Sensitive to light, struggling to stand up and needing multiple medications to make it through the day, Nicole Pope has been debilitated by long COVID.
The Adelaide mother caught the virus from her school-aged daughter in July but did not recover as expected.
"For the first three months, I was completely bedridden, unable to do even simple things around the house," Ms Pope said.
She experienced a range of strange symptoms, from crippling fatigue to painful, extreme acne outbreaks.
"It was just like my whole body was getting attacked, struggling, trying to fight it," she said.
As her symptoms began to subside, the 49-year-old was left with postural orthostatic tachycardia syndrome, or POTS, a condition that makes it difficult to stay standing up.
It is one of the types of "autonomic dysfunction", where part of the nervous system stops working properly that can be linked to long COVID.
Now Ms Pope is worried a new wave of COVID-19 cases will put many others in her position.
"It scares me that we're about to go into another wave and we have the majority of people not wearing masks," she said.
"There's no isolation periods, people aren't taking it seriously, they think it's a joke.
"If people try and speak out about it, they're laughed at.
"There's just going to be a growing number of people that are going to be left with long COVID and who knows what their lifelong health complications are going to be from that infection?"
Long COVID risk increases with reinfection
Ms Pope's fears are echoed in a submission to a parliamentary inquiry into long COVID and repeat COVID infection from Australian National University professor Quentin Grafton and other researchers.
"Both the mortality risk (all causes) and the risk of hospitalisation at six months of long COVID increase substantially with one symptomatic infection, then continue to increase with each additional symptomatic COVID infection," the submissions stated.
"Thus, Australians should expect an escalating accumulation of morbidity and mortality if COVID is continued to be allowed to spread, more or less, unchecked through the population."
The researchers said management measures – especially masks – would help reduce the rate of infections and the long-term damage from long COVID.
"The most effective way for Australia to reduce the incidence of COVID and long COVID would be to reintroduce and to ensure compliance with: mandatory mask wearing on public transport; isolation of infectious; and support for a program of mandatory air-quality monitoring and HEPA air filtering when the air quality deteriorates," their submission said.
Ms Pope and many people with chronic conditions are angry that COVID-19 management measures like masks remain voluntary across the country.
And they have a right to be worried: Australian Bureau of Statistics figures to July this year show 76 per cent of deaths from COVID-19 infections were people with an underlying chronic condition.
Call to wear masks to protect vulnerable
Newcastle resident Robyn McLean, who is caring for her immunocompromised daughter, told the ABC she has had to stay home since last December.
"I could count on less than one finger the number of times I've been to a public thing in the last year," she said.
"It's been isolating, it's been something that we've become very used to. It certainly seems like a long-term proposition for us."
Ms McLean said families like hers needed more consideration from the general public.
"I feel like the community could come on board and help those who are more vulnerable than they do because it would be very easy to ask the community to wear masks in public places again," she said.
"It's not asking them not to go anywhere, not to do anything, not to radically change their lives, just wear a mask. That really is the thing that would make such a big difference to our lives."
Even those who are relatively healthy are lamenting the loss of opportunities to travel or go out due to high COVID case numbers.
Adelaide retiree Nicholas Smales has been living in self-imposed isolation while the latest COVID wave runs through the population.
The successive outbreaks have ruined his plans to travel for the past three years.
"Our ability to go out there and, shall we say enjoy Australia and enjoy the world, is being heavily restricted by the threat of this outbreak of COVID," he said.
Mr Smales fears it may be too difficult to get anti-viral medication in a timely manner if he does get infected.
"The authorities are saying 'OK, Paxlovid is the answer'," he said.
"Well, we've got a doctor that works three days a week for a start and my pharmacist says 'no, you've got to get a particular script very rapidly to start the course of antivirals', so consequently it seems to be shutting the gate after the horse has bolted."
Antivirals and public education
But one expert said renewing mask mandates and capacity restrictions would not stop the spread of the new, highly-transmissible Omicron variants.
"It's just got a completely different dynamic because of its ability to spread, the ability to have reinfections in the community," said Professor Catherine Bennett, the chair in epidemiology at Deakin University.
"The same measures we had in place even for Delta will not work against Omicron."
Health authorities are instead hoping public education and quicker access to antiviral drugs can fill the gap.
"Mandates have a limited life, in terms of people's ability to stick with rules, even if they're mandated," Professor Bennett said.
"We saw that fade away even when we had mandates in place for a very long period of time.
"This is really about trying to shift to a more sustainable way of managing infection risk in the population and that is about giving the people the information they need to make safer choices.
"We need more people to be aware of the risk change and that's where public health messaging, not from the politicians, but from the health departments, is so critical now."
