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COVID-19 exposed our inequities. Long COVID may exacerbate them

Nearly 25% of Americans who were infected with the coronavirus are enduring symptoms of “long COVID,” which can last for months. New Republic freelance reporter Karina Piser reported on how the healthcare system is failing to recognize the symptoms and why underserved communities will be the hardest hit. She joins Hari Sreenivasan for more.

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  • Hari Sreenivasan:

    While the U.S. continues to tackle the surge of new COVID-19 cases from the delta variant, a growing body of research is showing that there is another coronavirus crisis on the horizon: the healthcare and treatment for COVID "long-haulers" whose symptoms can last for months.

    In an article for The New Republic, freelance reporter Karina Piser found that with a medical system slow to recognize long COVID systems, the impact is already starting to emerge, particularly in underserved communities.

  • Karina Piser:

    So I think that in general, the U.S. was slow to reckon with the scope of long COVID and the reality of it as a condition which, you know, isn't completely surprising, given that as the disease itself continues to develop, we keep finding ourselves forced to play catch up with variants, with changing symptoms, et cetera. So in general, what's kind of come together is a system, an infrastructure that is a bit behind and that, like you say, is currently unable to absorb the scope of the long COVID crisis.

  • Hari Sreenivasan:

    Is there an official billing code, say, for long COVID? Right, because that matters a lot to insurance companies, something as silly as a little number that we have to have with every visit to the doctor. I mean, how is long COVID understood and treated?

  • Karina Piser:

    Right. So I think that there is no singular answer to that question. And that is in large part why there is such kind of a piecemeal framework to deal with this condition. It wasn't until the spring that the CDC recommended creating a billable insurance code, even though it's been well over a year, that people suffering with symptoms of long COVID well after their initial infection started sounding alarm bells over the need to create a fixed health care response. And like you say, it might seem like a small little number, but a billable insurance code is really important because it creates kind of a direct way for people to report their symptoms and get treatment, but also in the long run, to have data on how many Americans are suffering from these symptoms. Without a billable insurance code, it will be very difficult to track.

  • Hari Sreenivasan:

    What you also point out is that the people who are likely to suffer the worst brunt of long COVID and the lack of an infrastructure to be able to deal with it are already the poorer and more marginalized communities that were hardest hit by the virus.

  • Karina Piser:

    Right. So, you know, we have seen the way that the disease itself of COVID has played out. It has affected the low income communities of color more than any others. And we also know what the state of health care looks like in this country. And the pandemic brought a lot of that to life. Safety net hospitals were ill equipped to deal with the influx of patients early in the pandemic, and they do not necessarily have the means to create these long COVID clinics.

    Similarly, in rural communities, the number of hospitals in rural America have decreased dramatically over the past decade. Same with community health centers that are kind of, you know, often the first recourse for low income communities that has already been depleted. And so the communities that were hit the hardest by the pandemic are not only going to have the most difficulty accessing care, going to these major medical centers where these long COVID clinics are emerging that are often in major cities where people in rural communities, they might not even know they exist.

    But also it's difficult to get there if you don't have transportation. It's difficult to miss work. There are so many reasons why people are being excluded from the treatment that is available.

  • Hari Sreenivasan:

    You know, besides the health factors here, what are the money implications and ramifications of a large population of people suffering basically long term disability? I mean, how do we determine whether or not they should qualify for disability payments? And what is the beginning and end of long COVID?

  • Karina Piser:

    Right. So, you know, that's a question that there is no answer to. And because there's no answer to it yet, that's creating a lot of problems for people in the thick of it. I spoke to one woman who had qualified for disability initially due to her long COVID symptoms. She was a nurse leader at a hospital in the Atlanta area. And when she put in a request to have her disability renewed, the her employer's third party affiliate denied that request, attributing her symptoms to behavioral health issues. And they cited notably anxiety and post-traumatic stress disorder. Whether or not she is experiencing anxiety and post-traumatic stress disorder are kind of beside the point because she tells me that she is walking using a walker. She's someone who used to be very physically active. She's using a walker to take a walk in the afternoon. And during our phone conversation, she was pausing regularly to catch your breath and that kind of chalking these symptoms up to behavioral health issues, saying, no, it's just anxiety you should seek psychiatric treatment is not only something that that women and people of color, I think you hear often in medical contexts, but especially in the context of long COVID.

  • Hari Sreenivasan:

    Freelance journalist Karina Piser joining us from Brooklyn. Thanks so much.

  • Karina Piser:

    Thank you.

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