Long-term covid…and Long-term Fiona, Long-term Ian…

Downed trees and power lines in Bartow, FL following Hurricane Ian – 52393701499” by State Farm is licensed under CC BY 2.0.

Consider this working definition of a natural disaster: disruption of an entire community, persisting after the hazard has come and gone, and exceeding the community’s ability to recover unaided.

For the moment, focus on the idea that the impacts of disasters don’t quickly fade, but linger.  

Start with the pandemic. Covid’s long-term, persisting disruption grows increasingly evident day by day and month on month. Over the past three years, one hundred million cases have been documented here in the United States. Fortunately, the great majority of these cases have proved mild, and recovery quick and seemingly complete. For most sufferers, the experience was hard to distinguish from a bad case of the flu. As a result, up to an additional 50 million cases nationwide may have gone unreported.

Of course, the fuller picture is more sobering. For a small minority the outcome of the infection was far worse – requiring hospitalization, and even proving fatal, in some cases.

What’s more, it appears that as many as one in five infected (whether severely or mildly) may experience symptoms of so-called long-term covid, that persist and are debilitating even months later. Those symptoms are both physical and mental. They vary in severity, but they include headaches, difficulty thinking or concentrating (sometimes referred to as “brain fog”), sleep problems, joint or muscle pain, dizziness when standing, shortness of breath, diarrhea, or stomach pain, and (perhaps unsurprisingly, given this list of woes) depression or anxiety. Victims may also be more vulnerable to type-2 diabetes, kidney failure, and heart problems. Long-covid, though defined only in the most general terms, and difficult to diagnose unambiguously, currently devastates millions.

In the face of these health impacts, and given the large numbers of people affected, experts have estimated the associated effect on the national economy. They’ve concluded that long-term covid:

This eye-watering figure is itself undoubtedly an underestimate. Additional covid long-term impacts include the following:

  • enduring financial and psychological, and spiritual burdens on the family members of those who died.
  • Inflation, stemming from governmental actions to ameliorate the impacts of widespread lockdowns. (Additionally, the specter of recession looms.)
  • A generation of school-age kids who have seen their educational progress impeded or even interrupted for 1-2 years, at a critical point in their maturation/development. Standard test scores have plummeted.

War – disaster by another name – imposes similar long-term losses. Some time back, economists made similar efforts to assess the cost to the United States of the Iraq and Afghanistan wars. They arrived at a total approaching some $3 trillion. What’s especially sobering? They have noted that only a third of this cost has already been incurred – and most of that money was borrowed, embedded in the national debt. Little of this has been pay-as-you-go. Two thirds of the expenses have yet to be experienced. The cost includes nearly $2 trillion in health care, disability payments, burial and other costs not yet incurred that will be due to 4 million veterans over the next several decades, peaking, we’re told, only around the year 2050 (!).

As the case with covid, any impacts of the wartime deaths on the families (say, the effects of the loss of a breadwinner at a critical stage in a family’s life; the grief of family members and the pervasive, continuing influence of that grief on family prospects) haven’t been factored in.

Which brings us to natural disasters. Take Hurricane Ian. On September 29, as many as 2.7 million of Florida’s businesses and homes – a quarter of the total – were without electrical power. By October 3, that figure had dropped below 600,000. On October 14, the Washington Post reported the remaining outages numbered only a few thousand. It could be argued that as has been the case with covid, the millions of people in the hurricane’s path who were homebound for a few days, or suffered a temporary loss of electrical power, were merely inconvenienced. But the same report ominously noted that

At Ian’s ground zero — places like Fort Myers Beach and Sanibel — it may be weeks, perhaps even months until the lights come back on. While many have sought refuge elsewhere as the islands are rebuilt, some vulnerable, elderly residents refuse to leave — meaning they are living without consistent access to lighting, refrigeration and, in some cases, even water.

On October 19, the New York Times reported that hundreds of people are still living in shelters following Hurricane Ian. The article contained this excerpt:

As of Tuesday, 476 people remained at two public shelters in Lee County, most of them at Hertz, an ice hockey and concert arena. The county took a direct hit, with 5,041 residential properties destroyed and 13,052 suffering major damage, records show. Many of their occupants have second homes or relatives with a guest room to fall back on, or can secure rental properties while they await federal disaster assistance, insurance adjusters and general contractors to help them begin rebuilding their lives.

But many of the people relying on shelters have none of those options. Sleeping side by side on American Red Cross cots and air mattresses are service-sector employees who are newly homeless and unemployed, retirees dependent on Social Security checks, and newcomers to the region with neither resources nor connections. Many were renters in North Fort Myers and other lower-income areas, barely making it even before Ian.

The Post article focuses on those living in shelters. But those displaced who are now living with relatives or in other rental properties are not much better off. At best their lives have been put on hold.

They’re experiencing long-Ian.

Amidst much media fanfare (occasioned by covid’s novelty), the covid virus is mutating into new variants, which in turn trigger surges of cases across the population. In the same way, hurricanes come and go, triggering surges of death, suffering, and economic loss. There’s the Hurricane Fiona variant. Go back a few years and we see the Hurricane Maria variant. The Harvey variant. The Katrina variant. The Andrew variant. Each of these has claimed its long-term casualties. Those who survived these and other natural disasters, but were severely impacted, are still alive – and many find their present circumstances, years later, still dictated by that single catastrophe. (Much as college graduates find themselves still enmeshed in college debt. However, long-term disaster survivors lack any benefit corresponding to that of the educational experience, or any political prospect of debt forgiveness.)

Some closing observations. First, the discussion here has focused solely on the hurricane “variants.” Natural hazards losses extend to flooding, drought, wildfire, tornados, and other events as well. Although definitive economic analysis of the long-term costs of natural hazards has yet to be accomplished, NOAA estimates that natural hazards losses totaled $145B in 2021, a figure roughly equal to the average for the past five years. At that rate, losses are aggregating at a rate of a trillion dollars every seven years. According to one estimate, one in ten U.S. homes (14 million!) experienced disaster loss in 2021. (That figure which primarily represents damage from winter storms, appears a bit extreme; it’s probably better characterized as “weather-related damage.”) More extensive, definitive economic analysis of these impacts would be useful.

Second – in contrast to the pandemic – the U.S. economy, its building stock, and ways of doing business have not been “vaccinated” against future losses, nor is there a buildup of any “natural immunity.” Successive weather and climate events can be expected to produce every bit as much shock and disruption as those in recent experience.

Third, and finally, the burden of these losses (covid-, military-, and hurricane-) is spread unevenly across the population. What’s more, the relatively unaffected world quickly moves on. Hurricane Ian no longer commands the headlines. For most Americans, today’s focus is on the upcoming mid-term elections, on gas prices, . But for the elderly on Sanibel island, or those families still in shelters and without jobs to return to, the nightmare is only just beginning, its full dimensions just coming into view. Just as long-covid sufferers or wounded veterans who’ve lost limbs or suffer from PTSD struggle to get medical attention, let alone actual relief, so Ian survivors experience loneliness and isolation – often leading to alienation – in the face of desperate need.  

This fraying of the nation’s social fabric may represent the greatest cost of all.

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