With the official end of the COVID-19 pandemic declared over a year ago, many are moving on. Yet, a steady stream of research reveals a more complicated and concerning picture of the virus’s long-term impact on our bodies and brains. To unpack these findings and what they mean for public health, we’re speaking with a leading expert in health policy and journalism who has been closely tracking the intersection of emerging science and government response. Our conversation will explore the profound and sometimes hidden consequences of COVID-19, from its effects on cognitive function and cardiovascular health to the potential for intergenerational harm, and examine how current health policies are aligning—or clashing—with these critical discoveries.
Recent studies suggest COVID-19 infection can lead to long-term cognitive decline and neurodevelopmental issues in children. Given these findings, what are the potential long-term societal and healthcare consequences of scaling back public health funding and vaccine development programs at this critical stage? Please elaborate with some examples.
It’s a deeply concerning disconnect. On one hand, the science is painting a clearer picture of COVID’s long shadow. We’re seeing studies that link a mother’s infection during pregnancy to a higher risk of autism or developmental delays in her child. This isn’t just a short-term illness; it’s a virus with the potential to impact future generations. At the same time, we’re seeing a significant pullback. The administration has not only halted nearly $500 million in funding for advanced mRNA vaccine development but also scaled back recommendations, just as we’re learning how vital these tools are. The long-term consequences are staggering. We’re looking at immense societal costs—the annual burden is already estimated at $9,000 per patient in the U.S. This translates to higher healthcare expenditures for years to come and greater demands on social programs and caregivers to support those with chronic conditions. People forget, as Michael Osterholm said, that the legacy of COVID will be long, and we are just beginning to understand its chronic effects.
Health officials have narrowed recommendations for COVID vaccines, aiming to restore “informed consent” and discourage “one size fits all” policies. How might this shift impact public trust and vaccination rates, especially when research highlights the vaccine’s role in reducing severe long-term health risks?
The stated goal of restoring “informed consent” sounds reasonable on the surface, but in practice, it creates a confusing and potentially dangerous landscape for the public. Trust is built on clear, consistent, science-backed guidance. When you have officials drastically limiting recommendations—for instance, to only those 65 or older or with specific risk factors—it sends a mixed message. It implicitly suggests the virus is no longer a broad threat, which runs counter to the evidence. We know from over a dozen studies that vaccines can reduce the risk of not just severe infection but also these longer-lasting health effects. Yet, we see the consequences of this messaging in the numbers: as of this past January, only about 17% of adults had received the updated shot. This shift risks eroding the public’s confidence in public health institutions and leaves millions of people more vulnerable to the very chronic issues—brain fog, heart problems, and more—that the science is telling us we should be aggressively trying to prevent.
Research has linked even mild COVID to cognitive deficits comparable to an IQ drop, with estimated U.S. productivity losses of $170 billion annually. Could you walk us through the day-to-day challenges individuals face with this “brain fog” and how this widespread issue impacts our workforce?
The impact is profound and deeply personal. That $170 billion figure represents millions of individual struggles. For someone experiencing this, it’s not just about forgetting a name or a date. It’s a fundamental disruption of their ability to function. Take Diane Yormark, a retired copywriter who described the feeling as being “out of it,” as if you’d had a bit too much wine the night before. Or Dee Farrand, who went from being an “Energizer bunny” to someone whose cognitive abilities declined so severely she couldn’t read a book because she’d forget the first sentence after reading the second. She had to leave reminders for herself about basic facts, like a food allergy. In the workplace, this translates to missed deadlines, errors in work, and an inability to perform complex tasks. We’re talking about a potential increase of 2.8 million adults in the U.S. with an IQ below 70, a level of impairment that often requires significant support. This isn’t just a minor inconvenience; it’s a silent epidemic of cognitive impairment that is actively hampering our workforce and economy.
We are learning that COVID’s inflammatory response can elevate cardiovascular risk for years and potentially reactivate dormant cancer cells. What specific monitoring protocols or steps should patients and doctors consider after an infection to proactively manage these serious, long-tail risks?
This is precisely where the call for more long-term monitoring becomes critical. The virus’s ability to provoke a lasting inflammatory response means the danger doesn’t end when the initial symptoms do. For cardiovascular health, we have seen studies showing the risk for a major cardiac event remains elevated for nearly three years post-infection, even in people who were never hospitalized. This suggests that patients, especially those with pre-existing risk factors, should be having more deliberate conversations with their doctors about monitoring heart health—things like regular blood pressure checks, cholesterol screenings, and paying close attention to new symptoms like arrhythmias. The findings on cancer are equally alarming. Research found a nearly twofold increase in cancer mortality among survivors who had been infected with COVID. This means for a cancer survivor, a subsequent COVID infection should trigger a period of heightened vigilance and follow-up with their oncology team to watch for any signs of relapse. The key is to shift our thinking from COVID as an acute respiratory illness to a systemic event that may require years of careful, proactive health management.
Emerging data suggests a mother’s COVID infection during pregnancy could affect her child’s long-term neurological and metabolic health. What does this potential for intergenerational impact mean for family planning and prenatal care, and what key metrics should researchers be tracking over the next decade?
This is one of the most sobering areas of research. The idea that a virus can cross the placental barrier and potentially alter a child’s developmental trajectory is a game-changer for how we approach prenatal care and counseling. It means that for those planning a family, preventing COVID infection becomes a crucial part of ensuring a healthy pregnancy and a healthy baby. The conversation must now include the fact that avoiding the virus may reduce risks not just for the mother but for the future generation. Over the next decade, researchers must meticulously track these children. Key metrics will include neurodevelopmental milestones—watching for delayed speech and motor skills, and monitoring for signs of conditions like autism. We also need to track metabolic health. One study already found accelerated weight gain in the first year of life for babies exposed in utero, which is a potential harbinger for later-life cardiovascular disease. We need long-term cohort studies that follow these children through adolescence to truly understand the full scope of this impact on their brain development, metabolism, and overall health.
What is your forecast for the long-term management of COVID-19?
My forecast is that we are heading toward a two-tiered reality. On one side, the scientific and medical communities will continue to uncover the deep, chronic, and complex ways this virus impacts human health, from the brain to the heart to our very DNA. The evidence of long-term harm will become undeniable. On the other side, I fear that public policy and public attention will continue to drift, treating COVID as a minor, seasonal nuisance. This growing gap between scientific reality and public policy will leave millions of people to navigate the consequences on their own, leading to a sicker population, a less productive workforce, and a healthcare system burdened by a wave of chronic conditions that we could have mitigated. The real challenge won’t be a lack of knowledge, but a lack of will to act on it.
