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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.

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    This Post Has 12 Comments
    1. Chronic Fatigue Syndrome (which includes burnout, Post Viral Fatigue, ME and the like) affects hundreds of thousands of people in the UK already – 2 in 1000 according to George Eliot Hospital pre-Covid. The longer term after effects of Covid for a number of people are very similar and there appears to be an increase in incidence (up to 2 in 100 by the look of it). Hopefully the increase in research funding can get to the bottom of it all, but the two are related at least, if not the same thing.

      What I find interesting is the correlation between workplace stress figures and the jobs of people ending up with long term illness (post-Covid and other CFS). https://www.hse.gov.uk/statistics/causdis/stress.pdf

      Whether there is any causal link – and which direction it is in – needs looking at, and hopefully will lead to better job design and staffing levels, particularly in the public sector.

    2. The left position was on board for a very long time.

      The game changer was the mandates and not giving people a choice and governments moving in to freeze bank accounts and assets.

      The social libertarian political quadrant were against that. What is happening to free speech during this war. The new laws being imposed on journalists and social media. While Julian Assange has been locked up for years.

      When you see it You have to call it out. Otherwise you end up talking out of both sides of the same mouth and saying different things.

      So parts of the left joined up the right at that point and things have snowballed since then. The main reason for that in my opinion is that large parts of the population no no longer believe a word the government’s say on any issue.

      They have lied over and over and over again on so many issues over the last 40 years that with the virus the pushback from the population has become amplified. There is a very real danger that the same thing will happen with climate change.

      I always believed that when globalism and Neoliberalism was new it was easier for government’s to bring the population along with them. Then once the results of both was well known the government’s would have to become more authoritarian to bring voters with them. That gave me some hope as I thought there was no way people would put up with government’s that resembled an authoritarian dictator.

      As a social Libertarian what I have witnessed over the last 2 months has removed that hope. The authoritarian ‘s have done what they do best and have doubled down on both free speech and many freedoms. Especially the right to protest.

      So what options do social libertarian ‘s have now Bill ?

      When all the other avenues are being systematically closed down. They hitch a ride on any campaign to try to be heard. At the moment the virus is that campaign of choice. In my view why you see social Libertarian’s joining up with the right on this issue.

      There is a far bigger picture taking shape here. Than just a single left wing issue on the virus. It is a combination of many things coming to a head. When a proportion of the population has decided not to believe anything the government says.Then we are living in interesting times.

    3. Not only has a proportion of the population decided not to believe anything the government says. Many now believe that money has replaced them vote and voting changes nothing.

      Brexit still hasn’t been completed after all this time it has been an undemocratic, neoliberal, glonalist, fudge. Another issue the left and right came together to win and seen the liberal corruption and lies upfront that are trying to stop it.

      There’s a big picture pressure cooker building up here with many pressure points. When it blows you can only guess what it is going to look like.

    4. Bill, I concur with much of what Derek above has said. One thing you’ve failed to address in your article is the massive censorship. We are not talking violent extremists here. We are talking scientists, doctors and other researchers who disagree with the mainstream view. This is an issue that goes beyond left and right. Science is discussion and debate; not censorship. Nor should the practice of science be democracy, where a matter is decided by vote. As you’re well aware, the ‘majority’ have been wrong on a great many issues in history. How would you feel I wonder if you were censored by your peers, web providers and other media outlets? “Sorry Dr Mitchell, but your views on monetary theory are a threat to stability in our society”

    5. Anthony Zappia: You are completely out of touch if you don’t think Bill has been censored and ostracised by many in the profession – even within his own University a right wing element was often trying to bring him down.. I worked st Newcastle University 20 years or so ago – I watched it first hand.
      Like Bill’s work or not – or not he’s always stood for what he believes in and backed it up with rigorous research and analysis.
      The rest of the crowd simply take the easy path and fall into line with the ruling ideology and make the easy money.

    6. I have read suggestions that, as seen in the HIV > AIDS progression, Long Covid is the *actual disease* that is caused by the SARS-Cov-2 virus, and that the cold or flu-like symptoms experienced initially on infection are merely manifestations of sero-conversion.

      There is now evidence that the virus attacks certain T-cells and can age the immune system in patients by ten years.

      If this is all true, then a time-bomb of ill health is building up in our populations, which may only become apparent in the months and years to come.

      If 10% of Covid infections result in Long Covid, and re-infections occur two or three times a year, and that’s assuming that a more severe variant doesn’t emerge, then how long until the *entire population* has Long Covid, with all the deleterious effects on the immune, cardiovascular or cognitive systems, and shortened life expectancy, that would imply?

      Could this become an extinction-level event?

    7. I posted this with a link to here.

      Oh my God. It seems like Mother Nature has created the perfect disease to “put us in our true place”. To knock us down a peg, or 3. First covid, then omicron-covid, and soon climate change. We are in for a rough next decade. Will it get as bad as the Black Death?

    8. Many conflicting opinions for me.
      Yes the idea of herd immunity to a coronavirus has ended up as yet another case of wishful thinking.
      Which means neither ‘letting it rip ‘or vaccines will stop mass infections .
      Vaccines have decimated death rates.
      So in a gruesome international league table of death per capita from Covid those countries that
      Pursued more restrictions while vaccines were developed are going to be near the top .Yes there are other factors general health, age spread of the population etc.
      So we’ll done countries like Australia .The libertarian sceptic approach pre vaccine was a killer
      With as Bill pointed out no economic benefit.
      Now with vaccines available and herd immunity a pipe dream should we lockdown for the foreseeable future?
      Partial measures have never been anywhere near as effective as lockdown and with more
      Transmissible omicron even less likely to be so now .
      Despite long Covid that’s a no from me ,long term social isolation for humans being even worse.

      One of my real pet hates is this idea that the enemy of my enemy is my friend. THEY ARE NOT.
      The left has been plagued by this thinking hitching their banner to many terrible dictators Stalin Mao etc
      Now some can look at the devastation in the Ukraine and see the west as the culprits.
      So I cannot get behind the idea that because the drivers of the libertarian sceptic approach to Covid restrictions were from the far right it was necessarily wrong
      It was wrong because it was a reckless bit of wishful thinking akin to climate change denial.
      Prudence was the key when you have a new virus filling up ITU’s in China then Italy.
      Prudence was the key when you understand that c02 admissions retain heat in the atmosphere
      I get and share to a point scepticism in the ability to model complexity.
      MMT understanding allows you to understand that governments can direct resources to tackle
      potential disastrous outcomes.
      The irony of Bills play that Covid scepticism must be wrong because it was driven by the far right
      is that is what I could not get beyond arguing for brexit with my left leaning friends.
      Let’s be clear brexit was driven by the far right the ONLY reason there was a referendum was
      Because Cameron was trying to stop losing votes to the right from then still Farage’s UKIP .
      This attitude of the enemy of my enemy is my friend is why LEXIT gained so little traction
      left learners could not join the far right and the racists at the ballot box.
      Play the ball and not the man.

      retain heat in the atmosphere need a cautious approach.
      The huge irony in Bills play that

    9. Is there any evidence to answer these questions?
      1] Can one get Long Covid every time you get covid?
      2] If yes, does the chance of Long Covid go down each time you get covid again?
      3] Or, does one’s chances stay the same or go up each time?

      If the answer to #3 is it stays the same or goes up, then it follows that the majority of people will get Long Covid sooner or later, unless covid is somehow almost totally contained.

      If this happen humanity is f’d.
      .

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