Pandemic legacy continues to weigh on health systems
Long Covid continues to cast a prolonged shadow over health systems and economies, with new analysis from the Organisation for Economic Co-operation and Development highlighting the enduring financial and clinical burden of the condition.
According to the report, the post-viral syndrome remains a significant challenge more than five years after the pandemic began, affecting millions across developed economies. At its peak in 2021, around 75 million people, over 5% of the OECD population, were living with long Covid, generating substantial healthcare demand and costs. While prevalence has declined since then, the OECD warns that the condition is far from resolved. Instead, it has transitioned into a chronic, system-wide issue that continues to place sustained pressure on services such as primary care, outpatient clinics and hospital systems.
Billions in costs driven by productivity losses
The economic impact of long Covid is considerable, with both direct healthcare spending and indirect productivity losses contributing to the overall burden. Across OECD countries, healthcare systems are expected to spend around $11 billion annually on long Covid-related care between 2025 and 2035, even under conservative projections.
However, the report emphasises that the majority of costs stem not from treatment, but from reduced workforce participation. Long Covid is linked to absenteeism, reduced working hours and, in some cases, permanent withdrawal from employment.
Overall, the OECD estimates that the condition could reduce GDP by 0.1–0.2% annually across member countries, equating to losses of around $135 billion (£100 billion) per year over the next decade. In the UK specifically, separate analyses have suggested that long Covid-related productivity losses alone run into billions annually, reinforcing concerns about its long-term economic impact.
Persistent burden on NHS and care pathways
For the NHS, long Covid represents a structural challenge rather than a temporary surge in demand. Evidence cited by the OECD shows that patients with the condition continue to use healthcare services at higher rates for years after initial infection. Primary care consultations, diagnostic testing and hospital admissions all remain elevated among long Covid patients compared with those who recovered fully from acute infection. In England, consultation costs alone were found to be significantly higher for this group, reflecting ongoing clinical complexity.
Despite this, the report highlights gaps in how health systems are responding. Fewer than half of OECD countries have established formal care pathways for long Covid, and many lack dedicated funding or national strategies to manage the condition effectively. In the UK, specialist long Covid clinics were established during the pandemic, but services have since evolved unevenly, raising questions about long-term provision and integration into routine care.
Digital health and data key to future response
The OECD report underscores the importance of digital health tools and data integration in improving long Covid management. Better use of electronic health records and population-level data could help identify patients earlier, track outcomes and design more effective care pathways. Data-driven approaches are also seen as essential for understanding the long-term trajectory of the condition, which remains poorly defined.
In addition, remote monitoring and digital self-management tools may support patients living with chronic symptoms, reducing the need for repeated in-person consultations while maintaining continuity of care. However, the report warns that progress in digital and clinical innovation has been uneven, with significant variation in how countries collect and use data on long Covid. Standardised definitions, coding systems and surveillance mechanisms are still lacking in many settings.
Call for coordinated policy action
A central message from the OECD is the need for a coordinated, system-wide response to long Covid. The organisation calls for clearer clinical guidelines, integrated care pathways and stronger links between health services, employment support and social care. It also highlights the importance of involving patients in the design of services, reflecting the role of patient-led advocacy in shaping research and policy to date. Without sustained action, the report warns that long Covid risks becoming a persistent drag on both health systems and economic growth.
A long-term challenge for health and technology
The findings reinforce the view that long Covid is not simply a legacy of the pandemic, but an ongoing public health and economic issue. For the NHS and wider health systems, the challenge lies in balancing immediate service pressures with the need to develop long-term, sustainable care models. Digital health technologies, data integration and workforce support will all play a critical role in addressing this burden. As policymakers look to the next decade, the OECD’s warning is clear: without coordinated investment and innovation, the “long shadow” of Covid-19 will continue to shape healthcare delivery and economic performance for years to come.
