As Long COVID Lingers, a Moonshot Is Launched

Since its emergence in 2019, COVID-19 has caused one of the most destructive pandemics in history. Excess deaths alone are estimated to be in the tens of millions and economic damage is running into the tens of trillions of dollars. Now, with deaths and hospitalizations finally subsiding due to high immunity, many are eager to forget COVID as an issue of the past, but the virus is still alive and present in many who caught it. These patients, who have largely recovered from the acute phase of their illness, may have lingering symptoms ranging from mild to debilitating for months, if not years. Together, these conditions have been dubbed long COVID, a poorly understood constellation of symptoms found in millions across the globe.

According to CDC data, millions of Americans currently suffer from long COVID symptoms, with especially high prevalence among women.

The CDC defines long COVID as conditions that continue or develop after the acute viral infection period. The most common symptoms according to the CDC are fatigue, fever, coughing, shortness of breath, headache, dizziness, and more. Such a list of symptoms demonstrates the wide range of ways COVID-19 can impede basic well-being and only illustrates the unpredictability of the disease.

It's unclear just how many people suffer from long COVID. Without a full understanding of its underlying causes or a test to confirm its presence, doctors must rely on symptoms and medical history. However, since most COVID cases during the pandemic went untested and long COVID has an extremely broad symptom range, this type of diagnosis can be almost impossible. However, in the United States alone, the condition is estimated to have affected almost 7% of the population. Globally, even celebrities like Billie Eilish, Gwyneth Paltrow, Chris Cuomo, and Salma Hayek have experienced symptoms.

Although it has been over four years since the first outbreak of COVID-19, questions remain about why the virus can cause so many symptoms and have such varying degrees of severity among the population. Experts do agree, however, that several demographics are at higher risk of getting long COVID, including the elderly and obese.

As for the actual mechanisms behind the disease, there are plenty of theories. One theory is that the virus still lingers in the body in small amounts after most of the population is eliminated by the immune system. Another states that COVID may trigger the activation of dormant viruses like Epstein-Barr Virus, sparking new illnesses. Others postulate long-term organ damage or autoimmune failure (that is, the immune system produces antibodies to attack the body’s own vital structures).

As COVID-19 is still a relatively novel and complex virus, there are no reliable cures and doctors can only develop treatments to control symptoms of the disease. What makes long COVID especially difficult to counter are its diverse clinical manifestations and overlap with other diseases. Without a specific test or foolproof symptom set to confirm the disease or even a firm grasp on the number of victims, there is simply not enough information to produce effective countermeasures.

As long COVID persists, frustration over a lack of information and treatments has grown. Source: Scripps News

There is no doubt that the economic cost of long COVID will be significant—both due to medical expenses that would be required for treatment and decreased productivity in the workforce. According to data cited by the NIH, decreased labor force participation and productivity alone will result in a loss of $ 50 billion a year to the US economic market. Since different variations of long COVID exist, calculating the economic costs of long COVID varies depending on the type of symptoms that may be present.

Several conditions associated with long COVID are comparable to other illnesses, which allows experts to calculate relative medical expenses. One such similar condition, myalgic encephalomyelitis, has an annual cost of $ 9000 per patient in the US according to the NIH. Brain fog and other symptoms relating to neurocognitive abilities would result in decreased concentration. Decreased concentration leads to decreased productivity. In Australia, multiple sclerosis (MS), a motor neuron disease that causes symptoms similar to some cases of long COVID, costs the economy 68000 per patient (in Australian dollars).

These calculations also fail to account for the domino effects caused by decreased productivity which are experienced in various industries, particularly the hospitality industry and supply chains. As downtowns across the US are seeking to recover from the COVID lockdowns, high vacancy rates in office spaces have had severe consequences for restaurants and shops. For example, in the nation’s capital, Washington DC, 20 percent of stores and offices remain vacant, and only 48% of office employees have returned to in-person work, with many who have retained their jobs consistently preferring to work from home.

Senator Bernie Sanders has been one of the most outspoken advocates for long COVID research in Congress. Source: Jose Luis Magana / AP

Compounding the issue, politicians have not paid much attention to long COVID, especially as the virus has become integrated into daily life as part of the “new normal.” However, Senator Bernie Sanders (I-Vermont) has developed a plan to combat long COVID. Dubbed the “Moonshot legislative proposal,” the initiative aims to “address the Long COVID crisis that is negatively impacting the health of some 22 million Americans.” Such a proposal would have to include drastic measures for funding further research into COVID and reforming the medical establishment, which Sanders claims has misdiagnosed patients who have long COVID.

Although the proposal appears promising, it would first have to gain enough support from the Senate Health, Education, Labor, and Pensions Committee (HELP). From there, the legislation must be passed by Congress, which presents a serious challenge as much of Washington remains gridlocked over other pressing issues. Meanwhile, long COVID victims everywhere will continue to suffer, a stark reminder of the cost of poor health security.