Long COVID Shows the Need for Public Health Infection Control Policies

The risk of permanent disability from long COVID and the continuous emergence of new COVID-19 variants show that rather than only rely on vaccines and anti-viral drugs, America should invest in public health and re-impose of infection control protocols to contain a virus that has caused over one million US deaths. Many journalists and pundits have recently downplayed the dangers of COVID-19. With vaccines and anti-viral drugs, they say, the worst of a pandemic is behind us. Vocal extremist anti-vaccine and anti-masking proponents has led to the unraveling of infection control policies now deemed politically unfeasible. But it is the status-quo of unchecked disease spread that cannot be sustained.

Policies, such as masking, social distancing, mandatory vaccinations, temperature checks, early detection of illness, and enforcement of quarantine and isolation orders, are standard evidence based public health practices used to contain infectious respiratory diseases. But the blocking of additional federal COVID-19 funding, including free testing for the uninsured, the rollback of indoor mask and vaccine mandates, and the lack of paid sick time to incentivize adherence to quarantine and isolation orders has sabotaged the ability of public health officials to contain COVID-19. Despite vaccines and anti-viral drugs, the danger poised to Americans by long COVID is too great to underestimate. Millions of Americans are suffering from the debilitating effects of long COVID—a condition scientists still do not fully understand.

Recent studies suggest that over 50% of COVID-19 survivors experience one or more symptoms of long COVID, including abnormal breathing, fatigue, chest and throat pain, abdominal symptoms, cognitive issues such as brain fog, and anxiety and depression. With a large percentage of Americans contracting COVID, and wave after wave of the virus exposing citizens to the risk of reinfection, the issue of long-term illness and disability from COVID-19 has raised alarm. According to a study from the Centers for Disease Control of 300,000 COVID survivors, one in four developed symptoms of long COVID, including crushing fatigue, musculoskeletal pain, heart problems, kidney failure, blood clots and diabetes. Of 80 million COVID cases, it was estimated that 15 million Americans have developed one or more symptoms of Long COVID. The annual economic impact is estimated at over two trillion dollars. According to one study, the impact of long COVID includes social and family-life impairment, long absence periods off work, adjusted workloads, and loss of employment.

The United States has pioneered medical interventions to reduce COVID-19 mortality. In 2021, America mobilized to distribute vaccines. In 2022 anti-viral drugs such as Paxlovid, taken within the first five days of developing symptoms to avoid hospitalization and severe illness, became available.

But in the nation with the highest prevalence of COVID-19 in the world, the lack of a coordinated public health response and extremist backlash to evidenced based science has sabotaged efforts at infection control. Rather than put people over profits, the nation has rejected any effort to regulate business, or restrict individual action. Masking, social distancing, temperature and vaccine checks at restaurants and bars, and paid sick time to incentivize adherence to isolation and quarantine orders have been rolled back and discarded. The CDC changed its metrics for determining high medium and low rates of contagion to focus on health system capacity rather than rates of disease. But surrendering to endemic COVID will continue to have a high cost. The continued impact of wave after wave of COVID-19 and the risk of long-term disability necessitates a renewed push towards evidenced based public health infection control measures and the need for enhanced funding for local and state public health departments.

Together we can do better and safeguard the lives of Americans. But it will take continued advocacy to counter complacency, pandemic fatigue, and conspiracy theories that threaten the public health and wellbeing.