Australia’s long COVID response is falling short of international standards and needs an urgent overhaul, a new study has warned.

The RMIT University and Northern Health research examined the country’s long COVID services, guidelines, and public health information, compared to international standards, finding Australia is lacking in several categories. These include early investigation, accessibility and availability of trustworthy public health information, and adequate multidisciplinary long COVID services to meet demand.

Dean of RMIT’s School of Health and Biomedical Services, and co-author of the paper, Professor Catherine Itsiopoulos, warned that the problem would only worsen over time.

“Long COVID is here to stay. As COVID-19 cases continue to accumulate, the cases of long COVID will also increase,” she said.

“With unclear diagnosis and unknown effective treatment, this new chronic disease will be highly costly to the individual and on public health systems worldwide.”

Data shows the COVID-19 pandemic has resulted in an estimated 642 million cases since the outbreak, with more than 11 million cases confirmed in Australia. In some cases, it can develop into long COVID – which the Australian definition considers when a person experiences symptoms for longer than 12 weeks after contracting COVID-19, yet, the US guidelines suggest four weeks.

“While most people recover fully, up to 40% of people experience lingering symptoms. Recent new data shows that 14% of Victorians who had COVID-19 suffer from long COVID,” Professor Itsiopoulos revealed.

“These symptoms can include fatigue, shortness of breath, persistent cough, joint pain, brain fog, cognitive dysfunction, anxiety, depression, loss of smell or taste, and insomnia.”

The study found Australia’s long COVID patients have fallen through the cracks due to poor diagnosis, complex multiple chronic disease needs, and poor access to healthcare.

“Because there’s so much confusion around the definition of long COVID and so little that we know about it, even healthcare professions – including GPs at the frontlines of healthcare – don’t know how to spot the early signs or how best to treat people experiencing it,” co-lead author Associate Professor Zhen Zheng added.

Researchers also found trustworthy public health information on long COVID – such as websites and webpages – either not readily available, or not advertised. Where they do exist, they are primarily written in English, disadvantaging from non-English speaking background, or with low health literacy.

To improve the country’s response to long COVID moving forward, researchers have proposed tapping into US, UK, and Australian guidelines, which prioritise early investigation, and insights from the Australian National Strategic Framework for Chronic Conditions.

Recommendations to improve Australia’s response are headed by early detection, including monitoring for long COVID from four weeks after infection, and educating the public, especially those with pre-existing conditions like chronic fatigue, arthritis or diabetes. Other strategies include addressing mental health issues in the acute phase, investigating symptoms at four to eight weeks, and referral to long COVID clinics if symptoms persist for more than eight weeks.

Co-lead author, Dr Shiqi Luo, helped identify 16 long COVID services in Australia during the research. Since then, seven services have been created, while three were terminated. Victoria operates nine of the services, all providing dedicated multidisciplinary rehabilitation for sufferers.

“Because long COVID affects so many parts of the body in different ways, the best rehabilitation is multidisciplinary – which makes these clinics costly to operate and they can only accommodate a small number of long COVID sufferers,” Dr Luo explained.

“In fact, three of the services in Victoria we looked at have already been terminated due to a lack of funding. We have insufficient long COVID clinics to meet the demand.”

Researchers now say it’s time for a coordinated response to improve the nation’s long COVID response, particularly for vulnerable groups. Research must focus on prevention and management, yet, critical barriers need to be overcome, including health workforce training, improved public health education, and funding for the implementation of multidisciplinary long COVID services.

Read the full study here