A long COVID patient in Burr Ridge, Ill., received physical therapy for some of her symptoms on Oct. 6, 2021. (Alex Wroblewski, New York Times/New York Times)

Opinion editor's note: Editorials represent the opinions of the Star Tribune Editorial Board, which operates independently from the newsroom.

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The rearview mirror held up to the 1918 influenza pandemic by a definitive historical account offers unexpected but valuable insights into a problem plaguing the modern era — an alarming workforce shortage.

"Pale Rider," a book by Laura Spinney, debuted in 2017, 99 years after the "Spanish flu" encircled the globe and three years before COVID-19 would bring the world to a halt in 2020. The most intriguing chapters are those that examine the 1918 pandemic's short- and long-term ripple effects.

If the past is prologue, expect a baby boom as we pull out of the current pandemic. Fertility rates rebounded "spectacularly'' as influenza ebbed a century ago, Spinney writes. Another implication if past patterns hold: The labor pool will be shallower than it should be for some time.

The obvious reason for that in 1918 was the pandemic's death toll. But today's policymakers should also take heed of lingering health effects in many influenza survivors. At the time, it was often referred to as lassitude and despair. "There is good evidence ... that the Spanish flu itself was a chronic disease, and that it had a negative impact on some people's health for months or even years after the initial flu," according to Spinney.

There appears to be a sequel in the COVID-19 pandemic. After the initial infection, an alarming number of people go on to struggle with long COVID. That's the informal name given to ongoing brain fog, fatigue, headaches, dizziness, shortness of breath and other symptoms. "While patients who were hospitalized are more susceptible, even those with mild cases can experience long COVID," according to the National Institutes of Health.

A new report from the Brookings Institution provides a valuable public service by drawing a direct line from long COVID to current labor shortages. It's a sobering read. Clearly, an ongoing national response is necessary to protect public health and the economy.

The report came out late last month. One of its contributions is its triangulation of surveys and other data to come up with a reliable estimate of how many Americans with long COVID are no longer working.

Information gathered came from the U.S. Census, the Federal Reserve Bank of Minneapolis, the Lancet medical journal, and other resources. The midpoint of the range of estimates is "3 million full-time equivalent workers," or "1.8% of the entire U.S. civilian labor force."

It's a staggering number, but as the report notes it's consistent with findings in other nations. It also reflects a Harvard economist's recent estimate that "labor market participation is still around 1 percentage point lower than demographics would predict."

Solutions outlined in the report are pragmatic and include:

"More speed, more money, and more trials are needed to understand the pathophysiology of long COVID (and other post-viral illnesses) and identify treatments." Although that effort would involve considerable sums of public dollars, this should be viewed as an investment necessary for a healthy workforce.
Measures to keep people with long COVID participating in the workforce. That could include remote work options or flexible work schedules, for example, that would help employees battling fatigue or other symptoms.
Continued tracking of long COVID and its impact on the workforce, as well as ongoing evaluation of successful interventions in helping those struggling with the condition continue working.
Ensuring that workers with long COVID can access medical care and, if need be, medical assistance programs so they can return to productivity. While Minnesota is fortunate to have clinics offering this care, federal incentives may be needed to ensure there are enough medical providers with this expertise.

State lawmakers have a role to play, too. Regrettably, Minnesota legislators missed a chance in the last session to enact a starter long COVID package to conduct surveillance and identify ways to assist struggling families. The measures made it through the DFL-controlled House but fell victim to end-of-session disagreements over health-and-human services finances with the Republican-controlled Senate.

That mistake needs to be rectified. Lawmakers should also draw upon Minnesota's world-class medical providers and employers to improve the state's response. Too often, this pandemic has elicited a false choice, pitting COVID countermeasures against economic growth. Both history and modern-day data suggest these complement, not counteract, each other.

Editorial Board members are David Banks, Jill Burcum, Scott Gillespie, Denise Johnson, Patricia Lopez, John Rash and D.J. Tice. Star Tribune Opinion staff members Maggie Kelly and Elena Neuzil also contribute, and Star Tribune Publisher and CEO Michael J. Klingensmith serves as an adviser to the board.