Black people continue to be among the communities hit hardest by COVID-19. But with more research on Long COVID coming to the surface, experts say the nature of the pandemic is changing.

Dr. Carol Oladele, director of research at Yale’s Equity Research and Innovation Center, says while experts don’t have all the answers about the long-term COVID condition, studies are underway and past trends suggest the Black community could be heavily affected. 

“All the studies are all trying to figure out what are the factors that cause people to continue to have symptoms beyond four weeks after infection. People thought that Black Americans would be most affected by Long COVID because they were disproportionately affected by COVID,” she says.

“The State of Black America and COVID-19, ” a report released by the Black Coalition Against COVID in March details how Black families were impacted by primary infections during the pandemic. 

For example, 1 in 310 Black children experienced the loss of a parent or caregiver compared to 1 in 738 white children between April 2020 and June 2021, according to the report.

But once the acute phase of the virus — with its accompanying fever, sore throat, body aches and other symptoms — has passed, too many Americans aren’t getting better. 

Black people are more likely to work in essential worker positions, live in crowded conditions, and be incarcerated — which increases the risk of contracting the virus. 

The State of Black America and COVID-19, Black Coalition Against COVID

An estimated 7% of people who contracted COVID are expected to experience Long COVID — 4.4% of people who weren’t hospitalized, 21.7% of people who were hospitalized, and 36.5% of people who were admitted to intensive care, according to report from Nature.

“The evidence so far shows that Black Americans and folks who are Hispanic are more likely to experience symptoms that are characterized as Long COVD,” says Oladele, who contributed to the Black Coalition Against COVID’s two-year assessment. 

People with Long COVID are dealing with fatigue, shortness of breath, and headaches — among other symptoms — for weeks or months after contracting the virus. The report from Nature shows Black people are more likely than other demographics to experience acute kidney injury, diabetes, chest pain, and cough. 

Oladele says in January, a time when there appeared to be an overall reduction in cases, Black Americans were still seeking care, seeing the highest rates of COVID-associated hospitalizations since the pandemic started. 

“It was sort of masking the continued burden that Black Americans were continuing to experience in a negative way,” she says. “The hospitalization rates were high, meaning people were sick enough to need the hospitalization.”

60% of Black people seeking COVID care feel they’re less likely than white people to have everything done to save their lives in the hospital. 

2020 COVID-19 Poll of African American Voters, naacp

The disproportionate impact of COVID on the Black community is due in part to preexisting social and structural inequities. Black people are more likely to work in essential worker positions, live in crowded conditions, and be incarcerated — which increases the risk of contracting the virus. 

And while Black folks continue to work and live in places with dense populations, mask mandates are being lifted. 

These factors could also contribute to disparities in Long COVID, Oladele says. To reduce the potential of this happening, she says it’s important for the Black community to be represented in studies. And in order for that to happen, barriers keeping Black people from participating must be addressed. 

“It’s really important to include communities in these studies that are seeking to identify novel treatments because they were hardest hit,” Oladele says. “And they’re the ones that stand to benefit since they were hardest hit. So, thinking about ways to increase representation by addressing those social and structural barriers to clinical trial participation or study participation.”

I think it’s particularly important for Black people to know that it’s important to seek treatment and share that you’re symptomatic with your providers.

Dr. Carol Oladele, director of research at Yale’s Equity Research and Innovation Center

Oladele says a part of this is addressing transportation and childcare issues. “A lot of Black Americans are overrepresented in essential worker jobs and work jobs that involve hourly wages,” Oladele says. “So, you know, maybe compensating people for missing hourly wages and embedding study sites within communities that were hardest hit.”

On top of high rates of infection, Black folks faced discrimination and bias while seeking COVID care, a poll conducted by the NAACP reveals. 

64% of Black people who participated said they’re less likely than white people to be offered testing and 60% felt they’re less likely to have everything done to save their lives in the hospital. 

Now researchers are saying the burden of Long COVID is falling heavily on non-hospitalized people. With that, the medical system could be challenged with surges in acute infections and caring for COVID-19 survivors who will require substantial support. 

Still, Black people must keep care in mind when considering Long COVID. 

“I think it’s particularly important for Black people to know that it’s important to seek treatment and share that you’re symptomatic with your providers — if you have a primary care provider,” Oladele says. “We don’t yet know the long-term consequences of Long COVID, but it’s really important to share that you’re continuing to have symptoms.”