How Many People Get Long Covid?

Why the answer is more complicated than you might think

Pictured: Exhaustion. Photo by Anh Nguyen on Unsplash

Of the many ongoing issues in the pandemic, one of the most difficult is Long Covid. Despite being a serious condition plaguing many people who recover from their initial Covid-19 infections, particularly for those who suffer debilitating, long-lasting symptoms, Long Covid is nevertheless often invisible, hard to diagnose, and even harder to treat. There are endless terrifying stories online about previously healthy people who were struck down, sometimes after quite mild initial Covid-19 infections, with persistent disabling symptoms.

In other words, Long Covid is a serious problem, and something that we as a society need to grapple with as a consequence of the pandemic.

Stock photos for “the future” are surprisingly filled with white lines. Photo by Christopher Burns on Unsplash

Recently, there has been a very tumultuous debate about a key point — how many people do we expect to get Long Covid after their initial infections? Headlines abound with terrifying statistics implying that nearly everyone will eventually get this condition, that more than 1/3 of Covid-19 sufferers are still suffering, and that we are all essentially doomed to be sick.

However, the reality is far more complex. A lot of this depends on definitions, and when you look at the data the proportion of people who have Long Covid is a very complicated topic, and may well be quite a lot lower than you’ve heard. Of course, a small proportion of a very large number is still a lot of people suffering, but the actual percentage may be quite a lot lower than scariest headlines suggest.

Let’s look at the evidence.

Definitions

Definitions matter in epidemiology. An expansive definition of a disease will always include more people, but may also reduce the usefulness of the term. A narrow one may be more useful clinically, but will exclude people who may be suffering a milder version of the same illness.

Take the ongoing debate about what constitutes hypertension (high blood pressure). On the one hand, setting the bar lower includes more people who will go on to develop serious…