Introduction by Croakey: People with lived experience of Long COVID are expected to join researchers in presenting to two public hearings this week, as part of a Parliamentary inquiry into Long COVID and repeated COVID infections.
The hearings, in Canberra and Naarm/Melbourne, are intended to “unpack some of the issues” raised in written submissions to the Inquiry.
Dr Mike Freelander, an experienced paediatrician, MP and Chair of the Standing Committee on Health, Aged Care and Sport, said: “Listening to Australians living with Long COVID about their experiences, journey to diagnosis and treatment is a key role of this Inquiry.”
The Committee will also hear from the Australian Department of Health and Aged Care, the National Aboriginal Community Controlled Organisation (NACCHO) and a roundtable of experts jointly organised by the Australian Academy of Science and the Australian Academy of Health and Medical Sciences.
Below, Croakey managing editor Alison Barrett discusses key recommendations from a review of written submissions to the inquiry by Australian researchers and research institutes.
Alison Barrett writes:
Australian governments are exposed to legal risk due to some of the decisions made in their responses to COVID-19, according to Dr Dominic Meagher at John Curtin Research Centre.
“Existing laws and regulatory instruments at both state and federal levels impose powers and obligations on Australian governments and companies in regard to the mitigation of COVID,” Meagher wrote in his submission to the Long COVID Inquiry.
Meagher, the Deputy Director and Chief Economist of the Centre, says policies involving legal risk include the removal of mask requirements in healthcare settings in some states and National Cabinet’s decision to put an end to isolation requirements for people with COVID.
The first example is inconsistent with the Australian Charter of Healthcare Rights, and the second inconsistent with governments’ obligations to public safety, he writes.
Dr Mike Freelander, Chair of the Standing Committee on Health, Aged Care and Sport, told Croakey via a spokesperson that “as he is not a lawyer, he can’t provide an appropriate response to those matters”.
Freelander said his main aim “is for the inquiry to help inform and shape good policy for the Minister for Health and the Department of Health”.
Sustainable prevention
Meagher argues that the need for more attention to infection prevention (and thus to preventing Long COVID) is required due to the disproportionate impact of COVID on priority populations and people at higher risk of developing Long COVID (including females, and people aged between 30 and 59 years).
“We call on Australia to prioritise reasonable and sustainable prevention as part of a national strategy to end the COVID emergency,” Meagher wrote.
As part of a ‘reasonable, practicable and sustainable prevention’ strategy, Meagher recommends:
- acknowledgement of the need for change, including legislation that imposes “duties of care to ensure all reasonable steps are taken to make workplaces and healthcare safe, and to minimise or eliminate discrimination based on disability, age and sex”
- correction of the official public health messaging and communications, especially around COVID infection prevention, which needs to be transparent, accountable and “consistent with legislative hierarchy”
- establishing indoor air quality as a national priority legislation and investment, following Belgium as best practice case study, investing in ventilation in public venues, ensuring low-cost air filters are available, establishment of air quality standards in building codes, and improving public adoption of face masks
- legislate infectious disease leave, by ensuring 20 days sick leave for infectious diseases and a scheme to support casual workers.
Some other submissions to the inquiry – but not all – also had a clear call for more action on infection prevention, recommending similar measures to Meagher.
Additional recommendations from other submissions include:
- access to updated COVID-19 vaccines on a regular basis
- accessible testing
- equitable access to anti-viral treatments.
One of the key recommendations from the National Clinical Evidence Taskforce on COVID-19 – defunded since the end of 2022 – is to continue investment “in collaborative preventive activities to strengthen the message that prevention of COVID-19 is the most-effective method of preventing long term health issues”.
Disproportionate impact
Submissions by the Australian Society for Medical Research, National Clinical Evidence Taskforce, the Long COVID Australia Collaboration, OzSage and the Faculty of Medicine, Dentistry and Health Sciences of University of Melbourne echoed sentiments highlighting the need to protect priority populations.
Research should focus on improving outcomes for the whole population “including those that are underserved by mainstream services such as Aboriginal and Torres Strait Islander people, culturally and linguistically diverse communities…and those living in rural or regional Australia,” according to the University of Melbourne.
In addition, submissions emphasised the need for equitable solutions, including access to healthcare, sick leave and other social and financial supports.
They also said it was important for governments, policy makers and healthcare workers to acknowledge and listen to those with lived experience of Long COVID, particularly children, adolescents and their families, whose impact of Long COVID and repeat infections are different to adults.
Including people with lived experience in research, response and project design was another common theme among submissions.
“Any response to Long COVID needs to address systemic disadvantage and involve all community members in co-design lest solutions miss their mark,” the Long COVID Australia Collaboration wrote in their submission.
Long COVID in Australian context
“Better data” was an almost universal request in the submissions, highlighting the lack of data on Long COVID in Australia, which has led to challenges determining the prevalence of the disease.
Much of the prevalence data and studies on Long COVID has been conducted overseas in countries that have had different experiences of COVID-19, and it is difficult to make direct comparisons between countries, according to Professor Martin Hensher of the Menzies Institute for Medical Research at the University of Tasmania.
Many submissions, including Hensher’s, recommended that national data on Long COVID be collected, similar to that collected by the United Kingdom’s Office for National Statistics.
From a policy perspective, it’s important to have more accurate estimates of Long COVID in Australia to help inform healthcare needs and manage the economic and longer-term needs for social welfare support (such as NDIS), according to Hensher.
While the submissions highlighted that many research studies on Long COVID are underway, most submissions emphasised the need for more research to gain a better understanding of Long COVID in Australia.
Further reading
The Future of Long COVID, by Katherine J Wu in The Atlantic
Covid-19: Australia’s future policies will be evidence led after “profound impact” of latest wave, says minister by Alison Barrett in the BMJ
Listen to the voices of lived experience of Long COVID by Jennifer Doggett in Croakey
Details about the Inquiry into Long COVID and Repeated Infections. The public hearing on Friday will be broadcast live at https://www.aph.gov.au/live
From Twitter
See Croakey’s extensive archive of articles on COVID-19.
