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BloombergBusinessweek November 16, 2020PREVIOUSSPREAD,CLOCKWISEFROMTOP:PHOTOGRAPHBYJOHNATHONKELSOFORBLOOMBERGBUSINESSWEEK.PHOTOGRAPHBYLAURAPANNACKFORBLOOMBERGBUSINESSWEEK.PHOTOGRAPHBYJESSICALEEFORBLOOMBERGBUSINESSWEEK.PHOTOGRAPHBYNADEGEMAZARSFORBLOOMBERGBUSINESSWEEK.PHOTOGRAPHBYCLAUDIAGORIFORBLOOMBERGBUSINESSWEEK.PHOTOGRAPHBYASHUTOSHSHAKTANFORBLOOMBERGBUSINESSWEEK.THISSPREAD:PHOTOGRAPHBY
LAURAPANNACKFORBLOOMBERGBUSINESSWEEKEight months and more
than 50 million docu-
mentedcasesintothepan-
demic, there’sstill much
wedon’tunderstandabout
SARS-CoV-2.We do know
thatthemajorityofthose
infected with the novel
coronavirusdisplaynoor
mildsymptoms.Worryingly,
a not-insignificantportionof
the 20 millionpeopleglob-
allywho’verecoveredsuffer
lingeringeffects,including
lung,heart,andnervoussys-
temimpairment.
Researchersarecollect-
ing patientdata to deter-
minethedurationanddepth
ofthehealthconsequences.
Meantime, post-Covid-19
clinicsareopeningtocater
toanexpandingpopulation
of so-called long haulers
(survivorsleftwithscarred
lungs,chronicheartdam-
age,post-viralfatigue,and
otherpersistent,debilitat-
ingconditions),a signthat
enduringdisabilitywillper-
hapsweighonhealthsys-
tems and the laborforce
longaftera vaccinebecomes
widelyavailable.
The phenomenon of
what’s known as “long
Covid”isn’tunique; post-
viralsyndromesoccurafter
many infections, includ-
ingwiththecommoncold,
influenza, and Epstein-
Barr. What’s novel about
SARS-CoV-2 is the broad
spectrum of symptoms
thatarebeingreportedand
the duration of months,
notweeks.Thelong-term,
multiorgan effects may pro-
long the pandemic’s eco-
nomic legacy, adding to its
unprecedented global cost—
predicted by Australian
National University schol-
ars to reach as much as
$35.3 trillion through 2025.“BecauseCovid-19is a newdisease,
muchabouttheclinicalcourseremains
uncertain—in particular, the possi-
blelong-termhealthconsequences,if
any,”CarlosdelRio,executiveassoci-
atedeanatEmoryUniversitySchool
of Medicine, and colleagueswrote
inanOct.5 paperintheJournalof
the American Medical Association
thatrevieweditspersistenteffects.
Multidisciplinarycareandthoughtfully
integratedresearchareneeded“tomit-
igatetheadversephysicalandmental
healtheffectsamonghundredsofthou-
sands,if notmillions,ofpeoplewho
recoverfromCovid-19,”thereportsaid.
Although it’sunclear howmany
Covidsurvivorsbecomelonghaulers,
a studyunderwayintheU.K.with
morethan4 millionparticipantshas
foundthat1 in 10 peopleissickforat
leastfourweeks.Surprisingly,people
withmildcasesofthediseasearemore
likelytohavea varietyof“strange”
symptomsthatcomeandgoovera lon-
gerperiod,accordingtoTimSpector,
professorofgeneticepidemiologyat
King’sCollegeLondon,who’sleading
thestudy.
King’sCollegeresearcherssaytheir
datasuggestthat,ofthoseaffectedby
thefirstwaveofthevirusintheU.K.,
300,000peoplewouldhavehadCovid
symptomsfora monthand60,000
forthree monthsormore. “Thisis
theothersideofCovid:thelonghaul-
ersthatcouldturnouttobea bigger
public-health problem thanexcess
deaths from Covid-19,whichmainly
affect the susceptibleelderly,”Spector
wrote in the forewordofan Oct. 5
report about thephenomenonforthe
Tony Blair InstituteforGlobalChange.
The dearth ofpatientfollow-upand
incomplete dataonthenumberofpeo-
ple afflicted by Covid-19makeit difficult
to predict the pandemic’slong-term
health and economicconsequences,
says Christopher Murray, director
of the Institute for Health Metrics
and Evaluation attheUniversityof
Washington inSeattle.Murray,who
plans to study theimpactofpost-Covid
disease as part oftheglobalburdenof
disease researchhe’sbeenconductingforalmost 30 years,saysthere’salready enough
informationtosuggest“it’sappreciable.”
Thatinformationwillbecriticalfor antici-
pating andfundingfuturehealth-care needs,
saysThomasFileJr.,presidentoftheInfectious
DiseasesSocietyofAmerica,whopredicts the
pandemicwillleave“asignificantburden on our
health-caresystemforyearstocome.”
Theeconomicimpactwillbemuchgreaterif
youngersurvivorsenduredecadesofcoronavirus-
relateddisability,saysOlgaJonas,a former eco-
nomicadviserattheWorldBankwhostudies the
impactofcontagionsatHarvard.Polio would
haveledtoanestimated$215billionintreatment
costsintheU.S.from 1955 to 2015 hadvaccines
notbecomewidelyavailable,a 2006study found.
There’s been little recognition so far of
Covid-19’s illeffects onyoungeradults, says
Hannah Wei, a 30-year-old long hauler in
Canada,who helpsconductresearch on the
diseaseforBodyPolitic,anonlineCovid sur-
vivorsupportgroup.Ananalysisofresponses
from 640 patientscollectedbythegroup,which
includesscientists,inAprilandMayfound “recov-
eryis volatile,includesrelapses,andcan take six
ormoreweeks.”
Althoughallrespondentsexperienced symp-
tomsconsistentwithCovid-19,48%were either
deniedtestingornottestedforanother reason.
Thatcanmakeobtainingfinancialassistance for
rehabilitationanddisabilityservicesmore diffi-
cult,saysWei,whofoundpeopleherage weren’t
diagnosedearlyinthepandemic,when scarce
testing resources were prioritizedfor older
patientswithtypicallymoreseriousillness.
Inrecentmonths,studieshaveshown younger
patientsmaynotonlysustainorgandamage but
alsobeoblivioustotheneedtotakesteps to pre-
ventfurtherharm.A smallstudyinSeptember
foundsignsofmyocarditis,a potentiallyfatal
inflammationoftheheartmuscle,in4 of 26 col-
legeathletes,includingin2 whosecoronavirus
infectioncausednoobvioussymptoms.
Evenifcasesof longCovidare identified,
there’s still no guarantee the economic
consequenceswill beadequatelyquantified,
says JanetCurrie, aneconomicsprofessor at
Princeton, notingthat employment surveys
favoredbyeconomistsdon’troutinelyask if peo-
plehavedisabilities.
Inthefollowingpages,youwillhear from
Wei andfive otherlong haulersabout what
it’sbeenliketolivewiththismystifying condi-
tion.Interviewshavebeeneditedforlength and
clarity. �With Suzi Ring and Lisa DuTHE NEW ECONOMY