Nancy Rose, who contracted COVID-19 in 2021 and continues to exhibit long-haul symptoms including brain fog and memory difficulties, pauses while organizing her desk space in Port Jefferson, N.Y. (John Minchillo, Associated Press/The Minnesota Star Tribune)

There's a timely focus on "off ramps" as COVID-19 cases decline and a weary public yearns for pandemic exits two years after the crisis began.

But as the transition to a new normal accelerates, it's vitally important to recognize and prepare for this reality: The path ahead is far from smooth for a substantial number of people who survived this viral illness but still suffer serious aftereffects.

Solutions and political collaboration to enact them are critical at the state and federal levels. In Minnesota, legislative action is imperative to help those affected and to understand potential impacts on the state's workforce and economy. A strong start this session addressing this multifaceted challenge is essential.

Long COVID is the working name given to the little-understood constellation of lingering symptoms after infection. It includes life-altering fatigue, breathing difficulties, cognitive impairment, heart problems, sleep disturbances, anxiety and depression.

Imagine working or trying to take care of a family — or both — while feeling this far out of sync. Now consider a Mayo Clinic physician's recent testimony before a Minnesota legislative committee.

A "conservative estimate" is that about 10% of those infected will suffer from long COVID symptoms, according to Dr. Greg Vanichkachorn, a Mayo occupational medicine specialist who is researching COVID's long-term health impacts. Vanichkachorn testified earlier this month before the Minnesota House's Health Finance and Policy Committee.

The doctor's math shows the scale of the problem. When he spoke to legislators, 74.3 million cases of COVID had been reported in the United States. That translates to 7.4 million long-haul cases nationally. Of that subgroup, Vanichkachorn said about 2.2 million will be unable to return to work.

That's a lot of people who will need ongoing care. Right now, there's a limited number of medical centers in Minnesota and elsewhere offering long COVID programs. Wait lists are common, and it may take patients several months to get in.

The number of those too ill to work is also sobering. It spotlights one potential cause of current labor force shortages and suggests that this could be a persistent problem.

Long COVID "is not just a health care challenge but a challenge for our society and economy as well," Vanichkachorn said.

Because long COVID is an emerging condition, statistics remain elusive on how many people in Minnesota have been diagnosed with it. "Tracking long COVID continues to be challenging as there is not yet an agreed-upon case definition," said Kate Murray, MDH program manager for Long COVID. "There wasn't an official diagnosis code for providers until July 2021, and it still isn't used consistently."

One of the obvious early remedies is filling this surprising gap on incidence and prevalence. But much more is needed. Gov. Tim Walz's push for related funding is a commendable early step. Walz's supplemental budget recommends "an investment to understand the impact of long COVID in Minnesota" and calls for $2.7 million for the current biennium and $7.4 million in 2024-25.

Goals include raising awareness of long COVID and developing "tools and resources" for patients, their families and their medical providers. Measures would also include statewide guidance for diagnosis, treatment and care. We would add one area to focus on: long COVID's potential to have thousands of new Minnesotans in need of services provided by public programs for the disabled.

The state investment is needed, especially with Congress making little progress on key legislation to strengthen the nation's long COVID response.

"We currently have some CDC funding through June 2023 to get started on tracking long-COVID, but nothing long-term. We need to follow COVID-19 long-term, and the budget proposal includes funds for doing so in partnership with stakeholders," MDH's Murray said in an e-mail.

She continued: "Minnesota is currently the only state that is proactively and deliberatively trying to establish a long COVID public health program at this time."

Vanichkachorn's legislative testimony caught Minnesota House members' attention. A similar long COVID spotlight is needed in the state Senate. The Star Tribune Editorial Board urges Sen. Paul Utke, R-Park Rapids, to have this Mayo doctor or other long COVID experts testify before that chamber's members. Utke is the new chair of the Health and Human Services Finance and Policy committee.

Compassionate, energetic collaboration on long COVID is necessary and would reflect well on Utke as he steps into this important health leadership role.