Long COVID contributing to brain health crisis disrupting labour force, economy

More than one million Canadians, or about five per cent of the Canadian labour force, could be affected

Inez Jabalpurwala 6 minute read May 26, 2022

The effects of long COVID — where symptoms of the COVID-19 virus persist beyond four weeks from initial infection — are disrupting our health, our labour force and our economy.

An estimated 10 to 30 per cent of COVID-19 survivors are currently experiencing a range of long COVID symptoms, which means that more than one million Canadians, or about five per cent of the Canadian labour force, could be affected.

Though long COVID affects the entire body, many of the most persistent symptoms are linked to brain health. These symptoms include headaches, “brain fog,” chronic fatigue, impaired memory or concentration, anxiety, depression and insomnia. Such symptoms directly limit a person’s ability to work or be productive at their former, pre-pandemic levels. That has implications for the economy. Knowledge-based economies rely on optimal “brain capital” for economic prosperity, and so without brain health, we compromise our wealth.

What’s more, long COVID is striking people in their prime working years. According to a survey conducted in May 2021 by Viral Neuro Exploration (VINEx), the COVID Long Haulers Support Group Canada and Neurological Health Charities Canada, nearly 60 per cent of the more than 1,000 long haulers polled are between the ages of 40 and 59. Their top symptoms include fatigue and “brain fog,” which have impacted their work. Nearly 70 per cent of long-haulers said they were forced to take a leave from their jobs and more than half had to reduce their hours. Over one quarter had to go on disability, but nearly 44 per cent were unable to access disability insurance.

Long COVID brain health symptoms have persisted, and so have its impacts. In a follow-up survey and report conducted this spring, more than 80 per cent of respondents said the virus has negatively or very negatively affected their brain health. More than 70 per cent had to take a leave from work, which in some cases stretched beyond a year. Still others had to leave the workforce altogether. Troublingly, more than 30 per cent of survey respondents felt they weren’t believed when initially describing their symptoms to a health-care professional.

Women appear to be bearing the brunt of long COVID symptoms; more than 87 per cent of the survey respondents identify as female. This is consistent with other studies showing women are disproportionately affected by as much as a four-to-one ratio to men, impacting women’s labour participation rate and further aggravating gender inequalities.

The brain health crisis in Canada isn’t new. Even before COVID-19, one in three people were estimated to have been directly impacted by a disease, disorder or injury of the brain, with indirect costs to families, the workplace, economy and society. But the pandemic, which led to shutdowns that caused social isolation and anxiety about an uncertain future, along with the virus itself and its lasting effects on long-haulers, only increased the prevalence of neurological and psychiatric disorders, putting additional stress on overall brain health.

We are now facing a global mental health crisis. In the United States, “an overwhelming majority of Americans believe the U.S. is in the grips of a full-blown mental health crisis,” according to a USA Today/Suffolk University poll. President Joe Biden also announced a strategy to address national mental health issues as part of his first state of the union address. In Canada, the federal government created a cabinet position dedicated to mental health. The minister of mental health and addiction has a mandate to create a comprehensive, evidence-based plan “to address the crisis in mental health,” and establish a Canada Mental Health Transfer to help expand the delivery of mental health services, including for prevention and treatment.

These investments in mental health are to be lauded, as is the the greater awareness of long COVID. But they fall short of what is needed for people living with persistent COVID symptoms, mental health impacts from the pandemic, and for those whose brain health is otherwise not optimal.

Lost productivity and increased insurance payouts have resulted from this accelerated brain health crisis. The Centre for Addiction and Mental Health estimates poor mental health costs the Canadian economy more than $50 billion annually, of which more than $6 billion is due to lost productivity. And according to the Canadian Life and Health Insurance Association’s latest data, Canadian insurers paid out $420 million in psychology claims in 2020, a staggering 24 per cent increase from 2019.

Much of the discussion about the “new normal” at the workplace has focused on how we will work. But we need to pay more attention to ensuring people are able to fully participate in the labour market. We are already facing labour shortages thanks to a shift in demographics and as workers choose to retire earlier or leave the workforce because of the pandemic.

There is a way forward: we need to treat the post-pandemic brain health crisis with the same urgency as the pandemic crisis. The development and deployment of vaccines bridged existing technology and research from basic to clinical trials; showed us the power and potential of global collaboration across disciplines, institutions, sectors, and countries; and brought together business and science leadership. We can apply these lessons to both research and care, beginning with long COVID. Governments and funders must move away from traditional silos, and think differently about how these may link to a bigger story about brain health. Here’s what that looks like:

  1. We need to continue the work to develop a concise definition of long COVID and develop a single test for diagnosing long COVID. This will allow us to better understand the size and impact of the problem;
  2. We need to bring attention to the stories of people with lived experience and counter the stigma being faced by those who are not believed because the illness is not well-defined and not always properly diagnosed. Beyond the mental health stress, this has an impact on the ability to access unemployment benefits and disability insurance;
  3. We need to establish more multidisciplinary care clinics to be able to treat the different dimensions of long COVID;
  4. We need to increase funding for multidisciplinary research and longitudinal studies, in order to advance our understanding of what causes long COVID, how to treat it, and the potential long-term impacts, which may include contributing to the development of neurodegenerative diseases in the future. This is not just up to governments. Businesses and the private sector have a role to play and a stake in funding such research; and
  5. Finally, from a workplace perspective, employers need to provide more flexibility and a gradual return to work for those ready to come back.

We cannot leave long-haulers behind and let long COVID mine the full potential of up to a million Canadians who may be in their prime working years. Brain health is our most precious asset; the health of our workplaces and of our labour force is a function of our brain health. Acting now to ensure it remains optimal will yield higher productivity, and a more dynamic, creative and resilient workforce.

— Inez Jabalpurwala is global director of VINEx.

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