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7 Best Breakfast Foods For Your Brain Health

There are so quite a few meals that contain nutrients recognised to benefit the mind. From nuts and seeds to fish, fruit, and veggies, you have a bounty of mind-boosting meals to pick from. To increase the effects your food items decisions can have on your mind wellbeing, it is greatest to take in a wide variety of mind-boosting food items in the course of the day. This involves breakfast. While thought of the most crucial meal of the day, breakfast is also infamous for sugary comfort meals, if not skipped entirely by lots of. But what can make this meal so critical is the fact that it replenishes the electricity amounts your human body is dependent on to have you bodily and mentally during the day.

With so many meals to select from, there is no cause to skip out on these brain-balanced merchandise, specially all through breakfast. For a superior breakfast that boosts your mind, below are seven food items you ought to try to eat for a productive, centered day. And for more dietitian-accredited breakfast tips to continue to keep you at the prime of your sport, be confident to examine Healthy Breakfast Meals Dietitians Say You Ought to Be Eating.

7 Best Breakfast Foods For Your Brain Health — Shutterstock

Recognized for their protein content material and ease of planning, eggs are also a source of choline. This nutrient is recognised to plays a lot of roles in the body, which include as a precursor to the neurotransmitter acetylcholine. For the reason that acetylcholine specially performs a purpose in memory and intelligence, it is essential to consume adequate amounts of choline for brain operate. Scrambled, boiled, or fried, eggs are a prosperous resource of brain-boosting choline to love at breakfast.

slices of smoked salmon on wooden board — Fabio Balbi/Shutterstock

Though most fish is not normally assumed of as remaining a breakfast food, smoked salmon is by considerably a single of the healthiest resources of protein to contain in your breakfast. In addition to protein, salmon also consists of necessary omega-3 fats that can profit the brain. Present analysis notes the essential position omega-3s can participate in in the mind development of youngsters, and maternal ingestion of omega-3s throughout being pregnant may well be favorable to the kid’s mental development. Further studies be aware weight loss plans deficient in Omega-3 might be affiliated with impairments in cognitive performance. Enjoy your salmon over a complete wheat bagel with a mild spread of product cheese for a scrumptious and uncomplicated breakfast.

bowl of fresh berries to eat to feel much younger than your age — Shutterstock

This class of fruit is regarded for its purple and red coloring and high nutrient price. Whilst all berries are a resource of fiber, nutritional vitamins, and minerals, they also consist of anti-oxidants identified as flavanols. All antioxidants safeguard cells from damage, and this compound in individual may perhaps have mind-boosting effects, also. In point, one particular study executed in grownup participants who ate blueberries discovered an advancement in memory and attention. Though this analyze only observed the positive aspects of having blueberries, it seems other berries possess comparable attribute. Enjoy berries in a smoothie, a major oatmeal or cereal, or as a aspect to your early morning eggs.

This seed is a plant-based mostly supply of omega-3 fat and may possibly residence some of the same rewards as the balanced fat located in salmon. Exploration conducted in rodents identified maternal flaxseed intake may perhaps promote neuroprotective consequences and spatial memory in their offspring. Although the styles of omega-3 located in fish could have more robust results than the sorts observed in plant resources, all types of omega-3 show up to be helpful to the brain. Simply incorporate milled or ground flaxseed to your oatmeal, smoothie, or selfmade muffin recipe.

A further food stuff effortless to integrate into breakfast, this nut has brain-boosting omega-3 fats and polyphenolic compounds. These compounds have antioxidant and anti-inflammatory attributes that show up to reward the mind. Exploration suggests a diet plan containing walnuts may perhaps have a optimistic impression on memory and learning, may strengthen cognition, and could lower the possibility of building gentle cognitive impairment. Walnuts can be blended into a smoothie, included into oatmeal or cereal, or included into selfmade pancakes or banana bread.

leafy greens kale spinach — Shutterstock

This category of vegetables includes kale, spinach, cabbage, and collard greens—just to name a several. Even though these veggies incorporate several beneficial nutrients, the lutein, folate, beta-carotene, and phylloquinone discovered in leafy greens may possibly support sluggish the purely natural decline in cognitive abilities noticed in more mature age. When you may perhaps imagine of greens as getting additional ideal for lunch or evening meal, there are various techniques to include them into your breakfast. Merely sauté and include leafy greens to your omelet, incorporate uncooked leafy greens into your smoothie, or toss them in olive oil and lemon just before topping your bagel and lox.

Even though all nuts and seeds comprise healthy unsaturated fats, the nutrients found in pumpkin seeds in distinct could be beneficial to the brain, too. Like lots of other food items on this list, pumpkin seeds comprise anti-oxidants that secure the cells of the body and mind from injury. On top of that, these seeds have a collection of minerals that are also concerned in brain overall health. Zinc is one particular nutrient discovered in pumpkin seeds that is discovered extremely concentrated in the mind and is included in the working of hundreds of methods and reactions in the body, including the nervous program. In reality, research suggests a zinc deficiency may well be linked to some neurological circumstances and brain ailments. You can integrate the brain-preserving advantages of pumpkin seeds by including them to your do-it-yourself granola, topping your yogurt parfait, or mixing them into your early morning oatmeal.

Report: Minnesota health care workers leaving at ‘crisis rates’

In 2022 Minnesota nursing properties documented staffing shortages that have been even worse than wherever else in the state. The ability to locate direct care workers for these establishments and other people has turn out to be a crisis. That’s in accordance to a new report from the University of Minnesota.

“The disaster of very low-wage health care personnel is a crisis for all those people that involve care,” report authors wrote.

While immediate treatment perform can be incredibly risky, it is not paid effectively. In accordance to the report, more than 40 p.c of direct care personnel in Minnesota receive under 200 {bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of the federal poverty line and just about half use Medicaid or Medicare for insurance policies.

That is for frontline function that included publicity to COVID-19 just before vaccines have been designed, and generates injuries premiums that are bigger than these experienced by firefighters.

“The workers knowledgeable a great deal of loss in the early months of the pandemic in which 15 per cent of the men and women who had been hospitalized were acquiring COVID before the vaccines,” mentioned Jamie Gulley, President of SEIU Health care Minnesota.

Now that vaccines are readily available, nevertheless, and the pandemic is waning, health care get the job done in Minnesota has turn out to be considerably additional difficult thanks to staff shortages.

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“While the pandemic was challenging in its own way, most of our respondents ended up indicating that the operate in fact grew to become much far more tough as we recovered from the pandemic since of employee shortages,” stated report creator Jeanette Dill.

The folks accomplishing immediate treatment get the job done in Minnesota are overwhelmingly ladies — 85 percent — and 36 percent are folks of shade. It is a legacy Dill claimed stems from America’s historical past of slavery and domestic labor.

“We have a historical past of based on Black ladies in particular and other gals of shade, like immigrant ladies, to offer that kind of domestic care and domestic provider. That’s element of our historic legacy listed here in the United States … women of all ages of colour have experienced much less obtain to education prospects and so are a lot more confined to these reduced wage care do the job occupations,” Dill mentioned.

To handle vital and expanding shortages, the report endorses a redistribution of Medicaid and Medicare investing. Latest Medicaid and Medicare reimbursement insurance policies and procedures, “often boost dramatic wage inequality within just and throughout wellness treatment occupations,” in accordance to the report, and favor companies concentrated all over male-dominated operate involving surgical procedures and technological know-how.

Other recommendations involve assistance for unionizing personnel. Close to 50 {bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of homecare personnel in Minnesota are unionized as very well as 32 per cent of nursing house workers.

“The lower wages effect has a huge sum of expense to the program,” Gulley claimed. “The selection one particular point that we require to see is increased spend. Certainly, union workers make a very little little bit a lot more than non-union workers, as you may anticipate. But we also stay lengthier. There is a great deal much more retention, you see a large amount extra continuity of care.”

Each Republican and Democratic lawmakers in Minnesota have expressed assist for addressing Minnesota’s immediate care troubles.

“It is a significant offer. It’s absent from form of a obstacle to a problem, to a huge problem to a disaster to I never know what the upcoming degree is, but the system’s on the verge of collapse,” mentioned Sen. Jim Abeler (R-Anoka).

Sen. John Hoffman (DFL-Champlin), who serves on the Getting old and Very long-Phrase Care policy committee with Abeler agrees, and hopes to assist set ahead a monthly bill addressing direct treatment difficulties in the future session.

“The folks that require (these) services, they’re dying, they are filling up our hospitals,” Hoffman claimed. “Caregiving is a system. Like Jim suggests, the infrastructure’s falling aside. 53,000 career vacancies and no one is having a significant discussion about shelling out people today what they want to be paid.”

Hospital shutdown in Pennsylvania spurs questions about private equity in health care

After a car accident last month, Latifa Dixon, a mother of two, arrived at the emergency room at Delaware County Memorial Hospital in suburban Philadelphia only to learn the ER had just shut down. Twenty-eight-year-old Cecilia Vizuete, who was having trouble feeding her one-year-old daughter because of a breast infection, said she was told by a security guard to search Google Maps for another hospital. Shirley Posey arrived there suffering from shortness of breath and tightness in her chest.

“This was the closest hospital to me and I needed help,” Posey said when CBS News met her outside Delaware County Memorial. Posey later recovered, but not until she raced to an urgent care, collapsed, and was transported by ambulance to another hospital.

For nearly a century, Delaware County Memorial delivered babies, treated trauma and tended to the critically ill. That all changed earlier this year, when its current owners, a Los Angeles-based for-profit company called Prospect Medical Holdings, began cutting services at the 168-bed hospital in Upper Darby, Pennsylvania. First the maternity ward went, then the operating rooms and the I.C.U., and then, last month, the emergency department closed its doors to the community’s nearly 85,000 residents.

The shutdown has raised questions about the role of private equity as it piles into the health care space, snapping up everything from local doctors’ practices to specialty clinics, even hospices. According to the consultancy Bain & Company, private equity firms posted a record year for deal volume in health care in 2021, with the total value of those deals topping $150 billion.

Backed by private equity investment, Prospect Medical Holdings rapidly grew to own 20 hospitals in six states by 2018. In 2016, it bought Crozer Health, a nonprofit Pennsylvania health system that was in danger of failing.

A CBS News investigation found that of those 20 hospitals owned by Prospect Medical, five have closed. In addition to Delaware County Memorial, Prospect Medical has suspended all services at Springfield, another acute care hospital in the same Pennsylvania health system. It also closed three hospitals in a San Antonio health system it purchased in 2012.

In court proceedings, Prospect Medical argues it is not seeking to close Delaware County Memorial for good. In a statement to CBS News, the company said it is working to transition the hospital to a “100 patient facility for those in need of behavioral health and other services.” As part of the plan, the hospital will lose inpatient “acute care services,” which includes the lone emergency room in the community of Upper Darby.

“There aren’t resources nearby and so we find that people wait longer to go to the hospital,” county official Monica Taylor told CBS News chief medical correspondent Dr. Jon LaPook, adding that closing what’s considered a safety-net hospital will hit the area’s low-income population hardest.

“We wouldn’t see a hospital closing down if this were a more affluent area,” said Taylor. “It leaves a gaping hole in this community that is going to be very hard and very difficult to fill.”

“What they cared about was making money”

In a presentation provided to Delaware County officials, Prospect Medical cited struggles with high labor costs, record inflation for supplies and pharmaceuticals, and the strain of the COVID-19 pandemic for its decision. Taylor said she believes the company has not been upfront, and has been reluctant to share its financials with the county.

“I had the sense they were not giving us all the information,” Taylor said.

Prospect Medical has faced scrutiny before. In 2019, Rhode Island Attorney General Peter Neronha’s office investigated a proposed company transaction. Prospect Medical owns two hospitals in the state, that Neronha said were “in real danger of closing” because of the debt Prospect Medical had taken on.

“This had nothing to do with the pandemic,” Neronha told CBS News. “Hospitals all over the country were facing the pandemic … but the problems here were exacerbated, frankly, by greed.”

Neronha invoked state law to force Prospect Medical to turn over its finances. A ruling by the attorney general’s office found the company put “every hospital in its system…at risk of reduction of services, sale or closure.”

“They didn’t care about health care,” Neronha said. “What they cared about was making money for their investors.”

Neronha hired two different outside experts to follow the money and discovered one reason why Prospect Medical was experiencing financial strain. In 2018, company owners took out a $1.12 billion loan, using proceeds to pay themselves and their private equity shareholders a $457 million dividend, according to the company’s financial statements, obtained by Neronha’s office in the course of the investigation.

“It’d be like a homeowner going to a bank, taking out a $100,000 loan, and instead of using it to invest in their property or pay for their kids to go to college, what they did was they just basically stuck it in their pockets as cash,” Neronha told CBS News.

The company’s financial statements revealed that to pay back that $1.12 billion loan, Prospect Medical sold the land and the buildings from hospitals they owned in California, Connecticut and Pennsylvania to a real estate investment trust for $1.386 billion. The documents show Prospect Medical then leased those hospitals back from the real estate investment trust.

“So now you’re even in a worse position because you have no equity any longer,” Neronha said. “You don’t own anything that you can then go to the bank and use as collateral to raise more money when you need it.”

In Delaware County, that lease-back arrangement instead meant the health system was saddled with $35 million a year in rent.

Delaware County Memorial Hospital in Upper Darby, Pennsylvania, was closed in November 2022 after being bought by a private equity firm, Prospect Medical Holdings.

CBS News

CBS News submitted detailed questions to Prospect Medical about these financial decisions, including about the $457 million dividend and the lease-back arrangement. The company, through a spokesman, declined to answer those questions.

“They are drawing the value out of these hospitals as they would money from a piggy bank,” said Eileen O’Grady, campaign director with the Private Equity Stakeholder Project, a nonprofit organization that has raised concerns about Prospect Medical to attorneys general in the six states where the company owned hospitals. “Meanwhile, the company’s owners have made out like bandits.”

Neronha’s office confirmed to CBS News that the Prospect Medical CEO’s personal share of the $457 million dividend was about $90 million.

“What they’ve done is extremely evil”

One of the early investors in Prospect Medical’s 2016 purchase of the Pennsylvania health system told CBS News that the company entered into the arrangement as the only bidder and “last hope for these failing hospitals.” When the purchase was announced, local officials said it came with a promise: to invest $200 million to “dramatically increase…service to the community.”

“They tried to tell us that they were going to run us the same way,” said emergency nurse Angela Neopolitano, who worked at Delaware County Memorial for 41 years. Instead Neopolitano, who was president of the local nurses’ union, says Prospect Medical dismantled the hospital piece by piece, leading to longer waits in the emergency room and forcing staff to transfer more patients to other hospitals.

“They kept on cutting services,” Neopolitano said. “Things wouldn’t get fixed. Our elevator in the back of the emergency room had been broken for over a year. When they closed the I.C.U., that was the knife in my heart.”

Neopolitano said at one point, the credit cards used by paramedics within the health system to fill their ambulances with fuel were disabled because Prospect Medical “didn’t pay their bill.”

The company did not respond to questions about its specific investments at Delaware County Memorial, but in an annual report said it had lived up to its commitment to invest $200 million in Crozer Health.

The company did not respond to a question about whether it neglected to pay fuel bills for ambulances, which was first reported in an investigation of the company by ProPublica. The company told ProPublica a company credit card was rejected because it had a charge limit as a security measure, and it increased the limit when it was brought to their attention to ensure there was not a disruption of services.

Now, the company has pivoted to a plan to convert Delaware County Memorial into a behavioral health facility. An executive with the hospital told the Philadelphia Inquirer last week that the new incarnation would not be “a moneymaker… but we go from losing $18 million a year to making $3 million and providing needed services to the community.”

The shut down of Delaware County Memorial in September has sparked a legal battle which has drawn in Pennsylvania’s attorney general and governor-elect Josh Shapiro.

In October, a judge granted an emergency injunction to keep the hospital open. Yet weeks later, the state’s health department shut it down anyway, after Prospect Medical notified the department of staffing issues.

In a statement to CBS News, Prospect Medical said the ongoing litigation limits what it can say, but that the company is communicating with state health officials about its “multiple efforts to address those staffing issues.” The company has pledged to save the facility by turning it into a “desperately needed 100-patient facility for those in need of behavioral health and other services.”

Next week, a judge will hear arguments over whether to require Prospect Medical to find a way to re-open the hospital’s doors. Shapiro’s office has asked the judge to hold Prospect Medical in contempt and to fine it $100,000 for every day it does not resolve the staffing issues.

Neopolitano told CBS News she thinks that the $457 million dividend Prospect Medical’s owners and private equity investors paid themselves should have gone back into the hospitals and into the community.

“What they’ve done is extremely evil, in my words,” said Neopolitano of Prospect Medical. “To gain a dollar, you maybe destroyed lives, maybe even ended lives, because they can’t get the help they need.”

Jon LaPook

Dr. Jonathan LaPook is the chief medical correspondent for CBS News.

Beyond barbells: Seniors require more to improve overall health

Some seniors run marathons. Others have difficulty getting up from their chairs. Most possess a level of physical fitness that falls somewhere between these two extremes.

“Medicare Advantage plans need to realize that a one-size-fits-all fitness solution no longer works. The needs of a generation that is in their eighties are so different from those aging into Medicare,” said Vince Pozinski, Head of Government Product, Optum Health Solutions. “When the 75- to 85-year-olds were younger, the YMCA is where they were able to work out and use the pool. It was also where they had their social connections. So, they still want to use these facilities, but there is a new generation of Medicare members who want more options.”

Seniors in their 60s have started working out at small boutique studios that offer yoga, cycling, Pilates or other specialized classes. And individuals suffering with certain diseases such as Parkinson’s or multiple sclerosis require programs that address their unique needs.

Some seniors simply don’t want to visit a gym or take an exercise class. Providing other activities such as community-based walking or pickleball clubs could help these members stay active.

In addition, health plans can make it convenient for seniors to exercise by offering home strength, yoga and dance kits that that include equipment and instructional materials.

Going digital
Online options are increasingly becoming the preferred choice for many members. “Mobile apps and live streaming classes speak to many of the members who are just now aging into Medicare Advantage plans,” Pozinski said.

The COVID-19 pandemic also contributed to the increased demand for digital content. During COVID, people grew accustomed to connecting with others virtually. For example, many older adults connected with their grandchildren online – and want to continue to enjoy virtual activities with them.

“It’s important for plans to offer content that enables members to share experiences with others. Creating that meaningful family impact is one of the things that plans can do to differentiate themselves from others,” he said.

Just as with in-person programs, health plans should offer a variety of digital programs to meet seniors’ differing needs. For example, Optum offers more than 35,000 pieces of digital content that not only addresses the needs of different groups of seniors, but of people of all ages.

Food matters
Health maintenance doesn’t start and stop on the exercise mat. Healthy eating is also important. “Nutrition is part of the equation. Health plans need to bring it into the conversation as they look more holistically at what they offer to members,” said Brett Hanson, Head of Market and Product Development, Optum Health Solutions.

To help seniors improve their nutrition, health plans could offer education related to healthy eating. “Members might just be looking to improve their overall wellness, or they might have a certain condition like cancer or diabetes that requires a specific diet. Having knowledge about the right meals and the right nutrition can help,” he explained.

Health plans can even help bring healthy food to the table. Optum’s One Pass, for example, offers free delivery of dietitian-designed meals, which are prepared with high-quality ingredients and tailored to support nutrition for common health conditions and dietary preferences. The program also offers free grocery delivery from various stores.

All about choice
Ultimately, health plans can keep seniors on track by providing an array of choices. “Members don’t necessarily want to go to the same gym, do the same activity or watch the same digital content each and every day,” Hanson concluded. “One day they may want to do a 10-minute digital yoga class, and the next, they might want to do an intense in-person strength or cardio class. In addition, to develop our fitness benefits, we try to look at what the topline holistic needs of the population are – not just at their levels of mobility and physical activity.”

Health plans should offer many different activities and services to better accommodate every member’s unique needs and situations. Considering the varying needs of different generations who may be participating in a Medicare Advantage plan, health plans with the flexibility to offer both online and in-person education, fitness experiences and opportunities for social connection will be better poised to succeed.

Amazon’s Creep Into Health Care Has Some Experts Spooked

Smith told WIRED that Amazon keeps patient health information confidential and secure in compliance with federal law and regulations, and in line with industry standards; Amazon Clinic customer data will be protected through the use of HIPAA-compliant encryption methods. “Protecting patient information is an important part of our business; we are not in the business of selling or sharing it,” Smith wrote.

Amazon’s recent efforts to break into health care raise a more fundamental question: Should Big Tech even be allowed in the sector? The motivations of a private company—efficiency, optimization, and above all, profit—don’t exactly square with serving the public good, says Tamar Sharon, a professor at Radboud University in the Netherlands whose work explores the politics and ethics of Big Tech in health and medicine—or as she dubs it, the “Googlization of health.”

Amazon Care, a telehealth service Amazon piloted among its employees and then rolled out to other customers, shows how things can go wrong. Its shutdown was announced a few months ago, with the senior vice president in charge of the program, Neil Lindsay, writing in an internal memo Amazon shared with WIRED: “Although our enrolled members have loved many aspects of Amazon Care, it is not a complete enough offering for the large enterprise customers we have been targeting, and wasn’t going to work long-term.”

But it was plagued by other problems, too. A Washington Post investigation alleged that moving at top speed and efficiency sometimes conflicted with best practices in medicine: For example, nurses were asked to process patient blood samples in their personal cars, the paper reported, and to store and dispose of medical supplies at home, which they protested. (Amazon told the Post that they could not find records of complaints about these matters.)

“Amazon Care followed common practices for in-home care and know them to be safe and appropriate,” Smith told WIRED. “For example, Amazon Care clinicians were always equipped with Stericycle medical waste return equipment to properly and securely return or dispose of supplies.”

For Sharon, a big concern is how reliant we risk becoming on big companies as mediators of fundamental public needs. “This is a dangerous situation—that we would become dependent on a handful of private actors for the distribution of very basic goods, like health, or education, or public services,” she says. For instance, as these companies increasingly fund and perform their own research, it’s possible they could influence how the research agenda is set. That could be a problem if tech founders’ penchant for wanting to live forever results in a focus on funding longevity research over, say, cancer treatments.

Yet private companies entering public spaces isn’t always inherently bad, says Wachter. Arguably, the multitrillion-dollar American health care system is the perfect target for new players. As Scott Galloway, a professor of marketing at the New York University Stern School of Business, points out in his newsletter, health care spending in the US far surpasses that of other rich countries, yet life expectancy is lower, creating an opportunity for new services to offer better value to patients. “The US health care industry is a wounded 7-ton seal, drifting aimlessly, bleeding into the sea. Predators are circling,” he wrote. “Amazon is the lurking megalodon, its 11-foot jaws and 7-inch teeth the largest in history.”

You could argue that Amazon is simply filling a gap in a broken system. With its new service, the company appears to be applying the same principles that made it so successful as a retailer: easy access, rapid delivery, competitive pricing—hard-to-refuse conveniences that appeal to humans’ inherent laziness, for sure, but which might also make good health care more affordable in a system divided between the haves and have-nots.

In exchange for convenience and better access, there are likely to be tradeoffs. “If we do that, we want to do it right,” says Wachter. “We just have to think about all the possible negative consequences to make sure that they don’t happen.”

Why long Covid could be ‘the next public health disaster’

Sam Norpel and her family. Norpel, 48, second from the right, got Covid-19 in December 2021 and hasn’t recovered. This chronic illness, known as long Covid, impacts up to 23 million Americans.

Kirstie Donohue

Sam Norpel used to present regular financial updates to C-suite executives.

Now, unpredictable bouts of broken, staccato speech make that impossible for the former e-commerce executive.

Despite being up to date with vaccines and boosters, Norpel, 48, got Covid-19 in December 2021, when the highly transmissible omicron variant was fueling record U.S. caseloads.

She never got better — and in fact, feels worse, with a range of debilitating symptoms that make it impossible to work.

More from Your Health, Your Money

Here’s a look at more stories on the complexities and implications of long Covid:

Her halting speech can be triggered by something as innocuous as cold water or cool air on the skin. Extreme noise sensitivity requires her to wear noise-canceling headphones all day. She’s also endured a low-grade migraine for nearly a year, which can flare up after prolonged screen time.

Why long Covid could be ‘the next public health disaster’

When it comes to her body and mind, “the computer is just slow,” said Norpel, who lives with her family outside Philadelphia. “Right now, for me, 48 [years old] feels like 78.”

Norpel is one of millions of Americans with long Covid, also known as long-haul Covid, post-Covid or post-acute Covid syndrome. While definitions vary, long Covid is, at its core, a chronic illness with symptoms that persist for months or years after a Covid infection.

Up to 30{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of Americans who get Covid-19 have developed long-haul symptoms, affecting as many as 23 million Americans, according to the U.S. Department of Health and Human Services.

Long Covid could be ‘the next public health disaster’…

The country is about to enter its fourth calendar year of the coronavirus outbreak, and new variants are expected to make for a tough winter.

Researchers think most Americans have had Covid-19 at this point.

Studies suggest subsequent infections raise the chances of an “adverse” outcome, including hospitalization and death. The virus has killed more than 1 million Americans to date, and some 2,000 more die each week, according to the Centers for Disease Control and Prevention.

Long Covid demonstrates that the virus is taking a lingering, pervasive and perhaps even more insidious toll. Medical experts have called it “the next public health disaster in the making.”

“There are just large numbers of people affected by this,” said Dr. Peter Hotez, co-director of the Center for Vaccine Development at Texas Children’s Hospital and a dean at Baylor College of Medicine.

That number will “only continue to grow” as Covid-19 continues to circulate, HHS said in a recent report.

“This could be game-changing in terms of how we do medical practice, in the same way HIV/AIDs was a game-changer,” Hotez said.

… one with a significant financial toll

But the tentacles of long Covid reach far beyond its medical impact: from the labor gap to disability benefits, life insurance, household debt, forfeit retirement savings and financial ruin.

This article is the first of a CNBC special report examining long Covid’s destructive impact on individuals, families and the U.S. economy at large.

All told, long Covid is a $3.7 trillion drag on the U.S. economy — about 17{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of our nation’s pre-pandemic economic output, said David Cutler, an economist at Harvard University. The aggregate cost rivals that of the Great Recession, Cutler wrote in a July report.

Cutler revised the $3.7 trillion total upward by $1.1 trillion from an initial report in October 2020, due to the “greater prevalence of long Covid than we had guessed at the time.” Even that revised estimate is conservative: It is based on the 80.5 million confirmed U.S. Covid cases at the time of the analysis, and doesn’t account for future caseloads.

Higher medical spending accounts for $528 billion of the total. But lost earnings and reduced quality of life are other sinister trickle-down effects, which respectively cost Americans $997 billion and $2.2 trillion.

“Long Covid will be around long after the pandemic subsides, impacting our communities, our health care system, our economy and the well-being of future generations,” the HHS report said.

Norpel was the household breadwinner, which allowed her husband to care for their kids. The family has been living on income from a long-term disability policy, a vestige of her old job; the funds replace just a third of her prior pay. Norpel’s husband must now juggle caretaking duties and the necessity of finding work, both for income and health insurance.

The money worries are multitude: the ability to continue funding her daughter’s college education, the odds of raiding retirement accounts or selling their home to subsist. Norpel’s 16-year old son recently wondered if he should get a job to support the family; but he doesn’t even have a driver’s license.

“All of it is just very heartbreaking,” said Norpel, adding that “long Covid changed everything.”

What is long Covid? It ‘depends on who you ask’

While there are still many unknowns about long Covid — shorthand for its scientific name “post-acute sequelae of Covid,” or PASC — what we do know so far is startling, experts say.

Anyone who’s had Covid-19 can develop the condition. People can get it regardless of the severity of their initial infection or the virus variant, according to the World Health Organization. It affects all age groups, even those who were previously fit and healthy.

Studies suggest women are at higher risk than men; one study found adult females to be twice as likely to have long-haul symptoms. People of color are also more likely to get sick due to the increased likelihood of a Covid-19 infection and less access to high-quality health care; it’s also more common in bisexual and trans people due to reduced care access and the stigma regarding their gender or sexuality, the HHS said in an October report.

New study raises serious concerns over long Covid impact

However, the medical community hasn’t arrived at an exact definition of long Covid, which complicates diagnosis and treatment.

The definition “depends on who you ask right now,” said Dr. Greg Vanichkachorn, medical director of the Mayo Clinic’s Covid Activity Rehabilitation Program.

Here are some of the points on which opinions diverge:

Cause: Doctors don’t yet know what causes long Covid. They have theories: Perhaps it’s an autoimmune disorder, like lupus or rheumatoid arthritis, whereby the virus is gone but the immune system remains active, attacking healthy cells by mistake; or maybe small blood clots develop in the brain, too small to cause a stroke but big enough to trigger neurologic issues.

Key symptoms: Long Covid has been linked to more than 200 symptoms, according to The Rockefeller Foundation. Shortness of breath, fatigue, and sleep disorders or insomnia are the most common symptoms, according to a recent global meta-analysis published in the Journal of the American Medical Association, a peer-reviewed journal. Others include anxiety, depression, body aches, headache, heart palpitations and “brain fog” — which describes challenges associated with cognition, like thinking, concentration, communication, comprehension, memory and motor function. Some sufferers have organ damage, to the heart, lungs, kidneys, skin and brain.

Duration: There’s no consistent definition of how long symptoms must persist for someone to be considered a long Covid patient. For example, the CDC says a person has long-haul symptoms if they persist beyond (or start after) one month from an initial Covid-19 infection. The WHO generally uses a three-month barometer. Different health clinics may use others still.

What experts do know is that for some, long Covid symptoms can last months or even years. About 15{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of people whose ailments persist three months after infection continued to experience symptoms at least 12 months after infection, according to the meta-analysis.

Meredith Hurst, a paralegal, is one of those people. Hurst caught Covid in November 2020. She was diagnosed with long Covid in December 2021; now, two years after the initial infection, she still hasn’t recovered.

The 42-year-old, who lives in Wilmington, Delaware, is unable to work and is in the process of filing for Social Security Disability Insurance — for which qualification is famously stringent. Brain fog, migraines and fatigue require her to complete the application in pieces; all of her progress, which had been saved in a draft, was recently deleted because too many days had elapsed.

Meanwhile, Hurst is struggling to make ends meet. In addition to Medicaid health benefits, she receives public assistance via food stamps. Her credit cards are “getting maxed out.”

“I don’t know if it’s for the rest of my life or not,” Hurst said of feeling long Covid symptoms.

“It will probably continue this way for me until there is a test, a medication, more research, more education for the public, for doctors,” she added. “This is going to be my experience for a while”

“It doesn’t mean forever,” Hurst said. “But for right now, this is my reality.”

‘All sorts of testing’ to try for a diagnosis

The formal diagnosis code for long Covid used by researchers and physicians is only a year old.

The CDC authorized the code (U09.9) in October 2021. An official diagnosis allows patients to more easily access long Covid-related treatments, file for disability insurance and request accommodations at work, according to the HHS report.

Yet its nebulous nature means there isn’t yet a definitive, yes-or-no lab test for it.

“There’s no diagnostic test,” said Dr. Jeff Parsonnet, an infectious disease physician who started the Post-Acute COVID Syndrome clinic at Dartmouth Hitchcock Medical Center. “It’s really a clinical diagnosis.”

Sometimes that process is straightforward: a confirmed, positive Covid-19 test result, with enough time passing after initial infection and persistent symptoms consistent with hundreds of other long Covid patients may be adequate, Vanichkachorn of the Mayo Clinic said.

But often, by the time Parsonnet sees patients at the Post-Acute COVID Syndrome clinic, they’ve had “all sorts of testing” from a primary care doctor or specialists. That might include pulmonary function tests or chest X-rays to look for heart or lung conditions, for example, magnetic resonance imaging (MRI) to identify brain inflammation or a “tilt table” test to evaluate a possible autonomic disorder.

Frustratingly for patients, such testing often comes back negative, according to medical experts, even as it adds to their financial burden.

“In many cases, the diagnosis is [long Covid] because there’s nothing else to explain the condition,” said Alice Burns, associate director of the Program on Medicaid and the Uninsured at health care nonprofit The Henry J. Kaiser Family Foundation. “It’s the diagnosis when all other diagnoses have been ruled out.”

There are a lot of physicians or care providers who are reluctant to apply a label they see as defined as everything but the kitchen sink.

Diana Güthe

founder of Survivor Corps

That can make some physicians unwilling to entertain long Covid as a reason for health complications.

“There are a lot of physicians or care providers who are reluctant to apply a label they see as defined as everything but the kitchen sink,” said Diana Güthe, founder of Survivor Corps, referring to the litany of symptoms. Survivor Corps is a grassroots Covid advocacy group with about 250,000 members; Güthe herself had and recovered from long Covid.

Donna Pohl, 56, met with a neuromuscular specialist in mid-November to help treat nerve damage that resulted from long Covid. The visit didn’t go well.

“[The specialist] said, ‘Everyone wants to blame Covid,'” said Pohl, who lives in Bettendorf, Iowa, and was diagnosed with long Covid last December. “We are sick, not stupid or crazy.”

People — including family and friends — often write off symptoms as “byproducts of anxiety and depression, or even worse, laziness and an excuse not to work,” the HHS report said.

Neurologists would see Norpel twitch and instead focus just on her migraines, she recalled. One told her to stop reading literature on long Covid when she mentioned the disease during an appointment. “It was like Dr. ‘Mansplaining,'” she said.

She eventually had a consultation in August at the Mayo Clinic, where she was told: “We believe you — you have long Covid.”

“I started crying when the doctors spoke to me,” Norpel said.