Finally, Long COVID Is Being Noticed

And more and more people are saying he’s doing an excellent job (sorry, I couldn’t resist).

On a far more serious note, I’ve felt like I’ve been gaslit about the prospects of long COVID. As some asshole with a blog noted a while ago:

So a reasonable estimate is that five percent of those who have been infected with COVID are suffering from long-term disability. In the U.S., 26 million people aged 18-64 have tested positive for COVID (that would be about 12.5% of that cohort). Given the massive undertesting in many parts of the U.S. (but not D.C.!*), that probably should be at least fifty million. Five percent of that is, well, a lot of people. And that five percent (give or take) will be disproportionately found in certain sectors (haven’t seen any stories about the Great Lawyer Shortage, but I could have missed them…).

Now, you might wonder why that’s not reflected in other statistics, especially since the U.S. has a generous benefits system and doesn’t stigmatize disability, so…

Ok, then. Moving along…

While one can quibble with my numbers (and, of course, they could be higher–five percent might be conservative), the point still remains: there are a lot of workers who can’t work, or whose work options have become (very) restricted. We have to start dealing with this. We also have to stop with the kinder, gentler Greater Barrington Declaration crap some Thinky Thought Leaders are promulgating: a few million long-term or permanently disabled people is worth worrying about, especially in an America as broken and cruel as ours.

The good news, if it can be called that, is this is slowly starting to enter The Discourse. From Barrons (boldface mine):

Here’s another theory about where the workers have gone: Many are suffering from what has come to be known as long Covid, or lingering negative effects of the virus, preventing a bigger-than-appreciated share of working-age people from resuming normal work lives…

Studies suggest that a sizable number of people suffer from post-Covid symptoms months after recovering from the virus. Researchers at Penn State College of Medicine say more than half of those diagnosed with Covid-19 experience long Covid, while the Lancet medical journal says 57% of hospitalized patients and 26% of non-hospitalized patients show post-Covid symptoms months after infection.

Long Covid itself is fuzzy, doctors say, with myriad symptoms of varying duration, which makes it hard for physicians to diagnose and treat. Dr. Neil Schluger, director of the department of medicine at Westchester Medical Center and chairman of the department of medicine at New York Medical College, has had about 500 patients come through the long-haul center he helps run, with most suffering for several months post-infection by the time he sees them. Schluger says symptoms usually include a combination of overwhelming fatigue, brain fog that impedes the performance of simple tasks, persistent breathlessness, psychiatric issues such as depression, and cardiac problems.

“A lot of people we see have been out of work for a significant amount of time,” says Dr. Schluger. “Almost all of the people we see who were previously working want very much to go back.”

Some patients have tried to return to the workforce, with limited success.

While doctors and public health officials are still putting together the pieces of long Covid, they have identified some common threads. Schluger says most patients had relatively mild cases of Covid; more women than men seem to suffer from long-haul symptoms, and most patients are in their 40s, 50s, and 60s…

Based on his research and communications with members of his group, Bunker estimates that roughly 20% of Covid cases in the U.S. turn into long Covid, and that at least half of that slice isn’t able to work. Doing some back-of-the-envelope math, that’s 4.6 million people. Some may have fully recovered by now, and not all of them would have been working before symptoms struck; Dr. Schluger says he has seen some patients in their 80s. But even assuming, conservatively, that around half of them had been in the workforce in some capacity, that suggests about two million people could be out of the labor market because of long Covid.

And the Washington Post is in the same ballpark (boldface mine):

Across America, many of the nearly 50 million people infected with the coronavirus continue to suffer from some persistent symptoms, with a smaller subset experiencing such unbearable fatigue and other maladies that they can’t work, forcing them to drop out of the workforce, abandon careers and rack up huge debts.

Hard data is not available and estimates vary widely, but based on published studies and their own experience treating patients, several medical specialists said 750,000 to 1.3 million patients likely remain so sick for extended periods that they can’t return to the workforce full time.

Long covid is testing not just the medical system, but also government safety nets that are not well suited to identifying and supporting people with a newly emerging chronic disease that has no established diagnostic or treatment plan. Insurers are denying coverage for some tests, the public disability system is hesitant to approve many claims, and even people with long-term disability insurance say they are struggling to get benefits.

It has been maddening to see so many policy makers and Thinky Thought Leaders fixate on deaths and hospitalizations–obviously these are horrible–but completely ignore long-term disability. Even if the rate here on out is long COVID in ‘only’ one percent of diagnosed cases, that’s not good, with around 100,000 cases per day. It does seem like two doses of vaccine lower the rates of long COVID, and hopefully, TEH BORCESTER (the third dose) will be even more useful.

But there are a lot of people, including some in public health, who are doing themselves (or us) no favors when they say things like ‘the vaccines weren’t designed to stop transmission’: well, we’re going to need to do that, and if a third dose helps stymie transmission, then that has to be part of the public health response.

Just frustrating as fuck.

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