Long Covid Is Just Getting Started. We’re Not Ready for It.

One of the more striking aspects of the pandemic is just how unwilling we’ve been to engage in the collective interventions that could mitigate it. Whether it’s wearing a mask, social distancing, or getting a shot, too many of us have been unwilling to sacrifice our individual choice for the collective well-being. The result is the vast scale of death and disease in the United States compared to other high-income societies. We suffered twice the number of cases that Canada did—and nearly three times the number of deaths per capita. That’s in part because 80 percent of Canadians are fully vaccinated compared to just 65 percent of Americans. It’s also because Canadian provinces instituted far more stringent vaccine requirements and social distancing guidelines than U.S. states did—and the Canadian government supported its population with far more generous Covid relief, the largest since World War II.

Should Covid-19 carry long-term consequences we don’t yet know about, Canadians will be far better prepared than our decentralized system leaves us.

But this should have been predictable. After all, Canadians have consistently invested more in the collective—and reaped the benefits. Take the Canadian health system, which guarantees every resident access to high-quality, affordable health care. Should Covid-19 carry long-term consequences we don’t yet know about, Canadians will be far better prepared than our decentralized system leaves us.

But unlike the pandemic phase, we have time to prepare for the long term—should we choose to use it. It’s notable that President Biden’s languishing Build Back Better package includes home- and community-based services for Americans needing long-term care. Guaranteeing this kind of support for Americans is critical to protecting ourselves from Covid sequelae we may not yet know exist.

The other critical investment is guaranteed national health insurance that provides Americans with affordable health coverage. Right now, nearly 10 percent of Americans don’t even have health care. Considering the racial and socioeconomic disparities in Covid infection, those uninsured are more likely to have suffered Covid-19. Worse, millions of people could lose their health care coverage as a result of a rollback in the pandemic-era Medicaid expansion.