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Jonah McGarva was infected with the novel coronavirus in March, 2020, just a few weeks after the WHO officially named it COVID-19.

More than 30 months later, the 43-year-old sound engineer from Burnaby, B.C., is still struggling with lingering symptoms, including brain fog, chronic fatigue, and gastrointestinal woes that have left him unable to work or do much else.

“The impact of long COVID on my physical and mental health has been devastating,” he said. “At times, I’ve battled the will to live.”

Mr. McGarva is one of the who-knows-how-many people worldwide suffering from long COVID, the catch-all term used to describe the constellation of symptoms some people experience after they recover from acute infection with SARS-CoV-2.

The numbers are frightening. The potential fallout, even more so.

The World Health Organization says there are tens of millions of long COVID sufferers worldwide, and governments need to mobilize to help them.

A recent study in Scotland found 42 per cent of people with COVID-19 still had lingering symptoms six to 18 months later, including 6 per cent who had not recovered at all. The U.S. Centers for Disease Control and Prevention estimates that one in five adults aged 18 to 64 in that country have long COVID, and so do one in four over the age of 65. New data from Statistics Canada show that 1.4 million Canadians have lingering COVID symptoms three months after infection. But we still don’t have good data collection.

There is no test to determine exactly who has long COVID. There isn’t even a clear definition. The diagnosis is often done by ruling out other possible causes for symptoms.

There are few specialized long COVID clinics. Treatment consists principally of symptom management. For example, asthma inhalers and antihistamines for those with trouble breathing. Perhaps anticoagulants, because one of the leading theories is that long COVID is caused by microclotting. Or therapy for those left depressed by the state of their health.

Who it affects, why and how, and what to do about it is all quite murky.

What is clear, though, is that long COVID is, in the words of Dr. Anthony Fauci, an “insidious public health emergency.”

If one in four, or one in 10, or even one in 100 of those infected with COVID-19 – about 60 per cent of the population so far – have lingering health symptoms, that’s going to have an impact on everything from the health system to the work force.

We’re already seeing evidence of this.

Canada’s health system is teetering. Not solely because of COVID-19; the virus is proving to be the straw that broke the camel’s back. And more straws are coming. A new study shows the increase in long COVID patients is already beginning to stress everything from family physicians to emergency departments.

For the first couple of years of the pandemic, we were largely dismissive of “long haulers” like Mr. McGarva. Now, we’re finally starting to take long COVID seriously.

But what can we do about it, practically speaking?

First and foremost, the obvious needs to be stated: The best way to avoid long COVID is to avoid short COVID.

Simple public health measures such as masking, physical distancing, isolating when ill, and better ventilation can help tamp down the spread of the virus. Unfortunately, we’ve all but abandoned mitigation measures.

Vaccination helps, too. Research shows that people who are vaccinated and boosted are less likely to get very sick with COVID-19, and also less likely to develop long COVID.

Better diagnostic criteria would certainly help. So would some decent data collection and analysis.

We need to know more about the physiology, root causes and risk factors for long COVID. That will hopefully lead to better prevention and treatment.

Research is certainly essential, but it has to be less scattershot, and more co-ordinated.

The U.S. National Institutes of Health has invested more than US$1.1-billion in long-COVID research through an initiative called RECOVER (Researching COVID to Enhance Recovery). The Canadian Institutes of Health Research have, for their part, allocated $414-million for COVID-related research, but not enough of that has been dedicated to long COVID.

We also need a support system for those suffering, offering supports such as financial aid and better access to clinical care.

There are no simple solutions for tackling the thorny, multifaceted challenge that is long COVID. But it all starts with acknowledging, not dismissing, the threat and forging a response.

As Mr. McGarva says: “Long COVID has the potential to be a mass disabling event of epic proportions.”

But Generation COVID need not become Generation Long COVID.

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