The Long Haul of COVID-19

Coronavirus, SARS-CoV-2, COVID-19. These terms come up all the time now in the industry and in our daily lives – so much so that they can sound normal, and it can feel like this virus has been around forever. But then I remember that it’s only been a little over a year since the pandemic really started. And in science, one year really isn’t very long at all. It is, however, long enough to see both a light at the end of the tunnel – and the potential for lasting effects.

Appreciation for Science
We are fortunate that scientists have been developing new delivery systems around immunizations since the 2012 MERS coronavirus outbreak. These tactics were applied to Operation Warp Speed (the public-private partnership initiated by the U.S. government to facilitate and accelerate the development, manufacturing and distribution of COVID-19 diagnostics, therapeutics and vaccines). It’s why we now have three options for COVID-19 vaccines – Moderna, Pfizer-BioNTech and Johnson & Johnson.

Much to Learn
So, what have we learned about those of us who were infected with COVID-19 prior to the availability of testing and immunizations? In a year, quite a lot actually. And we are recognizing that many people who experienced COVID-19 with different levels of severity have some various lingering problems for weeks to months following their positive test. There are many questions left to answer.

How many people are affected?  What percentage of people contracting COVID-19 could be affected? How many symptoms are they facing? What will be required regarding ongoing medical and/or pharmacy treatments? And, for those of us in the insurance industry, how will claim costs be impacted going forward?

We really don’t know the answers to any of these yet. In medicine, this information takes time. It’s initially reported anecdotally to each patient’s health care provider, and then, as a trend is observed, the knowledge is aggregated into clinical evidence or research and adoption occurs.

What Some Are Experiencing
According to the Centers for Disease Control and Prevention (CDC), there are currently three types of post-COVID scenarios that have been identified: (1) “Long COVID,” (2) multi-organ effects and (3) effects from treatment/hospitalization. Check out the symptoms and details associated with each below.

Being Aware
Those experiencing Long COVID are being called “long haulers.” Typically, they are suffering great inconveniences, but they are otherwise able to resume work and life, just possibly at a lesser level than normal until the symptoms dissipate or resolve. Management of symptoms should be done in conjunction with a health care provider or at a COVID long hauler clinic.

With regard to more severe outcomes, those facing multi-organ effects could experience varying degrees of permanent organ changes. Sometimes the impairment is from disease severity like sepsis, which can damage organs. Other times, it’s tied to the formation of blood clots, which can harm any organ in which they are lodged or the blood vessel that feeds that organ. If significant damage occurs, heart, lung and/or kidney transplants could be necessary. Life sustaining measures, like dialysis, use of a ventilator or extracorporeal membrane oxygenation (ECMO) could be expected. For cerebral vascular (brain) injury, stroke management is anticipated. Each of these multi-organ effects could occur independently or with those undergoing intense treatments or hospitalizations.

That said, it’s important to keep a close watch on claims to anticipate the direction where each scenario might head in order to implement or recommend the measures that may best help clients manage costs. This is a new situation – and we don’t know how long the impacts will last. Awareness and a watchful eye are essential.

What’s Next?
This pandemic has posed many new challenges and rapid change – things that bring about a lot of mental stress and the need for mental rehabilitation. Thankfully, watching the drop in cases as well as seeing the success with the vaccines should help with this process as we transition into a future of living with SARS-CoV-2 (just like people have lived with influenza, polio, HIV, hepatitis, MRSA and other contagious diseases through the years).

With every day that goes by, physicians become more knowledgeable of effective symptom management, and scientists look to solve for situations that may need more support. Those of us in clinical roles at HM Insurance Group will be studying the impact of post-COVID conditions and working to help clients better manage outcomes. As long as the situation persists, we’re in it for the long haul too.

Reference: “Post-COVID Conditions,” Centers for Disease Control and Prevention, https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html, accessed May 18, 2021