Long COVID and Worker’s Comp
Background:
There has been a lot of discussions about long COVID, its overall impact on patients, employee productivity and worker’s compensation. According to a WCRI report, 7% of workers compensation COVID claims received treatment for long COVID.[1] In this article, we tackle three important questions about long COVID. What exactly is long COVID, how to prevent it and why worker’s comp payers should care about it.
What is Long COVID?
Long-term COVID, long-haul COVID, post-acute COVID-19, together called Post-COVID Conditions (PCC) by the Department of Health and Human Services (HHS) in collaboration with CDC, [1] is a condition in which a wide range of new, returning, or ongoing health problems or symptoms that people experience after being affected with COVID-19.[2] Some of the stubborn symptoms such as fatigue, insomnia, shortness of breath, and “brain fog,” among others linger for weeks or longer.
Though it is still unclear why some patients develop PCC while others don’t, the most common factor observed in patients with PCC is severe COVID-19 illness. Although PCC can occur in patients who had mild or moderate COVID-19 illness, PCC is more likely in patients with severe COVID-19 illness, especially those who were hospitalized, needed intensive care, or had underlying health conditions prior to COVID. Even so, it is still unclear who is truly at risk for PCC, although health disparities may exacerbate people who are at increased risk of getting sick from COVID-19 because of where they live or work, or poor access health care. According to the CDC, the best way to prevent post-COVID conditions is to protect yourself and others from becoming infected. For those eligible, the CDC recommends staying up to date on COVID-19 vaccination, along with improving ventilation, getting tested for COVID-19 if needed, and seeking treatment for COVID-19 if eligible.
Why Payers Should Care About Long COVID:
Patients with PCC may develop or continue to have symptoms that are hard to explain and manage, which may impact productivity. A study published in The Lancet, found that 22% of people with long COVID were unable to work due to ill health, and another 45% had to reduce hours worked.[5] A 2022 report by Brookings estimated that long COVID potentially accounted for 15% of the labor shortage in America.[6]
Aside from the labor issues, PCC may be associated with medical costs as well. While the direct medical costs for treating long COVID have not been estimated, the cost of similar conditions have been estimated. For example, the symptoms reported by patients with long COVID are comparable to those reported by people with ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome).[7] ME/CFS is a serious long-term illness that affects many body systems, impacts daily activities, and cause severe fatigue and sleep problems. If treatment of long COVID is similar to treatment of ME/CFS, payers should expect to pay an estimated cost of approximately $9,000 per patient with long COVID annually.[8]
Additionally, long COVID has some long-term clinical costs as well. According to Kaiser Health Foundation, long-term COVID-19 can also make underlying health conditions worse, such as asthma, diabetes, or other medical conditions.[9] Patients with long COVID have reported difficulty with some daily activities, such as exercising, which may impact patient’s ability to rebuild strength and improve overall health.
Closing Thoughts:
Recovery from long-term COVID-19 varies widely, dependent on the patients’ initial COVID-19 illness, symptoms, and overall health status. There is sufficient evidence in the literature supporting the prevalence of PCC and the impact of its sequela on patients overall health and productivity which may present in different forms. There is no clear mechanism to predict and prevent PCC. The most up-to-date evidence for preventing PCC is prevention of COVID-19 itself and reducing severity of COVID illness. While the direct costs of PCC has not been calculated, Payers can expect an average cost of $9,000 annually per patient with long COVID, in addition to other health costs associated with its sequela.
At Prodigy, we continue to support our clients by presenting the most updated clinical data and research evidence in addition to information about best practices to enhance clients ability to make the best decision for their organization. For more information on this subject, contact pharmd@prodigyrx.com.
Citations:
[1] Characterizing long COVID in an international cohort: 7 months of symptoms and their impact - eClinicalMedicine (thelancet.com)
[2] New data shows long Covid is keeping as many as 4 million people out of work (brookings.edu)
[3] Long COVID or Post-COVID Conditions | CDC
[4] JAMA Health Forum – Health Policy, Health Care Reform, Health Affairs | JAMA Health Forum | JAMA Network
[5] Recovering from long-term COVID-19 | Kaiser Permanente
[5] Long COVID or Post-COVID Conditions | CDC
[6] Recovering from long-term COVID-19 | Kaiser Permanente
[7] COVID.gov - Find COVID-19 guidance for your community
[8] Long COVID or Post-COVID Conditions | CDC
[9] Long COVID in the Workers' Compensation System Early in the Pandemic | WCRI (wcrinet.org)