First They Get Long COVID, Then They Lose Their Health Care

Oct. 13, 2022 – It’s a devastating sequence of setbacks for lengthy COVID sufferers. First, they get the debilitating signs of their situation. Then they’re compelled to surrender their jobs, or severely curtail their work hours, as their signs linger. And subsequent, for a lot of, they lose their employer-sponsored medical insurance. 

While not all lengthy COVID sufferers are debilitated, the CDC’s ongoing survey on lengthy COVID discovered 1 / 4 of adults with lengthy COVID report it considerably impacts their day-to-day residing actions.

Estimates have proven that lengthy COVID has impacted the lives of anyplace from 16 million to 34 million Americans between the ages of 18 and 65. 

While exhausting information continues to be restricted, a Kaiser Family Foundation evaluation discovered that greater than half of adults with lengthy COVID who labored earlier than getting the virus at the moment are both out of labor or working fewer hours. 

According to information from the Census Bureau’s Household Pulse Survey, out of the estimated 16 million working-age adults who at present have lengthy COVID, 2 million to 4 million of them are out of labor attributable to their signs. The price of these misplaced wages ranges from $170 billion a 12 months to as a lot as $230 billion, the Census Bureau says. And provided that roughly 155 million Americans have employer-sponsored medical insurance, the welfare of working-age adults could also be underneath critical risk. 

“Millions of people are now impacted by long COVID, and oftentimes along with that comes the inability to work,” says Megan Cole Brahim, PhD, an assistant professor within the Department of Health Law, Policy, and Management at Boston University and co-director of the college’s Medicaid Policy Lab. “And because a lot of people get their health insurance coverage through employer-sponsored coverage, no longer being able to work means you may not have access to the health insurance that you once had.”

The CDC defines lengthy COVID as a big selection of well being circumstances, together with malaise, fatigue, shortness of breath, psychological well being points, issues with the a part of the nervous system that controls physique capabilities, and extra. 

Gwen Bishop was working remotely for the Human Resources Department on the University of Washington Medical Centers when she received COVID-19. When the an infection handed, Bishop, 39, thought she’d begin feeling effectively sufficient to get again to work – however that didn’t occur. 

“When I would log in to work and just try to read emails,” she says, “it was like they were written in Greek. It made no sense and was incredibly stressful.” . 

This falls in step with what researchers have came upon in regards to the nervous system points reported by individuals with lengthy COVID. People who’ve survived acute COVID infections have reported lasting sensory and motor operate issues, mind fog, and reminiscence issues. 

Bishop, who was recognized with ADHD when she was in grade faculty, says one other complication she received from her lengthy COVID was a brand new intolerance to stimulants like espresso and her ADHD treatment, Vyvanse, which have been regular elements of her on a regular basis life. 

“Every time I would take my ADHD medicine or have a cup of coffee, I would have a panic attack until it wore off,” says Bishop. “Vyvanse is a very long-acting stimulant, so that would be an entire day of an endless panic attack.” 

In order for her to get a medical depart accepted, Bishop wanted to get paperwork by a sure date from her physician’s workplace that confirmed her lengthy COVID prognosis. She was in a position to get a few extensions, however Bishop says that with the burden that has been positioned on our medical methods, getting in to see a health care provider by way of her employer insurance coverage was taking for much longer than anticipated. By the time she received an appointment, she says, she had already been fired for lacking an excessive amount of work. Emails she supplied displaying exchanges between her and her employer confirm her story. And with out her medical insurance, her appointment by way of that supplier would now not have been coated.

In July 2021, the U.S. Department of Health and Human Services issued steerage recognizing lengthy COVID as a incapacity “if the person’s condition or any of its symptoms is a ‘physical or mental’ impairment that ‘substantially limits’ one or more major life activities.” 

But gaining access to incapacity advantages hasn’t been straightforward for individuals with lengthy COVID. On prime of getting to be out of labor for 12 months earlier than having the ability to qualify for Social Security Disability Insurance, a few of those that have utilized say they’ve needed to put up a struggle to really acquire entry to incapacity insurance coverage. The Social Security Administration has but to disclose simply what number of purposes that cited lengthy COVID have been denied up to now.  

David Barnett, a former bartender within the Seattle space in his early 40s, received COVID-19 in March 2020. Before his an infection, he spent a lot of his time engaged on his toes, bodybuilding, and climbing together with his companion. But for the final practically 3 years, even simply going for a stroll has been a serious problem. He says he has spent a lot of his post-COVID life both chair-bound or bed-bound attributable to his signs. 

He is at present on his companion’s medical insurance plan however continues to be liable for copays and out-of-network appointments and coverings. After being unable to bartend any extra, he began a GoFundMe account and dug into his private financial savings. He says he utilized for meals stamps and is on the point of promote his truck. Barnett utilized for incapacity in March of this 12 months however says he was denied advantages by the Social Security Administration and has employed a lawyer to enchantment.

He runs a 24-hour on-line help group on Zoom for individuals with lengthy COVID and says that nobody in his shut circle has efficiently gotten entry to incapacity funds. 

Alba Azola, MD, co-director of Johns Hopkins School of Medicine’s Post-Acute COVID-19 Team, says no less than half of her sufferers want some stage of lodging to get again to work; most can, if given the correct lodging, corresponding to switching to a job that may be accomplished sitting down, or with restricted time standing. But there are nonetheless sufferers who’ve been extra severely disabled by their lengthy COVID signs. 

“Work is such a part of people’s identity. The people who are very impaired, all they want to do is to get back to work and their normal lives,” she says.

Many of Azola’s lengthy COVID sufferers aren’t in a position to return to their unique jobs. She says they typically have to seek out new positions extra tailor-made to their new realities. One affected person, a nurse and mom of 5 who beforehand labored in a facility the place she received COVID-19, was out of labor for 9 months after her an infection. She in the end misplaced her job, and Azola says the affected person’s employer was hesitant to offer her with any lodging. The affected person was lastly capable of finding a unique job as a nurse coordinator the place she doesn’t must be standing for greater than 10 minutes at a time.  

Ge Bai, PhD, a professor of well being coverage and administration at Johns Hopkins Bloomberg School of Public Health, says the novelty of lengthy COVID and the continued uncertainty round it increase questions for medical insurance suppliers. 

“There’s no well-defined pathway to treat or cure this condition,” Bai says. “Right now, employers have discretion to determine when a condition is being covered or not being covered. So people with long COVID do have a risk that their treatments won’t be covered.”