.”
The federal parliament’s health committee is investigating long Covid. In an issues paper released this week, the committee said that while Australia doesn’t have an accepted definition of the condition, it was considered as “ongoing symptoms more than three months after a confirmed Covid infection”.
The inquiry suggested the government needs to collect better data to get an accurate picture of how widespread the problem is – a call backed in by submissions from groups including the Stroke Foundation, the specialist Long Covid Clinic at Sydney’s St Vincent’s Hospital, the Asthma Foundation and UNSW’s Kirby Institute.
People have complained to the committee about impacts on their capacity to work, difficulty cooking or caring for children, and social isolation due to long-term symptoms. The paper warned Australia “may not have seen the full scope of the after-effects of this condition.”
The AMA said long Covid is difficult to diagnose as it manifests in varying symptoms.
“Due to the variation in symptoms, difficulties diagnosing and reporting, it is very difficult to say what percentage of people infected with Covid-19 will develop long Covid,” the AMA’s submission read.
It pointed to an international study in October estimating more than 6% of Covid patients had long Covid three months after their infection, and nearly 1% after a year. One British study found long Covid was more than twice as prevalent for those infected with the Delta variant, as compared to the Omicron variant.
The AMA said more research was needed into the reasons that long Covid can develop after infection, calling for “appropriate funding” from government. It also noted there were no clear protocols for treating patients, with varying symptoms and severity making treatment complex.
“Australia requires a data collection and research strategy to overcome the challenges of studying long Covid,” it said.
But the doctor’s association reserved criticism for governments winding back pandemic restrictions, saying complications around long Covid or repeated infections could be lessened if there was less risk of catching the virus.
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“The AMA is extremely concerned that many Covid-19 policies to support the health system have ended or are due to end on 31 December. The AMA perceives that many politicians and policy makers viewed the implementation of public health measures through a time-limited binary lens, where once mask mandates were lifted they could not be returned,” it said.
“This is poor policy and demonstrates weak political leadership. There may be a point where a mask mandate, be it in limited settings or full, is the best policy for preventing infections.”
The AMA claimed Australia had “moved too quickly” to cut restrictions, and called for “a pandemic plan that relies on more than vaccination”.
‘Overwhelming demand’ at clinic
St Vincents’ Long Covid clinic said more research into the condition was needed, as well as more public education and funding for specialist clinics. Its submission said the clinic had experienced “overwhelming demand” for limited resources, with wait times for a consultation up to six months.
“A number of patients are significantly frustrated by the length of time it takes to make a diagnosis and to achieve a clinical appointment,” the clinic said, but noted patients “are often overwhelmed by the recognition that their level of functional loss maybe caused by symptoms consistent with long Covid”.
The Kirby Institute’s Prof Raina Macintyre, a leading commentator and expert on Covid, estimated that nearly all Australians would have experienced at least one Covid infection by August 2023.
“Our findings suggest that in October 2023, over 1 million people could be experiencing long-Covid symptoms,” the submission said.
Her submission warned Australia “faces a growing burden of chronic disease” from long Covid, recommending the government consider vaccinating children from ages 0-4, and expanding third and fourth booster doses to more people.