REGIONAL- The effects of COVID-19 can vary greatly, from cold and flu-like symptoms to life-threatening complications. Recovery can be similarly complicated. Not everyone who contracts COVID-19 makes a fast or full recovery. Tens of thousands of Minnesotans face ongoing or new symptoms such as shortness of breath, extreme fatigue, headaches, dizziness, brain fog and more. This is known as “long COVID,” and even mild infections or reinfections can lead to symptoms that may last for months or years.
Long COVID can be as unpredictable as it is debilitating. Although it’s more common in adults, teens and children can also be affected. Some people with long COVID struggle with work, school, family life, education and daily tasks. This impacts their financial stability, quality of life and mental health.
Unfortunately, all too often, Minnesotans experiencing lasting symptoms after a COVID-19 infection do not recognize they are experiencing long COVID. Additionally, treating long COVID can require specialists and ongoing follow up that is not always accessible, especially for those already experiencing health inequities and barriers to care.
There is still much that is unknown about long COVID, but the Minnesota Department of Health is working to give the public and healthcare providers as much knowledge and awareness as possible through a new group called the Long COVID Guiding Council.
The council is a network of 20 primary care providers and specialists from community clinics, safety net hospitals, rural health systems, academic health centers and long COVID specialty centers who are focused on developing strategies to educate health care providers about long COVID and make quality care for the condition more accessible.
“Clinicians are telling us that there is very little communication among the care providers who see long COVID patients in Minnesota and that a coordinated learning network would increase access to care and the quality of care that is provided,” said Dr. Ruth Lynfield, state epidemiologist and medical director at the MDH. “We still have a lot to learn about long COVID. But laying the groundwork to expand awareness about the emerging evidence and the available treatments is an important first step toward improving outcomes for those suffering from the impacts of long COVID.”
The council meets monthly to discuss emerging evidence, treatment and current practices. They will incorporate input from patients, caregivers, nurses, community health workers and community leaders into the guidance they develop. With appropriate medical care, many people can manage their symptoms and improve their health and quality of life.
To better understand the lasting effects of COVID-19, MDH has launched two post-COVID surveys among people who have had COVID-19 – one statewide and one in McLeod County. The surveys will explore long-term symptoms people are facing since being infected and how this has impacted their lives, and the results will influence ongoing recommendations about long COVID issues.
MDH’s long COVID program is funded by a U.S. Centers for Disease Control and Prevention (CDC) COVID and Health Equity grant through June. A proposal to extend MDH’s long COVID work has been recommended by Gov. Tim Walz.
Emergency exit
In February, the Biden administration announced that the federal COVID emergency that has been in effect since almost the beginning of the pandemic would be allowed to expire on May 11. But a measure advanced by Congressional Republicans to terminate the emergency earlier gained House approval in February, and last week it passed in the Senate, effectively muddying the waters as to what will happen when Biden signs the bill, which he has indicated he will do.
The confusion has ensued because there have effectively been two emergency declarations operating at once, and only the one based on former President Donald Trump’s initial emergency proclamation is affected by the House bill, which will be effective before May 11 upon Biden’s signature. The underlying message has been that when the emergency terminates, so, too will the various measures the federal government has implemented to deal with the pandemic, but the House bill will evidently not immediately terminate services provided through the Department of Health and Human Services (HHS).
In a statement posted to its website, HHS indicates that the public health emergency declaration it has been operating under is one made pursuant to the Public Health Service Act, which is not the Trump-declared emergency. HHS and the Centers for Medicare and Medicaid Services will continue to target May 11 as the transition date for their COVID-related policies and programs, many of which will continue and be phased out over a period of months.
For those on Medicare, as of May 11:
• Coverage will continue to include COVID vaccinations without cost sharing.
• PCR and antigen testing with no cost sharing is available for traditional Medicare recipients if ordered by a physician, physician’s assistant, or certain other health care providers and provided by a laboratory. People enrolled in a Medicare Advantage plan can also receive testing if covered by their Medicare, but may have a change in the cost sharing for the test. By law, Medicare does not cover over-the-counter home COVID test costs, and current access to free over-the-counter tests will end May 11.
• Medicare participants will see no changes in COVID treatment options, cost sharing and deductibles.
For Medicaid recipients and the Children’s Health Insurance Program (CHIP)
• Coverage for vaccinations, testing, and treatments without cost sharing will continue through Sept. 30. After that date, many recipients may still have coverage for vaccinations.
For those with private health insurance:
• Most forms of private insurance must continue to cover COVID vaccines without cost sharing that are furnished by an in-network provider. Out-of-network vaccinations could require cost sharing.
• Mandated coverage for over-the-counter and lab testing will end May 11. Individuals should check with their insurance provider to determine if testing services are covered and what requirements may exist for prior authorizations and cost sharing.
• There will be no changes resulting from the emergency termination related to private insurers and how treatments are determined and covered.
Meanwhile, health care providers will see numerous changes as various rule waivers implemented under the emergency declaration will come to an end on May 11.
Data trends
The overall COVID picture in Minnesota and St. Louis County continued to improve last week, with confirmed case counts, hospitalizations and deaths all decreasing from the week prior, continuing the latest statewide trend.
And while the highly contagious variant XBB.1.5 now accounts for over 90 percent of the COVID viral load in the state, according to CDC data, a related surge in infections like what was seen with XBB.1.5 in New York and other eastern states hasn’t materialized here.