Protracted COVID remains a problem, raising global costs to the tune of $1 trillion

For months, public officials around the world have seemed to avoid discussing the specter of long-term COVID. As a new review makes clear, that’s wishful thinking — and the latest COVID variants could well kick the long-running COVID into overdrive, a scenario scientists and experts have been warning against for some time.

“I think they (government agencies) are itching to pretend that COVID is over and that COVID won’t be around much longer,” says Ziyad Al-Aly, director of the Clinical Epidemiology Center at Veterans Affairs St. Louis Health Care System and lead author of the book. the review. “It’s much more fun to pretend if emergency room visits and hospitalizations have not been increasing this much summer.”

In a Naturopathy review this week, Al-Aly and several other top researchers lay out a hard truth: Long-term COVID has already affected an estimated 400 million people worldwide, a figure the authors say is likely conservative, with an economic cost of about $1 trillion dollars annually – equivalent to 1% of the world economy.

Furthermore, a person’s risk of contracting prolonged COVID increases with repeated infections of the virus itself, and recent COVID activity has experts watching closely. As Critique co-author Eric Topol noted in a recent blog post, the current COVID-19 outbreak is rising rapidly, with one modeler estimating 900,000 new infections per day in the US alone.

“The new critical wave,” Topol said via X. “It’s hard to believe that we’re well into our fifth year with this virus and that we’re not taking the necessary steps to bring it under control.”

The virus is constantly evolving. Multiple COVID subtypes, collectively called FLiRT, are strongly present in the United States, and reports from California indicate that some patients are complaining of throat pain so severe it feels like they’re “swallowing razor blades or broken glass,” according to Los Angeles Times. Topol, meanwhile, says Japan’s Sato Lab has characterized one of the latest COVID strains, KP.3.1.1, in preprint which have the “highest immune variance and infectivity of any strain” derived from previous potent iterations of the JN.1 strain, which was prominent last winter.

Although the Centers for Disease Control and Prevention says so severe sequelae and deaths from COVID have decreased significantly overall since the early days of the pandemic, wastewater data shows that viral activity is “high” nationally and that COVID-19 infections are increasing or likely to increase in 35 states. More COVID infections mean more cases of chronic COVID. And the long run of COVID is already exacting an enormous toll on both the world’s people and economies.

These are words you don’t hear from many government agencies. But, say the researchers, the evidence tells the story.

“Despite the dire effects of chronic COVID on individuals and society, I fear that many people are still unaware of the danger,” says Akiko Iwasaki, professor of immunology at the Yale School of Medicine and principal investigator of the study. of the university COVID-19 recovery study. “There is an urgent need to provide proper diagnosis and treatment for people living with chronic COVID.

The authors make several recommendations for preventive policies, including increased mask use, improved ventilation, and a vaccination program that pairs COVID shots with a seasonal flu shot to extend their coverage to improve uptake. But it’s a genuine question whether enough people are paying close attention for any of this to matter.

As the authors point out, a survey found that as of last August, a third of American adults had still not even heard of long-term COVID. In reality, long-term COVID was diagnosed and defined in the first full year of the pandemic, 2020, and the number of cases has been increasing ever since..

This type of COVID is particularly dangerous because, for many, its symptoms can last for years (or a lifetime), and its effects can trigger all kinds of related problems and costs. Chronic COVID “affects nearly every organ system,” the review says, including the cardiovascular, immune, gastrointestinal, and reproductive systems. While more than 200 symptoms have been identified, common symptoms include memory problems, difficulty concentrating, fatigue, palpitations, persistent cough, shortness of breath or shortness of breath, and recurring headaches.

Frighteningly, most people who get a long run of COVID didn’t have a particularly bad case of the virus to begin with. That’s partly because so many more people experience a mild form of COVID rather than a severe one. (In most studies, long-term COVID risk increases with the severity of the initial infection.) And each time people are reinfected with the virus, they are at risk of developing long-term COVID, even if they haven’t experienced it before.

The authors note that research on recovery from chronic COVID is “scattered and inconsistent. But those who have closely evaluated individual manifestations of the virus have found recovery rates to be quite low at one year, with only 7% to 10% fully recovered at two years. For millions and millions of people, the debilitating effects of chronic COVID are just that.

The economic toll is its own story. The Census Bureau’s 2022 Household Pulse Survey found that between 2 million and 4 million working-age Americans were out of work because they were sidelined by prolonged COVID. Meanwhile, 20% of people with long-term COVID surveyed by the UK Trades Union said they were not working. Another 16% were working a shorter schedule.

An estimated annual global economic shock of $1 trillion applies to Organization for Economic Co-operation and Development (OECD) countries due to “reductions in quality of life and employment.” Naturopathy review says. And that price tag doesn’t factor in direct health care costs, another likely category of deep financial cracks.

Al-Aly and his co-authors are calling on governments, especially US health agencies, to dramatically improve their efforts to study long-term COVID, learn more about its mechanisms and pathways, and develop vaccines that better prevent infection. They’re also pushing for large-scale field trials to test multiple drugs simultaneously, so we can quickly learn what works and what doesn’t.

They have an ally in the parliament. US Senator Bernie Sanders recently introduced the Long COVID Research Moonshot Act, a bill that would secure $1 billion a year for a decade to the National Institutes of Health “to support long-term COVID research, the urgent search for treatments and the expansion of care.” for patients all over the country.”

Sanders’ press release announcing the act says the long COVID count in the U.S. is 22 million, including a million children. Among other things, the bill would require the NIH to establish a lengthy COVID database and grant process to expedite clinical trials and make any subsequent treatments “affordable” so that every patient could receive them.

“The legislation we’ve introduced finally recognizes that long-standing COVID is a public health emergency,” Sanders said. “Congress must act now to ensure treatments are developed and available to Americans struggling with prolonged COVID.”

If nothing else, Sanders’ proposal could help lift the lid on long-running COVID in the country and around the world. It’s a topic that has largely been pushed into the shadows as government agencies — and public policy — tried to construct a reality where COVID in general was just no longer an important issue.

That was never the case and it certainly isn’t now. “The reality is different,” says Al-Aly. As the virus mutates into new strains and continues to affect millions, the long tail of COVID forces itself into center stage once again.


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