Long COVID Keeps People Out of Work and Hurts the Economy
Long COVID isn’t just a health issue—it’s hitting wallets and workplaces hard. Millions of Americans are struggling to return to work months after their initial infection, and the economic toll is staggering as governments and employers scramble to address this growing challenge.
For example, a recent Yale-led study found that up to 14% of 3,500 Long COVID patients surveyed in the US had not returned to work three months after getting sick. (To date, 20 million Americans have been diagnosed with Long COVID.) The research team also found that nearly one in 10 Long COVID patients suffered from five or more symptoms. These participants—which included young, previously healthy individuals—were twice as likely to be unable to return to work within three months compared to those without symptoms.
“It’s a myth to assume this data reflects issues limited to unvaccinated individuals, retiring adults, or people with pre-existing medical conditions,” says Arjun Venkatesh, MD, professor of emergency medicine at Yale School of Medicine and the primary author of the study. “Our cohort tends to be younger and highly vaccinated, yet the reality is that they continue to have prolonged symptoms after an acute COVID infection, which significantly affects their ability to work.”
However, getting the COVID-19 vaccine and subsequent booster shots is still the best way to reduce both the likelihood of getting COVID-19 in the first place but also the risk of developing Long COVID after infection, Dr. Venkatesh adds. He is currently conducting longer-term analyses to see if these patients eventually return to work even one or two years after infection.
Long COVID has a substantial economic cost
By keeping so many people out of the workforce, Long COVID has a significant impact on the economy, too. Research published in Nature Medicine estimates that over 400 million people worldwide have developed Long COVID at some point, resulting in an annual global economic cost of $1 trillion.
“It’s difficult to conceptualize what $1 trillion really means,” says Ziyad Al-Aly, MD, chief of Research and Development Service at Veterans Affairs St. Louis Health Care System and the study’s senior author. “It’s about 1% of the global GDP and that’s significant. That 1% loss of the total productivity of all humans around the world is a significant drag on progress and economic expansion.”
The Organization for Economic Co-operation and Development (OECD) has provided a similar estimate of $864 million to $1.04 trillion, even when excluding the direct costs of medical care. Back in 2022, research from Harvard estimated the total cost of Long COVID at a staggering $3.7 trillion, using three key parameters: lost quality of life ($2.2 trillion), lost earnings ($1 trillion), and additional medical expenses ($528 billion). Lost quality of life represents the largest share of this estimate as individuals struggle to work, support their families, and participate in consumption and spending.
Long COVID also presents a significant drain on healthcare resources. “Before the pandemic, we were already managing diseases like cancer, diabetes, and others,” says Dr. Al-Aly. “Those did not go away. Now, on top of all that, there are 20 million Americans who have Long COVID.”
Ultimately, a coordinated global research agenda focused on Long COVID prevention and treatment is the best policy measure available. “It would be a huge mistake to not learn from the pandemic and optimize our preparedness for the next pandemic,” says Dr. Al-Aly.
Disability policymaking for Long COVID
Currently, the U.S. Department of Health and Human Services recognizes 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 capacity of hospitals and health clinics to treat Long COVID is limited, primarily due to a mismatch between the overwhelming demand for care and the supply of healthcare providers. Additionally, the lack of reliably effective treatments and no clear understanding of Long COVID’s mechanisms leave many providers unsure of how to best address patients’ needs.
“For the 20 million Americans who are impacted by Long COVID, gaining access to disability benefits and an effective treatment is the most important,” says Dr. Al-Aly. “Streamlining the process and decreasing wait times to support the people who need it should remain the government’s focus.”
Kenny Cheng is an undergraduate majoring in molecular, cellular, and developmental biology at Yale University.
The last word from Lisa Sanders, MD:
In previous posts, we have addressed the medical and physical toll of Long COVID, but this post addresses what may be an even greater burden: the economic toll. A study published last year estimated that the pandemic may have reduced the U.S. labor force by half a million people.
That’s the effect on the labor force, but the impact on the individuals who made up that labor force is much greater. A study published last summer concluded that: “symptomatic SARS-CoV-2 infection may have contributed to over 12.9 million individuals not returning to work within three months of infection. … Given the disproportionate burden of SARS-CoV-2 infection observed among workers in public-facing industries, such as education and healthcare, the economic impacts of Long COVID may be more concentrated in select occupations and economic sectors.”
And that impact is ongoing. A report by the Federal Reserve found that compared with people who were not infected with COVID-19, those who were and who had symptoms lasting more than 12 weeks after viral exposure were 10% less likely to be employed at all, and, if employed, worked 50% fewer hours.
David Cutler, an economist at Harvard who has been examining the economic impact of the pandemic, concludes a recent report thus: “The enormity of these costs implies that policies to address Long COVID are urgently needed. With costs this high, virtually any amount spent on Long COVID detection, treatment, and control would result in benefits far above what it costs.”
The NIH clearly agrees. They recently approved an additional $147 million to the $515 million allocated earlier this year, bringing total new funding to $662 million to further support the Researching COVID to Enhance Recovery (RECOVER) Initiative, a nationwide research program to fully understand, diagnose, and treat Long COVID.
Results can’t come soon enough. At Yale’s Long COVID Care Center, we have but a single physician and physician associate, and because of this modest staffing, we are scheduling new patient appointments into the early summer. In the meantime, the most effective tool we have in preventing Long COVID is the vaccine, which both reduces the likelihood of getting the infection and reduces the odds of getting Long COVID if you do.
Read other installments of Long COVID Dispatches here.
If you’d like to share your experience with Long COVID for possible use in a future post (under a pseudonym), write to us at: LongCovidDispatches@yale.edu. It may appear, space permitting, in a future post.
Information provided in Yale Medicine content is for general informational purposes only. It should never be used as a substitute for medical advice from your doctor or other qualified clinician. Always seek the individual advice of your health care provider for any questions you have regarding a medical condition.
