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Opinion: Omitting long Covid from pandemic messaging is harmful for public health

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Public health messaging about Covid-19 has focused almost exclusively on hospitalizations and deaths. The omission of long Covid, which may affect between 8 million and 23 million Americans, deprives the public of the knowledge necessary to understand the risks of various activities, make informed decisions about risk-taking, and understand what is happening to them if they feel sick for an extended period.

Local and national public health entities continue to characterize infections not resulting in hospitalization as “mild,” and most media have followed their lead. Recent guidance from the Centers for Disease Control and Prevention that removed masking recommendations for the majority of the U.S. is linked primarily to local hospital capacity, and was communicated by CDC Director Rochelle Walensky with risk levels couched in terms of impacts on health care systems and prevalence of severe illness.

In this way, authorities have been shaping a narrative in which the primary risks from Covid are acute illness, death, and impacts on health care systems. Yet evidence is rapidly mounting that post-acute sequelae of SARS-CoV-2 infection (PASC, or long Covid) can cause symptoms — often debilitating symptoms — that persist for months or even years after infection. Studies have found anywhere from 7% to 61% of those infected with Covid later experience long Covid, including those who initially had “mild” cases and were never hospitalized.

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