Long Covid must be treated as the serious threat it is to public health

People suffering with long Covid can be forgiven for thinking they are members of a lost and forgotten tribe.

As the world convinces itself that Covid-19 is no longer an active problem – even though there were, in December 2023 alone, some 10,000 deaths in 50 countries and a 42 per cent increase in hospitalisations – between 10 and 20 per cent of those infected go on to develop the prolonged symptoms and health complications that make up long Covid syndrome.

The World Health Organisation (WHO) defines long Covid as symptoms that persist for 12 weeks or more post-infection with the SARS-CoV-2 virus. Although more than 200 symptoms have been described by long Covid patients, the most common symptoms are extreme tiredness (fatigue), feeling short of breath, losing the sense of smell, brain fog and memory loss/confusion. Recently, researchers at Trinity College Dublin had a breakthrough investigating why people with long Covid can suffer from brain fog.

Whereas Covid-19 was initially thought to be an infection of the respiratory system, it has turned into a much more complex illness that affects our immune systems, our cardiovascular health, our gastrointestinal wellness and leads to abnormalities in our nervous systems. Virus particles have been found in almost all organs in Covid-19 patients who have undergone postmortem examination. This explains the broad nature of long Covid symptoms and why, for some people, long Covid can last for more than three years.

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In May 2023, the Health Information and Quality Authority (Hiqa) published a long Covid epidemiology report. It found that, “as a community, patients with long Covid are finding it difficult to access services, with the lack of informed support contributing to trauma and potentially increasing the risk of physical deterioration and psychological impact of this condition”.

[ Long Covid study: Scans reveal multiple organ abnormalities months after infection ]

The systematic Hiqa review did not identify evidence of the prevalence of long Covid in Ireland. “Given this, and the uncertainty regarding the burden of long Covid internationally, further research relevant to the Irish population may help to inform the delivery of healthcare services for those with long Covid in Ireland,” the authors said.

Long Covid Advocacy Ireland (LCAI) is the formal long Covid patient advocacy group here. It believes that there are inadequate supports and services in place for patients in Ireland. While acknowledging the provision of six public long Covid clinics by Government (located in Beaumont, St James’s and St Vincent’s in Dublin and in Cork University Hospital, University Hospital Limerick and University Hospital Galway), it says that patients report problems such as prolonged wait times and an unhappiness with the care they are receiving. LCAI does not believe the public clinics are offering sufficient symptom management.

“LCAI is asking the Government to take urgent action regarding many of the challenges facing LC patients, including but not limited to; access to healthcare, employment rights, social welfare issues, occupational illness status, public awareness, and Covid-19 mitigations,” it says.

In terms of preventing long Covid, the only way of absolutely not getting the condition is not to get Covid. Vaccination has a key role to play: a recent meta-analysis of 24 studies looking at whether Covid vaccines protect from long Covid provides encouraging evidence that there’s about a 70 per cent reduction in risk.

Dr Maria van Kerkhove, the WHO Covid-19 technical lead, says “Covid is still a global health threat, and it’s causing far too much burden when we can prevent it. Five, 10 years from now, what are we going to see in terms of cardiac impairment, of pulmonary impairment, of neurologic impairment? We don’t know.”

Long Covid clearly represents a serious threat of major public health concern. And it is not being given sufficient priority by Government.

It would be interesting to hear about, and publish an analysis of, readers’ experience of long Covid. If you would like to send details of your experience (how long you have had long Covid, what treatments you have had, etc), please do so to muiris.houston@irishtimes.com. Thank you.