Long COVID is keeping as many as 4 million people out of work

While much of the public has moved past the COVID-19 pandemic, the pandemic itself has yet to move past the public. Indeed, many of those who contracted COVID months or even years ago have since become sufferers of “long COVID” — a colloquial term for post-acute sequelae SARS-CoV-2 infection (PASC). Referring to the cluster of long-term symptoms that often persist even after the initial COVID-19 infection has passed, as many as 20% of those who contract COVID-19 will end up with long COVID symptoms. 

While much research has fixated on the causes and treatments for the range of symptoms that typify long COVID, there has been less research into the economic effects — as measured by the number of people out of the workforce due to their chronic illness. Now, a recent study from the Brookings Institute reveals that long COVID’s legacy is measurable in dollar signs as well as literal human suffering.

According to the report, roughly 2 to 4 million Americans are currently out of work because they have long COVID. This is only a fraction of the total estimated number of the working age (18 to 65) Americans with long COVID (roughly 16.3 million), but monetarily it adds up: The Brookings Institute estimates that, in lost wages alone, the annual cost ranges from $170 billion to $230 billion. If the lost earnings are calculated at the low end, that still equals roughly one percent of America’s gross domestic product (GDP). The Federal Reserve of St. Louis estimates that the American workforce consisted of 164.5 million people immediately prior to the pandemic in 2020; 4 million Americans removed from the workforce would represent 2.4% of that number.

The Brookings Institute report also includes proposed solutions, suggesting at least five policy solutions the government can introduce to “reduce the economic burden of long COVID.” These include expanding paid sick leave, broadening access to disability insurance, improving prevention and treatment options, improving workplace accommodations and gathering more data on the long-term economic effects of long COVID.

“There is a wide range of symptoms that long COVID patients experience,” Katie Bach, a nonresident senior fellow at Brookings and author of the report, told Salon by email. “Some of the more common ones that I have heard can interfere with work are: brain fog (memory problems, trouble concentrating, trouble finding words); headaches; extreme fatigue; orthostatic intolerance (dizziness / significantly elevated heartrate / other symptoms when upright); difficulty breathing / shortness of breath; joint / muscle pain; worsening of symptoms with mental / physical exertion, and more.”

Bach added, “That last point is really important: a lot of long COVID patients get worse if they don’t rest. That makes it really hard to work.”

---

Want more health and science stories in your inbox? Subscribe to Salon’s weekly newsletter The Vulgar Scientist.

---

Salon reached out to economists for their views on the Brookings report. While neither of them challenged the accuracy or integrity of the data itself, they also expressed concerns that the policy recommendations and underlying economic diagnosis do not go far enough.

“These policy recommendations seem good but could go further,” Dr. Gabriel Mathy, associate professor of economics at American University, told Salon by email. “We need to move to a system of universal, affordable health care so that Americans don’t delay treatment until problems like COVID get worse and turn into long COVID.”

Dr. Richard Wolff, professor emeritus of economics at the University of Massachusetts–Amherst, echoed Mathy’s observations.

“There is a structural problem and, in very typical fashion, the Brookings Institute dances around the edges of what is the key structural issue because it has to do with capitalism and its basic structure,” Wolff told Salon. After arguing that a substantive criticism of capitalism itself would be “taboo” for the liberal Brookings Institute, Wolff explained that “when you’re dealing with a basically threatening socially threatening disease like COVID-19, you need to be able to stop think through how you can best treat the threat and the illness. In the United States, the structure of our society prevents that.”

The reason for this, Wolff pointed out, is that “large corporations and the very wealthy amongst us are willing, able and do in fact allocate very large resources to shaping those policy decisions” that impact ordinary people’s lives during a crisis like a pandemic. Because America’s health care system is primarily oriented toward maximizing profit for the wealthiest class of citizens, the influential corporations insisted on keeping the economy going, systematically refused to close their operations because they would lose money by doing so, and “sabotaged the effort” to get Americans through the pandemic in the best shape possible by “ignoring the government policies that were relevant whenever it was suitable to them to do.” He contrasted America’s pandemic response to that of China, which has avoided many of the problems with issues like long COVID that currently afflict the United States.

“Their response was not to allow the business interests to ‘keep the economy going’ and to have the kind of outsized influence on the outcome,” Wolff pointed out. “They shut places down, including the businesses where they felt it was necessary.”

As Mathy noted, the economic inequality issues that caused America to bungle its response to the pandemic are also likely to plague long COVID victims for the foreseeable future.

“The same economic inequities that drove COVID exposure are causing the same disadvantaged people to lack access to medical care,” Mathy pointed out. “Long COVID will cause a decline in productivity relative to a world without COVID, and so will represent a real cost to both those affected and the American economy as a whole.”

Going forward, more research will need to occur to quantify and track the impact that long COVID has on the economy.

“I would love to see long COVID questions added to the current population survey (CPS), which is the US’s primary source of employment data,” Bach wrote to Salon. She also expressed hope that “beyond additional data, I would like to see case studies of effective employer accommodations, industry-specific breakdowns of impact, studies of impact on household finances of impacted patients, an assessment of the caregiving burden of long COVID, and more.”