The Long COVID Denial Zone: When the Pandemic Isn’t “Over” For Everyone
I wrote a version of this article and posted it, and pulled it down to correct the reference links. Then our large family, who so far mostly avoided SARS-COV-2 infection, had two infections, and I had to focus on taking care of them. Here is the updated version. Thank you to all those who sent messages of support.
Onward!
America has entered what I call the COVID denial zone, that strange psychological space where millions pretend everything’s back to normal while a growing shadow population struggles with long-term illness.
The Psychology of Mass Denial
Psychology tells us something powerful about human perception: personal experience trumps everything else. This cognitive tendency is called the availability heuristic (mental shortcut), we judge probability and risk based on examples that come easily to mind.
Back in 2020, the evidence of crisis was unavoidable, hospitals at capacity, death counts climbing daily, nursing homes decimated, grocery stores ransacked. Society was collectively freaking out because we all witnessed the same catastrophe simultaneously. If you watched the news on what was going on in in Italy, you felt this fear.
5.5 years Later Now
Five and a half years later? We’ve entered a dangerous phase where perception and reality have divorced. Studies show that approximately 85% of Americans have had COVID at least once by 2023, with many experiencing multiple infections. For those who recovered without complications, their lived experience shapes their worldview: “I survived COVID five times, so what’s the big deal?”
This perception is reinforced everywhere they look, grocery stores filled with shoppers, concerts packed with fans, and restaurants buzzing with conversation. The visible world appears “normal,” creating a powerful feedback loop that validates their experience.
The Invisible Suffering - Long COVID
But what about those who aren’t okay? Research from the Brookings Institution estimates that between 2-4 million Americans remain unable to work due to Long COVID symptoms. That’s equivalent to the entire population of Chicago vanishing from the workforce. Then there are those who can work, but are still deeply affected.
These suffering millions fall into several categories:
The Disappeared
These people aren’t visible in public spaces because they’re too sick to participate. A 2023 study in Nature Medicine found that 1 in 20 people with Long COVID experience symptoms so severe they become housebound or bedbound. They don’t shop at your grocery store. They don’t attend your concerts. Their absence reinforces the illusion that everyone recovered.
The Present But Invisible
Most chronically ill people don’t advertise their condition. The Journal of Health Psychology documented this phenomenon: chronic illness often becomes an “invisible identity” because sufferers fear stigma, disbelief, or simply don’t want pity. When was the last time you announced your health problems to strangers?
The Unrecognized
Many don’t connect their new health problems to COVID infection. Many patients with neurological symptoms post-COVID often attributed them to stress, aging, or “just feeling off” – especially when symptoms appeared weeks after acute infection.
The Growing Crisis We Don’t Want to See
Long COVID patients feel gaslit by a society racing to “move on.” They watch in horror as mask mandates disappeared, testing decreased, and public health messaging shifted to individual responsibility. Meanwhile, their community grows larger every day.
The data is alarming: according to CDC estimates, approximately 7-15% of COVID infections result in Long COVID lasting three months to years. With hundreds of millions of cumulative infections, we’re talking about a massive population, between 14-28 million Americans affected.
And treatment options? Limited at best. While specialized clinics have opened nationwide, wait times often exceed 6-12 months and many closing their doors. A systematic review in The Lancet found that most current approaches focus on symptom management rather than addressing underlying causes.
The Coming Reckoning
This is how society processes collective trauma, through denial until reality becomes undeniable. History shows us this pattern repeatedly. Think about climate change denial that persisted for decades until hurricanes started demolishing coastal cities annually.
The tipping point will come when:
1. Insurance companies notice the profit impact of millions with chronic conditions
2. Disability systems buckle under unprecedented claims (Social Security already reports a 50% increase in disability applications mentioning post-viral symptoms)
3. Economic productivity statistics can’t hide the missing workforce anymore
4. Politicians and their families join the ranks of the chronically ill
5. Doctors practices filling up. (Let’s not forget, they can also get Long COVID. I know two)
It’s like watching a bucket slowly fill with water. Right now, many people stand dry-footed, pointing at the bucket saying, “Look, it’s not overflowing yet!” But those paying attention can see the water level rising steadily. Eventually, everyone’s shoes will get wet.
Seeds of Change
Don’t surrender hope. The recent HHS meeting on Long COVID surprised many with its seriousness and candor. For the first time, officials acknowledged viral persistence as a legitimate mechanism of disease, something patients and advocates have argued for years.
It’s worth noting that reports suggest RFK Jr’s son developed Long COVID, potentially bringing personal urgency to the administration’s approach. Throughout history, health crises often gain political momentum when they touch the powerful.
Researchers haven’t abandoned the fight either. The NIH’s RECOVER initiative has now enrolled over 10,000 participants in what represents the largest coordinated research effort on post-viral illness in history. Breakthrough treatments may still be years away, but the scientific groundwork is being laid.
The Reality Check
History teaches us that denial is always temporary. Reality eventually breaks through because, well, it’s reality. The growing economic and human costs of Long COVID can’t remain invisible forever.
For now, we exist in this strange liminal space where millions suffer while others party like it’s 2019. But as the bucket continues to fill, drop by inexorable drop, more people will find the water rising around their ankles.
And when that happens, perhaps we’ll finally have the honest conversation about what living with endemic SARS-CoV-2 actually means for humanity.
I wrote a version of this article and posted it, and pulled it down to correct the reference links. Then our large family, who so far mostly avoided SARS-COV-2 infection, had two infections, and I had to focus on taking care of them. Here is the updated version. Thank you to all those who sent messages of support.
Onward!
America has entered what I call the COVID denial zone, that strange psychological space where millions pretend everything’s back to normal while a growing shadow population struggles with long-term illness.
The Psychology of Mass Denial
Psychology tells us something powerful about human perception: personal experience trumps everything else. This cognitive tendency is called the availability heuristic (mental shortcut), we judge probability and risk based on examples that come easily to mind.
Back in 2020, the evidence of crisis was unavoidable, hospitals at capacity, death counts climbing daily, nursing homes decimated, grocery stores ransacked. Society was collectively freaking out because we all witnessed the same catastrophe simultaneously. If you watched the news on what was going on in in Italy, you felt this fear.
5.5 years Later Now
Five and a half years later? We’ve entered a dangerous phase where perception and reality have divorced. Studies show that approximately 85% of Americans have had COVID at least once by 2023, with many experiencing multiple infections. For those who recovered without complications, their lived experience shapes their worldview: “I survived COVID five times, so what’s the big deal?”
This perception is reinforced everywhere they look, grocery stores filled with shoppers, concerts packed with fans, and restaurants buzzing with conversation. The visible world appears “normal,” creating a powerful feedback loop that validates their experience.
The Invisible Suffering - Long COVID
But what about those who aren’t okay? Research from the Brookings Institution estimates that between 2-4 million Americans remain unable to work due to Long COVID symptoms. That’s equivalent to the entire population of Chicago vanishing from the workforce. Then there are those who can work, but are still deeply affected.
These suffering millions fall into several categories:
The Disappeared
These people aren’t visible in public spaces because they’re too sick to participate. A 2023 study in Nature Medicine found that 1 in 20 people with Long COVID experience symptoms so severe they become housebound or bedbound. They don’t shop at your grocery store. They don’t attend your concerts. Their absence reinforces the illusion that everyone recovered.
The Present But Invisible
Most chronically ill people don’t advertise their condition. The Journal of Health Psychology documented this phenomenon: chronic illness often becomes an “invisible identity” because sufferers fear stigma, disbelief, or simply don’t want pity. When was the last time you announced your health problems to strangers?
The Unrecognized
Many don’t connect their new health problems to COVID infection. Many patients with neurological symptoms post-COVID often attributed them to stress, aging, or “just feeling off” – especially when symptoms appeared weeks after acute infection.
The Growing Crisis We Don’t Want to See
Long COVID patients feel gaslit by a society racing to “move on.” They watch in horror as mask mandates disappeared, testing decreased, and public health messaging shifted to individual responsibility. Meanwhile, their community grows larger every day.
The data is alarming: according to CDC estimates, approximately 7-15% of COVID infections result in Long COVID lasting three months to years. With hundreds of millions of cumulative infections, we’re talking about a massive population, between 14-28 million Americans affected.
And treatment options? Limited at best. While specialized clinics have opened nationwide, wait times often exceed 6-12 months and many closing their doors. A systematic review in The Lancet found that most current approaches focus on symptom management rather than addressing underlying causes.
The Coming Reckoning
This is how society processes collective trauma, through denial until reality becomes undeniable. History shows us this pattern repeatedly. Think about climate change denial that persisted for decades until hurricanes started demolishing coastal cities annually.
The tipping point will come when:
1. Insurance companies notice the profit impact of millions with chronic conditions
2. Disability systems buckle under unprecedented claims (Social Security already reports a 50% increase in disability applications mentioning post-viral symptoms)
3. Economic productivity statistics can’t hide the missing workforce anymore
4. Politicians and their families join the ranks of the chronically ill
5. Doctors practices filling up. (Let’s not forget, they can also get Long COVID. I know two)
It’s like watching a bucket slowly fill with water. Right now, many people stand dry-footed, pointing at the bucket saying, “Look, it’s not overflowing yet!” But those paying attention can see the water level rising steadily. Eventually, everyone’s shoes will get wet.
Seeds of Change
Don’t surrender hope. The recent HHS meeting on Long COVID surprised many with its seriousness and candor. For the first time, officials acknowledged viral persistence as a legitimate mechanism of disease, something patients and advocates have argued for years.
It’s worth noting that reports suggest RFK Jr’s son developed Long COVID, potentially bringing personal urgency to the administration’s approach. Throughout history, health crises often gain political momentum when they touch the powerful.
Researchers haven’t abandoned the fight either. The NIH’s RECOVER initiative has now enrolled over 10,000 participants in what represents the largest coordinated research effort on post-viral illness in history. Breakthrough treatments may still be years away, but the scientific groundwork is being laid.
The Reality Check
History teaches us that denial is always temporary. Reality eventually breaks through because, well, it’s reality. The growing economic and human costs of Long COVID can’t remain invisible forever.
For now, we exist in this strange liminal space where millions suffer while others party like it’s 2019. But as the bucket continues to fill, drop by inexorable drop, more people will find the water rising around their ankles.
And when that happens, perhaps we’ll finally have the honest conversation about what living with endemic SARS-CoV-2 actually means for humanity.
Some More Reading
What It’s Like to Live With an Invisible Illness - Psychology Today
psychologytoday.com/us/blog/turnin…
Tipping Points?
New data shows long Covid is keeping as many as 4 million people out of work.
This data is from 3 years ago, this will be much higher now -’brookings.edu/articles/new-d…
Employment and labor force participation
People reporting long Covid show lower employment rates and higher economic inactivity in household and population surveys. pmc.ncbi.nlm.nih.gov/articles/PMC11…
Increased absenteeism for employers and schools
Workers with long Covid miss more workdays on average than matched peers and report higher short term and intermittent absence. journals.plos.org/plosone/articl…
Impacts on military readiness
Military health authorities report persistent post infection illness among service members, with lost duty days, training interruptions, and effects on readiness tracked by military medicine. Prolonged cases create operational challenges for force health management and training pipelines. health.mil/Reference-Cent…
Insurance costs and claims burden
Workers compensation and insurer reports show increased complexity and ongoing medical costs from long term post infection claims. Insurers and regulators are monitoring evolving claim volumes and severity because sustained increases in long term claims can push premiums and reserves.
wcirb.com/sites/default/…
Disability claims and benefits systems
Advocates and researchers document rising demand for disability evaluations tied to long Covid, plus guidance and case series on documenting functional impairment. Social Security and other systems face adjudication challenges and uneven access to benefits for people with fluctuating, non visible symptoms. pmc.ncbi.nlm.nih.gov/articles/PMC10…
US - The Economic Cost of Long COVID
The Economic Cost of Long COVID: An Update - Harvard
scholar.harvard.edu/files/cutler/f…
What It’s Like to Live With an Invisible Illness - Psychology Today
psychologytoday.com/us/blog/turnin…
Tipping Points?
New data shows long Covid is keeping as many as 4 million people out of work.
This data is from 3 years ago, this will be much higher now -’brookings.edu/articles/new-d…
Employment and labor force participation
People reporting long Covid show lower employment rates and higher economic inactivity in household and population surveys. pmc.ncbi.nlm.nih.gov/articles/PMC11…
Increased absenteeism for employers and schools
Workers with long Covid miss more workdays on average than matched peers and report higher short term and intermittent absence. journals.plos.org/plosone/articl…
Impacts on military readiness
Military health authorities report persistent post infection illness among service members, with lost duty days, training interruptions, and effects on readiness tracked by military medicine. Prolonged cases create operational challenges for force health management and training pipelines. health.mil/Reference-Cent…
Insurance costs and claims burden
Workers compensation and insurer reports show increased complexity and ongoing medical costs from long term post infection claims. Insurers and regulators are monitoring evolving claim volumes and severity because sustained increases in long term claims can push premiums and reserves.
wcirb.com/sites/default/…
Disability claims and benefits systems
Advocates and researchers document rising demand for disability evaluations tied to long Covid, plus guidance and case series on documenting functional impairment. Social Security and other systems face adjudication challenges and uneven access to benefits for people with fluctuating, non visible symptoms. pmc.ncbi.nlm.nih.gov/articles/PMC10…
US - The Economic Cost of Long COVID
The Economic Cost of Long COVID: An Update - Harvard
scholar.harvard.edu/files/cutler/f…
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