The World Health Organization (WHO) estimates that 10 to 20% of people suffer from Long COVID after recovering from a first COVID infection.

The most common symptoms include fatigue, shortness of breath and “brain fog,” but more than 200 different symptoms have been associated with Long COVID. The condition affects daily functioning and can be debilitating.

Our study released today estimates the economic burden of Long COVID in Australia. We calculated that Long COVID cost the Australian economy almost A$10 billion in 2022 alone.

What is Long COVID?

The WHO defines “Long COVID” as the persistence or appearance of new symptoms three months after the initial COVID infection, with these symptoms persisting for at least two months without any other explanation.

The causes of Long COVID are not yet fully understood, but persistent symptoms can be explained by the different effects of SARS-CoV-2 (the virus that causes COVID) on different parts of the body. For example, the virus can affect the heart, blood vessels and lungs.

Research suggests that Long COVID is related to the virus remaining in the body long after infection, which in turn leads to immune system dysfunction.

SARS-CoV-2 can also affect the brain and cognition, particularly executive functions, the ability to plan, monitor and implement goals. This can lead to difficulty performing work tasks and other activities of daily living in people with Long COVID.

Our work

We used Australian data to estimate infections in 2022 and modelled long-COVID and recovery rates for all age groups to understand the burden of long-COVID.

We then used this data in a mathematical model to estimate the economy-wide labor losses in 2022 and determine the decline in real gross domestic product (GDP). Economic losses occur because people affected by Long Covid may not be able to work for a period of time or may only be able to work at reduced capacity.

We found that at a peak in September 2022, up to 1,374,805 people (5.4% of Australians) were living with Long COVID after a single infection. Taking into account recovery from Long COVID, up to 3.4% would still be living with Long COVID after 12 months.

We estimated that more than 100 million work hours were lost due to Long COVID in 2022. These lost work hours represent an economic cost of around $9.6 billion, equivalent to 0.5% of GDP for 2022.

The hardest hit were working-age adults aged 30 to 49. The estimated work loss was greatest among those aged 30 to 39 (27.5 million hours, or 26.9% of total work loss), who had the highest total number of long-COVID illnesses of any age group. Close behind were those aged 40 to 49, with an estimated 24.5 million work hours lost, or 23.9% of total work loss.

The higher number of long-COVID cases in these younger age groups is likely due to the fact that they experience more COVID infections, possibly because they are more mobile and have more contact with others.

We did not take into account the losses of healthy employees who were unable to work due to caring for other COVID or Long COVID patients. Also, we only considered a single COVID infection and the risk of developing Long COVID afterward. However, we did not take into account the risk of reinfections, which increase the likelihood of Long COVID. Therefore, our research likely underestimates the impact of Long COVID.

Long COVID affects people of all ages and can occur regardless of the severity of their COVID infection. Widespread and persistent COVID infections mean that even if only a small percentage of people get Long COVID, that is still a very large number of people.

By comparison, 2% of Australians have coronary heart disease, the leading cause of illness and death in Australia (and the world). Even if only 3.4% of people have persistent long COVID, this imposes very high costs on public health and the economy.

And unlike coronary heart disease, which disproportionately affects older people, our study suggests that the impact of Long COVID is most pronounced among working-age adults, which is why the economic impact is so large.

A global trend

Many countries, including the US and the UK, are experiencing similar economic losses due to Long Covid, and the number of people unable to work is increasing.

According to recent estimates, around 400 million people worldwide are suffering from Long Covid. The disease could cost one trillion US dollars annually – about one percent of the global economy.

Given the wealth of evidence surrounding Long COVID and its impact on public health, experts are calling for the disease to be taken into account in policy decisions.

What can we do?

In Australia, the immediate consequences of acute COVID illness, such as hospitalization and death, are primarily used to determine eligibility for antiviral drugs and the importance of vaccines. Healthy people under 70 are not eligible for subsidized antiviral drugs, while vaccines for children are limited and booster rates in adults are low.

However, there is strong evidence that vaccines reduce the likelihood of Long COVID, and some evidence that antivirals can also reduce the risk, so Long COVID should be considered in Australian policy and guidance on antivirals and vaccines.

Other measures that reduce the risk of COVID infection also reduce the risk of long-term COVID infection. These include focusing on safe indoor air and wearing masks in high-risk, crowded places during COVID epidemics, especially in health care and elderly care settings.

Finally, we need to think about how to support those who have Long COVID and are unable to work. Long COVID is the sting in the tail of SARS-CoV-2 and proactive planning will reduce the impact on society.