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There has been a lot of reporting on the total number of COVID-19 cases and deaths in the United States. But there has been much less of a focus on what is called “long COVID,” or on COVID-19 long-haulers.

In the typical case, someone infected with COVID-19 may experience fatigue, brain fog, difficulty breathing, coughing, muscle ache, nausea, fever, or loss of taste or smell, with these symptoms resolving over several days or weeks at most. But in those with long COVID, the symptoms do not dissipate, and can become debilitating. Those with long COVID vary in the severity of their symptoms, but for some, just doing everyday tasks can be difficult to impossible. Studies have shown that as many as 1 in 4 COVID-19 patients develop some form of long-term symptoms. “None of us can predict who’s going to have persistent symptoms,” said Lekshmi Santhosh, who runs a long-COVID clinic at UC San Francisco.

Long COVID can affect anyone, but statistically those who have been vaccinated have much lower risk. A large share of COVID-19 long-haulers contracted the virus before vaccines became widely available, but it is likely that those who continue to refuse vaccination are putting themselves at risk of developing long COVID in the future. Those with compromised immune systems are also more likely to be long-haulers.

It could be years before medical researchers fully understand the dynamics of long COVID.

COVID-19 long-haulers aren’t hard to find. Outgoing Virginia Governor Ralph Northam has opened up about his long COVID symptoms. Actress Alyssa Milano has pushed for vaccinations after describing her long COVID symptoms. The good news is that vaccination has a positive effect on easing the symptoms of long COVID. There are reports that receiving the COVID-19 vaccine can lead to improvements in 30 to 40% of long COVID patients. However, this indicates that the majority of those with long COVID symptoms won’t necessarily improve after vaccination. 

A large share of those with long COVID remain without any effective treatment. Academics have begun research into what causes the condition, and the National Institutes of Health announced an initiative aimed at learning what makes specific populations vulnerable.

But it could be years before medical researchers fully understand the dynamics of long COVID or how to effectively treat it. Some predict that this could leave up to 20% of those with long COVID unable to fully return to work. This could lead to a dramatic increase in disability claims and produce additional strain on the medical system. 

Unfortunately for those with long COVID, there is no clear light at the end of the tunnel. There is a lot that the medical community doesn’t know about COVID-19 long-haulers yet, and the process of figuring out how to provide effective treatment could be lengthy. The best protection against COVID-19 remains getting the vaccine. But those with long term symptoms face uncertain futures and difficult questions.

It is entirely possible that as the long-hauler community grows, long term COVID-19 symptoms become a bigger concern for politicians. Increased funding for research into long COVID and increased disability protections could become major issues for upcoming campaigns. But that doesn’t solve today’s problems for those with long term symptoms, and that can be a frustrating experience for everyone involved.

Marcus Johnson

Marcus Johnson is a political commentator and a political science Ph.D. candidate at American University. His primary research focus is the impact of political institutions on the racial wealth gap.