This chapter identifies the persisting challenges facing health care systems in addressing long COVID, and reports on the common priorities that countries have identified through the OECD policy survey. The chapter summarises the progress made in addressing long COVID to date across the surveyed OECD and EU countries, and what gaps remain to be addressed in order to improve the coordination and organisation of care for patients living with long COVID.
Addressing the Costs and Care for Long COVID
The Long Shadow of the Pandemic
Abstract
OECD countries reported multiple clinical, administrative and logistical challenges in responding to a question about the burden of long COVID in their health systems (Figure 7.1). Lack of recognition of the condition and a lack of clear clinical guidelines at the national level were highlighted as the main challenges faced by nine countries. Ten countries cited the lack of an organised model of care as a key challenge for responding to and managing long COVID in the health system. Poland, for example, highlighted the lack of standardised management protocols, leading to fragmented care and unequal access to specialists for long COVID. In addition, a lack of dedicated funding for research was noted as a challenge in Sweden and Poland.
Note: Survey question: “What are the current key challenges faced in responding to long COVID at national level in 2025? (Select all that apply)”.
Source: 2025 OECD Long COVID Mapping Policy Survey.
As reported in Chapter 5, Section 5.1, four countries (Australia, Austria, Canada and the Netherlands) have developed a national strategy or plan; however, implementation and operationalisation at the regional or local level can be impeded by a lack of resource allocation and recognition of long COVID as a medical condition across health and social welfare systems. The Netherlands reported that implementing and making accessible the recently launched national care pathway remains a challenge, especially in primary care.
Four countries (Australia, Canada, France and Slovenia) identified additional key challenges to addressing the long-term effects of long COVID. In France, community-based care and networks for managing complex care lack sufficient human and financial resources. Organising a community-based network in each geographical area is also challenging due to demographic heterogeneity and differences in priorities and implementation on the ground within these networks. In the meantime, various healthcare bodies have created their own clinical guidelines through their clinics. Slovenia highlighted challenges with obtaining sick leave and the absence of financial support for younger patients without social insurance. Australia pinpointed the lack of a unified response spearheaded by government, including clear clinical guidelines.
Overall, the responses indicate that lack of recognition, clear management guidelines and organised care pathways for long COVID at the national level are the key challenges that remain in 2025. At the same time, operationalisation of such plans via engagement of primary care providers in different communities requires tailored approaches. To address this challenge, Canada developed the Canadian Guidelines for Post COVID‑19 Condition to help healthcare professionals, public health officials, policymakers, and people with long COVID and their caregivers make informed decisions about long COVID (CAN-PCC, 2025[1]). In parallel, however, the provinces and territories have scope to adapt the guidelines to their specific circumstances, based on the needs and resources available.
Almost all OECD countries identified multiple policy areas in which they could benefit from support (Figure 7.2). Interest in sharing evidence‑based recommendations and policies, including effective therapies and care models, was reported by 12 countries. In addition, ten countries reported a high need for national evidence‑based clinical guidelines and clear referral pathways. Australia pointed to the need for additional government support for trials on long COVID management and interventions, while Canada noted the need for additional information on government financial support for people with long COVID. Both Slovenia and Poland highlighted the need for support in training healthcare workers, with Poland noting the importance of connecting the healthcare workforce to the latest research developments on long COVID. The establishment of medical or healthcare professional associations was not seen as a particular need, possibly because a number of countries already have a national scientific committee or institute able to advise on long COVID evidence and policy (see Chapter 5, Section 5.3).
Note: Survey question: “What forms of support or collaboration would be most beneficial to address long COVID? (Select all that apply)”.
Source: 2025 OECD Long COVID Mapping Policy Survey.
This report provides an update on the status of long COVID initiatives under way in OECD countries in 2025, five years after the COVID‑19 pandemic began. As a new and emerging condition, long COVID poses a double challenge to health systems in the need both for a scientific evidence base to inform effective clinical management and health policies, and for adaptation or reorganisation of healthcare resources to incorporate this condition into existing services.
Since 2022, considerable progress has been made in official recognition and diagnosis of this condition, through national health policy and adaptation of international definitions. The majority of countries rely on the WHO definition, although recognition of paediatric long COVID is still lacking in many countries. Appropriate coding of long COVID in health systems can also help in assessing the disease burden and providing insights into the care patterns, treatment and outcomes of patients at a population level. While most countries rely on ICD‑10 coding, practices are inconsistent owing to the diagnostic challenges of long COVID, a lack of awareness of the condition among clinicians and a lack of availability of relevant diagnostic codes. As such, ME/CFS and depressive disorder are often conferred as alternative diagnoses for reporting purposes. This, combined with the lack of a reliable surveillance system in most OECD countries, further complicates monitoring of the disease burden of long COVID. As associated healthcare costs are usually covered by general universal healthcare provisions, several countries reported that patients sometimes seek private services to meet their specific long COVID care needs. Similarly, most countries do not have specific sick leave or disability provisions allocated for a long COVID diagnosis, meaning that people unable to work due to the condition must navigate complex and unclear eligibility processes to receive support, and often face financial vulnerability.
At the national level, only 4 of the 16 surveyed countries have a national plan in place to address the long-term health and social consequences of long COVID. For most countries, the issue of long COVID remains limited to the health ministry, although a few have taken a broader intersectoral approach, involving education, social welfare and scientific ministries – as well as labour and insurance groups – in developing relevant policies, services and support. In most countries, a scientific committee or advisory group has been established to provide evidenced-based policy or clinical recommendations, with many countries ensuring formal participation of patients in these processes. While a number of countries have funded long COVID research, few have health budgets specifically dedicated to the condition. Furthermore, in the context of budgetary constraints, financial commitments to long COVID initiatives face uncertainty in the medium to long term.
Organisation of care for long COVID employs a mixed approach across countries, reliant on both primary and specialist care. Most countries have organised some level of long COVID specialised clinics at the regional or national level. Since 2022, countries have made substantive progress in consensus and guidelines for the clinical management of long COVID. Almost all OECD countries surveyed have national recommendations or clinical guidelines available to support healthcare professionals and patients facing a long COVID diagnosis. Given that no specific treatment for the condition currently exists, pharmacotherapy recommendations are lacking in most countries, although prescription of off-label medicines to treat symptoms is used in some places. Very few countries report training of healthcare workers on long COVID, highlighting the opportunity to benefit from the OECD/WHO initiative to develop a long COVID training course freely available to healthcare workers globally.
As it stands in 2025, progress has been made across OECD countries in adopting the WHO definition as a consensus for diagnosis, using ICD‑10 coding in health systems, and improving the knowledge base through scientific advisory committees and dedicated research funding for long COVID. Nonetheless, there remain ongoing challenges for surveillance of cases, organisation of care and availability of treatment guidelines. Finally, recognition and support for patients outside the health system, especially for children with long COVID and patients with reduced work capacity, are lacking. Continued international collaboration to support the development of evidenced-based policies, clinical guidelines and care pathways at the national level will help reduce the economic and social burden of long COVID both for individual patients and for OECD countries.
References
[1] CAN-PCC (2025), Resources for Healthcare Professionals, Canadian Guidelines for Post COVID-19 Condition, https://canpcc.ca/resources/#tab-content-ov.