ANZPID Submission: Inquiry into Long COVID and Repeated COVID Infections
The Australian and New Zealand Paediatric Infectious Diseases Group (ANZPID) of the Australasian Society for Infectious Diseases (ASID) advocates for prioritised understanding and delivery of coordinated support to children and young people affected by post-COVID conditions, including long COVID.
As paediatricians who care for children in the hospitals of Australia and New Zealand, we recognise the health harms of COVID-19. While COVID-19 infection in children is generally mild or asymptomatic, some children will develop severe acute disease or long-term postCOVID conditions, and children live within a wider society, with family members and carers who may also be affected by COVID-19 and its after-effects.
Current evidence on the burden of post-COVID conditions, including long COVID, in Australian children is lacking. Systematic reviews of long COVID in children suggest estimates from countries overseas are of limited quality, based on studies with significant limitations, including absence of control subjects (Zimmerman et al, Pediatr Infect Dis J 2021 and 2022). ANZPID recognises the need for high quality, local data on the burden of post-COVID disease in children that is integrated into the health system response. This will also be key to forming a sustainable plan to manage COVID-19 into the future.
For affected children and young people, a symptom-based care model is anticipated to be most effective for children with post-COVID conditions to ensure rehabilitation back to usual activities, including school attendance. This will require multidisciplinary and allied health funding (including for occupational therapists, physiotherapists, and psychologists). A formal model should be evidence-based and avoid the use of potentially harmful, non-evidence based therapies, in affected children and young people (National Clinical Evidence Taskforce, Care after COVID-19. Interventions should also be family-based where required, recognising that multiple family members may also be affected (Bertran et al, SSRN 2022). Care models may need to be newly created, or may be adapted from existing multidisciplinary services, caring for children and families.
Since it is vital that children with post-COVID conditions be supported to participate in school, health services and governments must work in partnerships with educational services, with adequate resourcing for this. Achievement of these goals will require multi-jurisdictional coordination, with a plan to ensure equity of access for children and young people living in rural and regional centres. Support and guidance for primary care services and local paediatric services will be required.
Our organisation is in close contact with Infectious Diseases specialists internationally and notes the UK model of specialist post-COVID hubs for young people (https://www.england.nhs.uk/2021/06/nhs-sets-up-specialist-young-peoples-services-in-100-million-long-covid-care-expansion/). These provide central guidance and coordination, supporting locally-led care (i.e. led by the child or young person’s GP or local paediatrician). A whole-of-healthcare intersection between primary, secondary and tertiary care will be an important component of the Australian response.
Children and young people have also been disproportionately affected by indirect impacts of the COVID pandemic, with disrupted education and socialisation. ANZPID asks governments to consider this, in efforts to support young Australians affected by post-COVID conditions, including long COVID.
This Inquiry into Long COVID and Repeated COVID Infections Submission 214 was submitted on 18 November 2022 by The Australian and New Zealand Paediatric Infectious Diseases Group (ANZPID) to The House of Representatives' Standing Committee on Health, Aged Care and Sport.