Exploring the persisting challenge of long Covid around the globe

While the World Health Organisation has removed Covid-19's health emergency label, it is still a threat, with millions around the world now grappling with long-term health problems after recovering from the virus.

This condition – known as long Covid, post-Covid-19 syndrome or PASC – is also found in other viral diseases such as Zika and Ebola.

About 765 million cases of Covid-19 have been recorded worldwide, though this is believed to be a major undercount.

Long Covid has been observed in those with a history of SARS-CoV-2 infection whose symptoms persist for at least two months, about three months after the onset of Covid-19.

Patients suffering from long Covid often display a variety of symptoms, including fatigue, headache, attention disorder, dyspnea and cognitive dysfunction, which can significantly affect daily functions.

Notably, the occurrence and duration of these symptoms can vary, with neurological and cognitive symptoms tending to appear later and persist longer than respiratory and other symptoms.

The US Centres for Disease Control and Prevention uses the term “Post-Covid Conditions” to describe these symptoms.

Sufferers from long Covid often report having difficulty in falling or staying asleep. Alamy
Chest pain can be one of the more acute symptom of long Covid. Getty Images
Fatigue is a common long-term symptom. Getty Images
Anxiety and depression can persist after being infected with coronavirus.
One of the first reported symptoms of Covid-19 was a lack of taste and smell, which can persist even after testing negative for the virus. Getty Images
So-called brain fog is a common long-term symptom of Covid-19. Getty Images
Even the most active people can suffer from prolonged joint and muscle pain after contracting Covid-19. Getty Images
Some people complain of feeling tightness in the chest for months after supposedly having recovered from Covid-19. Getty Images

The impact of long Covid

New symptoms may appear after the initial recovery, or symptoms from the acute infection may persist, fluctuate or relapse over time.

These ongoing health issues can have a major effect on a person's quality of life and can be associated with functional impairments.

Even seemingly unrelated conditions or diseases, such as autoimmune diseases or diabetes mellitus, can be triggered.

Healthcare professionals have also identified distinct clinical phenotypes related to various underlying disease mechanisms in patients suffering from long Covid.

For instance, a study presented at the 33rd European Congress of Clinical Microbiology and Infectious Diseases organised patients into three distinct phenotypes based on differing characteristics and symptoms.

Long Covid can affect diverse patient populations, including those with comorbidities, pregnant women, the elderly and children.

In February, the WHO released a new definition for paediatric long Covid, paving the way for better characterisation of the disease in paediatric age groups and improving awareness.

Long Covid's prevalence and research needs

Existing research suggests a majority of patients with post Covid-19 condition improve slowly over a two-year course.

Some of the clinical findings associated with long Covid, modified from Davis et al. Photo: Davis et al

Estimates suggest that 43 per cent to 80 per cent of people who catch the virus will experience long Covid.

But more research is needed to understand how people are affected and how symptoms change over time.

Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.

Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.

“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.

Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.

“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.

Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.

From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.

Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.

BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.

Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.

Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.

“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.

Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.

“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.

“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”

The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”

Exploring the persisting challenge of long Covid around the globe

Millions of people worldwide are experiencing long-term symptoms of coronavirus

The impact of long Covid

Long Covid's prevalence and research needs