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The Economy Could Have a Long Case of Long Covid


This is the first column in a three-part Heard on the Street series on long Covid.

Long Covid could cast a long shadow over the economy.

Shortly after the pandemic struck in 2020, an unsettling problem among people who had contracted Covid-19 became apparent: Months later, some were suffering from symptoms such as shortness of breath, confusion and fatigue, sometimes to a debilitating extent.

Two years later there is still much that scientists and health professionals don’t know about what has come to be called long Covid, but they do know that it is a real problem—one that could place fresh burdens on the U.S. economy. Treating people with long Covid comes with a cost that will fall to some extent on patients and their families and to some extent on society.

The World Health Organization has said long Covid is a condition in people who had Covid-19 three months previously, with symptoms such as severe fatigue and cognitive issues that last at least two months. Regardless of how one defines it, the numbers are daunting: Researchers who analyzed the records of Veterans Health Administration patients reckon that 4% to 7% of patients who have been infected with Covid-19 developed long Covid. That is actually on the low side of most recent estimates but, considering that the bulk of the U.S. population appears to have been infected, still translates into millions of sufferers.

The researchers found that, beyond the risk of experiencing symptoms such as difficulty thinking, people who have had Covid are at increased risk of serious conditions such as heart disease and Type 2 diabetes. That is an especially worrisome development, says Ziyad Al-Aly, chief of research and development at the VA St. Louis Health Care System and a clinical epidemiologist at Washington University in St. Louis, who led the research. Long Covid symptoms such as persistent cough can fade, but chronic diseases won’t.

Dr. Al-Aly and his co-researchers estimate that people who have had Covid have a 40% higher chance of developing diabetes than if they hadn’t been infected. Recent research finds that the lifetime direct medical cost for treating diabetes and diabetes complications in men aged 45 to 54 with Type 2 diabetes is $106,200. If the ranks of people with Type 2 diabetes swell, the U.S. could be burdened with multiple billions of dollars in additional healthcare costs.

Expecting the medical establishment to follow up on its record-fast development of vaccines with a treatment for long Covid might be wishful thinking. Post-viral disorders have multiple symptoms and often no clear-cut measure of success for treatment.

Beyond healthcare costs, people with long Covid might in some cases be unable to work and require additional support or they might choose to retire early. The good news for now is that, since the start of the pandemic, applications to the Social Security Administration’s disability program have actually slipped. To some degree, this might be driven by the additional flexibility that many workers now have—for example the ability to take a nap at home.

New studies offer clues about who may be more susceptible to long Covid, a term for lingering Covid-19 symptoms. WSJ breaks down the science of long Covid and the state of treatment. Illustration: Jacob Reynolds for the Wall Street Journal

Colorado School of Public Health economist Lauren Nicholas cautions that some long Covid sufferers hoping their condition improves might not yet see themselves as candidates for the curtailment of work required for disability program applications. Claims and insurance losses can jump when unemployment does—such as following the 2008-09 financial crisis—so public and private insurance could see a rise in claims in the event of an economic downturn.

The bulk of direct Covid-19 deaths are likely behind us due to vaccines and treatments, but some large private life and disability insurers are concerned about rising loss ratios in group disability insurance, which people typically get through work. Whether long Covid is directly playing a role yet isn’t clear. There is also a worry that other pandemic effects, such as people having put off preventive care, might lead to a longer-term rise in risk.

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Moreover, despite the job market’s strength, many long Covid sufferers are struggling to make ends meet. June survey figures released by the Census Bureau show that 61% of adults who said they experienced Covid symptoms that lasted over three months (some of whom no longer had symptoms) were meeting needs with the regular income sources they used before the pandemic, which compares with 67% for the remainder of the population. Among those who had experienced long Covid symptoms, 30% said they were dipping into savings or selling assets and possessions to meet needs versus 23% among other adults.

To the extent that long Covid sufferers are unable to return to work, or to work as many hours, that will represent a loss for the economy. One reason the unemployment rate is so low is that a smaller share of the population is working or looking for work than before the pandemic. Some share of the people no longer in the workforce are probably long Covid sufferers. Absent those workers, the economy might not be able to grow as quickly as it otherwise might, leaving the country worse off.

Researchers still know too little about long Covid to quantify what sort of burden it might place on the country, but the available evidence suggests the costs could be significant enough to take very seriously.

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