For the past nine years, Maria McBirney (Ngāpuhi, Tainui, Kūki Āirani) has woken up early and gone for her daily walk.
"I probably cover about four rugby fields. It might be bigger," the 66-year-old said.
But ever since she caught Covid in March, her morning walks have become a struggle.She now gets breathless about halfway through.
It's not the only physical change McBirney has noticed - she gets dizzy spells, needles in her legs, headaches, brain fog and fatigue. She also can't taste or smell her food.
But the most debilitating symptom she is experiencing is the depression.
"It comes really fast and then it disappears. You're trying to dig yourself out of this dark hole, and it's horrible," she said.
McBirney is one of a number of Kiwis who caught Covid but is still struggling to recover.
For those who are still showing symptoms after three months - and when other discernible causes have been ruled out - the condition is being described as long Covid.
The medical community agrees that long Covid exists, but questions remain over how prevalent it is: estimates range from 5 per cent of Covid cases to 50 per cent.
Researchers Dr Lynne Russell (Ngāti Kahungunu, Rangitāne, Kāi Tahu, Ngāti Porou) and Dr Mona Jeffreys of Te Herenga Waka Victoria University have been monitoring the condition closely as part of a wider study for the Ministry of Health about the impacts of Covid-19.
Although the physical impacts are clearly uncomfortable, many of the study's participants also spoke of continued mental distress. Russell said these facets were interlinked.
"Identity is such an important part of who we are, particularly as Māori, knowing who we are, where we fit into the world, how we relate to everybody around us.
"Covid is changing that for people. It's changing who they are within their family structure. Roles that people might have played before - that were big - they're not physically able to do anymore.
"So they start to wonder where their place is in the world."
Another issue Russell and Jeffreys identified was difficulties with medical professionals, with many patients reporting their GPs were reluctant to give a long Covid diagnosis, and often unsure how to progress when patients reported continuing symptoms, even when their lives were being significantly affected.
Dr Filipo Katavake-McGrath (Ngai Tahu, Kāti Huirapa, Ngāti Raukawa ki te Tonga, Te Atiawa, Ma'ufanga, Mu'a) said it took four to five doctors to get a long Covid diagnosis.
A once-healthy 40-year-old, Katavake-McGrath now needs a walking stick to move more than 10 metres.
In the end, it was Katavake-McGrath's GP who made the call.
"He looked at all of my notes going, 'So all this other stuff has come back fine, but these are your symptoms'. And I think he just made a line call and said, 'this is long Covid'," Katavake-McGrath said.
It was reassuring for Katavake-McGrath, because it gave them something to work with.
"It gave me something to say: right, I have this, what are the things I can do about it?"
But in the same conversation with their GP, Katavake-McGrath said the doctor admitted that the medical fraternity still doesn't have a lot of information about long Covid.
Medical director of the Royal New Zealand College of General Practitioners Dr Bryan Betty said one of the problems with long Covid at the moment is that it was ill-defined.
There also isn't a clear, definitive test for it yet.
Whakaata Māori reporter Ximena Smith and Dr Bryan Betty. Photo / Te Ao with Moana
"In an ideal world, we'd have some sort of blood test or biochemical test to say, yep, absolutely, that's what we're dealing with, to really provide that certainty. We don't have that at the moment."
In lieu of a definitive test, Betty said there's a real need for clear guidelines and messaging to the general practice sector over how to manage patients with long Covid.
He said it's also important that doctors listen to and respect what their patients are telling them about what they're experiencing, and that doctors need to accept long Covid is real.
Russell and Jeffreys agreed.
They heard particularly from Māori in the study that some GPs had just not asked about any symptoms in the first place.
"[That's] because it just doesn't exist for them. So, if it doesn't exist, you can't ask about it," Russell said.
Russell and Jeffreys said GPs can also provide long Covid patients with a clear pathway of care.
"So we know that there isn't a magic pill but we also know that there's a lot of symptom management that can help," Jeffreys said.
"So for example, for people who've got dizziness, there are people who can help with that. There are ways and strategies that can help with that. If you've got fatigue, there are strategies that can help with that.
"But at the moment, that's not really being offered."
