While scientists and health experts still do not understand the full extent of long Covid, the condition is estimated to affect millions of Americans, placing a heavy burden on patients as well as the U.S. economy, as well as insurers and life sciences companies.

Case study: Recovery clinics for Covid-19 long-haulers

Long Covid's impact on the economy

In an analysis of Veterans Health Administration patient records, researchers concluded that an estimated 4% to 7% of patients who have been infected with the coronavirus also developed long Covid. While more recent studies suggest the proportion may be higher, that percentage of the total population infected by the virus places the number of individuals with long Covid in the millions.

Ziyad Al-Aly, chief of research and development at the VA St. Louis Health Care System and a clinical epidemiologist at Washington University, who led the research, estimated that people who have been infected with the virus have a 40% higher chance of developing diabetes than those who have not been infected.

According to recent research, the estimated direct medical cost to treat Type 2 diabetes and diabetes complications in men aged 45 to 54 is $106,200 over the course of a lifetime. If the number of people with Type 2 diabetes increases, the U.S. economy could be met with billions in additional health care costs.

In addition to direct health care costs, many with long Covid could be unable to work due to the condition's debilitating symptoms.

Lauren Nicholas, an economist at the Colorado School of Public Health, warned that some long Covid patients waiting for their condition to improve might not yet consider themselves candidates for disability programs.

However, claims and insurance losses can increase with unemployment, which could result in an increase in public and private insurance claims during an economic downturn.

A June Census Bureau survey found that just 61% of adults who said they experienced Covid symptoms for more than three months were meeting their needs with their regular source of income, compared with 67% for the rest of the population.

Among respondents who said they experienced long Covid symptoms, 30% said they were relying on their savings or selling possessions to meet their needs, compared with 23% among other adults.

Long Covid's impact on insurers

With millions likely suffering from long Covid and millions more cases, insurers are questioning what the future mortality and disability risk profile of the population will look like.

"We are at an inflection point, and exactly where risk goes isn't yet clear," said Stuart Silverman, a principal and consulting actuary at Milliman, which works with insurance companies.

Since the start of the pandemic, Covid-19 has had a far-reaching impact on life, disability, and insurers beyond deaths.

For instance, Brian Schneider, senior director for insurance at Fitch Ratings, estimated that roughly 10% of all workers' compensation claims in 2020 were related to Covid-19. While many claims were filed to recover lost wages, others were filed to help cover extended medical treatments.

In a study of thousands of claims by the Workers' Compensation Insurance Rating Bureau of California (WCIRB), researchers found that around 11% of claims for mild Covid-19 infections also involved workers who received medical treatments for long Covid symptoms within four months of receiving acute care. Notably, that figure increased to around 36% and 40% for severe and critical cases, respectively.

"The potential long-term cost impacts of long Covid on healthcare systems and disability insurance programs are also increasingly concerning," WCIRB said.

Will we see a treatment soon?

Ultimately, finding a treatment for long Covid has proven to be more difficult than developing an initial Covid-19 vaccine.

Like other post-viral disorders, long Covid is characterized by a variety of symptoms. It can cause neurological issues like brain fog for some, and digestive symptoms for others. In addition, studies suggest that some long Covid patients develop blood clots, strokes, diabetes, and kidney damage.

Steven Deeks, an HIV expert who is studying long Covid at the University of California, San Francisco, said representatives at life sciences companies tell him that, "no one knows how to define [long Covid], so no one wants to invest $1 billion in a Phase III program" for potential treatments.

Currently, scientists are still collecting data and studying long Covid in laboratories to gain a better understanding of the condition. According to Jeremy Levin, a former executive at Bristol-Myers Squibb and Teva Pharmaceuticals, pharmaceutical companies need more time to determine the best way to effectively target long Covid.

"It's not that the industry doesn't want to get in; it's just that the data hasn't played out, yet. And until you can have more clear targets, you don't have a measurable outcome," Levin said. (Lahart, Wall Street Journal, 7/8; Wainer, Wall Street Journal, 7/11; Demos, Wall Street Journal, 7/11)