covid's brain impacts will have long-term economic effects

in a knowledge-based economy, we place a high value on brain function. but how much value do we place on understanding the factors that impact brain health, and developing solutions to ensure the condition of our brains remain optimal? how much do we value  brain capital , which encompasses brain skills and brain health, in a global economy that depends on it for growth and prosperity? as we learn more about the lasting impacts of sars-cov-2 — the virus that causes covid-19 — on the brain, these questions take on greater relevance for business and the economy.

the fight against viruses is more nuanced than simply preventing death. when kenneth irving and his partners founded rocket science health , a medical device company, in 2017, they set priorities that would have a social impact, including pandemic preparedness. when covid-19 was just beginning to grow into a global pandemic, kenneth asked: what if this respiratory virus could enter the central nervous system, or otherwise impact the brain? what would be the long-term consequences? will we be prepared with answers and solutions?

these questions led to the creation of a non-profit venture called the viral neural exploration ( vinex ) in april of 2020. the growth of vinex, which i lead, has mirrored a growing recognition that the devastating consequences of the covid-19 pandemic would not end for everyone after vaccination. this issue was first raised by researchers and clinicians, and then by people with lived experience who were beginning to organize on social media, and finally by public health officials and governments .

it is estimated that  10 to 35 per cent  of covid-19 survivors experience symptoms that persist weeks or even months after infection; this phenomenon is known as “long covid,” and it can be  debilitating . while there are a range of reported symptoms — as many as  200 by some counts — many are neurological or psychiatric in nature, including headaches, “brain fog,” chronic fatigue, impaired memory or concentration, anxiety, depression and insomnia. and if we look to the  evidence of other infectious diseases causing prolonged complications with long recoveries, and even triggering chronic illnesses, there is a precedent going back centuries — including post-pandemic brain impacts observed in the  russian  and  spanish flus — for what we are observing with covid-19 and what may lie ahead. but covid-19’s scale means prolonged complications and recoveries have the potential to become a national and global crisis that could significantly impact our available workforce, long into the future.

a  survey  conducted last may by vinex, the  covid long haulers support group canada  and  neurological health charities canada , found that 60 per cent of people living with long covid had to take a leave from work, 70 per cent had to reduce their hours, and one quarter had to go on disability leave. in addition,  women in their middle years — their prime working years — are disproportionately impacted by long covid, with estimates ranging from  60 per cent to 80 per cent  of all reported cases. while these findings point to direct costs to businesses, what has not been captured is the more insidious and difficult-to-measure costs: when brain health is not optimal, our workforce is not optimal; workers are less resilient to everyday stress, and they cannot deploy fully their intellect, creativity, and problem-solving skills. this represents a threat to productivity and profitability. as noted by the  oecd , business leaders (and governments) need to recognize that “economic and business activity are modulated by the mental capacity of their people.” indeed, the oecd’s new approaches to economic challenges group has established a  neuroscience-inspired policy initiative , which aims to use insights from brain science to influence policies supporting productivity, education and innovation.

the fact that  women , different  socio-demographic groups and  cultural communities , especially ethnic and racial minorities, are disproportionately impacted by the virus presents one more barrier to their full participation in the economy. for women in particular, as they shoulder the majority of caretaking and household management, the impact extends to unpaid (and sometimes unrecognized) work.

we are also learning that long covid does not just strike adults. while  estimates  of the incidence of long covid in children have varied considerably, according to preliminary results from a  study out of the u.k., up to 14 per cent still had symptoms 15 weeks following a positive covid diagnosis. as a consequence, parents and guardians of affected children have become caregivers and this may impact their ability to work full time.

at the start of the pandemic, we could not have imagined that a virus — not another financial crisis — would have such wide-ranging effects on the global economy. as i write this, a fourth wave  has gained  momentum. whatever calculations we have made to date of the economic cost of covid-19 are therefore too low.

nonetheless, there have been some staggering estimates thus far, varying from us$10 trillion to more than  us$16 trillion . this is multiples of the economic impact of the great recession. and while almost all countries in the world experienced negative growth, this was most marked in the  poorest countries . the costs will likely be higher as these figures do not include the financial impact caused by long covid; according to the  journal of the american medical association , “because there are approximately seven times as many survivors from severe or critical covid-19 disease as there are covid-19 deaths, long-term impairment might affect more than twice as many people as the number of people who die.”

for instance, it is estimated that  less than one per cent of alzheimer’s cases  have a direct genetic cause. a combination of genes, lifestyle and the environment all are thought to play a role, and there is ongoing research into whether  viruses can trigger alzheimer’s.

if viruses play a role in triggering neurodegenerative diseases such as alzheimer’s, a global viral pandemic could add to the anticipated immense economic and human cost of dementia alone. the  world health organization  estimates the global cost of dementia to have been us$ 1.3 trillion in 2019. the cost is projected to increase to us$ 1.7 trillion by 2030, or us$ 2.8 trillion if corrected for increases in care costs. these figures do not include the unpaid care or reduction in paid work taken on by loved ones.

research on the brain has therefore evolved from neuroscience to many different fields and disciplines converging, and to a broader view of how what is happening outside of the brain must be part of understanding brain function and brain disease. canada has been a leader in interdisciplinary  research  that requires us to connect concepts previously thought to be unrelated, and the intersection of the brain and infectious agents is an area of research that needs greater attention and investment.

the effects of the covid-19 pandemic will ripple for years, and probably even decades to come. understanding the pandemic’s impact on brain health, and thus on brain capital, will be central to the success of our knowledge-based economy. we need business leadership to  better support  members of the workforce who may continue to suffer from lasting impacts of covid-19, as the virus becomes endemic and long covid cases continue to grow. these cases may be difficult to diagnose and the impacts not immediately “visible,” but they are real, and in some cases, require paid leaves of absence.