The rising incidence of Long Covid and its labour market impacts

I have written about the so-called – Great Barrington Declaration – before. The Great Barrington reference is just the name of the town where the letter was drafted and signed during a conference and bears no inference of greatness – far from it. I was also disappointed that some Left commentators fell under the spell of the anti-restriction, lockdown, vaccine lobby that the GBD represented. What transpires is that we now have an increasing body of evidence that suggests the main assumption of those behind the GBD – that herd immunity would be reached by an open slather approach to Covid (with some protections for the vulnerable) – has not been realised. Specifically, the idea of vulnerability was poorly constructed because it didn’t foresee the increasing incidence of Long Covid. The evidence now coming out by credible researchers is that we are mostly all vulnerable to long-term debilitating effects of a Covid infection and the jury is still out on how bad this will turn out to be. And, while it is clearly a medical issue, it is also causing havoc in labour markets, with increasing numbers of workers not being able to work to full potential or at all. And with the fiscal support for incomes now largely gone, that spells trouble for low-income workers. It is also a factor that will prolong the current inflationary episode.

This was my last blog post on the topic – Why are the progressive left mixing with the dark right on Covid? (January 12, 2022).

In that post, I documented the creation of a new ‘Academy for Science and Freedom’, that had been set up in a little-known college in Michigan.

The college is a breeding ground for young, right-wing, Christian conservatives and its president was a Trump supporter. It advertises for funding on Fox News in the US and provides a conduit for conservative politicians – speechwriters and other administrative roles.

The Koch Foundation helped fund the college.

This new Academy is at the forefront of attacks on public health measures designed to reduce the Covid infection rate.

The Great Barrington Declaration (GBD) was authored by some characters connected to this new Academy.

It as signed at a conference organised by the American Institute of Economic Research (AIER), which receives funding from “anti-regulation” groups and is deeply tied up with the Mont Pelerin Society and “the Koch-backed Cato Institute” (Source).

The GBD recommended that governments should:

… allow those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk. We call this Focused Protection.

In other words, governments should have let the virus rip through the population and only placed protections on the the most vulnerable – aged care residents, and the like.

The authors claimed, for example:

… nursing homes should use staff with acquired immunity and perform frequent testing of other staff and all visitors.

It was all predicated on their belief that we would reach herd immunity through natural infection.

Non-vulnerable citizens, accordingly should “immediately be allowed to resume life as normal … Schools and universities should be open for in-person teaching … sports, should be resumed … Young low-risk adults should work normally, rather that from home .. Restaurants and businesses should open. Arts, music, sport and other cultural activities should resume.”

The implication was that once infected, the disease would cause little sickness and then immunity would offer on-going protection.

Once a skilled, aged care worker, for example, had become ill and recovered they could step back in the workplace dealing with the most vulnerable because they had become immune to the disease.

Except, of course, reinfection within a relatively short period is a characteristic we now know about Covid, which compromises the whole notion of herd immunity in this case.

The GBD was predicated on the belief that the virus would do little damage to those who were not already old or sick and that normality would return with high rates of infection.

Even the WHO, in late 2020, before Delta, thought that we would achieve herd immunity if “a substantial portion of a population” was vaccinated (Source).

But that assumed the vaccines would prevent infection and the emergence of Delta put paid to that belief.

The two issues that suggest the herd immunity belief underpinning the GBD was based on poor information are:

1. Reinfection – people are getting multiple bouts of Covid.

2. Deaths and Long Covid.

Regular readers will know that I supported the restrictions that our governments introduced to slow the infection rate. I think the abandonment of these restrictions will prove to be a costly mistake in terms of the impact on workers’ lives.

I still wear a mask whenever I am out of my home and avoid situations where there are a lot of people in close proximity.

I realise that there is a current among Left-thinking commentators that reject my position and support the GBD position, even though it was funded and pushed by Right, neoliberal interests. Apparently the Covid issue is neither ‘right nor left’.

I reject the attacks on the professional working class by these Left commentators – who dismiss this group as a privileged ‘woke’. Why? Because they were able to work from home.

Note: they are still ‘working’ which means they are still generating surplus value and being ripped off by the capitalist class.

I don’t buy into attacks on segments of the working class who, in this case, were lucky enough to be able to work from home. And subsequent research is showing that in doing so, they have in many cases been able to get more discretion over their working lives etc. while staying clear of the virus.

I also understand the point that the restrictions etc were punitive for low-income workers who have little saving buffers to tolerate isolation rules etc.

And I understand this group was forced to work and be at the forefront of infection rates because of the nature of their jobs – they do not work in an office in front of a computer as I do.

But, for me the true Left position, which is also based on my understanding of MMT, was that the solution was not to just let the virus rip and force all workers out into its front, but to use the fiscal capacity of the government to fully protect incomes – for those forced into isolation, to legislative against employers who wanted to exploit the precarious nature of these jobs and expose their workers to illness, and more.

I also understand the role that big pharma played in pushing the vaccine narrative. But the mistake governments made was to pay the going price to these companies. It would have been better to abandon patent rules and force the vaccine companies to make them available at cost.

I believe the confidence exuded by the GBD about herd immunity and the low impact on less vulnerable groups assumption was based on a lack of data, which as time passes we are now starting to gain access to.

New data came out today in Australia from the Australian Bureau of Statistics – Household Impacts of COVID-19 Survey – which helps to fill in the details somewhat.

Further, international studies are now coming forth that benefit from nearly 2.5 years of data collection and the news, in my view, is not good.

On November 16, 2021, a meta study was published in preprint form on the incidence of long Covid – Global Prevalence of Post-Acute Sequelae of COVID-19 (PASC) or Long COVID: A Meta-Analysis and Systematic Review.

This briefing note from the NSW government Health Department summarises several new studies on what is now known as Post Acute Sequelaw of Covid-19 (PASC) or Long Covid.

We have known about sequel disease for a long time. For example, there is now a lot of research on so-called post-polio syndrome which emerges decades after the initial polio infection and cause disabling conditions in older age.

But Long Covid seems to be a different enduring impact, emerging as part of the initial infection.

The WHO defines PASC as the (Source):

… condition that occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms and that last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms include fatigue, shortness of breath, cognitive dysfunction but also others and generally have an impact on everyday functioning. Symptoms may be new onset following initial recovery from an acute COVID- 19 episode or persist from the initial illness. Symptoms may also fluctuate or relapse over time.

The November 2021 publication investigated the “longer lasting health impacts” of Covid using meta-analysis – which synthesises many varied studies of the phenomenon (40 in total).

I understand that some commentators express doubt about data etc – claiming all sorts of conspiracy theories etc. Yes, a single study can be corrupted by researcher malfeasance and tobacco companies and the like have certainly made up research to justify their claims against health controls.

I also, obviously understand the pattern of behaviour in academies which we refer to as Groupthink, where a whole profession becomes captive to an ideology and suppresses facts etc to maintain dominance in the academy.

I am in a profession that has clearly succumbed to Groupthink and Modern Monetary Theory (MMT) is a minority rebellion in that profession (at present).

But in general, when there are many studies across many institutions and nations using facts that even I can understand, then I think we should take heed.

The results of the meta study are clear enough:

1. “0.43 (95% confidence interval [CI]: 0.35, 0.63), with a higher pooled PASC prevalence estimate of 0.57 (95% CI: 0.45, 0.68), among those hospitalized during the acute phase of infection.”

So Long Covid appears in 43 to 63 per cent of all cases, with higher prevalence in those who end up in hospital (more than 50 per cent).

2. Females are at higher risk as are those who are moderately overweight or worse. What proportion of the population fits into that cohort? Answer: huge proportion.

3. “PASC prevalence for 30, 60, 90, and 120 days after index test positive date were estimated to be 0.36 (95% CI: 0.25, 0.48), 0.24 (95% CI: 0.13, 0.39), 0.29 (95% CI: 0.12, 0.57) and 0.51 (95% CI: 0.42, 0.59), respectively.”

Meaning that even after 120 days there was a 51 per cent prevalence.

4. “Nonetheless, the health effects of COVID-19 appear to be prolonged and can exert marked stress on the healthcare system”.

Other studies note there are difficulties in establishing PASC in children but the probabilities range up to 44.8 per cent of those who are infected might end up with Long Covid. It is early days on that type of research.

Other studies (reported by the NSW Health Department) report common symptoms as:

… fatigue, dyspnoea and smell or taste impairment, and neurological and cardiovascular impairment have been reported for up to 12 months.

The studies show that:

1. 63.2 per cent of Covid survivors have PASC after one month.

2. 55 per cent after 90 days.

3. 54 per cent after 6 months.

4. around 50 per cent after 12 months.

While PASC is clearly a health problem it is also a labour market issue and with supply-chain constraints still driving accelerating inflation, PASC becomes a major contributor – workers cannot work if they sick and enduring long-term symptoms.

Imagine if governments had have followed the advice from the GBD – we would have so many more workers vulnerable to PASC and their workplaces would have been more decimated than they already were as a result of the infection rates.

Even the conservative press is realising this is a problem.

A recent Financial Times article (April 10, 2022) – Long Covid: the invisible public health crisis fuelling labour shortages – documents case studies from the US and the UK, which report on the debilitating impacts on continuity of working lives as a result of PASC.

The FT note:

While long Covid is taking a heavy toll on the individuals affected, it also represents a disaster in the making for businesses and economies – potentially pushing significant numbers of people out of labour markets where employers are already struggling to hire.

And now that the governments have bowed under the pressure of the anti-restriction lobby and ‘opened’ their economies up and withdrawn the bulk of their fiscal support, these workers are getting sick, staying sick and are without the sort of income support they should enjoy.

This study from Brookings – Is ‘long Covid’ worsening the labor shortage? (January 11, 2022) – suggests that around 1.6 million full-time equivalent workers could be suffering PASC or about “15% of the nation’s unfilled jobs.”

The British Office of National Statistics reported last week (April 7, 2022) – Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK : 7 April 2022 – that:

An estimated 1.7 million people living in private households in the UK (2.7% of the population) were experiencing … (PASC) …

… 422,000 (24%) first had (or suspected they had) COVID-19 less than 12 weeks previously, 1.2 million people (69%) at least 12 weeks previously, 784,000 (45%) at least one year previously and 74,000 (4%) at least two years previously.

That total number has risen from just over a million in April 2021.

The FT reports data that shows that “a rise of some 200,000 since the start of the pandemic in the number of people who are not working or job-seeking because of long-term ill health”.

None of this mayhem was foreseen by the GBD mob and it is ironic that corporations, who are now being squeezed by difficulties with their workforce who are ill, supported the lobby that led to the anti-restriction, GBD-type narratives that influenced governments to abandon restrictions prematurely.

I don’t see how it helps the low-income workers to increase their chances of infection and the risk of being forced to endure a long-term debilitative illness.

I don’t see how that could be a ‘Left’ position.

Conclusion

There is a long way to go with this pandemic yet.

And our approach should be infection control to minimise the chances workers will get sick and have to endure Long Covid in increasing numbers.

The current inflationary pressure is being influenced by these medical realities.

And, I am still wearing my P2 mask – and I put two masks on when I go to the football!

That is enough for today!

(c) Copyright 2022 William Mitchell. All Rights Reserved.