New modelling conducted for WHO/Europe by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington’s School of Medicine in the United States shows that in the first two years of the pandemic, at least 17 million individuals across the 53 Member States of the WHO European Region may have experienced post COVID-19 condition, also known as long COVID. In other words, an estimated 17 million people met the WHO criteria of a new case of long COVID with symptom duration of at least three months in 2020 and 2021.

The modelling indicates a staggering 307% increase in new long COVID cases identified between 2020 and 2021, driven by the rapid increase in confirmed COVID-19 cases from late 2020 and through-out 2021. The modelling also suggests that females are twice as likely as males to experience long COVID. Furthermore, the risk increases dramatically among severe COVID-19 cases needing hospitalization, with one in three females and one in five males likely to develop long COVID.

“While there is much we still need to learn about long COVID, especially how it presents in vaccinated versus unvaccinated populations and how it impacts reinfections, this data highlights the urgent need for more analysis, more investment, more support, and more solidarity with those who experience this condition,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. “Millions of people in our Region, straddling Europe and central Asia, are suffering debilitating symptoms many months after their initial COVID-19 infection. They cannot continue to suffer in silence. Governments and health partners must collaborate to find solutions based on research and evidence.”

Dr Christopher Murray, Director of IHME, one of WHO’s 800 Collaborating Centres, said: “IHME’s research shows that nearly 145 million people around the world in the first two years of the pandemic suffered from any of the three symptom clusters of long COVID: fatigue with bodily pain and mood swings, cognitive problems, and shortness of breath. Fast-forward to today and millions of people continue to suffer because of COVID-19’s lingering impact on their health and livelihoods. Knowing how many people are affected and for how long is important for health systems and government agencies to develop rehabilitative and support services. It’s also paramount for employers to understand, so that special accommodations can be made to help those facing limitations.”

Fatigue, breathlessness and cognitive dysfunction
Post COVID-19 condition, or long COVID, refers collectively to the constellation of long-term symptoms that some people experience after they have had COVID-19. While most people who develop COVID-19 fully recover, it is estimated that 10–20% develop a variety of mid- and long-term effects like fatigue, breathlessness, and cognitive dysfunction (for example, confusion, forgetfulness, or a lack of mental focus and clarity). Long COVID can also directly and indirectly affect mental health. Prolonged suffering and distress due to long COVID can impact psychological well-being. These symptoms might persist from the initial illness or develop after recovery. They can come and go or relapse over time. The condition can affect a person’s ability to perform daily activities such as work or household chores.

To help to address the gaps in our knowledge and advocate for people living with long COVID, WHO/Europe has partnered with Long COVID Europe, a network organization that comprises 19 patient associations based in Member States across the European Region.

Long COVID Europe and WHO/Europe have together developed three goals – the 3Rs – jointly calling upon governments and health authorities to focus attention on long COVID and people living with it through greater:
• recognition and knowledge sharing, where all services are adequately equipped, and no patient is left alone or having to struggle to navigate a system that is not prepared, or not capable of, recognizing this debilitating condition;
• research and reporting through data gathering and reporting of cases, and well-coordinated research, with full participation of patients needed to advance understanding of the prevalence, causes and costs of long COVID; and
• rehabilitation that is based on evidence and effectiveness, and is safe for both patients and carers.

“For these goals to be achieved, we need all countries in the WHO European Region to recognize that long COVID is a serious problem with serious consequences and that it requires a serious response to stop the lives of those affected from getting any worse – and not just on a physical health level,” said Dr Kluge. “We are hearing stories of so many individual tragedies, of people in financial crisis, facing relationship problems, losing their jobs, and falling into depression. Many health workers who risked their lives on the front lines of the pandemic now have this chronic and debilitating condition as a result of an infection acquired in the workplace. They, and millions of others, need our support. The consequences of long COVID are clearly severe and multifaceted.”

Dr Natasha Azzopardi-Muscat, WHO/Europe’s Director of Country Health Policies and Systems, said: “Leaving no one behind is more than just a tagline, and leaving people struggling with the consequences of their COVID-19 infections while others move on with their lives is not an option. WHO/Europe is committed to working with long COVID patient associations, research institutions, public health authorities and governments to improve research and ensure that health services can support patients properly with their rehabilitation needs.”