Roughly one in twenty American adults was living with active Long COVID symptoms at any given point during 2022 and 2023 — a figure that carries significant implications for workforce capacity, economic productivity, and the broader health security of the nation. Despite widespread assumptions that occupation would be a meaningful predictor of Long COVID risk, a new federal analysis finds that the burden of the condition was strikingly similar across most worker categories, complicating the policy picture for employers, occupational health officials, and labor economists alike.
The analysis, published in January 2025 by the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Planning and Evaluation (ASPE), is among the first to use nationally representative survey data to compare Long COVID prevalence across distinct occupational groups. Authored by researchers in ASPE’s Office of Science and Data Policy, the cross-sectional study drew on the Census Bureau’s Household Pulse Survey (HPS) across four data collection phases spanning September 2022 through August 2023.
A Persistent and Costly Condition
The economic stakes of Long COVID are substantial. Prior research has estimated lost income attributable to the condition at between $101 billion and $430 billion annually among U.S. workers. A Brookings Institution analysis estimated that Long COVID may have reduced labor force participation by 0.3 percentage points — the equivalent of approximately 700,000 people removed from the workforce. Against that backdrop, understanding which workers are most vulnerable has direct implications for targeted public health intervention, workforce planning, and disability policy.
The ASPE study found that overall prevalence of current Long COVID (defined as experiencing COVID-19 symptoms lasting three months or longer and still symptomatic at the time of survey) stood at approximately 6.8% in September 2022, declining to around 5.6 to 5.7% in subsequent survey phases through mid-2023. Put differently, even as the acute phase of the pandemic receded, roughly one in 18 to one in 20 adults reported actively living with Long COVID symptoms during this period — a prevalence rate modestly higher than contemporaneous estimates from the National Center for Health Statistics, which placed current Long COVID at approximately 3.5% for 2022.
Few Meaningful Differences by Worker Type — With One Exception
The research team categorized participants into four groups: essential healthcare workers (including hospital, pharmacy, ambulatory care, and nursing settings); essential non-healthcare workers (spanning food supply, education, transit, corrections, and social services, among others); non-essential workers; and those not currently working. Across more than 653,000 eligible survey respondents, the analysis found that Long COVID prevalence tracked closely across most groups, with rankings shifting from phase to phase and no single worker category consistently bearing the highest burden.
The one consistent outlier was essential healthcare workers, who recorded the lowest Long COVID prevalence in every survey phase — ranging from 4.3% to 6.4% compared to 5.2% to 7.8% across other groups. The authors offer several possible explanations: healthcare settings were more likely to maintain institutional infection-prevention controls such as masks and personal protective equipment throughout the study period, and healthcare workers may have adopted higher levels of protective behavior overall. Notably, however, essential healthcare workers in this sample reported lower COVID-19 vaccination rates than other employed groups — 68% compared to 85% for essential non-healthcare workers and 90% for non-essential workers — which complicates a straightforward protective-behavior interpretation and warrants further investigation.
The authors also caution that lower COVID infection risk does not necessarily translate directly to lower Long COVID risk, since unmeasured differences in underlying chronic disease burden across occupational groups could independently affect Long COVID susceptibility.
Ongoing Workforce Strain
The ASPE findings serve as a reminder that Long COVID represents not just a clinical challenge but an ongoing strain on the national workforce — one that does not map neatly onto occupational risk categories that informed much pandemic-era policy. The near-uniformity of Long COVID prevalence across essential and non-essential workers suggests that occupation-specific interventions alone are unlikely to be sufficient to address the condition’s workforce impact.
The data also highlight a gap in longitudinal surveillance: without studies capable of tracking individuals over time, attributing Long COVID risk to specific occupational exposures remains difficult. As policymakers consider workforce resilience strategies, disability accommodation frameworks, and future pandemic preparedness planning, the ASPE report makes clear that Long COVID’s labor market consequences are diffuse and systemic — and that understanding them will require more robust, representative, and longitudinal data than currently exist.
Sources and further reading:
Suvada K, Beleche T, Porterfield D. Long COVID among Essential Workers, Non-Essential Workers, and Not Working Persons in the United States, 2022-2023. HHS Office of the Assistant Secretary for Planning and Evaluation. January 17, 2025.