Long COVID, characterized by various symptoms such as fatigue, respiratory difficulties, and cognitive decline persisting for months after infection with the novel coronavirus (COVID-19), has emerged as a new challenge for global public health. Dr. Ziyad Al-Ali of Washington University in St. Louis noted, "The pandemic will recur, and the question is only 'when'." He emphasized that addressing long-term sequelae will be key in managing future infectious diseases.
According to a study by the National Institutes of Health (NIH) and Washington University, approximately 20 million people in the U.S. have long COVID. They report complex symptoms such as chronic fatigue, brain fog (cognitive decline), chest pain, depression, and sleep disturbances, and a significant number are experiencing difficulties in daily life and economic activities.
Long COVID is not only a problem associated with COVID-19. Experts explained that after the 1918 flu pandemic, symptoms resembling Parkinson's disease, asthenia, and concentration disorders were widely reported, with farmers at that time struggling to carry out even fieldwork, leading to an economic crisis. Similar "post-infection syndromes" have appeared after other infectious diseases such as SARS, MERS, Ebola, Lyme disease, and dengue fever, all impacting for years after the pandemics.
An analysis that aggregated various research findings from last year revealed that about half of long COVID patients suffer from myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This condition is characterized by extreme fatigue after exertion and has consistently been linked to abnormal immune responses following viral infections.
The NIH launched the "Recovery Project" aimed at identifying the biological causes of long COVID and developing treatment methods. This project is tracking over 15,000 patients across 33 states and 83 institutions, gathering vast amounts of data that encompass everything from initial infection to long-term symptoms. Researchers explained that they are building early warning and prevention models applicable to future infectious diseases through this data.
However, related policies and budgets are retreating. The U.S. Department of Health and Human Services (HHS) dismantled its long COVID dedicated organization in 2023, and the advisory committee was dissolved before holding its first meeting. The budget proposal for fiscal year 2025 presented by the Trump administration includes a HHS budget cut alongside a 40% reduction in the NIH budget. This raises concerns that it could be a severe blow to research on various infectious diseases, including long COVID.
The shortage of medical personnel has also emerged as a structural problem. Hospitals and local medical institutions in the U.S. are already exhausted from the COVID-19 pandemic, and there are concerns about insufficient capacity to respond if another pandemic recurs. In particular, voices are growing louder calling for an urgent reconstruction of systems specialized in treating long-term symptoms after infectious diseases, as there is a dire lack of expert personnel.
Moreover, the politicization of science-based health measures such as mask-wearing, ventilation, and the use of antiviral drugs is threatening the effectiveness of public health policy. Experts are expressing concern that valuable lessons learned during the pandemic are evaporating, even using the term "collective amnesia."
Dr. Al-Ali stressed, "More than 1.1 million people in the U.S. have lost their lives, and we are turning a blind eye to the knowledge and experience gained as a consequence. Now is the time to establish an integrated and sustainable response system for the pandemic as a whole, including long-term sequelae."