Long Covid (Part 1)
“The debate so far on the long-term sick is attributing it to mental health and musculoskeletal disorders, but there is hardly any mention of Long Covid. It is the illness that dare not be spoken of.”
Since last year, the ONS surveys have shown large numbers of people being out of the workforce due to long-term illness. As of March last year, almost 2 million people were diagnosed with Long Covid, but then for some mysterious reason, the government decided to stop compiling data on Long Covid cases. There is about to be a Winter Infection Survey report released today (25 April) where, according to some Long Covid support groups, stats on updated Long Covid cases will hopefully be revealed. The debate so far on the long-term sick is attributing it to mental health and musculoskeletal disorders, but there is hardly any mention of Long Covid. It is the illness that dare not be spoken of. The reason is that if the real impact is revealed, the public will become aware of how much they have been thrown to the lions, or in this case the virus, with no mitigations to protect them as part of the so-called “living with Covid” strategy. Apart from the level of suffering caused by ill health, there is a real economic impact. This was analysed by Cambridge Econometrics in a major hard-hitting report issued in March this year.
Costs for the NHS and healthcare system
The Cambridge Econometrics report highlights the significant costs that Long Covid poses for the NHS and the healthcare system. Based on UK employment trends, the analysis suggests a need for some 46,300 public healthcare workers to support Long Covid treatment. If government expenditures do not increase to accommodate this, then one possible outcome is that spending and staffing for other public services may have to fall. The UK health system is, however, already under strain. Another possibility is that health expenditures relating to Long Covid lead to further reductions in elective care, in the form of longer waiting lists and a reduced service. Either situation would be exacerbated by higher future prevalence and there are policy choices to be made in this regard. The analysis also does not consider the possibility of resorting to private care, which would further raise the monetary cost on people and their families.
“Based on UK employment trends, the analysis suggests a need for some 46,300 public healthcare workers to support Long Covid treatment.”
Sectoral Employment Impacts
The trend in economic inactivity of the 1.9 million people with Long Covid in the UK and the cost of treating the condition could lead to around 138,000 fewer jobs by 2030. The health needs of those with Long Covid could also lead to greater demand for healthcare workers, by as many as 46,300 by 2030.
The sectoral employment effects reflect both the pattern of Long Covid infections across sectors and the composition of the UK economy, with almost 80% of job losses in service sectors especially affecting sectors such as IT, legal and accounting, architecture, and property management, which could see 93,800 fewer jobs by 2030. The Retail and Hospitality sector could also suffer with a further 13,000 fewer jobs.
Different Finance Options for treating Long Covid
The report considered alternative tax options for government funding of healthcare, rather than reallocating existing government expenditure. Their analysis showed that Long Covid treatment can be funded on top of existing government expenditures, although the choice of tax instrument does itself have macroeconomic impacts. Income taxes tend to have a slightly more negative impact than, for example, higher national insurance contributions on the part of employers.
Overall economic cost
On the fall in household incomes, the report projected a fall of over £2 billion if the number of cases rose to 4 million by 2030. This is quite likely to happen with the continuing number of reinfections which scientists have warned will inevitably give rise to more cases. Furthermore, many of these cases will render those with the condition unable to work for a long time and in some cases permanently. This is a ticking economic timebomb and will have huge implications for the funding and operation of the NHS as well as for the economy generally. The conspiracy of silence continues about these very real costs, despite the efforts of Long Covid groups and others to sound the alarm bell. The report also made the point that it did not include the loss of income and the added economic costs to informal carers. Policy makers must grasp this nettle, or it will act as a huge economic drag on the UK economy for decades to come.
Long Covid (Part 2) THE HUMAN COST
How people are affected
The NHS has listed the following symptoms: fatigue, shortness of breath, problems with memory and concentration, palpitations, dizziness, joint pain and muscle aches. However, research by other bodies such as the Zoe Health Study, which collects data from affected individuals, reports many other symptoms including chest pains, breathing difficulties, gut problems, sore/dry eyes, hair loss, depression and confusion. Those most likely to be affected include women, older people, people with underlying health conditions including asthma and diabetes, those with conditions affecting the immune system, and people with mental health conditions.
“Many have lost livelihoods, access to education, the ability to socialise and participate fully in society.”
Whilst the NHS puts the average length of time at four months, this includes those who have experienced symptoms for only very short periods. In fact, many people are affected for much longer and some do not make a full recovery. Anyone who is affected for six months or more would be considered under the Equality Act 2010 to be disabled.
There is treatment available to avoid the worst effects of Long Covid but currently it is only generally available for those who are classed as clinically vulnerable. Otherwise, the main focus is help in the form of physio for those experiencing difficulties with breathing. For the most part, emphasis is on managing the condition. There is a significant need for funding for proper research into possible treatments.
An historical perspective
Many of the symptoms resemble those of ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome), a condition first recognised in the 1980s. At the time it was mocked in the media as “Yuppy flu” and regarded by many, including some medical practitioners, as psychosomatic. An early flawed research project, based on a study that instead of confining itself to those who met the criteria for a diagnosis of ME/CFS included anyone complaining of tiredness, resulted in the acceptance of a combination of Graded Exercise Therapy and Cognitive Behaviour Therapy (GET/CBT) being accepted by NICE (the body advising health professionals on treatment of health conditions), despite the fact that a significant number of those participating found their health worsening and dropped out of the research programme. This has been the recommended treatment until 2017, and still continues to be recommended by many health professionals despite being discredited.
This is relevant because similar treatments are now being thought suitable for Long Covid without the backup of proper research. The idea being that doctors have to rely on this because no other course of treatment is available. Some GPs recommend pacing (ie short stints of activity balanced by rest) as a more positive way of managing both conditions.
The comparison is also relevant because the existence of long-term Long Covid is also disbelieved by many, and this may result in people being unable to access even the moral support they need.
In many cases those diagnosed with ME/CFS have experienced considerable problems in being awarded benefits. There are signs that this has also happened with Long Covid and current government policy is likely to make this a great deal worse.
Current and proposed DWP measures and the impact on those with Long Covid
On 19 April, Conservative Prime Minister Rishi Sunak announced proposed changes to the benefit system which would make it even more difficult for people with Long Covid to be supported via benefits. This will make it harder for people to be signed off work. “Fit notes” will be awarded by people other than doctors; there is no guarantee that those who make judgements about people’s capacity for work have any medical knowledge or qualifications at all.
The rhetoric behind the policy is based on the assumption that many of those unable to work are making dishonest claims, reviving the all-too-familiar “scrounger” narrative. This dangerous language now has the potential to inflict even greater harm on vulnerable individuals than it has in the past. The DWP already has a troubling history of causing immense suffering, and this policy threatens to dramatically worsen the situation, leading to devastating consequences for those in need of support.
The policy not only means people will be deprived of benefits; there are other measures included as well: for example, scrutiny of claimants’ bank accounts, seizing of goods and property if any evidence of fraud is found. Whilst the basic policy is extremely unlikely to be enacted during the government’s current term of office, since it will be subject to judicial review, many of the secondary measures are likely to be introduced before the next election. And many of those whose lives have been damaged by Long Covid will be at serious risk.
The Devastating Impact and the Urgent Need for Action
The devastating impact of Long Covid on individuals, families, and the economy cannot be overstated. The government’s failure to acknowledge the true extent of the problem, coupled with the proposed changes to the benefit system, threatens to push countless sufferers into financial hardship and despair. The human cost of this debilitating condition is immeasurable, with lives shattered, careers destroyed, and families torn apart. It is time for policy makers to confront the reality of Long Covid head-on, to invest in research and treatment, and to provide the support that those affected so desperately need. Failure to do so will not only prolong the suffering of millions but will also have far-reaching consequences for the nation’s health, wealth, and wellbeing for generations to come. The choice is clear: we can either continue to ignore the problem and pay the price, or we can take decisive action to support those affected and build a better future for all.
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