Long COVID can be a debilitating and life-altering repercussion of COVID-19. But between its relative newness and wide array of symptoms, it can be hard for patients and
The CDC estimates that 19% of Americans have symptoms of long COVID, while research group the Brookings Institution found that long COVID may be keeping four million Americans out of work. Yet, when health data analytics company Springbuk analyzed hundreds of thousands of employee health claims, only 1.8% had a long COVID diagnosis.
"There is a discrepancy between what is being reported and what we're actually seeing in claims," says Janet Young, lead clinical scientist at Springbuk. "And one of the biggest factors is the ambiguity that gets in the way of making a diagnosis."
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Young notes that as of October 2021, long COVID has an ICD-10 diagnosis code, which helps communicate to insurers why patients are seeking care. This should make it easier to pinpoint how many people are experiencing lingering or worsening COVID symptoms — but Young found that wasn't the case. Instead, the data revealed that long COVID is still escaping identification on a systemic level.
"Something like diabetes, we can test for depending on the level of glucose that we find in someone's blood," says Young. "But when it comes to long COVID, it's a diagnosis of exclusion. You have to determine whether some of the symptoms could be from something else."
There isn't even an agreed-upon timeframe for long COVID. The CDC claims that post-COVID symptoms can be identified as early as four weeks after infection, while the World Health Organization has that number at three months.
Young also points out that those who had fairly severe symptoms may have left the workforce altogether, limiting Springbuk's data pool. And if individuals are not seeking care to begin with, their symptoms will not be assessed. Like healthcare providers, many suffering from long COVID may not realize that their symptoms are connected to COVID.
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Fatigue, difficulty breathing, chest pain, heart palpitations, headaches, depression, anxiety and joint or muscle pain are all symptoms under long COVID, but those symptoms are not exclusive to it. On top of that, there is less nationwide COVID lab testing, with many American taking at-home tests instead. So it's become harder to track the precursor to long COVID, let alone the aftermath, explains Young.
Still, Young is confident that long COVID is and will continue to be a major challenge for employers — whether it's counted or not. Nomi Health, a healthcare services provider based in Utah, found that employer spend on long COVID was over $2,500 per employee, which is 26% higher than what employers spend on diabetes. Alongside healthcare costs comes a loss of productivity and talent. "When you don't really know how many people are suffering from long COVID, it's hard to get a handle on costs and the types of services needed," says Young.
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Young predicts tracking long COVID will not get easier in the near future and advises employers to prioritize prevention, whether that means encouraging vaccinations, masking, testing or all of the above, especially when the employer's community experiences the next wave of cases. Employers can also prepare to incur costs associated with long COVID symptoms and put the necessary benefits in place, like expanded sick leave and telehealth visits.
"It's hard to get a good handle on how many people are impacted by this," says Young. "We will have to look beyond a specific diagnosis for long COVID."
