Life, death and everything in between: Crikey readers weigh in on long COVID, voluntary assisted dying

Andy Cox writes: No God-bothering crusaders such as John Howard and Tony Abbott and their mates are going to tell me when I can die, support a person who wants an abortion or who I sleep with (“John Howard’s legacy thwarts progress on voluntary assisted dying”). It’s always intrigued me how the religious right likes to spend their time telling the rest of us what we can and cannot do with our lives. I just wish they’d crawl back under their rock.

Dr Linda Swan writes: Seeking approval for voluntary assisted dying is a complex and careful process that requires multiple conversations and visits to health professionals. These ideally all occur in person and that is the preferred model of care. However, some people are either too sick, too fragile or too far away to have everything done via in-person consultations. A ban on telehealth means that dying people who are too ill or who live outside our major cities are denied their legal end-of-life choice. 

It is patients, in consultation with their healthcare team, who should make decisions about what care is clinically appropriate — not politicians.

(Note: Swan is CEO of Go Gentle Australia)

Bernard Cannon writes: “God so loved the world that he gave his only begotten son.” Was that son all-knowing? If so, he would have known what his father wanted and went along with it. So why don’t we regard the crucifixion of Christ as an act of voluntary assisted dying?

Francis Coombe writes: The Federal Court ruling of November 30 interpreting voluntary assisted dying as suicide is ridiculous, savage and damaging.

Every Australian state now has laws allowing VAD. These laws are limited to criteria of a terminal illness — suicide has no such limitation. VAD requires a medical pathway with two doctors assessing for decision-making capacity — suicide has no medical pathway and is often impulsive, with mental illness often involved.

VAD is a peaceful, reliable death where the person can be supported by loved ones — suicide is generally done alone by necessity as assisting a suicide is against the law. It is often botched and violent. VAD allows good bereavement outcomes — suicide begets terrible bereavement outcomes. Our community overwhelmingly wants VAD to be available — our community overwhelmingly wants to prevent suicide.

Under the Federal Court ruling, all people assisting in the VAD process, doctors, pharmacists, nurses, care navigators, hospital VAD liaisons, witnesses to the requests and administrative staff could be accused of assisting suicide — and under laws that allow them to do so! Attorney-General Mark Dreyfus must urgently amend the Commonwealth Criminal Code to remove the confusion and disruption in the administration of VAD acts in every state.

(Note: Coombe is president of Voluntary Assisted Dying South Australia.)

Masked crusaders

Dr Dominic Meagher writes: Re “Does it make sense to still worry about long COVID?”: I wear an N95 respirator whenever I’m indoors (except at home). At home I have two air filters running 24/7 and no longer have guests — I meet people at the local park, café or beer garden. I don’t go to indoor events unless the organisers/venue explain the ventilation or filtration available.

Why? Because as Jason Murphy observed in his article, long COVID is keeping many people out of work. As a research economist, if I can’t focus I can’t work. The risk of dementia is about 50% higher for each infection. Stroke or heart attack is about 40% more likely. The risk of diabetes is about 20% higher.

These figures are difficult to be precise with because the virus keeps changing. But what we can see is that NSW teachers, police, retail and hospitality workers have been claiming workers’ compensation at about a 25% higher rate since Omicron, relative to pre-COVID, though WorkSafe NSW does nothing to intervene.

We can see that the number of workers who could no longer work last year is about equal to a normal year of immigration. The excess workforce loss due to sickness was more than 1% of the total workforce last year. We can see that the death rate if you catch COVID at an Australian hospital as a patient is 10%, but hospitals don’t require airborne infection prevention and control measures.

In the UK, more than 1.5% of the workforce is unable to work due to COVID. You can call that a 1.5% loss of GDP due to lost income. That’s almost equal to the entire defence budget. We’re not doing any better than the UK — we’re just six months behind.

Yes, COVID is the biggest preventable drain on incomes and the most preventable source of inflation. In a cost-of-living crisis, infection prevention and control continues to be the lowest-hanging fruit for government action to help people get by, but the government refuses to acknowledge it. 

(Note: Meagher is chief economist at John Curtin Research Centre.)

Gemma Donaldson writes: I still wear a mask in most circumstances. A year ago I was in active treatment for cancer and found having to do tasks like picking up medication from the chemist and attending pathology for blood tests quite terrifying as an immunocompromised person surrounded by people willingly going about unmasked.

The main reason I still wear a mask is solidarity with immunocompromised people, to make them safer in public — but also to not feel alone. I also mask on public transport and when shopping. Recently we flew from Auckland to Perth and I masked except during meals. My husband picked up COVID on the flight and I didn’t. That’s enough evidence for me.

Pippa Yeoman writes: I was healthy and triple-vaccinated when I was first infected in March 2022. Since then I have been diagnosed with a pulmonary embolism, sleep apnoea, adrenal hypersecretion, postural orthostatic tachycardia syndrome (POTS), platelet hyperactivation and micro clots, and cerebral hypoperfusion. I didn’t work at all for six months last year and I am still unable to work more than 25 hours a week — 50 was normal for me pre-COVID. So it’s unsurprising that I still wear a mask.

I wish others understood the risks they take with their and others’ health when choosing not to mask.

Stephanie Allen writes: I have been wearing an N95 with eyewear protection or a 6200 half-mask respirator with a face shield since the middle of 2020. I even wear a fisherman’s hat with the 6200 in high-risk settings when the need arises.

During 2020 I sat in the petri dish called a train and said to myself: “I will be masking forever.” I have not had COVID-19 and refuse to just lie down and get it. With more evidence that COVID causes damage not only to the brain but to other organs, I am waiting it out for as long as possible.

Watch society become a health burden where only the smart survive.

Claire H. Wheeler writes: My family still masks up when we go indoors with other people. It takes courage to wear a mask because it has become a symbol of restriction rather than one of protection. If the reverse had been the narrative, society would be a better place. But we seem determined to continue down the path of denial amid cases of chronic sickness and disability. I long ago gave up on expecting anything to change and have resigned myself to being a forever mask wearer, knowing now what I know about this virus and the diseases it causes. 

I am perfectly healthy and in my 40s, except for a couple of co-morbidities that don’t feature on the list of high-risk conditions. But vulnerability is not fixed and your health can shift in the blink of an eye. That’s why I still mask. The other reason I mask is because I know COVID hangs in the air, you will never know where it is, who is infected and who is not.

No-one ever believes it will happen to them but the odds of long COVID are somewhere around one in 10 people. That’s a pretty high risk. And that’s before we know more about the other potentially devastating effects on the brain, heart and other organs.

Rebecca Curran writes: I still wear a mask — minimum KF94 in lower-risk situations, otherwise N95/P2 on public transport, at indoor public venues (including shops, galleries, museums etc) and outdoors if distancing isn’t possible. I work from home on my own, so I don’t mask there. My 12-year-old also masks indoors at school. 

I am a self-employed, sole parent. I am also a middle-aged woman. Studies indicate my cohort is at increased risk of developing long COVID. Acquiring a chronic illness or disability that affects my ability to work would have catastrophic consequences for me and my child. If I am unable to work who will pay for our housing, food, clothing and health expenses?

I mask because there is strong evidence that wearing a good quality, well-fitting mask reduces transmission. We still don’t know enough about the long-term implications of being infected with COVID, especially multiple times, but what we do know is concerning and worthy of taking precautions.

I also wear a mask out of respect for people who are vulnerable to serious illness, or who can’t mask (e.g. very young children, some people with disability and some older people). The only thing it costs me is money, and I acknowledge my privilege in being able to afford to buy good-quality masks. I care what others think of me and how they treat me, but not enough to stop masking.

Ishita Akhter writes: It’s unfortunate that with a current rise in cases and deaths in Australia, there appears to be not a lot of awareness among the masses regarding COVID.

My husband and I don KN95 or above respirators whenever we are in high-risk situations, as our only known infection at home had caused me significant post-COVID symptoms which have lingered for more than 16 months. We fell short in diligence in terms of our COVID precautions once and were infected, so naturally want to do our best to not catch it again.

Peter Vogel writes: My family continues to take reasonable care to avoid COVID and other airborne diseases. We dine out only if there’s outdoor seating, and avoid large indoor gatherings unless we’re sure there is good ventilation. If we must join indoor crowds (such as a school assembly) we mask and open windows where possible.

Only one of the four of us has had COVID (at least that was symptomatic). We accept that we can’t avoid it completely but fewer, smaller exposures must be less risky.

Amy Lewis writes: I continue to wear a mask in indoor public areas. I have to because I have long COVID and my husband has had a double lung transplant, so he is heavily immunocompromised — at worst COVID represents a life-threatening risk for him.

COVID is often falsely compared with the flu, but the incidence is much higher, as is the mortality rate; there are several COVID waves a year (compared with one for the flu) and the long-term effects of COVID are serious and more common.

State and federal governments continue to use the term “protecting the vulnerable”, but what protection is there if you’re at risk and have kids at school, a job, or want to be an active member of your community? Even though long COVID has severely affected my health and life for nearly two years, I don’t even qualify for antivirals. We are told by the government to take “personal responsibility”, but the tools we use to do this are progressively reduced and removed.

We do understand how to reduce COVID transmission risk and governments now need to act preventively just as for other serious health issues. The current “vaccine-only” approach is clearly not working, and the onus should not be on at-risk people to protect themselves. For what other public health issue do we do that? The strategy not only puts vulnerable people at unfair risk but also results in more and more people with long COVID.

We all need to pull our heads out of the sand, just like we have for climate change, acknowledge there is a problem and start to act on it.

For anyone seeking help, Lifeline is on 13 11 14 and Beyond Blue is on 1300 22 4636. In an emergency, call 000.