“Completely flattened by fatigue, cognitive dysfunction, and lightheadedness” are some of the terms used to describe the experiences of young, healthy, often athletic students who contracted COVID-19. As much as the pandemic has impacted higher education over the past two years and we want to believe that the worst is over, we fear this might not be the case. In fact, we may be facing a second health crisis, or what some are calling a pandemic after the pandemic, one that will impact the way we work, teach and learn: long COVID.
Understanding Long COVID in the Context of Higher Education
While our essay focuses on students and long COVID, it is important to remember that anyone can be impacted by long COVID, including faculty and staff members and administrators.
The virus that causes COVID-19 is thought to alter key neural structures and therefore cognitive functioning, such as attention, memory and motivation. Recent studies have also shown that many individuals who had the COVID-19 virus continue to suffer from virus-related symptoms such as pulmonary illnesses and cardiovascular dysfunction.
Initially, it was thought that younger people, especially those who are healthy, didn’t need to worry about long COVID, especially if their COVID-19 symptoms were mild. This assumption is far from the truth. In fact, we are learning that long COVID impacts children and young adults in devastating ways. Furthermore, chronic stress seems to exacerbate long COVID symptoms; a large volume of current research on long COVID is focused on vulnerable populations, such as college students, who are already at high risk of developing chronic stress.
Even before the pandemic, medical and educational professionals were seriously concerned about college students’ social and emotional and mental health. The pandemic only made the situation more dire. A recent article in The Chronicle of Higher Education underscores how many of our students seem disconnected and checked out. One critical question to ponder when considering student motivation and focus is what are the different contributing factors that are causing students to disconnect? Are those factors mostly psychological? What about the physical and physiological toll the pandemic has taken on students? How many of the students who are experiencing mental fog, disconnect and disenchantment are experiencing those systems because of underlying neurological issues brought about by long COVID?
One recent study reports that almost 37 percent of those who had COVID-19 continued to experience persisting symptoms of long COVID between three and six months following their illness. The study also reveals that almost 40 percent of patients with long COVID experienced symptoms between three and six months after their illness that they had not experienced in the first three months. Another study underscores the fact that symptoms of long COVID even occur in people who were not hospitalized for COVID, confirming that long COVID occurs even in young people and those who had a relatively mild illness. We wonder how many of our students suffered or continue to suffer from long COVID. What impact does that have on their learning?
Students, Chronic Stress and Long COVID
Research has found that students are exhibiting significant stress-related responses to the COVID-19 pandemic. Additionally, many students have been experiencing traumatic stress since the pandemic began. Traumatic stress is a clinical term used to describe the physiological response that a person exhibits when they encounter a drastic and overwhelming change in their life, relationships or health. In other words, something shocking or overwhelming happens to the person, and their body and nervous system react to protect them. The pandemic alone triggered or amplified the chronic stress, if not, trauma, among many students, certainly those from historically underserved communities.
While our understanding of long COVID is evolving, we know that the experience of stress in the time before acute COVID-19 infection can act as a predictor of long COVID.
While many conversations are taking place within higher education about moving beyond an ongoing pandemic and going back to or establishing a new normal, it is important to remember that for many students, the lingering effects of the infection continue. Students with long COVID are subject to increased feelings of isolation, loss and hopelessness because of the severity of the symptoms and the lack of acknowledgment from the people surrounding them.
While health experts continue to research and debate long COVID and its devastating consequences, college students are expected to show up, engage, learn, return to pre-pandemic norms and perform at a certain standard. While this is not reasonable to expect from most students, it is even more unreasonable to expect that from those who are battling cognitive disabilities, especially in an institution that has no supports in place to support students with these types of evolving challenges.
Science tells us that it is neurobiologically challenging to learn in a meaningful and sustainable way if a student is not well, physically or mentally. Chronic fatigue, a key symptom of long COVID, presents a major challenge to learning. Consequently, our students with long COVID may have a hard time readily engaging and learning. Colleges and universities need to prepare to meet their learners where they are. We know that a student with a certain physical or cognitive disability is capable of learning given a supportive environment.
Supporting Our Students Through Long COVID
Below we offer five suggestions to college administrators, staff and faculty to support students’ mental and physical health through their battles with long COVID.
1. Investigate the issue. We suggest that institutions investigate the percentage of their students who had COVID-19. How many times did they contract the virus? In addition, inquire how many of them were diagnosed with long COVID. Some students may not know if they have long COVID, so inquire within your survey about ongoing symptoms they may have, especially symptoms related to mental fog, memory loss, concentration and focus.
These data can be collected through confidential surveys taken by the student body. By gathering this information, the institution along with its faculty and staff members can modify its current curriculum and protocols to offer greater levels of support for students.
Surveying students can also increase awareness of the impact and severity of long COVID. Many people, students included, are unaware that their symptoms of brain fog, shortness of breath or cardiac issues may be related to having the COVID-19 virus. Information gathered from this survey could provide those surveyed with a better understanding of their own health and capabilities.
Beyond surveys, we also need to have conversations with students and try to understand what they are struggling with. We need to ensure students know about resources available to them on and off campus.
2. Adapt testing and provide other accommodations. Long COVID cognitive disabilities can manifest as a loss of focus and concentration, which can greatly hinder a student’s test-taking abilities. Due to this impaired concentration, students deserve accommodations and support to help them succeed. We suggest that institutions help empower their faculty and staff to understand and accommodate the distinctive needs of their students with long COVID. Such accommodations mean institutions should be flexible with the amount of time we provide students to complete their exams or other assignments, as well as the form that those assignments take.
3. Provide comprehensive and holistic wellness services. Nutrition, physical activity and mindfulness can drastically affect a student’s well-being, especially when they are experiencing symptoms of long COVID. We suggest that universities and colleges offer holistic support to students suffering from long COVID and consider everything from improving their dining options to enhancing the physical activities available to students. Diet and nutrition can drastically impact mental processing and cognitive function, both of which are negatively affected in individuals with long COVID. Offering events such as weekend yoga classes can also improve students’ health through physical activity and mindfulness, helping them reflect and improve their mental and physical health.
Importantly, we will also need to continue doing research to keep up with what the science tells us about what we need to do to help students rehabilitate. For example, while it may seem intuitive for many that exercise will help with symptoms of long COVID, research shows that vigorous exercise after an acute COVID-19 infection may have a negative impact on the person. This finding and its implication is especially important for student athletes.
4. Partner with local long COVID clinics. An important aspect of supporting students suffering from long COVID is offering them the necessary treatments and resources to improve their health. We suggest that institutions explore and network with local long COVID clinics in an effort to offer a resource for students (linked here is a helpful online resource for locating long COVID clinics nationwide). A partnership between these clinics and institutions can make them more accessible to students who might otherwise not be familiar with them.
5. Remember that long COVID is an equity issue as well. We wrote earlier this year that it is important to educate the college community about long COVID and its consequences. College administrators and faculty and staff members should have the understanding that not all students possess the same access to health education and treatment and deserve an equal playing field when it comes to understanding the gravity of long COVID and getting help. We suggest that institutions think about long COVID as an equity issue and provide students with educational opportunities, such as seminars and workshops, to help educate them about symptoms, resources and support. Institutions may also want to document the potential disparities—incidence or severity of long COVID, for example—among different student populations and intentionally address those inequities.
Colleges and universities need to have a comprehensive and holistic plan to support students—and any other college and university community members—who are suffering with long COVID. Long COVID is an issue that needs to be addressed collectively and systematically—it is not merely a student health services, student life, faculty, staff or administrative issue.
It is true that many people with COVID-19 get better within weeks. It is also true that we can’t simply wish long COVID away. Recently, the Office for Civil Rights of the Department of Health and Human Services and the civil rights division of the Department of Justice declared that the effects of long COVID can qualify as a disability. Both the government and the National Institutes of Health are undertaking important initiatives to study and treat long COVID. Are we within higher education prepared to understand and respond to this evolving situation?
Unfortunately, long COVID is something we will be dealing with for many years to come and is not something we can ignore. We wrote this piece as a call to action to everyone within higher education to pay closer attention to the long-term impact of the pandemic and to consider our individual and collective roles in helping our students not only to move forward but also to heal and to thrive.