Long COVID exposes lingering challenges
LONDON — The increasing reports of people getting “long COVID” have exposed the challenges in combating the pandemic.
Experts said 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 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.
Nearly 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, or IHME, at the University of Washington’s School of Medicine 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.
Undercounting cases
The United States’ Centers for Disease Control and Prevention suggested that nearly 1 in 5 US adults who have had been infected now have long COVID.
A study published in medical journal JAMA Network Open earlier this month looked at post-COVID-19 symptoms two years after a SARSCoV-2 infection among hospitalized versus nonhospitalized patients.
“I take a study such as this one from Spain to mean we may have been undercounting long COVID,” said Danny Altmann, an immunologist at Imperial College London. He emphasized the knowledge gaps 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.
“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 said.
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.
Certain populations in the US experience higher rates of diabetes, high blood pressure, 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 US has seen over 98 million COVID-19 cases and more than 1 million related deaths. Public health experts said the virus’ outsized impact on the US can be attributed in part to underinvestment in long-term care, primary care and public health departments.
“This is more than just a failure of a health system,” David Rosner, who studies public health and social history at Columbia University’s Mailman School of Public Health, told The Guardian in May. “It’s a failure of an American ideology.”