The Hidden Cost of Long COVID: How It Impacts Lives and the Economy

Long COVID represents more than a health concern—it is severely affecting finances and workplaces. Millions of Americans are facing challenges in returning to their jobs months post their initial infection, and the economic impact is alarming as employers and governments race to tackle this escalating issue.

For instance, a recent study led by Yale revealed that as many as 14% of 3,500 Long COVID patients surveyed in the U.S. had not resumed work three months after falling ill. (As of now, 20 million Americans have been diagnosed with Long COVID.) Additionally, researchers discovered that almost one in 10 Long COVID patients experienced five or more symptoms. These participants—comprising younger, previously healthy individuals—were twice as likely to be unable to return to work within three months compared to those free of symptoms.

“It’s a misconception to think that this data pertains only to unvaccinated individuals, older adults, or those with existing health conditions,” states Arjun Venkatesh, MD, a professor of emergency medicine at Yale School of Medicine and the study’s lead author. “Our sample is generally younger and predominantly vaccinated, yet the fact remains that they persist in experiencing extended symptoms following an acute COVID infection, which drastically affects their ability to work.”

Nonetheless, receiving the COVID-19 vaccine along with subsequent booster doses is still the optimal approach to lessen both the chances of initially contracting COVID-19 and the likelihood of developing Long COVID post-infection, Dr. Venkatesh emphasizes. He is presently conducting longer-term studies to determine if these patients ultimately return to employment even one or two years following infection.

Long COVID incurs a considerable economic burden

By hindering such a large number of people from the labor market, Long COVID exerts a substantial influence on the economy as well. A study published in Nature Medicine suggests that over 400 million individuals globally have encountered Long COVID at some point, leading to an annual worldwide economic burden of $1 trillion.

“It’s challenging to grasp what $1 trillion truly signifies,” remarks Ziyad Al-Aly, MD, head of Research and Development Service at the Veterans Affairs St. Louis Health Care System and the senior author of the study. “That’s around 1% of global GDP, which is significant. That 1% reduction in total productivity among all humans worldwide poses a meaningful hindrance to development and economic growth.”

The Organization for Economic Co-operation and Development (OECD) has provided a comparable estimate of $864 million to $1.04 trillion, even while disregarding the direct expenses related to medical attention. In 2022, research from Harvard noted the overall cost of Long COVID to be an astonishing $3.7 trillion, employing three primary factors: diminished quality of life ($2.2 trillion), lost income ($1 trillion), and additional healthcare costs ($528 billion). The loss of quality of life constitutes the largest portion of this figure as individuals struggle to find work, support their families, and engage in consumption and spending.

Long COVID also represents a considerable strain on healthcare resources. “Prior to the pandemic, we were already managing conditions such as cancer, diabetes, and others,” Dr. Al-Aly states. “Those did not disappear. Now, in addition to all that, there are 20 million Americans coping with Long COVID.”

Ultimately, an organized global research initiative aimed at Long COVID prevention and treatment is the most effective policy strategy available. “It would be a significant error not to learn from the pandemic and enhance our preparedness for the next one,” Dr. Al-Aly concludes.

Disability policymaking regarding Long COVID

At present, the U.S. Department of Health and Human Services acknowledges Long COVID as a physical or mental disability under the Americans with Disabilities Act, Section 504, and Section 1557 if the condition “substantially limits” one or more major life activities. However, the capability of hospitals and clinics to manage Long COVID cases is restricted, mainly due to an imbalance between the excessive demand for care and the availability of healthcare providers. Furthermore, the absence of consistently effective treatments and a clear grasp of Long COVID’s mechanisms leave many providers uncertain about how best to meet their patients’ needs.

“For the 20 million Americans affected by Long COVID, securing access to disability benefits and effective treatments is paramount,” states Dr. Al-Aly. “Simplifying the process and reducing waiting times to assist those in need should be the government’s priority.”

Kenny Cheng is an undergraduate specializing in molecular, cellular, and developmental biology at Yale University.

The concluding thoughts from Lisa Sanders, MD:

In earlier articles, we have discussed the medical and physical consequences of Long COVID, but this article focuses on what might be an even larger burden: the financial impact. A study published last year estimated that the pandemic may have decreased the U.S. labor force by half a million workers.

That illustrates the effect on the labor market, but the repercussions for the individuals within that labor force are far more profound. A study published last summer found that: “symptomatic SARS-CoV-2 infections may have caused over 12.9 million individuals not to return to work within three months of their illness. … Considering the unequal burden of SARS-CoV-2 infection seen among employees in public-facing sectors, such as education and healthcare, the economic effects of Long COVID may be more pronounced in specific job roles and sectors.”

Moreover, that effect persists. A report from the Federal Reserve revealed that compared to those who were not infected with COVID-19, individuals who were infected and experienced symptoms lasting more than 12 weeks afterward were 10% less likely to be employed at all, and if employed, were working 50% fewer hours.

David Cutler, an economist at Harvard who…has been investigating the financial repercussions of the pandemic, according to a recent report that concludes: “The magnitude of these expenses indicates that strategies to tackle Long COVID are critically necessary. Given such high costs, nearly any expenditure on Long COVID identification, treatment, and management would yield advantages far exceeding the expenses involved.”

The NIH evidently concurs. They have recently sanctioned an additional $147 million on top of the $515 million designated earlier this year, raising the total new funding to $662 million to bolster the Researching COVID to Enhance Recovery (RECOVER) Initiative, a comprehensive research program aimed at thoroughly understanding, diagnosing, and treating Long COVID.

Results are eagerly anticipated. At Yale’s Long COVID Care Center, we currently have just one physician and one physician associate, and due to this limited workforce, we are scheduling new patient consultations into early summer. In the interim, the most potent measure we possess in preventing Long COVID is the vaccine, which not only lessens the likelihood of contracting the virus but also diminishes the chances of developing Long COVID should you contract it.

Explore additional segments of Long COVID Dispatches here.

Should you wish to share your journey with Long COVID for possible inclusion in a future post (anonymously), please contact us at: LongCovidDispatches@yale.edu. Your submission may be featured, subject to space availability, in a forthcoming post.

The information provided in Yale Medicine content is intended for general informational purposes exclusively. It should never be considered a replacement for medical guidance from your healthcare provider or another qualified clinician. Always seek personalized advice from your healthcare provider regarding any inquiries related to a medical condition.