The UK will pay an economic price for failing to consider long Covid when lifting restrictions and making recommendations on vaccinations for children, a doctor has warned. The decision to drop all Covid rules in England was largely based on whether the NHS could handle the number of sick patients, but far more people are expected to develop long-term medical problems after fighting off the virus. Speaking at a Royal Society conference on the science of Covid on Thursday, Dr Nathalie MacDermott, a specialist in paediatric infectious disease at King’s College London, said high levels of infection would result in more long Covid that would blight people’s lives, harm children’s education and undermine the economy. “We talk about hospitalisations and we talk about deaths, but I don’t hear people saying long Covid is an issue. We need to consider that when we adjust our public health measures, when we introduce different measures to try and contain this pandemic, or we decide to not have any measures whatsoever,” she said. “Economically, that is going to be to our downfall in the coming years.” The Office for National Statistics (ONS) estimates that 1.5 million people in UK households are living with long Covid, where symptoms from fatigue and brain fog to loss of smell and taste persist for more than four weeks after infection. Nearly half of those surveyed by the ONS reported ailments lasting at least a year. Older people, women, and obese people are most at risk of long Covid. MacDermott caught Covid two years ago and now has to take cabs to work and use a mobility scooter after developing long Covid, also known as post-Covid syndrome. Beyond the impact it has on individuals’ lives, she said, the condition would have a substantial impact on people’s ability to work, their earning potential, and costs to government and businesses. “That’s going to be a significant hit to our economy, not just to people’s lives.” Speaking at a separate conference held by the Royal Society of Medicine, Clare Gerada, the president of the Royal College of GPs, said doctors also needed to be mindful of not over-attributing illnesses to long Covid. “There is a real risk of attributing the chronic cough to long Covid when it’s actually lung cancer,” she said. “As a doctor sitting there [we have to] think long Covid, but then we [should] think: ‘What else could it be?’” It is unclear how well Covid vaccines reduce the risk of long Covid, but MacDermott said decisions on who to vaccinate should have taken it into account. The government’s vaccine advisory body, the Joint Committee on Vaccination and Immunisation, was cautious about recommending Covid vaccines for children, partly because of rare side-effects, but about one in 50 infected children are expected to develop long Covid. While that was a small percentage, high infection rates meant many would miss school and not fulfil their academic potential, MacDermott said. “Why was that not considered when we were considering vaccinating children?” she asked the meeting. Prof Danny Altmann, an immunologist at Imperial College London, said he “couldn’t agree more strongly” with MacDermott. “There seems a binary difference between the urgent policy immediacy of dealing with fatalities from an acute pandemic, and a willingness, globally, to kick the can down the road in relation to a massive, persistent disease pandemic that we’ll be grappling with messily for years to come,” he said. Speaking at the RSM conference, Prof Chris Whitty said the pandemic was “not over yet” and that Covid would “keep throwing surprises at us over the next few years”. The chief medical officer for England said: “This is still a point where we are under significant pressure and I don’t think we should allow anyone to imply otherwise.” Whitty added that he would be “strongly making the case” for the UK to maintain sufficient testing and surveillance capacity to protect against any future emerging infectious diseases. “If you look at every single epidemic and pandemic the thing you always need at the beginning is diagnostic [and surveillance] capacity,” he said. “I really hope we don’t make that mistake again.”