Covid’s chronic effects loom increasingly large

A fresh wave of Covid-19 is deluging much of the world this month, fuelled by the rapid takeover of the latest iteration of Omicron. This marks the third substantial wave from the variant’s offshoots in seven months, since it ushered in a new chapter of the pandemic late last year.

Considering the sheer volume of these infections — at the height of the UK’s March wave, one in 13 people had Covid, four times the peak of the grim winter of 2020 — it is remarkable that the number of Covid patients in hospital this year has never climbed above half its winter 2020 levels. The number of deaths attributable to the disease has climbed to barely a sixth of past highs.

This attenuation of severe disease, seen globally, has been hard-won, chiefly through the biggest vaccination programme in history, but also increasingly through hundreds of millions of accumulated infections. The result is that being infected with Covid now carries roughly 30 times less risk of hospitalisation than it did two years ago, and 60 times less risk of death.

Unsurprisingly, this has transformed our relationship with the virus, with governments and citizens alike taking an increasingly relaxed stance to mitigation and many aspects of life returning to pre-pandemic norms. But while the acute risks of an encounter with Covid may have waned, the virus is still causing profound disruption to the health of millions, with repercussions for society.

The chief concern is now long Covid. This condition frequently draws sceptical responses due to its oft-changing clinical definition and the difficulties in teasing it apart from other underlying health issues, but there is mounting evidence of a very real phenomenon.

In the UK, the ONS’s flagship Covid infection survey estimates that 2mn people — roughly three per cent of the population — were suffering from long Covid as of early May 2022. The self-reported nature of this headline figure means it should be treated with caution, but the numbers become more solid when one digs beneath the surface.

Of those people, 1.4mn say ongoing symptoms are limiting their daily activities — a well-established method for tracking population-level health trends. And perhaps most importantly, that figure has doubled in the last year, tracking the cumulative incidence of Covid infections.

Unless something else has been causing extended periods of fatigue, shortness of breath and difficulty concentrating to rise in lockstep with Covid’s spread, it is reasonable to conclude that between 700,000 — the number who were not reporting these symptoms when the survey began, but now are — and 1.4mn people are currently living diminished lives as a result of the virus.

Given most Britons have now had at least one infection, this figure of somewhere between one and two per cent of the population would indicate that around one in 40 to 80 of those infected may develop ongoing symptoms that affect their daily life.

If an uptick in self-reported brain fog still doesn’t pass muster for you, then perhaps an uptick in self-reported dropping out of the workforce might. The above trends are echoed by labour market data on both sides of the Atlantic, which show marked increases in the number of people either absent from work, cutting their hours or exiting the labour force entirely due to ill health.

In the UK, 1.8mn people were out of work and not looking for a job due to illness in the three months ending April 2022, up by 269,000 or 17 per cent since the start of the pandemic. In the US, 1.35mn people were absent from work due to illness in May 2022, up 44 per cent on the pre-pandemic average for the same month, while 2.2mn had shifted from full-time to part-time work due to illness, a 37 per cent rise. The number outside the labour force who have a disability has jumped by 800,000 since the pandemic began, accounting for one-fifth of the 4mn labour force dropouts over this period.

With new rounds of vaccines on the horizon, the direction of travel is still positive. But for the time being at least, it’s clear that living with Covid will be a bumpy ride.

[email protected], @jburnmurdoch