Understanding the global public health impact of long COVID and strategies for sustainable care

Long COVID, often called the “pandemic after the pandemic”, is silently reshaping the lives of millions across the world. While the world’s attention shifts to recovery and rebuilding, a growing number of people continue to suffer long after their initial COVID-19 infection. With symptoms ranging from relentless fatigue and brain fog to breathlessness and emotional distress, Long COVID is more than a lingering illness, it is a complex, disabling condition that threatens health, livelihoods, and dignity. This review explores the profound human and societal cost of Long COVID. For many, especially in low- and middle-income countries, the road to recognition and care remains filled with uncertainty. Diagnostic tools are lacking, healthcare systems are overwhelmed, and too many patients feel invisible, disbelieved, undiagnosed, and unsupported. The burden is not shared equally. Women, frontline workers, and those living in poverty are among the most affected, often facing stigma, financial loss, and long-term disability with little help. Despite these challenges, hopeful solutions are emerging. Some health systems are beginning to integrate Long COVID care into primary health services, while community-based surveillance and virtual rehabilitation teams offer promising models. Yet access remains uneven, and ethical concerns around global research equity, funding, and inclusion persist. This review calls for a shift in how we understand and respond to Long COVID, not just as a clinical condition, but as a human rights issue. An inclusive, coordinated, and compassionate public health response is urgently needed. If we fail to act, we risk abandoning those who have already borne the brunt of the pandemic’s long shadow.