Covid – the long and short of it

What do we mean by long Covid? Well there’s no concrete, internationally agreed definition, and even the name varies, e.g. also known as “post-Covid-19 syndrome”¹, but as with the well-known potential for post-viral fatigue after an influenza infection, individuals infected with SARS-CoV-2 can continue to be affected by the virus for months after the typical acute phase of the illness has passed. The best estimation at the moment for COVID-19 is that at least 10% are still unwell 4-9 months after infection². This could of course extend as time passes and more data becomes available, but as a noteworthy comparison, 40% of SARS-CoV-1 (SARS) patients suffered from chronic fatigue up to 3.5 years after infection³.

Viral fatigue is not the only symptom. From what we know so far, the symptoms of long Covid can be grouped into two broad categories: Unspecific, fluctuating (over hours/days) post-viral fatigue and joint pain symptoms (let’s call these Group 1); and specific, objectively measurable organ-centered disease symptoms (let’s call these Group 2). From a life insurance product perspective, Group 1 cases could primarily impact Disability covers, while Group 2 cases could additionally impact Critical Illness, Long-term Care and Life covers.

Table 1: Summary of the symptoms/signs of long Covid and potentially impacted life insurance products; Disability (DI), Critical Illness (CI), Long-term Care (LTC) & Life. Left, Group 1 symptoms/signs of long Covid fluctuate and are medically unspecific. Right, Group 2 symptoms are specific and can be objectively measured. You’ll notice a lot of question marks in these tables: This, I’m afraid, is the reality of a new virus as more time/data is needed to fill-in the gaps in our understanding. Source: PartnerRe.

Who’s at risk? All ages can be impacted, even the young and healthy. However, the risk of developing long Covid increases amongst those who were hospitalized, older ages, and for those with pre-existing chronic conditions⁴.

And can it be stopped? Here I am pleased to end on a positive note. Although further studies are needed, SARS-CoV-2 vaccination has been reported to significantly reduce, if not stop, long Covid symptoms in some individuals⁵. The efficacy of some of the vaccines is very high, in particular the mRNA vaccines (currently at 94-95% efficacy with respect to hospitalization and death). As vaccination programs expand and new vaccines are developed, including the highly promising pan-corona vaccine⁶, vaccination could, in my opinion, also hold the key to conquering the long side of Covid.