THE Royal Australian College of General Practitioners (RACGP) is urging patients to consider the impact of contracting COVID-19 on their long-term health when making an informed decision on getting vaccinated.

“Long COVID” is a broad term referring to a range of symptoms that can last for weeks or months after the initial illness. At this stage the ongoing effects remain unknown, and prolonged illness could potentially last for years. The symptoms can be very serious and include fatigue, breathlessness, anxiety and depression, chest pain, “brain fog” and changes to taste and smell.

Details of how many people are affected by long COVID and the impact some symptoms may have in the years or even decades ahead are still emerging. One study by Imperial College in London of half a million adults who contracted COVID-19 found over a third still had at least one symptom 12 weeks later.

There is emerging evidence that some people who have recovered from COVID-19 are more likely to score poorly on intelligence tests and although it is more common in older people, young people – including children – can suffer from long COVID.

RACGP president Dr Karen Price said the long-term health consequences of contracting COVID-19 needed to feature prominently in patient decision-making.

“When making an informed decision on getting vaccinated, patients must have long COVID front of mind,” she said.

“Throughout the vaccine rollout, there has been disproportionate focus on the extremely rare risk of blood clots resulting from the AstraZeneca vaccine. There has also, of course, understandably been a lot of attention paid to tragic deaths from COVID-19. This is not just a disease that affects older people; one recent death in Sydney was a student in her 30s.

“However, many patients are unaware of how serious long COVID is. Just because you have survived COVID-19, that does not mean you are out of the woods; serious symptoms may persist for months or even indefinitely.

“Long COVID symptoms, including serious neurological, cardiac and psychiatric issues, can severely compromise your quality of life and we do not have a full picture of what it will mean for patients in the years ahead.

“Younger people may feel they face less risk from COVID-19, but we know young people, including children, can suffer from long COVID. So please consider what long COVID could mean for your quality of life, your job, your relationships with loved ones and your long-term health and wellbeing.

“The decision-making matrix must change and my message to all patients is straightforward – this needs to be taken seriously. There are reports of ‘long haulers’, including young and otherwise healthy people, requiring long-term medical care, struggling psychologically, unable to work or even walk up a flight of stairs without pausing multiple times to catch their breath.”

Dr Price said raising public awareness of the risks of long COVID could help boost the pace of the vaccine rollout.

“We need to shift the conversation and change the way patients are assessing their health risks,” she said.

“This includes patients weighing up whether to be vaccinated at all and patients opting to delay receiving an AstraZeneca vaccination in the expectation they will receive a Pfizer vaccination later in the year. There are considerable risks with the wait-and-see approach that are only amplified when you factor in long COVID.

“Many patients have read media reports about thrombosis with thrombocytopenia syndrome, or TTS, and opted against receiving the AstraZeneca vaccine.

“That is an unfortunate but unsurprising reaction given the media coverage people are being exposed to every day concerning blood clots. However, current data tells us that TTS only occurs in around two out of every 100,000 people who receive the first dose of the vaccine. It is far rarer following second doses and even if you do contract TTS the fatality rate is three per cent.

“Now consider what can happen if you remain unvaccinated. There are some estimates that almost 9 per cent of people in their 70s die if they contract COVID-19 and if you are a younger person you may well survive but suffer from long COVID symptoms. Remember too, we don’t know the full scope of what this means for long-term patient health.

“So please, don’t just fixate on the extremely rare risk of the blood clotting syndrome, consider what will happen if you remain unvaccinated, contract the virus and then suffer health consequences for months or even years to come.”

Retired schoolteacher Audrey Cooke, who was a highly active person with no underlying health issues when she contracted COVID-19 and then suffered long COVID effects, said that greater public awareness was vital.

“I recovered from the initial COVID-19 symptoms in about two to three weeks, but that was only the beginning,” she said.

“I experienced symptoms including fatigue, loss of smell, shortness of breath and chest tightness for 10 months, as well as double vision. 

“We need to boost awareness of long COVID. This is a major problem for some people who have contracted COVID-19 and should not be taken lightly.”

The RACGP President said that time was of the essence.

“We are now in the winter months and this is the time of year when we know that this virus has a greater chance of taking hold of communities,” she said.

“The highly transmissible Delta variant is so much harder to control and what is currently happening in Sydney could happen elsewhere without warning. If you think you are immune because you live in a community that hasn’t had COVID-19 cases, you are playing a dangerous game – especially if you are aged over 60.

“So please, when making your decision on getting vaccinated don’t just focus on blood clots. Consider what could happen if you contract COVID-19, because even once you recover from the initial illness that might not be the end of your COVID-19 story – it could be just the beginning.”

An RACGP resource on caring for adult patients with post-COVID-19 conditions can be found at racgp.org.au/clinical-resources/covid-19-resources/other-health-issues/caring-for-adult-patients-with-post-covid-19.