Will 15% of Our Society Experience Long-Covid Caused Disabilities at Once?

I’ve seen predictions that, if we don’t implement policies which do much more to restrict covid transmission, we’ll face having 15-20% of people disabled by long covid, and our society can’t handle that, therefore our society will collapse.

My prediction is that having 15% of people in the United States with a long-covid disability as severe as ME/CFS at the same time has a 5% chance of happening within the next five years.

That I don’t rule out the possibility—that I think this has over 1% chance of happening—is horrifying. But I don’t think it’s the most likely scenario.

‘Long covid’ describes a range of conditions. Julia Bilek’s comment at the bottom is especially worth reading. I’ll quote her:

And then there are the people like me whose lives personal and professional lives have been seriously altered for years, but no tests really explain why. They tend to fit the ME/CFS profile – women in their 40s make up the largest demographic, whether they were hospitalized or not. Do we have long Covid? Or a variation of ME/CFS that is rightly getting attention, but isn’t categorically different? If it isn’t different, will be start to be ignored like everyone else who has had post-viral conditions that last for years or forever?

I’m biased and frustrated that there are still so few resources available for those of us in the last category. I’m sometimes angry that cases of rehabilitations lasting 3 months are being compared to the loss of agency and acumen I and so many others may never recover.

15% of people having covid symptoms last three months is different from 15% of people having ME/CFS-like conditions.

Not that covid symptoms which lasts 3+ months are something to dismiss. That takes a toll itself. Some people have difficulty eating for months because everything tastes terrible. Is that as bad as death? No. It’s still awful.

Even if current policies will lead to only 1% of people in the United States acquiring a form of long covid equivalent to ME/CFS within five years, that’s still a darn good reason to change our policies to reduce the transmission of covid. That means getting people to wear respirators, ventilation, making tests easy to obtain, mandating sick leave, etc.

I’ve had more trouble lately than I should getting PCR covid tests. Yes, I got them, and even better, I tested negative, but a health care system which was serious about cutting covid transmission wouldn’t have so many barriers. People need tests to know when they should isolate (or stop isolating).

To my surprise, some people I’m in contact find it even more difficult to get PCR tests than I do. We all get rapid antigen tests easily, but today the government will stop distributing free rapid antigen tests. (Health insurance typically covers a certain number of rapid antigen tests per month, but I don’t know how long that’s going to last, especially since some health insurance policies stopped covering the PCR tests).

I could link to various sources about the true, current prevalence of long covid… they all require caveats. Each study has limitations in the data. They all portray a different order of magnitude. I’ll just like to this piece by Eric Topol, which describes a study which found that 12.7% of adults infected with covid have symptoms persist for over 3 months because he lists some major caveats (note that many of those people in the 12.7% have something less severe than ME/CFS). He also reports progress in diagnosing long covid and treatments. Topol’s conclusion is:

I have many colleagues who have been severely affected, and have seen multiple patients in my clinic in recent weeks who are debilitated. I wish I had something to offer them, but hopefully over time we’ll build on this recent spurt of knowledge. While we have no treatment or biomarker, the CDC relaxation of Covid guidelines is totally unhelpful— staying Covid cautious is the right move, and we desperately need better tools to block infections and transmission. There’s some hope that the first completed 4,000 participant nasal vaccine randomized trial could be the start of patching up the leak of vaccines against the Omicron subvariants (currently BA.5). Prof Iwasaki and I have called for an urgent Operation Nasal Vaccine initiative. There’s only one surefire way to prevent Long Covid: not to get Covid.

The evidence I’ve seen suggests that vaccination reduces the risk of long covid, but sources disagree about the degree vaccination helps. Some say it helps a little, some day it helps a lot. The only things I can conclude are that a) vaccinations seem to offer at least a little protection against long covid and b) they don’t offer 100% protection. Shorter: vaccinations help, but aren’t enough.

I’ve found no evidence that prior infections reduce the odds of long covid for future infections. That is, if a first infection has a 10% risk of causing long covid (I made up that number as an example, it may not be the true risk) then a second infection also has a 10% risk of causing long covid.

It’s odd the vaccines would offer any protection and prior infections wouldn’t, but maybe immunity from prior infections reduces the odds of long covid and I haven’t seen measurements of the effect, or maybe covid causes damage which cancels out the benefits of immunity but vaccines don’t.

If the lower end of the range of numbers given for the prevalence of long covid of varying levels of severity are correct, it won’t cause our society to collapse, but it’s still bad enough to be worth reducing the transmission of covid. It’s a burden for the people suffering now. And as Topol says, the only surefire way to prevent long covid is to not be infected with covid.

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