"Long COVID" exposes long-term challenges

(Xinhua) 08:32, November 30, 2022

A medical worker collects a swab sample from a person at a COVID-19 testing site on Times Square in New York, the United States, March 29, 2022. (Xinhua/Wang Ying)

LONDON, Nov. 29 (Xinhua) -- The increasing reports of people getting "long COVID" have exposed the challenges in combatting the pandemic.

Experts said that long COVID is likely to result in growing pressure on social and medical resources, a shrinking labor force and economic downturn in the long run.


Post COVID-19 condition, also known as long COVID, is defined by the World Health Organization (WHO) as an illness that occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, with symptoms that last for at least two months and cannot be explained by an alternative diagnosis.

The WHO estimated that 10 to 20 percent of COVID-19 patients have been left with mid- and long-term symptoms such as fatigue, shortness of breath and cognitive dysfunction, as well as others that generally have an impact on everyday functioning. Women are more likely to suffer from the condition.

An estimated 17 million people in the WHO European region met the WHO criteria of a new case of long COVID with symptom duration of at least three months in 2020 and 2021, a recent study conducted by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington's School of Medicine in the United States showed.

"The IHME's research shows that nearly 145 million people around the world in the first two years of the pandemic suffered from any of the three symptom clusters of long COVID: fatigue with bodily pain and mood swings, cognitive problems, and shortness of breath. Fast-forward to today and millions of people continue to suffer because of COVID-19's lingering impact on their health and livelihoods," said Christopher Murray, director of the IHME.

A man receives a COVID-19 test on Times Square in New York, the United States, March 28, 2022. (Photo by Michael Nagle/Xinhua)

The U.S. Centers for Disease Control and Prevention suggested that nearly one in five American adults who have had COVID-19 now have long COVID.

A study published in the top-tier medical journal JAMA Network Open earlier this month looked at post-COVID-19 symptoms two years after a SARS-CoV-2 infection among hospitalized versus non-hospitalized patients.

"I take a study such as this one from Spain to mean we may have been under-counting long COVID," said Danny Altmann, an immunologist at Imperial College London. He emphasized the gaps in our knowledge regarding long COVID, saying "what we're not good at yet is working out the nuances of long COVID after different variants, such as delta."


As WHO Director-General Tedros Adhanom Ghebreyesus has warned, long COVID is "devastating" the lives and livelihoods of tens of millions of people, and wreaking havoc on health systems and economies. He urged countries to launch "immediate" and "sustained" efforts to tackle the "very serious" crisis.

In Britain, around 2.5 million people were economically inactive due to long-term sickness in the summer of 2022, compared to around 2 million people in the spring of 2019, said the Office for National Statistics (ONS) earlier this month.

This was the highest rate of inactivity among the long-term sick since records began in 1993, an ONS spokesperson told Xinhua. "It was generally falling, from shortly before the turn of the millennium, but started to rise again in 2019, and has now gone past its late 90s peak."

"While symptoms of long COVID may not be the only contributor to increased long-term sickness in the working-age population, the pandemic's wider impact on health is still likely to be an important factor in increased long-term sickness," said the ONS report.

A recent survey from Britain's Trades Union Congress found that 20 percent of people with long COVID were not working, and an additional 16 percent were working reduced hours.

People walk on Times Square in New York, the United States, March 29, 2022. (Xinhua/Wang Ying)

In January 2022, Brookings Metro published a report that assessed the impact of long COVID on the labor market. Data on the condition's prevalence was limited, so the report used various studies to make a conservative estimate: around 16 million working-age Americans -- those aged 18 to 65 -- have long COVID today. Of those, 2 to 4 million are out of work due to long COVID, while the annual cost of those lost wages alone is around 170 billion U.S. dollars a year, and potentially as high as 230 billion dollars.

While the worsening health of the British population is an emergency in its own right, with at least 5.5 million people in Britain waiting for hospital treatment, it has serious repercussions for the economy, the Financial Times reported.


"We're in an arms race against the virus, and the virus is now firmly in control of the battleground. Just because we've lost interest, the virus hasn't," Altmann told Xinhua recently.

Despite its name, SARS-CoV-2 not only causes acute respiratory disease but can also lead to acute and post-acute extrapulmonary sequelae in nearly every organ system, including acute and chronic kidney disease, and has affected millions of people around the world.

Given the scale and the chronic nature of several of its sequelae, "long COVID will reverberate with us for decades, and will have broad and deep social, economic, political and global security implications, long after the COVID-19 pandemic abates," said the report.

"I wish we could just raise the awareness levels a bit higher," said Altmann, advising people on public transport, in a theater or at the opera to wear masks, and "take it a tiny bit seriously."

A child is carried into a COVID-19 vaccination site in Times Square, New York, the United States, on June 22, 2022. (Photo by Michael Nagle/Xinhua)

From limited access to preventive care to increased risk for preexisting conditions, the reasons that the most vulnerable communities and groups are more susceptible to long COVID are many, according to Harvard Medical School.

Certain populations in the United States experience higher rates of diabetes, hypertension, obesity, asthma, heart disease, and cancer, conditions known to increase the risk for severe COVID-19 illness, which in turn increases the risk for long COVID.

In total, the United States has seen over 98 million COVID-19 cases and more than 1 million related deaths. According to public health experts, the virus's outsized impact on the United States can be attributed in part to underinvestment in long-term care, primary care and public health departments. As a result, some people were more vulnerable to COVID and had little connection to, or trust in, the healthcare providers who urged them to maintain social distancing, wear masks and get vaccinated.

"This is more than just a failure of a health system," David Rosner, who studies public health and social history at the Columbia University Mailman School of Public Health, told the Guardian in May. "It's a failure of an American ideology." 

(Web editor: Chang Sha, Liang Jun)


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