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Long-COVID in the United States: the next health disaster scenario?

The majority of adults in the West are now vaccinated. This is the case in, for example, more than half of the adult population in the United States. Here, several preventative health measures, such as mask wearing and social distancing, have been relaxed to enable a return to near-normal life. However, the 10 to 30% of patients infected with SARS-CoV-2 who developed long-COVID should not be forgotten. What will be the consequences of this illness in the United States and elsewhere? Have we learned the lessons of the past concerning chronic illness following infectious disease?

The CDC (Center for Disease Control and Prevention) has warned that 15 million Americans already have or will develop long-COVID. This illness is characterised by a whole range of symptoms that can last for weeks or months. It is not, however, always easy to diagnose since no consensus definition exists for the moment. Currently, no diagnostic marker or biomarker allows for reliable diagnosis.

The emergence of long-COVID is, however, not a complete surprise. Other similar post-infection syndromes exist, such as the post-treatment syndrome of Lyme disease, or Epstein-Barr. The long-term physiopathology of SARs-CoV-2 infection is still poorly understood. Certain scientists suspect that the virus remains in the organism and that patients still suffer from the after-effects of the inflammation. Others believe that it is a purely psychological disease. Whatever the case, public health authorities need to act, firstly to promote prevention by reminding people that vaccination is the best way to avoid long- COVID. It is also necessary to continue research work so as to identify the causes and mechanisms linked to this illness, and to find appropriate treatments.

In parallel with the pandemic of acute COVID-19, the world also needs to be prepared for large numbers of people with long-COVID. This illness is for the moment neither understood nor under control, but more than 30 hospitals and health centres in the United States have already set up services to deal with the consequences of this pathology.

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