Quantifying the Enduring Health and Employment Effects of COVID-19

• In Event: Lightning Session: Health Policy & Natural Resource, Energy, and Environmental Policy

Abstract

Long COVID, a term used to collectively refer to a wide range of persistent health complications from the acute infection, are estimated to affect as many as one in five COVID-19 survivors. It can impair individuals’ ability to work and potentially trigger life-long disabilities. Understanding the long-term implications of COVID-19 on health and employment is of first-order importance for public health policy and many safety net programs as long COVID patients are potential future beneficiaries of these programs. With its myriads of symptoms, a challenge in quantifying the impact of long COVID is the absence of definitive biomarkers and finding a reasonable comparison group. 

This paper quantifies the health and employment impacts of severe COVID-19 infections by comparing individuals hospitalized for COVID-19 to those hospitalized for other acute respiratory infections (ARI) in the pre-pandemic period. We conduct event study analyses for the 12 months before and after the focal hospitalization using all-payer claims data (APCD) for 2016--2021. We examine healthcare utilization and the frequency and persistence of specific conditions, such as chronic fatigue, that are likely precursors to changes in labor force participation. For the subsample of individuals with employer-sponsored insurance (ESI) plans as the primary beneficiaries, which we interpret as a proxy for full-time employment, we investigate their trajectories of primary ESI coverage rates. We adjust for firm-level differences in rates of separation by matching hospitalized individuals with coworkers who were employed at the same firm as each focal worker but were not hospitalized and have similar characteristics. 

We find that: (1) The health impacts of COVID-19 are largely similar to those of ARI, with a few exceptions: long-term diagnosis rates for chronic fatigue and sleep disorders are higher for COVID-19 than for ARI, with results largely driven by younger adults. (2) Relative to coworkers, the probability of having employer-sponsored insurance, taken as a proxy for employment, drops precipitously and immediately after discharge for ARI patients, but starts to decrease only in the third month after discharge for COVID-19 patients. And (3), COVID-19 affects the young, working-age population, who are generally less susceptible to respiratory complications, far more than ARI.

Our results may be surprising given that the popular discourse on long COVID emphasizes its peculiarity. While the long-term sequelae of COVID-19 are not necessarily more severe than ARI, the former is perhaps more concerning because of the population it affects (i.e., younger and healthier individuals). Our findings have important ramifications on the quality of life for many young individuals and the sustainability of social programs. This paper offers new insights to help contextualize the impact of long COVID on many public programs.

Author

• Adibah Abdulhadi, The Ohio State University
  Presenting Author