Long Covid could be costing NZ $2 billion a year in lost productivity: Experts urge preventive action

This Briefing reviews overseas evidence on the economic impact of Long Covid, considers its potential effects in the NZ context, and outlines actions that the NZ Government can take to mitigate these costs.

Long Covid refers to a change in health status that can persist for months or years following a Covid-19 infection.¹ Long Covid affects multiple organs and systems in the body and can occur at any age. Common symptoms include fatigue, shortness of breath, and cognitive impairment leading to difficulties with memory and attention. Even moderate levels of these symptoms can cause people to struggle with everyday tasks.² (See our previous Long Covid Briefing for further details).

Globally, the population prevalence of symptomatic Long Covid is estimated at around 6-7% of all adults.¹ Many affected people are unable to work and drop out of the workforce altogether.^1-3 Those who remain in the workforce may find themselves less productive, requiring additional support to perform their roles (see Appendix for further discussion of the types of impacts that Long Covid has on the workforce and some estimates of their prevalence). These effects put strain on businesses, health⁴ and education sectors, and the wider economy.

No robust analysis of Long Covid prevalence or productivity loss has been carried out in NZ, but international estimates of economic impacts are concerning. These include around £1.5 – 2.7 billion GDP loss for the UK in 2030 from decreased productivity and reallocation of healthcare resources; and a total economic and social welfare cost of US$864 billion to $1.04 trillion per year across the OECD. Economist Impact has estimated GDP losses from Long Covid during 2024 to be 0.5-2.3% (mean 1.0%; median 0.6%) across eight high-income countries.

Of particular relevance to NZ, Australian researchers conducted a detailed economic analysis of how Long Covid-related reductions in labour supply affected productivity and GDP from 2022-2024. Their just published research5 suggests that Long Covid is likely costing the Australian economy AU$9.6 billion (95% CI: $4.7–15.2 billion), equivalent to 0.5% of Australia’s GDP. Importantly, this estimate is likely to be conservative (see Appendix).

Given similarities in how the pandemic affected NZ and Australia, Long Covid will likely have a comparable economic impact. If NZ’s GDP (NZ$410 billion for the March 2024 year) faces a 0.5% reduction due to Long Covid, as seen in Australia, that would represent approximately NZ$2 billion per year.

Supporting evidence for the above estimate and that Long Covid is affecting productivity in Aotearoa comes from findings that Long Covid imposes an important burden on worker productivity. The Long COVID Registry Aotearoa reported that individuals with self-reported Long Covid worked 7.3-9.4 fewer hours a week in 2023/4 than they did before the pandemic. In addition to this reduction in hours, presenteeism (working despite being unwell) was reported by 61-71% of respondents.

The need for decisive action is clear. The global evidence indicates that both the health and economic burden from Long Covid in NZ are likely to be large. Ongoing high infection rates mean that each week, another cohort of New Zealanders enters the Long Covid lottery. The three key actions are as follows:

• Prevention. The NZ Government needs to do more to reduce Long Covid risk and incidence. This requires action to:

- Reduce case numbers using well-evidenced public health and social measures (including indoor ventilation and mask use where appropriate), with a focus on settings such as schools, hospitals and public transport where Covid-19 infection risks are high and sector-level impacts are already being felt.

- Increase vaccination coverage because this can substantially reduce the risk of Long Covid in adults and children following a Covid-19 infection.^6-8 NZ’s Covid-19 vaccine strategy must reflect this knowledge by immediately expanding eligibility for regular additional (booster) doses to younger age groups with a strong emphasis on occupations at increased risk, such as teachers.

• Occupational and social support must be strengthened. Occupational support could include extended sick leave policies, workplace accommodations to address productivity, workplace safety assessments, and comprehensive rehabilitation programmes to help those affected return to work. Social support must be provided for those who cannot work.

• Strengthen economic analysis and research. We need robust, local studies to quantify the true numbers and costs of Covid-19 infections and Long Covid in NZ, building on other NZ studies for assessing worker productivity loss from poor health.^9-11 These studies should include comparisons with appropriate control groups (eg, people with a history of Covid-19 infection who do not have Long Covid^{2 3}). Without accurate data, it will be difficult for policymakers to make informed decisions about how to efficiently and equitably protect New Zealanders from the health and economic harms of the ongoing Covid-19 pandemic.

Long Covid is more than a health crisis—it also imposes an important economic burden. As other countries have shown, the impact of Long Covid on workforce participation, productivity, and overall economic performance is substantial. NZ has yet to conduct its own in-depth analysis, which is clearly needed. In the meantime the NZ Government should invest more in a preventive approach, using evidenced-based measures to reduce the unsustainably high incidence of acute Covid-19 infection and Long Covid.