Today officially marks the first day of winter in Australia, but we're already in the thick of an increase in COVID-19 cases.
Some people take longer than others to bounce back after a bout of illness, but how do you tell the difference between a slow recovery and long COVID?
Let's unpack what we know about COVID's lasting shadow.
When does COVID become long COVID?
In simple terms, if you've had a COVID infection and you still have symptoms after three months it could be long COVID, explains Anthony Byrne.
He is an associate professor at the long COVID clinic at St Vincent's Hospital in Sydney and says there are two time frames to pay attention to:
- Persisting symptoms after 28 days are known as a "post-acute infection"
- Persisting symptoms after three months could be considered long COVID.
"Unless someone can find a better explanation," he said. "Sometimes we can, sometimes we can't."
He also said a long COVID diagnosis is dependent on the persistence of symptoms that "are not otherwise explained by an alternative diagnosis"
How can I tell if I have long COVID?
It can be really difficult.
That's because many symptoms overlap with other conditions, Deakin University's chair of epidemiology Catherine Bennett says.
If you suspect you might have long COVID, she suggests it’s best to see a doctor or respiratory physician to start the process.
More than 200 symptoms have now been associated with long COVID, affecting almost every organ system in the human body.
But work's being done to narrow it down.
What are the 12 symptoms of long COVID?
A significant new study based on nearly 10,000 patients in the US identified 12 common symptoms associated with those suffering with long COVID.
According to the study, led by the US National Institutes of Health's RECOVER Initiative and published in the medical journal JAMA, these symptoms commonly persisted for six months after infection.
Here are the top 12 symptoms:
- Post-exertional malaise (debilitating fatigue exacerbated by activity)
- Fatigue
- Brain Fog
- Dizziness
- Gastrointestinal symptoms
- Palpitations
- Changes in sexual desire or capacity
- Loss or change of taste and smell
- Thirst
- Chronic cough
- Chest Pain
- Abnormal movements (including tremors, slowed movements or sudden, unintended and uncontrollable jerky movements).
Researchers said a person with symptoms not on this list may still have long COVID, but it is a first step in identifying "common language" for those working toward treatments.
Professor Byrne says a symptom his clinic often sees not included on the US study findings is breathlessness.
"Breathlessness is a really important symptom ... As a respiratory physician we see it a lot in long COVID patients," he says.
Why do these symptoms matter?
With many in Australia struggling to get a diagnosis, Dr Bennett said the study could help by "attaching a long COVID diagnosis to different packages of symptoms."
"The study findings could be a basis for a diagnostic tool in Australia, and that's something we don't have," Dr Bennett said.
The recent parliamentary inquiry report found many long COVID patients were frustrated with the lack of answers or consistent advice from healthcare professionals, and were now disillusioned with Australia's healthcare system.
"Having a tool like this for doctors, collecting information on symptoms in a systematic way … it won't necessarily be 100 per cent correct as a diagnostic tool, but by using it will start to collect important data that will help us refine and understand the frequency and risk factors better also," Dr Bennett said.
"This is the sort of thing that could help GPs at the moment who often haven't seen a long COVID patient before."
Why do some people get long COVID, while others don't?
It's not entirely clear.
That's because there's still so much experts don't know about long COVID.
The World Health Organization estimates long COVID could affect 10 to 20 per cent of people who have a COVID-19 infection.
Reports cited in last month's parliamentary inquiry into long COVID puts that five down to about 5 per cent in Australia.
The US study said long COVID was more common and severe in participants infected before the Omicron strain emerged in late 2021, as well as unvaccinated participants.
People who got infected multiple times were also more likely to develop long COVID, the study said.
Data from an Australian post-COVID clinic shows it often affects women in their 40s and 50s, most of whom led active lives before they got sick.
What treatments are available for long COVID?
There are no treatments specifically approved for long COVID, though some patients get relief from painkillers, medications used for other conditions and physical therapy.
But that's not to say nothing can be done, Associate Professor Byrne said.
One example of a clinical trial St Vincent's is participating in is called IMPACT-ico.
"This provides long COVID patients the opportunity to receive an oral medication or standard care to potentially assist their recovery."
Along with clinical studies taking place, Associate Professor Byrne said the clinic "have comprehensive medical assessment to assess and treat co morbid conditions that are present in long COVID patients," he said.
Is more help on the horizon?
Australia's chief medical officer Paul Kelly said a national plan is being developed to respond to long COVID.
And more than $50 million has been allocated towards research now the parliamentary inquiry has wrapped up.
The committee also made nine unanimous recommendations in its new report, prompting the spend.
A key recommendation was coming up with a nationally agreed and consistent definition of long COVID — because, at the moment, there's a few going around.
Australia is currently using both the definition from WHO and the UK's National Institute for Health and Care Excellence.
Professor Kelly says both these definitions "are great for research purposes because they are so broad".
"But in terms of trying to understand [long COVID], we have to get beyond [them]."
The report also included an urgent call for improved data collection about long COVID cases.
In the meantime, Dr Byrne said he sees a lot of people spending unnecessary money on treatments not properly or rigorously evaluated.
"I just caution people, [things like] anti-inflammatory diet fads, or 'take these 20 vitamins because they’ll be really good for you', all of that stuff, you could spend a lot of money on it and it probably won't work," he said.
"It’s important to caution readers about being taken on a wild goose chase or being sold snake oil."
