Another Covid-19 wave is here.
So far, it looks relatively mild.
But even “mild” waves bring disruption—missed work, missed school, interrupted vacations—and risk of severe illness, especially for people who aren’t up to date on vaccines.
And then there’s long Covid.
Five years after it first appeared, hundreds of thousands of Americans are still living with its disabling effects. Progress in research has been slow and frustrating at times, but it has moved forward—study by study, patient by patient. Here’s what the science has revealed in the past year.
Note: If you’re new here, we share a long Covid update once or twice a year. This post builds on our last roundup—if you’d like to catch up, you can read that one here.
While some people gradually get better over time, full recovery is not guaranteed, and for the vast majority of people, symptoms persist or even evolve. For example:
- In one U.S. study of more than 1,000 people with long Covid: about half reported symptoms that came and went, 26% saw gradual improvement, 19% had no change, and 8% worsened.
- U.K. data—some of the best available—suggest about 30% of people recover within a year. That still leaves the majority struggling.
- Only ~2% report complete resolution of symptoms in some studies.
This pattern isn’t unique to Covid. After the original SARS outbreak in 2003, many survivors were still disabled nearly 20 years later.
For patients, the toll is wide-ranging: from brain fog to being bedridden, from repeat hospitalizations to major financial strain. One study found long Covid patients were three times more likely to be hospitalized again compared to with those without it.
Measuring long Covid has always been messy. Definitions vary, the virus keeps changing, and immunity levels shift.
Still, the best current estimates suggest about 3–8% of people in the general population have long Covid today.
Encouragingly, the number of new cases is falling.
Why? Mostly because vaccines and prior infections now protect many people from severe disease, which is strongly linked to long Covid risk.
- Vaccination contributed to an estimated 70% of the decline in one study.
- Each new variant has brought lower long Covid rates, likely due to rising immunity rather than changes in the virus itself.
- Reinfections carry a lower risk than first infections (around 6% vs. 15%).
But risk isn’t gone.
A recent preprint found that reinfections still increase the likelihood of long Covid compared with never being reinfected.
Put differently: reinfection raises relative risk by 35%, but the absolute increase is about 3 extra cases per 100 people.
Like Covid-19 itself, long Covid risk varies by group. Women, older adults, and people with underlying conditions remain more vulnerable.
This past year, studies added more detail:
- Preexisting asthma and COPD increase risk.
- Exposure to air pollution (fine particulate matter) raises risk, with supporting evidence from Spain, Saudi Arabia, and Sweden.
- Lower physical fitness is linked to higher risk.
- Certain professions—especially healthcare and dental workers—face elevated risk.
The takeaway: risk is uneven, shaped by both biology and environment.
There are still no FDA-approved treatments for long Covid.
Care today focuses on symptom relief, rehab, and trial-and-error management.
What’s urgently needed are biomarkers—tests that could diagnose and track the disease—and therapies that target its root causes.
That said, several promising randomized clinical trials are underway:
- Repurposed anti-inflammatory drugs (already approved for arthritis and lung disease) are being tested across four continents.
- A monoclonal antibody, originally designed to prevent Covid infection, is being studied in a randomized, placebo trial as a potential long Covid treatment in Florida.
Funding tells its own story. The Biden administration’s initial investment in 2021 went mostly to observational studies—helpful for understanding the problem but less so for finding treatments.
To accelerate progress, Senator Bernie Sanders introduced the Moonshot Act in 2024, proposing $1 billion annually for long Covid research over the next decade.
It has yet to move forward.
In late March, the Trump administration rescinded 45 grants to study long Covid, but thanks to quick news coverage and advocacy efforts, the money was restored. However, other funding cuts continue to impact long Covid research and support.
Still, there is bipartisan willpower.
At a recent Senate hearing, Senator Bill Cassidy (physician, Republican in Louisiana) noted research support for long Covid was important, and RFK Jr agreed, saying: “I am 100% committed to finding treatments for long Covid,” and “I have a son who is really dramatically affected.”
Long Covid is one of the reasons I still try to avoid getting Covid-19 infections. (That, and the fact that as a working mom, I don’t have the luxury of being knocked out for a week.)
But like many risks in life, long Covid risk isn’t something I can reduce to zero.
I think of it the same way I think about driving a car: every trip carries a small but real chance of an accident.
I still drive, but I do what I can to lower my risk—seatbelts, airbags, safe driving.
Right now, research suggests the risk of developing long Covid from a single infection is about 2–6%. To put that in perspective:
- Less likely than long Covid
- Being struck by lightning in your lifetime: ~1 in 15,000
- Dying in a plane crash: ~1 in 11 million per flight
- Being seriously injured in a car accident: ~1 in 700
- Similar ballpark
- More likely than long Covid
- Asthma diagnosis: ~1 in 10
- Developing diabetes (cumulative): ~2 in 5
So long Covid isn’t a freak accident like a lightning strike. It’s in the same category as other common medical conditions—serious enough that I don’t want to ignore it, but not inevitable either.
Long Covid remains one of the most serious legacies of the pandemic. Risk has decreased over time, but millions still live with symptoms that disrupt their lives. Treatments are not yet here, but the research pipeline is moving, and scientific and political willpower seem to remain strong.
The best protection remains prevention: stay up to date on vaccines, reduce exposure during surges, and care for your overall health.
Love, YLE
A big thanks to Andrea Tamayo and Hannah Totte for all the research that went into this post.
Your Local Epidemiologist (YLE) is founded and operated by Dr. Katelyn Jetelina, MPH PhD—an epidemiologist, wife, and mom of two little girls. YLE is a public health newsletter that reaches over 380,000 people in more than 132 countries, with one goal: to translate the ever-evolving public health science so that people are well-equipped to make evidence-based decisions. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members. To support the effort, subscribe or upgrade below:
