Longer-term challenges of Covid-19

How will it be possible to prove problems are Covid-related unless this country invests in seriously looking into this new field ploughed by the pandemic?

In New Zealand and Australia, health officials are expressing confidence that the worst of the latest Covid-19 wave is over. The Public Health Agency’s deputy director-general Dr Andrew Old said on Thursday: “While we know that some cases will always go unreported, testing of healthcare workers and our ongoing wastewater surveillance also supports the conclusion that for now at least, we’re seeing a true decline in community transmission of Covid-19.”

Modeller Dr Dion O’Neale said the virus’ reproduction number was just below one.

Australia’s chief medical officer Professor Paul Kelly said the country was over the top of the surge.

Both countries have had high infection rates in recent weeks compared to other developed nations.

While it is good news that confirmed daily community case numbers have been decreasing here since mid-July, it remains to be seen how low they will get, and data on hospital cases, people in ICU and those dying are still high.

New Zealand’s Covid data graphs continue to resemble thick mountain ranges rather than tall, thin peaks.

And there is a lot of coronavirus fallout that still lies ahead — as much as people hope it’s mainly behind us. If the pandemic spotlight does dim, its health legacy will likely come more into focus.

There’s still confusion over when and usually how long a person is infectious. Longer-term health is a major area of uncertainty. More medical impacts are regularly being highlighted through research.

Long-Covid is a subject that is still being sketched out as more is discovered.

Accounts of long-Covid make clear what a daily battle it is.

Data on how big a problem it is around the globe is insufficient.

A new study on self-reported longCovid in the UK from the Office for National Statistics outlines the current limitations: “Long-Covid is an emerging phenomenon that is not yet fully understood, and there is no universally agreed way to measure its prevalence. These are therefore experimental statistics.”

Two other new studies from the UK suggest there are three broad categories of long-Covid.

A pre-print study from researchers at King’s College London suggests that two of the types were linked to different stages of the pandemic.

They say there is a neurological strain, a respiratory-focused form of it and then a type with a range of symptoms.

The neurological type featuring symptoms such as fatigue, brain fog and headaches mostly involved people infected during Alpha and Delta waves. People with respiratory symptoms were mainly infected during the first wave in 2020. If this is correct, New Zealand’s tight border strategy until people were vaccinated likely limited some long-Covid damage. The third set of symptoms included heart palpitations, muscle ache and pain, and changes to skin and hair.

University of Birmingham researchers also noticed that people tended to be in one of three categories and said there were 62 long-Covid symptoms overall. The study suggested that females, younger people and those belonging to a minority ethnic group are at greater risk of long-Covid.

Dr Shamil Haroon, an associate clinical professor in public health and lead author of the Birmingham study, noted that “the symptoms of long-Covid are extremely broad and cannot be fully accounted for by other factors such as lifestyle risk factors or chronic health conditions”.

This gets at the developing and likely ongoing issue; how will medical problems arising from Covid infections be assessed? Is New Zealand compiling enough data on long-Covid, analysing how it can most effectively be treated, and working out overall policies and guidelines for health workers?

What will it mean for diagnosis generally as some symptoms are similar to signs of other potential problems? What will it mean for medical funding, research, benefit payments and insurance cover?

How will it be possible to prove problems are Covid-related unless this country invests in seriously looking into this new field ploughed by the pandemic?

The US government is setting up an office on long-Covid within its health department. Arguably, with the pandemic’s medical long tail, the need to compile lessons from what the country has been through, and to plan for future virus threats, New Zealand needs a specific body or forum for Covid issues.

It looks like the start of a long haul for officials, medical professionals, and the long-haulers themselves.