
If you didn’t already believe it, here’s more evidence the lockdowns were worth it. Emerging research is giving Australia’s COVID-19 elimination strategy an enormous tick of approval.
We know COVID-19 has had a fatality rate of 3% in the Australian context (909 deaths from 29,304 cases). That has robbed many people of years of life. But new evidence suggests the fatality rate only begins to measure the impact of the pandemic on Aussies’ health.
We’re talking about “long COVID”. Researchers from St Vincent’s Hospital in Sydney have been tracking patients who were diagnosed with COVID-19, and they have chilling news about the course of the illness.
The stats
Of 99 patients diagnosed by April 28, 2020 and followed since, 19% met the criteria for long COVID at 240 days post-diagnosis. As the below chart shows, many symptoms are ongoing, but fatigue is the most common problem for people who’ve had the virus.

Long COVID hits women more often than men, affects the young and the old, and while it’s more common in those who had severe symptoms in the acute stage, it can also afflict people who had only a mild course of COVID-19. The 19% estimate of the burden of long COVID excludes lots of patients who weren’t diagnosed directly at St Vincent’s and counts only some symptoms. The researchers describe the figure as “conservative”.
The implication of the research — which at this stage is a pre-print that’s yet to be peer-reviewed — is that from the 29,000 cases of acute COVID-19 in Australia, there would flow around 6000 cases of long COVID. Most of them will be in Melbourne, where the Victorian second wave hit more than 10,000 people in July and August. Those people are not as far through their course of illness as the Sydney cohort, and the study has bad news for them about the chances of improvement in coming months.
The researchers tracked long COVID patients over time and hoped symptoms would begin to resolve. Nope.
“There was no significant improvement in symptoms or measures of health-related quality of life between four- and eight-month assessments,” the researchers said in their paper.
“A considerable proportion (around 20% ) of the total cohort did not feel confident returning to pre-COVID work, had not returned to usual activities of daily living or had not returned to normal exercise level.”
As the next chart shows, there was no statistically significant change in the rate of long COVID between four-month follow-up and eight-month follow-up.

The researchers suggest the long COVID group has two subsets: people with damage to the heart and lungs from the virus; and people with fatigue and “brain fog”, whose illness is more akin to ME/CFS (chronic fatigue syndrome).
German researchers also found that around half the patients they assessed for long COVID met the criteria for ME/CFS. That’s potentially bad news, as ME/CFS can last a very long time and has no cure. It is not well-understood and research into it is poorly-funded.
The impact
What’s excellent about this paper is it is prospective. They selected the patient population before they got long COVID, and followed them afterwards to see what happened. All the people were diagnosed with COVID-19. This is a much more rigorous approach than many other papers, where the patient populations are selected after they got long COVID, and don’t all have COVID-19 diagnoses.
Why don’t the people with long COVID all have COVID-19 diagnoses? There’re a lot of people with long COVID in the US and UK who got it in those early waves when they weren’t testing. They have the experience of long COVID, but lack evidence of ever having had COVID-19. That leaves the door open for commentators to deny they ever had COVID-19, and therefore to psychologise their subsequent experience of long COVID.
A widely shared article in The Wall Street Journal in March took this approach, arguing: “Such symptoms can also be psychologically generated … Long COVID is largely an invention of vocal patient activist groups.”
The temptation to attribute to psychology that which medicine is yet unable to explain is huge. But why are people so attracted to the idea chronic illness is explained by rampant hypochondria?
Perhaps it has its origins in caveman society. Being sick was really bad for the collective so, to dissuade anyone from being sick, it was strongly socially punished. But these days, being chronically ill is mostly bad for the person who is ill. If you can barely leave your home, you’re probably poor and unable to participate in the good things society can offer. Perhaps you qualify for disability support pension, but you must repeatedly fight Centrelink for it.
The supposed upside of “imagining yourself” into chronic illness just isn’t there. Nevertheless, the idea chronic physical health symptoms represent some deep Freudian impulse won’t go away. Perhaps this is a manifestation of the “just world fallacy”, the idea that bad things happen only to bad people. It’s likely comforting to think that if people are desperately sick their whole life, it’s because, at some level, they want to be.
That’s why proper medical research into these post-infectious illnesses is so important.
(If anything, people are hyper-chondriac, not hypo-. In the Australian study, 54% of the people who qualified as having long COVID based on their reported symptoms nevertheless said they had recovered!)
These researchers will follow the patients for two years at least. But hopefully this will be the last prospective trial in Australia, because we just won’t have enough patients. The population of people who have had COVID-19 is mercifully low by international standards, and most people contracted it prior to the widespread recognition that long COVID is a real risk, so we can’t start new prospective studies.
Lockdowns, mask rules and border closures have meant fewer than 1000 new COVID-19 cases so far in 2021. They may also be saving us from a huge wave of long COVID sufferers who would be sick for years — or indeed for the rest of their lives.
Save this EOFY while you make a difference
Australia has spoken. We want more from the people in power and deserve a media that keeps them on their toes. And thank you, because it’s been made abundantly clear that at Crikey we’re on the right track.
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Now Jason’s comment really scares me. The possibility of a life that offers un-ending limitations viz-a-viz infection – death, not to be dismissed. Mr Prime Minister get your act together . . NOW!
“the idea chronic illness is explained by rampant hypochondria?” Tick
“But why are people so attracted to the idea chronic illness is explained by rampant hypochondria?” Tick
“The temptation to attribute to psychology that which medicine is yet unable to explain is huge” Tick
This whole sorry covid saga is hypochondria, illusionary, medical hocuspocus. But the politically agenda driven journalists have to write about something ( not you ) if they are not scoring political points they start suffering anxiety. Another talented journalist wasting his talent on said subject matter.
Over centuries there were people who attributed unexplained symptoms to psychological drivers of some form or another – hysteria was coming from the uterus etc. Science eventually established that there were underlying physical issues that caused the symptoms the ‘non believers’ called hypochondriasis. Now we have even more scientific facts, a history of proved repeated false attribution, and lots of urging for us to learn to be critical thinkers who analyse proven facts but we still have conspiracy theorists who prefer alternative facts.
Your comment just proves my point…anxiety.
My mother was fond of this rhyme which seems particularly apposite to your comment…
There was a faith-healer of Deal
Who said, “Although pain isn’t real,
When I sit on a pin,
And it punctures my skin,
I dislike what I fancy I feel.”
More of the same.
You must be pretty happy that the world has been able to rid itself of nearly 3 million hypochondriacs.
Who paid for your subscription to Crikey??
The IPA or Adam Schwab?
No. 3 million flu victims. Yes.
Smallpox would have never been eradicated with people like you, even now in Pakistan polio health workers are killed because of ignorance.
What an insane rant.
“Lockdowns, mask rules and border closures have meant fewer than 1000 new COVID-19 cases so far in 2021. They may also be saving us from a huge wave of long COVID sufferers who would be sick for years — or indeed for the rest of their lives.”
For a non medical journalist this is a well argued article about medical issues and consequences.
ME/CFS has been described as being like having cancer except you don’t die. Anyone close to someone afflicted with it will be aware of the agony, despair and shame it causes. If there is one possible silver lining to this depressing cloud, it is that perhaps now these ill-defined and poorly understood conditions might receive the clinical research effort necessary for a proper understanding and effective treatment.
I note that the author of this is an economist and freelance journalist – Not a Medical Dr. The following may be of interest to those that like to dig deeper.
https://www.statnews.com/2021/03/22/we-need-to-start-thinking-more-critically-speaking-cautiously-long-covid/
Snip:
So it’s highly probable that some or many long-haulers who were never diagnosed using PCR testing in the acute phase and who also have negative antibody tests are “true negatives.”Why does this matter?
For one thing, if some proportion of long Covid patients were never infected with SARS-COV-2, it shows that it’s possible for anyone to misattribute chronic symptoms to this virus. That’s not particularly surprising, since the symptoms of acute SARS-CoV-2 are often not unique, and can be caused by other respiratory infections. But what’s more notable is that the late-December survey also found virtually no difference in the long-haul symptom burden between those with and without antibody evidence of prior SARS-CoV-2 infection (or any positive test), which undercuts the likelihood of a causative role for SARS-CoV-2 as the predominant driver of chronic symptoms in that cohort.
Well spoken. Investors and those wretched speculators will probably go long on covid.