Some 6.8% of American adults are currently experiencing long Covid symptoms, according to a new survey from the US Centers for Disease Control and Prevention (CDC), revealing an “alarming” increase in recent months even as the health agency relaxes Covid isolation recommendations, experts say.
Estimates suggest that 17.6 million Americans could now be living with long-term Covid.
“This should be setting off alarms for many people,” said David Putrino, the Nash Family Director of the Cohen Center for Recovery From Complex Chronic Illness at Mount Sinai. “We’re really starting to see issues emerging faster than I expected.”
During the October survey, there were 5.3% of respondents who were experiencing long Covid symptoms.
The increase of 1.5 percentage points is a result of the second-biggest surge in infections across the US this winter, measured by available wastewater data.
More than three-quarters of the people with long Covid right now say the illness limits their day-to-day activity, and about one in five say it significantly affects their activities – an estimated 3.8 million Americans who are now experiencing debilitating illness after Covid infection.
A new study found that thousands of people in the UK may not be working because of COVID-19. The pandemic has caused Americans to miss work at a higher rate.
The rate of adults currently experiencing long Covid has not been this high since November 2022; the greatest height since CDC began tracking the illness was 7.6% in June and July 2022.
The “estimates represent just a snapshot in time”, making it difficult to identify the role of different factors like recent surges, vaccination rates, new variants and survey methods, said Dave Daigle, a spokesperson for the CDC.
The most recent Household Pulse survey took place between January 9th and February 5th, and asked respondents if their Covid symptoms were currently lasting three months or more. The rate could increase in the coming months despite the winter peak, as long Covid symptoms appear or linger after infection.
At the end of this month, the next survey results are expected.
According to US health agencies, long Covid is defined as symptoms that last four weeks or longer, therefore, the rate by that definition might be even higher than reported in this survey.
There are notable differences across geography, with the highest rates reported in North Dakota, Kentucky, West Virginia, Alaska, and Maine, and the lowest rates reported in Hawaii, Pennsylvania, and Wyoming.
A total of 17.6% of American adults have ever experienced long-term COVID-19 symptoms, according to the survey.
Although children are not included in the CDC survey, they also experience long Covid, including fatigue, brain fog and headaches, as well as serious respiratory and cardiovascular issues, such as myocarditis, studies show.
The rise in long Covid cases is particularly worrisome because “we still don’t know all of the things that long Covid does, how it does it, and why,” said Lara Jirmanus, a clinical instructor at Harvard Medical School and a member of the People’s CDC.
Ignoring Covid cases now is “hubris that almost assumes that we can see the future”, Jirmanus said. “Nobody knows what long Covid will do five years from now. I don’t think it’s wise to throw all caution to the wind.”
The survey results were released on February 22nd, more than a week before the CDC updated its Covid isolation recommendations. The CDC says in that guidance that the prevalence of long-term Covid appears to be decreasing, in contrast to its own survey findings.
The advice from the agency to leave isolation after symptoms have begun improving flies in the face of scientific evidence and will probably lead to more spread of the virus and more cases of long Covid, experts said.
“It’s very irresponsible advice, and it just doesn’t follow the science. And it’s a shame because we rely on public officials and we rely on government officials to interpret and present science to us – that’s their job. And right now, they’re failing in their responsibility to us,” said Putrino.
While vaccines help reduce the risk of developing long Covid, the best way to prevent it is by avoiding Covid, Putrino said – especially since repeat infections raise the likelihood of prolonged illness. “Every time you get a Covid infection, you place yourself at higher risk of going on to develop long Covid.”
Those who already have long-term Covid may experience a resurgence or worsening of symptoms with new infections. One study found that 80% of patients reported that their symptoms became more severe with reinfection.
There is no cure for long-lasting Covid, and funding for research on treatments and medications has been slow to materialize.
Putrino said he expects long Covid rates to rise and fall with each surge, but the baseline rate may increase over time, which can have immense repercussions for Americans’ health and wellbeing.
“All of these cases that are occurring with no protection from the government and no guidance from the government on infection prevention – it’s taking its toll,” Putrino said.
It is not yet clear whether the increase in long-term Covid sufferers has an upper limit or if cases will continue to increase indefinitely.
“It’s very troubling to me that those risks are not being shared with the public,” he continued. “Allow people to make their own decisions, but give them all the information to make their own decisions.”
Time to stop using term ‘long Covid’ as symptoms no worse than those after flu, Queensland’s chief health officer says
Long Covid may be no different from other post-viral syndromes such as those experienced after flu, according to new research from Queensland Health.
The lead author of the study, the state’s chief health officer Dr John Gerrard, said it was “time to stop using terms like ‘long Covid’” because they imply there is something unique about the longer-term symptoms associated with the virus, and in some cases create hypervigilance.
There are different definitions of long Covid but the World Health Organization defines post-Covid or long Covid as occurring in people still experiencing symptoms three months after their initial Covid-19 infection, when those symptoms can’t be explained by an alternative diagnosis.
The study surveyed 5,112 adults who had symptoms of respiratory illness and underwent PCR testing between May and June 2022. Of those, 2,399 were positive for Covid-19, 995 positive for influenza and 1,718 negative for both.
A year after their PCR test, participants were asked about ongoing symptoms and impairment using a questionnaire delivered via SMS link.
Overall, 16% reported ongoing symptoms a year later, and 3.6% reported moderate-to-severe impairment in their daily activities.
The results of the study, which Gerrard will present next month at the European Congress of Clinical Microbiology and Infectious Diseases in Barcelona, found no evidence that those who had Covid-19 were more likely to have functional limitations a year on compared with those who did not have Covid-19 (3.0% v 4.1%).
The 3% of the study participants who had ongoing impairments after Covid-19 infection was similar to the 3.4% who had ongoing impairments after influenza.
The study also looked at specific symptoms in the patients who had moderate to severe impairment, and found in both patients who were Covid positive and negative, the same percentage (94%) reported one or more of the commonly reported symptoms of long Covid: fatigue, post exertional symptom exacerbation, brain fog and changes to taste and smell.
Gerrard said long Covid may have appeared to be a distinct and severe illness because of the high number of people infected with Covid-19 within a short period of time, rather than the severity of long Covid symptoms.
“We believe it is time to stop using terms like ‘long Covid’. They wrongly imply there is something unique and exceptional about longer-term symptoms associated with this virus. This terminology can cause unnecessary fear, and in some cases, hypervigilance to longer symptoms that can impede recovery.”
In a press conference on Friday, Gerrard said: “I want to make it clear that the symptoms that some patients described after having Covid-19 are real, and we believe they are real. What we are saying is that the incidence of these symptoms is no greater in Covid-19 than it is with other respiratory viruses, and that to use this term ‘long Covid’ is misleading and I believe harmful.”
The researchers acknowledged that the findings are associations and do not represent prevalence, and acknowledged limitations in that participants who attended hospital or had pre-existing illness were not identifiable. They also said that because 90% of people in Queensland were vaccinated when Omicron emerged, the lower severity of long Covid could be due to vaccination and the variant.
Prof Philip Britton, a paediatric infectious diseases physician from the University of Sydney and a member of the Long Covid Australia Collaboration, welcomed the study given the lack of published research from Australia in this area.
However, Britton said the conclusion that it was time to stop using terms such as long Covid was “overstated and potentially unhelpful. Long Covid has been a global phenomenon, recognised by WHO.”
Prof Jeremy Nicholson, the director of the Australian National Phenome Centre at Murdoch University, said the question of whether long Covid is unique “cannot be simply answered in this work”.
“The study is observational, based on reported symptoms with no physiological or detailed functional follow-up data. Without laboratory pathophysiological assessment of individual patients, it is impossible to say that this is indistinguishable from flu-related or any other post-viral syndrome, as Nicholson said.
