Long COVID Examining Long-Term Health Effects of COVID-19 and Implications for the Social Security Administration: Proceedings of a Workshop (2022) / Chapter Skim
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1 Introduction
1 Introduction
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, was developed by a planning committee in accordance with the Statement of Task (see Box 1-1) .1 This Proceedings of a Workshop describes the presentations from invited subject matter experts and panel discussions held during the workshop, including responses to questions posed by planning committee members, SSA representatives, and the general public.
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The purpose of the workshop, he said, was to discuss the most current information available on the long-term effects of COVID-19. The workshop featured subject matter experts and discussions of current and emerging research on the potentially disabling health effects of COVID-19 infection.
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The workshop shall include presentations on the functional outcomes for indi viduals who have contracted and survived COVID-19, as well as medical advances, developments, and research in this area. The workshop shall feature invited presentations and panel discussions on such topics as: • An overview of ongoing and upcoming research into the long-term effects of COVID-19; • How gaps in access to treatment and other racial and ethnic disparities influence health and work outcomes for vulnerable populations; • The most commonly observed long-term post-COVID impairments, their frequency, and distribution of duration; • Laboratory or other findings showing patterns of patho logy and severity associated with specific symptomology, demographics, physical profiles, or certain comorbidities or genetic markers; • Patterns of long-term, work-related functional decline observed in adults, their frequency, distribution, and associated signs or laboratory findings; • Distinct patterns of long-term functional decline observed in children, their frequency, distribution, and associated signs or laboratory findings; • Effect of vaccine administration on the long-term func tional effects of COVID-19 and whether this effect varies between socioeconomic or racial and ethnic groups, in particular vulnerable populations, or based on the speci fic vaccine used or when in relation to COVID infection it was administered; • Long-term effects on mental health associated with both the virus itself and the societal impacts of the pandemic response and how those effects vary among adults and children; continued
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) ; • Laboratory or other findings demonstrating variations in functional or long-term effects among different strains of the virus; • Recent medical advances, promising research, or new technologies that may alter expected functional outcomes in COVID-19 survivors, and potential advances anticipa ted in the near future; • Potential long-term economic and labor effects of the COVID-19 pandemic and how those effects vary with employment sector or the vocational factors of age, education, and work experience.a The planning committee shall develop the agenda for the workshop sessions, select and invite speakers and discussants, and moderate the discussions.
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OVERVIEW OF SSA DISABILITY EVALUATION As background for workshop participants who were not familiar with SSA's disability programs, Vincent Nibali, policy analyst at the SSA Office of Disability Policy, provided an overview. SSA administers two programs that provide benefits on the basis of disability, he said: the Social Security Disability Insurance Program (SSDI)
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Nibali emphasized the absence of Long COVID in the SSA listing of impairments does not mean that individuals will not be eligible for disability benefits, it simply means that the process moves forward to the functional analysis. Nibali said that SSA is interested in hearing about the potential for identifying Long COVID-related criteria that preclude work in all cases; including these in the listings would enable SSA's rapid adjudication of some claims related to COVID-19.
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This is another area, said Nibali, in which the workshop presentations may be of critical assistance, because the existing information on recovery from Long COVID is minimal. Nibali closed by stating, "A greater understanding of the long-term effects of COVID-19 can contribute to our agency's mission to provide the most accurate disability decisions as efficiently as possible."
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(Katz, Tabacof, Vos) • The severity of the symptoms experienced by some patients with Long COVID is similar to the severity of symptoms expe rienced by patients with other disabling conditions, including postural orthostatic tachycardia syndrome (POTS)
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Variety and variability of symptoms make it challenging to recog nize and diagnose Long COVID. Education and training are needed to help clinicians diagnose Long COVID and deliver appropriate patient care.
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. Functional Outcomes • Functional impairment attributed to Long COVID symptoms is common.
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(Frontera) • Important policy priorities include strengthening primary care, optimizing data quality, and address domains of inequity.
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a This list is the rapporteurs' summary of points made by the individual speakers identified, and the statements have not been endorsed or verified by the National Academies of Sciences, Engineering, and Medicine. They are not intended to reflect a consensus among workshop participants.
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