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Speaker 1: My name is Lily Maddon and I'm a proud Arunda

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Speaker 1: Bungelung Calcuttin woman from Gadighl country. The Daily oz acknowledges

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Speaker 1: that this podcast is recorded on the lands of the

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Speaker 1: Gadighl people and pays respect to all Aboriginal and Torres

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Speaker 1: Strait Island and nations. We pay our respects to the

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Speaker 1: first peoples of these countries, both past and present.

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Speaker 2: Good morning and welcome to the Daily os It's Tuesday,

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Speaker 2: the eleventh of April. I hope you had a wonderful

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Speaker 2: Easter weekend. I'm Sam, I'm Zara. According to the World

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Speaker 2: Health Organization, ten to twenty percent of people infected with

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Speaker 2: COVID nineteen may go on to develop long COVID, and

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Speaker 2: it can impact young people too. In today's deep dive,

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Speaker 2: we're going to hear firsthand what it's like to live

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Speaker 2: with long COVID.

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Speaker 3: I feel like I'm a shelver person I used to be,

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Speaker 3: which has hugely impacted my mental health.

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Speaker 2: And talk to someone who's been on the front line

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Speaker 2: treating long COVID since the condition emerged.

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Speaker 4: This almost a forgotten population of people who are still

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Speaker 4: taking time to get over long COVID FIRS Aarrah.

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Speaker 2: What's making headlines this morning.

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Speaker 5: US officials have launched an investigation into the leak of

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Speaker 5: sensitive and highly classified documents that was first revealed by

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Speaker 5: The New York Times last week. An Australian government spokesperson

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Speaker 5: said in a statement yesterday the Australian Government is concerned

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Speaker 5: about the disclosure of US classified information.

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Speaker 2: At least forty four stockpiles of soft plastics have been

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Speaker 2: discovered across six states since the collapse of the Red

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Speaker 2: Cycle recycling scheme. Red Cycle was a soft plastics recycling

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Speaker 2: program used by Coals and Woollwartz that collapsed last year.

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Speaker 2: Willworths and Coals are now in possession of the stockpiles,

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Speaker 2: and the company said yesterday they need to navigate quote

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Speaker 2: a complex range of sites and challenges to establish how

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Speaker 2: to deal with the plastics.

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Speaker 5: Further details of the King's coronation, to be held in

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Speaker 5: London on this sixth of May have been revealed by

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Speaker 5: Buckingham Palace. The King and his wife Camilla will travel

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Speaker 5: part of the journey in a horse drawn carriage constructed

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Speaker 5: in Sydney, and another part of the journey in a

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Speaker 5: two hundred and sixty year old carriage that is the

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Speaker 5: oldest in use. A special emoji was also released to

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Speaker 5: mark the occasion.

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Speaker 2: And today's good news is one for all the footy fans.

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Speaker 2: Fans have set the record for attendance at the MCG

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Speaker 2: in the first ten matches of an AFL season, with

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Speaker 2: six hundred and sixty one four hundred and forty six

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Speaker 2: fans coming through the turnstiles. It smashed the previous record

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Speaker 2: of six hundred and twelve two hundred and eighty one fans,

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Speaker 2: which were set back in twenty fifteen. It's certainly been

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Speaker 2: a little while since we've talked about COVID on this podcast,

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Speaker 2: but for some people who had COVID, the virus never

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Speaker 2: really left. We know that long COVID is something impacting

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Speaker 2: a lot of people out there, and a lot of

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Speaker 2: people in the TDA community as well, like Hayley.

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Speaker 3: Hi. My name's Haley. I've had long COVID for about

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Speaker 3: nine months. My symptoms are mostly cardiovascular, muscular, skeletal and

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Speaker 3: extreme fatigue. I get a lot of pain in my chest,

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Speaker 3: muscles and joints, and I have recently been diagnosed with

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Speaker 3: a heart condition which is causing constant heart palpitations. Long

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Speaker 3: COVID has seriously impacted my life over the past nine months.

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Speaker 3: I'm a school teacher, so I cannot work from home

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Speaker 3: and therefore have had to take a lot of personal leave,

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Speaker 3: which has run into my long service leave. I currently

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Speaker 3: don't have any leave left, but I'm unable to work

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Speaker 3: due to worsening of symptoms which specialists are struggling to treat.

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Speaker 3: My quality of life has been affected immensely. ARE used

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Speaker 3: to be able to run out mountains. Now I can't

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Speaker 3: even walk up the stairs without being out of breath.

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Speaker 3: I no longer have a social life and cannot do

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Speaker 3: most of my hobbies before COVID, like running, hiking, and traveling.

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Speaker 3: I feel like I'm a shell of a person I

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Speaker 3: used to be, which has hugely impacted my mental health.

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Speaker 3: And it's so difficult to even try and get into

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Speaker 3: a psychologist to treat that. I've seen about ten doctors

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Speaker 3: to get advice on how to manage my long COVID. However,

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Speaker 3: most doctors don't know how to treat long COVID patients

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Speaker 3: and would blatantly state they didn't know what to do.

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Speaker 3: I remember on one occasion, after complaining about severe chest pain.

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Speaker 3: A doctor didn't even examine me. Instead, she asked what

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Speaker 3: my mental health was like before COVID. After nine months,

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Speaker 3: I got into the long COVID Clinic and they have

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Speaker 3: helped me understand the importance of rest, pacing and breathing properly. However,

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Speaker 3: I feel that if I had been admitted into the

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Speaker 3: long COVID clinic nine months ago, or had a doctor

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Speaker 3: who had properly treated long COVID, I wouldn't be in

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Speaker 3: the position I am in now, worsening long COVID symptoms,

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Speaker 3: unpaid leave, financial strain, and absolute exhaustion from dealing with

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Speaker 3: this disease.

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Speaker 2: So we wanted to know a bit more about long

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Speaker 2: COVID clinics and the work that they're doing. Four people

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Speaker 2: like Hayley, so reach out to doctor Stephen Foe. He

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Speaker 2: is one of the leaders of the long COVID Clinic

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Speaker 2: at the Saint Vincent's Hospital in Sydney. Stephen, thanks for

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Speaker 2: joining us on the Daily Eyes this morning.

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Speaker 4: Hi Sam, I'm sitting outside with my dog and I'm

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Speaker 4: in my lovely garden that my is my wife's treasure.

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Speaker 4: And so if you hear funny noises in the background,

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Speaker 4: it's because I'm in the great outdoors, love it.

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Speaker 2: Can we start with an explanation from you of what

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Speaker 2: exactly is long COVID.

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Speaker 4: Yeah, I've been just writing about that today. It's defined

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Speaker 4: by the WHO as symptoms that persist or continue for

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Speaker 4: three months after you've had COVID. They generally can start

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Speaker 4: anywhere between the time you have the infection and the

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Speaker 4: three month mark, but they have to persist for two months.

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Speaker 2: What's the prevalence of long COVID amongst patients at the moment?

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Speaker 4: In Australia The prevalence is dependent on the strain, the population,

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Speaker 4: the definition, and the way the data is collected. So

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Speaker 4: in New South Wales, for example, they say that the

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Speaker 4: prevalence of long COVID is somewhere between one and four percent.

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Speaker 4: The WHO says it's somewhere between ten and twenty percent.

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Speaker 4: It's higher in the UK, but you've got to remember

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Speaker 4: that over twelve million people have had COVID, so four

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Speaker 4: percent of them is still going to be very high.

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Speaker 4: So it's still a significant, significant illness that we need

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Speaker 4: to address.

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Speaker 2: And we'll come back to how to address that. But

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Speaker 2: from your answer there, it sounds like there's still a

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Speaker 2: lot that we don't understand about long COVID. For you,

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Speaker 2: what are the big undiscovered areas well?

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Speaker 4: The things that fascinate me is the areas such as

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Speaker 4: cognitive impairment, people who are having trouble remembering things and concentrating.

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Speaker 4: We've identified it Saint Vincent's in a small study that

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Speaker 4: there might be a blood marker where we can identify

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Speaker 4: the people who are likely to have problems with their thinking.

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Speaker 4: We've also still trying to work out them mechanism, you know,

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Speaker 4: what's actually going on physiologically. And for me as a

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Speaker 4: rehabilitation physician, one of the things I'm interested in is

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Speaker 4: how to get people back to work and back to

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Speaker 4: feeling normal and doing their usual things. And we're doing

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Speaker 4: that with a variety of treatments. So that's what's exciting

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Speaker 4: and sometimes frustrating, but sometimes inspiring. So that's why I'm

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Speaker 4: sort of involved in it. And those are the things

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Speaker 4: that are of interest to me.

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Speaker 2: Okay, and you're doing all of this work through a

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Speaker 2: long COVID clinic at Sinvinson's Hospital in Sydney. At what

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Speaker 2: point in the pandemic was a need for a specific

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Speaker 2: clinic identify it and is this a clinic that's going

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Speaker 2: to be around in fifty years time.

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Speaker 4: Great questions. Look, we identified that there was a need

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Speaker 4: at the end of twenty twenty because what was happening

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Speaker 4: to our emergency department and our general practices where the

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Speaker 4: people were turning up with prolonged symptoms and nobody knew

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Speaker 4: what to do. The eed department didn't know whether to

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Speaker 4: admit them or to discharge them, and so we thought

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Speaker 4: that we needed to start collecting people and looking at

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Speaker 4: them very carefully. So our clinic opened in March twenty

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Speaker 4: two and we had about seven hundred referrals within six months,

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Speaker 4: so there were a lot of referrals. It appears that

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Speaker 4: the later strains like omicron are less SEVEREAR and the

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Speaker 4: number of people getting long COVID from those strains are less.

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Speaker 4: So the question is will we still be around in

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Speaker 4: fifty years. I think I can't answer that really, But

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Speaker 4: if we look back at diseases like HIV, tuberculosis and

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Speaker 4: even polio yep, there were clinics running for many years.

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Speaker 4: So I have a feeling that whilst we might get

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Speaker 4: less people referred to us, we might still have a

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Speaker 4: role in the next sort of three to five years

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Speaker 4: at least.

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Speaker 2: Who's the typical patient coming through the Long COVID clinic.

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Speaker 4: There's a lot of there's a lot of typical patients.

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Speaker 4: In fact, there's no single typical patient, but there's a

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Speaker 4: handful of people. There's some people who are very frightened

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Speaker 4: because they can't work and they're worried about putting bread

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Speaker 4: on the table, and so they're coming to us very

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Speaker 4: stressed about that. There are other people who value their

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Speaker 4: capacity to do everything, so they hard workers, they exercise

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Speaker 4: a lot, and they can't tolerate the fact that they're

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Speaker 4: not able to get back to that. And then there

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Speaker 4: are other people who realize that there's no experts in

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Speaker 4: this area and are trying to find out an answer

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Speaker 4: themselves and are coming to us for help in that.

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Speaker 4: So there are no typical patients, but we get a

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Speaker 4: lot of people very frustrated, get a lot of people

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Speaker 4: very frightened. We get a lot of people who concerned

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Speaker 4: about loved ones who are not firing on all cylinders.

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Speaker 4: So I can't answer that there is no typical type.

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Speaker 2: Yet, concerned about you talking about this inability to return

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Speaker 2: to work and the financial impacts that can have. Are

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Speaker 2: we seeing a new type of disability come to the surface.

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Speaker 4: Well, it's interesting you'd say it was a disability if

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Speaker 4: it was prolonged and there were no chances of recovery.

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Speaker 4: And I don't know the answer to that yet. I

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Speaker 4: can tell you that twenty five percent of people who

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Speaker 4: come to our clinic have either stopped work, dropped work,

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Speaker 4: or closed their businesses. So that's a pretty significant number,

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Speaker 4: and I think we in the UK they found it

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Speaker 4: was nineteen percent. A lot of people are suffering. I'm

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Speaker 4: not sure whether it will actually become a defined disability.

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Speaker 2: I know there's a parliamentary inquiry at the moment. Would

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Speaker 2: you be willing to see recommendations about prolonged financial support

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Speaker 2: for those who are suffering from long COVID.

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Speaker 4: Well, we've written a submission to the parliamentary inquiry, which

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Speaker 4: I think is p So what we've suggested is firstly

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Speaker 4: that the government finance what we call vocational rehabilitation. Those

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Speaker 4: are people whose job it is to help you get

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Speaker 4: back to work if you've had a problem with your health,

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Speaker 4: and that's currently not finance, so people have to put

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Speaker 4: their hands in their pockets for that, and that will

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Speaker 4: improve the capacity of people to return to work and

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Speaker 4: decrease the risk of them being dependent on welfare payments.

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Speaker 4: We've also recommended that there be a registry of patients

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Speaker 4: so we can collect the numbers and follow their trajectory

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Speaker 4: so we can tell people Listen, you know, many people

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Speaker 4: are back at work within twelve months or within six

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Speaker 4: and at the moment we have some rough figures from

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Speaker 4: New South Wales, though we don't have any good figures

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Speaker 4: for the nation, and we don't really know where all

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Speaker 4: the people with long COVID are. And lastly, we've sort

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Speaker 4: of asked for some quarantine money for research because we

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Speaker 4: need to start looking at cures because what's happening is

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Speaker 4: a lot of people are trying things and we don't

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Speaker 4: have an randomized controlled studies looking at whether particular drugs work,

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Speaker 4: or particular psychological treatments work, or particular exercise works. So

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Speaker 4: those are some of the recommendations we made, amongst others.

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Speaker 2: I can imagine that all of this is very frustrating

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Speaker 2: for patients with long COVID. The sense from somebody at

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Speaker 2: the top of their field, like yourself, who's trying to

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Speaker 2: in real time understand this very impactful illness. What are

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Speaker 2: you saying to those with long COVID to reassure them

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Speaker 2: whilst acknowledging the fact that you know, as you've said

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Speaker 2: many times in this interview, you're not quite sure what

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Speaker 2: to say.

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Speaker 4: Well, I mean, the first thing we say we do

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Speaker 4: is validate them and say, look, you're not making it up.

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Speaker 4: It's real. We don't understand the physiology of it yet,

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Speaker 4: but we have a few ideas, but we do know

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Speaker 4: that multidiscipline rehabilitation is a supportive framework that helps people

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Speaker 4: return to normal function. So we're saying, look, we're with

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Speaker 4: you on this journey. We're going to help you out,

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Speaker 4: and we try and get the resources for them. Not

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Speaker 4: always easy, but we try and get them psychological treatments

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Speaker 4: if they need help with pacing themselves. We get physical

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Speaker 4: treatments if they're very exhausted. We also get occupational therapists

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Speaker 4: to check on their memory and thinking, and we try

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Speaker 4: and give them graded tasks to help them get back

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Speaker 4: to work or even looking after their families. So I

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Speaker 4: guess we offer validation, we offer support, and we offer

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Speaker 4: a framework of ongoing research that either can involve them

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Speaker 4: or keep them up to date on options in the future.

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Speaker 4: But there's almost a forgotten population of people who are

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Speaker 4: still taking time to get over long COVID. I hope,

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Speaker 4: I hope we find a way through this, but I

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Speaker 4: expect that it'll take a bit longer and the rehabilitation

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Speaker 4: physicians and respiratory physicians will end up helping people who

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Speaker 4: have prolonged symptoms. So I'm in it for the long

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Speaker 4: haul because there's a need.

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Speaker 2: Stephen Fair, thank you for being in it for the

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Speaker 2: long haul and for joining us today on the Daily OS.

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Speaker 4: Thanks very much. Sam, nice to speak to you.

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Speaker 2: Just before we clock off. I wanted to give a

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Speaker 2: quick shout out to Haley and everyone else who sent

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Speaker 2: us messages about living with long COVID. We really really

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Speaker 2: appreciate them and always learn so much from what you

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Speaker 2: have to say.

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Speaker 5: If you learned something from today's episode, don't forget to

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Speaker 5: hit subscribe so there's a TVA episode waiting for you

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Speaker 5: every weekday morning. We'll be back again tomorrow morning, but

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Speaker 5: until then, have a brilliant day.