When the COVID-19 pandemic reared its ugly head in March of 2020, colleges and universities across the nation responded swiftly and effectively. They switched to virtual learning. They ramped up COVID testing and reporting efforts. They enforced quarantines and social distancing on campus. But now, more than three years since the first case was reported in the U.S., a related crisis lurks. And many academic institutions are ill-prepared to face it.
You’ve probably heard about the long haulers. You might even count yourself among the group of American adults who continue feeling ill long after their COVID-19 diagnosis.
Debilitating fatigue. Difficulty sleeping. Shortness of breath. Brain fog. Dizziness. These are just a handful of the symptoms associated with long COVID, an ongoing condition identified at least four weeks after contracting COVID. Anyone who has had COVID is at risk of experiencing lingering post-COVID symptoms, which can last weeks, months, or even years.
While a CDC survey found that nearly 1 in 5 American adults who have had COVID suffer from long COVID, a George Washington University study found the rate of long COVID is actually closer to 1 in 3.
The effects of long COVID can be particularly devastating to college students. They’re often away from home and from their primary care practitioner, they’re balancing a slew of academic, financial, and social responsibilities, and they’re more prone to mental health conditions like anxiety and depression, which have been linked to long COVID.
All of which is to say: These students need help. Here’s how your administration can support them.
Understand long COVID and make sure your on-campus health providers do, too
Health care professionals and researchers are still working to better understand long COVID, but the symptoms identified so far by the CDC are:
- Tiredness or fatigue that interferes with daily life
- Symptoms that get worse after physical or mental effort (also known as “post-exertional malaise”)
- Difficulty breathing or shortness of breath
- Chest pain
- Fast-beating or pounding heart (heart palpitations)
- Difficulty thinking or concentrating (“brain fog”)
- Sleep problems
- Pins-and-needles feelings
- Change in smell or taste
- Depression or anxiety
- Stomach pain
- Joint or muscle pain
- Changes in menstrual cycles
Because many of these symptoms are often indicators of other illnesses or conditions—and because the results of routine tests like blood work and chest x-rays may be normal—long COVID can be difficult to diagnose. For college students, especially, the symptoms are easily attributed to common afflictions like stress, anxiety, and sleep deprivation.
When Valerie Bogdan-Powers’s son presented to his university’s student health center with extreme fatigue, dizzy spells, and heart palpitations—telltale symptoms of what he’d later learn was long COVID—he was misdiagnosed.
“He was told maybe he drank too much or wasn’t sleeping enough and that his heart wasn’t actually racing in the middle of the night,” says Bogdan-Powers, President of HORAN Health.
Then, after seeing multiple specialists including a cardiologist and a mental health professional, he was diagnosed with myocarditis and anxiety and began taking anti-anxiety medication.
“Mentally and emotionally, he was a wreck,” says Bogdan-Powers, whose son attends school in Boston. “He didn’t know what was wrong with him and he just wanted it fixed. He was spiraling and we were stressed. We’re not a drive away from him. We’re a flight away.”
Eventually, the family found a Cincinnati-based physician who specializes in long COVID and was able to accurately diagnose their son. He also provided the best medicine yet: empathy.
“He sat down with my son and said, ‘I bet you feel jipped. You are 20 years old and you wake up in the morning, get ready for the day, maybe do a load of laundry, go outside, and walk to class, and you’re done. You’re exhausted,’ ” Bogdan-Powers says. “He said, ‘You don’t understand it, nobody else understands it, and yet everyone is pushing you to do better.’ ”
Finally, her son felt heard. From there, he was able to take better care of himself and get the rest he needed until the worst of the symptoms subsided about 3 months later.
Consider educating your student health center staff on long COVID, so the condition can be more readily identified. A trusted partner like HORAN Campus Health can help your administration develop a plan and put it into action.
Help students access the care they need
With classes, clubs, athletics, jobs, and internships to manage, students juggle a lot. Seeking out a health care provider and cramming a visit into an already over-stuffed schedule can feel so overwhelming that some students simply choose not to. By offering a robust telehealth program, your campus administration can meet students where they are in terms of prioritizing their health. Virtual visits allow students to meet with a health care provider at a time that’s convenient for them in the comfort of their dorm.
Another way to encourage students to seek the long COVID care they need is to educate them on provider options. One of the ways HORAN Campus Health can support your student health center staff is to provide a directory of in-network providers who specialize in diagnosing and managing long COVID that can be distributed to students. This way, students feel empowered to seek the care they need and continue to see on-campus health centers as valuable resources for improving their health and wellness.
HORAN Campus Health can also provide data specific to COVID and long COVID, so your administration can better monitor the impact and prepare accordingly.
Expect more students to seek accommodations and plan accordingly
Long COVID is considered a disability by the U.S. Department of Education, which means students who suffer from it might be eligible for academic adjustments and reasonable modifications to ensure they maintain equal access to educational opportunities. Depending on how long COVID impacts a particular student, this could mean anything from virtual learning and deadline extensions to allowing them to register for classes early so they can choose the ones closest to them on campus.
For Bogdan-Powers’s son, extreme fatigue made keeping up with multiple assignments and exam prep difficult. At his request, the university granted accommodations that allowed him to have more control over his schedule, like spacing out major assignment deadlines and not having to sit for two exams on the same day.
Something to note: While Section 504 prohibits disability discrimination, it does not require colleges and universities to identify students with disability. Rather, students must request accommodations be made, usually through the campus disability services office.
Maintain COVID vaccination and booster efforts
Long COVID is found more often in people who had severe COVID illness, as well as those who were not vaccinated against COVID before becoming infected. Since vaccination has been shown to prevent or minimize severe illness from COVID and decrease the risk of post-COVID symptoms, making vaccines and booster shots readily available on your campus can support students’ long-term health.
Prioritize students’ mental health
A bout of long COVID is enough to derail a once-thriving college student from an otherwise successful academic year. Depression and anxiety are both symptoms of long COVID, and the stressors that come with chronic illness can aggravate those preexisting mental health conditions, which already plague college students at a disproportionate rate. Now’s the time to evaluate your on-campus mental health program and make improvements if needed. Ensuring your students have access to quality mental health care—and empowering them to seek it—is a powerful way to support their health and wellness and improve their campus experience overall.
Talking to someone who understood his condition is what ultimately set Bogdan-Powers’s son on the path to recovery.
"There’s not a whole lot of stuff you can bring to treat this, but one of them is empathy,” Bogdan-Powers says. “Just connecting with that student and telling them you understand they have chronic fatigue and they’re a good student and not just angling for more time to complete assignments goes a long way.”
Just as COVID has proven it isn’t going anywhere, long COVID, too, appears to be here to stay. Facing it informed and prepared is the best strategy. An experienced partner like HORAN Campus Health can help your team develop yours.
At HORAN Campus Health, we champion bold innovations and offer customized health plans, resources, and tools designed to improve the overall health and wellbeing of your students. Together, we can offer the holistic support students need to thrive on campus and succeed in life.
To get started, visit our Campus Health webpage to fill out a simple contact form or get in touch with Phillip Arrington, Vice President of HORAN Campus Health, at PhillipA@horanassoc.com.