Two years later and we are still grappling with what COVID is, its long-term effects and the way it has changed the way we live, socialise and communicate. Generally, or at least locally, it feels we are living in a calmer, safer and more stable environment. As we start to emerge from a chaotic and unpredictable period reflecting on ‘pre-COVID’ times has been interesting.

Last week I was reading an article in the Australian Physiotherapy Association monthly publication discussing Long-COVID. It sparked my interest, as anecdotally we are seeing many of our clients who have experienced COVID symptoms at some point, report long term effects with similarities to chronic fatigue, fibromyalgia, tick-borne illnesses and other autoimmune conditions. When they reflect back on a ‘pre-COVID’ time they were living, socialising and functioning differently. The world they are living in now is not calmer, safer or more stable.

Like any broad chronic condition, Long-COVID is difficult to pinpoint, frustrating to live with and challenging to treat. The most confusing thing is that currently we have no idea what causes it. Early on in the pandemic many health professionals and patients noticed that some people were left with lingering symptoms long after the infection had passed. Many of these people weren’t the ones who were severely or critically ill either. Even among Long-COVID patients there is a large difference in symptoms. The most common seem to be disproportionate levels of fatigue, shortness of breath, heart rate fluctuations and cognitive issues or ‘brain fog’. Statistics also aren’t super clear either with estimates of prevalence ranging from two to thirty percent.

Basically, it is confusing and has a lot of people stumped. There are similarities to Long-COVID and other conditions in the autoimmune/chronic pain/chronic fatigue syndrome basket, and for the purposes of this article I am going to lump them together. The health system as a whole has a history of stigmatising things it does not understand. It makes sense why this happens. As humans we like to be able to fix things, and fix them quickly. We don’t know what to do with things that don’t fit neatly in a box or things that don’t respond that way we want them to. Often with these complex conditions, the larger responsibility of following up treatment falls onto the person who is already struggling. This is unfair, as often what is needed is someone who will listen and believe their story.

As physios, there are many ways in which we can assist in managing and rehabilitating these complex conditions. Physio can include advice around pacing and gradual exercise progression, guided pulmonary and autonomic (nervous system) rehabilitation, management of musculoskeletal pain and management of dysfunctional breathing. In fact, early studies regarding physio intervention in Long-COVID are looking promising and the good news is that many of the symptoms of Long-COVID seem to improve over time. There is hope with the broader complex conditions that the emergence of Long-COVID will help shine a light on a neglected area of health research and funding.

Most importantly though, as physios we aim to care effectively. We will listen, we believe you and we will do our best to help you recover and thrive.