One unwelcome surprise of the Covid-19 pandemic has been the emergence of numerous symptoms such as brain fog, respiratory complaints or insomnia that can develop after acute infections.
As scientists begin to understand the syndrome known as long Covid, Swiss Re is following their work closely, to gauge its impact on our industry as we help make society more resilient for the next crisis.
In the United States, the United Kingdom and elsewhere, research is underway to better grasp the long-term, physical and psychological impacts of long Covid on patients.
We also see promising clinical trials seeking to find out whether medicines can be repurposed to help those suffering from post-acute Covid-19 symptoms.
What scientists ultimately discover about long Covid will be extremely important for insurers as products are adapted to take into account emerging data about morbidity and mortality impacts.
If past pandemics and their consequences are any guide, however, the search for definitive answers will be long and may be fraught with ambiguity.
For instance, in the years and decades after the 1918 flu pandemic, scientists also observed puzzling longer-term neurological symptoms in those who survived infections.
Similarly, the 20th century’s pre-vaccine polio outbreaks had a long tail; people who survived mild or even asymptomatic infections experienced disabling symptoms decades later.
Doctors are still working to understand post-polio syndrome.
Learning in real time
While no pandemic is alike, history teaches us that the long-term consequences of viral infections are complex and unpredictable.
This will likely be true for Covid-19 and long Covid, which is no single, monolithic entity or disease but has become an umbrella term for many persistent symptoms.
To better understand long Covid’s implications for the insurance industry, it will be extremely important to differentiate between the conditions that are now being categorised under this term. This is where robust research comes in.
It will help us transition from the tendency to view this syndrome as a single bucket of ailments, with a long and diffuse list of poorly understood symptoms, to having a more-nuanced grasp of its organ-specific risks and the associated impact.
Insurers should consider expanding on what is really known about these conditions, and importantly, whether they will eventually lead to adjustments to underwriting including for critical illness and disability insurance, to ensure that products remain sustainable and continue to meet the needs of customers.
Fortunately, the body of long Covid research, so far, suggests most people’s symptoms improve with time and, in some instances, appropriate rehabilitation.
A small percentage of those affected, potentially around 1%, may experience longer-term disability.
One challenge doctors and scientists face is that symptoms that occur in long Covid patients also occur in people suffering from ailments unrelated to Covid-19.
Preparing for the next pandemic
The frustrating uncertainty that often surrounds long Covid and complicates its management should serve as a reminder to society – and to the insurance industry – that we must do a better job preparing for the next pandemic.
We should work to better position the world to respond to early threats from infectious diseases, especially since there is ample evidence that they have lasting consequences even after the immediate crisis has passed.
In our latest study into the new and emerging risk facing society, the 2022 SONAR publication, we uncovered the necessity of not only renewing our focus on disease monitoring and prevention but also rebuilding trust in doctors, healthcare and institutions.
Studies have shown that people who mistrusted institutions may have also been less willing to receive a potentially life-saving vaccination.
Progress on this front can help avoid repeating the mistakes of this pandemic, if and when the next one comes.
Such work won’t be easy, however, especially with so many other crises – the war in Ukraine, inflation and slowing economic growth, political and judicial upheaval – now competing for our attention.
But it is essential that we do not lose sight of this objective.
The insurance industry, in partnership with governments and other organisations, has a key role to play in strengthening national healthcare systems and narrowing the protection gap.
This includes embracing the benefits of digitalisation to boost access to coverage, make it more affordable and meet evolving needs of insurance consumers whose mental and physical health suffered over the last two years, including from impacts of long Covid.
Keeping these goals squarely in focus will also be critical as we tackle the next phase of the current pandemic, as infections with Covid-19 subvariants in the United States, China, and elsewhere demonstrate that learning to live with this evolving virus remains the only alternative.